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Sample records for adverse cardiometabolic risk

  1. Fasting insulin has a stronger association with an adverse cardiometabolic risk profile than insulin resistance: the RISC study

    DEFF Research Database (Denmark)

    de Rooij, Susanne R; Dekker, Jacqueline M; Kozakova, Michaela;

    2009-01-01

    OBJECTIVE: Fasting insulin concentrations are often used as a surrogate measure of insulin resistance. We investigated the relative contributions of fasting insulin and insulin resistance to cardiometabolic risk and preclinical atherosclerosis. DESIGN AND METHODS: The Relationship between Insulin...

  2. Cardiometabolic risk in Canada: a detailed analysis and position paper by the cardiometabolic risk working group.

    Science.gov (United States)

    Leiter, Lawrence A; Fitchett, David H; Gilbert, Richard E; Gupta, Milan; Mancini, G B John; McFarlane, Philip A; Ross, Robert; Teoh, Hwee; Verma, Subodh; Anand, Sonia; Camelon, Kathryn; Chow, Chi-Ming; Cox, Jafna L; Després, Jean-Pierre; Genest, Jacques; Harris, Stewart B; Lau, David C W; Lewanczuk, Richard; Liu, Peter P; Lonn, Eva M; McPherson, Ruth; Poirier, Paul; Qaadri, Shafiq; Rabasa-Lhoret, Rémi; Rabkin, Simon W; Sharma, Arya M; Steele, Andrew W; Stone, James A; Tardif, Jean-Claude; Tobe, Sheldon; Ur, Ehud

    2011-01-01

    The concepts of "cardiometabolic risk," "metabolic syndrome," and "risk stratification" overlap and relate to the atherogenic process and development of type 2 diabetes. There is confusion about what these terms mean and how they can best be used to improve our understanding of cardiovascular disease treatment and prevention. With the objectives of clarifying these concepts and presenting practical strategies to identify and reduce cardiovascular risk in multiethnic patient populations, the Cardiometabolic Working Group reviewed the evidence related to emerging cardiovascular risk factors and Canadian guideline recommendations in order to present a detailed analysis and consolidated approach to the identification and management of cardiometabolic risk. The concepts related to cardiometabolic risk, pathophysiology, and strategies for identification and management (including health behaviours, pharmacotherapy, and surgery) in the multiethnic Canadian population are presented. "Global cardiometabolic risk" is proposed as an umbrella term for a comprehensive list of existing and emerging factors that predict cardiovascular disease and/or type 2 diabetes. Health behaviour interventions (weight loss, physical activity, diet, smoking cessation) in people identified at high cardiometabolic risk are of critical importance given the emerging crisis of obesity and the consequent epidemic of type 2 diabetes. Vascular protective measures (health behaviours for all patients and pharmacotherapy in appropriate patients) are essential to reduce cardiometabolic risk, and there is growing consensus that a multidisciplinary approach is needed to adequately address cardiometabolic risk factors. Health care professionals must also consider risk factors related to ethnicity in order to appropriately evaluate everyone in their diverse patient populations.

  3. Bicycling to school improves the cardiometabolic risk factor profile

    DEFF Research Database (Denmark)

    Ostergaard, Lars; Børrestad, Line A B; Tarp, Jakob;

    2012-01-01

    To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children.......To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children....

  4. The endocannabinoid system and cardiometabolic risk.

    Science.gov (United States)

    Szmitko, Paul E; Verma, Subodh

    2008-08-01

    Worldwide, the rates of obesity are rapidly rising. Abdominal obesity in particular is associated with increased cardiovascular risk factors, namely increased triglycerides, low high-density lipoprotein (HDL) cholesterol, elevated blood pressure and increased plasma glucose. The cluster of these obesity-related metabolic disorders identifies individuals with the cardiometabolic syndrome, who are at particular risk for cardiovascular disease and type 2 diabetes. The accumulation of intra-abdominal fat and the subsequent development of visceral obesity rely on the body's mechanisms to store energy and to stimulate appetite. The endocannabinoid system has been implicated in the regulation of energy balance and has emerged as a critical target for the modulation of visceral obesity and insulin resistance. Its overactivity appears to be associated with the development of obesity. The current review examines the role of the endocannabinoid system in cardiometabolic disease and its basis as a target for modulating cardiovascular risk.

  5. Abdominal obesity, cardiometabolic risk and endocannabinoid system

    Directory of Open Access Journals (Sweden)

    G. Bittolo Bon

    2013-05-01

    Full Text Available Abdominal obesity is the most prevalent manifestation of metabolic syndrome and is of central importance in the definition of global cardiometabolic risk. Visceral adipose tissue releases a large number of bioactive mediators, which influence body weight homeostasis, insulin resistance, alterations in lipids, blood pressure, coagulation, fibrinolysis and inflammation, leading to increased risk of cardiovascular events and of type 2 diabetes. Lifestyle modification is the first-line approach to the management of abdominal obesity and metabolic syndrome. However for patients at higher risk, who cannot achieve an appreciable reduction in weight and in global cardiometabolic risk with lifestyle modification alone, an adjunctive long term pharmacotherapy should be considered. The endocannabinoid system activity regulates food intake and metabolic factors through cannabinoid-1 (CB1 receptor located in multiple sites, including hypothalamus and limbic forebrain, adipose tissue, skeletal muscle, liver and the gastrointestinal tract. Evidence suggests that CB1 receptor blockade offers a novel therapeutic strategy. Data from four phase III trials suggest that rimonabant, the first cannabinoid receptor inhibitor, modulates cardiometabolic risk factors, both through its impact on body weight and metabolic parameters such as HDL-cholesterol, tryglicerides, Hb1Ac, through direct pathways that are not related to weight loss.

  6. Identification and management of cardiometabolic risk in Canada: a position paper by the cardiometabolic risk working group (executive summary).

    Science.gov (United States)

    Leiter, Lawrence A; Fitchett, David H; Gilbert, Richard E; Gupta, Milan; Mancini, G B John; McFarlane, Philip A; Ross, Robert; Teoh, Hwee; Verma, Subodh; Anand, Sonia; Camelon, Kathryn; Chow, Chi-Ming; Cox, Jafna L; Després, Jean-Pierre; Genest, Jacques; Harris, Stewart B; Lau, David C W; Lewanczuk, Richard; Liu, Peter P; Lonn, Eva M; McPherson, Ruth; Poirier, Paul; Qaadri, Shafiq; Rabasa-Lhoret, Rémi; Rabkin, Simon W; Sharma, Arya M; Steele, Andrew W; Stone, James A; Tardif, Jean-Claude; Tobe, Sheldon; Ur, Ehud

    2011-01-01

    With the objectives of clarifying the concepts related to "cardiometabolic risk," "metabolic syndrome" and "risk stratification" and presenting practical strategies to identify and reduce cardiovascular risk in multiethnic patient populations, the Cardiometabolic Working Group presents an executive summary of a detailed analysis and position paper that offers a comprehensive and consolidated approach to the identification and management of cardiometabolic risk. The above concepts overlap and relate to the atherogenic process and development of type 2 diabetes. However, there is confusion about what these terms mean and how they can best be used to improve our understanding of cardiovascular disease treatment and prevention. The concepts related to cardiometabolic risk, pathophysiology, and strategies for identification and management (including health behaviours, pharmacotherapy, and surgery) in the multiethnic Canadian population are presented. "Global cardiometabolic risk" is proposed as an umbrella term for a comprehensive list of existing and emerging factors that predict cardiovascular disease and/or type 2 diabetes. Health behaviour interventions (weight loss, physical activity, diet, smoking cessation) in people identified at high cardiometabolic risk are of critical importance given the emerging crisis of obesity and the consequent epidemic of type 2 diabetes. Vascular protective measures (health behaviours for all patients and pharmacotherapy in appropriate patients) are essential to reduce cardiometabolic risk, and there is growing consensus that a multidisciplinary approach is needed to adequately address cardiometabolic risk factors. Health care professionals must also consider ethnicity-related risk factors in order to appropriately evaluate all individuals in their diverse patient populations.

  7. Hostility Modifies the Association between TV Viewing and Cardiometabolic Risk

    Directory of Open Access Journals (Sweden)

    Anthony Fabio

    2014-01-01

    Full Text Available Background. It was hypothesized that television viewing is predictive of cardiometabolic risk. Moreover, people with hostile personality type may be more susceptible to TV-induced negative emotions and harmful health habits which increase occurrence of cardiometabolic risk. Purpose. The prospective association of TV viewing on cardiometabolic risk was examined along with whether hostile personality trait was a modifier. Methods. A total of 3,269 Black and White participants in the coronary artery risk development in young adults (CARDIA study were assessed from age 23 to age 35. A cross-lagged panel model at exam years 5, 10, 15, and 20, covering 15 years, was used to test whether hours of daily TV viewing predicted cardiometabolic risk, controlling confounding variables. Multiple group analysis of additional cross-lagged panel models stratified by high and low levels of hostility was used to evaluate whether the association was modified by the hostile personality trait. Results. The cross-lagged association of TV viewing at years 5 and 15 on clustered cardiometabolic risk score at years 10 and 20 was significant (B=0.058 and 0.051, but not at 10 to 15 years. This association was significant for those with high hostility (B=0.068 for exam years 5 to 10 and 0.057 for exam years 15 to 20 but not low hostility. Conclusion. These findings indicate that TV viewing is positively associated with cardiometabolic risk. Further, they indicate that hostility might be a modifier for the association between TV viewing and cardiometabolic risk.

  8. The role of fitness in the association between fatness and cardiometabolic risk from childhood to adolescence

    NARCIS (Netherlands)

    Brouwer, Silvia I.; Stolk, Ronald P.; Liem, Eryn T.; Lemmink, Koen A. P. M.; Corpeleijn, Eva

    2013-01-01

    Background Fatness and fitness both influence cardiometabolic risk. Objective The purpose of this study was to investigate whether childhood fatness and increasing fatness from childhood to adolescence are associated with cardiometabolic risk during adolescence and how fitness affects this associati

  9. Androidal fat dominates in predicting cardiometabolic risk in postmenopausal women

    Science.gov (United States)

    We hypothesized that soy isoflavones would attenuate the anticipated increase in androidal fat mass in postmenopausal women during the 36-month treatment, and thereby favorably modify the circulating cardiometabolic risk factors: triacylglycerol, LDLC, HDL-C, glucose, insulin, uric acid, C-reactive ...

  10. Dietary Intake and Cardiometabolic Risk in Ethnically Diverse Urban Schoolchildren

    Science.gov (United States)

    Au, Lauren E.; Economos, Christina D.; Goodman, Elizabeth; Houser, Robert F.; Must, Aviva; Chomitz, Virginia R.; Morgan, Emily H.; Sacheck, Jennifer M.

    2017-01-01

    Dietary factors vary widely among ethnic groups. However, the effect of specific nutrients on cardiometabolic risk is not well understood, especially in children. Four dietary factors known to influence cardiometabolic risk (ie, carbohydrate, saturated, monounsaturated, and polyunsaturated fat intake) were assessed by the Block Kids 2004 Food Frequency Questionnaire in a cross-sectional sample of racially diverse fourth- through eighth-grade students (n=148) in a Boston-area school district studied between January and April 2010. Fasting total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL) cholesterol, triglyceride, C-reactive protein (CRP), and interleukin-6 (IL-6) levels, and body mass index z scores were measured. Differences in dietary factors and cardiometabolic risk factors were examined among the following racial/ethnic groups: white (39%), Hispanic (32%), black (8%), Asian (10%), and multiracial/other (11%). In bivariate analyses, total, saturated, and polyunsaturated fat intakes differed by race/ethnicity (Psaturated fat intakes above the recommended level. Forty-seven percent of children had at least one suboptimal cardiometabolic risk factor. HDL cholesterol, triglyceride, and IL-6 concentrations differed by race/ethnicity (P<0.05, P<0.01, and P<0.01, respectively), with Hispanics having low HDL cholesterol levels and high triglyceride levels, whereas Asians had high IL-6 levels. In multivariate analyses controlling for demographic characteristics, none of the dietary factors examined explained racial/ethnic differences in lipid profiles or inflammatory markers. Body mass index z score was associated with lower HDL cholesterol, higher triglyceride, higher CRP, and higher IL-6 levels (P<0.0001). Further research is warranted to determine the influence of dietary recommendations at a young age among different racial/ethnic groups on cardiometabolic health. PMID:23102181

  11. Assessment of cardiometabolic risk among shift workers in Hungary

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    Jermendy György

    2012-02-01

    Full Text Available Abstract Aim Shift workers may be at risk of different diseases. In order to assess cardiometabolic risk in shift workers, a cross-sectional study was performed among active workers. Methods A total of 481 workers (121 men, 360 women were investigated; most of them were employees in light industry (58.2% or in public services (23.9%. Past medical history was recorded and physical examination was performed. Questionnaires were used to characterize daily activity. Fasting venous blood sample was collected for measuring laboratory parameters. Data from shift workers (n = 234, age: 43.9 ± 8.1 years were compared to those of daytime workers (n = 247, age: 42.8 ± 8.5 years, men and women were analyzed separately. Results In men, systolic blood pressure was higher in shift workers compared to daytime workers (133 ± 8 vs 126 ± 17 mmHg; p vs 67.7 ± 13.2 kg; p vs 13.4%; p vs 21.7%; p vs 1.68 ± 0.36 mmol/l; p Conclusion Middle-aged active shift workers, especially women, have a less healthy lifestyle and are at higher cardiometabolic risk as compared to daytime workers. Our study highlights the importance of measures for identifying and preventing cardiometabolic risk factors in shift workers.

  12. Sleep and cardiometabolic risk in children and adolescents

    DEFF Research Database (Denmark)

    Quist, Jonas Salling; Sjödin, Anders Mikael; Chaput, Jean-Philippe

    2016-01-01

    The evidence for a link between sleep and cardiometabolic risk factors in children and adolescents is accumulating; however, the literature has not yet been reviewed. Seventy-five studies investigating associations between sleep variables and measures of abdominal adiposity, glucose homeostasis......, blood lipids, blood pressure (BP), and inflammatory markers were included in the present review. The current evidence indicates that inadequate sleep may play a role in cardiometabolic risk at a later age for children and adolescents. Most compelling is the evidence for an association between inadequate...... weekdays and weekend days, at multiple time points over time. Meanwhile, based on the available evidence, we recommend that children and adolescents get adequate amounts of good sleep in a regular pattern....

  13. The prevalence of adverse cardiometabolic responses to exercise training with evidence-based practice is low

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    Dalleck LC

    2015-01-01

    Full Text Available Lance C Dalleck,1 Gary P Van Guilder,2 Tara B Richardson,1 Chantal A Vella3 1Recreation, Exercise, and Sport Science Department, Western State Colorado University, Gunnison, CO, USA; 2Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD, USA; 3Department of Movement Sciences, WWAMI Medical Education Program, University of Idaho, Moscow, ID, USA Background: The purpose of this study was to determine the prevalence of individuals who experienced exercise-induced adverse cardiometabolic response (ACR, following an evidence-based, individualized, community exercise program. Methods: Prevalence of ACR was retrospectively analyzed in 332 adults (190 women, 142 men before and after a 14-week supervised community exercise program. ACR included an exercise training-induced increase in systolic blood pressure of 10 mmHg, increase in plasma triglycerides (TG of >37.0 mg/dL (0.42 mmol/L, or decrease in high-density lipoprotein cholesterol (HDL-C of >4.0 mg/dL (0.12 mmol/L. A second category of ACR was also defined – this was ACR that resulted in a metabolic syndrome component (ACR-risk as a consequence of the adverse response. Results: According to the above criteria, prevalence of ACR between baseline and post-program was systolic blood pressure (6.0%, TG (3.6%, and HDL-C (5.1%. The prevalence of ACR-risk was elevated TG (3.2%, impaired fasting blood glucose (2.7%, low HDL-C (2.2%, elevated waist circumference (1.3%, and elevated blood pressure (0.6%. Conclusion: Evidence-based practice exercise programming may attenuate the prevalence of exercise training-induced ACR. Our findings provide important preliminary evidence needed for the vision of exercise prescription as a personalized form of preventative medicine to become a reality. Keywords: evidence-based research, cardiovascular health, community-based research, metabolic health

  14. Obesity and cardiometabolic disease risk factors among USadolescents with disabilities

    Institute of Scientific and Technical Information of China (English)

    Sarah E Messiah; Denise C Vidot; Gabriel Somarriba; Kanathy Haney; Semra Aytur; Ruby A Natale; Jeffrey P Brosco; Kristopher L Arheart

    2015-01-01

    AIM To generate prevalence estimates of weightstatus and cardiometabolic disease risk factors amongadolescents with and without disabilities.METHODS: Analysis of the 1999-2010 National Healthand Nutrition Examination Survey data was conductedamong 12-18 years old with (n = 256) and withoutdisabilities (n = 5020). Mean values of waist circumference,fasting glucose, high-density-lipoprotein cholesterol,triglycerides, systolic and diastolic blood pressure andmetabolic syndrome (MetS, ≥ 3 risk factors present) wereexamined by the following standardized body mass index(BMI) categories for those with and without disabilities;overweight (BMI ≥ 85th - 〈 95th percentile for age andsex), obesity (BMI ≥ 95th percentile) and severe obesity(BMI ≥35 kg/m2). Linear regression models were fit witheach cardiometabolic disease risk factor independently ascontinuous outcomes to show relationships with disabilitystatus.RESULTS: Adolescents with disabilities were significantly more likely to be overweight (49.3%), obese (27.6%)and severely obese (12%) vs their peers withoutdisabilities (33.1%, 17.5% and 3.6%, respectively, P≤ 0.01 for all). A higher proportion of overweight,obese and severely obese children with disabilities hadabnormal SBP, fasting lipids and glucose as well asMetS (18.9% of overweight, 32.3% of obese, 55% ofseverely obese) vs their peers without disabilities (9.7%,16.8%, 36.3%, respectively). US adolescents withdisabilities are over three times as likely to have MetS(OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs theirpeers with no disabilities.CONCLUSION: Results show that adolescents withdisabilities are disproportionately affected by obesityand poor cardiometabolic health vs their peers withno disabilities. Health care professionals shouldmonitor the cardiometabolic health of adolescents withdisabilities.

  15. Cardiometabolic Risk Factors in Patients with Erectile Dysfunction

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    Serhat Tanik

    2014-01-01

    Full Text Available Introduction. There is an increasing interest in the association between erectile dysfunction (ED and cardiovascular risk factor. Epicardial adipose tissue (EAT is associated with insulin resistance, increased cardiometabolic risk, and coronary artery disease. Our aim was to investigate relationships between epicardial fat thickness (EFT as a cardiometabolic risk factor and erectile dysfunction. Method. We selected 30 erectile dysfunction patients without comorbidities and 30 healthy individuals. IIEF-5 score was applied to all patients, and IIEF-5 score below 22 was considered as erectile dysfunction. EFT was measured by echocardiography. Results. Body mass index (BMI was higher in ED patients than those without ED (28.19 ± 4.45 kg/m2 versus 23.84±2.36 kg/m2, P = 0.001, resp.. Waist circumstance (WC was higher in ED patients than those without ED (106.60±5.90 versus 87.86 ± 14.51, P = 0.001, resp.. EFT was higher in ED patients compared to non-ED patients (0.49 ± 0.09 cm versus 0.45 ± 0.03 cm, P = 0.016, resp.. There was positive correlation among BMI, WC, and EFT. There was negative correlation between EFT and IIEF-5 score (r : -0.632, P = 0.001. Conclusion. EAT, BMI, and WC as cardiometabolic risk factors were higher in erectile dysfunction patients.

  16. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents

    DEFF Research Database (Denmark)

    Ekelund, Ulf; Luan, Jian'an; Sherar, Lauren B

    2012-01-01

    Sparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children.......Sparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children....

  17. The role of fitness in the association between fatness and cardiometabolic risk from childhood to adolescence

    NARCIS (Netherlands)

    Brouwer, Sylvia I.; Stolk, Ronald P.; Liem, Eryn T.; Lemmink, Koen A.P.M.

    2013-01-01

    BackgroundFatness and fitness both influence cardiometabolic risk. Objective:The purpose of this study was to investigate whether childhood fatness and increasing fatness from childhood to adolescence are associated with cardiometabolic risk during adolescence and how fitness affects this associatio

  18. Extreme Air Pollution Conditions Adversely Affect Blood Pressure and Insulin Resistance: The Air Pollution and Cardiometabolic Disease Study.

    Science.gov (United States)

    Brook, Robert D; Sun, Zhichao; Brook, Jeffrey R; Zhao, Xiaoyi; Ruan, Yanping; Yan, Jianhua; Mukherjee, Bhramar; Rao, Xiaoquan; Duan, Fengkui; Sun, Lixian; Liang, Ruijuan; Lian, Hui; Zhang, Shuyang; Fang, Quan; Gu, Dongfeng; Sun, Qinghua; Fan, Zhongjie; Rajagopalan, Sanjay

    2016-01-01

    Mounting evidence supports that fine particulate matter adversely affects cardiometabolic diseases particularly in susceptible individuals; however, health effects induced by the extreme concentrations within megacities in Asia are not well described. We enrolled 65 nonsmoking adults with metabolic syndrome and insulin resistance in the Beijing metropolitan area into a panel study of 4 repeated visits across 4 seasons since 2012. Daily ambient fine particulate matter and personal black carbon levels ranged from 9.0 to 552.5 µg/m(3) and 0.2 to 24.5 µg/m(3), respectively, with extreme levels observed during January 2013. Cumulative fine particulate matter exposure windows across the prior 1 to 7 days were significantly associated with systolic blood pressure elevations ranging from 2.0 (95% confidence interval, 0.3-3.7) to 2.7 (0.6-4.8) mm Hg per SD increase (67.2 µg/m(3)), whereas cumulative black carbon exposure during the previous 2 to 5 days were significantly associated with ranges in elevations in diastolic blood pressure from 1.3 (0.0-2.5) to 1.7 (0.3-3.2) mm Hg per SD increase (3.6 µg/m(3)). Both black carbon and fine particulate matter were significantly associated with worsening insulin resistance (0.18 [0.01-0.36] and 0.22 [0.04-0.39] unit increase per SD increase of personal-level black carbon and 0.18 [0.02-0.34] and 0.22 [0.08-0.36] unit increase per SD increase of ambient fine particulate matter on lag days 4 and 5). These results provide important global public health warnings that air pollution may pose a risk to cardiometabolic health even at the extremely high concentrations faced by billions of people in the developing world today.

  19. Dynamics in cardiometabolic risk among Turkish adults: Similarities to that in Iranians?

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    Altan Onat

    2011-01-01

    The author strongly suspects that such dynamics in the development of diabetes and CHD exist in Western adults prone to impaired glucose tolerance, and evidence is accumulating regarding general Iranian adults. These issues posing a vast threat on public cardiometabolic health will have to be recognized with the purpose of not delaying implementation of measures for the modification of cardiometabolic risk, especially in women.

  20. Quantifying Cardiometabolic Risk Using Modifiable Non–Self-Reported Risk Factors

    Science.gov (United States)

    Marino, Miguel; Li, Yi; Pencina, Michael J.; D’Agostino, Ralph B.; Berkman, Lisa F.; Buxton, Orfeu M.

    2014-01-01

    Background Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. Purpose To develop and validate a cumulative general cardiometabolic risk score that focuses on non–self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut off points for risk categories. Methods We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14–year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender–specific Cox proportional hazards models were considered to evaluate the effects of non–self-reported modifiable risk factors (blood pressure, total cholesterol, high–density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10–year general cardiometabolic risk score functions and evaluated its predictive performance in 2012–2013. Results HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit χ2=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). Conclusions This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk based on modifiable risk factors that can motivate an individual’s commitment to prevention and intervention. PMID:24951039

  1. Cardiometabolic Risk among African-American Women: A Pilot Study

    Science.gov (United States)

    Appel, Susan J.; Oster, Robert A.; Floyd, Natalie A.; Ovalle, Fernando

    2010-01-01

    Objective To determine the associations of the Homeostatic Model of Assessment-insulin resistance (HOMA-ir), acanthosis nigricans, high sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor-1 (PAI-1) with two of the commonly used definitions of the metabolic syndrome (Adult Treatment Panel III {ATP III} and International Diabetes Federation {IDF}) among reproductive age healthy free living African-American women. Methods A pilot study with a cross-sectional design examined 33 African-American women aged 20 to 46 (mean 31.24, +/- 7.25), for the presence of metabolic syndrome determined by ATP III and IDF criteria, insulin resistance (HOMA-ir and/or acanthosis nigricans), degree of inflammation (hs-CRP) and presence of dysfibrinolysis (PAI-1). Results HOMA-ir identified insulin resistance in 27 (81.8%) of the women, whereas the presence of acanthosis nigricans indicated that 16 (48 %) of these women manifested insulin resistance. Metabolic syndrome was found in 7 women (21.2 %) by ATP III or 9 (27.3 %) by IDF criteria. Bivariate correlations showed associations between HOMA-ir and waist circumference, body mass index (BMI), acanthosis nigricans, the ATP III and IDF definitions for metabolic syndrome. PAI-1 was significantly correlated with waist circumference, BMI, fasting glucose, HOMA-ir, and ATP III. Both HOMA-ir and PAI-1 were significantly and negatively correlated with HDL-C. hs-CRP was significantly correlated with BMI and 2-hour post glucose. Conclusion Both dysfibrinolysis (PAI-1 levels) and insulin resistance (HOMA-ir) when individually regressed on the ATP III definition of metabolic syndrome explained 32 % and 29% of the respective variance. The addition of HOMA-ir measurement may significantly improve early recognition of cardiometabolic risk among reproductive age African-American women who have not yet met the criteria for the ATP III or IDF definitions of the metabolic syndrome. Likewise, acanthosis nigricans is potentially a

  2. Fitness and Adiposity Are Independently Associated with Cardiometabolic Risk in Youth

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    Duncan S. Buchan

    2013-01-01

    Full Text Available Purpose. The purpose of the study was to examine the independent associations of adiposity and cardiorespiratory fitness with clustered cardiometabolic risk. Methods. A cross-sectional sample of 192 adolescents (118 boys, aged 14–16 years, was recruited from a South Lanarkshire school in the West of Scotland. Anthropometry and blood pressure were measured, and blood samples were taken. The 20 m multistage fitness test was the indicator of cardiorespiratory fitness (CRF. A clustered cardiometabolic risk score was constructed from HDL-C (inverted, LDL-C, HOMA, systolic blood pressure, and triglycerides. Interleukin-6, C-reactive protein, and adiponectin were also measured and examined relative to the clustered cardiometabolic risk score, CRF, and adiposity. Results. Although significant, partial correlations between BMI and waist circumference (WC and both CRF and adiponectin were negative and weak to moderate, while correlations between the BMI and WC and CRP were positive but weak to moderate. Weak to moderate negative associations were also evident for adiponectin with CRP, IL-6, and clustered cardiometabolic risk. WC was positively associated while CRF was negatively associated with clustered cardiometabolic risk. With the additional adjustment for either WC or CRF, the independent associations with cardiometabolic risk persisted. Conclusion. WC and CRF are independently associated with clustered cardiometabolic risk in Scottish adolescents.

  3. The Prevalence and Awareness of Cardiometabolic Risk Factors in Southern Chinese Population with Coronary Artery Disease

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    Xinrui Li

    2013-01-01

    Full Text Available Background. Cardiometabolic risk factors significantly accelerate the progression of coronary artery disease (CAD; however, whether CAD patients in South China are aware of the prevalence of these risk factors is not clear yet. Methods. The study consisted of 2312 in-admission CAD patients from 2008 to 2011 in South China. Disease history including hypertension, dyslipidemia, and diabetes was relied on patients' self-reported records. Physical and clinical examinations were tested to assess the real prevalence of the cardiometabolic risk factors. Results. 57.9% of CAD patients had more than 3 cardiometabolic risk factors in terms of the metabolic syndrome. The self-known and real prevalence of hypertension, diabetes, and dyslipidemia were 56.6%, 28.3%, and 25.1% and 91.3%, 40.9%, and 92.0%, respectively. The awareness rates were 64.4%, 66.3%, and 28.5% for hypertension, diabetes, and dyslipidemia. The prevalence of cardiometabolic risk factors was significantly different among gender and among disease status. Conclusions. Most CAD patients in South China had more than three cardiometabolic risk factors. However, the awareness rate of cardiometabolic diseases was low, especially for dyslipidemia. Strategies of routine physical examination programs are needed for the early detection and treatment of cardiometabolic risk factors in order to prevent CAD progression and prognosis.

  4. Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

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    Vasilios G. Athyros

    2013-11-01

    Full Text Available The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS or not, substantially increases the risk of cardiovascular disease (CVD and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS, and in high central aortic blood pressure (CABP, which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension.

  5. Management of obesity and cardiometabolic risk – role of phentermine/extended release topiramate

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    Sweeting AN

    2014-02-01

    Full Text Available Arianne N Sweeting,1 Eddy Tabet,1 Ian D Caterson,1,2 Tania P Markovic1,2 1Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; 2Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, NSW, Australia Abstract: The US Food and Drug Administration (FDA recently approved lorcaserin and the combination of phentermine and extended release topiramate (phentermine/topiramate ER for the treatment of obesity in conjunction with a lifestyle intervention, expanding the therapeutic options for long-term obesity pharmacotherapy, which was previously limited to orlistat. Combination phentermine/topiramate ER is associated with greater weight loss compared to its constituent monotherapy, with a more favorable adverse effect profile. Phentermine/topiramate ER also appears to have beneficial effects on cardiometabolic risk, although longer-term cardiovascular safety data are required. While there are no head-to-head studies among the currently available obesity pharmacotherapy agents, phentermine/topiramate ER appears to have a superior weight loss profile. This review will discuss the epidemiology, natural history, and cardiometabolic risk associated with obesity, provide an overview on current obesity pharmacotherapy, and summarize the recent clinical efficacy and safety data underpinning the FDA's approval of both phentermine/topiramate ER and lorcaserin as pharmacotherapy for a long-term obesity intervention. Keywords: obesity, phentermine/topiramate extended release, safety and efficacy, review

  6. Sedentary behaviour as an emerging risk factor for cardiometabolic diseases in children and youth.

    Science.gov (United States)

    Saunders, Travis J; Chaput, Jean-Philippe; Tremblay, Mark S

    2014-02-01

    Sedentary behaviour (e.g. TV viewing, seated video game playing, prolonged sitting) has recently emerged as a distinct risk factor for cardiometabolic diseases in children and youth. This narrative review provides an overview of recent evidence in this area and highlights research gaps. Current evidence suggests that North American children and youth spend between 40% and 60% of their waking hours engaging in sedentary pursuits. Although data are lacking concerning temporal trends of objectively measured sedentary time, self-reported sedentary behaviours have increased over the past half century, with a rapid increase since the late 1990s. Excessive sedentary behaviour has been found to have independent and deleterious associations with markers of adiposity and cardiometabolic disease risk. These associations are especially consistent for screen-based sedentary behaviours (TV viewing, computer games, etc), with more conflicting findings observed for overall sedentary time. The above associations are possibly mediated by the influence of screen-based sedentary behaviours on energy intake. Although excessive sitting has been reported to have adverse acute and chronic metabolic impacts in adults, research on children is lacking. Research is particularly needed to investigate the impact of characteristics of sedentary behaviour (i.e. type/context, sedentary bout length, breaks in sedentary time, etc), as well as interventions that examine the health and behavioural impacts of sitting per se.

  7. Preventing and Managing Cardiometabolic Risk: The Logic for Intervention

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    Rita Carreón

    2009-09-01

    Full Text Available Cardiometabolic risk (CMR, also known as metabolic syndrome or insulin resistance syndrome, comprises obesity (particularly central or abdominal obesity, high triglycerides, low HDL, elevated blood pressure, and elevated plasma glucose. Leading to death from diabetes, heart disease, and stroke, the root cause of CMR is inadequate physical activity, a Western diet identified primarily by low intake of fruits, vegetables, and whole grains, and high in saturated fat, as well as a number of yet-to-be-identified genetic factors. While the pathophysiological pathways related to CMR are complex, the universal need for adequate physical activity and a diet that emphasizes fruits and vegetables and whole grains, while minimizing food high in added sugars and saturated fat suggests that these behaviors are the appropriate focus of intervention.

  8. Laboratory assessment of cardiometabolic risk in overweight and obese children.

    Science.gov (United States)

    Sypniewska, Grazyna

    2015-04-01

    Childhood obesity has been identified as one of the most important risk factors of developing cardiovascular diseases. The global prevalence of overweight and obesity among children shows an increasing tendency. Many of overweight or obese children will become obese adults with enhanced risk for cardiovascular diseases. Childhood obesity is often accompanied by serious consequences such as dyslipidemia, hypertension, diabetes, pro-inflammatory state and non-alcoholic fatty liver disease. Hypertension, high LDL-cholesterol and triglyceride concentrations, insulin resistance, inflammation and disturbances in adipocytokines secretion are associated with endothelial dysfunction which precedes the development of atherosclerosis. Obese children and adolescents with a clinically-proven non-alcoholic fatty liver disease, which is currently recognized as the hepatic component of metabolic syndrome, are at more severe cardiovascular risk compared with normal-weight. Obesity-related insulin resistance is highly prevalent in children and adolescents, and is associated with the increased lifetime risk of type 2 diabetes and cardiovascular disease. Adipokines contribute to obesity-atherosclerosis relationships yet among several recently discovered adipokines only few (adiponectin, resistin, chemerin, fibroblast growth factor 21, apelin) have been partly studied in obese pediatric population. The aim of this review was to describe the spectrum of cardiovascular abnormalities observed in children with overweight and obesity and the role of laboratory in the assessment of cardiometabolic risk in order to differentiate between healthy obese and those at risk to most effectively prevent progression of cardiovascular disease in childhood.

  9. Development of cardiometabolic risk in childhood and adolescence. The PIAMA birth cohort study

    NARCIS (Netherlands)

    Berentzen, N.E.

    2016-01-01

    The atherosclerotic process leading to cardiovascular disease begins early in life and is influenced over time by several risk factors. Investigating determinants that contribute to an unfavourable cardiometabolic profile in childhood and adolescence is important for specifying time windows suitable

  10. The microvasculature: a target for nutritional programming and later risk of cardio-metabolic disease.

    Science.gov (United States)

    Musa, M G; Torrens, C; Clough, G F

    2014-01-01

    There is compelling evidence that microvascular deficits affecting multiple tissues and organs play an important role in the aetiopathogenesis of cardio-metabolic disease. Furthermore, both in humans and animal models, deficits in small vessel structure and function can be detected early, often before the onset of macrovascular disease and the development of end-organ damage that is common to hypertension and obesity-associated clinical disorders. This article considers the growing evidence for the negative impact of an adverse maternal diet on the long-term health of her child, and how this can result in a disadvantageous vascular phenotype that extends to the microvascular bed. We describe how structural and functional modifications in the offspring microcirculation during development may represent an important and additional risk determinant to increase susceptibility to the development of cardio-metabolic disease in adult life and consider the cell-signalling pathways associated with endothelial dysfunction that may be 'primed' by the maternal environment. Published studies were identified that reported outcomes related to the microcirculation, endothelium, maternal diet and vascular programming using NCBI PubMed.gov, MEDLINE and ISI Web of Science databases from 1980 until April 2013 using pre-specified search terms. Information extracted from over 230 original reports and review articles was critically evaluated by the authors for inclusion in this review.

  11. Cardiometabolic risk variables in overweight and obese children: a worldwide comparison

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    van Vliet Mariska

    2011-11-01

    Full Text Available Abstract The growing prevalence rate of pediatric obesity, which is frequently accompanied by several cardiometabolic risk factors, has become a serious global health issue. To date, little is known regarding differences for cardiometabolic risk factors (prevalence and means in children from different countries. In the present review, we aimed to provide a review for the available evidence regarding cardiometabolic risk factors in overweight pediatric populations. We therefore provided information with respect to the prevalence of impaired fasting glucose/impaired glucose tolerance, high triglycerides, low HDL-cholesterol and hypertension (components of the metabolic syndrome among cohorts from different countries. Moreover, we aimed to compare the means of glucose and lipid levels (triglycerides and HDL-cholesterol and systolic/diastolic blood pressure values. After careful selection of articles describing cohorts with comparable age and sex, it was shown that both prevalence rates and mean values of cardiometabolic risk factors varied largely among cohorts of overweight children. After ranking for high/low means for each cardiometabolic risk parameter, Dutch-Turkish children and children from Turkey, Hungary, Greece, Germany and Poland were in the tertile with the most unfavorable risk factor profile overall. In contrast, cohorts from Norway, Japan, Belgium, France and the Dominican Republic were in the tertile with most favorable risk profile. These results should be taken with caution, given the heterogeneity of the relatively small, mostly clinical cohorts and the lack of information concerning the influence of the values of risk parameters on true cardiometabolic outcome measures in comparable cohorts. The results of our review present a fair estimation of the true differences between cardiometabolic risk profiles among pediatric cohorts worldwide, based on available literature.

  12. Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors

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    Roya Kelishadi

    2015-01-01

    Full Text Available Background: The adverse health effects of abdominal obesity are well documented in adults, but such association remains to be determined in the pediatric age group. This study aims to perform a systematic review on the association between abdominal obesity and cardio-metabolic factors such as dyslipidemia, hypertension, and hyperglycemia among children and adolescents. Materials and Methods: A systematic literature search was conducted using PubMed, Scopus and Google Scholar databases to May 2014. Two independent reviewers identified relevant papers in several steps. After studying the titles and texts of documents, repeated and irrelevant ones were excluded. The search was refined to the English language. We did not consider any time limitation. Studies with different measuring methods of abdominal obesity were included. Studies with abdominal obese patients secondary to other disease were excluded from the study. In final, the data of association of cardio-metabolic risk factors and abdominal obesity extracted from studies. Results: Overall, 3966 articles were reviewed, and 61 of them were studied according to the inclusion and exclusion criteria. Waist circumference (WC, waist-to-height ratio, and waist-to-hip ratio were the most common indexes used for defining abdominal obesity. The association of high blood pressure with increasing WC was seen in several studies. The association of other cardio-metabolic risk factors was seen in some studies. Conclusion: Whatever the definition used for abdominal obesity and whatever the methods used for anthropometric measurements, central body fat deposition in children and adolescents increases the risk of cardio-metabolic risk factors. Therefore, more attention should be paid to abdominal obesity of children and adolescents both in clinical practice and in epidemiological studies.

  13. Diet scores and cardio-metabolic risk factors among Guatemalan young adults

    OpenAIRE

    2008-01-01

    We assessed the association of four diet quality scores with multiple cardio-metabolic outcomes among Guatemalan young adults experiencing the nutrition transition. We obtained cross-sectional dietary, demographic, anthropometric and cardio-metabolic risk factor data from 1220 Guatemalan adults (mean age 32·7 (SD 5·8) years) in 2002–4, and computed a Recommended Food Score (RFS), Not Recommended Food Score (NRFS), Food Variety Score (FVS) and the Dietary Quality Index-International (DQI-I). A...

  14. The effects of whey protein on cardiometabolic risk factors.

    Science.gov (United States)

    Pal, Sebely; Radavelli-Bagatini, Simone

    2013-04-01

    Obesity has reached epidemic proportions worldwide. The health consequences of obesity are more dangerous when associated with the metabolic syndrome and its components. Studies show that whey protein and its bioactive components can promote greater benefits compared to other protein sources such as egg and casein. The aim of this paper is to review the effects of whey protein on cardiometabolic risk factors. Using PubMed as the database, a review was conducted to identify current scientific literature on whey protein and the components of the metabolic syndrome published between 1970 and 2012. Consumption of whey protein seems to play an anti-obesity and muscle-protective role during dieting by increasing thermogenesis and maintaining lean mass. In addition, whey protein has been shown to improve glucose levels and insulin response, promote a reduction in blood pressure and arterial stiffness, and improve lipid profile. The collective view of current scientific literature indicates that the consumption of whey protein may have beneficial effects on some symptoms of the metabolic syndrome as well as a reduction in cardiovascular risk factors.

  15. Cardiometabolic risk markers in Indian children: comparison with UK Indian and white European children.

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    Claire M Nightingale

    Full Text Available UK Indian adults have higher risks of coronary heart disease and type 2 diabetes than Indian and UK European adults. With growing evidence that these diseases originate in early life, we compared cardiometabolic risk markers in Indian, UK Indian and white European children.Comparisons were based on the Mysore Parthenon Birth Cohort Study (MPBCS, India and the Child Heart Health Study in England (CHASE, which studied 9-10 year-old children (538 Indian, 483 UK Indian, 1375 white European using similar methods. Analyses adjusted for study differences in age and sex.Compared with Mysore Indians, UK Indians had markedly higher BMI (% difference 21%, 95%CI 18 to 24%, skinfold thickness (% difference 34%, 95%CI 26 to 42%, LDL-cholesterol (mean difference 0.48, 95%CI 0.38 to 0.57 mmol/L, systolic BP (mean difference 10.3, 95% CI 8.9 to 11.8 mmHg and fasting insulin (% difference 145%, 95%CI 124 to 168%. These differences (similar in both sexes and little affected by adiposity adjustment were larger than those between UK Indians and white Europeans. Compared with white Europeans, UK Indians had higher skinfold thickness (% difference 6.0%, 95%CI 1.5 to 10.7%, fasting insulin (% difference 31%, 95%CI 22 to 40%, triglyceride (% difference 13%, 95%CI 8 to 18% and LDL-cholesterol (mean difference 0.12 mmol/L, 95%CI 0.04 to 0.19 mmol/L.UK Indian children have an adverse cardiometabolic risk profile, especially compared to Indian children. These differences, not simply reflecting greater adiposity, emphasize the need for prevention strategies starting in childhood or earlier.

  16. Leisure-time physical activity and cardiometabolic risk among children and adolescents

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    Luz M. Cárdenas-Cárdenas

    2015-04-01

    Full Text Available OBJECTIVE: To assess the effect of Leisure-time physical activity (LTPA on cardiometabolic risk by nutritional status in Mexican children and adolescents. METHODS: This was a cross-sectional study conducted with 1,309 participants aged between 5 and 17 years. Nutritional status was classified according to the BMI Z-score by age and gender. A previously validated questionnaire was used to evaluate LTPA; a cardiometabolic risk score was calculated. Multiple linear regression analysis was performed to assess the effect of LTPA on cardiometabolic risk. RESULTS: After adjusting for risk factors, mild LTPA were positively associated with cardiometabolic risk score (ßMildvsIntenseLTPA: 0.68; 95% CI: 0.18 to 1.18; pfortrend = 0.007. This association became stronger when estimated for overweight (ß MildvsIntenseLTPA: 1.24; 95% CI: 0.24 to 2.24; pfortrend = 0.015 and obese participants (ß MildvsIntenseLTPA: 1.02; 95% CI: 0.07 to 1.97; pfortrend= 0.045 CONCLUSION: Mild LTPA was positively associated with cardiometabolic risk in overweight and obese children and adolescents. Given the emerging childhood obesity epidemic in Mexico, these results may be useful in the design of strategies and programs to increase physical activity levels in order to achieve better health.

  17. The Influence of Lifestyle on Cardio-metabolic Risk in Students from Timisoara University Center

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    Mihaela ORAVIȚAN

    2013-12-01

    Full Text Available This study is a part of the activities in a cross border cooperation project that has proposed the management of obesity and cardiometabolic risk at students from Timisoara and Szeged university centres. The target group of Timisoara University Center was formed out of 600 students enrolled in the four major universities from Timisoara; target group students were questioned about their lifestyle and were evaluated anthropometric parameters, body composition and arterial stiffness; based on questionnaires was determine too the risk of developing cardiovascular disease and/or diabetes mellitus type II. Analysis of the results revealed the strong correlations between lifestyle and cardio-metabolic risk in these students.

  18. Self-reported screen time and cardiometabolic risk in obese Dutch adolescents.

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    Teatske M Altenburg

    Full Text Available BACKGROUND: It is not clear whether the association between sedentary time and cardiometabolic risk exists among obese adolescents. We examined the association between screen time (TV and computer time and cardiometabolic risk in obese Dutch adolescents. METHODS AND FINDINGS: For the current cross-sectional study, baseline data of 125 Dutch overweight and obese adolescents (12-18 years participating in the Go4it study were included. Self-reported screen time (Activity Questionnaire for Adolescents and Adults and clustered and individual cardiometabolic risk (i.e. body composition, systolic and diastolic blood pressure, low-density (LDL-C, high-density (HDL-C and total cholesterol (TC, triglycerides, glucose and insulin were assessed in all participants. Multiple linear regression analyses were used to assess the association between screen time and cardiometabolic risk, adjusting for age, gender, pubertal stage, ethnicity and moderate-to-vigorous physical activity. We found no significant relationship between self-reported total screen time and clustered cardiometabolic risk or individual risk factors in overweight and obese adolescents. Unexpectedly, self-reported computer time, but not TV time, was slightly but significantly inversely associated with TC (B = -0.002; CI = [-0.003;-0.000] and LDL-C (B = -0.002; CI = [-0.001;0.000]. CONCLUSIONS: In obese adolescents we could not confirm the hypothesised positive association between screen time and cardiometabolic risk. Future studies should consider computer use as a separate class of screen behaviour, thereby also discriminating between active video gaming and other computer activities.

  19. Hypertension Control and Cardiometabolic Risk: A Regional Perspective

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    Martin Thoenes

    2012-01-01

    Full Text Available Background. We investigated the association between blood pressure control and common cardiometabolic risk factors from a global and regional perspective. Methods. In the present analysis of a large cross-sectional i-SEARCH study, 17.092 outpatients receiving antihypertensive treatment were included in 26 countries. According to clinical guidelines for the management of arterial hypertension, patients were classified based on the level of seated systolic/diastolic blood pressure (SBP/DBP. Uncontrolled hypertension was defined as SBP/DBP ≥140/90 mmHg for non-diabetics, and ≥130/80 mmHg for diabetics. Results. Overall, mean age was 63.1 years, 52.8% were male, and mean BMI was 28.9 kg/m2. Mean SBP/DBP was 148.9/87.0 mmHg, and 76.3% of patients had uncontrolled hypertension. Diabetes was present in 29.1% with mean HbA1c of 6.8%. Mean LDL-cholesterol was 3.2 mmol/L, HDL-cholesterol 1.3 mmol/L, and triglycerides 1.8 mmol/L; 49.0% had hyperlipidemia. Patients with uncontrolled hypertension had a higher BMI (29.4 versus 28.6 kg/m2, LDL-cholesterol (3.4 versus 3.0 mmol/L, triglycerides (1.9 versus 1.7 mmol/L, and HbA1c (6.8 versus 6.7% than those with controlled blood pressure (P<0.0001 for all parameters. Conclusions. Among outpatients treated for arterial hypertension, three quarters had uncontrolled blood pressure. Elevated SBP/DBP and uncontrolled hypertension were associated with increasing BMI, LDL-cholesterol, triglycerides, and HbA1c, both globally and regionally.

  20. Longitudinal associations between BMI, waist circumference, and cardiometabolic risk in US youth: Monitoring implications

    Science.gov (United States)

    This study examined whether change in body mass index (BMI) or waist circumference (WC)is associated with change in cardiometabolic risk factors and differences between cardiovascular disease specific and diabetes specific risk factors among adolescents. We also sought to examine any differences by ...

  1. Improvements in body composition, cardiometabolic risk factors and insulin sensitivity with trenbolone in normogonadic rats.

    Science.gov (United States)

    Donner, Daniel G; Beck, Belinda R; Bulmer, Andrew C; Lam, Alfred K; Du Toit, Eugene F

    2015-02-01

    Trenbolone (TREN) is used for anabolic growth-promotion in over 20 million cattle annually and continues to be misused for aesthetic purposes in humans. The current study investigated TREN's effects on body composition and cardiometabolic risk factors; and its tissue-selective effects on the cardiovascular system, liver and prostate. Male rats (n=12) were implanted with osmotic infusion pumps delivering either cyclodextrin vehicle (CTRL) or 2mg/kg/day TREN for 6 weeks. Dual-energy X-ray Absorptiometry assessment of body composition; organ wet weights and serum lipid profiles; and insulin sensitivity were assessed. Cardiac ultrasound examinations were performed before in vivo studies assessed myocardial susceptibility to ischemia-reperfusion (I/R) injury. Circulating sex hormones and liver enzyme activities; and prostate and liver histology were examined. In 6 weeks, fat mass increased by 34±7% in CTRLs (pTREN (pTREN rats. Histological examination of the prostates from TREN-treated rats indicated benign hyperplasia associated with an increased prostate mass (149% compared to CTRLs, pTREN treatment without evidence of adverse cardiovascular or hepatic effects that are commonly associated with traditional anabolic steroid misuse. Sex hormone suppression and benign prostate hyperplasia were confirmed as adverse effects of the treatment.

  2. The cardiometabolic benefits of flavonoids and dark chocolate intake in patients at risk

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    Andra-Iulia Suceveanu

    2014-02-01

    Full Text Available Scientific research proves that the cardiac and the metabolic functions are improved by the consumption of flavonoids, natural elements found in cocoa. The dark chocolate is the main alimentary compound rich in flavonoids, and for this reason it can be used to prevent some cardiometabolic disorders. This study aims to demonstrate the relationship between chocolate consumption and the cardiometabolic disorders risk in 85 patients hospitalized in Internal Medicine Unit of Emergency Hospital “St. Apostle Andrew” of Constanta. Patients were split according to the quantity of the dark chocolate consumption into 2 groups. The study groups were matched by the demographic parameters, the BMI, the physical activity and other risk factors (fats, saturated lipids, etc. We found that the daily consumption of dark chocolate, with content of cocoa > 35% according to European recommendations, had cardiometabolic benefits. The risk of coronary heart disease was reduced with 23% by the daily dark chocolate intake. The cardiovascular disease mortality and the risk of any cardiovascular disease were decreased with 19%, respectively with 38%. The risk of incident diabetes decreased with 28% after daily dark chocolate consumption, regardless the gender of patients. The number of ischemic cerebral events was reduced with 32%. In summary, the daily consumption of dark chocolate rich in flavonoids decreases the cardiometabolic disorders in patients at risk [1].

  3. Cardiometabolic and vascular risks in young and adolescent girls with Turner syndrome

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    Meenal Mavinkurve

    2015-06-01

    General significance: From a clinical perspective, this review highlights the importance of regular screening and pro-active management of cardiometabolic risk from childhood in TS cohorts and that future research should aim to address whether modification of these variables at a young age can alter the disease process and atherosclerotic outcomes in adulthood.

  4. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

    NARCIS (Netherlands)

    Lu, Yingchang; Day, Felix R; Gustafsson, Stefan; Buchkovich, Martin L; Na, Jianbo; Bataille, Veronique; Cousminer, Diana L; Dastani, Zari; Drong, Alexander W; Esko, Tõnu; Evans, David M; Falchi, Mario; Feitosa, Mary F; Ferreira, Teresa; Hedman, Åsa K; Haring, Robin; Hysi, Pirro G; Iles, Mark M; Justice, Anne E; Kanoni, Stavroula; Lagou, Vasiliki; Li, Rui; Li, Xin; Locke, Adam; Lu, Chen; Mägi, Reedik; Perry, John R B; Pers, Tune H; Qi, Qibin; Sanna, Marianna; Schmidt, Ellen M; Scott, William R; Shungin, Dmitry; Teumer, Alexander; Vinkhuyzen, Anna A E; Walker, Ryan W; Westra, Harm-Jan; Zhang, Mingfeng; Zhang, Weihua; Zhao, Jing Hua; Zhu, Zhihong; Afzal, Uzma; Ahluwalia, Tarunveer Singh; Bakker, Stephan J L; Bellis, Claire; Bonnefond, Amélie; Borodulin, Katja; Buchman, Aron S; Cederholm, Tommy; Choh, Audrey C; Choi, Hyung Jin; Curran, Joanne E; de Groot, Lisette C P G M; De Jager, Philip L; Dhonukshe-Rutten, Rosalie A M; Enneman, Anke W; Eury, Elodie; Evans, Daniel S; Forsen, Tom; Friedrich, Nele; Fumeron, Frédéric; Garcia, Melissa E; Gärtner, Simone; Han, Bok-Ghee; Havulinna, Aki S; Hayward, Caroline; Hernandez, Dena; Hillege, Hans; Ittermann, Till; Kent, Jack W; Kolcic, Ivana; Laatikainen, Tiina; Lahti, Jari; Mateo Leach, Irene; Lee, Christine G; Lee, Jong-Young; Liu, Tian; Liu, Youfang; Lobbens, Stéphane; Loh, Marie; Lyytikäinen, Leo-Pekka; Medina-Gomez, Carolina; Michaëlsson, Karl; Nalls, Mike A; Nielson, Carrie M; Oozageer, Laticia; Pascoe, Laura; Paternoster, Lavinia; Polašek, Ozren; Ripatti, Samuli; Sarzynski, Mark A; Shin, Chan Soo; Narančić, Nina Smolej; Spira, Dominik; Srikanth, Priya; Steinhagen-Thiessen, Elisabeth; Sung, Yun Ju; Swart, Karin M A; Taittonen, Leena; Tanaka, Toshiko; Tikkanen, Emmi; van der Velde, Nathalie; van Schoor, Natasja M; Verweij, Niek; Wright, Alan F; Yu, Lei; Zmuda, Joseph M; Eklund, Niina; Forrester, Terrence; Grarup, Niels; Jackson, Anne U; Kristiansson, Kati; Kuulasmaa, Teemu; Kuusisto, Johanna; Lichtner, Peter; Luan, Jian'an; Mahajan, Anubha; Männistö, Satu; Palmer, Cameron D; Ried, Janina S; Scott, Robert A; Stancáková, Alena; Wagner, Peter J; Demirkan, Ayse; Döring, Angela; Gudnason, Vilmundur; Kiel, Douglas P; Kühnel, Brigitte; Mangino, Massimo; Mcknight, Barbara; Menni, Cristina; O'Connell, Jeffrey R; Oostra, Ben A; Shuldiner, Alan R; Song, Kijoung; Vandenput, Liesbeth; van Duijn, Cornelia M; Vollenweider, Peter; White, Charles C; Boehnke, Michael; Boettcher, Yvonne; Cooper, Richard S; Forouhi, Nita G; Gieger, Christian; Grallert, Harald; Hingorani, Aroon; Jørgensen, Torben; Jousilahti, Pekka; Kivimaki, Mika; Kumari, Meena; Laakso, Markku; Langenberg, Claudia; Linneberg, Allan; Luke, Amy; Mckenzie, Colin A; Palotie, Aarno; Pedersen, Oluf; Peters, Annette; Strauch, Konstantin; Tayo, Bamidele O; Wareham, Nicholas J; Bennett, David A; Bertram, Lars; Blangero, John; Blüher, Matthias; Bouchard, Claude; Campbell, Harry; Cho, Nam H; Cummings, Steven R; Czerwinski, Stefan A; Demuth, Ilja; Eckardt, Rahel; Eriksson, Johan G; Ferrucci, Luigi; Franco, Oscar H; Froguel, Philippe; Gansevoort, Ron T; Hansen, Torben; Harris, Tamara B; Hastie, Nicholas; Heliövaara, Markku; Hofman, Albert; Jordan, Joanne M; Jula, Antti; Kähönen, Mika; Kajantie, Eero; Knekt, Paul B; Koskinen, Seppo; Kovacs, Peter; Lehtimäki, Terho; Lind, Lars; Liu, Yongmei; Orwoll, Eric S; Osmond, Clive; Perola, Markus; Pérusse, Louis; Raitakari, Olli T; Rankinen, Tuomo; Rao, D C; Rice, Treva K; Rivadeneira, Fernando; Rudan, Igor; Salomaa, Veikko; Sørensen, Thorkild I A; Stumvoll, Michael; Tönjes, Anke; Towne, Bradford; Tranah, Gregory J; Tremblay, Angelo; Uitterlinden, André G; van der Harst, Pim; Vartiainen, Erkki; Viikari, Jorma S; Vitart, Veronique; Vohl, Marie-Claude; Völzke, Henry; Walker, Mark; Wallaschofski, Henri; Wild, Sarah; Wilson, James F; Yengo, Loïc; Bishop, D Timothy; Borecki, Ingrid B; Chambers, John C; Cupples, L Adrienne; Dehghan, Abbas; Deloukas, Panos; Fatemifar, Ghazaleh; Fox, Caroline; Furey, Terrence S; Franke, Lude; Han, Jiali; Hunter, David J; Karjalainen, Juha; Karpe, Fredrik; Kaplan, Robert C; Kooner, Jaspal S; McCarthy, Mark I; Murabito, Joanne M; Morris, Andrew P; Bishop, Julia A N; North, Kari E; Ohlsson, Claes; Ong, Ken K; Prokopenko, Inga; Richards, J Brent; Schadt, Eric E; Spector, Tim D; Widén, Elisabeth; Willer, Cristen J; Yang, Jian; Ingelsson, Erik; Mohlke, Karen L; Hirschhorn, Joel N; Pospisilik, John Andrew; Zillikens, M Carola; Lindgren, Cecilia; Kilpeläinen, Tuomas Oskari; Loos, Ruth J F

    2016-01-01

    To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10(-8)), of which eight w

  5. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

    NARCIS (Netherlands)

    Y. Lu (Yingchang); F.R. Day (Felix); S. Gustafsson (Stefan); M.L. Buchkovich (Martin); Na, J. (Jianbo); V. Bataille (Veronique); D.L. Cousminer (Diana); Z. Dastani (Zari); A. Drong (Alexander); T. Esko (Tõnu); D.M. Evans (David); M. Falchi (Mario); M.F. Feitosa (Mary Furlan); T. Ferreira (Teresa); A.K. Hedman (Asa); R. Haring (Robin); P.G. Hysi (Pirro); M.M. Iles (Mark M.); A.E. Justice (Anne); S. Kanoni (Stavroula); V. Lagou (Vasiliki); R. Li (Rui); X. Li (Xin); A. Locke (Adam); C. Lu (Chao); R. Mägi (Reedik); J.R.B. Perry (John); T.H. Pers (Tune); Q. Qi; Sanna, M. (Marianna); E.M. Schmidt (Ellen); W.R. Scott (William R.); D. Shungin (Dmitry); A. Teumer (Alexander); A.A.E. Vinkhuyzen (Anna A.); Walker, R.W. (Ryan W.); H.J. Westra (Harm-Jan); M. Zhang (Mingfeng); W. Zhang (Weihua); J.H. Zhao; Z. Zhu; U. Afzal (Uzma); T.S. Ahluwalia (Tarunveer Singh); S.J.L. Bakker (Stephan); C. Bellis (Claire); A. Bonnefond (Amélie); K. Borodulin (Katja); Buchman, A.S. (Aron S.); T. Cederholm (Tommy); A.C. Choh (Audrey); Choi, H.J. (Hyung Jin); J.E. Curran (Joanne); L.C.P.G.M. de Groot (Lisette); P.L. de Jager (Philip); R.A.M. Dhonukshe-Rutten (Rosalie); A.W. Enneman (Anke); E. Eury (Elodie); D.S. Evans (Daniel); T. Forsen (Tom); N. Friedrich (Nele); Fumeron, F. (Frédéric); M. Garcia (Melissa); Gärtner, S. (Simone); B.-G. Han; A.S. Havulinna (Aki); C. Hayward (Caroline); D.G. Hernandez (Dena); H.L. Hillege (Hans); T. Ittermann (Till); J.W. Kent (Jack W.); I. Kolcic (Ivana); T. Laatikainen (Tiina); J. Lahti (Jari); I.M. Leach (Irene Mateo); Lee, C.G. (Christine G.); J.-Y. Lee (Jong-Young); T. Liu (Tian); Liu, Y. (Youfang); S. Lobbens (Stéphane); Loh, M. (Marie); L.-P. Lyytikäinen (Leo-Pekka); Medina-Gomez, C. (Carolina); K. Michaëlsson; M.A. Nalls (Michael); C. Nielson (Carrie); L. Oozageer (Laticia); L. Pascoe (Laura); L. Paternoster (Lavinia); O. Polasek (Ozren); S. Ripatti (Samuli); M.A. Sarzynski (Mark A.); Shin, C.S. (Chan Soo); Naranäiä, N.S. (Nina Smolej); Spira, D. (Dominik); P. Srikanth (Priya); Steinhagen-Thiessen, E. (Elisabeth); Sung, Y.J. (Yun Ju); K.M.A. Swart (Karin); Taittonen, L. (Leena); T. Tanaka (Toshiko); E. Tikkanen (Emmi); N. van der Velde (Nathalie); N.M. van Schoor (Natasja); N. Verweij (Niek); A.F. Wright (Alan); L. Yu (Lei); J. Zmuda (Joseph); N. Eklund (Niina); T. Forrester (Terrence); N. Grarup (Niels); A.U. Jackson (Anne); K. Kristiansson (Kati); T. Kuulasmaa (Teemu); J. Kuusisto (Johanna); P. Lichtner (Peter); J. Luan (Jian'An); A. Mahajan (Anubha); S. Männistö (Satu); C. Palmer (Cameron); J.S. Ried (Janina); R.A. Scott (Robert); A. Stancáková (Alena); P.J. Wagner (Peter); A. Demirkan (Ayşe); A. Döring (Angela); V. Gudnason (Vilmundur); D.P. Kiel (Douglas P.); B. Kuhnel (Brigitte); M. Mangino (Massimo); B. McKnight (Barbara); C. Menni (Cristina); O'Connell, J.R. (Jeffrey R.); B.A. Oostra (Ben); A.R. Shuldiner (Alan); K. Song (Kijoung); L. Vandenput (Liesbeth); C.M. van Duijn (Cock); P. Vollenweider (Peter); C.C. White (Charles); M. Boehnke (Michael); Boettcher, Y. (Yvonne); Cooper, R.S. (Richard S.); N.G. Forouhi (Nita); C. Gieger (Christian); H. Grallert (Harald); A. Hingorani (Aroon); T. Jorgensen (Torben); P. Jousilahti (Pekka); M. Kivimaki (Mika); M. Kumari (Meena); M. Laakso (Markku); C. Langenberg (Claudia); A. Linneberg (Allan); Luke, A. (Amy); C.A. McKenzie (Colin); A. Palotie (Aarno); O. Pedersen (Oluf); A. Peters (Annette); K. Strauch (Konstantin); B. Tayo (Bamidele); N.J. Wareham (Nick); D.A. Bennett (David A.); L. Bertram (Lars); J. Blangero (John); M. Blüher (Matthias); C. Bouchard (Claude); H. Campbell (Harry); Cho, N.H. (Nam H.); S.R. Cummings (Steven R.); S.A. Czerwinski (Stefan); I. Demuth (Ilja); Eckardt, R. (Rahel); K. Hagen (Knut); L. Ferrucci (Luigi); O.H. Franco (Oscar); P. Froguel (Philippe); R.T. Gansevoort (Ron); T. Hansen (T.); T.B. Harris (Tamara); N. Hastie (Nick); M. Heliovaara (Markku); Hofman, A. (Albert); Jordan, J.M. (Joanne M.); A. Jula (Antti); M. Kähönen (Mika); E. Kajantie (Eero); P. Knekt; Koskinen, S. (Seppo); P. Kovacs (Peter); T. Lehtimäki (Terho); W.H.L. Kao (Wen); Y. Liu (Yongmei); E.S. Orwoll (Eric); C. Osmond (Clive); M. Perola (Markus); L. Perusse (Louis); Raitakari, O.T. (Olli T.); T. Rankinen (Tuomo); Rao, D.C.; Rice, T.K. (Treva K.); F. Rivadeneira Ramirez (Fernando); I. Rudan (Igor); V. Salomaa (Veikko); T.I.A. Sørensen (Thorkild); M. Stumvoll (Michael); A. Tönjes (Anke); B. Towne (Bradford); G.J. Tranah (Gregory); Tremblay, A. (Angelo); A.G. Uitterlinden (André); P. van der Harst (Pim); Vartiainen, E. (Erkki); J. Viikari (Jorma); Vitart, V. (Veronique); M.-C. Vohl (Marie-Claude); H. Völzke (Henry); Walker, M. (Mark); H. Wallaschofski (Henri); S.H. Wild (Sarah); J.F. Wilson (James F.); L. Yengo (Loic); D.T. Bishop (David Timothy); I.B. Borecki (Ingrid); J.C. Chambers (John C.); L.A. Cupples (Adrienne); A. Dehghan (Abbas); P. Deloukas (Panagiotis); Fatemifar, G. (Ghazaleh); C.S. Fox (Caroline); Furey, T.S. (Terrence S.); L. Franke (Lude); J. Han; D. Hunter (David); J. Karjalainen (Juha); F. Karpe (Fredrik); R.C. Kaplan (Robert); J.S. Kooner (Jaspal S.); M.I. McCarthy (Mark); J. Murabito (Joanne); A.P. Morris (Andrew); Bishop, J.A.N. (Julia A. N.); K.E. North (Kari); C. Ohlsson (Claes); K.K. Ong (Ken); I. Prokopenko (Inga); Richards, J.B. (J. Brent); E.E. Schadt (Eric); T.D. Spector (Timothy); E. Widen (Elisabeth); C.J. Willer (Cristen); J. Yang (Joanna); Ingelsson, E. (Erik); K.L. Mohlke (Karen); J.N. Hirschhorn (Joel); J.A. Pospisilik (Andrew); M.C. Zillikens (Carola); C.M. Lindgren (Cecilia M.); T.O. Kilpeläinen (Tuomas); R.J.F. Loos (Ruth)

    2016-01-01

    textabstractTo increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (Po5108), of which e

  6. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

    DEFF Research Database (Denmark)

    Lu, Yingchang; Day, Felix R; Gustafsson, Stefan

    2016-01-01

    To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10(-8)), of which eigh...

  7. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

    NARCIS (Netherlands)

    Lu, Y.; Groot, de C.P.G.M.; Dhonukshe-Rutten, R.A.M.

    2016-01-01

    To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10−8), of which eight

  8. Neighborhood street scale elements, sedentary time and cardiometabolic risk factors in inactive ethnic minority women.

    Directory of Open Access Journals (Sweden)

    Rebecca E Lee

    Full Text Available BACKGROUND: Cardiometabolic risk factors such as obesity, excess percent body fat, high blood pressure, elevated resting heart rate and sedentary behavior have increased in recent decades due to changes in the environment and lifestyle. Neighborhood micro-environmental, street scale elements may contribute to health above and beyond individual characteristics of residents. PURPOSE: To investigate the relationship between neighborhood street scale elements and cardiometabolic risk factors among inactive ethnic minority women. METHOD: Women (N = 410 completed measures of BMI, percent body fat, blood pressure, resting heart rate, sedentary behavior and demographics. Trained field assessors completed the Pedestrian Environment Data Scan in participants' neighborhoods. Data were collected from 2006-2008. Multiple regression models were conducted in 2011 to estimate the effect of environmental factors on cardiometabolic risk factors. RESULTS: Adjusted regression models found an inverse association between sidewalk buffers and blood pressure, between traffic control devices and resting heart rate, and a positive association between presence of pedestrian crossing aids and BMI (ps<.05. Neighborhood attractiveness and safety for walking and cycling were related to more time spent in a motor vehicle (ps<.05. CONCLUSIONS: Findings suggest complex relationships among micro-environmental, street scale elements that may confer important cardiometabolic benefits and risks for residents. Living in the most attractive and safe neighborhoods for physical activity may be associated with longer times spent sitting in the car.

  9. Mendelian randomization suggests non-causal associations of testosterone with cardiometabolic risk factors and mortality.

    Science.gov (United States)

    Haring, R; Teumer, A; Völker, U; Dörr, M; Nauck, M; Biffar, R; Völzke, H; Baumeister, S E; Wallaschofski, H

    2013-01-01

    Prospective studies showed that low serum testosterone concentrations are associated with various cardiometabolic risk factors and mortality. However, the causal nature of these associations is controversial. We studied 1 882 men aged 20-79 years with serum testosterone concentrations and genotyping data from the longitudinal population-based Study of Health in Pomerania. Testosterone concentrations were cross-sectionally associated with cardiometabolic risk factors, including anthropometric, lipid, blood pressure and glycaemic parameters; and prospectively with all-cause mortality (277 deaths, 14.7%) during the 10-year follow-up. To overcome problems of residual confounding, reverse causation, or regression dilution bias in the investigated testosterone-outcome associations, we used two-stage least square regression models with previously identified polymorphisms at the SHBG gene (rs12150660) and X chromosome (rs5934505) as multiple genetic instruments in an instrumental variable (IV) approach, also known as Mendelian randomization. In standard regression analyses, testosterone was robustly associated with a wide range of cardiometabolic risk factors. In subsequent IV analyses, no such significant associations were observed. Similarly, prospective analyses showed a consistent association of low testosterone concentrations with increased all-cause mortality risk, which was not apparent in subsequent IV analyses. The present Mendelian randomization analyses did not detect any evidence for causal associations of testosterone concentrations with cardiometabolic risk factors and mortality, suggesting that previously reported associations might largely result from residual confounding or reverse causation. Although testosterone assessment might improve risk prediction, implementation of testosterone replacement therapy requires further evidence of a direct effect on cardiometabolic outcomes from double-blinded randomized controlled trials and large-scale Mendelian

  10. Omega-3 fatty acids and cardiovascular disease: epidemiology and effects on cardiometabolic risk factors.

    Science.gov (United States)

    Mori, Trevor A

    2014-09-01

    Clinical and epidemiological studies provide support that the polyunsaturated omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid from fish and fish oils are cardioprotective, particularly in the setting of secondary prevention. Omega-3 fatty acids benefit multiple cardiometabolic risk factors including lipids, blood pressure, vascular reactivity and cardiac function, as well as having antithrombotic, anti-inflammatory and anti-oxidative actions. Omega-3 fatty acids do not associate with any adverse effects and do not adversely interact with prescriptive drugs such as lipid-lowering, antihypertensive or hypoglycaemic medications. Clinical studies suggest that doses up to 4 g daily when prescribed with anticoagulant or antiplatelet drugs do not associate with increased risk of major bleeding episodes. Omega-3 fatty acids have gained widespread usage by general practitioners and clinicians in clinical settings such as pregnancy and infant development, secondary prevention in coronary heart disease patients and treatment of dyslipidaemias. Health authorities currently recommend an intake of at least two oily fish meals per week for the general population which equates to approximately 500 mg per day of eicosapentaenoic acid and docosahexaenoic acid. In patients with coronary heart disease the guidelines recommend 1 g daily supplements and in hypertriglyceridaemic patients up to 4 g per day. These doses are now achievable with readily available purified encapsulated preparations of omega-3 fatty acids. However, a more practical recommendation for increasing omega-3 fatty acid intake in the general population is to incorporate fish as part of a healthy diet that includes increased consumption of fruits and vegetables, and moderation of salt intake.

  11. Comprehensive Review of the Impact of Dairy Foods and Dairy Fat on Cardiometabolic Risk.

    Science.gov (United States)

    Drouin-Chartier, Jean-Philippe; Côté, Julie Anne; Labonté, Marie-Ève; Brassard, Didier; Tessier-Grenier, Maude; Desroches, Sophie; Couture, Patrick; Lamarche, Benoît

    2016-11-01

    Because regular-fat dairy products are a major source of cholesterol-raising saturated fatty acids (SFAs), current US and Canadian dietary guidelines for cardiovascular health recommend the consumption of low-fat dairy products. Yet, numerous randomized controlled trials (RCTs) have reported rather mixed effects of reduced- and regular-fat dairy consumption on blood lipid concentrations and on many other cardiometabolic disease risk factors, such as blood pressure and inflammation markers. Thus, the focus on low-fat dairy in current dietary guidelines is being challenged, creating confusion within health professional circles and the public. This narrative review provides perspective on the research pertaining to the impact of dairy consumption and dairy fat on traditional and emerging cardiometabolic disease risk factors. This comprehensive assessment of evidence from RCTs suggests that there is no apparent risk of potential harmful effects of dairy consumption, irrespective of the content of dairy fat, on a large array of cardiometabolic variables, including lipid-related risk factors, blood pressure, inflammation, insulin resistance, and vascular function. This suggests that the purported detrimental effects of SFAs on cardiometabolic health may in fact be nullified when they are consumed as part of complex food matrices such as those in cheese and other dairy foods. Thus, the focus on low-fat dairy products in current guidelines apparently is not entirely supported by the existing literature and may need to be revisited on the basis of this evidence. Future studies addressing key research gaps in this area will be extremely informative to better appreciate the impact of dairy food matrices, as well as dairy fat specifically, on cardiometabolic health.

  12. Anti-mullerian hormone is not associated with cardiometabolic risk factors in adolescent females.

    Directory of Open Access Journals (Sweden)

    Emma L Anderson

    Full Text Available Epidemiological evidence for associations of Anti-Müllerian hormone (AMH with cardiometabolic risk factors is lacking. Existing evidence comes from small studies in select adult populations, and findings are conflicting. We aimed to assess whether AMH is associated with cardiometabolic risk factors in a general population of adolescent females.AMH, fasting insulin, glucose, HDLc, LDLc, triglycerides and C-reactive protein (CRP were measured at a mean age 15.5 years in 1,308 female participants in the Avon Longitudinal Study of Parents and Children (ALSPAC. Multivariable linear regression was used to examine associations of AMH with these cardiometabolic outcomes.AMH values ranged from 0.16-35.84 ng/ml and median AMH was 3.57 ng/ml (IQR: 2.41, 5.49. For females classified as post-pubertal (n = 848 at the time of assessment median (IQR AMH was 3.81 ng/ml (2.55, 5.82 compared with 3.25 ng/ml (2.23, 5.05 in those classed as early pubertal (n = 460, P≤0.001. After adjusting for birth weight, gestational age, pubertal stage, age, ethnicity, socioeconomic position, adiposity and use of hormonal contraceptives, there were no associations with any of the cardiometabolic outcomes. For example fasting insulin changed by 0% per doubling of AMH (95%CI: -3%,+2% p  = 0.70, with identical results if HOMA-IR was used. Results were similar after additional adjustment for smoking, physical activity and age at menarche, after exclusion of 3% of females with the highest AMH values, after excluding those that had not started menarche and after excluding those using hormonal contraceptives.Our results suggest that in healthy adolescent females, AMH is not associated with cardiometabolic risk factors.

  13. Cardiometabolic risk factors in Iranians with spinal cord injury: Analysis by injury-related variables

    Directory of Open Access Journals (Sweden)

    Hadis Sabour, MD, PhD

    2013-08-01

    Full Text Available Persons with spinal cord injury (SCI have a high prevalence of abnormalities in carbohydrate and lipid metabolism. These abnormalities cause adverse coronary heart disease (CHD in patients with SCI. In this study, we performed a detailed analysis of the level-specific cardiometabolic risk factors in individuals with SCI and analyzed the association of injury level on these risk factors. This was a cross-sectional study of 162 patients with SCI, assessing the prevalence of diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking. Fasting blood sugar (>100 was diagnosed in 27 patients (16.7%. Of the total patients, 36 (22.2% had a total cholesterol (TC level of >200. A triglyceride level of >150 was present in 56 patients (34.6%. Hypertension was present in 2.5% of the entire patient group. Body mass index (BMI, TC, and low-density lipoprotein cholesterol (LDL-C were significantly higher in the paraplegia group than the tetraplegia group (24.44 +/– 4.23 vs 22.65 +/– 4.27, p = 0.01; 185.71 +/– 40.69 vs 163.28 +/– 37.92, p < 0.001; and 102.51 +/– 28.20 vs 89.15 +/– 22.35, p = 0.01, respectively. Patients with paraplegia may have increased hypertension, higher BMI, and increasing levels of serum LDL-C and TC than those with tetraplegia. Conventional risk factors for CHD should be identified and treated in individuals with SCI.

  14. Genetic risk scores link body fat distribution with specific cardiometabolic profiles

    DEFF Research Database (Denmark)

    Svendstrup, Mathilde; Sandholt, Camilla H; Andersson Galijatovic, Ehm Astrid

    2016-01-01

    OBJECTIVE: Forty-nine known single nucleotide polymorphisms (SNPs) associating with body mass index (BMI)-adjusted waist-hip-ratio (WHR) (WHRadjBMI) were recently suggested to cluster into three groups with different associations to cardiometabolic traits. Genetic risk scores of the clusters......, including fasting serum triglyceride (β = 0.98% mmol/L, P = 3.33 × 10(-) (8) ) and Matsuda index (β = -0.74%, P = 1.29 × 10(-) (4) ). No similar associations for Clusters 2 and 3 were found. The three clusters showed different patterns of association with waist circumference, hip circumference, and height...... on the risk of incident diabetes and associations with detailed cardiometabolic phenotypes were tested. METHODS: In a prospective study of 6,121 Inter99 individuals, the risk of incident diabetes using Cox proportional hazards regression was evaluated. Using linear regession, the associations between genetic...

  15. Potential role of the endocannabinoid receptor antagonist rimonabant in the management of cardiometabolic risk: a narrative review of available data

    Directory of Open Access Journals (Sweden)

    Kirk A Bronander

    2007-05-01

    Full Text Available Kirk A Bronander1, Michael J Bloch21Division of General Internal Medicine, 2Divisions of Cardiology and General Internal Medicine, Department of Medicine, University of Nevada School of Medicine, Reno, NV, USAAbstract: The endocannabinoid system (ECS is an endogenous physiological system composed of two cannabinoid receptors and several endogenous ligands. The ECS is intimately involved in appetite regulation and energy homeostasis, which makes it an intriguing target for pharmacological treatment of obesity, diabetes, and the metabolic syndrome. Rimonabant is the first cannabinoid receptor (CB-1 antagonist being studied and utilized to treat obesity (it is approved in Europe but is currently under review in the United States. Large randomized trials with rimonabant have demonstrated efficacy in treatment of overweight and obese individuals with weight loss significantly greater than a reduced calorie diet alone. In addition, multiple other cardiometabolic parameters were improved in the treatment groups including increased levels of high density lipoprotein cholesterol, reduced triglycerides, reduced waist circumference, improved insulin sensitivity, decreased insulin levels, and in diabetic patients improvement in glycosylated hemoglobin percentage. There was an increase in the adverse effects of depression, anxiety, irritability, and nausea in rimonabant-treated groups. This novel medication may become an important therapeutic option in the fight to reduce cardiovascular disease worldwide through its unique action on cardiometabolic risk.Keywords: rimonabant, endocannabinoid, metabolic syndrome, obesity

  16. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

    Science.gov (United States)

    Lu, Yingchang; Day, Felix R.; Gustafsson, Stefan; Buchkovich, Martin L.; Na, Jianbo; Bataille, Veronique; Cousminer, Diana L.; Dastani, Zari; Drong, Alexander W.; Esko, Tõnu; Evans, David M.; Falchi, Mario; Feitosa, Mary F.; Ferreira, Teresa; Hedman, Åsa K.; Haring, Robin; Hysi, Pirro G.; Iles, Mark M.; Justice, Anne E.; Kanoni, Stavroula; Lagou, Vasiliki; Li, Rui; Li, Xin; Locke, Adam; Lu, Chen; Mägi, Reedik; Perry, John R. B.; Pers, Tune H.; Qi, Qibin; Sanna, Marianna; Schmidt, Ellen M.; Scott, William R.; Shungin, Dmitry; Teumer, Alexander; Vinkhuyzen, Anna A. E.; Walker, Ryan W.; Westra, Harm-Jan; Zhang, Mingfeng; Zhang, Weihua; Zhao, Jing Hua; Zhu, Zhihong; Afzal, Uzma; Ahluwalia, Tarunveer Singh; Bakker, Stephan J. L.; Bellis, Claire; Bonnefond, Amélie; Borodulin, Katja; Buchman, Aron S.; Cederholm, Tommy; Choh, Audrey C.; Choi, Hyung Jin; Curran, Joanne E.; de Groot, Lisette C. P. G. M.; De Jager, Philip L.; Dhonukshe-Rutten, Rosalie A. M.; Enneman, Anke W.; Eury, Elodie; Evans, Daniel S.; Forsen, Tom; Friedrich, Nele; Fumeron, Frédéric; Garcia, Melissa E.; Gärtner, Simone; Han, Bok-Ghee; Havulinna, Aki S.; Hayward, Caroline; Hernandez, Dena; Hillege, Hans; Ittermann, Till; Kent, Jack W.; Kolcic, Ivana; Laatikainen, Tiina; Lahti, Jari; Leach, Irene Mateo; Lee, Christine G.; Lee, Jong-Young; Liu, Tian; Liu, Youfang; Lobbens, Stéphane; Loh, Marie; Lyytikäinen, Leo-Pekka; Medina-Gomez, Carolina; Michaëlsson, Karl; Nalls, Mike A.; Nielson, Carrie M.; Oozageer, Laticia; Pascoe, Laura; Paternoster, Lavinia; Polašek, Ozren; Ripatti, Samuli; Sarzynski, Mark A.; Shin, Chan Soo; Narančić, Nina Smolej; Spira, Dominik; Srikanth, Priya; Steinhagen-Thiessen, Elisabeth; Sung, Yun Ju; Swart, Karin M. A.; Taittonen, Leena; Tanaka, Toshiko; Tikkanen, Emmi; van der Velde, Nathalie; van Schoor, Natasja M.; Verweij, Niek; Wright, Alan F.; Yu, Lei; Zmuda, Joseph M.; Eklund, Niina; Forrester, Terrence; Grarup, Niels; Jackson, Anne U.; Kristiansson, Kati; Kuulasmaa, Teemu; Kuusisto, Johanna; Lichtner, Peter; Luan, Jian'an; Mahajan, Anubha; Männistö, Satu; Palmer, Cameron D.; Ried, Janina S.; Scott, Robert A.; Stancáková, Alena; Wagner, Peter J.; Demirkan, Ayse; Döring, Angela; Gudnason, Vilmundur; Kiel, Douglas P.; Kühnel, Brigitte; Mangino, Massimo; Mcknight, Barbara; Menni, Cristina; O'Connell, Jeffrey R.; Oostra, Ben A.; Shuldiner, Alan R.; Song, Kijoung; Vandenput, Liesbeth; van Duijn, Cornelia M.; Vollenweider, Peter; White, Charles C.; Boehnke, Michael; Boettcher, Yvonne; Cooper, Richard S.; Forouhi, Nita G.; Gieger, Christian; Grallert, Harald; Hingorani, Aroon; Jørgensen, Torben; Jousilahti, Pekka; Kivimaki, Mika; Kumari, Meena; Laakso, Markku; Langenberg, Claudia; Linneberg, Allan; Luke, Amy; Mckenzie, Colin A.; Palotie, Aarno; Pedersen, Oluf; Peters, Annette; Strauch, Konstantin; Tayo, Bamidele O.; Wareham, Nicholas J.; Bennett, David A.; Bertram, Lars; Blangero, John; Blüher, Matthias; Bouchard, Claude; Campbell, Harry; Cho, Nam H.; Cummings, Steven R.; Czerwinski, Stefan A.; Demuth, Ilja; Eckardt, Rahel; Eriksson, Johan G.; Ferrucci, Luigi; Franco, Oscar H.; Froguel, Philippe; Gansevoort, Ron T.; Hansen, Torben; Harris, Tamara B.; Hastie, Nicholas; Heliövaara, Markku; Hofman, Albert; Jordan, Joanne M.; Jula, Antti; Kähönen, Mika; Kajantie, Eero; Knekt, Paul B.; Koskinen, Seppo; Kovacs, Peter; Lehtimäki, Terho; Lind, Lars; Liu, Yongmei; Orwoll, Eric S.; Osmond, Clive; Perola, Markus; Pérusse, Louis; Raitakari, Olli T.; Rankinen, Tuomo; Rao, D. C.; Rice, Treva K.; Rivadeneira, Fernando; Rudan, Igor; Salomaa, Veikko; Sørensen, Thorkild I. A.; Stumvoll, Michael; Tönjes, Anke; Towne, Bradford; Tranah, Gregory J.; Tremblay, Angelo; Uitterlinden, André G.; van der Harst, Pim; Vartiainen, Erkki; Viikari, Jorma S.; Vitart, Veronique; Vohl, Marie-Claude; Völzke, Henry; Walker, Mark; Wallaschofski, Henri; Wild, Sarah; Wilson, James F.; Yengo, Loïc; Bishop, D. Timothy; Borecki, Ingrid B.; Chambers, John C.; Cupples, L. Adrienne; Dehghan, Abbas; Deloukas, Panos; Fatemifar, Ghazaleh; Fox, Caroline; Furey, Terrence S.; Franke, Lude; Han, Jiali; Hunter, David J.; Karjalainen, Juha; Karpe, Fredrik; Kaplan, Robert C.; Kooner, Jaspal S.; McCarthy, Mark I.; Murabito, Joanne M.; Morris, Andrew P.; Bishop, Julia A. N.; North, Kari E.; Ohlsson, Claes; Ong, Ken K.; Prokopenko, Inga; Richards, J. Brent; Schadt, Eric E.; Spector, Tim D.; Widén, Elisabeth; Willer, Cristen J.; Yang, Jian; Ingelsson, Erik; Mohlke, Karen L.; Hirschhorn, Joel N.; Pospisilik, John Andrew; Zillikens, M. Carola; Lindgren, Cecilia; Kilpeläinen, Tuomas Oskari; Loos, Ruth J. F.

    2016-01-01

    To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (PCRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk. PMID:26833246

  17. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

    DEFF Research Database (Denmark)

    Lu, Yingchang; Day, Felix R; Gustafsson, Stefan;

    2016-01-01

    To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P... were previously associated with increased overall adiposity (BMI, BF%) and four (in or near COBLL1/GRB14, IGF2BP1, PLA2G6, CRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger...... effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk....

  18. Adverse Drug Reaction reports for cardiometabolic drugs from sub-Saharan Africa : a study in VigiBase

    NARCIS (Netherlands)

    Berhe, Derbew Fikadu; Juhlin, Kristina; Star, Kristina; Beyene, Kidanemariam G. M.; Dheda, Mukesh; Haaijer-Ruskamp, Flora M.; Taxis, Katja; Mol, Peter G. M.

    2015-01-01

    OBJECTIVE: Identifying key features of cardiometabolic ADR reports in sub Saharan Africa (SSA) compared with reports from the rest of the world (RoW). METHODS: Reports on suspected ADRs of cardiometabolic drugs (ATC: A10[antidiabetic], B01[antithrombotics] and C[cardiovascular]) were extracted from

  19. The Influence of Lifestyle on Cardio-metabolic Risk in Students from Timisoara University Center

    OpenAIRE

    Mihaela ORAVIȚAN; Avram, Claudiu; Stela IURCIUC; Petru MERGHEȘ; Bogdan ALMĂJAN-GUȚĂ

    2013-01-01

    This study is a part of the activities in a cross border cooperation project that has proposed the management of obesity and cardiometabolic risk at students from Timisoara and Szeged university centres. The target group of Timisoara University Center was formed out of 600 students enrolled in the four major universities from Timisoara; target group students were questioned about their lifestyle and were evaluated anthropometric parameters, body composition and arterial stiffness; based on qu...

  20. Cardiometabolic risk in US Army recruits and the effects of basic combat training.

    Directory of Open Access Journals (Sweden)

    Stefan M Pasiakos

    Full Text Available BACKGROUND: Cardiometabolic disease risk in US military recruits and the effects of military training have not been determined. This study examined lifestyle factors and biomarkers associated with cardiometabolic risk in US Army recruits (209; 118 male, 91 female, 23 ± 5 yr before, during, and after basic combat training (BCT. METHODOLOGY/PRINCIPAL FINDINGS: Anthropometrics; fasting total (TC, high-density lipoprotein (HDL and low-density lipoprotein (LDL cholesterol; triglycerides (TG; glucose; and insulin were measured at baseline and every 3 wks during the 10 wk BCT course. At baseline, 14% of recruits were obese (BMI>30 kg/m(2, 27% were cigarette smokers, 37% were sedentary, and 34% reported a family history of cardiometabolic disease. TC was above recommended levels in 8%, LDL in 39%, TG in 5%, and glucose in 8% of recruits, and HDL was below recommended levels in 33% of recruits at baseline. By week 9, TC decreased 8%, LDL 10%, TG 13%, glucose 6% and homeostasis model assessment of insulin resistance (HOMA-IR 40% in men (P<0.05. In women, TC, LDL, glucose and HOMA-IR were decreased from baseline at weeks 3 and 6 (P<0.05, but were not different from baseline levels at week 9. During BCT, body weight declined in men but not women, while body fat percentage declined in both men and women (P<0.05. CONCLUSIONS/SIGNIFICANCE: At the start of military service, the prevalence of cardiometabolic risk in US military recruits is comparable to that reported in similar, college-aged populations. Military training appears to be an effective strategy that may mitigate risk in young people through improvements in lipid profiles and glycemic control.

  1. Prevalence of cardiometabolic risk factors and metabolic syndrome in obese Kuwaiti adolescents

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    Boodai SA

    2014-10-01

    Full Text Available Shurooq A Boodai,1 Lynne M Cherry,2 Naveed A Sattar,2 John J Reilly3 1University of Glasgow School of Medicine, Yorkhill Hospitals, Glasgow, Scotland; 2Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland; 3University of Strathclyde Physical Activity for Health Group, School of Psychological Sciences and Health, Glasgow, Scotland Background: Childhood and adolescent obesity is associated with insulin resistance, abnormal glucose metabolism, hypertension, dyslipidemia, inflammation, liver disease, and compromised vascular function. The purpose of this pilot study was to determine the prevalence of cardiometabolic risk factor abnormalities and metabolic syndrome (MetS in a sample of obese Kuwaiti adolescents, as prevalence data might be helpful in improving engagement with obesity treatment in future. Methods: Eighty obese Kuwaiti adolescents (40 males with a mean (standard deviation age of 12.3 years (1.1 years participated in the present study. All participants had a detailed clinical examination and anthropometry, blood pressure taken, and assessment of fasting levels of C-reactive protein, intracellular adhesion molecule, interleukin-6, fasting blood glucose, insulin, liver function tests (alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, lipid profile (cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin resistance by homeostasis model assessment, and adiponectin. MetS was assessed using two recognized criteria modified for use in younger individuals. Results: The cardiometabolic risk factors with highest prevalence of abnormal values included aspartate aminotransferase (88.7% of the sample and insulin resistance by homeostasis model assessment (67.5%, intracellular adhesion molecule (66.5%, fasting insulin (43.5%, C-reactive protein (42.5%, low

  2. Principal component analysis reveals gender-specific predictors of cardiometabolic risk in 6th graders

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    Peterson Mark D

    2012-11-01

    Full Text Available Abstract Background The purpose of this study was to determine the sex-specific pattern of pediatric cardiometabolic risk with principal component analysis, using several biological, behavioral and parental variables in a large cohort (n = 2866 of 6th grade students. Methods Cardiometabolic risk components included waist circumference, fasting glucose, blood pressure, plasma triglycerides levels and HDL-cholesterol. Principal components analysis was used to determine the pattern of risk clustering and to derive a continuous aggregate score (MetScore. Stratified risk components and MetScore were analyzed for association with age, body mass index (BMI, cardiorespiratory fitness (CRF, physical activity (PA, and parental factors. Results In both boys and girls, BMI and CRF were associated with multiple risk components, and overall MetScore. Maternal smoking was associated with multiple risk components in girls and boys, as well as MetScore in boys, even after controlling for children’s BMI. Paternal family history of early cardiovascular disease (CVD and parental age were associated with increased blood pressure and MetScore for girls. Children’s PA levels, maternal history of early CVD, and paternal BMI were also indicative for various risk components, but not MetScore. Conclusions Several biological and behavioral factors were independently associated with children’s cardiometabolic disease risk, and thus represent a unique gender-specific risk profile. These data serve to bolster the independent contribution of CRF, PA, and family-oriented healthy lifestyles for improving children’s health.

  3. Severe Obesity and Cardiometabolic Risk in Children: Comparison from Two International Classification Systems

    Science.gov (United States)

    Valerio, Giuliana; Maffeis, Claudio; Balsamo, Antonio; Del Giudice, Emanuele Miraglia; Brufani, Claudia; Grugni, Graziano; Licenziati, Maria Rosaria; Brambilla, Paolo; Manco, Melania

    2013-01-01

    Objectives There is no agreed-upon definition for severe obesity (Sev-OB) in children. We compared estimates of Sev-OB as defined by different cut-points of body mass index (BMI) from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) curves and the ability of each set of cut-points to screen for the presence of cardiometabolic risk factors. Research Design and Methods Cross-sectional, multicenter study involving 3,340 overweight/obese young subjects. Sev-OB was defined as BMI ≥99th percentile or ≥1.2 times the 95th percentile of the CDC or the WHO curves. High blood pressure, hypertriglyceridemia, low High Density Lipoprotein -cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors. Results The estimated prevalence of Sev-OB varied widely between the two reference systems. Either using the cut-point ≥99th percentile or ≥1.2 times the 95th percentile, less children were defined as Sev-OB by CDC than WHO (46.8 vs. 89.5%, and 63.3 vs. 80.4%, respectively p<0.001). The CDC 99th percentile had lower sensitivity (58.5 vs 94.2), higher specificity (57.6 vs 12.3) and higher positive predictive value (34.4 vs 28.9) than WHO in identifying obese children with ≥2 cardiometabolic risk factors. These differences were mitigated using the 1.2 times the 95th percentile (sensitivity 73.9 vs. 88.1; specificity 40.7 vs. 22.5; positive predictive value 32.1 vs. 30.1). Substantial agreement between growth curves was found using the 1.2 times the 95th percentile, in particular in children ≤10 years. Conclusions Estimates of Sev-OB and cardiometabolic risk as defined by different cut-points of BMI are influenced from the reference systems used. The 1.2 times the 95th percentile of BMI of either CDC or WHO standard has a discriminatory advantage over the 99th percentile for identifying severely obese children at increased cardiometabolic risk, particularly under 10 years of age. PMID:24386280

  4. A metabolic syndrome severity score: A tool to quantify cardio-metabolic risk factors.

    Science.gov (United States)

    Wiley, Joshua F; Carrington, Melinda J

    2016-07-01

    Metabolic syndrome is a cluster of cardio-metabolic risk factors and is associated with increased mortality. There is no standard, validated way to assess the severity of aggregated metabolic syndrome risk factors. Cardiovascular and diabetes risk factor data came from two studies conducted in Australia from 2006 to 2010 in adults aged 18 or above. In medication free adults, sex-specific clinical thresholds and Principal Component Analysis were used to develop a formula to calculate a metabolic syndrome severity score (MetSSS). These scores were compared to scores derived using the same process in subgroups by sex, age, medication status, and time. We also examined the MetSSS in relation to other known risk factors. In 2125 adults (57.6±14.7years of age), the MetSSS ranged from 0 to 8.7 with a mean of 2.6. There were strong correlations (.95-.99) between the MetSSS in medication free adults and the MetSSS calculated from subgroups. MetSSS predicted medication initiation for hypertension, hyperlipidemia and hyperglycemia over six months (OR=1.31, 95% CI [1.00-1.70], per MetSSS unit, p=.043). Lower education, medication prescription, history of smoking and age were associated with higher MetSSS (all p<.05). Higher physical but not mental health quality of life was associated with lower MetSSS (p<.001). A standardized formula to measure cardio-metabolic risk factor severity was constructed and demonstrated expected relations with known risk factors. The use of the MetSSS is recommended as a measure of change within individuals in cardio-metabolic risk factors and to guide treatment and management.

  5. Handgrip strength cutoff for cardiometabolic risk index among Colombian children and adolescents: The FUPRECOL Study

    Science.gov (United States)

    Ramírez-Vélez, Robinson; Peña-Ibagon, Jhonatan Camilo; Martínez-Torres, Javier; Tordecilla-Sanders, Alejandra; Correa-Bautista, Jorge Enrique; Lobelo, Felipe; García-Hermoso, Antonio

    2017-01-01

    Evidence shows an association between muscular strength (MS) and health among young people, however low muscular strength cut points for the detection of high metabolic risk in Latin-American populations are scarce. The aim of this study was twofold: to explore potential age- and sex-specific thresholds of MS, for optimal cardiometabolic risk categorization among Colombian children and adolescents; and to investigate whether cardiometabolic risk differed by MS group by applying the receiver operating characteristic curve (ROC) cut point. MS was estimated by using a handle dynamometer on 1,950 children and adolescents from Colombia, using MS relative to weight (handgrip strength/body mass). A metabolic risk score was computed from the following components: waist circumference, triglycerides, HDL-c, glucose, and systolic and diastolic blood pressure. ROC analysis showed a significant discriminatory accuracy of MS in identifying the low/high metabolic risk in children and adolescents and in both genders. In children, the handgrip strength/body mass levels for a low metabolic risk were 0.359 and 0.376 in girls and boys, respectively. In adolescents, these points were 0.440 and 0.447 in girls and boys, respectively. In conclusion, the results suggest an MS level relative to weight for having a low metabolic risk, which could be used to identify youths at risk. PMID:28195167

  6. Influence of cardiorespiratory fitness and physical activity levels on cardiometabolic risk factors during menopause transition: A MONET study.

    Science.gov (United States)

    Abdulnour, Joseph; Razmjou, Sahar; Doucet, Éric; Boulay, Pierre; Brochu, Martin; Rabasa-Lhoret, Rémi; Lavoie, Jean-Marc; Prud'homme, Denis

    2016-12-01

    To determine the influence of cardiorespiratory fitness (hereafter "fitness") and physical activity levels on cardiometabolic risk factors in premenopausal women going through the menopause transition. An ancillary study including 66 premenopausal women who participated to a 5-year observational, longitudinal study (2004 to 2009 in Ottawa) on the effects of menopause transition on body composition and cardiometabolic risk factors. Women underwent a graded exercise test on treadmill to measure peak oxygen uptake (VO2 peak) at year 1 and 5 and physical activity levels were measured using accelerometers. Cardiometabolic risk factors included: waist circumference, fasting plasma lipids, glucose and insulin levels, HOMA-IR score, c-reactive protein, apolipoprotein B (apoB) and resting systolic and diastolic blood pressure. Change in fitness was not associated with changes in cardiometabolic risk factors. The changes in total physical activity levels on the other hand showed a significant negative association with apoB levels. Three-way linear mixed model repeated measures, showed lower values of waist circumference, fasting triglycerides, insulin levels, HOMA-IR score, apoB and diastolic blood pressure in women with a fitness ≥ 30.0 mlO2 kg(- 1) min(- 1) compared to women with a fitness fitness and physical activity levels, fitness was associated with more favorable values of cardiometabolic risk factors in women followed for 5 years during the menopause transition.

  7. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: The Bogalusa Heart Study

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    Xu Jihua

    2010-10-01

    Full Text Available Abstract Background Body Mass Index (BMI is widely used to assess the impact of obesity on cardiometabolic risk in children but it does not always relate to central obesity and varies with growth and maturation. Waist-to-Height Ratio (WHtR is a relatively constant anthropometric index of abdominal obesity across different age, sex or racial groups. However, information is scant on the utility of WHtR in assessing the status of abdominal obesity and related cardiometabolic risk profile among normal weight and overweight/obese children, categorized according to the accepted BMI threshold values. Methods Cross-sectional cardiometabolic risk factor variables on 3091 black and white children (56% white, 50% male, 4-18 years of age were used. Based on the age-, race- and sex-specific percentiles of BMI, the children were classified as normal weight (5th - 85th percentiles and overweight/obese (≥ 85th percentile. The risk profiles of each group based on the WHtR ( Results 9.2% of the children in the normal weight group were centrally obese (WHtR ≥0.5 and 19.8% among the overweight/obese were not (WHtR Conclusion WHtR not only detects central obesity and related adverse cardiometabolic risk among normal weight children, but also identifies those without such conditions among the overweight/obese children, which has implications for pediatric primary care practice.

  8. Serum uric acid level and its association with cardiometabolic risk factors in prediabetic subjects

    Science.gov (United States)

    Iraj, Bijan; Feizi, Awat; Abdar-Esfahani, Morteza; Heidari-Beni, Motahar; Zare, Maryam; Amini, Masoud; Parsa, Fatemeh

    2014-01-01

    Background: Excess serum uric acid (UA) accumulation can lead to various diseases. Increasing evidences reveal that UA may have a key role in the pathogenesis of metabolic syndrome. Little is known about the associations of UA levels with cardiometabolic risk factors in prediabetic individuals. This study was designed to evaluate the association between UA and cardiometabolic risk factors in prediabetic subjects with family history of diabetes compared with those with normal glucose tolerance (NGT). Materials and Methods: In a cross-sectional setting, a sample containing 643 (302 prediabetic subjects and 341 normal) of the first-degree relatives of diabetic patients aged 35-55-years old were investigated. Samples were assessed in prediabetic and normal groups using glucose tolerance categories. Prediabetes was defined based on American Diabetes Association (ADA) criteria. Body weight and height, systolic and diastolic blood pressure (SBP and DBP), UA, creatinine (Cr), albumin (Alb), fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and lipid profiles were measured and compared between two groups. Results: Prediabetic persons were older and obese than normal persons. Also, prediabetic persons (5.2 ± 1.3 mg/dl) had significantly higher UA than normal persons (4.9 ± 1.4 mg/dl) (P 1, P < 0.05) associated with glucose tolerance categories. This association remained statistically significant after adjusting the effects of age and BMI. Also, the association between glucose tolerance categories and UA were positively significant in both genders. Conclusion: High UA level was associated with some cardiometabolic risk factors in prediabetic individuals compared with normal person. UA level was also a significant predictor for prediabetes condition. PMID:24949036

  9. Serum uric acid level and its association with cardiometabolic risk factors in prediabetic subjects

    Directory of Open Access Journals (Sweden)

    Bijan Iraj

    2014-01-01

    Full Text Available Background: Excess serum uric acid (UA accumulation can lead to various diseases. Increasing evidences reveal that UA may have a key role in the pathogenesis of metabolic syndrome. Little is known about the associations of UA levels with cardiometabolic risk factors in prediabetic individuals. This study was designed to evaluate the association between UA and cardiometabolic risk factors in prediabetic subjects with family history of diabetes compared with those with normal glucose tolerance (NGT. Materials and Methods: In a cross-sectional setting, a sample containing 643 (302 prediabetic subjects and 341 normal of the first-degree relatives of diabetic patients aged 35-55-years old were investigated. Samples were assessed in prediabetic and normal groups using glucose tolerance categories. Prediabetes was defined based on American Diabetes Association (ADA criteria. Body weight and height, systolic and diastolic blood pressure (SBP and DBP, UA, creatinine (Cr, albumin (Alb, fasting blood glucose (FBG, hemoglobin A1c (HbA1c, and lipid profiles were measured and compared between two groups. Results: Prediabetic persons were older and obese than normal persons. Also, prediabetic persons (5.2 ± 1.3 mg/dl had significantly higher UA than normal persons (4.9 ± 1.4 mg/dl (P 1, P < 0.05 associated with glucose tolerance categories. This association remained statistically significant after adjusting the effects of age and BMI. Also, the association between glucose tolerance categories and UA were positively significant in both genders. Conclusion: High UA level was associated with some cardiometabolic risk factors in prediabetic individuals compared with normal person. UA level was also a significant predictor for prediabetes condition.

  10. Association between quality of the diet and cardiometabolic risk factors in postmenopausal women

    OpenAIRE

    Ventura, Danyelle de Almeida; Fonseca, Vânia Matos; Ramos,Eloane Gonçalves; Marinheiro,Lizanka Paola Fiqueiredo; Souza,Rita Adriana Gomes de; Chaves, Celia Regina Moutinho de Miranda; Peixoto, Maria Virginia Marques

    2014-01-01

    Background Climateric is a phase of women’s life marked by the transition from the reproductive to the non-reproductive period. In addition to overall weight gain, the menopause is also associated with the increase of abdominal fat. We used The Healthy Eating Index as a summary measure to evaluate the major components and the quality of women’s diet after the onset of the menopause. This study aims at examining the association between the quality of the diet and cardiometabolic risk factors i...

  11. Evaluation of bioelectrical impedance analysis for identifying overweight individuals at increased cardiometabolic risk: a cross-sectional study.

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    Maxine J E Lamb

    Full Text Available OBJECTIVE: To investigate whether bioelectrical impedance analysis could be used to identify overweight individuals at increased cardiometabolic risk, defined as the presence of metabolic syndrome and/or diabetes. DESIGN AND METHODS: Cross-sectional study of a Scottish population including 1210 women and 788 men. The diagnostic performance of thresholds of percentage body fat measured by bioelectrical impedance analysis to identify people at increased cardiometabolic risk was assessed using receiver-operating characteristic curves. Odds ratios for increased cardiometabolic risk in body mass index categories associated with values above compared to below sex-specific percentage body fat thresholds with optimal diagnostic performance were calculated using multivariable logistic regression analyses. The validity of bioelectrical impedance analysis to measure percentage body fat in this population was tested by examining agreement between bioelectrical impedance analysis and dual-energy X-ray absorptiometry in a subgroup of individuals. RESULTS: Participants were aged 16-91 years and the optimal bioelectrical impedance analysis cut-points for percentage body fat for identifying people at increased cardiometabolic risk were 25.9% for men and 37.1% for women. Stratifying by these percentage body fat cut-points, the prevalence of increased cardiometabolic risk was 48% and 38% above the threshold and 24% and 19% below these thresholds for men and women, respectively. By comparison, stratifying by percentage body fat category had little impact on identifying increased cardiometabolic risk in normal weight and obese individuals. Fully adjusted odds ratios of being at increased cardiometabolic risk among overweight people with percentage body fat ≥ 25.9/37.1% compared with percentage body fat <25.9/37.1% as a reference were 1.93 (95% confidence interval: 1.20-3.10 for men and 1.79 (1.10-2.92 for women. CONCLUSION: Percentage body fat measured using

  12. Association of Cardiometabolic Multimorbidity With Mortality The Emerging Risk Factors Collaboration

    NARCIS (Netherlands)

    Di Angelantonio, Emanuele; Kaptoge, Stephen; Wormser, David; Willeit, Peter; Butterworth, Adam S.; Bansal, Narinder; O'Keeffe, Linda M.; Gao, Pei; Wood, Angela M.; Burgess, Stephen; Freitag, Daniel F.; Pennells, Lisa; Peters, Sanne A.; Hart, Carole L.; Haheim, Lise Lund; Gillum, Richard F.; Nordestgaard, Borge G.; Psaty, Bruce M.; Yeap, Bu B.; Knuiman, Matthew W.; Nietert, Paul J.; Kauhanen, Jussi; Salonen, Jukka T.; Kuller, Lewis H.; Simons, Leon A.; van der Schouw, Yvonne T.; Barrett-Connor, Elizabeth; Selmer, Randi; Crespo, Carlos J.; Rodriguez, Beatriz; Verschuren, W. M. Monique; Salomaa, Veikko; Svardsudd, Kurt; van der Harst, Pim; Bjorkelund, Cecilia; Wilhelmsen, Lars; Wallace, Robert B.; Brenner, Hermann; Amouyel, Philippe; Barr, Elizabeth L. M.; Iso, Hiroyasu; Onat, Altan; Trevisan, Maurizio; D'Agostino, Ralph B.; Cooper, Cyrus; Kavousi, Maryam; Welin, Lennart; Roussel, Ronan; Hu, Frank B.; Sato, Shinichi; Davidson, Karina W.; Howard, Barbara V.; Leening, Maarten; Rosengren, Annika; Dorr, Marcus; Deeg, Dorly J. H.; Kiechl, Stefan; Stehouwer, Coen D. A.; Nissinen, Aulikki; Giampaoli, Simona; Donfrancesco, Chiara; Kromhout, Daan; Price, Jackie F.; Peters, Annette; Meade, Tom W.; Casiglia, Edoardo; Lawlor, Debbie A.; Gallacher, John; Nagel, Dorothea; Franco, Oscar H.; Assmann, Gerd; Dagenais, Gilles R.; Jukema, J. Wouter; Sundstrom, Johan; Woodward, Mark; Brunner, Eric J.; Khaw, Kay-Tee; Wareham, Nicholas J.; Whitsel, Eric A.; Njolstad, Inger; Hedblad, Bo; Wassertheil-Smoller, Sylvia; Engstrom, Gunnar; Rosamond, Wayne D.; Selvin, Elizabeth; Sattar, Naveed; Thompson, Simon G.; Danesh, John

    2015-01-01

    IMPORTANCE The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS Age-and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individu

  13. Cardiometabolic risk in psoriasis: differential effects of biologic agents

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    Mariana J Kaplan

    2008-12-01

    Full Text Available Mariana J KaplanDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USAAbstract: Psoriasis is associated to an increased risk of cardiovascular (CV complications. Overall, the pathogenic mechanisms involved in premature CV complications in psoriasis appear to be complex and multifactorial, with traditional and nontraditional risk factors possibly contributing to the increased risk. Based on what is known about the pathogenesis of psoriasis and extrapolating the current knowledge on CV complications in other inflammatory diseases, studies are needed to investigate if appropriate control of the inflammatory, immunologic and metabolic disturbances present in psoriasis can prevent the development of this potentially lethal complication. It is clear that there is a great need for heightened awareness of the increased risk for vascular damage in patients with psoriasis. It is also crucial to closely monitor patients with psoriasis for CV risk factors including obesity, hypertension, diabetes, and hyperlipidemia. Whether treatment regimens that effectively manage systemic inflammation will lead to prevention of CV complications in psoriasis needs to be investigated. Clearly, studies should focus on establishing the exact mechanisms that determine CV risk in psoriasis so that appropriate preventive strategies and treatment guidelines can be established.Keywords: psoriasis, atherosclerosis, inflammation, vascular

  14. BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

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    Ana Díez-Fernández

    Full Text Available Muscular fitness levels have been associated with cardiometabolic risk in children, although whether body weight acts as a confounder or as an intermediate variable in this relationship remains controversial. The aim of this study was to examine whether the association between muscular fitness and cardiometabolic risk factors is mediated by body mass index (BMI.Cross-sectional study using a sample of 1158 schoolchildren aged 8-11 years from the province of Cuenca, Spain. We measured anthropometrics and biochemical variables and we calculated a muscular fitness index as the sum of z-scores of handgrip dynamometry/weight and standing long jump, and we estimated a previously validated cardiometabolic risk index (CMRI. Linear regression models were fitted for mediation analysis to assess whether the association between muscular fitness and cardiometabolic risk was mediated by BMI.Children with normal weight (NW had a better cardiometabolic risk profile than their overweight (OW or obese (OB peers after controlling for muscular fitness. Marginal estimated mean ± SE values for NW, OW and OB categories of CMRI were -0.75 ± 0.06 0.05 ± 0.09 >-1.16 ± 0.13 for lower, middle and upper quartiles of muscular fitness in boys and 1.01 ± 0.16 > 0.10 ± 0.09 > -1.02 ± 0.15 in girls, both p < 0.001, but differences disappeared when controlling for BMI. BMI acted as a full mediator between muscular fitness and most cardiometabolic risk factors (Sobel test z = -11.44 for boys; z = -11.83 for girls; p < 0.001 in CMRI mediation model and as a partial mediator in the case of waist circumference (Sobel test z=-14.86 for boys; z=-14.51 for girls; p<0.001.BMI mediates the association between muscular fitness and cardiometabolic risk in schoolchildren. Overall, good muscular fitness is associated with lower cardiometabolic risk, but particularly when accompanied by normal weight.

  15. Diet scores and cardio-metabolic risk factors among Guatemalan young adults.

    Science.gov (United States)

    Gregory, Cria O; McCullough, Marjorie L; Ramirez-Zea, Manuel; Stein, Aryeh D

    2009-06-01

    We assessed the association of four diet quality scores with multiple cardio-metabolic outcomes among Guatemalan young adults experiencing the nutrition transition. We obtained cross-sectional dietary, demographic, anthropometric and cardio-metabolic risk factor data from 1220 Guatemalan adults (mean age 32.7 (sd 5.8) years) in 2002-4, and computed a Recommended Food Score (RFS), Not Recommended Food Score (NRFS), Food Variety Score (FVS) and the Dietary Quality Index-International (DQI-I). All four scores were correlated with energy intake (r 0.23-0.49; all P metabolic syndrome or its components; rather some were positively associated with risk factors. Among both men and women the DQI-I was positively associated with BMI (kg/m2; beta = 0.10, 95 % CI 0.003, 0.21 (men); beta = 0.07, 95 % CI 0.01, 0.14 (women)) and waist circumference (cm; beta = 0.02, 95 % CI 0.01, 0.03 (men); beta = 0.02, 95 % CI = 0.01, 0.02 (women)). Among men, the RFS was positively associated with TAG (mg/l; beta = 0.11, 95 % CI 0.02, 0.21) and glucose (mg/l; beta = 0.13: 95 % CI 0.03, 0.22). We conclude that indices of diet quality are not consistently associated with chronic disease risk factor prevalence in this population of Guatemalan young adults.

  16. Prevalence and associated factors of cardio-metabolic risk factors in Iranian seafarers

    DEFF Research Database (Denmark)

    Baygi, Fereshteh; Jensen, Olaf C; Qorbani, Mostafa;

    2016-01-01

    -metabolic risk factors in seafarers of National Iranian Tanker Company (NITC). MATERIALS AND METHODS: A cross-sectional study was performed on 234 Iranian male seafarers of NITC in 2015. Metabolic syndrome (MetS) was diagnosed according to the reports of National Committee of Obesity. Three main blood parameters...... (of elevated total cholesterol, elevated low-density lipoprotein cholesterol, and elevated very low-density lipoprotein cholesterol) and general obesity were included as additional cardio-metabolic risk factors. RESULTS: The mean age of the participants was 36.0 ± 10.3 years. The prevalence of Met......S was 14.9%. The common cardio-metabolic risk factors were excess weight (51.1%), abdominal obesity (38.5%), and smoking (27.8%) among Iranian seafarers. In multivariate analysis, age (OR: 1.05, 95% CI: 1.01-1.09) and body mass index (OR: 1.14, 95% CI: 1.01-1.27) were associated with the increase...

  17. Primary dyslipidemia and cardiometabolic risk: potential of pitavastatin

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    Berezin A.E.

    2015-06-01

    Full Text Available The review is de­voted to the most important aspects of primary mixed dyslipidemia treatment in patients at high risk with concomitant metabolic comorbidities. Evidences for novel modern approaches regarding primary prevention of cardiovascular events among dyslipidemic patients are considered. The potential role of lipid-lowering treatment with statins and their role in reducing the cardiovascular risk are discussed. Information about modern methods of minimization of residual cardiovascular risk using a combined lipid-lowering strategies and new representatives of the statins are provided. It has been discussed various strategies of statin administering to patients with dyslipidemia of different age with exiting comorbidities, such as diabetes mellitus, obesity, metabolic syndrome. Objective findings and treatment approaches obtained from the patient with obesity, metabolic syndrome, and asymptomatic atherosclerosis are provided. The role of pitavastatin in primary prevention program of cardiovascular events is discussed.

  18. Cardiometabolic Risk Assessments by Body Mass Index z-Score or Waist-to-Height Ratio in a Multiethnic Sample of Sixth-Graders

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    Henry S. Kahn

    2014-01-01

    Full Text Available Convention defines pediatric adiposity by the body mass index z-score (BMIz referenced to normative growth charts. Waist-to-height ratio (WHtR does not depend on sex-and-age references. In the HEALTHY Study enrollment sample, we compared BMIz with WHtR for ability to identify adverse cardiometabolic risk. Among 5,482 sixth-grade students from 42 middle schools, we estimated explanatory variations (R2 and standardized beta coefficients of BMIz or WHtR for cardiometabolic risk factors: insulin resistance (HOMA-IR, lipids, blood pressures, and glucose. For each risk outcome variable, we prepared adjusted regression models for four subpopulations stratified by sex and high versus lower fatness. For HOMA-IR, R2 attributed to BMIz or WHtR was 19%–28% among high-fatness and 8%–13% among lower-fatness students. R2 for lipid variables was 4%–9% among high-fatness and 2%–7% among lower-fatness students. In the lower-fatness subpopulations, the standardized coefficients for total cholesterol/HDL cholesterol and triglycerides tended to be weaker for BMIz (0.13–0.20 than for WHtR (0.17–0.28. Among high-fatness students, BMIz and WHtR correlated with blood pressures for Hispanics and whites, but not black boys (systolic or girls (systolic and diastolic. In 11-12 year olds, assessments by WHtR can provide cardiometabolic risk estimates similar to conventional BMIz without requiring reference to a normative growth chart.

  19. Dietary intake and prospective changes in cardiometabolic risk factors in children and youth.

    Science.gov (United States)

    Setayeshgar, Solmaz; Ekwaru, John Paul; Maximova, Katerina; Majumdar, Sumit R; Storey, Kate E; McGavock, Jonathan; Veugelers, Paul J

    2017-01-01

    Only few studies examined the effect of diet on prospective changes in cardiometabolic (CM) risk factors in children and youth despite its importance for understanding the role of diet early in life for cardiovascular disease in adulthood. To test the hypothesis that dietary intake is associated with prospective changes in CM risk factors, we analyzed longitudinal observations made over a period of 2 years among 448 students (aged 10-17 years) from 14 schools in Canada. We applied mixed effect regression to examine the associations of dietary intake at baseline with changes in body mass index, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), and insulin sensitivity score between baseline and follow-up while adjusting for age, sex, and physical activity. Dietary fat at baseline was associated with increases in SBP and DBP z scores (per 10 g increase in dietary fat per day: β = 0.03; p hypertension in children and youth, and their cardiometabolic sequelae later in life.

  20. The association between vitamin D and cardiometabolic risk factors in children: a systematic review.

    Science.gov (United States)

    Dolinsky, Diana H; Armstrong, Sarah; Mangarelli, Caren; Kemper, Alex R

    2013-03-01

    The objective of this systematic review was to evaluate the association between serum 25-hydroxyvitamin D (25OHD) and cardiometabolic risk in children and the effect of vitamin D supplementation on risk. We included 35 clinical trials, cross-sectional studies, case-control studies, and cohort studies that evaluated the relationship between 25OHD and blood pressure, lipid levels, insulin/glucose metabolism, endothelial dysfunction, and arterial stiffness. One randomized clinical trial that randomized adolescents to 2000 or 400 IU/d of vitamin D and found improvement in arterial stiffness in the high-dose group and worsening in the low-dose group. One cross-sectional study found no relationship between 25OHD and endothelial dysfunction. Of 12 cross-sectional studies, 10 found an inverse association between 25OHD and systolic blood pressure, although 2 trials found no relationship. There was no consistent association between 25OHD and lipid levels or insulin/glucose metabolism. Insufficient evidence was available to conclude that vitamin D supplementation yields cardiometabolic benefit.

  1. Adverse drug reaction reports for cardiometabolic drugs from sub Sahara Africa: A study in VigiBase

    NARCIS (Netherlands)

    Berhe, Derbew F.; Juhlin, Kristina; Star, Kristina; Haaijer-Ruskamp, Flora M.; Michael, Kidane; Taxis, Katja; Mol, Peter G.M.

    2014-01-01

    Background: Many pharmacovigilance centers have been established in Sub Sahara Africa (SSA) in recent years. Their focus has been on ADRs to drugs for communicable diseases. Little is known about ADRs caused by drugs for cardiometabolic diseases, although its burden is increasing rapidly in SSA. Obj

  2. Association of cardiometabolic risk factors and dental caries in a population-based sample of youths

    Directory of Open Access Journals (Sweden)

    Kelishadi Roya

    2010-04-01

    Full Text Available Abstract Background Cardiovascular disease (CVD risk factors begin from early life and track onto adulthood. Oral and dental diseases share some risk factors with CVD, therefore by finding a clear relation between dental diseases and cardiometabolic risk factors; we can then predict the potential risk of one based on the presence of the other. This study aimed to compare the prevalence of dental caries between two groups of age-matched adolescents with and without CVD risk factors. Methods In this case-control study, the decayed, missing and filled surfaces (DMFS, based on the criteria of the World Health Organization, were compared in two groups of equal number (n = 61 in each group of population-based sample of adolescents with and without CVD risk factors who were matched for sex and age group. Results The study participants had a median age 13 y 5 mo, age range 11 y 7 mo to 16 y 1 mo, with male-to-female proportion of 49/51. We found significant difference between the mean values of DMFS, body mass index, waist and hip circumferences, as well as serum lipid profile in the case and control groups. Significant correlations were documented for DMFS with TC (r = 0.54, p = 0.02, LDL-C (r = 0.55, p = 0.01 and TG (r = 0.52, p = 0.04 in the case group; with LDL-C (r = 0.47, p = 0.03 in the whole study participants and with TC in control s(r = 0.45, p = 0.04. Conclusions Given the significant associations between dental caries and CVD risk factors among adolescents, more attention should be paid to oral health, as one of the topics to be taken into account in primordial/primary prevention of cardiometabolic disorders.

  3. Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study.

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    Johanna Riha

    2014-07-01

    Full Text Available Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA, where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24, low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23, and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77.This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA. Please see later in the article for the Editors' Summary.

  4. Cardiorespiratory Fitness, Adiposity, and Cardiometabolic Risk Factors in Schoolchildren.

    Science.gov (United States)

    Ramírez-Vélez, Robinson; Daza, Fernando; González-Jiménez, Emilio; Schmidt-RioValle, Jacqueline; González-Ruíz, Katherine; Correa-Bautista, Jorge E

    2016-08-01

    The aim of this study was to investigate the association between cardiorespiratory fitness (CRF) and cardiovascular risk factors (CVRF) in schoolchildren. A secondary aim was to evaluate the degree of association between overall and abdominal adiposity and CRF in a total of 1,875 children and adolescents attending public schools. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption. A CVRF ( Z score) was calculated and participants were divided into tertiles according to low and high levels of overall (sum of the skinfold thicknesses) and abdominal adiposity. Schoolchildren with a high-level of overall adiposity demonstrated significant differences in seven of the 10 variables analyzed (i.e., systolic and diastolic blood pressure, triglycerides, triglycerides/high density lipoproteins [HDL-c] ratio, total cholesterol, glucose, C-reactive protein [usCRP], HDL-c, low density lipoproteins [LDL-c], and cardiovascular risk score). Schoolchildren with high levels of both overall and abdominal adiposity and low CRF had the least favorable CVRF score.

  5. Heterogeneity in glucose response curves during an oral glucose tolerance test and associated cardiometabolic risk

    DEFF Research Database (Denmark)

    Hulman, Adam; Simmons, Rebecca Kate; Vistisen, Dorte;

    2017-01-01

    patterns of plasma glucose change during the oral glucose tolerance test. Cardiometabolic risk factor profiles were compared between the identified groups. Using latent class trajectory analysis, five glucose response curves were identified. Despite similar fasting and 2-h values, glucose peaks and peak...... in Denmark, the Netherlands and the USA. Each study included between 5 and 11 measurements at different time points during a 2-h oral glucose tolerance test, resulting in 9,602 plasma glucose measurements. Latent class trajectories with a cubic specification for time were fitted to identify different...... times varied greatly between groups, ranging from 7–12 mmol/L, and 35–70 min. The group with the lowest and earliest plasma glucose peak had the lowest estimated cardiovascular risk, while the group with the most delayed plasma glucose peak and the highest 2-h value had the highest estimated risk. One...

  6. [Cardiovascular pharmacotherapy. Risks and adverse effects].

    Science.gov (United States)

    Voigt, N; Heijman, J; Dobrev, D

    2014-03-01

    Adverse side effects of drugs are a significantly underestimated problem in modern medicine. In this review article, we summarize common adverse side effects of cardiovascular drugs. In particular, we highlight the factors promoting these adverse side effects in patients, including reduced hepatic or renal clearance in elderly patients that often requires dosage adjustment. Pharmacodynamic and pharmacokinetic interactions between drugs (e.g. through the cytochrome P450 system or P-glycoproteins) can modify the plasma concentration of many compounds, thereby also increasing the likelihood of unwanted side effects. The most prominent cardiac side effects include arrhythmias, e.g. atrioventricular (AV) block, drug-induced long-QT syndrome and torsade de pointes and altered inotropy. Non-cardiac side effects are subsequently discussed grouped by drug class. A better understanding of the risks and side effects of cardiovascular drugs is expected to reduce the mortality and morbidity associated with adverse side effects.

  7. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    OpenAIRE

    Claudiu Avram; Adina Avram; L.aura Crăciun; Stela Iurciuc; Lucian Hoble; Alexandra Rusu; Bogdan Almăjan-Guţă; Silvia Mancaş

    2010-01-01

    The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Grou...

  8. The Epidemiological Boehringer Ingelheim Employee Study—Part I: Impact of Overweight and Obesity on Cardiometabolic Risk

    Directory of Open Access Journals (Sweden)

    Kerstin Kempf

    2013-01-01

    Full Text Available Objective. Obesity-dependent diseases cause economic burden to companies. Large-scale data for working populations are lacking. Prevalence of overweight and obesity in the Boehringer Ingelheim (BI Employee cohort and the relationship between body mass index (BMI and cardiometabolic risk factors and diseases were estimated. Design and Methods. Employees (≥38 years, employed in Ingelheim ≥2 years; n=3151 of BI Pharma GmbH & Co. KG were invited by the medical corporate department to participate in intensive health checkups. Cross-sectional analysis of baseline data collected through 2006–2011 was performed. Results. 90% of eligible subjects participated (n=2849. Prevalences of overweight and obesity were 40% and 18% and significantly higher in men and participants ≥50 years. Cardiometabolic risk factor levels and prevalences of cardiometabolic diseases significantly increased with BMI and were higher in overweight and obese participants. Cut-points for increased risk estimated from ROC curves were ≈25 kg/m2 for hypertension, hypercholesterolemia, arteriosclerosis, and hypertriglyceridemia and 26.7–28.0 kg/m2 for the metabolic syndrome, insulin resistance, hyperinsulinemia, increased intima media thickness, and type 2 diabetes. Conclusion. This is the first large-scale occupational health care cohort from a single company. Cardiometabolic risk factors and diseases accumulate with increasing BMI. Occupational weight reduction programs seem to be reasonable strategies.

  9. Active Commuting to School, Weight Status, and Cardiometabolic Risk in Children from Rural Areas: The Cuenca Study

    Science.gov (United States)

    Gutiérrez-Zornoza, Myriam; Sánchez-López, Mairena; García-Hermoso, Antonio; González-García, Alberto; Chillón, Palma; Martínez-Vizcaíno, Vicente

    2015-01-01

    Purpose: The aim of this study was to examine (a) whether distance from home to school is a determinant of active commuting to school (ACS), (b) the relationship between distance from home to heavily used facilities (school, green spaces, and sports facilities) and the weight status and cardiometabolic risk categories, and (c) whether ACS has a…

  10. Muscle Carnosine Is Associated with Cardiometabolic Risk Factors in Humans.

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    Barbora de Courten

    Full Text Available Carnosine is a naturally present dipeptide abundant in skeletal muscle and an over-the counter food additive. Animal data suggest a role of carnosine supplementation in the prevention and treatment of obesity, insulin resistance, type 2 diabetes and cardiovascular disease but only limited human data exists.Samples of vastus lateralis muscle were obtained by needle biopsy. We measured muscle carnosine levels (high-performance liquid chromatography, % body fat (bioimpedance, abdominal subcutaneous and visceral adiposity (magnetic resonance imaging, insulin sensitivity (euglycaemic hyperinsulinemic clamp, resting energy expenditure (REE, indirect calorimetry, free-living ambulatory physical activity (accelerometers and lipid profile in 36 sedentary non-vegetarian middle aged men (45±7 years with varying degrees of adiposity and glucose tolerance. Muscle carnosine content was positively related to % body fat (r = 0.35, p = 0.04 and subcutaneous (r = 0.38, p = 0.02 but not visceral fat (r = 0.17, p = 0.33. Muscle carnosine content was inversely associated with insulin sensitivity (r = -0.44, p = 0.008, REE (r = -0.58, p<0.001 and HDL-cholesterol levels (r = -0.34, p = 0.048. Insulin sensitivity and physical activity were the best predictors of muscle carnosine content after adjustment for adiposity.Our data shows that higher carnosine content in human skeletal muscle is positively associated with insulin resistance and fasting metabolic preference for glucose. Moreover, it is negatively associated with HDL-cholesterol and basal energy expenditure. Intervention studies targeting insulin resistance, metabolic and cardiovascular disease risk factors are necessary to evaluate its putative role in the prevention and management of type 2 diabetes and cardiovascular disease.

  11. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality

    Science.gov (United States)

    Romero-Corral, Abel; Somers, Virend K.; Sierra-Johnson, Justo; Korenfeld, Yoel; Boarin, Simona; Korinek, Josef; Jensen, Michael D.; Parati, Gianfranco; Lopez-Jimenez, Francisco

    2010-01-01

    Aims We hypothesized that subjects with a normal body mass index (BMI), but high body fat (BF) content [normal weight obesity (NWO)], have a higher prevalence of cardiometabolic dysregulation and are at higher risk for cardiovascular (CV) mortality. Methods and results We analysed 6171 subjects >20 years of age from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES III mortality study, whose BMI was within the normal range (18.5–24.9 kg/m2), and who underwent a complete evaluation that included body composition assessment, blood measurements, and assessment of CV risk factors. Survival information was available for >99% of the subjects after a median follow-up of 8.8 years. We divided our sample using sex-specific tertiles of BF%. The highest tertile of BF (>23.1% in men and >33.3% in women) was labelled as NWO. When compared with the low BF group, the prevalence of metabolic syndrome in subjects with NWO was four-fold higher (16.6 vs. 4.8%, P < 0.0001). Subjects with NWO also had higher prevalence of dyslipidaemia, hypertension (men), and CV disease (women). After adjustment, women with NWO showed a significant 2.2-fold increased risk for CV mortality (HR = 2.2; 95% CI, 1.03–4.67) in comparison to the low BF group. Conclusion Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality. PMID:19933515

  12. The role of physical training in lowering the cardio-metabolic risk

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    Szasz Timea

    2009-12-01

    Full Text Available The cardio-metabolic risk represents the overall risk of developing type 2 diabetes mellitus and / or cardiovascular disease(including heart atack or stroke due to a complex risk factors. The aim of the current prospective study is to evaluate thelifestyle intervention group in a special benefit (overweight young students with cardio-metabolic risk. Material andMethods: Subjects considered for the study: young obese, sedentary, a number of 43 patients (mean age 21.3 ± 3.1years, 93% female. There were made two evaluations on an interval of 6 months, during which patients haveperformed physical training at least 3 times a week (individually according to the individual test, supervised by aphysical therapist. The remission rate was high (37%, from the initial of 43 patients only 27 remained at the second test.Results: After 6 months of lifestyle intervention, we noticed a significant decrease of weight (from 83.61 ± 21.04 to 79.7 ±20.13, body mass index (from 30.93 ± 6.67 to 29.55 ± 6.74, FindRisc score (2.7 to 2 waist circumference (from 98.98 ±10.14 to 89.54 ± 12.32, waist to hip ratio (from 0.87 to 0.85, visceral fat area (98.6 to 88. Conclusion: The activeintervention and closely monitoring of changing lifestyles leads to a significant improvement of cardiovascular risk factors atyoung obese patients. This type of intervention is effective both in terms of benefits in medium term, and relatively increaseddue compliance of young patients to programs involving physical activity.

  13. Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity?

    Science.gov (United States)

    Lambert, Elisabeth A; Straznicky, Nora E; Dixon, John B; Lambert, Gavin W

    2015-07-15

    The sympathetic nervous system (SNS) plays a key role in both cardiovascular and metabolic regulation; hence, disturbances in SNS regulation are likely to impact on both cardiovascular and metabolic health. With excess adiposity, in particular when visceral fat accumulation is present, sympathetic activation commonly occurs. Experimental investigations have shown that adipose tissue releases a large number of adipokines, cytokines, and bioactive mediators capable of stimulating the SNS. Activation of the SNS and its interaction with adipose tissue may lead to the development of hypertension and end-organ damage including vascular, cardiac, and renal impairment and in addition lead to metabolic abnormalities, especially insulin resistance. Lifestyle changes such as weight loss and exercise programs considerably improve the cardiovascular and metabolic profile of subjects with obesity and decrease their cardiovascular risk, but unfortunately weight loss is often difficult to achieve and sustain. Pharmacological and device-based approaches to directly or indirectly target the activation of the SNS may offer some benefit in reducing the cardiometabolic consequences of obesity. Preliminary evidence is encouraging, but more trials are needed to investigate whether sympathetic inhibition could be used in obesity to reverse or prevent cardiometabolic disease development. The purpose of this review article is to highlight the current knowledge of the role that SNS plays in obesity and its associated metabolic disorders and to review the potential benefits of sympathoinhibition on metabolic and cardiovascular functions.

  14. Importance of proper scaling of aerobic power when relating to cardiometabolic risk factors in children

    DEFF Research Database (Denmark)

    McMurray, Robert; Hosick ‎, Peter; Bugge, Anna

    2011-01-01

    BACKGROUND: The relationship between cardiometabolic risk factors (CMRF) and aerobic power (VO(2max)) scaled as mL O(2) per kilogram body mass is controversial because mass includes both fat and fat-free mass, and fat mass is independently associated with the CMRF. AIM: To examine common units used...... to scale VO(2max) and their relationships to mean blood pressure (MBP), total cholesterol (TC), HDL cholesterol, triglycerides (TG), insulin resistance (HOMA-IR) and cumulative risk score (z-score). SUBJECTS: 1784, 8-18 year-old youths, 938 girls and 886 boys. METHODS: Fasting blood samples were obtained....... VO(2max) was estimated in mL/min from cycle ergometry and scaled to body mass (kg), fat free mass (kg(FFM)), body surface area (m(2)), height (cm) and allometric (mL/kg(0.67)/min). RESULTS: Unadjusted correlations between CMRF and many of the scaled VO(2max) units were significant (p

  15. Influence of cardiorespiratory fitness and physical activity levels on cardiometabolic risk factors during menopause transition: A MONET study

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    Joseph Abdulnour

    2016-12-01

    Full Text Available To determine the influence of cardiorespiratory fitness (hereafter “fitness” and physical activity levels on cardiometabolic risk factors in premenopausal women going through the menopause transition. An ancillary study including 66 premenopausal women who participated to a 5-year observational, longitudinal study (2004 to 2009 in Ottawa on the effects of menopause transition on body composition and cardiometabolic risk factors. Women underwent a graded exercise test on treadmill to measure peak oxygen uptake (VO2 peak at year 1 and 5 and physical activity levels were measured using accelerometers. Cardiometabolic risk factors included: waist circumference, fasting plasma lipids, glucose and insulin levels, HOMA-IR score, c-reactive protein, apolipoprotein B (apoB and resting systolic and diastolic blood pressure. Change in fitness was not associated with changes in cardiometabolic risk factors. The changes in total physical activity levels on the other hand showed a significant negative association with apoB levels. Three-way linear mixed model repeated measures, showed lower values of waist circumference, fasting triglycerides, insulin levels, HOMA-IR score, apoB and diastolic blood pressure in women with a fitness ≥30.0 mlO2 kg−1 min−1 compared to women with a fitness <30.0 mlO2 kg−1 min−1 (P < 0.05. However, only fasting triglycerides was lower in women with physical activity levels ≥770.0 Kcal/day (P < 0.05. Between fitness and physical activity levels, fitness was associated with more favorable values of cardiometabolic risk factors in women followed for 5 years during the menopause transition.

  16. A diet based on multiple functional concepts improves cardiometabolic risk parameters in healthy subjects

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    Tovar Juscelino

    2012-04-01

    Full Text Available Abstract Background Different foods can modulate cardiometabolic risk factors in persons already affected by metabolic alterations. The objective of this study was to assess, in healthy overweight individuals, the impact of a diet combining multiple functional concepts on risk markers associated with cardiometabolic diseases (CMD. Methods Fourty-four healthy women and men (50-73 y.o, BMI 25-33, fasting glycemia ≤ 6.1 mmol/L participated in a randomized crossover intervention comparing a multifunctional (active diet (AD with a control diet (CD devoid of the "active" components. Each diet was consumed during 4 wk with a 4 wk washout period. AD included the following functional concepts: low glycemic impact meals, antioxidant-rich foods, oily fish as source of long-chain omega-3 fatty acids, viscous dietary fibers, soybean and whole barley kernel products, almonds, stanols and a probiotic strain (Lactobacillus plantarum Heal19/DSM15313. Results Although the aim was to improve metabolic markers without promoting body weight loss, minor weight reductions were observed with both diets (0.9-1.8 ± 0.2%; P P P P = 0.0056, LDL/HDL (-27 ± 2%; P P 1c (-2 ± 0.4%; P = 0.0013, hs-CRP (-29 ± 9%; P = 0.0497 and systolic blood pressure (-8 ± 1%¸ P = 0.0123. The differences remained significant after adjustment for weight change. After AD, the Framingham cardiovascular risk estimate was 30 ± 4% (P P Conclusion The improved biomarker levels recorded in healthy individuals following the multifunctional regime suggest preventive potential of this dietary approach against CMD.

  17. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis.

    Science.gov (United States)

    Ashwell, M; Gunn, P; Gibson, S

    2012-03-01

    Our aim was to differentiate the screening potential of waist-to-height ratio (WHtR) and waist circumference (WC) for adult cardiometabolic risk in people of different nationalities and to compare both with body mass index (BMI). We undertook a systematic review and meta-analysis of studies that used receiver operating characteristics (ROC) curves for assessing the discriminatory power of anthropometric indices in distinguishing adults with hypertension, type-2 diabetes, dyslipidaemia, metabolic syndrome and general cardiovascular outcomes (CVD). Thirty one papers met the inclusion criteria. Using data on all outcomes, averaged within study group, WHtR had significantly greater discriminatory power compared with BMI. Compared with BMI, WC improved discrimination of adverse outcomes by 3% (P < 0.05) and WHtR improved discrimination by 4-5% over BMI (P < 0.01). Most importantly, statistical analysis of the within-study difference in AUC showed WHtR to be significantly better than WC for diabetes, hypertension, CVD and all outcomes (P < 0.005) in men and women. For the first time, robust statistical evidence from studies involving more than 300 000 adults in several ethnic groups, shows the superiority of WHtR over WC and BMI for detecting cardiometabolic risk factors in both sexes. Waist-to-height ratio should therefore be considered as a screening tool.

  18. Cardiometabolic aspects of polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    Li Wei Cho

    2007-03-01

    Full Text Available Li Wei Cho1, Harpal S Randeva2, Stephen L Atkin11Department of Medicine, University of Hull; 2Metabolic Unit, University Hospitals Coventry & Warwickshire NHS Trust, UKAbstract: It is estimated that 6%–7% of women of reproductive age have polycystic ovarian syndrome (PCOS. Women with this condition exhibit an adverse cardiovascular risk profile, characteristic of the cardiometabolic syndrome and given the high prevalence of PCOS in the female population, this condition may contribute towards the acceleration of cardiovascular disease among young women. This article summarizes the recent development and findings in the cardiometabolic abnormalities in patients with PCOS. Patients with PCOS have the clinical features of oligomenorrhoea, hirsutism and infertility; however, they also exhibit hyperinsulinemia, obesity, hypertension, dyslipidemia, and an increased pro-thrombotic state. They have an increased risk of type 2 diabetes and impaired glucose tolerance, and sleep apnea is also found more commonly in this population. However, despite the presence of cardiovascular risk factors and increased surrogate markers of cardiovascular disease it is unclear if they have accelerated atherosclerosis. End point studies are currently lacking and the available evidence are conflicting. Adipose tissue has emerged as an important endocrine organ over the last decade and gained recognition in having an important role in the cardiometabolic syndrome. Adiponectin that is secreted exclusively by adipocytes has recently been recognized as an important marker of cardiometabolic syndrome, obesity, type 2 diabetes, and coronary artery disease. Other adipocytokines like leptin and resistin have also recently been recognized. This article will address the current evidence for the adverse cardiovascular risk in PCOS and the other factors that may be implicated. Finally the therapeutic options for treatment will be discussed.Keywords: cardiometabolic syndrome

  19. Cardiometabolic risk loci share downstream cis- and trans-gene regulation across tissues and diseases.

    Science.gov (United States)

    Franzén, Oscar; Ermel, Raili; Cohain, Ariella; Akers, Nicholas K; Di Narzo, Antonio; Talukdar, Husain A; Foroughi-Asl, Hassan; Giambartolomei, Claudia; Fullard, John F; Sukhavasi, Katyayani; Köks, Sulev; Gan, Li-Ming; Giannarelli, Chiara; Kovacic, Jason C; Betsholtz, Christer; Losic, Bojan; Michoel, Tom; Hao, Ke; Roussos, Panos; Skogsberg, Josefin; Ruusalepp, Arno; Schadt, Eric E; Björkegren, Johan L M

    2016-08-19

    Genome-wide association studies (GWAS) have identified hundreds of cardiometabolic disease (CMD) risk loci. However, they contribute little to genetic variance, and most downstream gene-regulatory mechanisms are unknown. We genotyped and RNA-sequenced vascular and metabolic tissues from 600 coronary artery disease patients in the Stockholm-Tartu Atherosclerosis Reverse Networks Engineering Task study (STARNET). Gene expression traits associated with CMD risk single-nucleotide polymorphism (SNPs) identified by GWAS were more extensively found in STARNET than in tissue- and disease-unspecific gene-tissue expression studies, indicating sharing of downstream cis-/trans-gene regulation across tissues and CMDs. In contrast, the regulatory effects of other GWAS risk SNPs were tissue-specific; abdominal fat emerged as an important gene-regulatory site for blood lipids, such as for the low-density lipoprotein cholesterol and coronary artery disease risk gene PCSK9 STARNET provides insights into gene-regulatory mechanisms for CMD risk loci, facilitating their translation into opportunities for diagnosis, therapy, and prevention.

  20. Evaluation of clinical and laboratory markers of cardiometabolic risk in overweight and obese children and adolescents

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    Heloísa Marcelina da Cunha Palhares

    Full Text Available OBJECTIVE: This study analyzed the frequency of cardiometabolic risk markers and metabolic syndrome occurrence in overweight and obese children and adolescents. METHODS: The participants included 161 overweight (n=65 and obese (n=96 individuals aged between 5 and 19 years. Clinical markers were assessed (body mass index, body fat percentage, waist circumference, acanthosis, systolic and diastolic blood pressures, laboratory parameters [glucose, insulin, cholesterol (total and fractions and triglyceride levels and homeostasis model assessment of insulin resistance (HOMA-IR index] and leptin and adiponectin levels. The frequency of changes, odds ratios and correlations among markers were determined. Metabolic syndrome was assessed according to International Diabetes Federation criteria. RESULTS: A high frequency of acanthosis (51.6%; increased waist circumference (45.4%, systolic blood pressure / diastolic blood pressure (8.1% / 9.3%, glucose (10%, insulin (36.9% and HOMA-IR (44.3% values; and reduced high-density lipoprotein levels (47.2% were observed. Leptin levels were increased in 95% of obese and in 66% of overweight subjects. Adiponectin was decreased in 29.5% of obese and in 34% of overweight subjects. An odd ratio analysis revealed a greater probability of increased waist circumference (9.0, systolic blood pressure (4.1, triglyceride (2.3 and insulin (2.9 levels and HOMA-IR (3.0 in the obese group than in the overweight group. The clinical and laboratory parameters and leptin levels exhibited significant correlations, whereas adiponectin was negatively correlated with systolic blood pressure. The occurrence rate of metabolic syndrome was 13.6%. CONCLUSIONS: The high frequency of changes in clinical, laboratory and adipokine markers indicates the need for early interventions aimed at preventing cardiometabolic complications in adulthood.

  1. Synergistic in vitro antioxidant activity and observational clinical trial of F105, a phytochemical formulation including Citrus bergamia, in subjects with moderate cardiometabolic risk factors.

    Science.gov (United States)

    Babish, John G; Dahlberg, Clinton J; Ou, Joseph J; Keller, William J; Gao, Wei; Kaadige, Mohan R; Brabazon, Holly; Lamb, Joseph; Soudah, Hani C; Kou, Xiaolan; Zhang, Zhe; Pacioretty, Linda M; Tripp, Matthew L

    2016-12-01

    We examined the clinical safety and efficacy of F105 in 11 subjects with moderate dyslipidemia. F105 is a combination of bergamot fruit extract (Citrus bergamia, BFE) and 9 phytoextracts selected for their ability to improve the antioxidant and anti-inflammatory activity of BFE. In vitro F105 exhibited a synergistic inhibition of oxygen radical absorbing capacity, peroxynitrite formation, and myeloperoxidase activity. Following 12 weeks of F105 daily, no treatment-related adverse events or changes in body mass were seen. Statistically significant changes were noted in total cholesterol (-7.3%), LDL-cholesterol (-10%), non-HDL cholesterol (-7.1%), cholesterol/HDL (-26%), and apolipoprotein B (-2.8%). A post hoc analysis of 8 subjects with HbA1c > 5.4 and HOMA-IR score > 2 or elevated triglycerides revealed additional statistically significant changes in addition to those previously observed in all subjects including triglycerides (-27%), oxLDL (-19%), LDL/HDL (-25%), triglycerides/HDL (-27%), oxLDL/HDL (-25%), and PAI-1 (-37%). A follow-up case report of a 70-year-old female patient, nonresponsive to statin therapy and placed on F105 daily, demonstrated improved cardiometabolic variables over 12 weeks similar to the subgroup. In summary, F105 was clinically well-tolerated and effective for ameliorating dyslipidemia in subjects with moderate cardiometabolic risk factors, particularly in the individuals with HbA1c > 5.4%.

  2. Psoriasis is the independent factor for early atherosclerosis: A prospective study of cardiometabolic risk profile

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    Dinić Miroslav Ž.

    2016-01-01

    Full Text Available Background/Aim. Psoriasis as multisystemic inflammatory dis-ease is related with an increased cardiometabolic risk. The aim of the study was to analyze risk biomarkers, peripheral and renal arteries ultrasonography and echocardiography for subclinical atherosclerosis and metabolic disease in 106 subjects (66 psoriasis patients and 40 controls, 20 eczema patients and 20 healthy volunteers. Methods. In all exameenes following parameters were analyzed: body mass index (BMI, C-reactive protein, D-dimer, serum amyloid A (SAA, apolipoprotein (Apo A1, ApoB, ApoB/Apo A1 index, fasting glucose, C-peptide, fasting insulinemia, homeostatic model assessment-insulin resistance (HOMA-IR, HOMA-β-cell, lipid profile, serum uric acid concentration (SUAC, 24-h proteinuria and microalbuminuria. Carotid, brachial, femoral and renal arteries ultrasonography, as well as echocardiography was also performed. Results. Five of 66 (7.6% psoriasis patients had metabolic syndrome (not present in both control groups. The following variables were increased in patients with psoriasis compared to both control groups: BMI (p = 0.012, insulinemia (p < 0.001, HOMA-IR (p = 0.003, HOMA-β cell (p < 0.001, SUAC (p = 0.006, ApoB/ApoA1 ra-tio (p = 0.006 and microalbuminuria (p < 0.001. Also, increased C-peptide (p = 0.034, D-dimer (p = 0.029, triglycerides (p = 0.044, SAA (p = 0.005 and decreased ApoA1 (p = 0.014 were found in the psoriasis patients compared to healthy controls. HDL cholesterol was decreased in the psoriasis patients compared to the control group of eczema patients (p = 0.004. Common carotid (CIMT and femoral artery intima-media thickness (FIMT was significantly greater (p < 0.001 and the maximal flow speed (cm/s in brachial artery significantly de-creased (p = 0.017 in the patients with psoriasis in comparison to both control groups. In multivariate logistic regression analysis, after the adjustment for confounding variables, the most important predictor of CIMT and

  3. The risk of adverse pregnancy outcome after bariatric surgery

    DEFF Research Database (Denmark)

    Kjær, Mette Karie Mandrup; Lauenborg, Jeannet; Breum, Birger Michael;

    2013-01-01

    The aim of this study was to describe the risk of adverse obstetric and neonatal outcome after bariatric surgery.......The aim of this study was to describe the risk of adverse obstetric and neonatal outcome after bariatric surgery....

  4. Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: A Fresh Look at the Evidence

    OpenAIRE

    Micha, Renata; Mozaffarian, Dariush

    2010-01-01

    Dietary and policy recommendations frequently focus on reducing saturated fatty acid consumption for improving cardiometabolic health, based largely on ecologic and animal studies. Recent advances in nutritional science now allow assessment of critical questions about health effects of saturated fatty acids (SFA). We reviewed the evidence from randomized controlled trials (RCTs) of lipid and non-lipid risk factors, prospective cohort studies of disease endpoints, and RCTs of disease endpoints...

  5. A behavioral intervention in a cohort of Japanese-Brazilians at high cardiometabolic risk

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    Bianca de Almeida-Pititto

    2012-08-01

    Full Text Available OBJECTIVE: To assess the effect of a health promotion program on cardiometabolic risk profile in Japanese-Brazilians. METHODS: A total of 466 subjects from a study on diabetes prevalence conducted in the city of Bauru, southeastern Brazil, in 2000 completed a 1-year intervention program (2005-2006 based on healthy diet counseling and physical activity. Changes in blood pressure and metabolic parameters in the 2005-2006 period were compared with annual changes in these same variables in the 2000-2005 period. RESULTS: During the intervention, there were greater annual reductions in mean (SD waist circumference [-0.5(3.8 vs. 1.2(1.2 cm per year, p<0.001], systolic blood pressure [-4.6(17.9 vs. 1.8(4.3 mmHg per year, p<0.001], 2-hour plasma glucose [-1.2(2.1 vs. -0.2(0.6 mmol/L per year, p<0.001], LDL-cholesterol [-0.3(0.9 vs. -0.1(0.2 mmol/L per year, p<0.001] and Framingham coronary heart disease risk score [-0.25(3.03 vs. 0.11(0.66 per year, p=0.02] but not in triglycerides [0.2(1.6 vs. 0.1(0.42 mmol/L per year, p<0.001], and fasting insulin level [1.2(5.8 vs. -0.7(2.2 IU/mL per year, p<0.001] compared with the pre-intervention period. Significant reductions in the prevalence of impaired fasting glucose/impaired glucose tolerance and diabetes were seen during the intervention (from 58.4% to 35.4%, p<0.001; and from 30.1% to 21.7%, p= 0.004, respectively. CONCLUSIONS: A one-year community-based health promotion program brings cardiometabolic benefits in a high-risk population of Japanese-Brazilians.

  6. High versus Moderate Intensity Running Exercise to Impact Cardiometabolic Risk Factors: The Randomized Controlled RUSH-Study

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    Wolfgang Kemmler

    2014-01-01

    Full Text Available Aerobic exercise positively impacts cardiometabolic risk factors and diseases; however, the most effective exercise training strategies have yet to be identified. To determine the effect of high intensity (interval training (HI(IT versus moderate intensity continuous exercise (MICE training on cardiometabolic risk factors and cardiorespiratory fitness we conducted a 16-week crossover RCT with partial blinding. Eighty-one healthy untrained middle-aged males were randomly assigned to two study arms: (1 a HI(IT-group and (2 a sedentary control/MICE-group that started their MICE protocol after their control status. HI(IT focused on interval training (90 sec to 12 min >85–97.5% HRmax intermitted by active recovery (1–3 min at 65–70% HRmax, while MICE consisted of continuous running at 65–75% HRmax. Both exercise groups progressively performed 2–4 running sessions/week of 35 to 90 min/session; however, protocols were adjusted to attain similar total work (i.e., isocaloric conditions. With respect to cardiometabolic risk factors and cardiorespiratory fitness both exercise groups demonstrated similar significant positive effects on MetS-Z-Score (HI(IT: -2.06±1.31, P=.001 versus MICE: -1.60±1.77, P=.001 and (relative VO2max (HI(IT: 15.6±9.3%, P=.001 versus MICE: 10.6 ± 9.6%, P=.001 compared with the sedentary control group. In conclusion, both exercise programs were comparably effective for improving cardiometabolic indices and cardiorespiratory fitness in untrained middle-aged males.

  7. Relationship between Dietary and Other Lifestyle Habits and Cardiometabolic Risk Factors in Men

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    Katano Sayuri

    2011-11-01

    Full Text Available Abstract Background Prevalence of men with cardiometabolic risk factors (CMRF is increasing in Japan. Few studies have comprehensively examined the relation between lifestyles and CMRF. Methods We examined the baseline data from 3,498 male workers ages 19 to 69 years who participated in the high-risk and population strategy for occupational health promotion (HIPOP-OHP study at 12 large-scale companies throughout Japan. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ. Dietary intake was surveyed by a semi-quantitative Food Frequency Questionnaire. We defined four CMRF in this study as follows: 1 high blood pressure (BP: systolic BP ≥ 130 mmHg, or diastolic BP ≥ 85 mmHg, or the use of antihypertensive drugs; 2 dyslipidemia: high-density lipoprotein-cholesterol concentration 2. Results Those who had 0 to 4 CMRF accounted for 1,597 (45.7%, 1,032 (29.5%, 587 (16.8%, 236 (6.7%, and 44 (1.3% participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors that contributed to the number of CMRF were age (b = 0.020, P Conclusions Alcohol intake, percent protein and total energy intake were positively associated, whereas drinking frequency and IPAQ were inversely associated, with the number of CMRF.

  8. Effect of adolescent obesity on cardiometabolic risk in african-americans and Caucasians.

    Science.gov (United States)

    Hoffman, Robert P

    2012-01-01

    African-Americans have more hypertension, stroke, and type 2 diabetes than do Caucasians. Endothelial dysfunction and insulin resistance are precursors for each. Since these diseases have origins in pediatrics and are associated with obesity, this study was designed to determine if obesity has different effects on endothelial function, insulin sensitivity, and secretion in African-American and Caucasian adolescents. Thirty-three Caucasian and 25 African-Americans (10-18 years old) were subdivided by BMI into lean, overweight, and obesity groups. Endothelial function was measured as forearm vascular resistance (FVR) over 1 min following 5 min of upper arm vascular occlusion. Insulin sensitivity and secretion were measured using intravenous glucose tolerance test and minimal model. Postocclusive FVR was significantly increased in obese African-Americans. Insulin sensitivity was reduced in obese subjects but did not differ by race. Insulin secretion was increased in African-Americans but did not differ by obesity. Subjects were subdivided into risk groups based on 20th percentile for postocclusion FVR response in lean. Seven of nine obese African-Americans were in the high risk group compared to 0 of 5 obese Caucasians. These results demonstrate that obesity significantly impairs endothelial function in African-Americans. Endothelial dysfunction likely predisposes to future cardiometabolic disease in obese African-American adolescents.

  9. Awareness of Abdominal Adiposity as a Cardiometabolic Risk Factor (The 5A Study: Mexico

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    Garcia-Rubi E

    2011-03-01

    Full Text Available Daniel Cuevas Ramos1, Roopa Mehta1, Julieta De La Luz Castro2, Rutila Castañeda Limones3, Ernesto García Rubí4, Carlos A Aguilar-Salinas11Department of Endocrinology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran" (INCMNSZ; 2Cardiodiabetes Unit, Sanofi-Aventis de México; 3Clinical Epidemiology Research Unit, Hospital General Regional No 1 Dr Carlos Mac Gregor Sánchez Navarro; 4Department of Endocrinology, Hospital Angeles Metropolitano, Mexico City, MexicoBackground: The Awareness of Abdominal Adiposity as a Cardiometabolic Risk Factor Study assesses the prevalence of cardiometabolic risk factors in adults with abdominal obesity (waist circumference ≥90 cm in men and ≥80 cm in women and evaluates how physicians manage these patients.Methods: This is an observational cross-sectional study. Internists, cardiologists, and endocrinologists contributed patients to the study. A standardized questionnaire was completed and registered demographics, anthropometric measurements, lab results from the medical files, and any treatment utilized to manage dyslipidemia, arterial hypertension, diabetes, and cardiovascular disease.Results: A total of 1312 patients was included. The mean age was 49.3 ± 14.6 years and 834 (63.6% were female. The primary reason for the physician consultation was treatment of obesity (47.5%, followed by management of arterial hypertension (27.7%, diabetes (18.3%, dyslipidemia (14.2%, and cardiovascular disease (7.1%. The majority of patients identified excess body weight as a health problem (81.4%. However, patients had lost a mean of 4.3 ± 3.5 kg. Only 63.4% of patients with arterial hypertension were on drug therapy. Few of them had reached target values for diastolic (24.1% and systolic/diastolic (13.3% pressure. Less than half of the patients with dyslipidemia were receiving lipid-lowering medication. Only 32.2% were at their target low-density lipoprotein cholesterol levels. In patients with

  10. Incremental increases in economic burden parallels cardiometabolic risk factors in the US

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    McQueen RB

    2016-08-01

    Full Text Available R Brett McQueen,1 Vahram Ghushchyan,1,2 Temitope Olufade,3 John J Sheehan,4 Kavita V Nair,1 Joseph J Saseen1,5 1Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Aurora, CO, USA; 2College of Business and Economics, American University of Armenia, Yerevan, Armenia; 3AstraZeneca, Wilmington, DE, 4AstraZeneca, Fort Washington, PA, 5Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA Objective: Estimate the economic burden associated with incremental increases in the number of cardiometabolic risk factors (CMRFs in the US. Methods: We used the nationally representative Medical Expenditure Panel Survey from 2010 to 2012 to create a retrospective cohort of people based on the number of CMRFs (one, two, and three or four, and a comparison cohort of people with zero CMRFs. CMRFs included abdominal obesity, elevated blood pressure, elevated triglycerides, and elevated glucose and were defined using diagnostic codes, prescribed medications, and survey responses. Adjusted regression analysis was developed to compare health expenditures, utilization, and lost-productivity differences between the cohorts. Generalized linear regression was used for health care expenditures, and negative binomial regression was used for utilization and productivity, controlling for individual characteristics. Results: The number of CMRFs was associated with significantly more annual utilization, health care expenditures, and reduced productivity. As compared with people with zero CMRFs, people with one, two, and three or four CMRFs had 1.15 (95% confidence interval [CI]: 1.06, 1.24, 1.37 (95% CI: 1.25, 1.51, and 1.39 (95% CI: 1.22, 1.57 times higher expected rate of emergency room visits, respectively. Compared with people with zero CMRFs, people with one, two, and three or four CMRFs had increased incremental health care expenditures of US$417 (95

  11. Assessment of Cardio-Metabolic Risk Factors among Young Adult Females

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    Swati Dhruv

    2012-01-01

    Full Text Available Problem statement: Over the past two decades there has been a striking increase in the number of people with metabolic syndrome in developing countries. The current study was thus undertaken to map the prevalence of Metabolic Syndrome (MS and to assess the cardio-metabolic risk factors among young adult females (n = 1303 aged 18-26y from four girls hostel of the Maharaja Sayajirao University of Baroda. Approach: The anthropometric analysis showed a high prevalence of overweight/obesity (20.8%, abdominal obesity (12.7% among the subjects. The clinical profile revealed that 12.1% were hypertensives. The prevalence of dyslipidemia revealed that no one had hypercholesterolemia and 4.1% had hypertriglyceridemia, 12.1% had elevated LDL-C and 40.3% had low levels of HDL-C. The prevalence of metabolic syndrome was 2.4 and 4.1% according to the International Diabetes Federation (IDF and World Health Organization (WHO criteria respectively. Lipid profile in relation to metabolic syndrome showed that VLDL-C and Triglyceride (TG values were non-significantly higher among the young adult females and HDL-C values were significantly (pResults: The three common and predominant risk factors (>80% identified were lower intake of fruits (81.5%, vegetables (96% and physical inactivity (88.7%. The other risk factors which were present between 30-50% were hypertension, lower HDL-C, Body Mass Index (BMI and Waist Circumference (WC. Among the non-modifiable factor heredity component was present in 34% of the subjects. Conclusion: The study highlights that lifestyle factors had equivalent risk for overweight and metabolic syndrome. Multiple risk factor scenario calls for lifestyle management to avert later consequences.

  12. Cardiometabolic risk factors in different clinicomorphological stages of non-alcoholic fatty liver disease in patients with abdominal obesity

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    K A Komshilova

    2012-09-01

    Full Text Available The aim of the study was to compare clinical, laboratory and morphological parameters in patients with abdominal obesity and non-alcoholic fatty liver disease (NAFLD, and assessing the relationship between the degree of severity, stage NAFLD and cardiometabolic risk factors for type 2 diabetes mellitus and cardiovascular disease. The present study examined the content of adiponectin and rates of glucose and lipid metabolism in obese patients at different stages of NAFLD. According to the study, morphologically NAFLD was confirmed in 95.2% of patients. NAFLD was associated with various cardiometabolic disorders (dyslipidemia, disorders of glucose metabolism and insulin resistance, growing in frequency and severity with the progression NAFLD; and low levels of adiponectin decreasing with a deterioration NAFLD.

  13. Vitamin D Deficiency and Cardiometabolic Risks: A Juxtaposition of Arab Adolescents and Adults.

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    Nasser M Al-Daghri

    Full Text Available The recent exponential surge in vitamin D research reflects the global epidemic of vitamin D deficiency and its potential impact on several chronic diseases in both children and adults. Several subpopulations, including Arab adolescent boys and girls, remain understudied. This study aims to fill this gap. A total of 2225 apparently healthy Saudi adolescents (1187 boys and 1038 girls, aged 13-17 years old and 830 adults (368 men and 462 women, aged 18-50 years old were respectively recruited from different public schools and medical practices within Riyadh, Saudi Arabia. Anthropometrics were taken and fasting blood samples withdrawn to examine serum glucose and lipid profile by routine analysis and 25-hydroxyvitamin D by ELISA. Almost half of the girls (47.0% had vitamin D deficiency as compared to only 19.4% of the boys (p<0.001, 36.8% of the adult women and 17.7% of the adult men (p<0.001. Furthermore, in boys there were more significant inverse associations between serum 25(OHvitamin D levels and cardiometabolic indices than girls, while in contrast women had more significant associations than men. Vitamin D deficiency was significantly associated with diabetes mellitus type 2 (DMT2 [OR 3.47 (CI1.26-5.55; p<0.05] and pre-DM [OR 2.47 (CI 1.48-4.12; p<0.01] in boys. Furthermore, vitamin D insufficiency was significantly associated with abdominal obesity in boys [OR 2.75 (CI 1.1-7.1; p<0.05]. These associations for DMT2 and abdominal obesity were not observed in adult males, girls and adult women. Vitamin D deficiency/insufficiency and hyperglycemia is high among Arab adolescents. Vitamin D deficiency is mostly associated with cardiometabolic risk factors in adolescent Arab boys. This indicates a sex- and age-related disadvantage for boys with low vitamin D status and challenges the extra-skeletal protection of vitamin D correction in adolescent females.

  14. Western-Style Fast Food Intake and Cardiometabolic Risk in an Eastern Country

    Science.gov (United States)

    Odegaard, Andrew O.; Koh, Woon Puay; Yuan, Jian-Min; Gross, Myron D.; Pereira, Mark A.

    2014-01-01

    Background Western-style fast food contributes to a dietary pattern portending poor cardiometabolic health in the United States. With globalization, this way of eating is becoming more common in developing and recently developed populations. Methods and Results We examined the association of Western-style fast food intake with risk of incident type 2 diabetes mellitus and coronary heart disease mortality in Chinese Singaporeans. This analysis included men and women 45 to 74 years of age who enrolled in the Singapore Chinese Health Study from 1993 to 1998. For CHD mortality, 52 584 participants were included and 1397 deaths were identified through December 31, 2009, via registry linkage. For type 2 diabetes mellitus, 43 176 participants were included and 2252 cases were identified during the follow-up interview (1999 –2004) and validated. Hazard ratios for incident type 2 diabetes mellitus and coronary heart disease mortality were estimated with thorough adjustment for demographic, lifestyle, and dietary factors. Chinese Singaporeans with relatively frequent intake of Western-style fast food items (≥2 times per week) had an increased risk of developing type 2 diabetes mellitus (hazard ratio, 1.27; 95% confidence interval, 1.03–1.54) and dying of coronary heart disease (hazard ratio, 1.56; 95% confidence interval, 1.18 –2.06) relative to their peers with little or no reported intake. These associations were not materially altered by adjustments for overall dietary pattern, energy intake, and body mass index. Conclusions Western-style fast food intake is associated with increased risk of developing type 2 diabetes mellitus and of coronary heart disease mortality in an Eastern population. These findings suggest the need for further attention to global dietary acculturation in the context of ongoing epidemiological and nutrition transitions. PMID:22753304

  15. Role of ω3 long-chain polyunsaturated fatty acids in reducing cardio-metabolic risk factors.

    Science.gov (United States)

    Abeywardena, Mahinda Y; Patten, Glen S

    2011-09-01

    atherogenic form to the larger, less damaging particle size, have also been noted. ω3 LC-PUFA are effective modulators of the inflammation that accompanies several cardio-metabolic abnormalities. Taking into consideration the pleiotropic nature of their actions, it can be concluded that dietary supplementation with ω3 LC-PUFA will lead to improvements in cardio-metabolic health parameters. These fatty acids pose only minor side effects and more importantly, do not interact adversely with the common drug therapies used in the management and treatment of hypertension, dyslipidemia, type-2 diabetes, and obesity/metabolic syndrome, but in some instances work synergistically, thereby providing additional cardiovascular benefits.

  16. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence.

    Science.gov (United States)

    Micha, Renata; Mozaffarian, Dariush

    2010-10-01

    Dietary and policy recommendations frequently focus on reducing saturated fatty acid consumption for improving cardiometabolic health, based largely on ecologic and animal studies. Recent advances in nutritional science now allow assessment of critical questions about health effects of saturated fatty acids (SFA). We reviewed the evidence from randomized controlled trials (RCTs) of lipid and non-lipid risk factors, prospective cohort studies of disease endpoints, and RCTs of disease endpoints for cardiometabolic effects of SFA consumption in humans, including whether effects vary depending on specific SFA chain-length; on the replacement nutrient; or on disease outcomes evaluated. Compared with carbohydrate, the TC:HDL-C ratio is nonsignificantly affected by consumption of myristic or palmitic acid, is nonsignificantly decreased by stearic acid, and is significantly decreased by lauric acid. However, insufficient evidence exists for different chain-length-specific effects on other risk pathways or, more importantly, disease endpoints. Based on consistent evidence from human studies, replacing SFA with polyunsaturated fat modestly lowers coronary heart disease risk, with ~10% risk reduction for a 5% energy substitution; whereas replacing SFA with carbohydrate has no benefit and replacing SFA with monounsaturated fat has uncertain effects. Evidence for the effects of SFA consumption on vascular function, insulin resistance, diabetes, and stroke is mixed, with many studies showing no clear effects, highlighting a need for further investigation of these endpoints. Public health emphasis on reducing SFA consumption without considering the replacement nutrient or, more importantly, the many other food-based risk factors for cardiometabolic disease is unlikely to produce substantial intended benefits.

  17. Imbalance in the intestinal microbiota as a risk factor of cardiometabolic diseases

    Directory of Open Access Journals (Sweden)

    Yu. V. Lobzin

    2014-01-01

    Full Text Available The review shows the role of the intestinal microflora in the development of atherosclerosis, coronary heart disease, overweight / obesity and diabetes. It is well known that consumption of foods rich in saturated fats and cholesterol (meat, egg yolk and milk products with high fat content is associated with an increased risk of cardiovascular disease. However, new studies show that the atherogenic properties of these products are also due to the high content of L-carnitine and its structural analog choline, which, after entering the body is metabolized by intestinal bacteria up to trimethylamine (TMA, and then converted in the liver to trimethylamine-N-oxide (TMAO having direct atherogenic action. It was found that elevated levels of TMAO increases the risk of myocardial infarction, stroke, cardiac failure and death, including the common causes. In the center of international attention is also the question of the role of the intestinal microbiota imbalance in the development of insulin resistance, endothelial dysfunction, increase of the adhesive properties of macrophages, the appearance of dyslipidemia, elevated blood pressure, overweight. Attention of the doctors is focused on the extremely importance of maintaining a normal balance of the intestinal microbiota to prevent cardiometabolic diseases apart from implementation of already well-known and generally accepted preventive measures.

  18. Pubertal timing and adult obesity and cardiometabolic risk in women and men: a systematic review and meta-analysis.

    Science.gov (United States)

    Prentice, P; Viner, R M

    2013-08-01

    Obesity has complex multifactorial aetiology. It has been suggested by many, but not all, reports that earlier pubertal maturation may increase adult obesity risk. We conducted a systemic review and meta-analysis in both women and men, and hypothesised that any association between pubertal timing and adult obesity is likely to be confounded by childhood adiposity. In addition, we investigated whether pubertal timing is related to other cardiometabolic risk and long-term cardiovascular morbidity/mortality. Literature search was undertaken using MEDLINE, EMBASE, Web of Knowledge and TRIP databases, with a hand search of references. Both authors independently reviewed and extracted pre-defined data from all selected papers. Meta-analyses were conducted using Review Manager (RevMan) 5.0.24. A total of 48 papers were identified. Out of 34 studies, 30 reported an inverse relationship between pubertal timing and adult body mass index (BMI), the main adiposity measure used. Meta-analysis of 10 cohorts showed association between early menarche (menarche metabolic syndrome (MetS) and abnormal glycaemia. Earlier pubertal timing is predictive of higher adult BMI and greater risk of obesity. This effect appears to be partially independent of childhood BMI. Earlier pubertal development appears to also be inversely correlated with risk of other cardiometabolic risk factors and cardiovascular mortality. Further work is needed to examine potential mechanisms and the level at which interventions may be targeted.

  19. Low Physical Activity Level and Short Sleep Duration Are Associated with an Increased Cardio-Metabolic Risk Profile: A Longitudinal Study in 8-11 Year Old Danish Children

    DEFF Research Database (Denmark)

    Hjorth, Mads F.; Chaput, Jean-Philippe; Damsgaard, Camilla T.;

    2014-01-01

    Background: As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood. Obj...

  20. Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review.

    Science.gov (United States)

    Bouchenak, Malika; Lamri-Senhadji, Myriem

    2013-03-01

    of the nutritional quality of legumes and their potential contribution in cardiometabolic risk prevention.

  1. Antioxidants deficiency: a sensitive indicator of cardiometabolic risk in chronic renal failure?

    Directory of Open Access Journals (Sweden)

    Pooja S.K. Rai

    2013-04-01

    Full Text Available Background: Antioxidant depletion occurring in chronic renal failure patients is an important cause of associated morbidity & mortality, which in turn imposes a great socioeconomic burden of health care. Early diagnosis & targeted management of this preventable deficiency may have a positive impact on the management of co morbidities associated with chronic renal failure. Aims & Objectives: To evaluate the status of antioxidants as an early indicator of cardiometabolic risk in chronic renal failure patients. Settings & Design: This was a randomised case Control study including 10 controls of either sex with normal renal function between age group 20-60 years and 15 patients of chronic renal failure on dialysis between the age group of 16 - 60 years. Methods: 12 hour fasting venous blood samples were collected from all the participants and were assayed for various antioxidants. Statistical analysis: Results were analyzed by unpaired t test, p value was determined & Correlation coefficient was calculated amongst various parameters. Results: In the present study, significantly low levels of vitamin C ( Cases: 0.367 ± 0.13 mg/dl controls: 1.324 ± 0.61 mg/dl; p < 0.01 & vitamin E (cases: 0.235 ± 0.102 mg/dl, controls (0.854 ± 0.28 mg/dl; p < 0.01 were observed in chronic renal failure patients as compared to controls. Conclusion: Diminished levels of Vitamin C & E in our study may be an indicator of increased oxidative stress which can be a responsible factor for increased incidence of cardiovascular complications. Supplementing these patients with recommended dosage of these vitamins may provide an essential tool to reduce the burden of suffering. [Int J Res Med Sci 2013; 1(2.000: 87-92

  2. Usual dietary glycemic load is associated with cardiometabolic risk factors in physically active Brazilian middle-aged men

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    Paula G. Cocate

    2014-02-01

    Full Text Available Introduction: The effects of dietary glycemic load (GL on cardiometabolic risk factors in physically active subjects are not completely known. Objective: This cross-sectional study assessed the association of habitual dietary GL with cardiometabolic risk factors in physically active Brazilian middle-aged men. Methods: One-hundred seventy-six subjects (Age: 50.6 ± 5.0 years, BMI: 25.5 ± 3.6 kg/m² were evaluated. Anthropometry, lifestyle features, insulin resistance, oxidative stress biomarkers (8-iso-prostaglandin F2α; 8-iso-PGF2α and 8-hydroxydeoxyguanosine; 8-OHdG and lipid profile were assessed. Dietary intake was estimated through a quantitative food frequency questionnaire. Results: The dietary GL was positively associated with free fatty acid concentrations (β = 0.311, r² = 0.13, P-value = 0.034 and triglycerides/HDL cholesterol ratio (β = 0.598, r² = 0.19, P-value = 0.028 regardless of confounding factors (central obesity, red meat consumption, age and energy intake. The oxidative stress biomarker, 8-OHdG, was associated with habitual dietary GL (β = 0.432, r² = 0.11, P-value = 0.004, regardless of previous confounding factors plus excessive alcohol consumption, iron intake and current smoking status. Conclusions: The dietary GL was positively associated with lipid profile (free fatty acid concentrations and triglycerides/HDL cholesterol ratio and oxidative stress biomarker (8-OHdG. These results indicate potential harmfulness of diet with higher GL to cardiometabolic risk factors in middle-aged men, even in physically active individuals.

  3. Omega-3 polyunsaturated fatty acid profiles and relationship with cardiometabolic risk factors in Cree (Eeyouch) of Northern Québec

    OpenAIRE

    Proust, Françoise; Drescher, Olivia; Laouan-Sidi, Elhadji A.; Robinson, Elizabeth; Lucas, Michel; Dewailly, Éric

    2016-01-01

    Background. n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) from fish are known modulators of cardiometabolic risk factors.Objective. To examine fatty acids (FAs) status and the relationship between n-3 LC-PUFA and cardiometabolic risk factors in Cree participants.Design. We analyzed data from a cross-sectional study (n=829) conducted in Cree adults (aged 18–74 years) from 7 communities of the James Bay territory of Quebec (Canada) in 2005–2009. Sociodemographic, lifestyle, clinical and...

  4. Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors

    Directory of Open Access Journals (Sweden)

    Lin Xu

    2009-05-01

    Full Text Available Abstract Background Poor sleep quality has been associated with increased risk of heart disease, diabetes and mortality. However, limited information exists on the distribution and determinants of sleep quality and its associations with cardio-metabolic risk factors in Chinese populations. We aimed to evaluate this in the current study. Methods A cross-sectional survey conducted in 2005 of 1,458 men and 1,831 women aged 50–70 years from urban and rural areas of Beijing and Shanghai. Using a questionnaire, sleep quality was measured in levels of well, common and poor. Comprehensive measures of socio-demographical and health factors and biomarkers of cardio-metabolic disease were recorded. These were evaluated in association with sleep quality using logistic regression models. Results Half of the population reported good sleep quality. After adjusting for potential confounders, women and Beijing residents had almost half the probability to report good sleep quality. Good physical and mental health (good levels of self-rated health (OR 2.48; 95%CI 2.08 to 2.96 and no depression (OR 4.05; 95%CI 3.12 to 5.26 related to an increased chance of reporting good sleep quality, whereas short sleep duration ( Conclusion Levels of good sleep quality in middle-age and elderly Chinese were low. Gender, geographical location, self-rated health, depression and sleep quantity were major factors associated with sleep quality. Prospective studies are required to distil the factors that determine sleep quality and the effects that sleep patterns exert on cardio-metabolic health.

  5. Association between food and nutrition insecurity with cardiometabolic risk factors in childhood and adolescence: a systematic review

    Directory of Open Access Journals (Sweden)

    Naruna Pereira Rocha

    2016-06-01

    Full Text Available Abstract Objective: To address the association between food and nutrition insecurity and cardiometabolic risk factors in childhood and adolescence. Data source: Articles were selected from the Medline, Lilacs and SciELO databases with no publication date limit, involving children and adolescents, using the descriptors: food and nutrition security, diabetes mellitus, hypertension, metabolic syndrome, stress and dyslipidemia. The terms were used in Portuguese, English and Spanish. The search was carried out systematically and independently by two reviewers. Data synthesis: Exposure to food insecurity during childhood and adolescence ranged from 3.3% to 82% in the selected publications. Exposure to food insecurity was associated with stress, anxiety, greater chance of hospitalization, nutritional deficiencies, excess weight and inadequate diets with reduced intake of fruits and vegetables and increased consumption of refined carbohydrates and fats. Conclusions: Food and nutrition insecurity was associated with the presence of cardiometabolic risk factors in the assessed publications. Childhood and adolescence constitute a period of life that is vulnerable to food insecurity consequences, making it extremely important to ensure the regular and permanent access to food. Because this is a complex association, some difficulties are found, such as the synergy between risk factors, the assessment of heterogeneous groups and extrapolation of data to other populations, in addition to the influence of environmental factors.

  6. The Heart of New Ulm Project: using community-based cardiometabolic risk factor screenings in a rural population health improvement initiative.

    Science.gov (United States)

    VanWormer, Jeffrey J; Johnson, Pamela Jo; Pereira, Raquel F; Boucher, Jackie L; Britt, Heather R; Stephens, Charles W; Thygeson, N Marcus; Graham, Kevin J

    2012-06-01

    Awareness of cardiovascular disease and diabetes risk factors can improve the health of individuals and populations. Community-based risk factor screening programs may be particularly useful for quantifying the burden of cardiometabolic risk in a given population, particularly in underserved areas. This study provided a description of a screening platform and how it has been used to monitor the cardiometabolic risk profile within the broader Heart of New Ulm Project, which is based in a rural Minnesota community. A cross-sectional, descriptive examination of baseline screening data indicated that 45% of the target population participated in the program over 8 months. Overall, 13% of the sample reported a personal history of diabetes or cardiovascular disease. Among the subset without active cardiometabolic disease, 35% were found to be at high risk for developing cardiovascular disease or type 2 diabetes over the next 8-10 years. A high prevalence of metabolic syndrome, high low-density lipoprotein cholesterol, obesity, and low fruit/vegetable consumption were of particular concern in this community. This article describes the use of screening results to inform the design of intervention programs that target these risk factors at both the community and individual levels. In addition, design considerations for future community-based cardiometabolic risk factor screening programs are discussed, with a focus on balancing program objectives related to health surveillance, research, and the delivery of preventive health care services.

  7. Evaluation of a multispectral diffuse optical spectroscopy device for assessment of cardiometabolic risk related alterations of body composition

    Science.gov (United States)

    Marcinkevics, Z.; Volceka, K.; Ozolina-Moll, L.; Zaharans, J.

    2013-11-01

    Cardiometabolic diseases encompass a combination of conditions which lead to an increase in the risk of cardiovascular disease and diabetes. With the increasing percentage of the population becoming overweight, it is important to diagnose when the excess adipose tissue becomes malign. The development of a safe, mobile, non-invasive method that would be easy to perform, and low-cost, but also would offer an accurate assessment of subcutaneous adipose tissue (SAT) both in lean and in obese persons is required. A prototype device using an optical method for measurement of the SAT in vivo has been developed, it contains multiple LEDs with four wavelengths (660nm, 780nm, 870nm, 940nm) distributed at various distances from the photodetector which allow different light penetration depths into the subcutaneous tissue. Five young healthy female students participated in the study; the measurements were performed on three body sites: calf, upper and lower abdomen. The backscattered light acquired with the prototype was compared to SAT measured with high resolution ultrasound imaging. The coefficient of variation indicated high reliability of the measurements. Statistically significant (from r=0.81 to r=0.95; p<0.05) correlation between intensity of backscattered light and SAT thicknesses for all four wavelength was observed, especially at source-detector distance 25mm. The novel device prototype has a potential to be a good alternative for conventional SAT measurement and assessment of cardiometabolic risk. Amultispectral approach can potentially increase precision and spatial resolution of SAT determination.

  8. Incremental increases in economic burden parallels cardiometabolic risk factors in the US

    Science.gov (United States)

    McQueen, R Brett; Ghushchyan, Vahram; Olufade, Temitope; Sheehan, John J; Nair, Kavita V; Saseen, Joseph J

    2016-01-01

    Objective Estimate the economic burden associated with incremental increases in the number of cardiometabolic risk factors (CMRFs) in the US. Methods We used the nationally representative Medical Expenditure Panel Survey from 2010 to 2012 to create a retrospective cohort of people based on the number of CMRFs (one, two, and three or four), and a comparison cohort of people with zero CMRFs. CMRFs included abdominal obesity, elevated blood pressure, elevated triglycerides, and elevated glucose and were defined using diagnostic codes, prescribed medications, and survey responses. Adjusted regression analysis was developed to compare health expenditures, utilization, and lost-productivity differences between the cohorts. Generalized linear regression was used for health care expenditures, and negative binomial regression was used for utilization and productivity, controlling for individual characteristics. Results The number of CMRFs was associated with significantly more annual utilization, health care expenditures, and reduced productivity. As compared with people with zero CMRFs, people with one, two, and three or four CMRFs had 1.15 (95% confidence interval [CI]: 1.06, 1.24), 1.37 (95% CI: 1.25, 1.51), and 1.39 (95% CI: 1.22, 1.57) times higher expected rate of emergency room visits, respectively. Compared with people with zero CMRFs, people with one, two, and three or four CMRFs had increased incremental health care expenditures of US$417 (95% CI: $70, $763), US$2,326 (95% CI: $1,864, $2,788), and US$4,117 (95% CI: $3,428, $4,807), respectively. Those with three or four CMRFs reported employment of 60%, compared with 80% in patients with zero CMRFs. People with three or four CMFRs had 1.75 (95% CI: 1.42, 2.17) times higher expected rate of days missed at work due to illness, compared with people with zero CMRFs. Conclusion Our findings demonstrate a direct association between economic burden and number of CMRFs. Although this was expected, the increase in burden

  9. Thiamine and its phosphate esters in relation to cardiometabolic risk factors in Saudi Arabs

    OpenAIRE

    Al-Daghri, Nasser M.; Al-Attas, Omar S.; Alkharfy, Khalid M.; Alokail, Majed S; Abd-Alrahman, Sherif H; Sabico, Shaun

    2013-01-01

    Background Thiamine deficiency has suggested to be linked to several insulin-resistance complications. In this study, we aim to associate circulating thiamine levels among cardiometabolic parameters in an Arab cohort using a simple, sensitive, rapid and selective high-performance liquid chromatography (HPLC) method that has recently been developed. Methods A total of 236 randomly selected, consenting Saudi adult participants (166 males and 70 females) were recruited and screened for the prese...

  10. Prevalence and predictors of diabetes and cardiometabolic risk among construction workers in Ireland: the Construction Workers Health Trust screening study.

    LENUS (Irish Health Repository)

    Thabit, Hood

    2013-07-01

    Construction workers (CW) are at increased risk for a range of chronic diseases. We screened 983 CW for diabetes and cardiometabolic risk. The age range was 18-64 years, with mean age of 36.3 years. Self-reported questionnaires, Finnish diabetes risk score and fasting blood tests were collected at the workplace. The unadjusted prevalence of pre-diabetes and type 2 diabetes mellitus were 3.6% and 1.2%, respectively; 21% of CW had the metabolic syndrome (MetS). The majority were either overweight (48.3%) or obese (21.8%). In a regression model, age remained the strongest predictor of fasting glucose (p < 0.001). Pre-diabetes and diabetes mellitus were significantly associated with presence of the MetS [odds ratio (OR) 5.6; 95% confidence interval (CI): 2.8-11.5, p < 0.001 and OR 5.5; 95% CI: 1.6-18.7, p = 0.006, respectively]. Subjects engaged in greater physical activity outside of work had lower body mass index (26.9 vs. 28.8 kg\\/m(2), p = 0.03), waist circumference (95.8 vs. 98.1 cm, p = 0.03) and fasting serum triglycerides (1.1 vs. 1.4 mmol\\/L, p = 0.03) compared to those who were sedentary. Despite their youth and a physically demanding occupation, CW are at risk of cardiometabolic diseases. This risk increases with age and the MetS. Screening tools may be useful to identify those who are at risk.

  11. A comparison of cardiometabolic risk factors in households in rural Uganda with and without a resident with type 2 diabetes, 2012-2013

    DEFF Research Database (Denmark)

    Nielsen, Jannie; Bahendeka, Silver K.; Gregg, Edward W.

    2015-01-01

    with a person with T2D may have unexpected benefits on the risk factor profile for cardio-metabolic diseases, probably because of improved health behaviors and a closer connection with the health care system. Thus, future studies should consider the household for interventions targeting primary and secondary...

  12. Associations between prolonged sedentary time and breaks in sedentary time with cardiometabolic risk in 10-14-year-old children: The HAPPY study.

    Science.gov (United States)

    Bailey, Daniel P; Charman, Sarah J; Ploetz, Thomas; Savory, Louise A; Kerr, Catherine J

    2016-11-28

    This study examines the association between prolonged sedentary time and breaks in sedentary time with cardiometabolic risk in 10-14-year-old children. This cross-sectional design study analysed accelerometry-determined sedentary behaviour and physical activity collected over 7 days from 111 (66 girls) UK schoolchildren. Objective outcome measures included waist circumference, fasting lipids, fasting glucose, blood pressure, and cardiorespiratory fitness. Logistic regression was used for the main data analysis. After adjustment for confounders, the odds of having hypertriglyceridaemia (P = 0.03) and an increased clustered cardiometabolic risk score (P = 0.05) were significantly higher in children who engaged in more prolonged sedentary bouts per day. The number of breaks in sedentary time per day was not associated with any cardiometabolic risk factor, but longer mean duration of daily breaks in sedentary time were associated with a lower odds of having abdominal adiposity (P = 0.04) and elevated diastolic blood pressure (P = 0.01). These associations may be mediated by engagement in light activity. This study provides evidence that avoiding periods of prolonged uninterrupted sedentary time may be important for reducing cardiometabolic disease risk in children.

  13. The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders : a meta-analysis

    NARCIS (Netherlands)

    Bruins, Jojanneke; Jörg, Frederike; Bruggeman, Richard; Slooff, C. J.; Corpeleijn, Eva; Pijnenborg, Marieke

    2014-01-01

    AIMS: The aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined. MATERIAL AND METHODS: W

  14. Eicosapentaenoic acid and docosahexaenoic acid in whole blood are differentially and sex-specifically associated with cardiometabolic risk markers in 8-11-year-old danish children

    DEFF Research Database (Denmark)

    Damsgaard, Camilla T.; Eidner, Maj B.; Stark, Ken D.;

    2014-01-01

    ) investigated associations between EPA and DHA in whole blood and early cardiometabolic risk markers in 713 children aged 8-11 years and 2) explored potential mediation through waist circumference and physical activity and potential dietary confounding. We collected data on parental education, pubertal stage, 7...

  15. Cross-Sectional Assessment of Nut Consumption and Obesity, Metabolic Syndrome and Other Cardiometabolic Risk Factors: The PREDIMED Study

    Science.gov (United States)

    Ibarrola-Jurado, Núria; Bulló, Mònica; Guasch-Ferré, Marta; Ros, Emilio; Martínez-González, Miguel A.; Corella, Dolores; Fiol, Miquel; Wärnberg, Julia; Estruch, Ramón; Román, Pilar; Arós, Fernando; Vinyoles, Ernest; Serra-Majem, Lluis; Pintó, Xavier; Covas, María-Isabel; Basora, Josep; Salas-Salvadó, Jordi

    2013-01-01

    Introduction Prospective studies have consistently suggested that nut consumption is inversely related to fatal and non-fatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors. Objective To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS), type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk. Materials and Methods Cross-sectional study of 7,210 men and women (mean age, 67 y) recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia) by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as 3 servings/wk. Control of confounding was done with multivariate logistic regression. Results Compared to participants consuming 3 servings/wk had lower adjusted odds ratios (OR) for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend <0.001), MetS (0.74, 0.65 to 0.85; P-trend<0.001), and diabetes (0.87, 0.78 to 0.99; P-trend = 0.043). Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend<0.001). No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose. Conclusions Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk. PMID:23460844

  16. Cross-sectional assessment of nut consumption and obesity, metabolic syndrome and other cardiometabolic risk factors: the PREDIMED study.

    Directory of Open Access Journals (Sweden)

    Núria Ibarrola-Jurado

    Full Text Available INTRODUCTION: Prospective studies have consistently suggested that nut consumption is inversely related to fatal and non-fatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors. OBJECTIVE: To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS, type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk. MATERIALS AND METHODS: Cross-sectional study of 7,210 men and women (mean age, 67 y recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as 3 servings/wk. Control of confounding was done with multivariate logistic regression. RESULTS: Compared to participants consuming 3 servings/wk had lower adjusted odds ratios (OR for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend <0.001, MetS (0.74, 0.65 to 0.85; P-trend<0.001, and diabetes (0.87, 0.78 to 0.99; P-trend = 0.043. Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend<0.001. No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose. CONCLUSIONS: Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk.

  17. A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis.

    Science.gov (United States)

    Teasdale, Scott B; Ward, Philip B; Rosenbaum, Simon; Watkins, Andrew; Curtis, Jackie; Kalucy, Megan; Samaras, Katherine

    2016-06-01

    Severe mental illness is characterised by a 20-year mortality gap due to cardiometabolic disease. Poor diet in those with severe mental illness is an important and modifiable risk factor. The present study aimed to (i) examine baseline nutritional intake in youth with first-episode psychosis (FEP), (ii) evaluate the feasibility and acceptability of nutritional intervention early in FEP and (iii) to evaluate the effectiveness of early dietary intervention on key nutritional end points. Participants were recruited over a 12-month period from a community-based programme specifically targeting young people aged 15-25 years with newly diagnosed FEP. Individual dietetic consultations and practical group sessions were offered as part of a broader lifestyle programme. Dietary assessments were conducted before and at the end of the 12-week intervention. Participants exceeded recommended energy and Na intakes at baseline. Retention within the nutrition intervention was 67 %, consistent with other interventions offered to FEP clients. There was a 47 % reduction in discretionary food intake (-94 g/d, PNutrition intervention delivered shortly after initiation of antipsychotic medication is feasible, acceptable and effective in youth with FEP. Strategies to prevent weight gain and metabolic decline will contribute to prevent premature cardiometabolic disease in this vulnerable population.

  18. Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents

    Directory of Open Access Journals (Sweden)

    Chun-Ying Lee

    2016-09-01

    Full Text Available Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12–16 years were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1–2 and ≥3 risk components for pediatric metabolic syndrome (MetS were defined as potential MetS (pot-MetS and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5–1.6 and 1.9–4.2-fold, respectively. Low physical activity (<952.4 MET·min/week, long screen time (≥3 h/day and high sugar-sweetened beverage intake (>500 mL/day were associated with a 3.3- (95% confidence intervals (CI = 1.5–7.3, 2.2- (95% CI = 1.1–4.4, and 26.9-fold (95% CI = 3.2–229.0 odds ratio (OR of MetS, respectively. Pediatric body mass index (BMI accounted for 18.8%–95.6% and 16.9%–60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3–17.3; p for multiplicative interaction, 0.009. The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI

  19. Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents

    Science.gov (United States)

    Lee, Chun-Ying; Lin, Wei-Ting; Tsai, Sharon; Hung, Yu-Chan; Wu, Pei-Wen; Yang, Yu-Cheng; Chan, Te-Fu; Huang, Hsiao-Ling; Weng, Yao-Lin; Chiu, Yu-Wen; Huang, Chia-Tsuan; Lee, Chien-Hung

    2016-01-01

    Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12–16 years) were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1–2 and ≥3 risk components for pediatric metabolic syndrome (MetS) were defined as potential MetS (pot-MetS) and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5–1.6 and 1.9–4.2-fold, respectively). Low physical activity (beverage intake (>500 mL/day) were associated with a 3.3- (95% confidence intervals (CI) = 1.5–7.3), 2.2- (95% CI = 1.1–4.4), and 26.9-fold (95% CI = 3.2–229.0) odds ratio (OR) of MetS, respectively. Pediatric body mass index (BMI) accounted for 18.8%–95.6% and 16.9%–60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3–17.3); p for multiplicative interaction, 0.009). The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI explains a part of these associations. Pediatric adiposity might be

  20. Does the fractionalization of daily physical activity (sporadic vs. bouts impact cardiometabolic risk factors in children and youth?

    Directory of Open Access Journals (Sweden)

    Rebecca M Holman

    Full Text Available OBJECTIVE: Children and youth accumulate their daily moderate-to-vigorous physical activity (MVPA in bouts (i.e., ≥ 5 consecutive minutes and in a sporadic manner (i.e., <5 consecutive minutes. The study objective was to determine, within children and youth, whether MVPA accumulated in bouts is more strongly associated with cardiometabolic risk factors than an equivalent volume of MVPA accumulated sporadically. METHODS: Participants consisted of 2754 children and youth aged 6-19 years from the 2003-2006 National Health and Nutrition Examination Survey, a representative cross-sectional study. Bouts and sporadic MVPA were measured objectively over 7 days using Actigraph accelerometers. Thresholds of 5 and 10 consecutive minutes were used to differentiate between bouts and sporadic MVPA. A high cardiometabolic risk factor score (CRS was created based on measures of waist circumference, non-high-density lipoprotein cholesterol, C-reactive protein, and systolic blood pressure. Associations were examined using logistic regression and controlled for covariates (sex, age, ethnicity, socioeconomic status, dietary fat and sodium, smoking, and accelerometry wear time. RESULTS: The odds of a high CRS decreased in a dose-response for both the sporadic and bout MVPA measures. Relative to quartile 1, the odds ratio (95% confidence interval for a high CRS in quartile 4 was 0.25 (0.10-0.60 for sporadic MVPA, 0.17 (0.09-0.34 for ≥ 5 minute bouts of MVPA, and 0.19 (0.11-0.34 for ≥ 10 minute bouts of MVPA. The sporadic and bout MVPA measures had a similar ability to distinguish between participants with high and normal CRS. Relative to 0 minutes of MVPA, an equivalent number of minutes of sporadic MVPA and bouts of MVPA had an almost identical odds ratio for a high CRS. The findings were consistent for 5 and 10 minute bout thresholds. CONCLUSIONS: The relations between sporadic MVPA and bouts of MVPA with cardiometabolic risk factors were remarkably similar

  1. Fructose-containing sugars, blood pressure, and cardiometabolic risk: a critical review.

    Science.gov (United States)

    Ha, Vanessa; Jayalath, Viranda H; Cozma, Adrian I; Mirrahimi, Arash; de Souza, Russell J; Sievenpiper, John L

    2013-08-01

    Excessive fructose intake from high-fructose corn syrup (HFCS) and sucrose has been implicated as a driving force behind the increasing prevalence of obesity and its downstream cardiometabolic complications including hypertension, gout, dyslidpidemia, metabolic syndrome, diabetes, and non-alcoholic fatty liver disease (NAFLD). Most of the evidence to support these relationships draws heavily on ecological studies, animal models, and select human trials of fructose overfeeding. There are a number of biological mechanisms derived from animal models to explain these relationships, including increases in de novo lipogenesis and uric acid-mediated hypertension. Differences between animal and human physiology, along with the supraphysiologic level at which fructose is fed in these models, limit their translation to humans. Although higher level evidence from large prospective cohorts studies has shown significant positive associations comparing the highest with the lowest levels of intake of sugar-sweetened beverages (SSBs), these associations do not hold true at moderate levels of intake or when modeling total sugars and are subject to collinearity effects from related dietary and lifestyle factors. The highest level of evidence from controlled feeding trials has shown a lack of cardiometabolic harm of fructose and SSBs under energy-matched conditions at moderate levels of intake. It is only when fructose-containing sugars or SSBs are consumed at high doses or supplement diets with excess energy that a consistent signal for harm is seen. The available evidence suggests that confounding by excess energy is an important consideration in assessing the role of fructose-containing sugars and SSBs in the epidemics of hypertension and other cardiometabolic diseases.

  2. An Exploratory Analysis of the Relationship between Cardiometabolic Risk Factors and Cognitive/Academic Performance among Adolescents

    Directory of Open Access Journals (Sweden)

    Ting-Kuang Yeh

    2015-01-01

    Full Text Available This exploratory study examines the relationship between cardiometabolic risk factors (blood pressure, waist circumference, BMI, and total cholesterol and cognitive/academic performance. In this study, 1297 Taiwanese tenth-grade volunteers are recruited. Scores from the Basic Competency Test, an annual national competitive entrance examination, are used to evaluate academic performance. Cognitive abilities are accessed via the Multiple Aptitude Test Battery. The results indicate that systolic blood pressure is significantly, negatively associated with academic performance, both in male and female subjects. BMI and waist circumference are associated with verbal reasoning performance with an inverse U-shaped pattern, suggesting that both low and high BMI/waist circumference may be associated with lower verbal reasoning performance.

  3. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2010-12-01

    Full Text Available The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Group O (N=37 - attended the outpatient cardiac rehabilitation program; Group H (N=37 - attended the inpatient cardiacrehabilitation program; Group C (N=34 - did not participate in any cardiac rehabilitation program. Between those two momentsof assessment: T0 - revascularization / early post-revascularization and T1 - time of the interview (16±2.3 months afterrevascularization, patients in groups A and S participated in outpatient cardiac rehabilitation program (12 weeks, 3sessions/week of exercise training, with clinical and paraclinical evaluation scheduled at 1, 6, 12 months afterrevascularization, or inpatient cardiac rehabilitation program (3 weeks, intensive sessions, scheduled at 1, 3, 6 and 12months after revascularization. Results: at the end of the study, we found significant differences among the three groups forthe following parameters: body mass index (p=0.01, systolic blood pressure (p=0.002, total cholesterol (p<0.001, LDLcholesterol(p<0.001 and non-HDL cholesterol (p=0.004 in favor of groups A and S, that have participated in comprehensivecardiac rehabilitation programs. Conclusions: comprehensive cardiac rehabilitation programmes, performed outpatient orinpatient, are effective methods of reducing the high cardiometabolic risk, specific in revascularized coronary patients withdiabetes.

  4. Dietary pattern and its association with the prevalence of obesity and related cardiometabolic risk factors among Chinese children.

    Directory of Open Access Journals (Sweden)

    Xianwen Shang

    Full Text Available BACKGROUND: The association of dietary pattern with chronic diseases has been investigated widely in western countries. However, information is quite limited among children in China. Our study is aimed to identify the dietary patterns of Chinese children and examine their association with obesity and related cardiometabolic risk factors. METHODS: A total of 5267 children were selected using multistage random sampling from 30 primary schools of 5 provincial capital cities in China. Dietary intake was derived from 24 hour dietary recall for three consecutive days. Anthropometric measurements, glucose and lipid profiles were obtained. Factor analysis combined with cluster analysis was used for identifying major dietary patterns. The associations of dietary patterns with obesity and related cardiometabolic risk factors were examined by logistic regression analysis. RESULTS: Three mutually exclusive dietary patterns were identified, which were labeled as the healthy dietary pattern, the transitive dietary pattern, and the Western dietary pattern. Compared with children of the healthy dietary pattern, the multiple-adjusted odds ratios (95% confidence interval (CI of obesity were 1.11 (0.89-1.38 for children with the transitive dietary pattern and 1.80 (1.15-2.81 for children with the Western dietary pattern, which was 1.31 (95%CI 1.09-1.56 and 1.71 (95%CI: 1.13-2.56, respectively, for abdominal obesity. The Western dietary pattern was associated with significantly higher concentrations of low-density lipoprotein cholesterol (P<.001, triglycerides (P<.001, systolic blood pressure (P = 0.0435 and fasting glucose (P = 0.0082 and a lower concentration of high-density lipoprotein cholesterol (P = 0.0023, as compared with the healthy dietary pattern. CONCLUSIONS: The Western dietary pattern characterized by red meat, eggs, refined grain and products, was positively associated with odds of obesity, the levels of plasma glucose, low-density lipoprotein

  5. Dietary protein intake is associated with favorable cardiometabolic risk factors in adults: Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Mirmiran, Parvin; Hajifaraji, Majid; Bahadoran, Zahra; Sarvghadi, Farzaneh; Azizi, Fereidoun

    2012-03-01

    In this study, we investigated the hypothesis that dietary protein content and type are related to cardiometabolic risk factors including body mass index, waist circumference (WC), serum triglycerides, high-density lipoprotein cholesterol (HDL-C), serum fasting glucose, and blood pressure. This population-based study was conducted on 2537 subjects aged 19 to 70 years and selected from among participants of the Tehran Lipid and Glucose Study (2006-2008). Dietary data were collected using a validated semiquantitative food frequency questionnaire. Associations between intakes of total protein as well as the animal-to-plant (A/P) protein ratio and cardiometabolic risk factors were analyzed using multivariate linear regression models. Dietary protein intakes were 13.7% and 13.6% of energy, in men and women, respectively; the A/P protein ratio in women was significantly higher than in men (1.8 ± 1.4 vs 1.4 ± 0.9). Body mass index was associated with total protein intake in men (β = 0.14, P = .01) and A/P protein ratio in women (β = 0.075, P = .01). Waist circumference was associated with total protein intake (β = -0.048, P = .03) and A/P protein ratio (β=0.031, P = .05) in women. Serum fasting glucose was associated with both total protein intake (β=0.061 and 0.11, P protein intake (β = 0.107 and 0.07, P protein intake (β = -0.125, P = .01). In conclusion, higher dietary protein intake was associated with enhanced HDL-C levels, WC, and diastolic BP, and a higher ratio of A/P protein intake was related with lower serum fasting glucose andWC.

  6. Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?

    Science.gov (United States)

    Montani, J-P; Schutz, Y; Dulloo, A G

    2015-02-01

    Despite the poor prognosis of dieting in obesity management, which often results in repeated attempts at weight loss and hence weight cycling, the prevalence of dieting has increased continuously in the past decades in parallel to the steadily increasing prevalence of obesity. However, dieting and weight cycling are not limited to those who are obese or overweight as substantial proportions of the various population groups with normal body weight also attempt to lose weight. These include young and older adults as well as children and adolescents who perceive themselves as too fat (due to media, parental and social pressures), athletes in weight-sensitive competitive sports (i.e. mandatory weight categories, gravitational and aesthetic sports) or among performers for whom a slim image is professionally an advantage. Of particular concern is the emergence of evidence that some of the potentially negative health consequences of repeated dieting and weight cycling are more readily seen in people of normal body weight rather than in those who are overweight or obese. In particular, several metabolic and cardiovascular risk factors associated with weight cycling in normal-weight individuals have been identified from cross-sectional and prospective studies as well as from studies of experimentally induced weight cycling. In addition, findings from studies of experimental weight cycling have reinforced the notion that fluctuations of cardiovascular risk variables (such as blood pressure, heart rate, sympathetic activity, blood glucose, lipids and insulin) with probable repeated overshoots above normal values during periods of weight regain put an additional stress on the cardiovascular system. As the prevalence of diet-induced weight cycling is increasing due to the opposing forces of an 'obesigenic' environment and the media pressure for a slim figure (that even targets children), dieting and weight cycling is likely to become an increasingly serious public health issue.

  7. Hemoglobin A1c levels and aortic arterial stiffness: the Cardiometabolic Risk in Chinese (CRC study.

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    Jun Liang

    Full Text Available OBJECTIVE: The American Diabetes Association (ADA recently published new clinical guidelines in which hemoglobin A1c (HbA1c was recommended as a diagnostic test for diabetes. The present study was to investigate the association between HbA1c and cardiovascular risk, and compare the associations with fasting glucose and 2-hour oral glucose tolerance test (2 h OGTT. RESEARCH DESIGN AND METHODS: The study samples are from a community-based health examination survey in central China. Carotid-to-femoral pulse wave velocity (cfPWV and HbA1c were measured in 5,098 men and women. RESULTS: After adjustment for age, sex, and BMI, the levels of HbA1c were significantly associated with an increasing trend of cfPWV in a dose-dependent fashion (P for trend 0.05. CONCLUSIONS: HbA1c was related to high cfPWV, independent of conventional cardiovascular risk factors. Senior age and high blood pressure might amplify the adverse effects of HbA1c on cardiovascular risk.

  8. Accounting for Life-Course Exposures in Epigenetic Biomarker Association Studies: Early Life Socioeconomic Position, Candidate Gene DNA Methylation, and Adult Cardiometabolic Risk.

    Science.gov (United States)

    Huang, Jonathan Y; Gavin, Amelia R; Richardson, Thomas S; Rowhani-Rahbar, Ali; Siscovick, David S; Hochner, Hagit; Friedlander, Yechiel; Enquobahrie, Daniel A

    2016-10-01

    Recent studies suggest that epigenetic programming may mediate the relationship between early life environment, including parental socioeconomic position, and adult cardiometabolic health. However, interpreting associations between early environment and adult DNA methylation may be difficult because of time-dependent confounding by life-course exposures. Among 613 adult women (mean age = 32 years) of the Jerusalem Perinatal Study Family Follow-up (2007-2009), we investigated associations between early life socioeconomic position (paternal occupation and parental education) and mean adult DNA methylation at 5 frequently studied cardiometabolic and stress-response genes (ABCA1, INS-IGF2, LEP, HSD11B2, and NR3C1). We used multivariable linear regression and marginal structural models to estimate associations under 2 causal structures for life-course exposures and timing of methylation measurement. We also examined whether methylation was associated with adult cardiometabolic phenotype. Higher maternal education was consistently associated with higher HSD11B2 methylation (e.g., 0.5%-point higher in 9-12 years vs. ≤8 years, 95% confidence interval: 0.1, 0.8). Higher HSD11B2 methylation was also associated with lower adult weight and total and low-density lipoprotein cholesterol. We found that associations with early life socioeconomic position measures were insensitive to different causal assumption; however, exploratory analysis did not find evidence for a mediating role of methylation in socioeconomic position-cardiometabolic risk associations.

  9. Immunological and cardiometabolic risk factors in the prediction of type 2 diabetes and coronary events: MONICA/KORA Augsburg case-cohort study.

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    Christian Herder

    Full Text Available BACKGROUND: This study compares inflammation-related biomarkers with established cardiometabolic risk factors in the prediction of incident type 2 diabetes and incident coronary events in a prospective case-cohort study within the population-based MONICA/KORA Augsburg cohort. METHODS AND FINDINGS: Analyses for type 2 diabetes are based on 436 individuals with and 1410 individuals without incident diabetes. Analyses for coronary events are based on 314 individuals with and 1659 individuals without incident coronary events. Mean follow-up times were almost 11 years. Areas under the receiver-operating characteristic curve (AUC, changes in Akaike's information criterion (ΔAIC, integrated discrimination improvement (IDI and net reclassification index (NRI were calculated for different models. A basic model consisting of age, sex and survey predicted type 2 diabetes with an AUC of 0.690. Addition of 13 inflammation-related biomarkers (CRP, IL-6, IL-18, MIF, MCP-1/CCL2, IL-8/CXCL8, IP-10/CXCL10, adiponectin, leptin, RANTES/CCL5, TGF-β1, sE-selectin, sICAM-1; all measured in nonfasting serum increased the AUC to 0.801, whereas addition of cardiometabolic risk factors (BMI, systolic blood pressure, ratio total/HDL-cholesterol, smoking, alcohol, physical activity, parental diabetes increased the AUC to 0.803 (ΔAUC [95% CI] 0.111 [0.092-0.149] and 0.113 [0.093-0.149], respectively, compared to the basic model. The combination of all inflammation-related biomarkers and cardiometabolic risk factors yielded a further increase in AUC to 0.847 (ΔAUC [95% CI] 0.044 [0.028-0.066] compared to the cardiometabolic risk model. Corresponding AUCs for incident coronary events were 0.807, 0.825 (ΔAUC [95% CI] 0.018 [0.013-0.038] compared to the basic model, 0.845 (ΔAUC [95% CI] 0.038 [0.028-0.059] compared to the basic model and 0.851 (ΔAUC [95% CI] 0.006 [0.003-0.021] compared to the cardiometabolic risk model, respectively. CONCLUSIONS: Inclusion of multiple

  10. Yogurt consumption and impact on health: focus on children and cardiometabolic risk.

    Science.gov (United States)

    Marette, André; Picard-Deland, Eliane

    2014-05-01

    An accumulating body of epidemiologic data, clinical trials, and mechanistic studies suggests that yogurt consumption as part of a healthy diet may be beneficial to cardiometabolic health. This brief review focuses on children and adolescents, introducing new concepts underlying the effect of yogurt consumption on body weight maintenance and the prevention of cardiovascular diseases. Specific properties of yogurt are discussed, which highlight that yogurt is an easy-to-digest, nutrient-dense, and satiating food that contains high-quality protein and specific amino acids. Moreover, the role of yogurt as a modulator of the gut microbiota in infancy is explored. We also propose the idea that the specific matrix of yogurt has bioavailability and metabolic properties that can be exploited to increase the functionality of this dairy product.

  11. Moderate Activity and Fitness, Not Sedentary Time, Are Independently Associated with Cardio-Metabolic Risk in U.S. Adults Aged 18–49

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    Jeroen H. P. M. van der Velde

    2015-02-01

    Full Text Available This cross-sectional study is one of the first to examine and compare the independent associations of objectively measured sedentary time, moderate to vigorous physical activity (MVPA and fitness with cardio-metabolic risk factors. We studied 543 men and women (aged 18–49 years from the NHANES 2003–2004 survey. Sedentary time and MVPA were measured by accelerometry. Fitness was assessed with a submaximal treadmill test. Cardio-metabolic risk factors included: waist circumference (WC, BMI, blood pressure, fasting glucose, HDL- and non HDL cholesterol, triglycerides (TG, and C-reactive protein (CRP. Sedentary time, MVPA and fitness were used as predictors for the cardio-metabolic outcomes in a multiple regression analysis. Standardized regression coefficients were computed. Results show that sedentary time was associated with HDL-cholesterol (β = −0.080, p = 0.05 and TG (β = 0.080, p = 0.03. These results became non-significant after adjustment for MVPA and fitness. MVPA was associated with WC (β = −0.226, BMI (β = −0.239, TG (β = −0.108 and HDL-cholesterol (β = 0.144 (all p < 0.05. These results remained significant after adjustment for sedentary time and fitness. Fitness was associated with WC (β = −0.287, BMI (β = −0.266, systolic blood pressure (β = −0.159, TG (β = −0.092, and CRP (β = −0.130 (all p < 0.05. After adjustment for sedentary time and MVPA these results remained significant. These differences in relative importance of sedentary time, MVPA and fitness on cardio-metabolic-risk are important in the design of prevention programs. In this population, the strength of the associations between MVPA and fitness with cardio-metabolic markers appeared to be similar; both MVPA and fitness showed independent associations with cardio-metabolic risk factors. In contrast, sedentary time showed no independent associations with cardio-metabolic risk after correction for fitness and MVPA.

  12. Effect of cardiometabolic risk factors on hypertension management: a cross-sectional study among 28 physician practices in the United States

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    Zacker Christopher

    2010-02-01

    Full Text Available Abstract Objective This cross-sectional study sought to determine the prevalence of cardiometabolic risk factor clusters (CMRFCs and their effect on BP control among hypertensive patients from 28 US physician practices. Methods Each participating practice identified a random sample of 150-300 adults aged ≥ 18 years diagnosed with hypertension. The primary outcome variable was BP control (BP Results Overall, 6,527 hypertensive patients were identified for study inclusion. More than half (54.3% were female, and mean age was 64.7 years. Almost half (48.7% were obese (BMI ≥ 30 kg/m2. About 1 in every 4 patients (25.3% had diabetes, and 60.7% had dyslipidemia. Mean blood pressure was 132.5/77.9 mmHg, and 55.0% of all patients had controlled BP; 62.4% of non-diabetic patients, and 33.3% of diabetic hypertensive patients, had BP controlled to recommended levels. Most (81.7% hypertensive patients had ≥ 1 cardiometabolic risk factor, and 12.2% had all 3 risk factors. As compared to hypertensive patients without additional risk factors, adjusted odds ratios for BP control were significantly lower for all combinations of CMRFCs (ORs 0.15-0.83, all p Conclusions Across 28 US practices, only 18% of hypertensive patients did not have any additional cardiometabolic risk factors. The high prevalence of CMRFCs presents a challenge to effective hypertension management.

  13. Obesity and obesity-associated cardiometabolic risk factors in indigenous Nenets women from the rural Nenets Autonomous Area and Russian women from Arkhangelsk city

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    Natalia Petrenya

    2014-07-01

    Full Text Available Background: The prevalence of obesity and obesity-related conditions varies by population groups. Indigenous women of the circumpolar north are believed to be at high risk of obesity. Objective: We studied, first the obesity prevalence in indigenous Arctic women, Nenets, compared to urban Russian women. Second, the association between obesity and cardiometabolic risk factors in the combined group of Nenets and Russian women. Third, ethnic differences in the association between obesity and cardiometabolic risk factors. Design: Cross-sectional study performed in 2008–2009. Subjects: 93 Nenets women, aged 19–77 (the indigenous village, the Nenets Autonomous Area and 132 Russian women, aged 21–72 (Arkhangelsk city. Obesity was defined as body mass index (BMI≥30 kg/m2, waist circumference (WC≥88 cm and or waist-to-hip ratio (WHR≥0.85%. We assessed associations between obesity and cardiometabolic risk factors by linear and logistic regression models that included covariates of ethnicity, age, smoking and physical activity. We also tested for interaction between obesity measurements and ethnicity. Results: Prevalence of obesity estimated through BMI, WC and WHR were 42.5, 45.3 and 41.9% in Nenets and 34.4, 46.4 and 29.5% in Russians, respectively, with no differences found. BMI, WC and WHR associated positively with triglycerides, fasting insulin and Homeostasis Model Assessment of Insulin Resistance index. In addition, BMI and WC correlated negatively with high-density lipoprotein cholesterol and positively with systolic blood pressure and apolipoprotein B/apoliporotein A–I ratio. WC explained significant variation in fasting glucose (FG level. BMI predicted type 2 diabetes history. FG level associated strongly with ethnicity and was found to be higher in Russians. Conclusions: We found no differences in prevalence of obesity between Nenets and Russian females. Obesity was associated with cardiometabolic risk factors independently of

  14. Cardiometabolic Risk Factor Changes Observed in Diabetes Prevention Programs in US Settings: A Systematic Review and Meta-analysis.

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    Uma Mudaliar

    2016-07-01

    Full Text Available The Diabetes Prevention Program (DPP study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk. No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in nonresearch settings in the United States.In this systematic review and meta-analysis, we pooled data from studies in the United States implementing DPP lifestyle modification programs (focused on modest [5%-7%] weight loss through ≥150 min of moderate physical activity per week and restriction of fat intake in clinical, community, and online settings. We reported aggregated pre- and post-intervention weight and cardiometabolic risk factor changes (fasting blood glucose [FBG], glycosylated hemoglobin [HbA1c], systolic or diastolic blood pressure [SBP/DBP], total [TC] or HDL-cholesterol. We searched the MEDLINE, EMBASE, Cochrane Library, and Clinicaltrials.gov databases from January 1, 2003, to May 1, 2016. Two reviewers independently evaluated article eligibility and extracted data on study designs, populations enrolled, intervention program characteristics (duration, number of core and maintenance sessions, and outcomes. We used a random effects model to calculate summary estimates for each outcome and associated 95% confidence intervals (CI. To examine sources of heterogeneity, results were stratified according to the presence of maintenance sessions, risk level of participants (prediabetes or other, and intervention delivery personnel (lay or professional. Forty-four studies that enrolled 8,995 participants met eligibility criteria. Participants had an average age of 50.8 years and body mass index (BMI of 34.8 kg/m2, and 25.2% were male. On average, study follow-up was 9.3 mo (median 12.0 with a range of 1.5 to 36 months; programs offered a mean of 12.6 sessions, with mean participant attendance of 11.0 core sessions. Sixty percent of programs offered some form of

  15. Relation among the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio, insulin resistance, and associated cardio-metabolic risk factors in men and women.

    Science.gov (United States)

    Salazar, Martin R; Carbajal, Horacio A; Espeche, Walter G; Leiva Sisnieguez, Carlos E; Balbín, Eduardo; Dulbecco, Carlos A; Aizpurúa, Marcelo; Marillet, Alberto G; Reaven, Gerald M

    2012-06-15

    Results of recent studies using the ratio of plasma triglyceride (TG) to high-density lipoprotein (HDL) cholesterol concentration to identify insulin-resistant patients at increased cardiometabolic risk have emphasized that the cut point used for this purpose will vary with race. Because TG and HDL cholesterol concentrations vary with gender, this analysis was initiated to define gender-specific plasma TG/HDL cholesterol concentration ratios that best identified high-risk subjects among women (n = 1,102) and men (n = 464) of primarily European ancestry. Insulin resistance was defined as the 25% of the population with the highest values for fasting plasma insulin concentration and homeostasis model assessment of insulin resistance. Using TG/HDL concentration ratios >2.5 in women and >3.5 in men identified subgroups of men and women that were comparable in terms of insulin resistance and associated cardiometabolic risk, with significantly higher values for fasting plasma insulin, homeostasis model assessment of insulin resistance, blood pressure, body mass index, waist circumference, and glucose and TG concentrations and lower HDL cholesterol concentrations than in women and men below these cut points. The sensitivity and specificity of these gender-specific cut points to identify insulin-resistant subjects were about 40% and about 80%, respectively. In conclusion, the plasma TG/HDL cholesterol concentration ratio that identifies patients who are insulin resistant and at significantly greater cardiometabolic risk varies between men and women.

  16. Combining functional features of whole-grain barley and legumes for dietary reduction of cardiometabolic risk: a randomised cross-over intervention in mature women.

    Science.gov (United States)

    Tovar, Juscelino; Nilsson, Anne; Johansson, Maria; Björck, Inger

    2014-02-01

    The usefulness of dietary strategies against cardiometabolic risk is increasingly being acknowledged. Legumes and whole grains can modulate risk markers associated with cardiometabolic diseases, but their possible additive/synergistic actions are unknown. The objective of the present study was to assess, in healthy subjects, the effect of a diet including specific whole-grain barley products and legumes with prior favourable outcomes on cardiometabolic risk parameters in semi-acute studies. A total of forty-six overweight women (50-72 years, BMI 25-33 kg/m² and normal fasting glycaemia) participated in a randomised cross-over intervention comparing a diet rich in kernel-based barley products, brown beans and chickpeas (D1, diet 1 (functional diet)) with a control diet (D2, diet 2 (control diet)) of similar macronutrient composition but lacking legumes and barley. D1 included 86 g (as eaten)/d brown beans, 82 g/d chickpeas, 58 g/d whole-grain barley kernels and 216 g/d barley kernel bread. Both diets followed the Nordic Nutrition Recommendations, providing similar amounts of dietary fibre (D1: 46·9 g/d; D2: 43·5 g/d), with wheat-based products as the main fibre supplier in D2. Each diet was consumed for 4 weeks under weight-maintenance conditions. Both diets decreased serum total cholesterol, LDL-cholesterol and HDL-cholesterol levels, but D1 had a greater effect on total cholesterol and LDL-cholesterol levels (Plegume diet improves cardiometabolic risk-associated biomarkers in a healthy cohort, showing potential preventive value beyond that of a nutritionally well-designed regimen.

  17. The endocannabinoid system--back to the scene of cardiometabolic risk factors control?

    Science.gov (United States)

    Martins, C J M; Genelhu, V; Di Marzo, V; Francischetti, E A

    2014-07-01

    This review examines the impact of the endocannabinoid signaling system on metabolic and cardiovascular health and the new therapeutic strategies that selectively target dysfunctional endocannabinoid action in peripheral tissues, without causing the undesirable central nervous system effects that occurred with the first-generation of CB1 receptor blockers. We first review the components of the endocannabinoid system and the enzymes that synthesize and degrade the endocannabinoids, the critical role of the system in the homeostasis of energy balance, and its hedonic aspects related to the incentive and motivational value of food. Second, we describe the central and peripheral actions of the endocannabinoid system and its interactions with other biological modulators, such as ghrelin and leptin. Third, we summarize data from human clinical trials with the CB1 inverse agonist rimonabant, showing that the drug, although effective in increasing weight loss with accompanying improvements in the metabolic profile of the participants in the RIO (Rimonabant In Obesity) trials, was withdrawn from the market because of the risk of serious adverse events. Finally, we describe: 1) the development of new selective peripheral blockers that interrupt endocannabinoid action selectively in peripheral tissues and that have been suggested as an alternative approach to treat the metabolic consequences of obesity and related diseases, without undesirable central nervous system effects, and 2) the potential for inhibition of enzymes of synthesis, as well as the possible role of endocannabinoid congeners, with opposing effects as compared to CB1 receptor agonists, in the control of metabolic disorders.

  18. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis.

    Science.gov (United States)

    Lo, K; Wong, M; Khalechelvam, P; Tam, W

    2016-12-01

    Waist-to-height ratio (WHtR) is superior to body mass index and waist circumference for measuring adult cardio-metabolic risk factors. However, there is no meta-analysis to evaluate its discriminatory power in children and adolescents. A meta-analysis was conducted using multiple databases, including Embase and Medline. Studies were included that utilized receiver-operating characteristics curve analysis and published area under the receiver-operating characteristics curves (AUC) for adiposity indicators with hyperglycaemia, elevated blood pressure, dyslipidemia, metabolic syndrome and other cardio-metabolic outcomes. Thirty-four studies met the inclusion criteria. AUC values were extracted and pooled using a random-effects model and were weighted using the inverse variance method. The mean AUC values for each index were greater than 0.6 for most outcomes including hypertension. The values were the highest when screening for metabolic syndrome (AUC > 0.8). WHtR did not have significantly better screening power than other two indexes in most outcomes, except for elevated triglycerides when compared with body mass index and high metabolic risk score when compared with waist circumference. Although not being superior in discriminatory power, WHtR is convenient in terms of measurement and interpretation, which is advantageous in practice and allows for the quick identification of children with cardio-metabolic risk factors at an early age.

  19. Omega-3 polyunsaturated fatty acid profiles and relationship with cardiometabolic risk factors in Cree (Eeyouch of Northern Québec

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    Françoise Proust

    2016-07-01

    Full Text Available Background: n-3 long-chain polyunsaturated fatty acids (LC-PUFAs from fish are known modulators of cardiometabolic risk factors. Objective: To examine fatty acids (FAs status and the relationship between n-3 LC-PUFA and cardiometabolic risk factors in Cree participants. Design: We analyzed data from a cross-sectional study (n=829 conducted in Cree adults (aged 18–74 years from 7 communities of the James Bay territory of Quebec (Canada in 2005–2009. Sociodemographic, lifestyle, clinical and anthropometric data were collected. FAs were quantified in red blood cells (RBCs under fasting conditions. Results: A total of 89% of the participants were overweight (with 69% obesity, 33% had hypertriglyceridemia, 44% had low plasma HDL-c and 77% had fasting plasma insulin ≥90 pmol/l. Total n-3 PUFAs accounted for 6% of total FAs and were higher among older participants, while n-6 PUFAs accounted for 31% of total FAs and were higher among younger participants. According to the adjusted multiple linear regression models, n-3 LC-PUFA was associated (p<0.05 with higher total cholesterol, LDL-c and apo B-100, and was also associated (p<0.05 with lower blood glucose. Conclusion: Overall, this study showed that n-3 LC-PUFA levels measured in the RBCs of the Cree adults are relatively low and tend towards lower levels among youth. These levels might be insufficient to offset the prevalence of cardiometabolic risk factors.

  20. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial

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    Roya Kelishadi

    2014-01-01

    Full Text Available OBJECTIVE: this triple-masked controlled trial aimed to assess the effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in obese children and adolescents. METHODS: the study comprised 50 participants, aged 10 to16 years, who were randomly assigned into two groups of equal number. In this 12-week trial, one group received oral vitamin D (300,000 IU and the other group received placebo. Cardiometabolic risk factors, insulin resistance, and a continuous value of metabolic syndrome (cMetS were determined. Statistical analysis was conducted after adjustment for covariate interactions. RESULTS: overall, 21 patients in the vitamin D group and 22 in the placebo group completed the trial. No significant difference was observed in the baseline characteristics of the two groups. After the trial, in the vitamin D group, serum insulin and triglyceride concentrations, as well as HOM -IR and C-MetS decreased significantly, both when compared with the baseline and with the placebo group. No significant difference was observed when comparing total cholesterol, LDL-C, HDL-C, fasting blood glucose, and blood pressure. CONCLUSION: the present findings support the favorable effects of vitamin D supplementation on reducing insulin resistance and cardiometabolic risk factors in obese children.

  1. Adverse Risks Associated With Proton Pump Inhibitors: A Systematic Review

    OpenAIRE

    Heidelbaugh, Joel J.; Goldberg, Kathleen L.; Inadomi, John M.

    2009-01-01

    Proton pump inhibitors (PPIs) are among the most commonly utilized agents for treatment of symptomatic disorders of the upper gastrointestinal tract, accounting for a significant proportion of sales of both over-the-counter and prescription formulations. A systematic review of the literature was conducted via MEDLINE to evaluate the most rigorous studies linking the potential risk of PPI therapy with adverse events. Emerging data illustrate the potential risks associated with both short-and l...

  2. Zinc Status Biomarkers and Cardiometabolic Risk Factors in Metabolic Syndrome: A Case Control Study

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    Erika P. S. Freitas

    2017-02-01

    Full Text Available Metabolic syndrome (MS involves pathophysiological alterations that might compromise zinc status. The aim of this study was to evaluate zinc status biomarkers and their associations with cardiometabolic factors in patients with MS. Our case control study included 88 patients with MS and 37 controls. We performed clinical and anthropometric assessments and obtained lipid, glycemic, and inflammatory profiles. We also evaluated zinc intake, plasma zinc, erythrocyte zinc, and 24-h urinary zinc excretion. The average zinc intake was significantly lower in the MS group (p < 0.001. Regression models indicated no significant differences in plasma zinc concentration (all p > 0.05 between the two groups. We found significantly higher erythrocyte zinc concentration in the MS group (p < 0.001 independent from co-variable adjustments. Twenty-four hour urinary zinc excretion was significantly higher in the MS group (p = 0.008, and adjustments for age and sex explained 21% of the difference (R2 = 0.21, p < 0.001. There were significant associations between zincuria and fasting blood glucose concentration (r = 0.479, waist circumference (r = 0.253, triglyceride concentration (r = 0.360, glycated hemoglobin concentration (r = 0.250, homeostatic model assessment—insulin resistance (r = 0.223, and high-sensitivity C-reactive protein concentration (r = 0.427 (all p < 0.05 in the MS group. Patients with MS had alterations in zinc metabolism mainly characterized by an increase in erythrocyte zinc and higher zincuria.

  3. Zinc Status Biomarkers and Cardiometabolic Risk Factors in Metabolic Syndrome: A Case Control Study

    Science.gov (United States)

    Freitas, Erika P. S.; Cunha, Aline T. O.; Aquino, Sephora L. S.; Pedrosa, Lucia F. C.; Lima, Severina C. V. C.; Lima, Josivan G.; Almeida, Maria G.; Sena-Evangelista, Karine C. M.

    2017-01-01

    Metabolic syndrome (MS) involves pathophysiological alterations that might compromise zinc status. The aim of this study was to evaluate zinc status biomarkers and their associations with cardiometabolic factors in patients with MS. Our case control study included 88 patients with MS and 37 controls. We performed clinical and anthropometric assessments and obtained lipid, glycemic, and inflammatory profiles. We also evaluated zinc intake, plasma zinc, erythrocyte zinc, and 24-h urinary zinc excretion. The average zinc intake was significantly lower in the MS group (p 0.05) between the two groups. We found significantly higher erythrocyte zinc concentration in the MS group (p waist circumference (r = 0.253), triglyceride concentration (r = 0.360), glycated hemoglobin concentration (r = 0.250), homeostatic model assessment—insulin resistance (r = 0.223), and high-sensitivity C-reactive protein concentration (r = 0.427) (all p < 0.05) in the MS group. Patients with MS had alterations in zinc metabolism mainly characterized by an increase in erythrocyte zinc and higher zincuria. PMID:28241426

  4. Association of Nut Consumption with Cardiometabolic Risk Factors in the 2008/2009 New Zealand Adult Nutrition Survey.

    Science.gov (United States)

    Brown, Rachel C; Tey, Siew Ling; Gray, Andrew R; Chisholm, Alexandra; Smith, Claire; Fleming, Elizabeth; Parnell, Winsome

    2015-09-08

    Nut consumption has been associated with improvements in risk factors for chronic disease in populations within North America, Europe and Iran. This relationship has not been investigated in New Zealand (NZ). The associations between nut consumption and cardiometabolic risk factors among New Zealanders were examined. Data from the 24-h diet recalls of 4721 participants from the NZ Adult Nutrition Survey 2008/2009 (2008/2009 NZANS) were used to determine whole and total nut intake. Anthropometric data and blood pressure were collected, as well as blood samples analysed for total cholesterol (total-C) and HDL cholesterol (HDL-C), glycated haemoglobin (HbA1c), C-reactive protein (CRP) and folate. Participants were classified according to their five-year cardiovascular disease (CVD) risk. Both whole and total nut consumers had significantly lower weight, body mass index (BMI), waist circumference and central adiposity than non-nut consumers (all p ≤ 0.044). Whole blood, serum and red blood cell folate concentrations were significantly higher among whole nut consumers compared to non-whole nut consumers (all p ≤ 0.014), with only serum folate higher in total nut consumers compared to non-total nut consumers (p = 0.023). There were no significant differences for blood pressure, total-C, HDL-C and HbA1c; however, significant negative associations between total nut consumption and CVD risk category (p Nut consumption was associated with more favourable body composition and a number of risk factors, which could collectively reduce chronic disease.

  5. Association of Nut Consumption with Cardiometabolic Risk Factors in the 2008/2009 New Zealand Adult Nutrition Survey

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    Rachel C. Brown

    2015-09-01

    Full Text Available Nut consumption has been associated with improvements in risk factors for chronic disease in populations within North America, Europe and Iran. This relationship has not been investigated in New Zealand (NZ. The associations between nut consumption and cardiometabolic risk factors among New Zealanders were examined. Data from the 24-h diet recalls of 4721 participants from the NZ Adult Nutrition Survey 2008/2009 (2008/2009 NZANS were used to determine whole and total nut intake. Anthropometric data and blood pressure were collected, as well as blood samples analysed for total cholesterol (total-C and HDL cholesterol (HDL-C, glycated haemoglobin (HbA1c, C-reactive protein (CRP and folate. Participants were classified according to their five-year cardiovascular disease (CVD risk. Both whole and total nut consumers had significantly lower weight, body mass index (BMI, waist circumference and central adiposity than non-nut consumers (all p ≤ 0.044. Whole blood, serum and red blood cell folate concentrations were significantly higher among whole nut consumers compared to non-whole nut consumers (all p ≤ 0.014, with only serum folate higher in total nut consumers compared to non-total nut consumers (p = 0.023. There were no significant differences for blood pressure, total-C, HDL-C and HbA1c; however, significant negative associations between total nut consumption and CVD risk category (p < 0.001 and CRP (p = 0.045 were apparent. Nut consumption was associated with more favourable body composition and a number of risk factors, which could collectively reduce chronic disease.

  6. Innovation through Wearable Sensors to Collect Real-Life Data among Pediatric Patients with Cardiometabolic Risk Factors

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    Kestens Yan

    2014-01-01

    Full Text Available Background. While increasing evidence links environments to health behavior, clinicians lack information about patients’ physical activity levels and lifestyle environments. We present mobile health tools to collect and use spatio-behavioural lifestyle data for personalized physical activity plans in clinical settings. Methods. The Dyn@mo lifestyle intervention was developed at the Sainte-Justine University Hospital Center to promote physical activity and reduce sedentary time among children with cardiometabolic risk factors. Mobility, physical activity, and heart rate were measured in free-living environments during seven days. Algorithms processed data to generate spatio-behavioural indicators that fed a web-based interactive mapping application for personalised counseling. Proof of concept and tools are presented using data collected among the first 37 participants recruited in 2011. Results. Valid accelerometer data was available for 5.6 (SD=1.62 days in average, heart rate data for 6.5 days, and GPS data was available for 6.1 (2.1 days. Spatio-behavioural indicators were shared between patients, parents, and practitioners to support counseling. Conclusion. Use of wearable sensors along with data treatment algorithms and visualisation tools allow to better measure and describe real-life environments, mobility, physical activity, and physiological responses. Increased specificity in lifestyle interventions opens new avenues for remote patient monitoring and intervention.

  7. Innovation through Wearable Sensors to Collect Real-Life Data among Pediatric Patients with Cardiometabolic Risk Factors.

    Science.gov (United States)

    Yan, Kestens; Tracie, Barnett; Marie-Ève, Mathieu; Mélanie, Henderson; Jean-Luc, Bigras; Benoit, Thierry; St-Onge, Maxime; Marie, Lambert

    2014-01-01

    Background. While increasing evidence links environments to health behavior, clinicians lack information about patients' physical activity levels and lifestyle environments. We present mobile health tools to collect and use spatio-behavioural lifestyle data for personalized physical activity plans in clinical settings. Methods. The Dyn@mo lifestyle intervention was developed at the Sainte-Justine University Hospital Center to promote physical activity and reduce sedentary time among children with cardiometabolic risk factors. Mobility, physical activity, and heart rate were measured in free-living environments during seven days. Algorithms processed data to generate spatio-behavioural indicators that fed a web-based interactive mapping application for personalised counseling. Proof of concept and tools are presented using data collected among the first 37 participants recruited in 2011. Results. Valid accelerometer data was available for 5.6 (SD = 1.62) days in average, heart rate data for 6.5 days, and GPS data was available for 6.1 (2.1) days. Spatio-behavioural indicators were shared between patients, parents, and practitioners to support counseling. Conclusion. Use of wearable sensors along with data treatment algorithms and visualisation tools allow to better measure and describe real-life environments, mobility, physical activity, and physiological responses. Increased specificity in lifestyle interventions opens new avenues for remote patient monitoring and intervention.

  8. Geographic epidemiology of cardiometabolic risk factors in middle class urban residents in India: cross–sectional study

    Directory of Open Access Journals (Sweden)

    Rajeev Gupta

    2015-06-01

    these risk factors in both sexes (P<0.05. Conclusions Urban middle–class men and women in eastern region of India have significantly lower cardiometabolic risk factors compared to northern, western and southern regions. Low human social development index cities have lower risk factor prevalences.

  9. Evaluation of lifestyle interventions to treat elevated cardiometabolic risk in primary care (E-LITE: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wilson Sandra R

    2009-11-01

    Full Text Available Abstract Background Efficacy research has shown that intensive individual lifestyle intervention lowers the risk for developing type 2 diabetes mellitus and the metabolic syndrome. Translational research is needed to test real-world models of lifestyle interventions in primary care settings. Design E-LITE is a three-arm randomized controlled clinical trial aimed at testing the feasibility and potential effectiveness of two lifestyle interventions: information technology-assisted self-management, either alone or in combination with care management by a dietitian and exercise counselor, in comparison to usual care. Overweight or obese adults with pre-diabetes and/or metabolic syndrome (n = 240 recruited from a community-based primary care clinic are randomly assigned to one of three treatment conditions. Treatment will last 15 months and involves a three-month intensive treatment phase followed by a 12-month maintenance phase. Follow-up assessment occurs at three, six, and 15 months. The primary outcome is change in body mass index. The target sample size will provide 80% power for detecting a net difference of half a standard deviation in body mass index at 15 months between either of the self-management or care management interventions and usual care at a two-sided α level of 0.05, assuming up to a 20% rate of loss to 15-month follow-up. Secondary outcomes include glycemic control, additional cardiovascular risk factors, and health-related quality of life. Potential mediators (e.g., treatment adherence, caloric intake, physical activity level and moderators (e.g., age, gender, race/ethnicity, baseline mental status of the intervention's effect on weight change also will be examined. Discussion This study will provide objective evidence on the extent of reductions in body mass index and related cardiometabolic risk factors from two lifestyle intervention programs of varying intensity that could be implemented as part of routine health care

  10. Eicosapentaenoic acid and docosahexaenoic acid in whole blood are differentially and sex-specifically associated with cardiometabolic risk markers in 8-11-year-old danish children

    DEFF Research Database (Denmark)

    Damsgaard, Camilla T.; Eidner, Maj B.; Stark, Ken D.

    2014-01-01

    ) investigated associations between EPA and DHA in whole blood and early cardiometabolic risk markers in 713 children aged 8-11 years and 2) explored potential mediation through waist circumference and physical activity and potential dietary confounding. We collected data on parental education, pubertal stage, 7......n-3 long-chain polyunsaturated fatty acids improve cardiovascular risk markers in adults. These effects may differ between eicosapentaenoic acid (EPA, 20∶5n-3) and docosahexaenoic acid (DHA, 22∶6n-3), but we lack evidence in children. Using baseline data from the OPUS School Meal Study we 1...

  11. [Adverse drug reaction - Definitions, risk factors and pharmacovigilance].

    Science.gov (United States)

    Krähenbühl, Stephan

    2015-12-01

    Adverse drug reactions (ADR} are the downside of active pharmacotherapies and can only partially be avoided. Risk factors have been identified for certain ADR which should be taken into account for the choice and dosing of critical drugs. Medical staff have a legal obligation to report severe ADR and ADR caused by newly licensed drugs. Such reports are important for monitoring the safety of drugs that are on the market.

  12. Threshold values of sagittal abdominal diameter for the detection of cardio-metabolic risk factors in Northeastern Mexico: a cross-sectional study

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    Francisco Javier Guzmán de la Garza

    Full Text Available Background: The use of sagittal abdominal diameter (SAD has been proposed for screening cardio-metabolic risk factors; however, its accuracy can be influenced by the choice of thresholds values. Aim: To determine the SAD threshold values for cardio-metabolic risk factors in Mexican adults; to assess whether parallel and serial SAD testing can improve waist circumference (WC sensitivity and specificity; and to analyze the effect of considering SAD along with WC and body mass index (BMI in detecting cardio-metabolic risk. Methods: This cross-sectional study was conducted during 2012-2014 in Northeast Mexico (n = 269. Data on anthropometric, clinical, and biochemical measurements were collected. Sex-adjusted receiver-operating characteristic curves (ROC were obtained using hypertension, dysglycemia, dyslipidemia and insulin resistance as individual outcomes and metabolic syndrome as a composite outcome. Age-adjusted odds ratios and 95% confidence intervals (CI were estimated using logistic regression. Results: The threshold value for SAD with acceptable combination of sensitivity and specificity was 24.6 cm in men and 22.5 cm in women. Parallel SAD testing improved WC sensitivity and serial testing improved WC specificity. The co-occurrence of high WC/high SAD increased the risk for insulin resistance by 2.4-fold (95% CI: 1.1-5.3, high BMI/high SAD by 4.3-fold (95% CI: 1.7-11.9 and SAD alone by 2.2-fold (95% CI: 1.2.-4.2. Conclusions: The use of SAD together with traditional obesity indices such as WC and BMI has advantages over using either of these indices alone. SAD may be a powerful screening tool for interventions for high-risk individuals.

  13. Relation of physical activity to cardiovascular disease mortality and the influence of cardiometabolic risk factors.

    Science.gov (United States)

    Reddigan, Jacinta I; Ardern, Chris I; Riddell, Michael C; Kuk, Jennifer L

    2011-11-15

    Physical activity can improve several metabolic risk factors associated with cardiovascular disease (CVD) and is associated with a lower risk of CVD mortality. We sought to evaluate the extent to which metabolic risk factors mediate the association between physical activity and CVD mortality and whether physical activity provides protective effects against CVD mortality in healthy adults and those with metabolic risk factors. A sample of 10,261 adults from the Third National Health and Nutrition Examination Survey with public-access mortality data linkage (follow-up 13.4 ± 3.9 years) was used. Physical activity was assessed by questionnaire and classified into inactive, light, and moderate/vigorous activity categories. Metabolic risk factors (dyslipidemia, type 2 diabetes mellitus, obesity, hypertension, inflammation, and insulin resistance) were categorized using clinical thresholds. After adjusting for basic confounders, engaging in light or moderate/vigorous physical activity was associated with a lower risk of CVD mortality (p activity remained at lower risk of CVD mortality. In addition, physical activity provided protective effects for CVD mortality in healthy subjects and those with metabolic risk factors in isolation or in clusters. In conclusion, physical activity was associated with a lower risk of CVD mortality independent of traditional and inflammatory risk factors. Taken together these results suggest that physical activity may protect against CVD mortality regardless of the presence of metabolic risk factors.

  14. Adverse pregnancy outcomes and cardiovascular risk factor management.

    Science.gov (United States)

    Mehta, Puja K; Minissian, Margo; Bairey Merz, C Noel

    2015-06-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman's risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia can be evaluated for hypertension and other CVD risk factors within 6 months to 1-year post-partum. Given the burden and impact of CVD on women in our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors.

  15. Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort

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    Mark D Huffman

    2015-01-01

    Full Text Available Background & objectives: Abnormal endothelial function represents a preclinical marker of atherosclerosis. This study was conducted to evaluate associations between anthropometry, cardiometabolic risk factors, and early life factors and adult measures of endothelial function in a young urban Indian cohort free of clinical cardiovascular disease. Methods: Absolute changes in brachial artery diameter following cuff inflation and sublingual nitroglycerin (400 µg were recorded to evaluate endothelium-dependent and -independent measures of endothelial function in 600 participants (362 men; 238 women from the New Delhi Birth Cohort (2006-2009. Data on anthropometry, cardiometabolic risk factors, medical history, socio-economic position, and lifestyle habits were collected. Height and weight were recorded at birth, two and 11 yr of age. Age- and sex-adjusted linear regression models were developed to evaluate these associations. Results: The mean age of participants was 36±1 yr. Twenty two per cent men and 29 per cent women were obese (BMI th > 30 kg/m [2] . Mean systolic blood pressure (SBP was 131±14 and 119±13 mmHg, and diabetes prevalence was 12 and 8 per cent for men and women, respectively. Brachial artery diameter was higher for men compared with women both before (3.48±0.37 and 2.95±0.35 cm and after hyperaemia (3.87±0.37 vs. 3.37±0.35 cm. A similar difference was seen before and after nitroglycerin. Markers of increased adiposity, smoking, SBP, and metabolic syndrome, but not early life anthropometry, were inversely associated with endothelial function after adjustment for age and sex. Interpretation & conclusions: The analysis of the current prospective data from a young urban Indian cohort showed that cardiometabolic risk factors, but not early life anthropometry, were associated with worse endothelial function.

  16. Effects of a Multi-Disciplinary Lifestyle Intervention on Cardiometabolic Risk Factors in Young Women with Abdominal Obesity: A Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Bianca L Share

    Full Text Available Young women are under-represented in cardiovascular disease research, with obesity and cardiometabolic risk factor interventions generally targeting older adults. Furthermore, appropriate study designs for young women remain uncertain. This study aimed to assess the impact of a 12 week multi-disciplinary lifestyle intervention on cardiometabolic risk factors in premenopausal women with abdominal obesity.Women aged 18-30 y with abdominal obesity [waist circumference (WC ≥ 80 cm] were randomised to a 12 week lifestyle intervention (n = 26 of physical activity, nutrition education and cognitive behavioural therapy, or a wait-list control group (n = 17. Both groups completed anthropometric, biochemical, nutrition and fitness testing, at pre (0 weeks and post (12 weeks, with intervention participants completed follow-up testing at 24 weeks.Results from a linear mixed model showed no between-group differences, other than increased physical activity in the intervention group, at post. In the intervention group alone, positive within-group changes were observed in WC, waist-hip-ratio (WHR, waist-height-ratio (WHtR, resting heart rate, blood pressure, predicted VO2max, and total energy intake. Most changes were maintained at 24 weeks post-intervention. Similar within-group improvements were observed in control participants in WC, WHR, WHtR, and systolic blood pressure but no changes were detected in physical activity and nutrition.Cardiometabolic risk factors were decreased as a result of a lifestyle intervention in young women with abdominal obesity. It is difficult to describe observations in the control group without greater understanding of the behaviour of wait-list participants.Australian New Zealand Clinical Trials Registry ACTRN12612001017819.

  17. Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies

    OpenAIRE

    Zahra Bahadoran; Parvin Mirmiran; Fereidoun Azizi

    2015-01-01

    Background: There are growing concern globally regarding the alarming trend of fast food consump­tion and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa­bolic risk factors. Methods: Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, S...

  18. Cardiometabolic risk factors are associated with high urinary enterolactone concentration, independent of urinary enterodiol concentration and dietary fiber intake in adults.

    Science.gov (United States)

    Frankenfeld, Cara L

    2014-09-01

    The study objective was to evaluate independent and interactive associations of dietary fiber intake and high urinary enterolignans with cardiometabolic risk factors. The analysis included 2260 adults (≥20 y of age) from the 2003-2010 NHANES. Logistic regression models were used to evaluate obesity and clinically defined cardiometabolic risk factors in relation to dietary fiber intake and urinary enterolignan concentrations. Three sets of models were created: 1) independent associations, 2) mutually adjusted associations, and 3) interactions. Models were adjusted for age, gender, race/ethnicity, education, smoking status, and energy intake. High concentrations were considered to be above the 90th percentile of urinary enterolignan concentrations. Increasing dietary fiber intake was associated with high blood pressure (P = 0.02) and low serum HDL cholesterol (P-trend = 0.03). High urinary enterodiol concentration was not associated with obesity or cardiometabolic risk factors. High urinary enterolactone concentration was inversely associated with obesity (OR: 0.44; 95% CI: 0.29, 0.66), abdominal obesity (OR: 0.58; 95% CI: 0.39, 0.87), high serum C-reactive protein (CRP; OR: 0.52; 95% CI: 0.37, 0.74), high serum triglycerides (OR: 0.39; 95% CI: 0.23, 0.61), low serum HDL cholesterol (OR: 0.37; 95% CI: 0.23, 0.61), and metabolic syndrome (OR: 0.47; 95% CI: 0.30, 0.74). In mutually adjusted models, enterolactone associations observed in independent models remained similar, but associations for dietary fiber intake were attenuated, with the exception of blood pressure. In interaction models, there were 2 significant interactions: between high urinary enterodiol concentration and dietary fiber intake for high serum CRP (P = 0.04) and high plasma glucose (P = 0.04). Overall, being in the highest 10% of urinary enterolactone concentration was associated with cardiometabolic risk factors, independent of dietary fiber intake and enterodiol concentration. Future studies are

  19. Fructose content of low calorie diets: effect on cardiometabolic risk factors in obese women with polycystic ovarian syndrome: a randomized controlled trial

    OpenAIRE

    Johnson, Line K; Holven, Kirsten B.; Nordstrand, Njord; Mellembakken, Jan R.; Tanbo, Tom; Hjelmesæth, Jøran

    2015-01-01

    We aimed to examine whether a whole-grain crispbread (CB) low-fructose, low-calorie diet (LCD) might be superior to a traditional LCD based on fructose-rich liquid meal replacements (LMRs) with respect to improvement of various cardiometabolic risk factors and reproductive hormones. Parallel-group randomised controlled clinical trial. Morbidly obese women with polycystic ovarian syndrome (PCOS) were randomised to either an 8-week CB-LCD or LMR-LCD (900–1100 kcal/day, fructose 17 g/day or 85 g...

  20. Joint Association of Screen Time and Physical Activity with Cardiometabolic Risk Factors in a National Sample of Iranian Adolescents: The CASPIANIII Study

    OpenAIRE

    Ramin Heshmat; Mostafa Qorbani; Amir Eslami Shahr Babaki; Shirin Djalalinia; Asal Ataei-Jafari; Mohammad Esmaeil Motlagh; Gelayol Ardalan; Tahereh Arefirad; Fatemeh Rezaei; Hamid Asayesh; Roya Kelishadi

    2016-01-01

    Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by sel...

  1. Periodontal therapy and risk for adverse pregnancy outcomes.

    Science.gov (United States)

    Oliveira, Alcione Maria Soares Dutra; de Oliveira, Peterson Antonio Dutra; Cota, Luís Otávio Miranda; Magalhães, Claúdia Silami; Moreira, Allyson Nogueira; Costa, Fernando Oliveira

    2011-10-01

    Periodontitis has been associated with adverse pregnancy outcomes. Results from intervention studies are few and controversial. The present study assessed the effects of non-surgical periodontal treatment in the occurrence of adverse pregnancy outcomes. Two hundred forty-six eligible women were randomly divided into two groups: periodontitis intervention (n = 122; undergoing non-surgical treatment during gestation) and periodontitis control (n = 124; not treated during gestation). Univariate analysis was performed and estimates of relative risk were reported. Data from 225 women were analyzed. No differences for preterm birth (p = 0.721), low birth weight (p = 0.198), and preterm low birth weight (p = 0.732) rates were observed. Relative risk estimates for preterm birth, low birth weight, and preterm low birth weight in the periodontitis intervention group were 0.915 (95% CI 0.561-1.493), 0.735 (95% CI 0.459-1.179), and 0.927 (0.601-1.431), respectively. Non-surgical periodontal treatment during the second semester of gestation did not reduce the risk for preterm birth, low birth weight, and preterm low birth weight.

  2. Low-density lipoprotein electronegativity is a novel cardiometabolic risk factor.

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    Jing-Fang Hsu

    Full Text Available BACKGROUND: Low-density lipoprotein (LDL plays a central role in cardiovascular disease (CVD development. In LDL chromatographically resolved according to charge, the most electronegative subfraction-L5-is the only subfraction that induces atherogenic responses in cultured vascular cells. Furthermore, increasing evidence has shown that plasma L5 levels are elevated in individuals with high cardiovascular risk. We hypothesized that LDL electronegativity is a novel index for predicting CVD. METHODS: In 30 asymptomatic individuals with metabolic syndrome (MetS and 27 healthy control subjects, we examined correlations between plasma L5 levels and the number of MetS criteria fulfilled, CVD risk factors, and CVD risk according to the Framingham risk score. RESULTS: L5 levels were significantly higher in MetS subjects than in control subjects (21.9±18.7 mg/dL vs. 11.2±10.7 mg/dL, P:0.01. The Jonckheere trend test revealed that the percent L5 of total LDL (L5% and L5 concentration increased with the number of MetS criteria (P<0.001. L5% correlated with classic CVD risk factors, including waist circumference, body mass index, waist-to-height ratio, smoking status, blood pressure, and levels of fasting plasma glucose, triglyceride, and high-density lipoprotein. Stepwise regression analysis revealed that fasting plasma glucose level and body mass index contributed to 28% of L5% variance. The L5 concentration was associated with CVD risk and contributed to 11% of 30-year general CVD risk variance when controlling the variance of waist circumference. CONCLUSION: Our findings show that LDL electronegativity was associated with multiple CVD risk factors and CVD risk, suggesting that the LDL electronegativity index may have the potential to be a novel index for predicting CVD. Large-scale clinical trials are warranted to test the reliability of this hypothesis and the clinical importance of the LDL electronegativity index.

  3. Low Physical Activity Level and Short Sleep Duration Are Associated with an Increased Cardio-Metabolic Risk Profile: A Longitudinal Study in 8-11 Year Old Danish Children

    DEFF Research Database (Denmark)

    Hjorth, Mads F.; Chaput, Jean-Philippe; Damsgaard, Camilla T.

    2014-01-01

    index (fat mass/height(2)) was assessed using Dual-energy X-ray absorptiometry. The MetS-score was based on z-scores of waist circumference, mean arterial blood pressure, homeostatic model assessment of insulin resistance, triglycerides and high density lipoprotein cholesterol. All measurements were......Background: As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood...

  4. Dairy products, yogurt consumption, and cardiometabolic risk in children and adolescents.

    Science.gov (United States)

    Moreno, Luis A; Bel-Serrat, Silvia; Santaliestra-Pasías, Alba; Bueno, Gloria

    2015-08-01

    The high prevalence of obesity in children is a global health issue. Obesity in children and adolescents can result in hypertension, dyslipidemia, chronic inflammation, and hyperinsulinemia, increasing the risk of death, as children grow into adulthood, and raising public health concerns. Type 2 diabetes in children and adolescents is a cardiovascular disease (CVD) risk factor. Dairy consumption may have a protective effect against the development of CVD, but there is scarce evidence of this in children and adolescents. Within the Healthy Lifestyle in Europe by Nutrition in Adolescence, the objective of this study was to investigate the relationship between dairy consumption and CVD risk factors in a sample of adolescents (aged 12.5-17.5 years) from 8 European cities. Overall, dairy products emerged as the food group that best identified adolescents at low CVD risk. Higher consumption of milk and yogurt and of milk- and yogurt-based beverages was associated with lower body fat, lower risk for CVD, and higher cardiorespiratory fitness.

  5. Predicting incident fatty liver using simple cardio-metabolic risk factors at baseline

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    Sung Ki-Chul

    2012-07-01

    Full Text Available Abstract Background Non alcoholic fatty liver disease (NAFLD is associated with increased risk of type 2 diabetes and chronic liver disease but identifying patients who have NAFLD without resorting to expensive imaging tests is challenging. In order to help identify people for imaging investigation of the liver who are at high risk of NAFLD, our aim was to: a identify easily measured risk factors at baseline that were independently associated with incident fatty liver at follow up, and then b to test the diagnostic performance of thresholds of these factors at baseline, to predict or to exclude incident fatty liver at follow up. Methods 2589 people with absence of fatty liver on ultrasound examination at baseline were re-examined after a mean of 4.4 years in a Korean occupational cohort study. Multi-variable logistic regression analyses were used to identify baseline factors that were independently associated with incident fatty liver at follow up. The diagnostic performance of thresholds of these baseline factors to identify people with incident fatty liver at follow-up was assessed using receiver operating characteristic (ROC curves. Results 430 incident cases of fatty liver were identified. Several factors were independently associated with incident fatty liver: increased triglyceride (per mmol/l increase OR 1.378 [95%CIs 1.179, 1.611], p 9/L increase OR 1.004 [1.001, 1.006], p = 0.001; were each independently associated with incident fatty liver. Binary thresholds of the five factors were applied and the area under the ROC curve for incident fatty liver was 0.75 (95%CI 0.72–0.78 for the combination of all five factors above these thresholds. Conclusion Simple risk factors that overlap considerably with risk factors for type 2 diabetes allow identification of people at high risk of incident fatty liver at who use of hepatic imaging could be targeted.

  6. Cardiometabolic disease risk and HIV status in rural South Africa : establishing a baseline

    NARCIS (Netherlands)

    Clark, Samuel J.; Gomez-Olive, F. Xavier; Houle, Brian; Thorogood, Margaret; Klipstein-Grobusch, Kerstin; Angotti, Nicole; Kabudula, Chodziwadziwa; Williams, Jill; Menken, Jane; Tollman, Stephen

    2015-01-01

    Background: To inform health care and training, resource and research priorities, it is essential to establish how non-communicable disease risk factors vary by HIV-status in high HIV burden areas; and whether long-term anti-retroviral therapy (ART) plays a modifying role. Methods: As part of a coho

  7. Associations between Dietary Acid-Base Load and Cardiometabolic Risk Factors in Adults: The Tehran Lipid and Glucose Study

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    Zahra Bahadoran

    2015-06-01

    Full Text Available BackgroundIn this study we investigated the associations of dietary acid-base load, identified by potential renal acid load (PRAL and protein to potassium (Pro:K ratio, with cardiometabolic risk factors in Tehranian adults.MethodsA cross-sectional study was conducted within the framework of the fourth phase of the Tehran Lipid and Glucose Study (2009 to 2011 on 5,620 men and women aged 19 to 70 years. Dietary data were collected by a trained dietitian using a validated, 147-food item, semi-quantitative food frequency questionnaire, and dietary PRAL and Pro:K ratio were calculated. Multiple linear regression models with adjustment for potential confounding variables were used to evaluate the associations of dietary acid-base load with anthropometric measures, blood pressure, serum triglycerides, high density lipoprotein cholesterol (HDL-C, serum creatinine, and fasting blood glucose.ResultsThe mean±SD age of the participants was 39.8±12.8 years and 54% of participants were women. Mean±SD PRAL was -22.0±29.1; mean PRAL was -15.6 in men and -26.8 in women. Dietary PRAL was associated with weight (β=0.098, P<0.001, waist circumference (β=0.062, P<0.01, serum triglycerides (β=0.143, P<0.01, HDL-C (β=-0.11, P<0.01, diastolic blood pressure (β=0.062, P<0.01, and serum creatinine (β=0.142, P<0.001. Pro:K ratio was associated with weight (β=0.055, P<0.001, waist circumference (β=0.04, P<0.01, serum HDL-C (β=-0.06, P<0.01, serum triglycerides (β=0.03, P<0.05, diastolic blood pressure (β=0.026, P<0.05, and serum creatinine (β=0.07, P<0.01.ConclusionA more acidic dietary acid-base load may be a risk factor for the development of metabolic disorders.

  8. A cross-sectional investigation of regional patterns of diet and cardio-metabolic risk in India

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    Reddy KS

    2011-01-01

    Full Text Available Abstract Background The role of diet in India's rapidly progressing chronic disease epidemic is unclear; moreover, diet may vary considerably across North-South regions. Methods The India Health Study was a multicenter study of men and women aged 35-69, who provided diet, lifestyle, and medical histories, as well as blood pressure, fasting blood, urine, and anthropometric measurements. In each region (Delhi, n = 824; Mumbai, n = 743; Trivandrum, n = 2,247, we identified two dietary patterns with factor analysis. In multiple logistic regression models adjusted for age, gender, education, income, marital status, religion, physical activity, tobacco, alcohol, and total energy intake, we investigated associations between regional dietary patterns and abdominal adiposity, hypertension, diabetes, and dyslipidemia. Results Across the regions, more than 80% of the participants met the criteria for abdominal adiposity and 10 to 28% of participants were considered diabetic. In Delhi, the "fruit and dairy" dietary pattern was positively associated with abdominal adiposity [highest versus lowest tertile, multivariate-adjusted OR and 95% CI: 2.32 (1.03-5.23; Ptrend = 0.008] and hypertension [2.20 (1.47-3.31; Ptrend trend = 0.03] and the "snacks and sweets" pattern was positively associated with abdominal adiposity [2.05 (1.34-3.14; Ptrend = 0.03]. In Mumbai, the "fruit and vegetable" pattern was inversely associated with hypertension [0.63 (0.40-0.99; Ptrend = 0.05] and the "snack and meat" pattern appeared to be positively associated with abdominal adiposity. Conclusions Cardio-metabolic risk factors were highly prevalent in this population. Across all regions, we found little evidence of a Westernized diet; however, dietary patterns characterized by animal products, fried snacks, or sweets appeared to be positively associated with abdominal adiposity. Conversely, more traditional diets in the Southern regions were inversely related to diabetes and

  9. Serum Adiponectin and Cardiometabolic Risk in Patients with Acute Coronary Syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Gustavo Bernardes de Figueiredo, E-mail: goliveira@cardiol.br; França, João Ítalo Dias; Piegas, Leopoldo Soares [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2013-11-15

    The adipose tissue is considered not only a storable energy source, but mainly an endocrine organ that secretes several cytokines. Adiponectin, a novel protein similar to collagen, has been found to be an adipocyte-specific cytokine and a promising cardiovascular risk marker. To evaluate the association between serum adiponectin levels and the risk for cardiovascular events in patients with acute coronary syndromes (ACS), as well as the correlations between adiponectin and metabolic, inflammatory, and myocardial biomarkers. We recruited 114 patients with ACS and a mean 1.13-year follow-up to measure clinical outcomes. Clinical characteristics and biomarkers were compared according to adiponectin quartiles. Cox proportional hazard regression models with Firth's penalization were applied to assess the independent association between adiponectin and the subsequent risk for both primary (composite of cardiovascular death/non-fatal acute myocardial infarction (AMI)/non-fatal stroke) and co-primary outcomes (composite of cardiovascular death/non-fatal AMI/non-fatal stroke/ rehospitalization requiring revascularization). There were significant direct correlations between adiponectin and age, HDL-cholesterol, and B-type natriuretic peptide (BNP), and significant inverse correlations between adiponectin and waist circumference, body weight, body mass index, Homeostasis Model Assessment (HOMA) index, triglycerides, and insulin. Adiponectin was associated with higher risk for primary and co-primary outcomes (adjusted HR 1.08 and 1.07/increment of 1000; p = 0.01 and p = 0.02, respectively). In ACS patients, serum adiponectin was an independent predictor of cardiovascular events. In addition to the anthropometric and metabolic correlations, there was a significant direct correlation between adiponectin and BNP.

  10. Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk: a longitudinal study in Danish children

    DEFF Research Database (Denmark)

    Hjorth, M.; Chaput, J.; Damsgaard, C.

    2014-01-01

    Graph GT3X/GT3X+). The continuous MetS-score was based on z-scores of waist circumference, mean arterial blood pressure, HOMA-IR, triglycerides and HDL-cholesterol. Fat mass index (fat mass/height2) was measured by DEXA. All measurements were taken at two time points separated by 200 days and used......-hour; 95% CI (−0.87;−0.04)], but not sedentary time, were prospectively associated with the MetS-score (P ≤ 0.03). Adjusting for fat mass index while removing waist circumference from the MetS-score rendered the associations no longer statistically significant (P ≥ 0.17). Conclusions: Independent......Background: As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity [PA], sedentary time and sleep) and cardio-metabolic risk in childhood may aid to prevent metabolic syndrome in adulthood. Aim...

  11. A-FABP Concentration Is More Strongly Associated with Cardiometabolic Risk Factors and the Occurrence of Metabolic Syndrome in Premenopausal Than in Postmenopausal Middle-Aged Women

    Directory of Open Access Journals (Sweden)

    Anna Stefanska

    2014-01-01

    Full Text Available We aimed at the evaluation of the relationship between adipocyte fatty acid binding protein (A-FABP and cardiometabolic risk factors in premenopausal and postmenopausal women. Additionally, we compared A-FABP with adipokines related to metabolic syndrome (MetS such as leptin and adiponectin. 94 premenopausal and 90 early postmenopausal middle-aged Caucasian women were subject to examinations. Postmenopausal women had higher A-FABP than premenopausal; this difference became insignificant after controlling for age. We found significantly higher correlation coefficients between A-FABP and TC/HDL-C ratio and number of MetS components in premenopausal women, compared to postmenopausal. Each 1 ng/dL increase in A-FABP concentration significantly increased the probability of occurrence of atherogenic lipid profile in premenopausal women, even after multivariate adjustment. All odds ratios became insignificant after controlling for BMI in postmenopausal women. A-FABP was more strongly associated with MetS than leptin and adiponectin in premenopausal women. Adiponectin concentration was a better biomarker for MetS after menopause. Our results suggest that the A-FABP is more strongly associated with some cardiometabolic risk factors in premenopausal than in postmenopausal women. Higher values of A-FABP after menopause are mainly explained by the fact that postmenopausal women are older. Because of the limitation of study, these results should be interpreted with caution.

  12. An Intervention with Mineral Water Decreases Cardiometabolic Risk Biomarkers. A Crossover, Randomised, Controlled Trial with Two Mineral Waters in Moderately Hypercholesterolaemic Adults

    Directory of Open Access Journals (Sweden)

    Laura Toxqui

    2016-06-01

    Full Text Available Water intake is essential for health maintenance and disease prevention. The effects of an intervention with two mineral waters, sodium-bicarbonated mineral water (BW or control mineral water low in mineral content (CW, on cardiometabolic risk biomarkers were studied. In a randomised-controlled crossover-trial, sixty-four moderately hypercholesterolaemic adults were randomly assigned to consume 1 L/day of either BW (sodium, 1 g/L; bicarbonate, 2 g/L or CW with the main meals for eight weeks, separated by an eight-week washout period. Blood lipids, lipid oxidation, glucose, insulin, aldosterone, urine pH, urinary electrolytes, blood pressure, body weight, fluid intake, energy, and nutrients from total diet and beverages were determined. Total cholesterol, LDL cholesterol, and glucose decreased (p < 0.01, oxidised LDL tended to decrease (p = 0.073, and apolipoprotein B increased during the intervention, without water type effect. Energy and carbohydrates from beverages decreased since soft drinks and fruit juice consumptions decreased throughout the trial. BW increased urinary pH (p = 0.006 and reduced calcium/creatinine excretion (p = 0.011. Urinary potassium/creatinine decreased with both waters. Consumption of 1 L/day of mineral water with the main meals reduces cardiometabolic risk biomarkers, likely to be attributed to a replacement of soft drinks by water. In addition, BW does not affect blood pressure and exerts a moderate alkalizing effect in the body.

  13. Severe Calorie Restriction Reduces Cardiometabolic Risk Factors and Protects Rat Hearts from Ischemia/Reperfusion Injury

    Science.gov (United States)

    Melo, Dirceu S.; Costa-Pereira, Liliane V.; Santos, Carina S.; Mendes, Bruno F.; Costa, Karine B.; Santos, Cynthia Fernandes F.; Rocha-Vieira, Etel; Magalhães, Flávio C.; Esteves, Elizabethe A.; Ferreira, Anderson J.; Guatimosim, Sílvia; Dias-Peixoto, Marco F.

    2016-01-01

    Background and Aims: Recent studies have proposed that if a severe caloric restriction (SCR) is initiated at the earliest period of postnatal life, it can lead to beneficial cardiac adaptations later on. We investigated the effects of SCR in Wistar rats from birth to adult age on risk factors for cardiac diseases (CD), as well as cardiac function, redox status, and HSP72 content in response to ischemia/reperfusion (I/R) injury. Methods and Results: From birth to the age of 3 months, CR50 rats were fed 50% of the food that the ad libitum group (AL) was fed. Food intake was assessed daily and body weight were assessed weekly. In the last week of the SCR protocol, systolic blood pressure and heart rate were measured and the double product index was calculated. Also, oral glucose and intraperitoneal insulin tolerance tests were performed. Thereafter, rats were decapitated, visceral fat was weighed, and blood and hearts were harvested for biochemical, functional, tissue redox status, and western blot analyzes. Compared to AL, CR50 rats had reduced the main risk factors for CD. Moreover, the FR50 rats showed increased cardiac function both at baseline conditions (45% > AL rats) and during the post-ischemic period (60% > AL rats) which may be explained by a decreased cardiac oxidative stress and increased HSP72 content. Conclusion: SCR from birth to adult age reduced risk factors for CD, increased basal cardiac function and protected hearts from the I/R, possibly by a mechanism involving ROS. PMID:27092082

  14. Does Microalbuminuria Affect Resistin and Cardiometabolic Risk Factors in Hypertensive Non-Diabetic Females?

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    Sena Ulu

    2014-09-01

    Full Text Available Aim: Hypertension, obesity, insulin resistance and lipid levels are risk factors for cardiovascular disease. The association of cardiovascular risk with C-reactive protein and homocysteine has been debated for decades. Resistin and microalbuminuria are presumed to be associated with diabetes mellitus, insulin resistance and cardiovascular disease. The objective of our study was to investigate the relationship of microalbuminuria with antropometric and metabolic parameters, C-reactive protein, homocyteine and resistin in non-diabetic hypertensive females. Methods: We conducted a randomized study including 37 female non-diabetic hypertensives without microalbuminuria and 47 female non-diabetic hypertensive patients with microalbuminuria. We made comparisons of anthropometric and metabolic parameters, C-reactive protein, homocysteine, insulin resistance index and resistin between the groups. Results: C-reactive protein, homocysteine, resistin, insulin levels and homeostasis model assessment of insulin resistance were higher in hypertensives with microalbuminuria than in hypertensives without microalbuminuria (all p<0.05. Conclusion: We found that microalbuminuria may have an influence on C-reactive protein, homocysteine and resistin levels in non-diabetic hypertensives. We also think that insulin and insulin resistance may also be related with microalbuminuria in non-diabetic hypertensive female patients. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 172-6

  15. Cardiometabolic Risk Factors Related to Vitamin D and Adiponectin in Obese Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Fatih Kardas

    2013-01-01

    Full Text Available Obesity-related diseases are becoming the most important causes of mortality worldwide. Several studies have suggested an association between low levels of vitamin D and obesity. In addition, plasma adiponectin levels have been found to be lower in obese subjects. We evaluated the association of metabolic risk factors with both adiponectin and vitamin D levels and that between adiponectin and vitamin D levels. The study consisted of 114 obese and healthy subjects. 25-Hydroxy vitamin D [25(OHD] levels were positively correlated with adiponectin and HDL-cholesterol (HDL-C and inversely correlated with body mass index (BMI, LDL-cholesterol (LDL-C, total cholesterol (T-C, triglyceride (TG, fasting glucose, homeostasis model assessment of insulin resistance (HOMA index, systolic blood pressure (SBP, and diastolic blood pressure (DBP. The mean 25(OHD levels in the obese and nonobese groups were and  ng/mL, respectively (. The mean adiponectin level in the obese group was lower than that in the nonobese group (. Lower vitamin D and adiponectin levels were strongly associated with metabolic risk factors and obesity in Turkish children and adolescents.

  16. Effects of supplementation with n-3 polyunsaturated fatty acids on cognitive performance and cardiometabolic risk markers in healthy 51 to 72 years old subjects: a randomized controlled cross-over study

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    Nilsson Anne

    2012-11-01

    Full Text Available Abstract Background Higher plasma n-3 polyunsaturated fatty acids (PUFA have been associated with a lower risk of age related cognitive decline, and to beneficially affect cardiometabolic risk factors. A relation exists between metabolic disorders such as diabetes type 2 and cognitive decline. Results regarding the potential effects of n-3 PUFA on risk factors in healthy subjects are divergent, and studies regarding the possible relation between cardiometabolic parameters and cognitive performance are scarce. The objective was to evaluate the effects of five weeks intake of long chain n-3 PUFA on cognitive performance in healthy individuals, and to exploit the possible relation between outcomes in cognitive tests to cardiometabolic risk parameters. Methods Fish oil n-3 PUFA (3g daily were consumed during 5weeks separated by a 5 week washout period in a cross-over placebo controlled study, including 40 healthy middle aged to elderly subjects. Cognitive performance was determined by tests measuring working memory (WM and selective attention. Results Supplementation with n-3 PUFA resulted in better performance in the WM-test compared with placebo (p p p p = 0.05, and s-TNF-α (p = 0.05, were inversely related to the performance in cognitive tests. Conclusions Intake of n-3 PUFA improved cognitive performance in healthy subjects after five weeks compared with placebo. In addition, inverse relations were obtained between cardiometabolic risk factors and cognitive performance, indicating a potential of dietary prevention strategies to delay onset of metabolic disorders and associated cognitive decline.

  17. The effect of prebiotic supplementation with inulin on cardiometabolic health: Rationale, design, and methods of a controlled feeding efficacy trial in adults at risk of type 2 diabetes.

    Science.gov (United States)

    Mitchell, Cassie M; Davy, Brenda M; Halliday, Tanya M; Hulver, Mathew W; Neilson, Andrew P; Ponder, Monica A; Davy, Kevin P

    2015-11-01

    Prediabetes is associated with low-grade chronic inflammation that increases the risk for developing type 2 diabetes (T2D) and cardiovascular disease (CVD). An elevated lipopolysaccharide concentration, associated with dysbiosis of the intestinal microbiota, has been implicated in the development of both T2D and CVD. Selective modulation of the intestinal microbiota with prebiotics reduces intestinal permeability and endotoxin concentrations, inflammation, and metabolic dysfunction in rodents. The effect of prebiotic supplementation on cardio-metabolic function in humans at risk for T2D is not known. The primary aim of this trial is to determine the influence of prebiotic supplementation with inulin on insulin sensitivity and skeletal muscle metabolic flexibility in adults at risk for T2D. We hypothesize that prebiotic supplementation with inulin will improve insulin sensitivity and skeletal muscle metabolic flexibility. We will randomize 48 adults (40-75 yrs) with prediabetes or a score ≥ 5 on the American Diabetes Association (ADA) risk screener to 6 weeks of prebiotic supplementation with inulin (10 g/day) or placebo. Subjects will be provided with all food for the duration of the study, to avoid potential confounding through differences in dietary intake between individuals. Intestinal permeability, serum endotoxin concentrations, insulin sensitivity, skeletal muscle metabolic flexibility, endothelial function, arterial stiffness, and fecal bacterial composition will be measured at baseline and following treatment. The identification of prebiotic supplementation with inulin as an efficacious strategy for reducing cardio-metabolic risk in individuals at risk of T2D could impact clinical practice by informing dietary recommendations and increasing acceptance of prebiotics by the scientific and medical community.

  18. Polycystic Ovary Syndrome: Important Underrecognised Cardiometabolic Risk Factor in Reproductive-Age Women

    Directory of Open Access Journals (Sweden)

    Dinka Pavicic Baldani

    2015-01-01

    Full Text Available Polycystic ovary syndrome (PCOS is the most common endocrine disorder amongst women of reproductive age. Although PCOS is diagnosed exclusively based on reproductive criteria, it is also a metabolic disorder. Insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, obesity, and dyslipidemia are more common in women with PCOS than in age-comparable women without PCOS. Many of the metabolic abnormalities that manifest in PCOS are worsened by the concurrent incidence of obesity. However, some of these metabolic perturbations occur even in lean women with PCOS and therefore are rightfully recognized as intrinsic to PCOS. The intrinsic factors that produce these metabolic disturbances are reviewed in this paper. The consequences of obesity and the other metabolic aberrations are also discussed. The metabolic perturbations in PCOS patients lead to chronic low-grade inflammation and to cardiovascular impairments that heighten the risk of having cardiovascular disease. Even though many studies have shown an elevation in surrogate biomarkers of cardiovascular disease in PCOS women, it is still not clear to what extent and magnitude the elevation precipitates more frequent and earlier events.

  19. Cardiometabolic and Skeletal Risk Factors in Black Men with Prostate Cancer Starting Androgen Deprivation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gunnarsson, Orvar, E-mail: orvar.gunnarsson@uphs.upenn.edu [Department of Medicine, Division of Hematology and Oncology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 16 Penn Tower, Philadelphia, PA 19104 (United States); Basaria, Shehzad [Department of Medicine, Section of Men’s Health, Aging and Metabolism, Brigham and Women’s Hospital, Boston, MA 02115 (United States); Gignac, Gretchen A. [Department of Medicine, Section of Hematology and Oncology, Boston University School of Medicine, Boston, MA 02118 (United States)

    2015-04-22

    Background: Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with multiple metabolic complications, previously predominantly evaluated in the white population. Methods: A chart-based retrospective review was conducted on black patients with PCa, considered for ADT, from September 2007 to July 2010. Baseline data were collected on body mass index (BMI), vitamin-D status, bone mineral density (BMD), dyslipidemia and diabetes. Overweight and obesity were classified as BMI ≥ 25 and BMI ≥ 30, respectively. Vitamin-D sufficiency was defined as levels ≥30 ng/mL, insufficiency as <30 ng/mL and deficiency as ≤20 ng/mL. Osteopenia was defined as T scores between −1 to −2.5 and osteoporosis when T scores ≤−2.5. Results: Of the initial cohort of 130 black men, 111 (85.4%) patients underwent ADT. At baseline, average BMI was 28.1 ± 5.9 with 43.3% of men being overweight and 30.8% obese. More than one-third of the patients had pre-existing dyslipidemia while 28.8% were diabetics. 50% were vitamin-D deficient while 41% had low bone mass. Conclusions: Black men with PCa presenting for consideration of ADT have a high prevalence of existing metabolic risk factors. Close monitoring of this patient population is needed during ADT to prevent and treat metabolic complications.

  20. Cardiometabolic and Skeletal Risk Factors in Black Men with Prostate Cancer Starting Androgen Deprivation Therapy

    Directory of Open Access Journals (Sweden)

    Orvar Gunnarsson

    2015-04-01

    Full Text Available Background: Androgen deprivation therapy (ADT for prostate cancer (PCa is associated with multiple metabolic complications, previously predominantly evaluated in the white population. Methods: A chart-based retrospective review was conducted on black patients with PCa, considered for ADT, from September 2007 to July 2010. Baseline data were collected on body mass index (BMI, vitamin-D status, bone mineral density (BMD, dyslipidemia and diabetes. Overweight and obesity were classified as BMI ≥ 25 and BMI ≥ 30, respectively. Vitamin-D sufficiency was defined as levels ≥30 ng/mL, insufficiency as <30 ng/mL and deficiency as ≤20 ng/mL. Osteopenia was defined as T scores between −1 to −2.5 and osteoporosis when T scores ≤−2.5. Results: Of the initial cohort of 130 black men, 111 (85.4% patients underwent ADT. At baseline, average BMI was 28.1 ± 5.9 with 43.3% of men being overweight and 30.8% obese. More than one-third of the patients had pre-existing dyslipidemia while 28.8% were diabetics. 50% were vitamin-D deficient while 41% had low bone mass. Conclusions: Black men with PCa presenting for consideration of ADT have a high prevalence of existing metabolic risk factors. Close monitoring of this patient population is needed during ADT to prevent and treat metabolic complications.

  1. The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. NHANES 1999-2006

    Science.gov (United States)

    The goal of this study was to examine the association between breakfast skipping and type of breakfast consumed with overweight /obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome. Three breakfast groups were identified (breakfast skippers, ready-to-eat-cereal ...

  2. The association between Mediterranean Diet Score and glucokinase regulatory protein gene variation on the markers of cardiometabolic risk: an analysis in the European Prospective Investigation into Cancer (EPIC)-Norfolk study.

    Science.gov (United States)

    Sotos-Prieto, Mercedes; Luben, Robert; Khaw, Kay-Tee; Wareham, Nicholas J; Forouhi, Nita G

    2014-07-14

    Consumption of a Mediterranean diet (MD) and genetic variation in the glucokinase regulatory protein (GCKR) gene have been reported to be associated with TAG and glucose metabolism. It is uncertain whether there is any interaction between these factors. Therefore, the aims of the present study were to test the association of adherence to a MD and rs780094 (G>A) SNP in the GCKR gene with the markers of cardiometabolic risk, and to investigate the interaction between genetic variation and MD adherence. We studied 20 986 individuals from the European Prospective Investigation into Cancer (EPIC)-Norfolk study. The relative Mediterranean Diet Score (rMED: range 0-18) was used to assess MD adherence. Linear regression was used to estimate the association between the rMED, genotype and cardiometabolic continuous traits, adjusting for potential confounders. In adjusted analyses, we observed independent associations of MD adherence and genotype with cardiometabolic risk, with the highest risk group (AA genotype; lowest rMED) having higher concentrations of TAG, total cholesterol and apoB (12·5, 2·3 and 3·1%, respectively) v. those at the lowest risk (GG genotype; highest rMED). However, the associations of MD adherence with metabolic markers did not differ by genotype, with no significant gene-diet interactions for lipids or for glycated Hb. In conclusion, we found independent associations of the rMED and of the GCKR genotype with cardiometabolic profile, but found no evidence of interaction between them.

  3. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the ‘Gold Standard’ Tarnished?

    Science.gov (United States)

    Hands, Beth; Pennell, Craig E.; Lye, Stephen J.; Mountain, Jennifer A.

    2016-01-01

    Background and Aims Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults. Methods and Results 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR. Conclusion Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults. PMID:27622523

  4. Combination of diabetes risk factors and hepatic steatosis in Chinese: the Cardiometabolic Risk in Chinese (CRC Study.

    Directory of Open Access Journals (Sweden)

    Jun Liang

    Full Text Available AIMS: Hepatic steatosis has been related to insulin resistance and increased diabetes risk. We assessed whether combination of diabetes risk factors, evaluated by the Finnish Diabetes Risk Score, was associated with risk of hepatic steatosis in an apparently healthy Chinese population. RESEARCH DESIGN AND METHODS: The study samples were from a community-based health examination survey in central China. In total 1,780 men and women (18-64 y were included in the final analyses. Hepatic steatosis was diagnosed by ultrasonography. We created combination of diabetes risk factors score on basis of age, Body Mass Index, waist circumference, physical activity at least 4 h a week, daily consumption of fruits, berries or vegetables, history of antihypertensive drug treatment, history of high blood glucose. The total risk score is a simple sum of the individual weights, and values range from 0 to 20. RESULTS: Hepatic steatosis was present 18% in the total population. In multivariate models, the odds ratios of hepatic steatosis were 1.20 (95%CI 1.15-1.25 in men and 1.25 (95%CI 1.14-1.37 in women by each unit increase in the combination of diabetes risk factors score, after adjustment for blood pressure, liver enzymes, plasma lipids, and fasting glucose. The area under the receiver operating characteristic curve for hepatic steatosis was 0.78 (95%CI 0.76-0.80, 0.76 in men (95%CI 0.74-0.78 and 0.83 (95%CI 0.79-0.87 in women. CONCLUSIONS: Our data suggest that combination of major diabetes risk factors was significantly related to risk of hepatic steatosis in Chinese adults.

  5. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?

    OpenAIRE

    Sonestedt, Emily; Øverby, Nina Cecilie; David E Laaksonen; Birgisdottir, Bryndis Eva

    2012-01-01

    Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake onmetabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugarintake (sugar-sweetened beverages, sucrose and fructose) on association with type 2 diabetes, cardiovasculardisease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, bloodpressure, uric acid, inflammation markers), and on all-cause morta...

  6. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    David E. Laaksonen

    2012-07-01

    Full Text Available Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake on metabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugar intake (sugar-sweetened beverages, sucrose and fructose on association with type 2 diabetes, cardiovascular disease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, blood pressure, uric acid, inflammation markers, and on all-cause mortality, through a systematic review of prospective cohort studies and randomised controlled intervention studies published between January 2000 and search dates. The methods adopted were as follows: the first search was run in PubMed in October 2010. A second search with uric acid as risk marker was run in April 2011. The total search strategy was rerun in April 2011 in SveMed+. An update was run in PubMed in January 2012. Two authors independently selected studies for inclusion from the 2,743 abstracts according to predefined eligibility criteria. The outcome was that out of the 17 studies extracted, 15 were prospective cohort studies and two were randomised controlled crossover trials. All of the studies included only adults. With respect to incident type 2 diabetes (nine studies, four of six prospective cohort studies found a significant positive association for sugar-sweetened beverage intake. In general, larger cohort studies with longer follow-up more often reported positive associations, and BMI seemed to mediate part of the increased risk. For other metabolic or cardiovascular risk factors or outcomes, too few studies have been published to draw conclusions. In conclusion, data from prospective cohort studies published in the years 2000–2011 suggest that sugar-sweetened beverages probably increase the risk of type 2 diabetes. For related metabolic risk factors, cardiovascular disease or all-cause mortality and other types of sugars, too few studies

  7. Effects of 6-month soccer and traditional physical activity programmes on body composition, cardiometabolic risk factors, inflammatory, oxidative stress markers and cardiorespiratory fitness in obese boys.

    Science.gov (United States)

    Seabra, André; Katzmarzyk, Peter; Carvalho, Maria José; Seabra, Ana; Coelho-E-Silva, Manuel; Abreu, Sandra; Vale, Susana; Póvoas, Susana; Nascimento, Henrique; Belo, Luís; Torres, Sandra; Oliveira, José; Mota, Jorge; Santos-Silva, Alice; Rêgo, Carla; Malina, Robert M

    2016-10-01

    Physical activity is important in obesity prevention, but the effectiveness of different physical activity modalities remains to be determined among children. The main purpose of this study was to compare the effects of a 6-month soccer programme and a traditional physical activity programme on changes in body composition, cardiometabolic risk factors, inflammatory and oxidative markers, cardiorespiratory fitness and perceived psychological status in obese boys. Eighty-eight boys (8-12 years; BMI > +2 standard deviations of WHO reference values) participated in one of three groups: soccer, traditional activity and control. Soccer and traditional activity programmes involved 3 sessions per week for 60-90 min at an average intensity of 70-80% of maximal heart rate. Control group participated in activities of normal daily living. All boys participated in school physical education, two sessions per week of 45-90-min. Measurements were taken at baseline and after 6 months, and included body size and composition, cardiometabolic risk factors, inflammatory and oxidative markers, cardiorespiratory fitness and perceived psychological status. Physical activity and dietary intake were assessed before and immediately following the intervention. The three groups had similar characteristics at baseline. After 6 months, both intervention groups had significantly lower relative fatness (% fat), waist circumference and total cholesterol, and higher cardiorespiratory fitness, self-esteem, perceived physical competence and attraction to physical activity compared with control group. In conclusion, physical activity interventions over 6 months positively influenced several indicators of health status among obese boys. The results also suggested that soccer has the potential as an effective tool for the prevention and reduction of childhood obesity and associated consequences.

  8. Maternal obesity in early pregnancy and risk of adverse outcomes.

    Directory of Open Access Journals (Sweden)

    Inmaculada Bautista-Castaño

    Full Text Available OBJECTIVES: To assess the role of the health consequences of maternal overweight and obesity at the start of pregnancy on gestational pathologies, delivery and newborn characteristics. METHODS: A cohort of pregnant women (n = 6.558 having delivered at the Maternal & Child University Hospital of Gran Canaria (HUMIGC in 2008 has been studied. Outcomes were compared using multivariate analyses controlling for confounding variables. RESULTS: Compared to normoweight, overweight and obese women have greater risks of gestational diabetes mellitus (RR = 2.13 (95% CI: 1.52-2.98 and (RR = 2.85 (95% CI: 2.01-4.04, gestational hypertension (RR = 2.01 (95% CI: 1.27-3.19 and (RR = 4.79 (95% CI: 3.13-7.32 and preeclampsia (RR = 3.16 (95% CI: 1.12-8.91 and (RR = 8.80 (95% CI: 3.46-22.40. Obese women have also more frequently oligodramnios (RR = 2.02 (95% CI: 1.25-3.27, polyhydramnios. (RR = 1.76 (95% CI: 1.03-2.99, tearing (RR = 1.24 (95% CI: 1.05-1.46 and a lower risk of induced deliveries (RR = 0.83 (95% CI: 0.72-0.95. Both groups have more frequently caesarean section (RR = 1.36 (95% CI: 1.14-1.63 and (RR = 1.84 (95% CI: 1.53-2.22 and manual placenta extraction (RR = 1.65 (95% CI: 1.28-2.11 and (RR = 1.77 (95% CI: 1.35-2.33. Newborns from overweight and obese women have higher weight (p<0.001 and a greater risk of being macrosomic (RR = 2.00 (95% CI: 1.56-2.56 and (RR = 2.74 (95% CI: 2.12-3.54. Finally, neonates from obese mother have a higher risk of being admitted to special care units (RR = 1.34 (95% CI: 1.01-1.77. Apgar 1 min was significantly higher in newborns from normoweight mothers: 8.65 (95% CI: 8.62-8.69 than from overweight: 8.56 (95% CI: 8.50-8.61 or obese mothers: 8.48 (95% CI: 8.41-8.54. CONCLUSION: Obesity and overweight status at the beginning of pregnancy increase the adverse outcomes of the pregnancy. It is important to promote the normalization of bodyweight in those

  9. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie;

    2015-01-01

    INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (.... Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Calculations were adjusted for the mother's age at delivery, parity, ethnicity, socioeconomic status, smoking, and in supplementary analyses for year of birth. RESULTS: Referred women gave birth to children....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study...

  10. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie;

    2015-01-01

    INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (.../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study....... Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Calculations were adjusted for the mother's age at delivery, parity, ethnicity, socioeconomic status, smoking, and in supplementary analyses for year of birth. RESULTS: Referred women gave birth to children...

  11. Development and validation of a risk model for predicting adverse drug reactions in older people during hospital stay: Brighton Adverse Drug Reactions Risk (BADRI) model

    OpenAIRE

    2014-01-01

    BACKGROUND:\\ud \\ud Older patients are at an increased risk of developing adverse drug reactions (ADR). Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR during hospital stay would enable healthcare staff to put measures in place to reduce the risk of such an event developing. The current study aimed to (1) develop and (2) validate an ADR risk prediction m...

  12. Discontinuation of hormone replacement therapy after myocardial infarction and short term risk of adverse cardiovascular events

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Hansen, Peter Riis; Sørensen, Rikke;

    2012-01-01

    To assess the risk of adverse cardiovascular events in women who discontinue hormone replacement therapy after myocardial infarction compared with those who continue.......To assess the risk of adverse cardiovascular events in women who discontinue hormone replacement therapy after myocardial infarction compared with those who continue....

  13. Childhood adversities and adolescent depression : A matter of both risk and resilience

    NARCIS (Netherlands)

    Oldehinkel, Albertine J.; Ormel, Johan; Verhulst, Frank C.; Nederhof, Esther

    2014-01-01

    Childhood adversities have been proposed to modify later stress sensitivity and risk of depressive disorder in several ways: by stress sensitization, stress amplification, and stress inoculation. Combining these models, we hypothesized that childhood adversities would increase risk of early, but not

  14. Association of Cardiometabolic Multimorbidity With Mortality

    DEFF Research Database (Denmark)

    Di Angelantonio, Emanuele; Kaptoge, Stephen; Wormser, David;

    2015-01-01

    IMPORTANCE: The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE: To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS: Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using...... was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy. CONCLUSIONS AND RELEVANCE: Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination...... of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity....

  15. Development and validation of a risk model for predicting adverse drug reactions in older people during hospital stay: Brighton adverse drug reactions risk (BADRI) model

    NARCIS (Netherlands)

    Tangiisuran, B.; Scutt, G.; Stevenson, J.; Wright, J.; Onder, G.; Petrovic, M.; van der Cammen, T.J.M.; Rajkumar, C.; Davies, G.

    2014-01-01

    Background: Older patients are at an increased risk of developing adverse drug reactions (ADR). Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR during hospita

  16. Development and validation of a risk model for predicting adverse drug reactions in older people during hospital stay: Brighton adverse drug reactions risk (BADRI) model

    NARCIS (Netherlands)

    B. Tangiisuran (Balamurugan); G. Scutt (Greg); J.M. Stevenson; J. Wright (Juliet); G. Onder (Graziano); M. Petrovic (Mirko); T.J.M. van der Cammen (Tischa); C. Rajkumar (Chakravarthi); G. Davies (Graham)

    2014-01-01

    textabstractBackground: Older patients are at an increased risk of developing adverse drug reactions (ADR). Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR du

  17. Associations between retinol-binding protein 4 and cardiometabolic risk factors and subclinical atherosclerosis in recently postmenopausal women: cross-sectional analyses from the KEEPS study

    Directory of Open Access Journals (Sweden)

    Huang Gary

    2012-07-01

    Full Text Available Abstract Background The published literature regarding the relationships between retinol-binding protein 4 (RBP4 and cardiometabolic risk factors and subclinical atherosclerosis is conflicting, likely due, in part, to limitations of frequently used RBP4 assays. Prior large studies have not utilized the gold-standard western blot analysis of RBP4 levels. Methods Full-length serum RBP4 levels were measured by western blot in 709 postmenopausal women screened for the Kronos Early Estrogen Prevention Study. Cross-sectional analyses related RBP4 levels to cardiometabolic risk factors, carotid artery intima-media thickness (CIMT, and coronary artery calcification (CAC. Results The mean age of women was 52.9 (± 2.6 years, and the median RBP4 level was 49.0 (interquartile range 36.9-61.5 μg/mL. Higher RBP4 levels were weakly associated with higher triglycerides (age, race, and smoking-adjusted partial Spearman correlation coefficient = 0.10; P = 0.01, but were unrelated to blood pressure, cholesterol, C-reactive protein, glucose, insulin, and CIMT levels (all partial Spearman correlation coefficients ≤0.06, P > 0.05. Results suggested a curvilinear association between RBP4 levels and CAC, with women in the bottom and upper quartiles of RBP4 having higher odds of CAC (odds ratio [95% confidence interval] 2.10 [1.07-4.09], 2.00 [1.02-3.92], 1.64 [0.82-3.27] for the 1st, 3rd, and 4th RBP4 quartiles vs. the 2nd quartile. However, a squared RBP4 term in regression modeling was non-significant (P = 0.10. Conclusions In these healthy, recently postmenopausal women, higher RBP4 levels were weakly associated with elevations in triglycerides and with CAC, but not with other risk factors or CIMT. These data using the gold standard of RBP4 methodology only weakly support the possibility that perturbations in RBP4 homeostasis may be an additional risk factor for subclinical coronary atherosclerosis. Trial registration ClinicalTrials.gov number NCT

  18. Low Physical Activity Level and Short Sleep Duration Are Associated with an Increased Cardio-Metabolic Risk Profile: A Longitudinal Study in 8-11 Year Old Danish Children

    DEFF Research Database (Denmark)

    Hjorth, Mads F.; Chaput, Jean-Philippe; Damsgaard, Camilla T.;

    2014-01-01

    . Objective: To examine independent and combined cross-sectional and longitudinal associations between movement behaviors and the MetS score in 8-11 year old Danish children. Design: Physical activity, sedentary time and sleep duration (seven days and eight nights) were assessed by accelerometer and fat mass......Background: As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood...... taken at three time points separated by 100 days. Average of the three measurements was used as habitual behavior in the cross-sectional analysis and changes from first to third measurement was used in the longitudinal analysis. Results: 723 children were included. In the cross-sectional analysis...

  19. Lifestyle and Dietary Factors Associated with the Evolution of Cardiometabolic Risk over Four Years in West-African Adults: The Benin Study

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    Charles Sossa

    2013-01-01

    Full Text Available Aim. To assess in adults from Benin changes in cardiometabolic risk (CMR using both the Framingham risk score (FRS and metabolic syndrome (MetS and to examine the effects of diet, and lifestyles, controlling for location and socioeconomic status. Methods. Apparently healthy subjects (n=541 aged 25–60 years and randomly selected in the largest city, a small town, and rural areas were included in the four-year longitudinal study. Along with CMR factors, socioeconomic, diet and lifestyle data were collected in individual interviews. A food score based on consumption frequency of four “sentinel” food groups (meat and poultry, dairy, eggs, and vegetables was developed. Lifestyle included physical activity, alcohol and tobacco use. Education and income (proxy were the socioeconomic variables. Results. Among the subjects with four-year follow-up data (n=416, 13.5% were at risk at baseline, showing MetS or FRS ≥ 10%. The incidence of MetS and FRS ≥ 10% during follow-up was 8.2% and 5%, respectively. CMR deteriorated in 21% of subjects. Diet and lifestyle mediated location and income effects on CMR evolution. Low food scores and inactivity increased the likelihood of CMR deterioration. Conclusion. Combining MetS and FRS might be appropriate for surveillance purposes in order to better capture CMR and inform preventive measures.

  20. Economic growth and longevity risk with adverse selection

    NARCIS (Netherlands)

    Heijdra, Ben J.; Reijnders, Laurie S. M.

    2013-01-01

    We study the implications of adverse selection in annuity markets in a general-equilibrium model of the closed economy. Agents differ in their health type and invest their assets in the annuity market. Without informational asymmetries each agent would obtain an actuarially fair insurance. If the in

  1. Equilibria in health exchanges: Adverse selection vs. reclassification risk

    OpenAIRE

    Van Handel, Ben; Hendel, Igal; Michael D. Whinston

    2015-01-01

    This paper studies regulated health insurance markets known as exchanges, motivated by their inclusion in the Affordable Care Act (ACA). We use detailed health plan choice and utilization data to model individual-level projected health risk and risk preferences. We combine the estimated joint distribution of risk and risk preferences with a model of competitive insurance markets to predict outcomes under different regulations that govern insurers' ability to use health status information in p...

  2. Healthy Chilean Adolescents with HOMA-IR ≥ 2.6 Have Increased Cardiometabolic Risk: Association with Genetic, Biological, and Environmental Factors

    Directory of Open Access Journals (Sweden)

    R. Burrows

    2015-01-01

    Full Text Available Objective. To determine the optimal cutoff of the homeostasis model assessment-insulin resistance (HOMA-IR for diagnosis of the metabolic syndrome (MetS in adolescents and examine whether insulin resistance (IR, determined by this method, was related to genetic, biological, and environmental factors. Methods. In 667 adolescents (16.8 ± 0.3 y, BMI, waist circumference, glucose, insulin, adiponectin, diet, and physical activity were measured. Fat and fat-free mass were assessed by dual-energy X-ray absorptiometry. Family history of type 2 diabetes (FHDM was reported. We determined the optimal cutoff of HOMA-IR to diagnose MetS (IDF criteria using ROC analysis. IR was defined as HOMA-IR values above the cutoff. We tested the influence of genetic, biological, and environmental factors on IR using logistic regression analyses. Results. Of the participants, 16% were obese and 9.4 % met criteria for MetS. The optimal cutoff for MetS diagnosis was a HOMA-IR value of 2.6. Based on this value, 16.3% of participants had IR. Adolescents with IR had a significantly higher prevalence of obesity, abdominal obesity, fasting hyperglycemia, and MetS compared to those who were not IR. FHDM, sarcopenia, obesity, and low adiponectin significantly increased the risk of IR. Conclusions. In adolescents, HOMA-IR ≥ 2.6 was associated with greater cardiometabolic risk.

  3. The complement system in human cardiometabolic disease.

    Science.gov (United States)

    Hertle, E; Stehouwer, C D A; van Greevenbroek, M M J

    2014-10-01

    The complement system has been implicated in obesity, fatty liver, diabetes and cardiovascular disease (CVD). Complement factors are produced in adipose tissue and appear to be involved in adipose tissue metabolism and local inflammation. Thereby complement links adipose tissue inflammation to systemic metabolic derangements, such as low-grade inflammation, insulin resistance and dyslipidaemia. Furthermore, complement has been implicated in pathophysiological mechanisms of diet- and alcohol induced liver damage, hyperglycaemia, endothelial dysfunction, atherosclerosis and fibrinolysis. In this review, we summarize current evidence on the role of the complement system in several processes of human cardiometabolic disease. C3 is the central component in complement activation, and has most widely been studied in humans. C3 concentrations are associated with insulin resistance, liver dysfunction, risk of the metabolic syndrome, type 2 diabetes and CVD. C3 can be activated by the classical, the lectin and the alternative pathway of complement activation; and downstream activation of C3 activates the terminal pathway. Complement may also be activated via extrinsic proteases of the coagulation, fibrinolysis and the kinin systems. Studies on the different complement activation pathways in human cardiometabolic disease are limited, but available evidence suggests that they may have distinct roles in processes underlying cardiometabolic disease. The lectin pathway appeared beneficial in some studies on type 2 diabetes and CVD, while factors of the classical and the alternative pathway were related to unfavourable cardiometabolic traits. The terminal complement pathway was also implicated in insulin resistance and liver disease, and appears to have a prominent role in acute and advanced CVD. The available human data suggest a complex and potentially causal role for the complement system in human cardiometabolic disease. Further, preferably longitudinal studies are needed to

  4. Childhood adverse life events and parental psychopathology as risk factors for bipolar disorder.

    Science.gov (United States)

    Bergink, V; Larsen, J T; Hillegers, M H J; Dahl, S K; Stevens, H; Mortensen, P B; Petersen, L; Munk-Olsen, T

    2016-10-25

    Childhood adverse events are risk factors for later bipolar disorder. We quantified the risks for a later diagnosis of bipolar disorder after exposure to adverse life events in children with and without parental psychopathology. This register-based population cohort study included all persons born in Denmark from 1980 to 1998 (980 554 persons). Adversities before age 15 years were: familial disruption; parental somatic illness; any parental psychopathology; parental labour market exclusion; parental imprisonment; placement in out-of-home care; and parental natural and unnatural death. We calculated risk estimates of each of these eight life events as single exposure and risk estimates for exposure to multiple life events. Main outcome variable was a diagnosis of bipolar disorder after the age of 15 years, analysed with Cox proportional hazard regression. Single exposure to most of the investigated adversities were associated with increased risk for bipolar disorder, exceptions were parental somatic illness and parental natural death. By far the strongest risk factor for bipolar disorder in our study was any mental disorder in the parent (hazard ratio 3.53; 95% confidence interval 2.73-4.53) and the additional effects of life events on bipolar risk were limited. An effect of early adverse life events on bipolar risk later in life was mainly observed in children without parental psychopathology. Our findings do not exclude early-life events as possible risk factors, but challenge the concept of adversities as important independent determinants of bipolar disorder in genetically vulnerable individuals.

  5. Joint Association of Screen Time and Physical Activity with Cardiometabolic Risk Factors in a National Sample of Iranian Adolescents: The CASPIANIII Study.

    Directory of Open Access Journals (Sweden)

    Ramin Heshmat

    Full Text Available Metabolic syndrome (MetS and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys school students with a mean age of 14.73 (SD: 2.41 were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC and MetS components (abdominal obesity, elevated blood pressure (BP, low high-density lipoprotein cholesterol (HDL-C, elevated triglycerides (TG and high fasting blood sugar (FBG were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC, elevated low-density lipoprotein cholesterol (LDL-C, and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score, WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.

  6. Impact of whole body electromyostimulation on cardiometabolic risk factors in older women with sarcopenic obesity: the randomized controlled FORMOsA-sarcopenic obesity study

    Science.gov (United States)

    Wittmann, Katharina; Sieber, Cornel; von Stengel, Simon; Kohl, Matthias; Freiberger, Ellen; Jakob, Franz; Lell, Michael; Engelke, Klaus; Kemmler, Wolfgang

    2016-01-01

    Background Sarcopenic obesity (SO) is characterized by a combination of low muscle and high fat mass with an additive negative effect of both conditions on cardiometabolic risk. The aim of the study was to determine the effect of whole-body electromyostimulation (WB-EMS) on the metabolic syndrome (MetS) in community-dwelling women aged ≥70 years with SO. Methods The study was conducted in an ambulatory university setting. Seventy-five community-dwelling women aged ≥70 years with SO living in Northern Bavaria, Germany, were randomly allocated to either 6 months of WB-EMS application with (WB-EMS&P) or without (WB-EMS) dietary supplementation (150 kcal/day, 56% protein) or a non-training control group (CG). WB-EMS included one session of 20 min (85 Hz, 350 μs, 4 s of strain–4 s of rest) per week with moderate-to-high intensity. The primary study endpoint was the MetS Z-score with the components waist circumference (WC), mean arterial pressure (MAP), triglycerides, fasting plasma glucose, and high-density lipoprotein cholesterol (HDL-C); secondary study endpoints were changes in these determining variables. Results MetS Z-score decreased in both groups; however, changes compared with the CG were significant (P=0.001) in the WB-EMS&P group only. On analyzing the components of the MetS, significant positive effects for both WB-EMS groups (P≤0.038) were identified for MAP, while the WB-EMS group significantly differed for WC (P=0.036), and the WB-EMS&P group significantly differed for HDL-C (P=0.006) from the CG. No significant differences were observed between the WB-EMS groups. Conclusion The study clearly confirms the favorable effect of WB-EMS application on the MetS in community-dwelling women aged ≥70 years with SO. However, protein-enriched supplements did not increase effects of WB-EMS alone. In summary, we considered this novel technology an effective and safe method to prevent cardiometabolic risk factors and diseases in older women unable or

  7. [Preventive and curative value of yoga in cardiometabolic diseases].

    Science.gov (United States)

    Apor, Péter

    2016-02-28

    Yoga and other body-mind techniques enjoy an increasing popularity in many fields of health maintaining practices, in prevention of some illnesses and in curative medicine in spite of our incomplete knowledge about its applicability and effects. There are large differences among the various yoga-schools and the heterogeneity of indications etc. In this article a bucket of recent information is offered for the inquirers on the potential advantages of yoga (diet, mind-exercises, asanas, pranayamas) for decreasing cardio-metabolic risk factors, stabilizing mental health, and its addictive use in curative medicine. Few adverse side-effects may occur only in the case of misapplication. Its advantages are low costs, availability for broad population, and very few contraindications. Disadvantages include differences in the ability of yoga instructors and in yoga practices.

  8. Molecular Analysis of a Genetic Variants Panel Related to Nutrients and Metabolism: Association with Susceptibility to Gestational Diabetes and Cardiometabolic Risk in Affected Women

    Science.gov (United States)

    Nicolucci, Antonio; Celentano, Claudio; Liberati, Marco; Stuppia, Liborio

    2017-01-01

    Gestational diabetes mellitus (GDM) is the most frequent metabolic disorder in pregnancy. Women with a GDM history are at increased risk of developing diabetes and cardiovascular diseases. Studies have demonstrated a significant correlation between several genes involved in the metabolic pathway of insulin and environmental factors. The aim of this study was to investigate the relationship between clinical parameters in GDM and variants in genes involved with nutrients and metabolism. Several variants PPARG2 rs1801282 (C>G); PPARGC1A rs8192678 (C>T); TCF7L2 rs7903146 (C>T); LDLR rs2228671 (C>T); MTHFR rs1801133 (C>T); APOA5 rs662799 (T>C); GCKR rs1260326 (C>T); FTO rs9939609 (T>A); MC4R rs17782313 (T>C) were genotyped in 168 pregnant Caucasian women with or without GDM by High Resolution Melting (HRM) analysis. A significant correlation was observed between TT genotype of TCF7L2 gene and increased risk of GDM (OR 5.4 [95% CI 1.5–19.3]). Moreover, a significant correlation was observed between lipid parameters and genetic variations in additional genes, namely, PPARG2 [p = 0,02], APOA5 [p = 0,02], MC4R [p = 0,03], LDLR [p = 0,01], and FTO [p = 0,02]. Our findings support the association between TCF7L2 rs7903146 variant and an increased GDM risk. Results about the investigated genetic variants provide important information about cardiometabolic risk in GDM and help to plan future prevention studies. PMID:28133617

  9. Prostate Cancer; Metabolic Risk Factors, Drug Utilisation, Adverse Drug Reactions

    OpenAIRE

    Grundmark, Birgitta

    2013-01-01

    Increased possibilities during the last decades for early detection of prostate cancer have sparked research on preventable or treatable risk factors and on improvements in therapy. Treatments of the disease still entail significant side effects potentially affecting men during the rest of their lives. The studies of the present thesis concern different aspects of prostate cancer from etiological risk factors and factors influencing treatment to an improved methodology for the detection of tr...

  10. The effects of oestrogens and their receptors on cardiometabolic health.

    Science.gov (United States)

    Morselli, Eugenia; Santos, Roberta S; Criollo, Alfredo; Nelson, Michael D; Palmer, Biff F; Clegg, Deborah J

    2017-03-17

    Cardiovascular disease (CVD) is one of the leading causes of mortality in developed countries. The incidence of CVD is sexually dimorphic, and research has focused on the contribution of sex steroids to the development and progression of the cardiometabolic syndrome, which is defined as a clustering of interrelated risk factors that promote the development of atherosclerosis (which can lead to CVD) and type 2 diabetes mellitus. Data are inconclusive as to how sex steroids and their respective receptors increase or suppress the risk of developing the cardiometabolic syndrome and thus CVD. In this Review, we discuss the potential role, or roles, of sex hormones in cardiometabolic health by first focusing on the influence of oestrogens and their receptors on the risk of developing cardiometabolic syndrome and CVD. We also highlight what is known about testosterone and its potential role in protecting against the development of the cardiometabolic syndrome and CVD. Given the inconclusive nature of the data regarding the direct effects of each sex hormone, we advocate and highlight the importance of studying the relative levels and the ratio of sex hormones to each other, as well as the use of cross sex hormone therapy and its effect on cardiometabolic health.

  11. Medical abortion and the risk of subsequent adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Virk, Jasveer; Zhang, Jun; Olsen, Jørn

    2007-01-01

    BACKGROUND: The long-term safety of surgical abortion in the first trimester is well established. Despite the increasing use of medical abortion (abortion by means of medication), limited information is available regarding the effects of this procedure on subsequent pregnancies. METHODS: We...... identified all women living in Denmark who had undergone an abortion for nonmedical reasons between 1999 and 2004 and obtained information regarding subsequent pregnancies from national registries. Risks of ectopic pregnancy, spontaneous abortion, preterm birth (at ... weight (abortion were compared with risks in women who had had a first-trimester surgical abortion. RESULTS: Among 11,814 pregnancies in women who had had a previous first-trimester medical abortion (2710 women...

  12. Cardiometabolic Effects of Cheese Intake

    DEFF Research Database (Denmark)

    Thorning, Tanja Kongerslev

    In several countries, the dietary guidelines for preventing CVD focus on reducing the intake of saturated fat. A high cheese intake in particular may however not be associated with CVD risk, despite a high content of saturated fat. This could be due to a reduced digestibility of fat in cheese...... of cheese-matrix may influence the HDL-cholesterol response, while the ripening duration may affect the level of free fatty acids and insulin in the blood. Furthermore the results showed that a diet with saturated fat in cheese or meat caused a higher HDL-cholesterol, but not LDL-cholesterol, compared....... The aim of this PhD thesis was to investigate how the fat content of the cheese-matrix and the cheese ripening duration affect cardiometabolic risk markers and fecal fat excretion. The thesis is based on three intervention studies, two in pigs and one in humans. The results suggested that fat content...

  13. Patients at high risk of adverse events from intravenous contrast media after computed tomography examination

    Energy Technology Data Exchange (ETDEWEB)

    Reddan, Donal [University College Galway Hospitals, Unit 7, Merlin Park Hospital, Galway (Ireland)]. E-mail: donal.reddan@mailn.hse.ie

    2007-05-15

    Adverse reactions to iodinated contrast media (CM) may occur and require prompt recognition and treatment. Although adverse reactions to radiocontrast agents cannot be eliminated, an important first step toward reducing their incidence is to identify patients at greatest risk. Prior to examinations using CM, patients should be adequately assessed by obtaining thorough medical histories and using simple screening tests. Studies have demonstrated that patients with a history of asthma, allergy, hyperthyroidism, and previous reaction to CM are at risk for severe reactions to iodinated CM. Renal adverse reactions reportedly occur more frequently in patients with pre-existing chronic kidney disease, especially those with diabetic nephropathy. Patients with congestive heart failure, dehydration, older age, and those who use nephrotoxic medications are also at risk for developing contrast-associated nephropathy. The occurrence of adverse events may be further increased in patients with multiple risk factors. As the number of patients undergoing computed tomography procedures continues to increase, it is essential for physicians to be able to identify patients at risk for adverse events of CM. Patient-related risk factors are discussed and simple tools for risk stratification presented.

  14. Movement Behaviors in Children and Indicators of Adverse Health

    DEFF Research Database (Denmark)

    Hjorth, Mads Fiil

    to promote a healthy lifestyle. Thirdly, short sleep duration and a high variability in sleep duration, as well as sleep problems, were associated with an obesity-promoting diet. Short sleep duration was also associated with a higher fat mass index and increased cardio-metabolic risk. Furthermore, a decline...... among children. Early puberty is a period characterized by rapid changes in body composition and movement behaviors. As movement behaviors, obesity, and cardio-metabolic risk appear to track from childhood to adulthood, this may be a critical period for implementing preventive strategies aimed...... at reducing obesity and its associated metabolic complications in adulthood. In my PhD thesis I assessed objectively measured physical activity, sedentary behavior, and sleep in 8- to 11-year-old Danish children and related these movement behaviors to indicators of adverse health (dietary intake, adiposity...

  15. Optimal waist-to-height ratio values for cardiometabolic risk screening in an ethnically diverse sample of South African urban and rural school boys and girls.

    Directory of Open Access Journals (Sweden)

    Tandi E Matsha

    Full Text Available BACKGROUND: The proposed waist-to-height ratio (WHtR cut-off of 0.5 is less optimal for cardiometabolic risk screening in children in many settings. The purpose of this study was to determine the optimal WHtR for children from South Africa, and investigate variations by gender, ethnicity and residence in the achieved value. METHODS: Metabolic syndrome (MetS components were measured in 1272 randomly selected learners, aged 10-16 years, comprising of 446 black Africans, 696 mixed-ancestry and 130 Caucasians. The Youden's index and the closest-top-left (CTL point approaches were used to derive WHtR cut-offs for diagnosing any two MetS components, excluding the waist circumference. RESULTS: The two approaches yielded similar cut-off in girls, 0.465 (sensitivity 50.0, specificity 69.5, but two different values in boys, 0.455 (42.9, 88.4 and 0.425 (60.3, 67.7 based on the Youden's index and the CTL point, respectively. Furthermore, WHtR cut-off values derived differed substantially amongst the regions and ethnic groups investigated, whereby the highest cut-off was observed in semi-rural and white children, respectively, Youden's index0.505 (31.6, 87.1 and CTL point 0.475 (44.4, 75.9. CONCLUSION: The WHtR cut-off of 0.5 is less accurate for screening cardiovascular risk in South African children. The optimal value in this setting is likely gender and ethnicity-specific and sensitive to urbanization.

  16. Obesity and cardio-metabolic risk factors in urban adults of Benin: Relationship with socio-economic status, urbanisation, and lifestyle patterns

    Directory of Open Access Journals (Sweden)

    Delisle Hélène

    2008-03-01

    Full Text Available Abstract Background There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES, urbanisation as well as lifestyle patterns. Methods Anthropometric parameters (height, weight and waist circumference, blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income. Results The most prevalent CVD risk factors were overall obesity (18%, abdominal obesity (32%, hypertension (23%, and low HDL-cholesterol (13%. Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%. After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors. Conclusion Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the

  17. Impact of whole body electromyostimulation on cardiometabolic risk factors in older women with sarcopenic obesity: the randomized controlled FORMOsA-sarcopenic obesity study

    Directory of Open Access Journals (Sweden)

    Wittmann K

    2016-11-01

    Full Text Available Katharina Wittmann,1 Cornel Sieber,2 Simon von Stengel,1 Matthias Kohl,3 Ellen Freiberger,2 Franz Jakob,4 Michael Lell,5 Klaus Engelke,1 Wolfgang Kemmler1 1Institute of Medical Physics, Faculty of Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, 2Institute for Biomedicine of Aging, Faculty of Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, 3Faculty of Medical and Life Sciences, University of Furtwangen, 4Musculoskeletal Research Center, University of Würzburg, Würzburg, 5Department of Radiology and Nuclear Medicine, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Germany Background: Sarcopenic obesity (SO is characterized by a combination of low muscle and high fat mass with an additive negative effect of both conditions on cardiometabolic risk. The aim of the study was to determine the effect of whole-body electromyostimulation (WB-EMS on the metabolic syndrome (MetS in community-dwelling women aged ≥70 years with SO. Methods: The study was conducted in an ambulatory university setting. Seventy-five community-dwelling women aged ≥70 years with SO living in Northern Bavaria, Germany, were randomly allocated to either 6 months of WB-EMS application with (WB-EMS&P or without (WB-EMS dietary supplementation (150 kcal/day, 56% protein or a non-training control group (CG. WB-EMS included one session of 20 min (85 Hz, 350 µs, 4 s of strain–4 s of rest per week with moderate-to-high intensity. The primary study endpoint was the MetS Z-score with the components waist circumference (WC, mean arterial pressure (MAP, triglycerides, fasting plasma glucose, and high-density lipoprotein cholesterol (HDL-C; secondary study endpoints were changes in these determining variables. Results: MetS Z-score decreased in both groups; however, changes compared with the CG were significant (P=0.001 in the WB-EMS&P group only. On analyzing the components of the MetS, significant positive effects

  18. Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease

    Science.gov (United States)

    Danese, Andrea; Moffitt, Terrie E.; Harrington, HonaLee; Milne, Barry J.; Polanczyk, Guilherme; Pariante, Carmine M.; Poulton, Richie; Caspi, Avshalom

    2013-01-01

    Objective To understand why children exposed to adverse psychosocial experiences are at elevated risk for age-related disease, such as cardiovascular disease, by testing whether adverse childhood experiences predict enduring abnormalities in stress-sensitive biological systems, namely, the nervous, immune, and endocrine/metabolic systems. Design A 32-year prospective longitudinal study of a representative birth cohort. Setting New Zealand. Participants A total of 1037 members of the Dunedin Multidisciplinary Health and Development Study. Main Exposures During their first decade of life, study members were assessed for exposure to 3 adverse psychosocial experiences: socioeconomic disadvantage, maltreatment, and social isolation. Main Outcome Measures At age 32 years, study members were assessed for the presence of 3 age-related-disease risks: major depression, high inflammation levels (high-sensitivity C-reactive protein level >3 mg/L), and the clustering of metabolic risk biomarkers (overweight, high blood pressure, high total cholesterol, low high-density lipoprotein cholesterol, high glycated hemoglobin, and low maximum oxygen consumption levels. Results Children exposed to adverse psychosocial experiences were at elevated risk of depression, high inflammation levels, and clustering of metabolic risk markers. Children who had experienced socioeconomic disadvantage (incidence rate ratio, 1.89; 95% confidence interval, 1.36–2.62), maltreatment (1.81; 1.38–2.38), or social isolation (1.87; 1.38–2.51) had elevated age-related-disease risks in adulthood. The effects of adverse childhood experiences on age-related-disease risks in adulthood were nonredundant, cumulative, and independent of the influence of established developmental and concurrent risk factors. Conclusions Children exposed to adverse psychosocial experiences have enduring emotional, immune, and metabolic abnormalities that contribute to explaining their elevated risk for age-related disease. The

  19. Psychosocial job strain and risk of adverse birth outcomes

    DEFF Research Database (Denmark)

    Larsen, Ann Dyreborg; Hannerz, Harald; Juhl, Mette;

    2013-01-01

    OBJECTIVE: A number of studies examined the effects of prenatal stress on birth outcomes with diverging and inconclusive results. We aimed to examine if working with high job strain during pregnancy measured in week 16 was associated with risk of giving birth to a child born preterm or small....../large for gestational age (SGA/LGA), and second, if social support affected any associations. DESIGN: Study population was 48 890 pregnancies from the Danish National Birth Cohort. Multinomial logistic regression estimated ORs. Covariates included: maternal age, BMI, parity, exercise, smoking, alcohol and coffee...... consumption, manual work, serious maternal disease, parental height and gestational age at interview. In accordance with Good Epidemiological Practice, a protocol outlined the study design before analyses were initiated. RESULTS: High job strain was associated with significantly lower odds of being born LGA...

  20. Gestational Diabetes Mellitus Worsens the Profile of Cardiometabolic Risk Markers and Decrease Indexes of Beta-Cell Function Independently of Insulin Resistance in Nondiabetic Women with a Parental History of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Alina Sokup

    2014-01-01

    Full Text Available Background. Women with a history of both parental type 2 diabetes (pt2DM and previous gestational diabetes (pGDM represent a group at high risk of cardiovascular events. We hypothesized that pGDM changes cardiometabolic risk markers levels as well as theirs associations with glucose indices in nondiabetic pt2DM women. Methods. Anthropometric parameters, glucose regulation (OGTT, insulin resistance (HOMA-IR, beta-cell function, lipid levels, parameters of endothelial dysfunction, and inflammation were evaluated in 55 women with pt2DM, 40 with both pt2DM and pGDM 2–24 months postpartum, and 35 controls. Results. Prediabetes was diagnosed more frequently in women with both pt2DM and pGDM in comparison with women with only pt2DM (10 versus 8, P=0.04. The pGDM group had higher LDL-cholesterol, sICAM-1, tPa Ag, fibrinogen, and lower beta-cell function after adjustment for HOMA-IR, in comparison with pt2DM group. In pt2DM group postchallenge glucose correlated independently with hsCRP and in pGDM group fasting glucose with HOMA-IR. Conclusions. pGDM exerts a combined effect on cardiometabolic risk markers in women with pt2DM. In these women higher LDL-cholesterol, fibrinogen, sICAM-1, tPa Ag levels and decreased beta cell function are associated with pGDM independently of HOMA-IR index value. Fasting glucose is an important cardiometabolic risk marker and is independently associated with HOMA-IR.

  1. Childhood adverse life events and parental psychopathology as risk factors for bipolar disorder

    DEFF Research Database (Denmark)

    Bergink, Veerle; Tidselbak Larsen, Janne; Hillegers, M H J

    2016-01-01

    Childhood adverse events are risk factors for later bipolar disorder. We quantified the risks for a later diagnosis of bipolar disorder after exposure to adverse life events in children with and without parental psychopathology. This register-based population cohort study included all persons born...... in Denmark from 1980 to 1998 (980 554 persons). Adversities before age 15 years were: familial disruption; parental somatic illness; any parental psychopathology; parental labour market exclusion; parental imprisonment; placement in out-of-home care; and parental natural and unnatural death. We calculated...... risk estimates of each of these eight life events as single exposure and risk estimates for exposure to multiple life events. Main outcome variable was a diagnosis of bipolar disorder after the age of 15 years, analysed with Cox proportional hazard regression. Single exposure to most...

  2. Leisure-time physical activity, sedentary behaviors, sleep, and cardiometabolic risk factors at baseline in the PREDIMED-PLUS intervention trial: A cross-sectional analysis

    Science.gov (United States)

    Rosique-Esteban, Nuria; Díaz-López, Andrés; Martínez-González, Miguel A.; Corella, Dolores; Goday, Albert; Martínez, J. Alfredo; Romaguera, Dora; Vioque, Jesus; Arós, Fernando; Garcia-Rios, Antonio; Tinahones, Francisco; Estruch, Ramon; Fernández-García, José Carlos; Lapetra, José; Serra-Majem, Luís; Pinto, Xavier; Tur, Josep A.; Bueno-Cavanillas, Aurora; Vidal, Josep; Delgado-Rodríguez, Miguel; Daimiel, Lidia; Vázquez, Clotilde; Rubio, Miguel Ángel; Ros, Emilio; Salas-Salvadó, Jordi

    2017-01-01

    Limited data exists on the interrelationships between physical activity (PA), sedentary behaviors and sleep concerning cardiometabolic risk factors in aged adults at high cardiovascular disease risk. Our aim was to examine independent and joint associations between time spent in leisure-time PA, sedentary behaviors and sleep on the prevalence of obesity, type 2 diabetes (T2D) and components of the metabolic syndrome (MetS) in Mediterranean individuals at high cardiovascular risk. Cross-sectional analyses were performed on baseline data from 5776 Spanish adults (aged 55-75y in men; 60-75y in women) with overweight/obesity and MetS, from October 2013 to October 2016, in the PREDIMED-PLUS trial. Employing multivariable-adjusted Cox regression with robust variance and constant time (given the cross-sectional design), higher prevalence of obesity, T2D and abdominal obesity as component of the MetS were associated with greater time in TV-viewing (Relative Risk, RR: 1.02, 95%CI: 1.01, 1.03; RR:1.04, 95%CI: 1.02, 1.06 and RR: 1.01 95%CI: 1.00, 1.02; respectively, all P < .01). Conversely, greater time in moderate-vigorous PA (MVPA) was associated with lower prevalence of obesity, T2D, abdominal obesity and low HDL-cholesterol (RR: 0.95, 95%CI: 0.93, 0.97; RR: 0.94, 95%CI: 0.89, 0.99; RR: 0.97, 95%CI: 0.96, 0.98; and RR: 0.95, 95%CI: 0.91, 0.99, respectively, all P < .05). For these outcomes, theoretically substituting 1-h/day of MVPA for 1-h/day TV-viewing was also significantly associated with lower prevalence (RR 0.91 to 0.97, all P < .05). Similar lower RR in these outcomes was observed when substituting 1-h/day of MVPA for 1-h/day of sleeping. Longer time watching TV and not meeting MVPA recommendations were jointly associated with higher RR of the prevalence of obesity and T2D. We concluded that, in senior individuals at high cardiovascular risk, greater time spent on MVPA and fewer on sedentary behaviors was inversely associated with prevalence of obesity, T2D, and

  3. Provision of healthy school meals does not affect the metabolic syndrome score in 8-11-year-old children, but reduces cardiometabolic risk markers despite increasing waist circumference.

    Science.gov (United States)

    Damsgaard, Camilla T; Dalskov, Stine-Mathilde; Laursen, Rikke P; Ritz, Christian; Hjorth, Mads F; Lauritzen, Lotte; Sørensen, Louise B; Petersen, Rikke A; Andersen, Malene R; Stender, Steen; Andersen, Rikke; Tetens, Inge; Mølgaard, Christian; Astrup, Arne; Michaelsen, Kim F

    2014-12-14

    An increasing number of children are exhibiting features of the metabolic syndrome (MetS) including abdominal fatness, hypertension, adverse lipid profile and insulin resistance. Healthy eating practices during school hours may improve the cardiometabolic profile, but there is a lack of evidence. In the present study, the effect of provision of school meals rich in fish, vegetables and fibre on a MetS score (primary outcome) and on individual cardiometabolic markers and body composition (secondary outcomes) was investigated in 834 Danish school children. The study was carried out as a cluster-randomised, controlled, non-blinded, cross-over trial at nine schools. Children aged 8-11 years received freshly prepared school lunch and snacks or usual packed lunch from home (control) each for 3 months. Dietary intake, physical activity, cardiometabolic markers and body composition were measured at baseline and after each dietary period. The school meals did not affect the MetS score (P= 1.00). However, it was found that mean arterial pressure was reduced by 0.4 (95% CI 0.0, 0.8) mmHg (P= 0.04), fasting total cholesterol concentrations by 0.05 (95% CI 0.02, 0.08) mmol/l (P= 0.001), HDL-cholesterol concentrations by 0.02 (95% CI 0.00, 0.03) mmol/l, TAG concentrations by 0.02 (95% CI 0.00, 0.04) mmol/l (both PWaist circumference increased 0.5 (95% CI 0.3, 0.7) cm (Pwaist circumference and HDL-cholesterol concentrations.

  4. Self-reported body weight and height: an assessment tool for identifying children with overweight/obesity status and cardiometabolic risk factors clustering.

    Science.gov (United States)

    Chan, Noel P T; Choi, Kai C; Nelson, E Anthony S; Sung, Rita Y T; Chan, Juliana C N; Kong, Alice P S

    2013-02-01

    Body mass index (BMI) is commonly used for assessing body fat. Self-reported body weight and height derived BMI (SRDBMI) is a simple, low cost and non-invasive assessment tool and it may be a useful self-reported assessment tool to monitor the prevalence of overweight/obesity in community settings and for epidemiological research. We assessed the agreement of BW and BH between assessor measured and child self-reported values and evaluated the diagnostic ability of SRDBMI to identify children with overweight/obesity status and cardiometabolic risk factors (CMRFs) clustering. A cross-sectional study was conducted in school settings using a cluster sampling method. A total of 1,614 children aged 6-18 years were included in the analysis. Children were given a questionnaire to complete at home prior to the anthropometric measurements and blood taking at the schools. There was almost perfect agreement on BW, BH and BMI between self-reported and measured values [intraclass correlation coefficients ranged from 0.93 (95% CI: 0.93-0.94) to 0.99 (95% CI: 0.98-0.99)]. About half of the children reported their BW and BH absolute values within 1 kg and 2 cm of measured values, respectively. The SRDBMI demonstrated good diagnostic ability for identifying children with overweight/obesity status (sensitivity, specificity, positive and negative predictive values ranged from 0.83 to 0.98) and CMRFs clustering (AUC-ROCs values of BMI between measured and self-reported values were close ranging from 0.85 to 0.89). Self-reported BW and BH demonstrated almost perfect agreement with measured values and could substantially identify children with overweight/obesity status and CMRFs clustering.

  5. Effects of grapefruit, grapefruit juice and water preloads on energy balance, weight loss, body composition, and cardiometabolic risk in free-living obese adults

    Directory of Open Access Journals (Sweden)

    Niswender Kevin D

    2011-02-01

    Full Text Available Abstract Background Reducing dietary energy density has proven to be an effective strategy to reduce energy intakes and promote weight control. This effect appears most robust when a low energy dense preload is consumed before meals. Yet, much discussion continues regarding the optimal form of a preload. The purpose of the present study was to compare effects of a solid (grapefruit, liquid (grapefruit juice and water preload consumed prior to breakfast, lunch and dinner in the context of caloric restriction. Methods Eighty-five obese adults (BMI 30-39.9 were randomly assigned to (127 g grapefruit (GF, grapefruit juice (GFJ or water preload for 12 weeks after completing a 2-week caloric restriction phase. Preloads were matched for weight, calories, water content, and energy density. Weekly measures included blood pressure, weight, anthropometry and 24-hour dietary intakes. Resting energy expenditure, body composition, physical performance and cardiometabolic risk biomarkers were assessed. Results The total amount (grams of food consumed did not change over time. Yet, after preloads were combined with caloric restriction, average dietary energy density and total energy intakes decreased by 20-29% from baseline values. Subjects experienced 7.1% weight loss overall, with significant decreases in percentage body, trunk, android and gynoid fat, as well as waist circumferences (-4.5 cm. However, differences were not statistically significant among groups. Nevertheless, the amount and direction of change in serum HDL-cholesterol levels in GF (+6.2% and GFJ (+8.2% preload groups was significantly greater than water preload group (-3.7%. Conclusions These data indicate that incorporating consumption of a low energy dense dietary preload in a caloric restricted diet is a highly effective weight loss strategy. But, the form of the preload did not have differential effects on energy balance, weight loss or body composition. It is notable that subjects in GF

  6. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age.

    Directory of Open Access Journals (Sweden)

    Yi-Hao Weng

    Full Text Available Although a number of studies have investigated correlations of maternal age with birth outcomes, an extensive assessment using age as a continuous variable is lacking. In the current study, we estimated age-specific risks of adverse birth outcomes in childbearing women.National population-based data containing maternal and neonatal information were derived from the Health Promotion Administration, Taiwan. A composite adverse birth outcome was defined as at least anyone of stillbirth, preterm birth, low birth weight, macrosomia, neonatal death, congenital anomaly, and small for gestational age (SGA. Singletons were further analyzed for outcomes of live birth in relation to each year of maternal age. A log-binomial model was used to adjust for possible confounders of maternal and neonatal factors.In total, 2,123,751 births between 2001 and 2010 were utilized in the analysis. The risk of a composite adverse birth outcome was significantly higher at extreme maternal ages. In specific, risks of stillbirth, neonatal death, preterm birth, congenital anomaly, and low birth weight were higher at the extremes of maternal age. Furthermore, risk of macrosomia rose proportionally with an increasing maternal age. In contrast, risk of SGA declined proportionally with an increasing maternal age. The log-binomial model showed greater risks at the maternal ages of 30 years for a composite adverse birth outcome.Infants born to teenagers and women at advanced age possess greater risks for stillbirth, preterm birth, neonatal death, congenital anomaly, and low birth weight. Pregnancies at advanced age carry an additional risk for macrosomia, while teenage pregnancies carry an additional risk for SGA. The data suggest that the optimal maternal ages to minimize adverse birth outcomes are 26∼30 years.

  7. Association of overweight and obesity with health status, weight management, and exercise behaviors among individuals with type 2 diabetes mellitus or with cardiometabolic risk factors

    Directory of Open Access Journals (Sweden)

    James R Gavin

    2009-01-01

    Full Text Available James R Gavin, III1, Helena W Rodbard2, Kathleen M Fox3, Susan Grandy4 for the SHIELD Study Group1Emory University School of Medicine, Atlanta, GA, USA; 2Endocrine and Metabolic Consultants, Rockville, MD, USA; 3Strategic Healthcare Solutions, LLC, Monkton, MD, USA; 4AstraZeneca LP, Wilmington, DE, USAObjectives: This investigation evaluated the role of obesity in health status and behaviors for weight management and exercise among individuals with type 2 diabetes mellitus (T2DM or cardiometabolic risk factors.Methods: Self-reported health status, exercise behaviors, and weight management were assessed in the SHIELD study for respondents with T2DM or high risk (HR for diabetes (ie, ≥3 of the following: abdominal obesity, body mass index [BMI] ≥28 kg/m2, self-reported diagnosis of dyslipidemia, hypertension, or history of cardiovascular disease. Respondents were stratified into three BMI categories: <25 kg/m2 (underweight or normal weight, 25.0−29.9 kg/m2 (overweight, and ≥30 kg/m2 (obese, with comparisons made using analysis of variance. Comparisons between T2DM and HR were made using chi-square tests.Results: T2DM (n = 3,918 and HR (n = 5,464 groups were similar for age (mean = 59 years, race (≥85% white, and obesity. Overweight (31% or obese T2DM (18% respondents were significantly less likely to report excellent health compared with overweight or obese HR respondents (42% and 30%, respectively, p < 0.001. There were no differences between T2DM and HR groups for exercise behaviors. More obese respondents (20% T2DM, 21% HR were “contemplating exercising”, and fewer (21%−23% were currently “exercising regularly” compared with overweight and normal weight respondents, p < 0.001. More obese respondents (78% T2DM, 83% HR attempted weight management than normal (28%−35% or overweight (57%−61% respondents, p < 0.001.Conclusions: Obesity was negatively associated with self-perception of current health, exercising regularly, and

  8. Linear Growth and Fat and Lean Tissue Gain during Childhood: Associations with Cardiometabolic and Cognitive Outcomes in Adolescent Indian Children.

    Directory of Open Access Journals (Sweden)

    Ghattu V Krishnaveni

    Full Text Available We aimed to determine how linear growth and fat and lean tissue gain during discrete age periods from birth to adolescence are related to adolescent cardiometabolic risk factors and cognitive ability.Adolescents born to mothers with normal glucose tolerance during pregnancy from an Indian birth cohort (N = 486, age 13.5 years had detailed anthropometry and measurements of body fat (fat%, fasting plasma glucose, insulin and lipid concentrations, blood pressure and cognitive function. Insulin resistance (HOMA-IR was calculated. These outcomes were examined in relation to birth measurements and statistically independent measures (conditional SD scores representing linear growth, and fat and lean tissue gain during birth-1, 1-2, 2-5, 5-9.5 and 9.5-13.5 years in 414 of the children with measurements at all these ages.Birth length and linear growth at all ages were positively associated with current height. Fat gain, particularly during 5-9.5 years was positively associated with fat% at 13.5 years (0.44 SD per SD [99.9% confidence interval: 0.29,0.58]. Greater fat gain during mid-late childhood was associated with higher systolic blood pressure (5-9.5 years: 0.23 SD per SD [0.07,0.40] and HOMA-IR (5-9.5 years: 0.24 [0.08,0.40], 9.5-13.5 years: 0.22 [0.06,0.38]. Greater infant growth (up to age 2 years in linear, fat or lean components was unrelated to cardiometabolic risk factors or cognitive function.This study suggests that factors that increase linear, fat and lean growth in infancy have no adverse cardiometabolic effects in this population. Factors that increase fat gain in mid-late childhood may increase cardiometabolic risk, without any benefit to cognitive abilities.

  9. Parental history of type 2 diabetes and cardiometabolic biomarkers in offspring

    NARCIS (Netherlands)

    Abbasi, Ali; Corpeleijn, Eva; van der Schouw, Yvonne T.; Stolk, Ronald P.; Spijkerman, Annemieke; van der A, Daphne L.; Navis, Gerjan; Bakker, Stephan J. L.; Beulens, Joline W. J.

    2012-01-01

    Eur J Clin Invest 2012; 42 (9): 974982 Abstract Background Parental history of type 2 diabetes (T2D) is associated with cardiometabolic risk. We aimed to investigate the associations of parental history of T2D with cardiometabolic biomarkers and to subsequently investigate to what extent these putat

  10. The effect of communicating the genetic risk of cardiometabolic disorders on motivation and actual engagement in preventative lifestyle modification and clinical outcome: a systematic review and meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Li, Sherly X; Ye, Zheng; Whelan, Kevin; Truby, Helen

    2016-09-01

    Genetic risk prediction of chronic conditions including obesity, diabetes and CVD currently has limited predictive power but its potential to engage healthy behaviour change has been of immense research interest. We aimed to understand whether the latter is indeed true by conducting a systematic review and meta-analysis investigating whether genetic risk communication affects motivation and actual behaviour change towards preventative lifestyle modification. We included all randomised controlled trials (RCT) since 2003 investigating the impact of genetic risk communication on health behaviour to prevent cardiometabolic disease, without restrictions on age, duration of intervention or language. We conducted random-effects meta-analyses for perceived motivation for behaviour change and clinical changes (weight loss) and a narrative analysis for other outcomes. Within the thirteen studies reviewed, five were vignette studies (hypothetical RCT) and seven were clinical RCT. There was no consistent effect of genetic risk on actual motivation for weight loss, perceived motivation for dietary change (control v. genetic risk group standardised mean difference (smd) -0·15; 95 % CI -1·03, 0·73, P=0·74) or actual change in dietary behaviour. Similar results were observed for actual weight loss (control v. high genetic risk SMD 0·29 kg; 95 % CI -0·74, 1·31, P=0·58). This review found no clear or consistent evidence that genetic risk communication alone either raises motivation or translates into actual change in dietary intake or physical activity to reduce the risk of cardiometabolic disorders in adults. Of thirteen studies, eight were at high or unclear risk of bias. Additional larger-scale, high-quality clinical RCT are warranted.

  11. Histone Deacetylases and Cardiometabolic Diseases

    OpenAIRE

    Yiew, Kan Hui; Chatterjee, Tapan K.; Hui, David Y.; Weintraub, Neal L.

    2015-01-01

    Cardiometabolic disease, emerging as a worldwide epidemic, is a combination of metabolic derangements leading to type 2 diabetes and cardiovascular disease. Genetic and environmental factors are linked through epigenetic mechanisms to the pathogenesis of cardiometabolic disease. Post-translational modifications of histone tails, including acetylation and deacetylation, epigenetically alter chromatin structure and dictate cell-specific gene expression patterns. The histone deacetylase (HDAC) f...

  12. Studying Biology to Understand Risk: Dosimetry Models and Quantitative Adverse Outcome Pathways

    Science.gov (United States)

    Confidence in the quantitative prediction of risk is increased when the prediction is based to as great an extent as possible on the relevant biological factors that constitute the pathway from exposure to adverse outcome. With the first examples now over 40 years old, physiologi...

  13. Cortisol Reactivity to Social Stress as a Mediator of Early Adversity on Risk and Adaptive Outcomes

    Science.gov (United States)

    Conradt, Elisabeth; Abar, Beau; Lester, Barry M.; LaGasse, Linda L.; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R.; Whitaker, Toni M.; Hammond, Jane A.

    2014-01-01

    Children chronically exposed to stress early in life are at increased risk for maladaptive outcomes, though the physiological mechanisms driving these effects are unknown. Cortisol reactivity was tested as a mediator of the relation between prenatal substance exposure and/or early adversity on adaptive and maladaptive outcomes. Data were drawn…

  14. Teen Pregnancy : Are Pregnancies following an Elective Termination Associated with Increased Risk for Adverse Perinatal Outcomes?

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Haeri, Sina; Baker, Arthur M.

    2015-01-01

    Study Objective: The authors sought to determine whether pregnancies in adolescents following an abortion of pregnancy is associated with an elevated risk for adverse perinatal outcomes. Methods: In a cohort study of all adolescent (younger than 18 years) deliveries over a 4-year period at 1 institu

  15. Adverse drug reactions in internal medicine units and associated risk factors

    OpenAIRE

    Sánchez Muñoz-Torrero, Juan Francisco; Barquilla, Paloma; Velasco, Raul; Fernández Capitan, Maria Del Carmen; Pacheco, Nazaret; Vicente, Lucia; Chicón, Jose Luis; Trejo, Sara; Zamorano, Jose; Lorenzo Hernandez, Alicia

    2010-01-01

    Abstract Objectives This study was designed to assess the prevalence of adverse drug reactions (ADRs) in the internal medicine wards of two teaching Hospitals, identify the most common ADRs, the principal medications involved, and determine the risk factors implicated in the occurrence of such ADRs. Methods All admissions over 10 weeks were followed prospectively using an intensive drug surveillance method...

  16. Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Nerylee Watson

    2016-05-01

    Full Text Available Despite evidence for the benefits of higher-protein (HP diets in weight loss, their role in type 2 diabetes mellitus (T2DM management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23% on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index 34.3 ± 5.1 kg/m2, aged 55 ± 8 years with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8 who withdrew. Following weight loss (M ± SEM: −7.8 ± 0.6 kg, there were significant reductions in HbA1c (−1.4% ± 0.1%, p < 0.001 and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance.

  17. Adverse Childhood Experiences and Risk of Binge Drinking and Drunkenness in Middle-Aged Finnish Men

    Directory of Open Access Journals (Sweden)

    Laura Kauhanen

    2011-01-01

    Full Text Available Objective. The purpose of this study was to investigate associations between adverse childhood experiences and binge drinking and drunkenness in adulthood using both historical and recalled data from childhood. Methods. Data on childhood adverse experiences were collected from school health records and questionnaires completed in adulthood. Adulthood data were obtained from the baseline examinations of the male participants (n=2682 in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD in 1984–1989 from eastern Finland. School health records from the 1930s to 1950s were available for a subsample of KIHD men (n=952. Results. According to the school health records, men who had adverse childhood experiences had a 1.51-fold (95% CI 1.05 to 2.18 age- and examination-year adjusted odds of binge drinking in adulthood. After adjustment for socioeconomic position in adulthood or behavioural factors in adulthood, the association remained unchanged. Adjustment for socioeconomic position in childhood attenuated these effects. Also the recalled data showed associations with adverse childhood experiences and binge drinking with different beverages. Conclusions. Our findings suggest that childhood adversities are associated with increased risk of binge drinking in adulthood.

  18. Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montréal

    Directory of Open Access Journals (Sweden)

    Provost Sylvie

    2011-11-01

    Full Text Available Abstract Background The goal of this project is to evaluate the implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk (PCMR. The intervention is based on the Chronic Care Model. The study will evaluate the implementation of the PCMR in 6 of the 12 health and social services centres (CSSS in Montréal, and the effects of the PCMR on patients and the practice of their primary care physicians up to 40 months following implementation, as well as the sustainability of the program. Objectives are: 1-to evaluate the effects of the PCMR and their persistence on patients registered in the program and the practice of their primary care physicians, by implementation site and degree of exposure to the program; 2-to assess the degree of implementation of PCMR in each CSSS territory and identify related contextual factors; 3-to establish the relationships between the effects observed, the degree of PCMR implementation and the related contextual factors; 4-to assess the impact of the PCMR on strengthening local services networks. Methods/Design The evaluation will use a mixed design that includes two complementary research strategies. The first strategy is similar to a quasi-experimental "before-after" design, based on a quantitative approach; it will look at the program's effects and their variations among the six territories. The effects analysis will use data from a clinical database and from questionnaires completed by participating patients and physicians. Over 3000 patients will be recruited. The second strategy corresponds to a multiple case study approach, where each of the six CSSS constitutes a case. With this strategy, qualitative methods will set out the context of implementation using data from semi-structured interviews with program managers. The quantitative data will be analyzed using linear or multilevel models complemented with an interpretive approach to qualitative data analysis

  19. Do adverse childhood experiences increase the risk of postdeployment posttraumatic stress disorder in US Marines?

    Directory of Open Access Journals (Sweden)

    Ryan Margaret AK

    2010-07-01

    Full Text Available Abstract Background Posttraumatic stress disorder (PTSD has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies. It has not been well established if adverse childhood experiences reported predeployment are independently associated with postdeployment PTSD. Methods Data were evaluated from 8,391 male responders of the Recruit Assessment Program survey at Marine Corps Recruit Depot in San Diego who were deployed in support of military conflicts between September 2001 and June 2004. Using patient medical records to determine PTSD diagnoses, Cox proportional hazard modeling was performed to examine if adverse childhood experiences were independently associated with postdeployment PTSD. Results After adjustment, those who reported adverse childhood experiences in more than one category were significantly more likely to be diagnosed with postdeployment PTSD. Specifically, childhood physical neglect was mostly strongly associated with postdeployment PTSD. Conclusions Findings suggest that Marines who experience multiple types of adverse childhood experiences may be at increased risk for postdeployment PTSD. It is possible, however, that these results indicate that men willing to report childhood adverse experiences are also more willing to seek care for PTSD.

  20. Glycaemic Profiles of Children With Overweight and Obesity in Free-living Conditions in Association With Cardiometabolic Risk

    Science.gov (United States)

    Rijks, Jesse; Karnebeek, Kylie; van Dijk, Jan-Willem; Dorenbos, Elke; Gerver, Willem-Jan; Stouthart, Pauline; Plat, Jogchum; Vreugdenhil, Anita

    2016-01-01

    Insulin resistance is common among children with overweight and obesity. However, knowledge about glucose fluctuations in these children is scarce. This study aims to evaluate glycaemic profiles in children with overweight and obesity in free-living conditions, and to examine the association between glycaemic profiles with insulin resistance and cardiovascular risk parameters. One hundred eleven children with overweight and obesity were included. 48-hour sensor glucose concentrations in free-living conditions, fasting plasma and post-glucose load concentrations, serum lipid and lipoprotein concentrations, homeostatic model assessment of insulin resistance (HOMA-IR), and blood pressure were evaluated. Hyperglycaemic glucose excursions (≥7.8 mmol/L) were observed in 25% (n = 28) of the children. The median sensor glucose concentration was 5.0 (2.7–7.3) mmol/L, and correlated with fasting plasma glucose concentrations (rs = 0.190, p = 0.046), serum insulin concentrations (rs = 0.218, p = 0.021), and HOMA-IR (rs = 0.230, p = 0.015). The hyperglycaemic area under the curve (AUC) correlated with waist circumference z-score (rs = 0.455, p = 0.025), triacylglycerol concentrations (rs = 0.425, p = 0.024), and HOMA-IR (rs = 0.616, p obesity in free-living conditions. Children with insulin resistance had higher median sensor glucose concentrations and a larger hyperglycaemic sensor glucose AUC, which are both associated with specific parameters predicting cardiovascular disease risk. PMID:27534260

  1. Relevance of Fukushima Nuclear Accident to India: Nuclear Radiation Risk and Interventions to Mitigate Adverse Fallout

    Directory of Open Access Journals (Sweden)

    Yadav Kapil, Varshney Neha, Aslesh OP, Karmakar MG, Pandav Chandrakant S

    2012-09-01

    Full Text Available The environmental radiation release from Fukushima nuclear power following tsunami in Japan has once again highlighted the omnipotent risk of radiation injury in the today’s world. India is at a real risk from radiation fallout both due to nuclear power plant accidents and nuclear warfare threat. The risk from nuclear radiation accident in India is further increased by the region being endemic for iodine deficiency as adverse effects following nuclear radiation fallout like thyroid cancer is significantly higher in iodine deficient populations .There is need to institute disaster preparedness measures to mitigate the damage in case of a nuclear accident. Interventions to control adverse fallout of nuclear radiation include evacuation, sheltering and food controls as well as iodine prophylaxis

  2. Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample

    Directory of Open Access Journals (Sweden)

    Lin Fang

    2016-12-01

    Full Text Available Recent HIV research suggested assessing adverse childhood experiences (ACEs as contributing factors of HIV risk behaviors. However, studies often focused on a single type of adverse experience and very few utilized population-based data. This population study examined the associations between ACE (individual and cumulative ACE score and HIV risk behaviors. We analyzed the 2012 Behavioral Risk Factor Surveillance Survey (BRFSS from 5 states. The sample consisted of 39,434 adults. Eight types of ACEs that included different types of child abuse and household dysfunctions before the age of 18 were measured. A cumulative score of ACEs was also computed. Logistic regression estimated of the association between ACEs and HIV risk behaviors using odds ratio (OR with 95% confidence intervals (CIs for males and females separately. We found that ACEs were positively associated with HIV risk behaviors overall, but the associations differed between males and females in a few instances. While the cumulative ACE score was associated with HIV risk behaviors in a stepwise manner, the pattern varied by gender. For males, the odds of HIV risk increased at a significant level as long as they experienced one ACE, whereas for females, the odds did not increase until they experienced three or more ACEs. Future research should further investigate the gender-specific associations between ACEs and HIV risk behaviors. As childhood adversities are prevalent among general population, and such experiences are associated with increased risk behaviors for HIV transmission, service providers can benefit from the principles of trauma-informed practice.

  3. Sun Exposure and Its Effects on Human Health: Mechanisms through Which Sun Exposure Could Reduce the Risk of Developing Obesity and Cardiometabolic Dysfunction

    Science.gov (United States)

    Fleury, Naomi; Geldenhuys, Sian; Gorman, Shelley

    2016-01-01

    Obesity is a significant burden on global healthcare due to its high prevalence and associations with chronic health conditions. In our animal studies, ongoing exposure to low dose ultraviolet radiation (UVR, found in sunlight) reduced weight gain and the development of signs of cardiometabolic dysfunction in mice fed a high fat diet. These observations suggest that regular exposure to safe levels of sunlight could be an effective means of reducing the burden of obesity. However, there is limited knowledge around the nature of associations between sun exposure and the development of obesity and cardiometabolic dysfunction, and we do not know if sun exposure (independent of outdoor activity) affects the metabolic processes that determine obesity in humans. In addition, excessive sun exposure has strong associations with a number of negative health consequences such as skin cancer. This means it is very important to “get the balance right” to ensure that we receive benefits without increasing harm. In this review, we detail the evidence around the cardiometabolic protective effects of UVR and suggest mechanistic pathways through which UVR could be beneficial. PMID:27727191

  4. Development and validation of a risk model for predicting adverse drug reactions in older people during hospital stay: Brighton Adverse Drug Reactions Risk (BADRI model.

    Directory of Open Access Journals (Sweden)

    Balamurugan Tangiisuran

    Full Text Available Older patients are at an increased risk of developing adverse drug reactions (ADR. Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR during hospital stay would enable healthcare staff to put measures in place to reduce the risk of such an event developing. The current study aimed to (1 develop and (2 validate an ADR risk prediction model.We used a combination of univariate analysis and multivariate binary logistic regression to identify clinical risk factors for developing an ADR in a population of older people from a UK teaching hospital. The final ADR risk model was then validated in a European population (European dataset.Six-hundred-ninety patients (median age 85 years were enrolled in the development stage of the study. Ninety-five reports of ADR were confirmed by independent review in these patients. Five clinical variables were identified through multivariate analysis and included in our final model; each variable was attributed a score of 1. Internal validation produced an AUROC of 0.74, a sensitivity of 80%, and specificity of 55%. During the external validation stage the AUROC was 0.73, with sensitivity and specificity values of 84% and 43% respectively.We have developed and successfully validated a simple model to use ADR risk score in a population of patients with a median age of 85, i.e. the oldest old. The model is based on 5 clinical variables (≥8 drugs, hyperlipidaemia, raised white cell count, use of anti-diabetic agents, length of stay ≥12 days, some of which have not been previously reported.

  5. Development and Validation of a Risk Model for Predicting Adverse Drug Reactions in Older People during Hospital Stay: Brighton Adverse Drug Reactions Risk (BADRI) Model

    Science.gov (United States)

    Tangiisuran, Balamurugan; Scutt, Greg; Stevenson, Jennifer; Wright, Juliet; Onder, G.; Petrovic, M.; van der Cammen, T. J.; Rajkumar, Chakravarthi; Davies, Graham

    2014-01-01

    Background Older patients are at an increased risk of developing adverse drug reactions (ADR). Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR during hospital stay would enable healthcare staff to put measures in place to reduce the risk of such an event developing. The current study aimed to (1) develop and (2) validate an ADR risk prediction model. Methods We used a combination of univariate analysis and multivariate binary logistic regression to identify clinical risk factors for developing an ADR in a population of older people from a UK teaching hospital. The final ADR risk model was then validated in a European population (European dataset). Results Six-hundred-ninety patients (median age 85 years) were enrolled in the development stage of the study. Ninety-five reports of ADR were confirmed by independent review in these patients. Five clinical variables were identified through multivariate analysis and included in our final model; each variable was attributed a score of 1. Internal validation produced an AUROC of 0.74, a sensitivity of 80%, and specificity of 55%. During the external validation stage the AUROC was 0.73, with sensitivity and specificity values of 84% and 43% respectively. Conclusions We have developed and successfully validated a simple model to use ADR risk score in a population of patients with a median age of 85, i.e. the oldest old. The model is based on 5 clinical variables (≥8 drugs, hyperlipidaemia, raised white cell count, use of anti-diabetic agents, length of stay ≥12 days), some of which have not been previously reported. PMID:25356898

  6. The Decreased Growth Hormone Response to Growth Hormone Releasing Hormone in Obesity Is Associated to Cardiometabolic Risk Factors

    Directory of Open Access Journals (Sweden)

    Fernando Cordido

    2010-01-01

    Premenopausal obese women, aged 35–52 years, were studied. GH secretion, IGF-I, serum cardiovascular risk markers, insulin, leptin, mid-waist and hip circumference, total body fat, and truncal fat were measured. Subjects were classified as meeting the criteria for GH deficiency (GHD when peak GH after stimulation with GHRH was ≤3 μg/L. Mean total and LDL cholesterol, fasting insulin, and HOMA-IR were all higher, in subjects who would have been classified as GH-deficient compared with GH-sufficient. Peak GH secretion after stimulation was inversely associated with fasting insulin (R=−0.650, P=.012, HOMA-IR (R=−0.846, P=.001, total cholesterol (R=−0.532, P=.034, and LDL cholesterol (R=−0.692, P=.006 and positively associated with HDL cholesterol (R=0.561, P=.037. These data strongly suggest a role for insulin resistance in the decreased GH secretion of obesity and that the blunted GH secretion of central obesity could be the pituitary expression of the metabolic syndrome.

  7. Perception of the risk of adverse reactions to analgesics: differences between medical students and residents

    Directory of Open Access Journals (Sweden)

    Sandra Castillo-Guzman

    2016-07-01

    Full Text Available Background. Medications are not exempt from adverse drug reactions (ADR and how the physician perceives the risk of prescription drugs could influence their availability to report ADR and their prescription behavior. Methods. We assess the perception of risk and the perception of ADR associated with COX2-Inbitors, paracetamol, NSAIDs, and morphine in medical students and residents of northeast of Mexico. Results. The analgesic with the highest risk perception in both group of students was morphine, while the drug with the least risk perceived was paracetamol. Addiction and gastrointestinal bleeding were the ADR with the highest score for morphine and NSAIDs respectively. Discussion. Our findings show that medical students give higher risk scores than residents toward risk due to analgesics. Continuing training and informing physicians about ADRs is necessary since the lack of training is known to induce inadequate use of drugs.

  8. Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma

    DEFF Research Database (Denmark)

    Ali, Zarqa; Nilas, Lisbeth; Ulrik, Charlotte Suppli

    2016-01-01

    BACKGROUND: Asthma in pregnancy have been associated with an increased risk of pregnancy complications. Our aim was to estimate incidence and describe risk factors for adverse obstetrical and perinatal outcomes in pregnant women with asthma. METHODS: Women enrolled in the Management of Asthma......, although women with asthma had a statistically significant higher risk of pre-eclampsia (5% vs. 3%, ORadj 1.60, 95% CI 1.07-2.38; p = 0.02) and small for gestational age neonates (SGA) (ORadj 1.30, 95% CI 1.10-1.54; p ... with a higher risk of SGA (60% vs 53%, ORadj. 1.30, 95% CI 1.10-1.54; p pre-eclampsia (ORadj 3.33 95% CI 0.96-11.65, p = 0.06) compared to pregnancies without any exacerbations. CONCLUSION: The overall risk...

  9. Cintura hipertrigliceridêmica e risco cardiometabólico em mulheres hipertensas Hypertriglyceridemic waist and cardiometabolic risk in hypertensive women

    Directory of Open Access Journals (Sweden)

    Nayra Anielly Lima Cabral

    2012-10-01

    Full Text Available OBJETIVO: Avaliar a associação entre cintura hipertrigliceridêmica (CH e fatores de risco cardiometabólicos em mulheres portadoras de hipertensão arterial. MÉTODOS: Foi realizado um estudo transversal em 218 pacientes acompanhadas pelo Programa do Sistema de Cadastramento e Acompanhamento de Hipertensos e Diabéticos (HiperDia, em duas unidades de saúde de São Luís, MA, Brasil. A variável dependente foi CH e as variáveis independentes foram sociodemográficas, estilo de vida, antropométricas e agravos à saúde. RESULTADOS: A CH esteve presente em 33% da amostra e foi predominante na idade > 60 anos (56,4%, não brancas (81,7%, com oito anos ou menos de estudo (57,3% e pertencentes à classe C (49%. Observaram-se excesso de peso (68,8% e hipercolesterolemia (68,8%. A CH associou-se a: tabagismo (RP: 2,08; p = 0,017, sobrepeso (RP: 2,46; p = 0,010, obesidade (RP: 4,13; p 100 mg/dL ou ser diabética (RP: 1,86; p = 0,006. Após ajustamento, permaneceram associados o colesterol total (RP = 1,78; p = 0,012, HDL colesterol (RP: 3,03; p 25 a 30 kg/m² (RP = 3,61; p OBJECTIVE: To evaluate the association between hypertriglyceridemic waist (HW and cardiometabolic risk factors in women with hypertension. METHODS: A cross-sectional study was performed in 218 patients monitored by HiperDia (Enrollment and Monitoring Program for Hypertensive and Diabetic Individuals in two health units in São Luis, MA, Brazil. The dependent variable was HW and the independent variables were sociodemographics, lifestyle, anthropometrics, and health problems. RESULTS: HW was present in 33% of the sample and was predominant in women aged > 60 years (56.4%, non-whites (81.7%, those with eight or fewer years of schooling (57.3%, and those belonging to socioeconomic class C (49%. Excess weight (68.8% and hypercholesterolemia (68.8% were observed. HW was associated with: smoking (PR: 2.08; p = 0.017, overweight (PR: 2.46; p = 0.010, obesity (PR: 4.13; p 100 mg/dL or

  10. Early life adversity is associated with brain changes in subjects at family risk for depression.

    LENUS (Irish Health Repository)

    Carballedo, Angela

    2012-12-01

    The interplay of genetic and early environmental factors is recognized as an important factor in the aetiology of major depressive disorder (MDD). The aim of the present study was to examine whether reduced volume of hippocampus and frontal brain regions involved in emotional regulation are already present in unaffected healthy individuals at genetic risk of suffering MDD and to investigate whether early life adversity is a relevant factor interacting with these reduced brain structures.

  11. Adverse drug reactions to CT contrast media in south Korea: Incidence and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Soo; Jeon, Kyung Nyeo; Moon, Jin Il; Choi, Bo Hwa; Baek, Hye Jin; Cho, Soo Buem [Dept. of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon (Korea, Republic of); Lee, Sang Min; Ha, Ji Young; Choi, Dae Seob; Cho, Jae Min; Na, Jae Beom [Dept. of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

    2016-07-15

    To evaluate the incidence, severity, and risk factors of adverse drug reactions (ADR) to intravenous administration of nonionic iodinated contrast media in computed tomography (CT), and to determine the recurrence rate after premedication in patients with a previous history of ADR. We prospectively recorded all ADR to intravenous CT contrast media in 32313 consecutive outpatients (54572 cases) who underwent contrast enhanced CT examinations. Clinical report forms and electronic medical records were reviewed to search for the incidence of ADR, treatment, and clinical outcome of patients. The risk factors of ADR to CT contrast media (age, sex, history of previous ADR, season) were evaluated using statistical analysis. Of the 54572 cases, a total of 191 (0.35%) had adverse reactions. Of the 191 cases, 157 (82%) were categorized as mild reactions, 29 (15%) were moderate, and 5 (3%) were severe. A total of 165 (86.4%) cases had acute adverse reactions (which occurred within 1 hour after administration), while 26 (13.6%) had delayed adverse reactions (occurred 1 hour after the administration). The rate of ADR was significantly higher in females [relative risk (RR) = 2.05, 95% confidence interval (CI) 1.53-2.75], patients under the age of 60 years (RR = 1.45, 95% CI 1.07-1.98), patients with a history of previous ADR (RR = 6.51, 95% CI 3.13-13.57), and in the spring season (RR = 1.44, 95% CI 1.07-1.95). The recurrence rate after premedication in patients with previous ADR to CT contrast media was 3.2% (8/247). No deaths occurred that were attributed to the contrast media. The incidence of ADR to nonionic CT contrast media was 0.35%; most of which were mild reactions. Risk factors for ADR included female gender, an age of under 60 years, a history of previous ADR, and spring season.

  12. Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    Qing Xiao

    2016-01-01

    Full Text Available Objective. To examine the association of polycystic ovary syndrome (PCOS in early pregnancy with gestational diabetes mellitus (GDM and adverse birth outcomes. Methods. In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders. Results. Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14–2.09. A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08–2.67. On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03–1.92 and among women with PCOS who conceived spontaneously was 1.60 (1.18–2.15. No increased risk for other adverse birth outcomes was observed. Conclusions. Women with PCOS were more likely to experience GDM and preterm birth.

  13. Life insurance and breast cancer risk assessment: adverse selection, genetic testing decisions, and discrimination.

    Science.gov (United States)

    Armstrong, Katrina; Weber, Barbara; FitzGerald, Genevieve; Hershey, John C; Pauly, Mark V; Lemaire, Jean; Subramanian, Krupa; Asch, David A

    2003-07-30

    Life insurance industry access to genetic information is controversial. Consumer groups argue that access will increase discrimination in life insurance premiums and discourage individuals from undergoing genetic testing that may provide health benefits. Conversely, life insurers argue that without access to risk information available to individuals, they face substantial financial risk from adverse selection. Given this controversy, we conducted a retrospective cohort study to evaluate the impact of breast cancer risk information on life insurance purchasing, the impact of concerns about life insurance discrimination on use of BRCA1/2 testing, and the incidence of life insurance discrimination following participation in breast cancer risk assessment and BRCA1/2 testing. Study participants were 636 women who participated in genetic counseling and/or genetic testing at a University based clinic offering breast cancer risk assessment, genetic counseling, and BRCA1/2 testing between January 1995 and May 2000. Twenty-seven women (4%) had increased and six (1%) had decreased their life insurance since participation in breast cancer risk assessment. The decision to increase life insurance coverage was associated with predicted breast cancer risk (adjusted OR 1.03 for each 1% absolute increase in risk, 95% CI 1.01-1.10) and being found to carry a mutation in BRCA1/2 (OR 5.10, 95% CI 1.90-13.66). Concern about life insurance discrimination was inversely associated with the decision to undergo BRCA1/2 testing (RR 0.67, 95% CI 0.52-0.85). No respondent reported having life insurance denied or canceled. In this cohort of women, these results indicate that information about increased breast cancer risk is associated with increase in life insurance purchasing, raising the possibility of adverse selection. Although fear of insurance discrimination is associated with the decision not to undergo BRCA1/2 testing, there was no evidence of actual insurance discrimination from BRCA1

  14. Prevalence of Type 2 Diabetes and Impaired Glucose Regulation with Associated Cardiometabolic Risk Factors and Depression in an Urbanizing Rural Community in Bangladesh: A Population-Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Bishwajit Bhowmik

    2012-12-01

    Full Text Available BackgroundTo determine the prevalence of type 2 diabetes (T2DM and impaired glucose regulation (impaired fasting glucose [IFG] and impaired glucose tolerance [IGT] in an urbanizing rural population of Bangladesh and associated cardiometabolic risk indicators and depression.MethodsA total of 2,293 subjects aged ≥20 years in an urbanizing rural Bangladeshi community were investigated. Socio-demographic and anthropometric details, blood pressure, fasting plasma glucose (FPG, 2 hours after 75 g plasma glucose (2hPG, glycosylated hemoglobin, fasting serum insulin and lipid profiles were studied. Presence of depressive symptoms using Montogomery-Asberg Depression Rating Scale was also assessed.ResultsThe prevalence of IFG, IGT, IFG+IGT, and T2DM were 3.4%, 4.0%, 1.2%, and 7.9%, respectively. The prevalence of T2DM and impaired glucose regulation differed between males and females, but, both increased with age in both sexes. FPG and 2hPG had positive correlation. Employing logistic regression, it was found that increased age, waist to hip ratio, systolic blood pressure, total cholesterol, triglycerides, and depression were independent risk indicators for diabetes. Both insulin resistance and β-cell deficiency were significantly related for causation of diabetes. Among the study population, 26.2% had general obesity, 39.8% central obesity, 15.5% hypertension, 28.7% dyslipidemia, 17.6% family history of diabetes, and 15.3% had depression. Physical inactivity and smoking habits were significantly higher in male.ConclusionRising prevalence of diabetes and impaired glucose regulation in this urbanizing rural population exist as a significant but hidden public health problem. Depression and other cardiometabolic risk indicators including obesity, hypertension, and dyslipdemia were also prevalent in this population.

  15. Chosen risk level during car-following in adverse weather conditions.

    Science.gov (United States)

    Hjelkrem, Odd André; Ryeng, Eirin Olaussen

    2016-10-01

    This study examines how precipitation, light conditions and surface conditions affect the drivers' risk perception. An indicator CRI (Chosen Risk Index) is defined, which describes the chosen risk level for drivers in a car-following situation. The dataset contains about 70 000 observations of driver behaviour and weather status on a rural road. Based on the theory of risk homeostasis and an assumption that driving behaviour in situations with daylight, dry road and no precipitation reflects drivers' target level of risk, generalised linear models (GLM) were estimated for cars and trucks separately to reveal the effect of adverse weather conditions on risk perception. The analyses show that both car and truck drivers perceive the highest risk when driving on snow covered roads. For car drivers, a snow covered road in combination with moderate rain or light snow are the factors which lowers the CRI the most. For trucks, snow cover and partially covered roads significantly lowers the CRI, while precipitation did not seem to impose any higher risk. Interaction effects were found for car drivers only.

  16. 青少年心血管代谢性健康风险与身体活动的剂量效应%Dose-effect relations between cardiometabolic health risks and physical activities of teenagers

    Institute of Scientific and Technical Information of China (English)

    关尚一; 朱为模

    2013-01-01

    In order to clarify dose-effect relations between medium and high intensity physical activities and obe-sity, hypertension, dyslipidemia and metabolic syndrome of teenagers, so as to determine medium and high intensity physical activity doses recommended for preventing cardiometabolic health risks of teenagers, the authors selected 3162 aged 12~17 teenagers in US Health and Nutrition Survey in 200-2004 and 2005-2006 as their research sub-jects, measured the height, weight, waist circumference, blood pressure, blood sugar, blood fat, food intake and physical activity levels of the testees, used the fractional polynomial model to respectively analyze the relations be-tween medium and high intensity physical activity times and cardiometabolic health risks (obesity risk, hypertension risk, dyslipidemia risk and metabolic syndrome risk), worked out their dose-effect curves by fitting, and revealed the following findings:there were dose-effect relations between medium and high intensity physical activity times and obesity risk, hypertension risk, low and high density lipoprotein risks, high triglyceride risk and metabolic syndrome risk of teenagers;these cardiometabolic health risks tended to decrease in a curvilinear manner as daily medium and high intensity physical activity times increased.%为阐明中高强度身体活动与青少年肥胖、高血压、血脂异常和代谢综合征之间的剂量效应,以确定预防青少年心血管代谢性健康风险的中高强度身体活动推荐量。选取2003-2004、2005-2006年美国健康营养调查中3162名6~17岁的青少年作为研究对象,测量受试者的身高、体重、腰围、血压、血糖、血脂、膳食摄入情况以及身体活动水平,采用分数多项式模型分别分析中高强度身体活动时间与心血管代谢性健康风险(肥胖风险、高血压风险、血脂异常风险和代谢综合征风险)之间的关系,并拟合出它们之间的剂量效应曲线。结果显

  17. Association of Cardiometabolic Multimorbidity With Mortality

    NARCIS (Netherlands)

    Di Angelantonio, Emanuele; Kaptoge, Stephen; Wormser, David; Willeit, Peter; Butterworth, Adam S; Bansal, Narinder; O'Keeffe, Linda M; Gao, Pei; Wood, Angela M; Burgess, Stephen; Freitag, Daniel F; Pennells, Lisa; Peters, Sanne A; Hart, Carole L; Håheim, Lise Lund; Gillum, Richard F; Nordestgaard, Børge G; Psaty, Bruce M; Yeap, Bu B; Knuiman, Matthew W; Nietert, Paul J; Kauhanen, Jussi; Salonen, Jukka T; Kuller, Lewis H; Simons, Leon A; van der Schouw, Yvonne T; Barrett-Connor, Elizabeth; Selmer, Randi; Crespo, Carlos J; Rodriguez, Beatriz; Verschuren, W M Monique; Salomaa, Veikko; Svärdsudd, Kurt; van der Harst, Pim; Björkelund, Cecilia; Wilhelmsen, Lars; Wallace, Robert B; Brenner, Hermann; Amouyel, Philippe; Barr, Elizabeth L M; Iso, Hiroyasu; Onat, Altan; Trevisan, Maurizio; D'Agostino, Ralph B; Cooper, Cyrus; Kavousi, Maryam; Welin, Lennart; Roussel, Ronan; Hu, Frank B; Sato, Shinichi; Davidson, Karina W; Howard, Barbara V; Leening, Maarten J G; Leening, Maarten; Rosengren, Annika; Dörr, Marcus; Deeg, Dorly J H; Kiechl, Stefan; Stehouwer, Coen D A; Nissinen, Aulikki; Giampaoli, Simona; Donfrancesco, Chiara; Kromhout, Daan; Price, Jackie F; Peters, Annette; Meade, Tom W; Casiglia, Edoardo; Lawlor, Debbie A; Gallacher, John; Nagel, Dorothea; Franco, Oscar H; Assmann, Gerd; Dagenais, Gilles R; Jukema, J Wouter; Sundström, Johan; Woodward, Mark; Brunner, Eric J; Khaw, Kay-Tee; Wareham, Nicholas J; Whitsel, Eric A; Njølstad, Inger; Hedblad, Bo; Wassertheil-Smoller, Sylvia; Engström, Gunnar; Rosamond, Wayne D; Selvin, Elizabeth; Sattar, Naveed; Thompson, Simon G; Danesh, John

    2015-01-01

    IMPORTANCE: The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE: To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS: Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using indi

  18. [Methodology for Estimating the Risk of Adverse Drug Reactions in Pregnant Women: Analysis of the Japanese Adverse Drug Event Report Database].

    Science.gov (United States)

    Sakai, Takamasa; Ohtsu, Fumiko; Sekiya, Yasuaki; Mori, Chiyo; Sakata, Hiroshi; Goto, Nobuyuki

    2016-01-01

    Safety information regarding drug use during pregnancy is insufficient. The present study aimed to establish an optimal signal detection method to identify adverse drug reactions in pregnant women and to evaluate information in the Japanese Adverse Drug Event Report (JADER) database between April 2004 and November 2014. We identified reports on pregnant women using the Standardised MedDRA Queries. We calculated the proportional reporting ratio (PRR) and reporting odds ratio (ROR) of the risk factors for the two known risks of antithyroid drugs and methimazole (MMI) embryopathy, and ritodrine and fetal/infant cardiovascular events. The PRR and ROR values differed between all reports in the JADER database and those on pregnant women, affecting whether signal detection criteria were met. Therefore we considered that reports on pregnant women should be used when risks associated with pregnancy were determined using signal detection. Analyses of MMI embryopathy revealed MMI signals [PRR, 159.7; ROR, 669.9; 95% confidence interval (CI), 282.4-1588.7] but no propylthiouracil signals (PRR, 1.98; ROR, 2.0; 95%CI, 0.3-15.4). These findings were consistent with those of reported risks. Analyses of fetal/infant cardiovascular events revealed ritodrine signals (PRR, 2.1; ROR, 2.1; 95%CI, 1.4-3.3). These findings were also consistent with reported risks. Mining the JADER database was helpful for analyzing adverse drug reactions in pregnant women.

  19. Antiepileptic drug teratogenesis: what are the risks for congenital malformations and adverse cognitive outcomes?

    Science.gov (United States)

    Harden, Cynthia L

    2008-01-01

    Antiepileptic drug (AED) exposure in utero has been associated with major congenital malformations (MCMs) and adverse cognitive outcomes in the offspring of women with epilepsy (WWE). However, determining the exact risk and the relative risks of AEDs for these outcomes has been challenging, and only in recent years has improved study designs enabled us to get a clearer picture of the risks. Still, there is a startling lack of information for many of the newer and widely used AEDs. At this point of time, studies clearly show that valproate (VPA) as a part of polytherapy or when used as a monotherapy is associated with an increased risk of MCMs, and that it poses about threefold the risk of carbamazepine (CBZ). It is unclear if any other AEDs studied pose an increased risk of MCM occurrence; in the best available large study the absolute rates of MCMs with other several other AEDs were not different from untreated WWE. The absolute risks have been reported as CBZ 2.2%, lamotrigine (LTG) 3.2%, phenytoin (PHT) 3.7%, untreated WWE 3.5%, with VPA as the outlier at 6.2%. In utero VPA exposure is also associated with a risk of lower verbal intelligence quotient (IQ) in children, at approximately 10 points lower than controls. CBZ appears to pose no risk to cognitive outcome, and there is some evidence that PHT and phenobarbital (PB) may be associated with risk of reduced cognitive outcome. Polytherapy is associated with greater risk than monotherapy for both MCMs and cognitive outcome. Although more information is needed and hopefully will be obtained from ongoing prospective studies, it is clear that WWE taking VPA and planning pregnancy should have a discussion with their physician about considering changing to another AED before pregnancy, if possible.

  20. Vitamin D Deficiency Increases the Risk of Adverse Neonatal Outcomes in Gestational Diabetes

    Science.gov (United States)

    Weinert, Letícia Schwerz; Reichelt, Angela Jacob; Schmitt, Leonardo Rauber; Boff, Roberta; Oppermann, Maria Lucia Rocha; Camargo, Joiza Lins; Silveiro, Sandra Pinho

    2016-01-01

    Background Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM. Methods 184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement. Vitamin D was measured by chemiluminescence and deficiency was defined as dystocia was no statistically different between groups. Conclusions In this cohort of pregnant women with GDM, vitamin D deficiency was associated with a major increase in the incidence of adverse neonatal outcomes such as SGA newborns and neonatal hypoglycemia. PMID:27764194

  1. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    .72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and...

  2. Do prescription stimulants increase the risk of adverse cardiovascular events?: A systematic review

    Directory of Open Access Journals (Sweden)

    Westover Arthur N

    2012-06-01

    Full Text Available Abstract Background There is increasing concern that prescription stimulants may be associated with adverse cardiovascular events such as stroke, myocardial infarction, and sudden death. Public health concerns are amplified by increasing use of prescription stimulants among adults. Methods The objective of this study was to conduct a systematic review of the evidence of an association between prescription stimulant use and adverse cardiovascular outcomes. PUBMED, MEDLINE, EMBASE and Google Scholar searches were conducted using key words related to these topics (MESH: ADHD; Adults; Amphetamine; Amphetamines; Arrhythmias, Cardiac; Cardiovascular Diseases; Cardiovascular System; Central Nervous Stimulants; Cerebrovascular; Cohort Studies; Case–control Studies; Death; Death, Sudden, Cardiac; Dextroamphetamine; Drug Toxicity; Methamphetamine; Methylphenidate; Myocardial Infarction; Stimulant; Stroke; Safety. Eligible studies were population-based studies of children, adolescents, or adults using prescription stimulant use as the independent variable and a hard cardiovascular outcome as the dependent variable. Results Ten population-based observational studies which evaluated prescription stimulant use with cardiovascular outcomes were reviewed. Six out of seven studies in children and adolescents did not show an association between stimulant use and adverse cardiovascular outcomes. In contrast, two out of three studies in adults found an association. Conclusions Findings of an association between prescription stimulant use and adverse cardiovascular outcomes are mixed. Studies of children and adolescents suggest that statistical power is limited in available study populations, and the absolute risk of an event is low. More suggestive of a safety signal, studies of adults found an increased risk for transient ischemic attack and sudden death/ventricular arrhythmia. Interpretation was limited due to differences in population, cardiovascular outcome

  3. Effects of high-intensity training on cardiovascular risk factors in pre- and postmenopausal women

    DEFF Research Database (Denmark)

    Mandrup Jensen, Camilla Maria; Egelund, Jon; Nyberg, Michael Permin

    2017-01-01

    the postmenopausal women had higher total cholesterol (pwaist circumference (p...BACKGROUND: Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors that contribute to the deterioration of cardio-metabolic health...... in postmenopausal women is debated as the menopausal transition is also associated with increased age and fat mass. Furthermore, indications of reduced cardio-metabolic adaptations to exercise in postmenopausal women add to the adverse health profile. OBJECTIVE: To evaluate risk factors for type 2 diabetes...

  4. Defining molecular initiating events in the adverse outcome pathway framework for risk assessment.

    Science.gov (United States)

    Allen, Timothy E H; Goodman, Jonathan M; Gutsell, Steve; Russell, Paul J

    2014-12-15

    Consumer and environmental safety decisions are based on exposure and hazard data, interpreted using risk assessment approaches. The adverse outcome pathway (AOP) conceptual framework has been presented as a logical sequence of events or processes within biological systems which can be used to understand adverse effects and refine current risk assessment practices in ecotoxicology. This framework can also be applied to human toxicology and is explored on the basis of investigating the molecular initiating events (MIEs) of compounds. The precise definition of the MIE has yet to reach general acceptance. In this work we present a unified MIE definition: an MIE is the initial interaction between a molecule and a biomolecule or biosystem that can be causally linked to an outcome via a pathway. Case studies are presented, and issues with current definitions are addressed. With the development of a unified MIE definition, the field can look toward defining, classifying, and characterizing more MIEs and using knowledge of the chemistry of these processes to aid AOP research and toxicity risk assessment. We also present the role of MIE research in the development of in vitro and in silico toxicology and suggest how, by using a combination of biological and chemical approaches, MIEs can be identified and characterized despite a lack of detailed reports, even for some of the most studied molecules in toxicology.

  5. Rationale and methods of the cardiometabolic valencian study (escarval-risk for validation of risk scales in mediterranean patients with hypertension, diabetes or dyslipidemia

    Directory of Open Access Journals (Sweden)

    Trillo Jose L

    2010-11-01

    Full Text Available Abstract Background The Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic health recording system comparing predicted events with observed during 5 years follow-up study. Methods/Design A cohort prospective 5 years follow-up study has been designed including 25000 patients with hypertension, diabetes and/or dyslipidemia attended in usual clinical practice. All information is registered in a unique electronic health recording system (ABUCASIS that is the usual way to register clinical practice in the Valencian Health System (primary and secondary care. The system covers about 95% of population (near 5 million people. The system is linked with database of mortality register, hospital withdrawals, prescriptions and assurance databases in which each individual have a unique identification number. Diagnoses in clinical practice are always registered based on IDC-9. Occurrence of CV disease was the main outcomes of interest. Risk survival analysis methods will be applied to estimate the cumulative incidence of developing CV events over time. Discussion The Escarval-Risk study will provide information to validate different cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia from a low risk Mediterranean Region, the Valencia Community.

  6. Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events

    DEFF Research Database (Denmark)

    Khashan, Ali; Abel, Kathryn; McNamee, R.

    2008-01-01

    CONTEXT: Most societies believe that a mother's psychological state can influence her unborn baby. Severe adverse life events during pregnancy have been consistently associated with an elevated risk of low birth weight and prematurity. Such events during the first trimester have also been...... during the first trimester. DESIGN: Population-based study. SETTING: Denmark. PARTICIPANTS: In a cohort of 1.38 million Danish births from 1973 to 1995, mothers were considered exposed if 1 (or more) of their close relatives died or was diagnosed with cancer, acute myocardial infarction, or stroke...

  7. Risk managers' descriptions of programs to support second victims after adverse events.

    Science.gov (United States)

    White, Andrew A; Brock, Douglas M; McCotter, Patricia I; Hofeldt, Ron; Edrees, Hanan H; Wu, Albert W; Shannon, Sarah; Gallagher, Thomas H

    2015-01-01

    Guidelines call for healthcare organizations to provide emotional support for clinicians involved in adverse events, but little is known about how these organizations seek to meet this need. We surveyed US members of the American Society for Healthcare Risk Management (ASHRM) about the presence, features, and perceived efficacy of their organization's provider support program. The majority reported that their organization had a support program, but features varied widely and there are substantial opportunities to improve services. Provider support programs should enhance referral mechanisms and peer support, critically appraise the role of employee assistance programs, and demonstrate their value to institutional leaders.

  8. Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models.

    Science.gov (United States)

    Stevenson, Jennifer M; Williams, Josceline L; Burnham, Thomas G; Prevost, A Toby; Schiff, Rebekah; Erskine, S David; Davies, J Graham

    2014-01-01

    Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012) to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with practical design and good performance. Only then can implementation and impact be assessed with the aim of generating a model of high enough quality to be considered for use in clinical care to prioritize older people at high risk of suffering an ADR.

  9. Is overweight a risk factor for adverse events during removal of impacted lower third molars?

    Science.gov (United States)

    de Carvalho, Ricardo Wathson Feitosa; do Egito Vasconcelos, Belmiro Cavalcanti

    2014-01-01

    Being overweight is recognised as a significant risk factor for several morbidities; however, the experience of the dentistry faculties focusing on this population is still low. The aim of the present study was to determine the occurrence of adverse events during removal of impacted lower third molars in overweight patients. A prospective cohort study was carried out involving overweight patients subjected to surgical removal of impacted lower third molar as part of a line of research on third molar surgery. Predictor variables indicative of the occurrence of adverse events during surgery were classified by their demographic, clinical, radiographic, and surgical aspects. Descriptive and bivariate statistics were computed. In total, 140 patients fulfilled the eligibility criteria, and 280 surgeries were performed. Patients' mean age was 25.1±2.2 years, and the proportion of women to men was 3:1. Eight different adverse events during surgery were recorded. These events occurred in approximately 29.3% of cases and were significantly associated with predictor variables (Pimpacted third molar surgery. The study suggests that overweight patients are highly likely to experience morbidities.

  10. Circulating Endocannabinoids and the Polymorphism 385C>A in Fatty Acid Amide Hydrolase (FAAH) Gene May Identify the Obesity Phenotype Related to Cardiometabolic Risk: A Study Conducted in a Brazilian Population of Complex Interethnic Admixture.

    Science.gov (United States)

    Martins, Cyro José de Moraes; Genelhu, Virginia; Pimentel, Marcia Mattos Gonçalves; Celoria, Bruno Miguel Jorge; Mangia, Rogerio Fabris; Aveta, Teresa; Silvestri, Cristoforo; Di Marzo, Vincenzo; Francischetti, Emilio Antonio

    2015-01-01

    The dysregulation of the endocannabinoid system is associated with cardiometabolic complications of obesity. Allelic variants in coding genes for this system components may contribute to differences in the susceptibility to obesity and related health hazards. These data have mostly been shown in Caucasian populations and in severely obese individuals. We investigated a multiethnic Brazilian population to study the relationships among the polymorphism 385C>A in an endocannabinoid degrading enzyme gene (FAAH), endocannabinoid levels and markers of cardiometabolic risk. Fasting plasma levels of endocannabinoids and congeners (anandamide, 2-arachidonoylglycerol, N-oleoylethanolamide and N-palmitoylethanolamide) were measured by liquid chromatography-mass spectrometry in 200 apparently healthy individuals of both genders with body mass indices from 22.5 ± 1.8 to 35.9 ± 5.5 kg/m2 (mean ± 1 SD) and ages between 18 and 60 years. All were evaluated for anthropometric parameters, blood pressure, metabolic variables, homeostatic model assessment of insulin resistance (HOMA-IR), adiponectin, leptin, C-reactive protein, and genotyping. The endocannabinoid levels increased as a function of obesity and insulin resistance. The homozygous genotype AA was associated with higher levels of anandamide and lower levels of adiponectin versus wild homozygous CC and heterozygotes combined. The levels of anandamide were independent and positively associated with the genotype AA position 385 of FAAH, C-reactive protein levels and body mass index. Our findings provide evidence for an endocannabinoid-related phenotype that may be identified by the combination of circulating anandamide levels with genotyping of the FAAH 385C>A; this phenotype is not exclusive to mono-ethnoracial populations nor to individuals with severe obesity.

  11. Circulating Endocannabinoids and the Polymorphism 385C>A in Fatty Acid Amide Hydrolase (FAAH Gene May Identify the Obesity Phenotype Related to Cardiometabolic Risk: A Study Conducted in a Brazilian Population of Complex Interethnic Admixture.

    Directory of Open Access Journals (Sweden)

    Cyro José de Moraes Martins

    Full Text Available The dysregulation of the endocannabinoid system is associated with cardiometabolic complications of obesity. Allelic variants in coding genes for this system components may contribute to differences in the susceptibility to obesity and related health hazards. These data have mostly been shown in Caucasian populations and in severely obese individuals. We investigated a multiethnic Brazilian population to study the relationships among the polymorphism 385C>A in an endocannabinoid degrading enzyme gene (FAAH, endocannabinoid levels and markers of cardiometabolic risk. Fasting plasma levels of endocannabinoids and congeners (anandamide, 2-arachidonoylglycerol, N-oleoylethanolamide and N-palmitoylethanolamide were measured by liquid chromatography-mass spectrometry in 200 apparently healthy individuals of both genders with body mass indices from 22.5 ± 1.8 to 35.9 ± 5.5 kg/m2 (mean ± 1 SD and ages between 18 and 60 years. All were evaluated for anthropometric parameters, blood pressure, metabolic variables, homeostatic model assessment of insulin resistance (HOMA-IR, adiponectin, leptin, C-reactive protein, and genotyping. The endocannabinoid levels increased as a function of obesity and insulin resistance. The homozygous genotype AA was associated with higher levels of anandamide and lower levels of adiponectin versus wild homozygous CC and heterozygotes combined. The levels of anandamide were independent and positively associated with the genotype AA position 385 of FAAH, C-reactive protein levels and body mass index. Our findings provide evidence for an endocannabinoid-related phenotype that may be identified by the combination of circulating anandamide levels with genotyping of the FAAH 385C>A; this phenotype is not exclusive to mono-ethnoracial populations nor to individuals with severe obesity.

  12. Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer

    DEFF Research Database (Denmark)

    Schwab, Ursula; Lauritzen, Lotte; Tholstrup, Tine

    2014-01-01

    were also included when limited or no data were available from other study types. Altogether 607 articles were quality graded and the observed effects in these papers were summarized. Convincing evidence was found that partial replacement of saturated fat (SFA) with polyunsaturated fat (PUFA......The effects of both the amount and quality of dietary fat have been studied intensively during the past decades. Previously, low-fat diets were recommended without much attention to the quality of fat, whereas there is general emphasis on the quality of fat in current guidelines. The objective...... of this systematic review (SR) was to assess the evidence of an effect of the amount and type of dietary fat on body weight (BW), risk factors, and risk of non-communicable diseases, that is, type 2 diabetes (T2DM), cardiovascular diseases (CVD), and cancer in healthy subjects or subjects at risk for these diseases...

  13. Milk fat biomarkers and cardiometabolic disease

    Science.gov (United States)

    Risérus, Ulf; Marklund, Matti

    2017-01-01

    Purpose of review Dairy is a major food group with potential impact on cardiometabolic health. Self-reported dairy intake has limitations that can partly be avoided by using biomarkers. This review aims to summarize the evidence of odd-chain saturated fatty acids (OCFAs), that is, pentadecanoic acid (C15 : 0) and heptadecanoic acid (17 : 0), as biomarkers of dairy fat intake. In addition, the associations of OCFA biomarkers with cardiometabolic disease will be overviewed. Recent findings Adipose tissue 15 : 0 is the preferred biomarker but also circulating 15 : 0, and to a weaker extent 17 : 0, reflects both habitual and changes in dairy intake. Whereas results from studies assessing cardiovascular outcomes are inconsistent, OCFA biomarkers are overall associated with lower diabetes risk. Residual confounding should however be considered until interventional data and mechanisms are available. Although OCFA biomarkers mainly reflect dairy fat intake, recently proposed endogenous synthesis and metabolism do motivate further research. Summary Taking into account the study population diet and limitations of OCFA biomarkers, both adipose and circulating levels of 15 : 0, in particular, are useful for estimating total dairy fat intake. OCFA biomarkers are overall not linked to cardiovascular disease risk, but a possible beneficial role of dairy foods in diabetes prevention warrant further study. PMID:27906713

  14. Self-Rated Health in middle-aged and elderly Chinese: distribution, determinants and associations with cardio-metabolic risk factors

    Directory of Open Access Journals (Sweden)

    Yu Zhijie

    2009-09-01

    Full Text Available Abstract Background Self-rated health (SRH has been demonstrated to be an accurate reflection of a person's health and a valid predictor of incident mortality and chronic morbidity. We aimed to evaluate the distribution and factors associated with SRH and its association with biomarkers of cardio-metabolic diseases among middle-aged and elderly Chinese. Methods Survey of 1,458 men and 1,831 women aged 50 to 70 years, conducted in one urban and two rural areas of Beijing and Shanghai in 2005. SRH status was measured and categorized as good (very good and good vs. not good (fair, poor and very poor. Determinants of SRH and associations with biomarkers of cardio-metabolic diseases were evaluated using logistic regression. Results Thirty two percent of participants reported good SRH. Males and rural residents tended to report good SRH. After adjusting for potential confounders, residence, physical activity, employment status, sleep quality and presence of diabetes, cardiovascular disease, and depression were the main determinants of SRH. Those free from cardiovascular disease (OR 3.68; 95%CI 2.39; 5.66, rural residents (OR 1.89; 95% CI 1.47; 2.43, non-depressed participants (OR 2.50; 95% CI 1.67; 3.73 and those with good sleep quality (OR 2.95; 95% CI 2.22; 3.91 had almost twice or over the chance of reporting good SRH compared to their counterparts. There were significant associations -and trend- between SRH and levels of inflammatory markers, insulin levels and insulin resistance. Conclusion Only one third of middle-aged and elderly Chinese assessed their health status as good or very good. Although further longitudinal studies are required to confirm our findings, interventions targeting social inequalities, lifestyle patterns might not only contribute to prevent chronic morbidity but as well to improve populations' perceived health.

  15. The Risk of Heart Failure and Cardiometabolic Complications in Obesity May Be Masked by an Apparent Healthy Status of Normal Blood Glucose

    Directory of Open Access Journals (Sweden)

    Shuchita Tiwari

    2013-01-01

    Full Text Available Although many obese individuals are normoglycemic and asymptomatic of cardiometabolic complications, this apparent healthy state may be a misnomer. Since heart failure is a major cause of mortality in obesity, we investigated the effects of heme-oxygenase (HO on heart failure and cardiometabolic complications in obese normoglycemic Zucker-fatty rats (ZFs. Treatment with the HO-inducer, hemin, reduced markers of heart failure, such as osteopontin and osteoprotegerin, abated left-ventricular (LV hypertrophy/fibrosis, extracellular matrix/profibrotic proteins including collagen IV, fibronectin, TGF-β1, and reduced cardiac lesions. Furthermore, hemin suppressed inflammation by abating macrophage chemoattractant protein-1, macrophage-inflammatory protein-1 alpha, TNF-α, IL-6, and IL-1β but enhanced adiponectin, atrial-natriuretic peptide (ANP, HO activity, insulin sensitivity, and glucose metabolism. Correspondingly, hemin improved several hemodynamic/echocardiographic parameters including LV-diastolic wall thickness, LV-systolic wall thickness, mean-arterial pressure, arterial-systolic pressure, arterial-diastolic pressure, LV-developed pressure, +dP/dt, and cardiac output. Contrarily, the HO-inhibitor, stannous mesoporphyrin nullified the hemin effect, exacerbating inflammatory/oxidative insults and aggravated insulin resistance (HOMA-index. We conclude that perturbations in insulin signaling and cardiac function may be forerunners to overt hyperglycemia and heart failure in obesity. Importantly, hemin improves cardiac function by suppressing markers of heart failure, LV hypertrophy, cardiac lesions, extracellular matrix/profibrotic proteins, and inflammatory/oxidative mediators, while concomitantly enhancing the HO-adiponectin-ANP axis.

  16. Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

    LENUS (Irish Health Repository)

    O Caoimh, Rónán

    2014-09-19

    Functional decline and frailty are common in community dwelling older adults, increasing the risk of adverse outcomes. Given this, we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults, using the Risk Instrument for Screening in the Community (RISC).

  17. Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders: Evidence Report

    Science.gov (United States)

    Slack, Kelley J.; Williams, Thomas J.; Schneiderman, Jason S.; Whitmire, Alexandra M.; Picano, James J.; Leveton, Lauren B.; Schmidt, Lacey L.; Shea, Camille

    2016-01-01

    In April 2010, President Obama declared a space pioneering goal for the United States in general and NASA in particular. "Fifty years after the creation of NASA, our goal is no longer just a destination to reach. Our goal is the capacity for people to work and learn and operate and live safely beyond the Earth for extended periods of time, ultimately in ways that are more sustainable and even indefinite." Thus NASA's Strategic Objective 1.1 emerged as "expand human presence into the solar system and to the surface of Mars to advance exploration, science, innovation, benefits to humanity, and international collaboration" (NASA 2015b). Any space flight, be it of long or short duration, occurs in an extreme environment that has unique stressors. Even with excellent selection methods, the potential for behavioral problems among space flight crews remain a threat to mission success. Assessment of factors that are related to behavioral health can help minimize the chances of distress and, thus, reduce the likelihood of adverse cognitive or behavioral conditions and psychiatric disorders arising within a crew. Similarly, countermeasures that focus on prevention and treatment can mitigate the cognitive or behavioral conditions that, should they arise, would impact mission success. Given the general consensus that longer duration, isolation, and confined missions have a greater risk for behavioral health ensuring crew behavioral health over the long term is essential. Risk, which within the context of this report is assessed with respect to behavioral health and performance, is addressed to deter development of cognitive and behavioral degradations or psychiatric conditions in space flight and analog populations, and to monitor, detect, and treat early risk factors, predictors and other contributing factors. Based on space flight and analog evidence, the average incidence rate of an adverse behavioral health event occurring during a space mission is relatively low for the

  18. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie;

    2015-01-01

    INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (... pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period....... Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Calculations were adjusted for the mother's age at delivery, parity, ethnicity, socioeconomic status, smoking, and in supplementary analyses for year of birth. RESULTS: Referred women gave birth to children...

  19. Development of an adverse drug reaction risk assessment score among hospitalized patients with chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Fatemeh Saheb Sharif-Askari

    Full Text Available BACKGROUND: Adverse drug reactions (ADRs represent a major burden on the healthcare system. Chronic kidney disease (CKD patients are particularly vulnerable to ADRs because they are usually on multiple drug regimens, have multiple comorbidities, and because of alteration in their pharmacokinetics and pharmacodynamic parameters. Therefore, one step towards reducing this burden is to identify patients who are at increased risk of an ADR. OBJECTIVE: To develop a method of identifying CKD patients who are at increased risk for experiencing ADRs during hospitalisation. MATERIALS AND METHODS: Factors associated with ADRs were identified by using demographic, clinical and laboratory variables of patients with CKD stages 3 to 5 (estimated glomerular filtration rate, 10-59 ml/min/1.73 m2 who were admitted between January 1, 2012, and December 31, 2012, to the renal unit of Dubai Hospital. An ADR risk score was developed by constructing a series of logistic regression models. The overall model performance for sequential models was evaluated using Akaike Information Criterion for goodness of fit. Odd ratios of the variables retained in the best model were used to compute the risk scores. RESULTS: Of 512 patients (mean [SD] age, 60 [16] years, 62 (12.1% experienced an ADR during their hospitalisation. An ADR risk score included age 65 years or more, female sex, conservatively managed end-stage renal disease, vascular disease, serum level of C-reactive protein more than 10 mg/L, serum level of albumin less than 3.5 g/dL, and the use of 8 medications or more during hospitalization. The C statistic, which assesses the ability of the risk score to predict ADRs, was 0.838; 95% CI, 0.784-0.892. CONCLUSION: A score using routinely available patient data can be used to identify CKD patients who are at increased risk of ADRs.

  20. Left atrial enlargement increases the risk of major adverse cardiac events independent of coronary vasodilator capacity

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Angela S. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); National Heart Centre Singapore, Singapore (Singapore); Murthy, Venkatesh L.; Sitek, Arkadiusz; Gayed, Peter; Bruyere, John; Di Carli, Marcelo F. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Wu, Justina [Brigham and Women' s Hospital, Division of Cardiology, Department of Medicine, and the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Dorbala, Sharmila [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Department of Radiology and the Division of Cardiology, Noninvasive Cardiovascular Imaging Section, Boston, MA (United States)

    2015-09-15

    Longstanding uncontrolled atherogenic risk factors may contribute to left atrial (LA) hypertension, LA enlargement (LAE) and coronary vascular dysfunction. Together they may better identify risk of major adverse cardiac events (MACE). The aim of this study was to test the hypothesis that chronic LA hypertension as assessed by LAE modifies the relationship between coronary vascular function and MACE. In 508 unselected subjects with a normal clinical {sup 82}Rb PET/CT, ejection fraction ≥40 %, no prior coronary artery disease, valve disease or atrial fibrillation, LAE was determined based on LA volumes estimated from the hybrid perfusion and CT transmission scan images and indexed to body surface area. Absolute myocardial blood flow and global coronary flow reserve (CFR) were calculated. Subjects were systematically followed-up for the primary end-point - MACE - a composite of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, coronary artery disease progression or revascularization. During a median follow-up of 862 days, 65 of the subjects experienced a composite event. Compared with subjects with normal LA size, subjects with LAE showed significantly lower CFR (2.25 ± 0.83 vs. 1.95 ± 0.80, p = 0.01). LAE independently and incrementally predicted MACE even after accounting for clinical risk factors, medication use, stress left ventricular ejection fraction, stress left ventricular end-diastolic volume index and CFR (chi-squared statistic increased from 30.9 to 48.3; p = 0.001). Among subjects with normal CFR, those with LAE had significantly worse event-free survival (risk adjusted HR 5.4, 95 % CI 2.3 - 12.8, p < 0.0001). LAE and reduced CFR are related but distinct cardiovascular adaptations to atherogenic risk factors. LAE is a risk marker for MACE independent of clinical factors and left ventricular volumes; individuals with LAE may be at risk of MACE despite normal coronary vascular function. (orig.)

  1. Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review.

    Science.gov (United States)

    Palomba, Stefano; Homburg, Roy; Santagni, Susanna; La Sala, Giovanni Battista; Orvieto, Raoul

    2016-11-04

    In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

  2. The risk of adverse pregnancy outcomes in women who are overweight or obese

    Directory of Open Access Journals (Sweden)

    Willson Kristyn J

    2010-09-01

    Full Text Available Abstract Background The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. Methods A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS. Women were categorized into three groups according to their body mass index (BMI: normal (BMI 18.5-24.9 kg/m2; overweight (BMI 25-29.9 kg/m2 and; obese (BMI 30-34.9 kg/m2. Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR 2.99 [95% confidence intervals (CI 1.88, 4.73], p Conclusion The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed. Trial Registration Current Controlled Trials ISRCTN00416244

  3. The Analysis of the Risk Factors of Adverse Prognosis of Myocardial Infarction in the Acute Period

    Directory of Open Access Journals (Sweden)

    A. E. Zakharova

    2016-01-01

    Full Text Available The aim was to identify the risk factors contributed to adverse outcome of myocardial infarction (MI in the acute period of the disease at a prehospital stage.Materials and methods. The study included the call cards of specialized resuscitation and anesthesia units of the budgetary institution A. S. Puchkov «Station of emergency medical care», to patients with complicated MI. The study included two groups of patients. The first group comprized of patients with complicated MI which resulted in circulatory arrest (n=184, the second group (the group of comparison included patients with com plicated MI without the outcome in circulatory arrest (n=271. Statistical processing of the material: significance of differences between two binomial observations was evaluated by the Barnard's Exact Test.The results of the research. The presence of risk of MI complication as a stopping of blood circulation was confirmed in patients of the age group of 40—60 years (P=0.01. Patients with MI complicated by a circulatory arrest was characterized by a significantly greater intensity of pain syndrome (the pain intensity of 9—10 points was typ ical for 11,2% and 3% of patients of the group with circulatory arrest and the group of comparison, respectively; P< 0.001. The combination of clinical manifestations of alveolar pulmonary edema and arrhythmia occurred in 50% of patients with circulatory arrest, resulted in poor prognosis (the frequency of same parameters in a control group was 28,7%, P=0.018. Tachysystolic arrhythmia was the most common form of alteration at a circulatory arrest.Conclusions. The risk factors for MI adverse outcome in acute period included age from 40 to 60 years, pain of high intensity, presence of cardiogenic shock in combination with alveolar pulmonary edema and tachyarrhythmia.

  4. Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Ursula Schwab

    2014-07-01

    Full Text Available The effects of both the amount and quality of dietary fat have been studied intensively during the past decades. Previously, low-fat diets were recommended without much attention to the quality of fat, whereas there is general emphasis on the quality of fat in current guidelines. The objective of this systematic review (SR was to assess the evidence of an effect of the amount and type of dietary fat on body weight (BW, risk factors, and risk of non-communicable diseases, that is, type 2 diabetes (T2DM, cardiovascular diseases (CVD, and cancer in healthy subjects or subjects at risk for these diseases. This work was performed in the process of updating the fourth edition of the Nordic Nutrition Recommendations from 2004. The literature search was performed in October 2010 covering articles published since January 2000. A complementary search was done in February 2012 covering literature until December 2011. Two authors independently selected articles for inclusion from a total of about 16,000 abstracts according to predefined criteria. Randomized controlled trials (RCT and prospective cohort studies (PCS were included as well as nested case–control studies. A few retrospective case–control studies were also included when limited or no data were available from other study types. Altogether 607 articles were quality graded and the observed effects in these papers were summarized. Convincing evidence was found that partial replacement of saturated fat (SFA with polyunsaturated fat (PUFA or monounsaturated fat (MUFA lowers fasting serum/plasma total and LDL cholesterol concentrations. The evidence was probable for a decreasing effect of fish oil on concentration of serum/plasma total triglycerides as compared with MUFA. Beneficial effect of MUFA both on insulin sensitivity and fasting plasma/serum insulin concentration was considered as probable in comparisons of MUFA and carbohydrates versus SFA, whereas no effect was found on fasting glucose

  5. Adverse Vascular Risk is Related to Cognitive Decline in Older Adults

    Science.gov (United States)

    Jefferson, Angela L.; Hohman, Timothy J.; Liu, Dandan; Haj-Hassan, Shereen; Gifford, Katherine A.; Benson, Elleena M.; Skinner, Jeannine S.; Lu, Zengqi; Sparling, Jamie; Sumner, Emily C.; Bell, Susan; Ruberg, Frederick L.

    2014-01-01

    Background Cardiovascular disease (CVD) and related risk factors are associated with Alzheimer’s disease (AD). This association is less well-defined in normal cognition (NC) or prodromal AD (mild cognitive impairment (MCI)). Objective Cross-sectionally and longitudinally relate a vascular risk index to cognitive outcomes among elders free of clinical dementia. Methods 3117 MCI (74±8 years, 56% female) and 6603 NC participants (72±8 years, 68% female) were drawn from the National Alzheimer’s Coordinating Center. A composite measure of vascular risk was defined using the Framingham Stroke Risk Profile (FSRP) score (i.e., age, systolic blood pressure, anti-hypertensive medication, diabetes, cigarette smoking, CVD history, atrial fibrillation). Ordinary linear regressions and generalized linear mixed models related baseline FSRP to cross-sectional and longitudinal cognitive outcomes, separately for NC and MCI, adjusting for age, sex, race, education, and follow-up time (in longitudinal models). Results In NC participants, increasing FSRP was related to worse baseline global cognition, information processing speed, and sequencing abilities (p-values<0.0001) and a worse longitudinal trajectory on all cognitive measures (p-values<0.0001). In MCI, increasing FSRP correlated with worse longitudinal delayed memory (p=0.004). In secondary models using an age-excluded FSRP score, associations persisted in NC participants for global cognition, naming, information processing speed, and sequencing abilities. Conclusions An adverse vascular risk profile is associated with worse cognitive trajectory, especially global cognition, naming, and information processing speed, among NC elders. Future studies are needed to understand how effective management of CVD and related risk factors can modify cognitive decline to identify the ideal timeframe for primary prevention implementation. PMID:25471188

  6. Dietary Capsaicin Protects Cardiometabolic Organs from Dysfunction.

    Science.gov (United States)

    Sun, Fang; Xiong, Shiqiang; Zhu, Zhiming

    2016-04-25

    Chili peppers have a long history of use for flavoring, coloring, and preserving food, as well as for medical purposes. The increased use of chili peppers in food is very popular worldwide. Capsaicin is the major pungent bioactivator in chili peppers. The beneficial effects of capsaicin on cardiovascular function and metabolic regulation have been validated in experimental and population studies. The receptor for capsaicin is called the transient receptor potential vanilloid subtype 1 (TRPV1). TRPV1 is ubiquitously distributed in the brain, sensory nerves, dorsal root ganglia, bladder, gut, and blood vessels. Activation of TRPV1 leads to increased intracellular calcium signaling and, subsequently, various physiological effects. TRPV1 is well known for its prominent roles in inflammation, oxidation stress, and pain sensation. Recently, TRPV1 was found to play critical roles in cardiovascular function and metabolic homeostasis. Experimental studies demonstrated that activation of TRPV1 by capsaicin could ameliorate obesity, diabetes, and hypertension. Additionally, TRPV1 activation preserved the function of cardiometabolic organs. Furthermore, population studies also confirmed the beneficial effects of capsaicin on human health. The habitual consumption of spicy foods was inversely associated with both total and certain causes of specific mortality after adjustment for other known or potential risk factors. The enjoyment of spicy flavors in food was associated with a lower prevalence of obesity, type 2 diabetes, and cardiovascular diseases. These results suggest that capsaicin and TRPV1 may be potential targets for the management of cardiometabolic vascular diseases and their related target organs dysfunction.

  7. Dietary Capsaicin Protects Cardiometabolic Organs from Dysfunction

    Directory of Open Access Journals (Sweden)

    Fang Sun

    2016-04-01

    Full Text Available Chili peppers have a long history of use for flavoring, coloring, and preserving food, as well as for medical purposes. The increased use of chili peppers in food is very popular worldwide. Capsaicin is the major pungent bioactivator in chili peppers. The beneficial effects of capsaicin on cardiovascular function and metabolic regulation have been validated in experimental and population studies. The receptor for capsaicin is called the transient receptor potential vanilloid subtype 1 (TRPV1. TRPV1 is ubiquitously distributed in the brain, sensory nerves, dorsal root ganglia, bladder, gut, and blood vessels. Activation of TRPV1 leads to increased intracellular calcium signaling and, subsequently, various physiological effects. TRPV1 is well known for its prominent roles in inflammation, oxidation stress, and pain sensation. Recently, TRPV1 was found to play critical roles in cardiovascular function and metabolic homeostasis. Experimental studies demonstrated that activation of TRPV1 by capsaicin could ameliorate obesity, diabetes, and hypertension. Additionally, TRPV1 activation preserved the function of cardiometabolic organs. Furthermore, population studies also confirmed the beneficial effects of capsaicin on human health. The habitual consumption of spicy foods was inversely associated with both total and certain causes of specific mortality after adjustment for other known or potential risk factors. The enjoyment of spicy flavors in food was associated with a lower prevalence of obesity, type 2 diabetes, and cardiovascular diseases. These results suggest that capsaicin and TRPV1 may be potential targets for the management of cardiometabolic vascular diseases and their related target organs dysfunction.

  8. Dietary Capsaicin Protects Cardiometabolic Organs from Dysfunction

    Science.gov (United States)

    Sun, Fang; Xiong, Shiqiang; Zhu, Zhiming

    2016-01-01

    Chili peppers have a long history of use for flavoring, coloring, and preserving food, as well as for medical purposes. The increased use of chili peppers in food is very popular worldwide. Capsaicin is the major pungent bioactivator in chili peppers. The beneficial effects of capsaicin on cardiovascular function and metabolic regulation have been validated in experimental and population studies. The receptor for capsaicin is called the transient receptor potential vanilloid subtype 1 (TRPV1). TRPV1 is ubiquitously distributed in the brain, sensory nerves, dorsal root ganglia, bladder, gut, and blood vessels. Activation of TRPV1 leads to increased intracellular calcium signaling and, subsequently, various physiological effects. TRPV1 is well known for its prominent roles in inflammation, oxidation stress, and pain sensation. Recently, TRPV1 was found to play critical roles in cardiovascular function and metabolic homeostasis. Experimental studies demonstrated that activation of TRPV1 by capsaicin could ameliorate obesity, diabetes, and hypertension. Additionally, TRPV1 activation preserved the function of cardiometabolic organs. Furthermore, population studies also confirmed the beneficial effects of capsaicin on human health. The habitual consumption of spicy foods was inversely associated with both total and certain causes of specific mortality after adjustment for other known or potential risk factors. The enjoyment of spicy flavors in food was associated with a lower prevalence of obesity, type 2 diabetes, and cardiovascular diseases. These results suggest that capsaicin and TRPV1 may be potential targets for the management of cardiometabolic vascular diseases and their related target organs dysfunction. PMID:27120617

  9. Dairy food products: good or bad for cardiometabolic disease?

    Science.gov (United States)

    Lovegrove, Julie A; Givens, D Ian

    2016-12-01

    Prevalence of type 2 diabetes mellitus (T2DM) is rapidly increasingly and is a key risk for CVD development, now recognised as the leading cause of death globally. Dietary strategies to reduce CVD development include reduction of saturated fat intake. Milk and dairy products are the largest contributors to dietary saturated fats in the UK and reduced consumption is often recommended as a strategy for risk reduction. However, overall evidence from prospective cohort studies does not confirm a detrimental association between dairy product consumption and CVD risk. The present review critically evaluates the current evidence on the association between milk and dairy products and risk of CVD, T2DM and the metabolic syndrome (collectively, cardiometabolic disease). The effects of total and individual dairy foods on cardiometabolic risk factors and new information on the effects of the food matrix on reducing fat digestion are also reviewed. It is concluded that a policy to lower SFA intake by reducing dairy food consumption to reduce cardiometabolic disease risk is likely to have limited or possibly negative effects. There remain many uncertainties, including differential effects of different dairy products and those of differing fat content. Focused and suitably designed and powered studies are needed to provide clearer evidence not only of the mechanisms involved, but how they may be beneficially influenced during milk production and processing.

  10. Drug adverse events and drop-out risk: a clinical case.

    Science.gov (United States)

    Scoyni, R M; Aiello, L; Trani, I; Felli, B; Masin, A M R; Camponi, V; Dignazio, L; Cortese, M; Pacitti, M T; Carratelli, D; Morocutti, C

    2007-01-01

    We report a brief discussion on a clinical case of a female patient, 85 years old, affected by severe cognitive impairment and chronic obstructive pulmonary disease (COPD). The patient was not taking drugs at home (apart from promazine: 10 drops when necessary to control her behavioral diseases). A previous neuropsychological evaluation had shown a severe cognitive impairment MMSE=16/30; ADL=3/6; IADL=0/8) due to multiple brain ischemic areas (confirmed in 2003 by MRI neuroimaging). When the patient was admitted to our center she was able to perform some basic activities of daily living such as eating and walking and was not too confused. She was included in cognitive rehabilitation groups. Since she showed signs of Parkinsonism, a therapy based on omeprazol 20mg, acetylsalicylic acid, donepezil 10mg, pramipexol 0.18 mg, nimodipine 10 drops, levodopa+carbidopa 100/25mg was started. A few days later she became sleepy during daytime and, once, she lost her balance and fell. She was not self-sufficient any more. At first this was attributed to a lung infection that the patient had, but her state continue after the infection was completely cured with appropriate antibiotics therapy. At that point an adverse drug reaction was suspected and therapy with pramipexol 0.18 mg was interrupted. In a few days the patient regained her previous level of consciousness and self-sufficiency. We consider this a typical case of complex management in a patient with dementia and comorbidity in which adverse drug reactions can play an important role in lowering the level of cognitive functions. In this case the relationship with the family of the patient was made difficult by the attitude of the patient's daughter who decided, after the onset of the adverse drug reaction, to interrupt her mother's stay in our center even at risk of the worst consequences.

  11. Potentially inappropriate prescribing and the risk of adverse drug reactions in critically ill older adults

    Directory of Open Access Journals (Sweden)

    Galli TB

    2016-12-01

    Full Text Available Background: Potentially inappropriate medication (PIM use in the elderly is associated with increased risk of adverse drug reactions (ADRs, but there is limited information regarding PIM use in the intensive care unit (ICU setting. Objective: The aim of the study is to describe the prevalence and factors associated with the use of PIM and the occurrence of PIM-related adverse reactions in the critically ill elderly. Methods: This study enrolled all critically ill older adults (60 years or more admitted to medical or cardiovascular ICUs between January and December 2013, in a large tertiary teaching hospital. For all patients, clinical pharmacists listed the medications given during the ICU stay and data on drugs were analyzed using 2012 Beers Criteria, to identify the prevalence of PIM. For each identified PIM the medical records were analyzed to evaluate factors associated with its use. The frequency of ADRs and, the causal relationship between PIM and the ADRs identified were also evaluated through review of medical records. Results: According to 2012 Beers Criteria, 98.2% of elderly patients used at least one PIM (n=599, of which 24.8% were newly started in the ICUs. In 29.6% of PIMs, there was a clinical circumstance that justified their prescription. The number of PIMs was associated with ICU length of stay and total number of medications. There was at least one ADR identified in 17.8% of patients; more than 40% were attributed to PIM, but there was no statistical association. Conclusions: There is a high prevalence of PIM used in acutely ill older people, but they do not seem to be the major cause of adverse drug reactions in this population. Although many PIMs had a clinical circumstance that led to their prescription during the course of ICU hospitalization, many were still present upon hospital discharge. Therefore, prescription of PIMs should be minimized to improve the safety of elderly patients.

  12. Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models

    Directory of Open Access Journals (Sweden)

    Stevenson JM

    2014-09-01

    Full Text Available Jennifer M Stevenson,1,2 Josceline L Williams,1,2 Thomas G Burnham,2 A Toby Prevost,3 Rebekah Schiff,4 S David Erskine,2 J Graham Davies1 1Institute of Pharmaceutical Sciences, King’s College London, London, UK; 2Pharmacy Department, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Primary Care and Public Health Sciences, King’s College London, London, UK; 4Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust, London, UK Abstract: Adverse drug reaction (ADR risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012 to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with

  13. [Development and Validation of Estimate Equations for Adverse Drug Reactions Using Risk Factors and Subjective Symptoms].

    Science.gov (United States)

    Suzuki, Ryohei; Ohtsu, Fumiko; Goto, Nobuyuki

    2015-01-01

      The purpose of this study was to develop and validate estimate equations for preventing adverse drug reactions (ADRs). We conducted five case-control studies to identify individual risk factors and subjective symptoms associated with the following five ADRs: drug-induced ischemic heart disease; renal damage; muscle disorder; interstitial pneumonia; and leucopenia. We performed logistic regression analysis and obtained eight regression equations for each ADR. We converted these to ADR estimate equations for predicting the likelihood of ADRs. We randomly selected 50 cases with non-individual ADRs from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65000 case reports of ADRs, and assigned these cases to a validation case group. We then calculated the predictive probability for 50 cases using the eight estimate equations for each ADR. The highest probability for each ADR was set as the probability of each ADR. If the probability was over 50%, the case was interpreted as ADR-positive. We calculated and evaluated the sensitivity, specificity, and positive likelihood ratio of this system. Sensitivity of the estimate equations for muscle disorder and interstitial pneumonia were ≥90%. Specificity and positive likelihood ratios of estimate equations for renal damage, interstitial pneumonia and leucopenia were ≥80% and ≥5, respectively. Our estimate equations thus showed high validity, and are therefore helpful for the prevention or early detection of ADRs.

  14. Organophosphate pesticides exposure among farmworkers: pathways and risk of adverse health effects.

    Science.gov (United States)

    Suratman, Suratman; Edwards, John William; Babina, Kateryna

    2015-01-01

    Organophosphate (OP) compounds are the most widely used pesticides with more than 100 OP compounds in use around the world. The high-intensity use of OP pesticides contributes to morbidity and mortality in farmworkers and their families through acute or chronic pesticides-related illnesses. Many factors contributing to adverse health effects have been investigated by researchers to determine pathways of OP-pesticide exposure among farmers in developed and developing countries. Factors like wind/agricultural pesticide drift, mixing and spraying pesticides, use of personal protective equipment (PPE), knowledge, perceptions, washing hands, taking a shower, wearing contaminated clothes, eating, drinking, smoking, and hot weather are common in both groups of countries. Factors including low socioeconomic status areas, workplace conditions, duration of exposure, pesticide safety training, frequency of applying pesticides, spraying against the wind, and reuse of pesticide containers for storage are specific contributors in developing countries, whereas housing conditions, social contextual factors, and mechanical equipment were specific pathways in developed countries. This paper compares existing research in environmental and behavioural exposure modifying factors and biological monitoring between developing and developed countries. The main objective of this review is to explore the current depth of understanding of exposure pathways and factors increasing the risk of exposure potentially leading to adverse health effects specific to each group of countries.

  15. Risk of adverse pregnancy outcomes in women with periodontal disease and the effectiveness of interventions in decreasing this risk: Protocol for systematic overview of systematic reviews

    NARCIS (Netherlands)

    S.F. Vanterpool (Sizzle); K. Tomsin (Kathleen); L. Reyes (Leticia); L.J.I. Zimmermann (Luc); B.W. Kramer (Boris); J.V. Been (Jasper V.)

    2016-01-01

    textabstractBackground: Periodontal disease is an inflammatory disease of the tissues supporting the teeth. Women who have periodontal disease while pregnant may be at risk of adverse pregnancy outcomes. Although the association between periodontal disease and adverse pregnancy outcomes has been add

  16. Risk factors for treatment-related adverse events in cancer-bearing dogs receiving piroxicam.

    Science.gov (United States)

    Eichstadt, L R; Moore, G E; Childress, M O

    2016-10-06

    Piroxicam has antitumour effects in dogs with cancer, although side effects may limit its use. The purpose of this study was to retrospectively identify factors predisposing cancer-bearing dogs to adverse events (AEs) following piroxicam therapy. Medical records of dogs presented to the Purdue Veterinary Teaching Hospital between 2005 and 2015 were reviewed, and 137 dogs met the criteria for study inclusion. Toxic effects of piroxicam in these dogs were graded according to an established system. Multivariate logistic regression was used to estimate the extent to which certain factors affected the risk for AEs. Age [odds ratio (OR) 1.250, P = 0.009; 95% confidence interval (CI) 1.057-1.479] and concurrent use of gastroprotectant medications (OR 2.612, P = 0.025; 95% CI 1.127-6.056) significantly increased the risk for gastrointestinal AEs. The results of this study may help inform the risk versus benefit calculation for clinicians considering the use of piroxicam to treat dogs with cancer.

  17. Adverse outcome pathway and risks of anticoagulant rodenticides to predatory wildlife

    Science.gov (United States)

    Rattner, Barnett A.; Lazarus, Rebecca; Elliott, John E.; Shore, Richard F.; van den Brink, Nico

    2014-01-01

    Despite a long history of successful use, routine application of some anticoagulant rodenticides (ARs) may be at a crossroad due to new regulatory guidelines intended to mitigate risk. An adverse outcome pathway for ARs was developed to identify information gaps and end points to assess the effectiveness of regulations. This framework describes chemical properties of ARs, established macromolecular interactions by inhibition of vitamin K epoxide reductase, cellular responses including altered clotting factor processing and coagulopathy, organ level effects such as hemorrhage, organism responses with linkages to reduced fitness and mortality, and potential consequences to predator populations. Risk assessments have led to restrictions affecting use of some second-generation ARs (SGARs) in North America. While the European regulatory community highlighted significant or unacceptable risk of ARs to nontarget wildlife, use of SGARs in most EU member states remains authorized due to public health concerns and the absence of safe alternatives. For purposes of conservation and restoration of island habitats, SGARs remain a mainstay for eradication of invasive species. There are significant data gaps related to exposure pathways, comparative species sensitivity, consequences of sublethal effects, potential hazards of greater AR residues in genetically resistant prey, effects of low-level exposure to multiple rodenticides, and quantitative data on the magnitude of nontarget wildlife mortality.

  18. Risk prediction models for major adverse cardiac event (MACE) following percutaneous coronary intervention (PCI): A review

    Science.gov (United States)

    Manan, Norhafizah A.; Abidin, Basir

    2015-02-01

    Five percent of patients who went through Percutaneous Coronary Intervention (PCI) experienced Major Adverse Cardiac Events (MACE) after PCI procedure. Risk prediction of MACE following a PCI procedure therefore is helpful. This work describes a review of such prediction models currently in use. Literature search was done on PubMed and SCOPUS database. Thirty literatures were found but only 4 studies were chosen based on the data used, design, and outcome of the study. Particular emphasis was given and commented on the study design, population, sample size, modeling method, predictors, outcomes, discrimination and calibration of the model. All the models had acceptable discrimination ability (C-statistics >0.7) and good calibration (Hosmer-Lameshow P-value >0.05). Most common model used was multivariate logistic regression and most popular predictor was age.

  19. Use of clopidogrel and calcium channel blockers and risk of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Schmidt, Morten; Johansen, Martin B; Robertson, Douglas J

    2012-01-01

    Eur J Clin Invest 2011 ABSTRACT: Background  The CYP3A4 inhibition by calcium channel blockers (CCBs) may attenuate the effectiveness of clopidogrel. Using time-varying drug exposure ascertainment, we examined whether CCB use modified the association between clopidogrel use and major adverse......-month follow-up, we tracked the use of clopidogrel and CCBs and the rate of MACE (composite of myocardial infarction, ischaemic stroke, stent thrombosis, target lesion revascularization, or cardiac death). We used Cox regression to compute hazard ratios, controlling for potential confounders. Results......  Overall, the 12-month risk for MACE was 14·5%. The rate was 130 per 1000 person years for concomitant clopidogrel and CCB use, 106 for clopidogrel without CCB use, 213 for CCB without clopidogrel use, and 248 for no use of either drug. The adjusted hazard ratio for MACE comparing clopidogrel use...

  20. Pharmacokinetic drug interaction profile of omeprazole with adverse consequences and clinical risk management

    Directory of Open Access Journals (Sweden)

    Li W

    2013-05-01

    Full Text Available Wei Li,1 Su Zeng,2 Lu-Shan Yu,2 Quan Zhou31Division of Medical Affairs, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 2Department of Pharmaceutical Analysis and Drug Metabolism, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaBackground: Omeprazole, a proton pump inhibitor (PPI, is widely used for the treatment of dyspepsia, peptic ulcer, gastroesophageal reflux disease, and functional dyspepsia. Polypharmacy is common in patients receiving omeprazole. Drug toxicity and treatment failure resulting from inappropriate combination therapy with omeprazole have been reported sporadically. Systematic review has not been available to address the pharmacokinetic drug-drug interaction (DDI profile of omeprazole with adverse consequences, the factors determining the degree of DDI between omeprazole and comedication, and the corresponding clinical risk management.Methods: Literature was identified by performing a PubMed search covering the period from January 1988 to March 2013. The full text of each article was critically reviewed, and data interpretation was performed.Results: Omeprazole has actual adverse influences on the pharmacokinetics of medications such as diazepam, carbamazepine, clozapine, indinavir, nelfinavir, atazanavir, rilpivirine, methotrexate, tacrolimus, mycophenolate mofetil, clopidogrel, digoxin, itraconazole, posaconazole, and oral iron supplementation. Meanwhile, low efficacy of omeprazole treatment would be anticipated, as omeprazole elimination could be significantly induced by comedicated efavirenz and herb medicines such as St John's wort, Ginkgo biloba, and yin zhi huang. The mechanism for DDI involves induction or inhibition of cytochrome P450, inhibition of P-glycoprotein or breast

  1. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions.

    Science.gov (United States)

    Font, Sarah A; Maguire-Jack, Kathryn

    2016-01-01

    Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks-depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions-marriage, divorce and separation, educational attainment, income and insurance status-mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact.

  2. Paraoxonase 1 polymorphism and prenatal pesticide exposure associated with adverse cardiovascular risk profiles at school age.

    Directory of Open Access Journals (Sweden)

    Helle R Andersen

    Full Text Available BACKGROUND: Prenatal environmental factors might influence the risk of developing cardiovascular disease later in life. The HDL-associated enzyme paraoxonase 1 (PON1 has anti-oxidative functions that may protect against atherosclerosis. It also hydrolyzes many substrates, including organophosphate pesticides. A common polymorphism, PON1 Q192R, affects both properties, but a potential interaction between PON1 genotype and pesticide exposure on cardiovascular risk factors has not been investigated. We explored if the PON1 Q192R genotype affects cardiovascular risk factors in school-age children prenatally exposed to pesticides. METHODS: Pregnant greenhouse-workers were categorized as high, medium, or not exposed to pesticides. Their children underwent a standardized examination at age 6-to-11 years, where blood pressure, skin folds, and other anthropometric parameters were measured. PON1-genotype was determined for 141 children (88 pesticide exposed and 53 unexposed. Serum was analyzed for insulin-like growth factor I (IGF-I, insulin-like growth factor binding protein 3 (IGFBP3, insulin and leptin. Body fat percentage was calculated from skin fold thicknesses. BMI results were converted to age and sex specific Z-scores. RESULTS: Prenatally pesticide exposed children carrying the PON1 192R-allele had higher abdominal circumference, body fat content, BMI Z-scores, blood pressure, and serum concentrations of leptin and IGF-I at school age than unexposed children. The effects were related to the prenatal exposure level. For children with the PON1 192QQ genotype, none of the variables was affected by prenatal pesticide exposure. CONCLUSION: Our results indicate a gene-environment interaction between prenatal pesticide exposure and the PON1 gene. Only exposed children with the R-allele developed adverse cardiovascular risk profiles thought to be associated with the R-allele.

  3. Paraoxonase 1 Polymorphism and Prenatal Pesticide Exposure Associated with Adverse Cardiovascular Risk Profiles at School Age

    Science.gov (United States)

    Andersen, Helle R.; Wohlfahrt-Veje, Christine; Dalgård, Christine; Christiansen, Lene; Main, Katharina M.; Nellemann, Christine; Murata, Katsuyuki; Jensen, Tina K.; Skakkebæk, Niels E.; Grandjean, Philippe

    2012-01-01

    Background Prenatal environmental factors might influence the risk of developing cardiovascular disease later in life. The HDL-associated enzyme paraoxonase 1 (PON1) has anti-oxidative functions that may protect against atherosclerosis. It also hydrolyzes many substrates, including organophosphate pesticides. A common polymorphism, PON1 Q192R, affects both properties, but a potential interaction between PON1 genotype and pesticide exposure on cardiovascular risk factors has not been investigated. We explored if the PON1 Q192R genotype affects cardiovascular risk factors in school-age children prenatally exposed to pesticides. Methods Pregnant greenhouse-workers were categorized as high, medium, or not exposed to pesticides. Their children underwent a standardized examination at age 6-to-11 years, where blood pressure, skin folds, and other anthropometric parameters were measured. PON1-genotype was determined for 141 children (88 pesticide exposed and 53 unexposed). Serum was analyzed for insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP3), insulin and leptin. Body fat percentage was calculated from skin fold thicknesses. BMI results were converted to age and sex specific Z-scores. Results Prenatally pesticide exposed children carrying the PON1 192R-allele had higher abdominal circumference, body fat content, BMI Z-scores, blood pressure, and serum concentrations of leptin and IGF-I at school age than unexposed children. The effects were related to the prenatal exposure level. For children with the PON1 192QQ genotype, none of the variables was affected by prenatal pesticide exposure. Conclusion Our results indicate a gene-environment interaction between prenatal pesticide exposure and the PON1 gene. Only exposed children with the R-allele developed adverse cardiovascular risk profiles thought to be associated with the R-allele. PMID:22615820

  4. UTERINE ARTERY DOPPLER STUDY FOR PREDICTION OF ADVERSE OUTCOME IN HIGH RISK PREGNANCY

    Directory of Open Access Journals (Sweden)

    Gunjan

    2015-07-01

    Full Text Available AIM : To detect abnormal waveforms in uterine artery in pregnancies at risk between 20 to 24 weeks of gestation and to measure Resistance index (RI and systolic/diastolic ratio(S/D of these waveforms in study population and to study correlation of Doppler dat a with adverse pregnancy outcome. METHODS : This is a prospective study included Doppler analysis of uterine artery waveforms in 107 normotensive women with singleton pregnancy between 20 to24 weeks of period of gestation who were considered to be at increa sed risk of developing pregnancy complications. Women with Multiple gestation, with congenital anomaly of fetus, chronic hypertension, renal disease, cardiac disease, Diabetes Mellitus were excluded from the study. Bilateral uterine artery Doppler was done and Parameters studied were S/D ratio and RI in uterine artery. Early diastolic notch in uterine artery was watched for. The flow velocity waveforms considered abnormal if there was an early diastolic notch in uterine artery in either right or left uterin e artery was watched for abnormal pregnancy outcomes considered are Gestational hypertension, Pre - eclampsia IUGR, Abruptio placentae, IUD and preterm deliveries. RESULTS : minimum women were aged 21 – 25 year with minimum of 18 years and maximum of 36 years, 28% were primigravidae while 72% were multigravidae mean gestational age of which scan was done was 22 wks 1 day (20 - 24 minimum gestational age at time of delivery was 28 wks of gestation 70% women were delivered vaginally and 30% LSCS. 7% women developed Gestational Hypertension, 5% developed Preeclampsia, 8% neonates with IUGR, 3% developed Placental Abruption while 4% had IUD and 8% had Preterm deliveries. CONCLUSION : Abnormal uterine artery Doppler studies in second trimester have been associated with subsequent adverse pregnancy out comes including Preeclampsia IUGR and perinatal mortality. Doppler velocimetry is a primary tool for fetomaternal surveillance in high

  5. Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis

    Science.gov (United States)

    Simmonds, Mark; Bryant, Maria; Sheldon, Trevor A; Tuffnell, Derek; Golder, Su; Dunne, Fidelma; Lawlor, Debbie A

    2016-01-01

    Objectives To assess the association between maternal glucose concentrations and adverse perinatal outcomes in women without gestational or existing diabetes and to determine whether clear thresholds for identifying women at risk of perinatal outcomes can be identified. Design Systematic review and meta-analysis of prospective cohort studies and control arms of randomised trials. Data sources Databases including Medline and Embase were searched up to October 2014 and combined with individual participant data from two additional birth cohorts. Eligibility criteria for selecting studies Studies including pregnant women with oral glucose tolerance (OGTT) or challenge (OGCT) test results, with data on at least one adverse perinatal outcome. Appraisal and data extraction Glucose test results were extracted for OGCT (50 g) and OGTT (75 g and 100 g) at fasting and one and two hour post-load timings. Data were extracted on induction of labour; caesarean and instrumental delivery; pregnancy induced hypertension; pre-eclampsia; macrosomia; large for gestational age; preterm birth; birth injury; and neonatal hypoglycaemia. Risk of bias was assessed with a modified version of the critical appraisal skills programme and quality in prognostic studies tools. Results 25 reports from 23 published studies and two individual participant data cohorts were included, with up to 207 172 women (numbers varied by the test and outcome analysed in the meta-analyses). Overall most studies were judged as having a low risk of bias. There were positive linear associations with caesarean section, induction of labour, large for gestational age, macrosomia, and shoulder dystocia for all glucose exposures across the distribution of glucose concentrations. There was no clear evidence of a threshold effect. In general, associations were stronger for fasting concentration than for post-load concentration. For example, the odds ratios for large for gestational age per 1 mmol/L increase of

  6. Relation between change in blood pressure in acute stroke and risk of early adverse events and poor outcome

    DEFF Research Database (Denmark)

    Sandset, Else C; Murray, Gordon D; Bath, Philip M W;

    2012-01-01

    The Scandinavian Candesartan Acute Stroke Trial (SCAST) found no benefits of candesartan in acute stroke. In the present analysis we aim to investigate the effect of change in blood pressure during the first 2 days of stroke on the risk of early adverse events and poor outcome.......The Scandinavian Candesartan Acute Stroke Trial (SCAST) found no benefits of candesartan in acute stroke. In the present analysis we aim to investigate the effect of change in blood pressure during the first 2 days of stroke on the risk of early adverse events and poor outcome....

  7. Cardioversion and Risk of Adverse Events with Dabigatran versus Warfarin-A Nationwide Cohort Study.

    Directory of Open Access Journals (Sweden)

    Jannik Langtved Pallisgaard

    Full Text Available Cardioversion can rapidly and effectively restore sinus rhythm in patients with persistent atrial fibrillation. Since 2011 dabigatran has been available as an alternative to warfarin to prevent thromboembolic events in patients with non-valvular atrial fibrillation undergoing cardioversion. We studied time to cardioversion, risk of adverse events, and risk of readmission with atrial fibrillation after cardioversion according to anticoagulation therapy.Through the nationwide Danish registries we included 1,230 oral anticoagulation naïve patients with first time non-valvular atrial fibrillation and first time cardioversion from 2011 to 2012; 37% in the dabigatran group (n = 456, and 63% in the warfarin group (n = 774. Median time to cardioversion was 4.0 (interquartile range [IQR] 2.9 to 6.5 and 6.9 (IQR 3.9 to 12.1 weeks in the dabigatran and warfarin groups respectively, and the adjusted odds ratio of cardioversion within the first 4 weeks was 2.3 (95% confidence interval [CI] 1.7 to 3.1 in favor of dabigatran. The cumulative incidence of composite endpoint of stroke, bleeding or death were 2.0% and 1.0% at 30 weeks in the warfarin and dabigatran groups respectively, with an adjusted hazard ratio of 1.33 (95% CI 0.33 to 5.42. Cumulative incidence of readmission with atrial fibrillation after 30 weeks were 9% and 11% in the warfarin and dabigatran groups, respectively, and an adjusted hazard ratio of 0.66 (95% CI 0.41 to 1.08.Anticoagulation treatment with dabigatran allows shorter time to cardioversion for atrial fibrillation than warfarin, and appears to be an effective and safe alternative treatment strategy to warfarin.

  8. Missing paternal demographics: A novel indicator for identifying high risk population of adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Wen Shi

    2004-11-01

    Full Text Available Abstract Background One of every 6 United Status birth certificates contains no information on fathers. There might be important differences in the pregnancy outcomes between mothers with versus those without partner information. The object of this study was to assess whether and to what extent outcomes in pregnant women who did not have partner information differ from those who had. Methods We carried out a population-based retrospective cohort study based on the registry data in the United States for the period of 1995–1997, which was a matched multiple birth file (only twins were included in the current analysis. We divided the study subjects into three groups according to the availability of partner information: available, partly missing, and totally missing. We compared the distribution of maternal characteristics, maternal morbidity, labor and delivery complications, obstetric interventions, preterm birth, fetal growth restriction, low birth weight, congenital anomalies, fetal death, neonatal death, post-neonatal death, and neonatal morbidity among three study groups. Results There were 304466 twins included in our study. Mothers whose partner's information was partly missing and (especially totally missing tended to be younger, of black race, unmarried, with less education, smoking cigarette during pregnancy, and with inadequate prenatal care. The rates of preterm birth, fetal growth restriction, low birth weight, Apgar score Conclusions Mothers whose partner's information was partly and (especially totally missing are at higher risk of adverse pregnant outcomes, and clinicians and public health workers should be alerted to this important social factor.

  9. Parental Alcoholism, Adverse Childhood Experiences, and Later Risk of Personal Alcohol Abuse among Chinese Medical Students

    Institute of Scientific and Technical Information of China (English)

    QIN XIAO; MA-XIA DONG; JIE YAO; WEN-XIAN LI; DONG-QING YE

    2008-01-01

    Objective To determine the status of adverse childhood experiences (ACEs) and the association of multiple ACEs with both parental alcoholism and later personal alcohol abuse among Chinese medical students with a view of improving adolescent health and reducing alcohol abuse among them. Methods In this cross-sectional study, 2073 Chinese medical students completed a survey on ten categories of ACEs in Anhui province of China. The association of parental alcoholism with ACEs and personal lcohol abuse was assessed by logistic regression analyses. Results The adjusted odds ratio (OR) for each category of ACEs in the subjects whose parents (either fathers or mothers or oth) had alcohol abuse was 2 to 14 times higher than that inthose with parental alcoholism (P<0.05). Subjects with i-parental alcoholism had the highest likelihood of ACEs. Compared with the subjects without ACEs, the risk of personal alcohol abuse was increased by 2-4-folds in the subjects with ACEs, irrespective of parental alcoholism (P<0.05). The total number of ACEs (ACE score) had a graded relationship to 4 categories of personal alcohol abuse with or without parental alcoholism. The prevalence of personal alcohol abuse among the subjects with parental alcoholism was higher, which was ndependent of ACE scores. Conclusion The prevalence of ACEs is generally serious in China. Efforts should be made to prevent and treat children with ACEs and subsequently to reduce alcohol abuse and later problems.

  10. Adverse effects of levamisole in cocaine users: a review and risk assessment.

    Science.gov (United States)

    Brunt, Tibor Markus; van den Berg, Jorrit; Pennings, Ed; Venhuis, Bastiaan

    2017-03-17

    The immunomodulatory adjuvant and antihelminth levamisole is increasingly used as an adulterant in cocaine worldwide. An accumulating body of clinical and toxicological literature has appeared since 2010 describing neutropenia, agranulocytosis, leukoencephalopathy and vasculitis in cases associated with levamisole-adulterated cocaine. Mostly, neutropenia and agranulocytosis were reported, characterized by a decimation of neutrophils. A large proportion of cases also involved vasculopathy, characterized by pronounced black and purple skin purpura with cutaneous necrosis. Females are more susceptible for both agranulocytosis and vasculitis. Another complication reported with levamisole-adulterated cocaine is leukoencephalopathy, a disabling and potentially fatal neurological disorder caused by cerebral demyelination. In this review, all adverse effects associated with therapeutic levamisole and levamisole-adulterated cocaine are described. In addition, this review provides an update of the pharmacology of levamisole, its metabolism, including toxic metabolites and metabolites that are relevant for levamisole's addition to cocaine. Special emphasis is put on the immunopathology and the dose-effect relationship of chronic levamisole exposure. Finally, a risk assessment is provided based on the current level of levamisole adulteration in street cocaine, the dose range calculated per gram and the pattern of chronic exposure in heavy or dependent users.

  11. Association of Cardiometabolic Multimorbidity With Mortality

    NARCIS (Netherlands)

    Angelantonio, Di Emanuele; Kaptoge, Stephen; Wormser, David; Willeit, Peter; Butterworth, Adam S.; Bansal, Narinder; O’Keeffe, Linda M.; Gao, Pei; Wood, Angela M.; Burgess, Stephen; Freitag, Daniel F.; Pennells, Lisa; Peters, Sanne A.; Hart, Carole L.; Håheim, Lise Lund; Gillum, Richard F.; Nordestgaard, Børge G.; Psaty, Bruce M.; Yeap, Bu B.; Knuiman, Matthew W.; Nietert, Paul J.; Kauhanen, Jussi; Salonen, Jukka T.; Kuller, Lewis H.; Simons, Leon A.; Schouw, van der Yvonne T.; Barrett-Connor, Elizabeth; Selmer, Randi; Crespo, Carlos J.; Rodriguez, Beatriz; Verschuren, Monique W.M.; Salomaa, Veikko; Svärdsudd, Kurt; Harst, Van Der Pim; Björkelund, Cecilia; Wilhelmsen, Lars; Wallace, Robert B.; Brenner, Hermann; Amouyel, Philippe; Barr, Elizabeth L.M.; Iso, Hiroyasu; Onat, Altan; Trevisan, Maurizio; agostino, D' Ralph B.; Cooper, Cyrus; Kavousi, Maryam; Welin, Lennart; Roussel, Ronan; Hu, Frank B.; Sato, Shinichi; Davidson, Karina W.; Howard, Barbara V.; Leening, Maarten J.G.; Rosengren, Annika; Dörr, Marcus; Deeg, Dorly J.H.; Kiechl, Stefan; Stehouwer, Coen D.A.; Nissinen, Aulikki; Giampaoli, Simona; Donfrancesco, Chiara; Kromhout, Daan; Price, Jackie F.; Peters, Annette; Meade, Tom W.; Casiglia, Edoardo; Lawlor, Debbie A.; Gallacher, John; Nagel, Dorothea; Franco, Oscar H.; Assmann, Gerd; Dagenais, Gilles R.; Jukema, Wouter J.; Sundström, Johan; Woodward, Mark; Brunner, Eric J.; Khaw, Kay-Tee; Wareham, Nicholas J.; Whitsel, Eric A.; Njølstad, Inger; Hedblad, Bo; Wassertheil-Smoller, Sylvia; Engström, Gunnar; Rosamond, Wayne D.; Selvin, Elizabeth; Sattar, Naveed; Thompson, Simon G.; Danesh, John

    2015-01-01

    Importance The prevalence of cardiometabolic multimorbidity is increasing.

    Objective To estimate reductions in life expectancy associated with cardiometabolic multimorbidity.

    Design, Setting, and Participants Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calcul

  12. Radiobiological risk estimates of adverse events and secondary cancer for proton and photon radiation therapy of pediatric medulloblastoma

    DEFF Research Database (Denmark)

    Brodin, N Patrik; Munck af Rosenschöld, Per Martin; Aznar, Marianne C;

    2011-01-01

    The aim of this model study was to estimate and compare the risk of radiation-induced adverse late effects in pediatric patients with medulloblastoma (MB) treated with either three-dimensional conformal radiotherapy (3D CRT), inversely-optimized arc therapy (RapidArc(®) (RA)) or spot-scanned inte...

  13. Major risk factors of maternal adverse outcome in women with two or more previous cesarean sections

    Directory of Open Access Journals (Sweden)

    Egić Amira

    2016-01-01

    Full Text Available Background/Aim. Maternal morbidity is defined as any condition that is attributed to or aggravated by pregnancy and childbirth that has a negative impact on the woman's wellbeing. In recent years, a growing trend of cesarean section rates can be seen throughout the world. The aim of this study was to assess factors that might have major impact on maternal adverse outcome in women with two or more previous cesarean sections. Methods. This retrospective study included women with single term pregnancy after two or more cesarean deliveries in a 10-year period (2004−2013 in the University Clinic “Narodni front” in Belgrade, Serbia. Medical records were reviewed for clinical data for maternal intraoperative and early postoperative complications regarding gestational age at delivery, the number of previous cesarean sections and mode of surgery (elective or emergency. Results. A total of 551 patients were included in the study. At 37 completed weeks delivered 14.1%, at 38 delivered 45.2% and at 39 completed weeks 40.7% patients. Women younger than 35 years more often delivered after 39 completed weeks compared with those over 35 years (69.2% vs 30.8%, p < 0.05. The overall rate of maternal complications in the study group was 16.5% with no statistical difference by gestational age at delivery. The overall rate of maternal adverse outcome was significantly less in the patients with three as compared with those with four or more cesareans (10.4% vs 66.7%, p < 0.05. There was a statistically significant difference between these groups of women regarding complications: scar dehiscence, the presence of adhesions, blood transfusion and admission in intensive care unit. Elective cesarean delivery was with less maternal complications compared with emergency cesarean deliveries (12.9% vs 27.3%, p < 0.05. Conclusion. Termination of pregnancy before completed 39 weeks does not decrease maternal morbidity. The major impact on maternal complications has the

  14. 'Check it out!' Decision-making of vulnerable groups about participation in a two-stage cardiometabolic health check: a qualitative study

    NARCIS (Netherlands)

    Groenenberg, I.; Crone, M.R.; Dijk, S. van; Gebhardt, W.A.; Meftah, J. Ben; Middelkoop, B.J.C.; Stiggelbout, A.M.; Assendelft, W.J.

    2015-01-01

    OBJECTIVE: Exploring determinants influencing vulnerable groups regarding (non-) participation in the Dutch two-stage cardiometabolic health check, comprising a health risk assessment (HRA) and prevention consultations (PCs) for high-risk individuals. METHODS: Qualitative study comprising 21 focus g

  15. Radiobiological risk estimates of adverse events and secondary cancer for proton and photon radiation therapy of pediatric medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Brodin, N. Patrik (Radiation Medicine Research Center, Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen (Denmark); Niels Bohr Inst., Faculty of Sciences, Univ. of Copenhagen (Denmark)), e-mail: brodin.patrik@gmail.com; Munck af Rosenschoeld, Per; Aznar, Marianne C.; Vogelius, Ivan R. (Radiation Medicine Research Center, Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen (Denmark)); Kiil-Berthelsen, Anne (Radiation Medicine Research Center, Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen (Denmark); Dept. of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Univ. of Copenhagen (Denmark)); Nilsson, Per; Bjoerk-Eriksson, Thomas (Dept. of Oncology, Skaane Univ. Hospital and Lund Univ., Lund (Sweden)); Lannering, Birgitta (Dept. of Paediatric Oncology, The Queen Silvia Children' s Hospital, Gothenburg (Sweden))

    2011-08-15

    Introduction. The aim of this model study was to estimate and compare the risk of radiation-induced adverse late effects in pediatric patients with medulloblastoma (MB) treated with either three-dimensional conformal radiotherapy (3D CRT), inversely-optimized arc therapy (RapidArc (RA)) or spot-scanned intensity-modulated proton therapy (IMPT). The aim was also to find dose-volume toxicity parameters relevant to children undergoing RT to be used in the inverse planning of RA and IMPT, and to use in the risk estimations. Material and methods. Treatment plans were created for all three techniques on 10 pediatric patients that have been treated with craniospinal irradiation (CSI) at our institution in 2007-2009. Plans were generated for two prescription CSI doses, 23.4 Gy and 36 Gy. Risk estimates were based on childhood cancer survivor data when available and secondary cancer (SC) risks were estimated as a function of age at exposure and attained age according to the organ-equivalent dose (OED) concept. Results. Estimates of SC risk was higher for the RA plans and differentiable from the estimates for 3D CRT at attained ages above 40 years. The risk of developing heart failure, hearing loss, hypothyroidism and xerostomia was highest for the 3D CRT plans. The risks of all adverse effects were estimated as lowest for the IMPT plans, even when including secondary neutron (SN) irradiation with high values of the neutron radiation weighting factors (WR{sub neutron}). Conclusions. When comparing RA and 3D CRT treatment for pediatric MB it is a matter of comparing higher SC risk against higher risks of non-cancer adverse events. Considering time until onset of the different complications is necessary to fully assess patient benefit in such a comparison. The IMPT plans, including SN dose contribution, compared favorably to the photon techniques in terms of all radiobiological risk estimates

  16. Risk of Adverse Health and Performance Effects of Celestial Dust Exposure

    Science.gov (United States)

    Scully, Robert R.; Meyers, Valerie E.

    2015-01-01

    silica (Permissible Exposure Limit [PEL] 0.05 mg/m3) but more toxic than the nuisance dust titanium dioxide (TiO2 [PEL 5.0 mg/m3]). A PEL for episodic exposure to airborne lunar dust during a six-month stay on the lunar surface was established, in consultation with an independent, extramural panel of expert pulmonary toxicologists, at 0.3 mg/m3. The PEL provided for lunar dust is limited to the conditions and exposure specified therefore additional research remains to be accomplished with lunar dust to further address the issues of activation, address other areas of more unique lunar geology (Glotch et al., 2010; Greenhagen et al., 2010), examine potential toxicological effects of inhaled or ingested dust upon other organ systems, such cardiovascular, nervous systems, and examine effects of acute exposure to massive doses of dust such as may occur during off-nominal situations. Work to support the establishment of PELs for Martian dust and dusts of asteroids remains to be accomplished. The literature that describes health effects of exposure to toxic terrestrial dusts provides substantial basis for concern that prolonged exposure to respirable celestial dust could be detrimental to human health. Celestial bodies where a substantial portion of the dust is in the respirable range or where the dusts have large reactive surface areas or contain transition metals or volatile organics, represent greater risks of adverse effects from exposure to the dust. It is possible that in addition to adverse effects to the respiratory system, inhalation and ingestion of celestial dusts could pose risks to other systems

  17. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis

    Science.gov (United States)

    Buitrago-Lopez, Adriana; Sanderson, Jean; Johnson, Laura; Warnakula, Samantha; Wood, Angela; Di Angelantonio, Emanuele

    2011-01-01

    Objective To evaluate the association of chocolate consumption with the risk of developing cardiometabolic disorders. Design Systematic review and meta-analysis of randomised controlled trials and observational studies. Data sources Medline, Embase, Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, reference lists of relevant studies to October 2010, and email contact with authors. Study selection Randomised trials and cohort, case-control, and cross sectional studies carried out in human adults, in which the association between chocolate consumption and the risk of outcomes related to cardiometabolic disorders were reported. Data extraction Data were extracted by two independent investigators, and a consensus was reached with the involvement of a third. The primary outcome was cardiometabolic disorders, including cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome. A meta-analysis assessed the risk of developing cardiometabolic disorders by comparing the highest and lowest level of chocolate consumption. Results From 4576 references seven studies met the inclusion criteria (including 114 009 participants). None of the studies was a randomised trial, six were cohort studies, and one a cross sectional study. Large variation was observed between these seven studies for measurement of chocolate consumption, methods, and outcomes evaluated. Five of the seven studies reported a beneficial association between higher levels of chocolate consumption and the risk of cardiometabolic disorders. The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels. Conclusions Based on observational evidence, levels of chocolate consumption seem to be associated with a substantial reduction in the risk of cardiometabolic disorders. Further experimental

  18. The role of adverse childhood experiences in cardiovascular disease risk: a review with emphasis on plausible mechanisms.

    Science.gov (United States)

    Su, Shaoyong; Jimenez, Marcia P; Roberts, Cole T F; Loucks, Eric B

    2015-10-01

    Childhood adversity, characterized by abuse, neglect, and household dysfunction, is a problem that exerts a significant impact on individuals, families, and society. Growing evidence suggests that adverse childhood experiences (ACEs) are associated with health decline in adulthood, including cardiovascular disease (CVD). In the current review, we first provide an overview of the association between ACEs and CVD risk, with updates on the latest epidemiological evidence. Second, we briefly review plausible pathways by which ACEs could influence CVD risk, including traditional risk factors and novel mechanisms. Finally, we highlight the potential implications of ACEs in clinical and public health. Information gleaned from this review should help physicians and researchers in better understanding potential long-term consequences of ACEs and considering adapting current strategies in treatment or intervention for patients with ACEs.

  19. Dietary Habits and Cardiometabolic Health in Obese Children

    Directory of Open Access Journals (Sweden)

    Luisa Gilardini

    2015-03-01

    Full Text Available Background: Prevalence rates of cardiometabolic risk factors vary largely among overweight children. This study investigated the relationships between dietary habits and cardiometabolic health among obese children living in a city of Northern Italy. Methods: Dietary habits were collected in 448 obese subjects aged 6-18 years, attending an obesity outpatient center in Milan. Anthropometry, blood pressure (BP, lipids, fasting and post-load glucose, and insulin were measured. Physical activity was assessed in adolescents using a questionnaire. Results: Frequency of glucose intolerance, hypertension and dyslipidemia was 0.7%, 13% and 27.2%, respectively. Plausible reporters consumed more animal protein and sodium and less legumes than recommended in nutritional recommendations and adequate amounts of fiber mainly derived from whole grains. Subjects skipping breakfast had unhealthy diets and greater body fatness. After adjustment for confounders, waist/height and fasting glucose were associated with sodium intake (r =0.149 and r = 0.142, respectively; p Conclusions: The cardiometabolic health of obese children improves with vegetable protein and whole grain intake, whereas dysglycemia and adiposity increase with sodium intake.

  20. Family Adversity, Positive Peer Relationships, and Children's Externalizing Behavior: A Longitudinal Perspective on Risk and Resilience

    OpenAIRE

    Criss, Michael M.; Pettit, Gregory S.; Bates, John E.; Dodge, Kenneth A.; Lapp, Amie L.

    2002-01-01

    Peer acceptance and friendships were examined as moderators in the link between family adversity and child externalizing behavioral problems. Data on family adversity (i.e., ecological disadvantage, violent marital conflict, and harsh discipline) and child temperament and social information processing were collected during home visits from 585 families with 5-year-old children. Children's peer acceptance, friendship, and friends' aggressiveness were assessed with sociometric methods in kinder...

  1. Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies

    Directory of Open Access Journals (Sweden)

    Zahra Bahadoran

    2015-12-01

    Full Text Available Background: There are growing concern globally regarding the alarming trend of fast food consump­tion and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa­bolic risk factors. Methods: Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, Scopus databases and Google scholar with related key words including "fast foods", "processed foods", "obesity", "overweight", "insulin resistance", "diabetes", "cardiovascular disease", "metabolic syndrome", "dyslipidemia" and "hypertension". Results: Fast food consumption and out-of-home eating behavior is a main risk factor for lower diet quality, higher calorie and fat intake and lower micronutrients density of diet. Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress. Higher fast food consumption also increases the risk of developmental diabetes, metabolic syndrome and cardiovascular disease. Conclusion: This review provides further evidence warning us against the irreparable effects of fast food consumption on public health especially the increasing global burden of obesity and cardiovascu­lar diseases.

  2. An analysis of risk factors and adverse events in ambulatory surgery

    Directory of Open Access Journals (Sweden)

    Kent C

    2014-06-01

    Full Text Available Christopher Kent, Julia Metzner, Laurent BollagDepartment of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USAAbstract: Care for patients undergoing ambulatory procedures is a broad and expanding area of anesthetic and surgical practice. There were over 35 million ambulatory surgical procedures performed in the US in 2006. Ambulatory procedures are diverse in both type and setting, as they span the range from biopsies performed under local anesthesia to intra-abdominal laparoscopic procedures, and are performed in offices, freestanding ambulatory surgery centers, and ambulatory units of hospitals. The information on adverse events from these varied settings comes largely from retrospective reviews of sources, such as quality-assurance databases and closed malpractice claims. Very few if any ambulatory procedures are emergent, and in comparison to the inpatient population, ambulatory surgical patients are generally healthier. They are still however subject to most of the same types of adverse events as patients undergoing inpatient surgery, albeit at a lower frequency. The only adverse events that could be considered to be unique to ambulatory surgery are those that arise out of the circumstance of discharging a postoperative patient to an environment lacking skilled nursing care. There is limited information on these types of discharge-related adverse events, but the data that are available are reviewed in an attempt to assist the practitioner in patient selection and discharge decision making. Among ambulatory surgical patients, particularly those undergoing screening or cosmetic procedures, expectations from all parties involved are high, and a definition of adverse events can be expanded to include any occurrence that interrupts the rapid throughput of patients or interferes with early discharge and optimal patient satisfaction. This review covers all types of adverse events, but focuses on the more

  3. Torsadogenic risk of antipsychotics: combining adverse event reports with drug utilization data across Europe.

    Directory of Open Access Journals (Sweden)

    Emanuel Raschi

    Full Text Available BACKGROUND: Antipsychotics (APs have been associated with risk of torsade de Pointes (TdP. This has important public health implications. Therefore, (a we exploited the public FDA Adverse Event Reporting System (FAERS to characterize their torsadogenic profile; (b we collected drug utilization data from 12 European Countries to assess the population exposure over the 2005-2010 period. METHODS: FAERS data (2004-2010 were analyzed based on the following criteria: (1 ≥ 4 cases of TdP/QT abnormalities; (2 Significant Reporting Odds Ratio, ROR [Lower Limit of the 95% confidence interval>1], for TdP/QT abnormalities, adjusted and stratified (Arizona CERT drugs as effect modifiers; (3 ≥ 4 cases of ventricular arrhythmia/sudden cardiac death (VA/SCD; (4 Significant ROR for VA/SCD; (5 Significant ROR, combined by aggregating TdP/QT abnormalities with VA and SCD. Torsadogenic signals were characterized in terms of signal strength: from Group A (very strong torsadogenic signal: all criteria fulfilled to group E (unclear/uncertain signal: only 2/5 criteria. Consumption data were retrieved from 12 European Countries and expressed as defined daily doses per 1,000 inhabitants per day (DID. RESULTS: Thirty-five antipsychotics met at least one criterium: 9 agents were classified in Group A (amisulpride, chlorpromazine, clozapine, cyamemazine, haloperidol, olanzapine, quetiapine, risperidone, ziprasidone. In 2010, the overall exposure to antipsychotics varied from 5.94 DID (Estonia to 13.99 (France, 2009. Considerable increment of Group A agents was found in several Countries (+3.47 in France: the exposure to olanzapine increased across all Countries (+1.84 in France and peaked 2.96 in Norway; cyamemazine was typically used only in France (2.81 in 2009. Among Group B drugs, levomepromazine peaked 3.78 (Serbia; fluphenazine 1.61 (Slovenia. CONCLUSIONS: This parallel approach through spontaneous reporting and drug utilization analyses highlighted drug- and

  4. EFFECT OF PHYSICAL ACTIVITY ON CARDIOMETABOLIC MARKERS IN ADOLESCENTS: SYSTEMATIC REVIEW

    Directory of Open Access Journals (Sweden)

    Valter Paulo Neves Miranda

    Full Text Available ABSTRACT The accumulation of body fat is a major risk factor for cardiometabolic diseases. Obesity can be considered a chronic systemic inflammatory disease in adults and younger people. The control of subclinical inflammation process through the practice of physical activity (PA can mitigate the effects of risk factors that trigger atherosclerosis that worsens with advancing age. The objective of this study was to conduct a systematic review of the influence of physical activity and/or exercise on cardiometabolic markers and othrer risk factors of cardiovascular disease in adolescents. A systematic review was conducted in electronic databases Scopus, Pubmed, Conchrane Collection and SciELO. The terms used in the search were "cardiovascular diseases AND inflammation AND adolescents AND physical activity OR exercise". A total of 24 original articles were evaluated, being 14 longitudinal and 10 cross-sectional studies. Overall, 16 articles (66.66% showed that PA, exercise and/or sedentary behavior may have influenced or have been related to the concentration of cardiometabolic markers. All studies that examined lifestyle changes showed reduction of cardiometabolic markers. Some limitations were observed: reduced samples, lack of dietary prescription, evaluation and control of volume and intensity of exercise. Most of the studies analyzed showed that the physical activity could influence and decrease the concentrations of cardiometabolic markers in adolescents. However, studies with representative sample size and precise control in assessing the level of physical activity and/or exercise are required to determine accurately the changes that the more active lifestyle can bring on inflammatory process, as well as other risk factors for cardiometabolic diseases in adolescents.

  5. Circulating Angiogenic Factors and the Risk of Adverse Outcomes among Haitian Women with Preeclampsia.

    Directory of Open Access Journals (Sweden)

    Melissa I March

    Full Text Available Angiogenic factors are strongly associated with adverse maternal and fetal outcomes among women with preterm preeclampsia (PE in developed countries. We evaluated the role of angiogenic factors and their relationship to adverse outcomes among Haitian women with PE.We measured plasma antiangiogenic soluble fms-like tyrosine kinase 1 (sFlt1 and proangiogenic placental growth factor (PlGF levels in women with PE (n=35 compared to controls with no hypertensive disorders (NHD (n=43 among subjects with singleton pregnancies that delivered at Hospital Albert Schweitzer (HAS in Haiti. We divided the preeclamptic women into two groups, early onset (≤ 34 weeks and late onset (>34 weeks and examined relationships between sFlt1/PlGF ratios on admission and adverse outcomes (abruption, respiratory complications, stroke, renal insufficiency, eclampsia, maternal death, birth weight 34 weeks with no adverse outcome.PE-related adverse outcomes are common in women in Haiti and are associated with profound angiogenic imbalance regardless of gestational age at presentation.

  6. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes

    DEFF Research Database (Denmark)

    Jensen, Dorte M; Korsholm, Lars; Ovesen, Per;

    2009-01-01

    OBJECTIVE: To study the association between peri-conceptional A1C and serious adverse pregnancy outcome (congenital malformations and perinatal mortality). RESEARCH DESIGN AND METHODS: Prospective data were collected in 933 singleton pregnancies complicated by type 1 diabetes. RESULTS: The risk...... malformation rate increased significantly at A1C above 10.4%, whereas perinatal mortality was increased even at A1C below 6.9%. CONCLUSIONS: These results support recent guidelines of preconceptional A1C levels diabetes....

  7. [Growing up under adversity in Germany : Design and methods of a developmental study on risk and protective mechanisms in families with diverse psychosocial risk].

    Science.gov (United States)

    Zimmermann, Peter; Vierhaus, Marc; Eickhorst, Andreas; Sann, Alexandra; Egger, Carine; Förthner, Judith; Gerlach, Jennifer; Iwanski, Alexandra; Liel, Christoph; Podewski, Fritz; Wyrwich, Sandra; Spangler, Gottfried

    2016-10-01

    Family adversity comprises many risk factors for parents and children. The German early intervention approach Frühe Hilfen aims at providing enduring, effective, and scientifically validated prevention and intervention for effective child protection against those risks. The study on risk and protective mechanisms in the development of families with diverse psychosocial risks aims at identifying those mechanisms that cause and stabilize or moderate and diminish maltreatment and neglect, as well as cognitive, social, and emotional developmental deviations in risk families, specifically in the current German social and child protection system. The study examines the development of competence and early behavior problems in a sample of infants and toddlers and the interaction quality with their caregivers by applying a longitudinal sequential-cohort design. The assessments include developmental tests, systematic observations, and questionnaire data. First results suggest stable risk group membership and moderate stability of single risk factors.

  8. The Risk Assessment of Adverse Events of Nursing Activities as the Element of Quality Management in Healhcare

    Directory of Open Access Journals (Sweden)

    Wiśniewska Malgorzata Z.

    2015-02-01

    Full Text Available The purpose of the paper is to present MedCARVER+Shock method and Pareto analysis and its usability for the risk assessment of adverse events of nursing activities. 888 activities carried out by all 190 nurses working at the District Hospital X located in Poland were taken into account. During the research the qualitative approach was used. As the result sixteen groups of nursing activities causing the highest risk of adverse events were selected. Special attention required in: admission of a patient to the ward, sterilization, verbal communication with the patient, using of intravenous cannulas, needles, syringes, devices for transfusion of infusion liquids, servicing of hospital rooms, first aid in life-threatening situations, using medical devices and equipment. Ten basic causes of the risk of adverse events were identified, among others: lack of trainings, of modern equipment, of staff, failure to comply with procedures, lack of staff supervision, poor quality of ancillary materials, lack of management commitment. Finally MedCARVER+Shock method and Pareto analysis usability has been confirmed but it appeared that it is time-consuming and requires support from skilled professionals. Several suggestions have been put forward to improve the utility of MedCARVER+Shock.

  9. Cardiometabolic interventions – focus on transcriptional regulators

    Directory of Open Access Journals (Sweden)

    Joshua T Chai

    2013-01-01

    Full Text Available Cardiovascular disease (CVD remains the largest healthcare burden in the Western world; and the increasing prevalence of type II diabetes mellitus, at least partially driven by a trend in lifestyle changes associated with global economic development, is likely to fuel this CVD burden worldwide. Over the past two decades, there has been an increased awareness of the convergence of risk factors contributing to both cardiovascular disease and diabetes leading to the concept of the metabolic syndrome, and the realisation of the opportunity to intervene at this intersection to simultaneously target CVD and metabolic dysfunction. This brings together the fields of cardiovascular medicine, diabetology, and increasingly clinical immunology for a unified and concerted effort to reduce risk for both conditions simultaneously. The discovery of the targeted pathways of drugs already in clinical use such as fibrates and thiazolidinediones (TZD has led to accelerated basic and clinicalresearch into selective and dual PPAR-α and PPAR-γ agonists, which can theoretically target glucose, lipid and lipoprotein metabolism, as well as potentially exerting inhibitoryeffects in vascular inflammation, all of which might be predicted to reduce atherosclerosis. In this article, we will discuss the basic science as well as recent clinical development in the pursuit of optimal cardiometabolic intervention along with insight into strategies for future drug development.

  10. Antipsychotics and torsadogenic risk : Signals emerging from the US FDA adverse event reporting system database

    NARCIS (Netherlands)

    E. Poluzzi (Elisabetta); E. Raschi (Emanuel); A. Koci (Ariola); U. Moretti (Ugo); E. Spina (Edoardo); E.R. Behr (Elijah ); M.C.J.M. Sturkenboom (Miriam); F. de Ponti (Fabrizio)

    2013-01-01

    textabstractBackground: Drug-induced torsades de pointes (TdP) and related clinical entities represent a current regulatory and clinical burden. Objective: As part of the FP7 ARITMO (Arrhythmogenic Potential of Drugs) project, we explored the publicly available US FDA Adverse Event Reporting System

  11. Risk of serious adverse effects of biological and targeted drugs in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Tarp, Simon; Eric Furst, Daniel; Boers, Maarten

    2016-01-01

    OBJECTIVES: To determine possible differences in serious adverse effects among the 10 currently approved biological and targeted synthetic DMARDs (b/ts-DMARDs) for RA. METHODS: Systematic review in bibliographic databases, trial registries and websites of regulatory agencies identified randomized...... differences in rates of SAEs. Our data suggest caution should be taken when deciding among available drugs. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42014014842....

  12. Potential roles of omics data in the use of adverse outcome pathways for environmental risk assessment

    Science.gov (United States)

    The current approach to assessing adverse effects of chemicals in the environment is largely based on a battery of in-vivo study methods and a limited number of accepted in-silico approaches. For most substances the pool of data from which to predict ecosystem effects is limited ...

  13. Associations between Dietary Fiber Intake in Infancy and Cardiometabolic Health at School Age: The Generation R Study

    Directory of Open Access Journals (Sweden)

    Rafaëlle M. A. van Gijssel

    2016-08-01

    Full Text Available Dietary fiber (DF intake may be beneficial for cardiometabolic health. However, whether this already occurs in early childhood is unclear. We investigated associations between DF intake in infancy and cardiometabolic health in childhood among 2032 children participating in a population-based cohort in The Netherlands. Information on DF intake at a median age of 12.9 months was collected using a food-frequency questionnaire. DF was adjusted for energy intake using the residual method. At age 6 years, body fat percentage, high-density lipoprotein (HDL-cholesterol, insulin, triglycerides, and blood pressure were assessed and expressed in age- and sex-specific standard deviation scores (SDS. These five factors were combined into a cardiometabolic risk factor score. In models adjusted for several parental and child covariates, a higher DF intake was associated with a lower cardiometabolic risk factor score. When we examined individual cardiometabolic factors, we observed that a 1 g/day higher energy-adjusted DF intake was associated with 0.026 SDS higher HDL-cholesterol (95% CI 0.009, 0.042, and 0.020 SDS lower triglycerides (95% CI −0.037, −0.003, but not with body fat, insulin, or blood pressure. Results were similar for DF with and without adjustment for energy intake. Our findings suggest that higher DF intake in infancy may be associated with better cardiometabolic health in later childhood.

  14. A Comparison between BMI, Waist Circumference, and Waist-To-Height Ratio for Identifying Cardio-Metabolic Risk in Children and Adolescents

    DEFF Research Database (Denmark)

    Sardinha, Luís B; Santos, Diana A; Silva, Analiza M

    2016-01-01

    BACKGROUND: There is controversial evidence on the associations between anthropometric measures with clustering of cardiovascular disease risk factors in pediatric ages. We aimed to examine the associations between body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHt...

  15. Risk of Major Adverse Cardiovascular Events and All-Cause Mortality in Patients With Hidradenitis Suppurativa

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Gislason, Gunnar H; Hansen, Peter R

    2016-01-01

    IMPORTANCE: Hidradenitis suppurativa (HS) is a common inflammatory skin disease. The disease has been associated with cardiovascular (CV) risk factors, but the risk of CV disease in patients with HS is unknown. OBJECTIVE: To investigate CV risk in patients with HS. DESIGN, SETTING, AND PARTICIPAN...

  16. Recently Discovered Adipokines and Cardio-Metabolic Comorbidities in Childhood Obesity

    Directory of Open Access Journals (Sweden)

    Gloria Maria Barraco

    2014-10-01

    Full Text Available White adipose tissue (WAT asset, in terms of cell number, fat storage capacity and endocrine function, is largely determined in early stages of life and is pivotal for shaping the WAT pro-inflammatory behavior. WAT derived adipokines have been shown to play a main role in several cardio-metabolic abnormalities of obesity. This review focuses on the most recently identified adipokines, namely adipocyte-fatty acid-binding protein, chemerin, fibroblast growth factor-21, lipocalin-2, omentin-1 and vaspin; their role in the pathogenesis of obesity and associated cardio-metabolic abnormalities; and on their adaptive response to body weight change. Evidence consistently suggests a pathogenic role for A-FABP, chemerin and FGF-21. Nevertheless, large population studies are needed to verify whether they can be useful to predict the risk of cardio-metabolic abnormalities in adulthood and/or monitor the clinical response to therapeutic interventions.

  17. Rat Models of Cardiometabolic Diseases: Baseline Clinical Chemistries, and Rationale for their Use in Examining Air Pollution Health Effects

    Science.gov (United States)

    This is the first of a series of 8 papers examining susceptibility of various rodent cardiometabolic disease models to ozone induced health effects. Individuals with cardiovascular and metabolic diseases (CVD) are shown to be more susceptible to adverse health effects o...

  18. Association between relocation and changes in cardiometabolic risk factors: a longitudinal study in tsunami survivors of the 2011 Great East Japan Earthquake

    OpenAIRE

    2016-01-01

    Objectives The aim of this study is to determine changes in atherosclerotic cardiovascular risk factors with and without serious disaster-related mental and socioeconomic problems represented by relocation (REL). Design A longitudinal survey. Setting Multiphasic health check-ups for the general population affected by the 2011 Great East Japan Earthquake and Tsunami. Participants A total 6528 disaster survivors in heavily tsunami-damaged municipalities were recruited. Two sequential surveys we...

  19. Adolescence as risk factor for adverse pregnancy outcome in Central Africa--a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Florian Kurth

    Full Text Available BACKGROUND: Sub-Saharan Africa has the highest rates of maternal and neonatal mortality worldwide. Young maternal age at delivery has been proposed as risk factor for adverse pregnancy outcome, yet there is insufficient data from Sub-Saharan Africa. The present study aimed to investigate the influence of maternal adolescence on pregnancy outcomes in the Central African country Gabon. METHODOLOGY AND PRINCIPAL FINDINGS: Data on maternal age, parity, birth weight, gestational age, maternal Plasmodium falciparum infection, use of bednets, and intake of intermittent preventive treatment of malaria in pregnancy were collected in a cross-sectional survey in 775 women giving birth in three mother-child health centers in Gabon. Adolescent women (≤16 years of age had a significantly increased risk to deliver a baby with low birth weight in univariable analysis (22.8%, 13/57, vs. 9.3%, 67/718, OR: 2.9, 95% CI: 1.5-5.6 and young maternal age showed a statistically significant association with the risk for low birth weight in multivariable regression analysis after correction for established risk factors (OR: 2.7; 95% CI: 1.1-6.5. In further analysis adolescent women were shown to attend significantly less antenatal care visits than adult mothers (3.3±1.9 versus 4.4±1.9 mean visits, p<0.01, n = 356 and this difference accounted at least for part of the excess risk for low birth weight in adolescents. CONCLUSION: Our data demonstrate the importance of adolescent age as risk factor for adverse pregnancy outcome. Antenatal care programs specifically tailored for the needs of adolescents may be necessary to improve the frequency of antenatal care visits and pregnancy outcomes in this risk group in Central Africa.

  20. Periodontal Disease: A Possible Risk-Factor for Adverse Pregnancy Outcome

    OpenAIRE

    Parihar, Anuj Singh; Katoch, Vartika; Rajguru, Sneha A; Rajpoot, Nami; Singh, Pinojj; Wakhle, Sonal

    2015-01-01

    Bacterial invasion in subgingival sites especially of gram-negative organisms are initiators for periodontal diseases. The periodontal pathogens with persistent inflammation lead to destruction of periodontium. In recent years, periodontal diseases have been associated with a number of systemic diseases such as rheumatoid arthritis, cardiovascular-disease, diabetes mellitus, chronic respiratory diseases and adverse pregnancy outcomes including pre-term low-birth weight (PLBW) and pre-eclampsi...

  1. Risk Managers’ Descriptions of Programs to Support Second Victims after Adverse Events

    OpenAIRE

    White, Andrew A; Brock, Doug; McCotter, Patricia I.; Hofeldt, Ron; Edrees, Hanan H.; Wu, Albert W.; Shannon, Sarah; Gallagher, Thomas H.

    2015-01-01

    Guidelines call for healthcare organizations to provide emotional support for clinicians involved in adverse events, but little is known about these organizations seek to meet this need. We surveyed U.S. members of ASHRM about the presence, features, and perceived efficacy of their organization’s provider support program. The majority reported that their organization had a support program, but features varied widely and there are substantial opportunities to improve services. Provider support...

  2. Comments concerning the real risk of sexual adverse events secondary to the use of 5-ARIs

    Directory of Open Access Journals (Sweden)

    Furio Pirozzi Farina

    2016-01-01

    Full Text Available Treatment-induced sexual dysfunctions (SD are a recurrent and controversial topic in recent literature on the adverse events related to the use of 5-alpha-reductase inhibitors (5ARIs (1, 2. In order to deal adequately with the various aspects of this topic, it is necessary to first cover some of the steps that allow a better definition and understanding of the subject.

  3. Pairing nuts and dried fruit for cardiometabolic health.

    Science.gov (United States)

    Carughi, Arianna; Feeney, Mary Jo; Kris-Etherton, Penny; Fulgoni, Victor; Kendall, Cyril W C; Bulló, Mònica; Webb, Densie

    2016-03-05

    Certain dietary patterns, in which fruits and nuts are featured prominently, reduce risk of diabetes and cardiovascular disease. However, estimated fruit consumption historically in the U.S. has been lower than recommendations. Dried fruit intake is even lower with only about 6.9 % of the adult population reporting any consumption. The 2015 Dietary Guidelines Advisory Committee identified a gap between recommended fruit and vegetable intakes and the amount the population consumes. Even fewer Americans consume tree nuts, which are a nutrient-dense food, rich in bioactive compounds and healthy fatty acids. Consumption of fruits and nuts has been associated with reduced risk of cardiometabolic disease. An estimated 5.5 to 8.4 % of U.S. adults consume tree nuts and/or tree nut butter. This review examines the potential of pairing nuts and dried fruit to reduce cardiometabolic risk factors and focuses on emerging data on raisins and pistachios as representative of each food category. Evidence suggests that increasing consumption of both could help improve Americans' nutritional status and reduce the risk of chronic diseases.

  4. Effects of early exposure to phthalates and bisphenols on cardiometabolic outcomes in pregnancy and childhood

    NARCIS (Netherlands)

    Philips, E.M. (Elise M.); V.W.V. Jaddoe (Vincent); Trasande, L. (Leonardo)

    2016-01-01

    textabstractPregnant women are exposed to various chemicals, including endocrine-disrupting chemicals (EDCs) such as phthalates and bisphenols. Increasing evidence suggests that early life exposures to phthalates and bisphenols may contribute to cardiometabolic risks. The aim of this narrative revie

  5. Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

    NARCIS (Netherlands)

    D. Berks (Durk)

    2017-01-01

    markdownabstractWomen with a history of cardiometabolic complicated pregnancy are at increased risk for future disease. The experience of having had a complicated pregnancy might open up a window of opportunity to guide these women to a healthier future. The general aim of the thesis is to develop a

  6. Family history of myocardial infarction, stroke and diabetes and cardiometabolic markers in children

    NARCIS (Netherlands)

    Berentzen, Nina E.; Wijga, Alet H.; van Rossem, Lenie; Koppelman, Gerard H.; van Nieuwenhuizen, Bo; Gehring, Ulrike; Spijkerman, Annemieke M. W.; Smit, Henriette A.

    2016-01-01

    Aims/hypothesis Despite the overlap in occurrence of cardiovascular disease (CVD) and type 2 diabetes and their risk factors, family history of these diseases has not yet been investigated simultaneously in relation to cardiometabolic markers in offspring. We examined how a family history of CVD and

  7. Growth in Total Height and Its Components and Cardiometabolic Health in Childhood

    DEFF Research Database (Denmark)

    Haugaard, Line Klingen; Baker, Jennifer Lyn; Perng, Wei;

    2016-01-01

    was a cardiometabolic risk score based on sex-specific internal z-scores for systolic blood pressure, waist circumference, homeostatic model assessment of insulin resistance, triglycerides and high-density lipoprotein-cholesterol. RESULTS: Mean (SD) total height was 97.9 (4.5) cm in boys and 97.1 (4.7) cm in girls...

  8. Eicosapentaenoic acid and docosahexaenoic acid in whole blood are differentially and sex-specifically associated with cardiometabolic risk markers in 8-11-year-old danish children

    DEFF Research Database (Denmark)

    Damsgaard, Camilla T.; Eidner, Maj B.; Stark, Ken D.;

    2014-01-01

    n-3 long-chain polyunsaturated fatty acids improve cardiovascular risk markers in adults. These effects may differ between eicosapentaenoic acid (EPA, 20∶5n-3) and docosahexaenoic acid (DHA, 22∶6n-3), but we lack evidence in children. Using baseline data from the OPUS School Meal Study we 1......-day dietary records, physical activity by accelerometry and measured anthropometry, blood pressure, and heart rate. Blood samples were analyzed for whole blood fatty acid composition, cholesterols, triacylglycerol, insulin resistance by the homeostatic model of assessment (HOMA-IR), and inflammatory...

  9. Influence of age on perioperative major adverse cardiovascular events and mortality risks in elective non-cardiac surgery

    DEFF Research Database (Denmark)

    Hansen, Peter Wæde; Gislason, Gunnar H.; Jørgensen, Mads Emil;

    2016-01-01

    -cause mortality were analyzed by multivariable logistic regression models (adjusted for comorbidities, revised cardiac risk index, cardiovascular pharmacotherapy, body mass index, and surgery type). RESULTS: A total of 386,818 procedures on 302,459 patients were included; mean age was 54.8years (min-max 20......BACKGROUND AND AIMS: Advanced age increases the risk of perioperative cardiovascular complications and may pose reluctance to subject elderly patients to surgery. We examined the impact of high age on perioperative major adverse cardiovascular events (MACE) and mortality in a nationwide cohort...... of patients undergoing elective surgery. METHODS: All Danish patients aged ≥20years undergoing non-cardiac, elective surgery in 2005-2011 were identified from nationwide administrative registers. Risks of 30-day MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, or cardiovascular death) and all...

  10. Effects of eight weeks of aerobic interval training and of isoinertial resistance training on risk factors of cardiometabolic diseases and exercise capacity in healthy elderly subjects

    Science.gov (United States)

    Bruseghini, Paolo; Calabria, Elisa; Tam, Enrico; Milanese, Chiara; Oliboni, Eugenio; Pezzato, Andrea; Pogliaghi, Silvia; Salvagno, Gian Luca; Schena, Federico; Mucelli, Roberto Pozzi; Capelli, Carlo

    2015-01-01

    We investigated the effect of 8 weeks of high intensity interval training (HIT) and isoinertial resistance training (IRT) on cardiovascular fitness, muscle mass-strength and risk factors of metabolic syndrome in 12 healthy older adults (68 yy ± 4). HIT consisted in 7 two-minute repetitions at 80%–90% of V˙O2max, 3 times/w. After 4 months of recovery, subjects were treated with IRT, which included 4 sets of 7 maximal, bilateral knee extensions/flexions 3 times/w on a leg-press flywheel ergometer. HIT elicited significant: i) modifications of selected anthropometrical features; ii) improvements of cardiovascular fitness and; iii) decrease of systolic pressure. HIT and IRT induced hypertrophy of the quadriceps muscle, which, however, was paralleled by significant increases in strength only after IRT. Neither HIT nor IRT induced relevant changes in blood lipid profile, with the exception of a decrease of LDL and CHO after IRT. Physiological parameters related with aerobic fitness and selected body composition values predicting cardiovascular risk remained stable during detraining and, after IRT, they were complemented by substantial increase of muscle strength, leading to further improvements of quality of life of the subjects. PMID:26046575

  11. Pretreatment Cardiometabolic Status in Youth With Early-Onset Psychosis

    DEFF Research Database (Denmark)

    Jensen, Karsten G; Correll, Christoph U; Rudå, Ditte

    2017-01-01

    OBJECTIVE: To describe pretreatment cardiometabolic constitution in children and adolescents with first-episode psychosis (FEP). METHODS: Baseline cardiometabolic assessment was performed in youths aged 12-17 years with FEP entering the Tolerability and Efficacy of Antipsychotics (TEA) trial...

  12. Which part of a short, global risk assessment, the Risk Instrument for Screening in the Community, predicts adverse healthcare outcomes?

    LENUS (Irish Health Repository)

    O’Caoimh, Rónán

    2015-01-01

    The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC (\

  13. Incidence and risk factors of serious adverse events during antituberculous treatment in Rwanda: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Natalie Lorent

    Full Text Available BACKGROUND: Tuberculosis (TB and TB-human immunodeficiency virus infection (HIV coinfection is a major public health concern in resource-limited settings. Although TB treatment is challenging in HIV-infected patients because of treatment interactions, immunopathological reactions, and concurrent infections, few prospective studies have addressed this in sub-Saharan Africa. In this study we aimed to determine incidence, causes of, and risk factors for serious adverse events among patients on first-line antituberculous treatment, as well as its impact on antituberculous treatment outcome. METHODS AND FINDINGS: Prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital from May 2008 through August 2009. Of 263 patients enrolled, 253 were retained for analysis: median age 35 (Interquartile range, IQR 28-40, 55% male, 66% HIV-positive with a median CD4 count 104 cells/mm(3 (IQR 44-248 cells/mm(3. Forty percent had pulmonary TB, 43% extrapulmonary TB and 17% a mixed form. Sixty-four (26% developed a serious adverse event; 58/167 (35% HIV-infected vs. 6/86 (7% HIV-uninfected individuals. Commonest events were concurrent infection (n = 32, drug-induced hepatitis (n = 24 and paradoxical reactions/TB-IRIS (n = 23. HIV-infection (adjusted Hazard Ratio, aHR 3.4, 95% Confidence Interval, CI 1.4-8.7 and extrapulmonary TB (aHR 2, 95%CI 1.1-3.7 were associated with an increased risk of serious adverse events. For TB/HIV co-infected patients, extrapulmonary TB (aHR 2.0, 95%CI 1.1-3.9 and CD4 count <100 cells/mm3 at TB diagnosis (aHR 1.7, 95%CI 1.0-2.9 were independent predictors. Adverse events were associated with an almost two-fold higher risk of unsuccessful treatment outcome at 6 months (HR 1.89, 95%CI 1.3-3.0. CONCLUSION: Adverse events frequently complicate the course of antituberculous treatment and worsen treatment outcome, particularly in patients with extrapulmonary

  14. Dairy consumption and cardiometabolic health: outcomes of a 12-month crossover trial

    Directory of Open Access Journals (Sweden)

    Crichton Georgina E

    2012-03-01

    Full Text Available Abstract Background A growing body of research suggests that regular consumption of dairy foods may counteract obesity and other components of the metabolic syndrome. However, human intervention trials are lacking. We aimed to determine the cardiometabolic health effects of increasing the consumption of reduced fat dairy foods in adults with habitually low dairy intakes in the absence of energy restriction. Methods An intervention trial was undertaken in 61 overweight or obese adults who were randomly assigned to a high dairy diet (HD, 4 serves of reduced fat dairy/day or a low dairy control diet (LD, ≤1 serve/day for 6 months then crossed over to the alternate diet for a further 6 months. A range of anthropometric and cardiometabolic parameters including body composition, metabolic rate, blood lipids, blood pressure and arterial compliance were assessed at the end of each diet phase. Results Total energy intake was 1120 kJ/day higher during the HD phase, resulting in slight weight gain during this period. However, there were no significant differences between HD and LD in absolute measures of waist circumference, body weight, fat mass or any other cardiometabolic parameter. Conclusion Recommended intakes of reduced fat dairy products may be incorporated into the diet of overweight adults without adversely affecting markers of cardiometabolic health. Trial Registration The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12608000538347 on 24th October, 2008.

  15. Childhood cardiometabolic outcomes of maternal obesity during pregnancy: the Generation R Study.

    Science.gov (United States)

    Gaillard, Romy; Steegers, Eric A P; Duijts, Liesbeth; Felix, Janine F; Hofman, Albert; Franco, Oscar H; Jaddoe, Vincent W V

    2014-04-01

    Maternal prepregnancy obesity is associated with impaired cardiometabolic health in offspring. Whether these associations reflect direct intrauterine causal mechanisms remains unclear. In a population-based prospective cohort study among 4871 mothers, fathers, and their children, we examined the associations of both maternal and paternal prepregnancy body mass index (BMI) with childhood body fat distribution and cardiometabolic outcomes and explored whether any association was explained by pregnancy, birth, and childhood factors. We measured childhood BMI, total body and abdominal fat distribution, blood pressure, and blood levels of lipids, insulin, and C-peptide at the age of 6 years. We observed that higher maternal and paternal prepregnancy BMI were associated with higher childhood BMI, total body and abdominal fat mass measures, systolic blood pressure, and insulin levels and lower high-density lipoprotein cholesterol levels (Peffect estimates for these outcomes were observed for paternal obesity. In conclusion, higher maternal and paternal prepregnancy BMI were associated with an adverse cardiometabolic profile in offspring, with stronger associations present for maternal prepregnancy BMI. These findings suggest that maternal prepregnancy BMI may influence the cardiometabolic health of offspring through direct intrauterine mechanisms.

  16. Tracing Differential Pathways of Risk: Associations among Family Adversity, Cortisol, and Cognitive Functioning in Childhood

    Science.gov (United States)

    Suor, Jennifer H.; Sturge-Apple, Melissa L.; Davies, Patrick T.; Cicchetti, Dante; Manning, Liviah G.

    2015-01-01

    Guided by family risk and allostasis theoretical frameworks, the present study utilized a prospective longitudinal design to examine associations among family risk experiences, basal cortisol patterns, and cognitive functioning in children. The sample included 201 low-income children living within a midsize city in the Northeastern United States.…

  17. Energy drink consumption in Europe: A review of the risks, adverse health effects and policy options to respond

    Directory of Open Access Journals (Sweden)

    João Joaquim Breda

    2014-10-01

    Full Text Available With the worldwide consumption of energy drinks increasing in recent years, concerns have been raised both in the scientific community and among the general public about the health effects of these products. Recent studies provide data on consumption patterns in Europe however more research is needed to determine the potential for adverse health effects related to the increasing consumption of energy drinks, particularly among young people. A review of the literature was conducted to identify published articles that examined the health risks, consequences and policies related to energy drink consumption. The health risks associated with energy drink consumption are primarily related to their caffeine content, but more research is needed that evaluates the long term effects of consuming common energy drink ingredients. The evidence indicating adverse health effects due to the consumption of energy drinks with alcohol is growing. The risks of heavy consumption of energy drinks among young people have largely gone unaddressed and are poised to become a significant public health problem in the future.

  18. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda

    Directory of Open Access Journals (Sweden)

    Turyakira Eleanor

    2011-10-01

    Full Text Available Abstract Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%, malpresentation or malposition (36.4% and hydrocephalus (0.3%. The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86, with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78, having delivered once before (AOR 1.57, 95% CI: 1.30-1.91 and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45. The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08 and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22. Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by

  19. One Egg per Day Improves Inflammation when Compared to an Oatmeal-Based Breakfast without Increasing Other Cardiometabolic Risk Factors in Diabetic Patients.

    Science.gov (United States)

    Ballesteros, Martha Nydia; Valenzuela, Fabrizio; Robles, Alma E; Artalejo, Elizabeth; Aguilar, David; Andersen, Catherine J; Valdez, Herlindo; Fernandez, Maria Luz

    2015-05-11

    There is concern that egg intake may increase blood glucose in patients with type 2 diabetes mellitus (T2DM). However, we have previously shown that eggs reduce inflammation in patients at risk for T2DM, including obese subjects and those with metabolic syndrome. Thus, we hypothesized that egg intake would not alter plasma glucose in T2DM patients when compared to oatmeal intake. Our primary endpoints for this clinical intervention were plasma glucose and the inflammatory markers tumor necrosis factor (TNF)-α and interleukin 6 (IL-6). As secondary endpoints, we evaluated additional parameters of glucose metabolism, dyslipidemias, oxidative stress and inflammation. Twenty-nine subjects, 35-65 years with glycosylated hemoglobin (HbA1c) values factor (TNF)-α (p < 0.01), one of our primary endpoints were significantly reduced during the egg period. These results suggest that compared to an oatmeal-based breakfast, eggs do not have any detrimental effects on lipoprotein or glucose metabolism in T2DM. In contrast, eggs reduce AST and TNF-α in this population characterized by chronic low-grade inflammation.

  20. Elevation of sE-Selectin Levels 2–24 Months following Gestational Diabetes Is Associated with Early Cardiometabolic Risk in Nondiabetic Women

    Directory of Open Access Journals (Sweden)

    Alina Sokup

    2012-01-01

    Full Text Available Objective. We hypothesised that the endothelial dysfunction is associated with early glucose dysregulation and/or atherosclerosis risk factors in nondiabetic women with a previous history of gestational diabetes (pGDM. Material/Methods. Anthropometric parameters, glucose regulation (OGTT, insulin resistance (HOMA, lipids, biomarkers of endothelial dysfunction, and inflammation were evaluated in 85 women with pGDM and in 40 controls 2–24 months postpartum. Results. The pGDM group consisted of 67% normoglycemic women (pGDM-N and 33% with prediabetic state (pGDM-P. The BMI, waist circumference, fasting and 2 h glucose (OGTT, soluble adhesion molecules, tissue plasminogen activator antigen, high sensitivity C-reactive protein, total-, LDL-cholesterol, and triglycerides/HDL-cholesterol ratio were higher in the pGDM women compared with the controls. After adjustment for BMI and fasting glucose, only higher triglycerides, higher TG/HDL and lower HDL-cholesterol were associated with pGDM. The pGDM-P differed from pGDM-N for only higher triglycerides and TG/HDL. The plasma level of sE-selectin was not independently associated with glucose concentration in pGDM group. sE-selectin level correlated with triglycerides, TG/HDL, plasminogen activator inhibitor-1 antigen, and sICAM-1. Conclusions. sE-selectin level correlated with components of metabolic syndrome, but only the atherogenic lipid profile was independently associated with a previous history of GDM in nondiabetic women 2–24 months postpartum.

  1. One Egg per Day Improves Inflammation when Compared to an Oatmeal-Based Breakfast without Increasing Other Cardiometabolic Risk Factors in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Martha Nydia Ballesteros

    2015-05-01

    Full Text Available There is concern that egg intake may increase blood glucose in patients with type 2 diabetes mellitus (T2DM. However, we have previously shown that eggs reduce inflammation in patients at risk for T2DM, including obese subjects and those with metabolic syndrome. Thus, we hypothesized that egg intake would not alter plasma glucose in T2DM patients when compared to oatmeal intake. Our primary endpoints for this clinical intervention were plasma glucose and the inflammatory markers tumor necrosis factor (TNF-α and interleukin 6 (IL-6. As secondary endpoints, we evaluated additional parameters of glucose metabolism, dyslipidemias, oxidative stress and inflammation. Twenty-nine subjects, 35–65 years with glycosylated hemoglobin (HbA1c values <9% were recruited and randomly allocated to consume isocaloric breakfasts containing either one egg/day or 40 g of oatmeal with 472 mL of lactose-free milk/day for five weeks. Following a three-week washout period, subjects were assigned to the alternate breakfast. At the end of each period, we measured all primary and secondary endpoints. Subjects completed four-day dietary recalls and one exercise questionnaire for each breakfast period. There were no significant differences in plasma glucose, our primary endpoint, plasma lipids, lipoprotein size or subfraction concentrations, insulin, HbA1c, apolipoprotein B, oxidized LDL or C-reactive protein. However, after adjusting for gender, age and body mass index, aspartate amino-transferase (AST (p < 0.05 and tumor necrosis factor (TNF-α (p < 0.01, one of our primary endpoints were significantly reduced during the egg period. These results suggest that compared to an oatmeal-based breakfast, eggs do not have any detrimental effects on lipoprotein or glucose metabolism in T2DM. In contrast, eggs reduce AST and TNF-α in this population characterized by chronic low-grade inflammation.

  2. Nick Hales Award Lecture 2011: glucocorticoids and early life programming of cardiometabolic disease.

    Science.gov (United States)

    Reynolds, R M

    2012-10-01

    Epidemiological studies have demonstrated an association between low birthweight and a range of diseases in adult life including cardiometabolic and psychiatric diseases. One of the key mechanisms proposed to underlie early life 'programming' of disease is overexposure of the developing foetus to glucocorticoids. This review will explore the data from human studies that glucocorticoids are not only mediators of programming, but also targets of programming. Cohort studies of men and women of known birthweight have demonstrated that low birthweight is associated with high fasting cortisol levels. In healthy individuals and in people with type 2 diabetes who are at high cardiovascular risk, there is a similar association between high fasting cortisol and the metabolic syndrome. The high cortisol levels appear to be due to activation of the hypothalamic-pituitary-adrenal (HPA) axis though detailed studies to further explore central negative feedback sensitivity are required. The evidence in humans that glucocorticoids mediate programming is more scanty, though changes in maternal body composition, stress and anxiety levels and activity of the placental barrier enzyme 11 β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) may all influence maternal HPA axis activity. Emerging studies are supportive that high maternal cortisol levels in humans and/or deficiencies placental 11β-HSD2 humans are associated with lower birthweight and adverse metabolic and neurocognitive outcomes in the offspring.

  3. Role of the endocannabinoid system in abdominal obesity and the implications for cardiovascular risk.

    Science.gov (United States)

    Rosenson, Robert S

    2009-01-01

    Several cardiometabolic factors present in obese and insulin-resistant individuals represent a continuum of increasing risk for the development of type 2 diabetes and cardiovascular disease. The importance of abdominal obesity as an independent risk factor is underscored by its association with adverse endocrine function. Recent evidence from animal and human studies has shown a role for the endocannabinoid system in maintaining energy balance and glucose and lipoprotein metabolism, with overactivity linked to aberrant glycemic and lipoprotein control, and a link to adiposity. Modulation of this system through endocannabinoid-receptor blockade has resulted in an improvement in a number of important risk factors in clinical trials, including visceral and subcutaneous abdominal adipose tissue, glucose tolerance, dyslipidemia and measures of inflammation. These findings may have significant implications for the management of patients at risk of developing cardiovascular and metabolic disease; however, the occurrence of psychiatric adverse events with rimonabant may preclude further development of centrally active endocannabinoid receptor antagonists for the treatment of cardiometabolic disorders. Future research is needed to explore the role of selective peripheral CB(1) receptor antagonists in the treatment of patients at high cardiometabolic risk.

  4. Associations between Sugar Intake from Different Food Sources and Adiposity or Cardio-Metabolic Risk in Childhood and Adolescence: The Korean Child-Adolescent Cohort Study.

    Science.gov (United States)

    Hur, Yang-Im; Park, Hyesook; Kang, Jae-Heon; Lee, Hye-Ah; Song, Hong Ji; Lee, Hae-Jeung; Kim, Ok-Hyun

    2015-12-31

    The increasing prevalence of childhood obesity is a serious public health problem associated with co-morbidities in adulthood, as well as childhood. This study was conducted to identify associations between total sugar intake and sugar intake from different foods (fruit, milk, and sugar-sweetened beverages (SSBs)), and adiposity and continuous metabolic syndrome scores (cMetS) among Korean children and adolescents using cohort data. The study subjects were children (n = 770) who participated in the 4th year (2008) of the Korean Child-Adolescent Cohort Study (KoCAS). Dietary intake data were collected via three-day 24-h food records, and sugar intake was calculated for the total sugar content of foods using our database compiled from various sources. Anthropometric measurements, assessments of body composition, and blood sample analysis were performed at baseline and at follow-up four years later. The cMetS was calculated based on waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and mean arterial blood pressure. According to multiple linear regression analysis, there were no significant associations between total sugar intake and adiposity and cMetS. However, higher intake of fruit sugar at baseline was significantly associated with lower body mass index (BMI) z-scores and body fat percentages at baseline (β = -0.10, p = 0.02 and β = -0.78, p sugar intake from fruit at baseline was still negatively associated with the above outcomes, but only the relationship with BMI z-scores retained statistical significance (β = -0.08, p sugar from SSBs and cMetS at baseline (β = 0.04, p = 0.02), but that relationship was not observed at follow-up (p = 0.83). Differences in consumption sugars from fruit and SSBs might play an important role in the risk of adiposity and metabolic disease in children and adolescents. Our results suggest that strategies for reducing sugar intake need to target particular food groups. Consequently, this

  5. Effects of high-intensity interval training and moderate-intensity continuous training on endothelial function and cardiometabolic risk markers in obese adults.

    Science.gov (United States)

    Sawyer, Brandon J; Tucker, Wesley J; Bhammar, Dharini M; Ryder, Justin R; Sweazea, Karen L; Gaesser, Glenn A

    2016-07-01

    We hypothesized that high-intensity interval training (HIIT) would be more effective than moderate-intensity continuous training (MICT) at improving endothelial function and maximum oxygen uptake (V̇o2 max) in obese adults. Eighteen participants [35.1 ± 8.1 (SD) yr; body mass index = 36.0 ± 5.0 kg/m(2)] were randomized to 8 wk (3 sessions/wk) of either HIIT [10 × 1 min, 90-95% maximum heart rate (HRmax), 1-min active recovery] or MICT (30 min, 70-75% HRmax). Brachial artery flow-mediated dilation (FMD) increased after HIIT (5.13 ± 2.80% vs. 8.98 ± 2.86%, P = 0.02) but not after MICT (5.23 ± 2.82% vs. 3.05 ± 2.76%, P = 0.16). Resting artery diameter increased after MICT (3.68 ± 0.58 mm vs. 3.86 ± 0.58 mm, P = 0.02) but not after HIIT (4.04 ± 0.70 mm vs. 4.09 ± 0.70 mm; P = 0.63). There was a significant (P = 0.02) group × time interaction in low flow-mediated constriction (L-FMC) between MICT (0.63 ± 2.00% vs. -2.79 ± 3.20%; P = 0.03) and HIIT (-1.04 ± 4.09% vs. 1.74 ± 3.46%; P = 0.29). V̇o2 max increased (P HIIT (2.19 ± 0.65 l/min vs. 2.64 ± 0.88 l/min) and MICT (2.24 ± 0.48 l/min vs. 2.55 ± 0.61 l/min). Biomarkers of cardiovascular risk and endothelial function were unchanged. HIIT and MICT produced different vascular adaptations in obese adults, with HIIT improving FMD and MICT increasing resting artery diameter and enhancing L-FMC. HIIT required 27.5% less total exercise time and ∼25% less energy expenditure than MICT.

  6. Risk factors of adverse drug reaction from non-steroidal anti-inflammatory drugs in Shanghai patients with arthropathy

    Institute of Scientific and Technical Information of China (English)

    Wen SHI; Yong-ming WANG; Shao-li LI; Min YAN; Duan Li; Bin-yah CHEN; Neng-neng CHENG

    2004-01-01

    AIM: The study was to screen the possible risk factors of adverse drug reaction (ADR) induced by non-steroidal anti-inflammatory drugs (NSAIDs) in Shanghai patients with arthropathy. METHODS: The subjects were randomly selected from a database of outpatients with arthropathy from 9 main hospitals in Shanghai. A door to door retrospective epidemiological survey was used to collect demographic information about the patients, both individual and familial. This included data on their medical histories, lifestyle and dietary habits, history of smoking and alcohol consumption, history of drug therapy, quality of life (QOL) prior to NSAIDs intake, history of NSAIDs therapy and its ADR events, etc. Descriptive statistical methods and univariate analysis were also used to identify possible risk factors for ADRs induced by NSAIDs. RESULTS: Of the 1002 patients surveyed, the average length of NSAIDs intake was 2 years. ADR incidence from different NSAIDs was high, in a range from 46.7 %-66.2 %.In general, the candidate risk factors for ADRs were different for each NSAID. Each of the candidate risk factors were defined and studied in order to evaluate its role in the determination of ADRs from NSAIDs. "Family history of ADRs caused by NSAIDs" was found to be a significant risk factor for the four commonly used NSAIDs:meloxicam, diclofenac, nimesulide, and nabumetone. CONCLUSION: A retrospective epidemiological survey was useful in detecting the risk factors for ADRs caused by NSAIDs. The study found that different NSAIDs might have different risk factors and that there is no single risk factor universally applicable to all NSAIDs.

  7. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Hvelplund, Anders; Abildstrøm, Steen Z

    2012-01-01

    AimsPatients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD...... with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 1998-2009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events.......ConclusionPatients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease....

  8. SSA 04-3 LEPTIN/ADIPONECTIN IN CARDIOMETABOLIC DISEASE.

    Science.gov (United States)

    Lopez-Jaramillo, Patricio

    2016-09-01

    Cardiovascular diseases (CVD) are major causes of death and illness worldwide. In recent decades an increased prevalence of CVD mortality has been reported in low-medium income countries, which has been associated with changes in life styles, deficiencies in health systems and the persistence of social inequities.The metabolic syndrome comprises a cluster of cardiometabolic risk factors, with insulin resistance and increased adiposity as its central features. Identifying individuals with metabolic syndrome is important due to its association with an increased risk of coronary heart disease and type 2 diabetes mellitus (DM2). Attention has focused on the visceral adipose tissue production of cytokines (adipokines) in metabolic syndrome and DM2, as the levels of the anti-inflammatory adipokine adiponectin are decreased, while proinflammatory cytokines are elevated, creating a proinflammatory state associated with insulin resistance and endothelial dysfunction. We have give special attention to the role of the leptin/adiponectin ratio and we have demonstrated that in individuals with severe coronary artery disease, abdominal obesity (AO) was uniquely related to decreased plasma concentrations of adiponectin and increased leptin levels. Leptin/adiponectin imbalance was associated with increased waist circumference and a decreased vascular response to acetylcholine and increased vasoconstriction due to angiotensin II. Leptin and adiponectin have opposite effects on subclinical inflammation and insulin resistance. Leptin upregulates proinflammatory cytokines such as tumor necrosis factor-I and interleukin-6; these are associated with insulin resistance, DM2, and CVD. In contrast, adiponectin has anti-inflammatory properties and downregulates the expression and release of a number of proinflammatory immune mediators. Its concentrations are negatively regulated by the accumulation of visceral fat, and clinical studies implicate hypoadiponectinemia in the pathogenesis of DM

  9. Repeat survey of current practice regarding corticosteroid prophylaxis for patients at increased risk of adverse reaction to intravascular contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, S. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom)]. E-mail: sureshradhakrish@hotmail.com; Manoharan, S. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom); Fleet, M. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom)

    2005-01-01

    AIM: To compare the findings of a survey undertaken by us in 2002 regarding steroid premedication given in radiology departments to reduce the risk of adverse reactions in patients at increased risk of intravascular contrast media reactions with a similar survey published in 1994 by R. Seymour et al. The high risk patients considered in our survey were patients with history of asthma, drug allergies, hay fever and eczema. MATERIALS AND METHODS: A total of 225 questionnaires were sent to the consultant in charge for audit for radiology departments from the list given by the Royal College of Radiologists. 175 of the 225 questionnaires were returned (response rate 77.8%) and of these 172 were analysed with respect to the type, dose and duration of steroids. RESULTS: Compared to the survey in 1994, it was found that the number of departments who use steroid cover for all category of risk factors had increased compared to previous survey (73.8% in 2002 versus 55.3% in 1994 (p=0.001). There is now almost universal use of non-ionic contrast 98.8% versus 82.4% in 1994 (p=0.001). There is no agreed policy among radiology departments for the need or the dose or duration of steroid cover. CONCLUSION: Despite the more widespread use of non-ionic contrast media, the use of steroid premedication has increased which is contrary to what is expected as the incidence of adverse reaction to non ionic media is less than ionic contrast media.

  10. Programmatic Considerations to Reduce the Risk of Adverse Renal Stone Events in Spaceflight

    Science.gov (United States)

    Antonsen, Erik; Pietrzyk, Robert

    2017-01-01

    Introduction: Microgravity exposure may alter the likelihood that astronauts will experience renal stones. The potential risk includes both acute and chronic health issues, with the potential for significant impact on mission objectives. Methods: To understand the role of the NASA's Human Research Program (HRP) research agenda in both preventing and addressing renal stones in spaceflight, current astronaut epidemiologic data and a summary of programmatic considerations are reviewed. Results: Although there has never been a symptomatic renal stone event in a U.S. crewmember during spaceflight, urine chemistry has been altered - likely due to induced changes in renal physiology as a result of exposure to microgravity. This may predispose astronauts to stone formation, leading the HRP to conduct and sponsor research to: 1) understand the risk of stone formation in space; 2) prevent stones from forming; and 3) address stones that may form by providing novel diagnostic and therapeutic approaches. Discussion: The development of a renal stone during spaceflight is a significant medical concern that requires the HRP to minimize this risk by providing the ability to prevent, diagnose, monitor and treat the condition during spaceflight. A discussion of the risk as NASA understands it is followed by an overview of the multiple mitigations currently under study, including novel ultrasound techniques for stone detection and manipulation, and how they may function as part of a larger exploration medical system.

  11. Are Migraineurs at Increased Risk of Adverse Drug Responses? : A Meta-Analytic Comparison of Topiramate-Related Adverse Drug Reactions in Epilepsy and Migraine

    NARCIS (Netherlands)

    Luykx, J.; Mason, M.; Ferrari, M. D.; Carpay, J.

    2009-01-01

    To compare adverse drug reactions (ADRs) to topiramate in patients with migraine and patients with epilepsy, we systematically reviewed all published randomized controlled trials (RCTs) that compare topiramate monotherapy in epilepsy and migraine. We included four epilepsy RCTs (N = 1,179 patients;

  12. Comparative cardiometabolic effects of fibrates and omega-3 fatty acids.

    Science.gov (United States)

    Han, Seung Hwan; Oh, Pyung Chun; Lim, Soo; Eckel, Robert H; Koh, Kwang Kon

    2013-09-10

    Even with the aggressive reduction of low-density lipoprotein cholesterol by statin therapy, a high residual risk of cardiovascular events remains substantially and attracts attention to the need for additional preventive therapies. Therefore, effective reductions of residual risk of cardiovascular disease have emerged as therapeutic targets. Fibrates and omega-3 fatty acids have been introduced to reduce triglycerides and to increase high-density lipoprotein cholesterol and have shown anti-atherosclerotic, vascular and metabolic effects. However, some effects are controversial and very recent randomized clinical trials report different results from the earlier ones. In this review, we address the vascular and metabolic effects and the results of recent clinical trials of fibrates and omega-3 fatty acids. We also compared their effects under modern guideline therapy regarding potential drugs to reduce a residual cardiometabolic risk of cardiovascular disease.

  13. Cardiometabolic Risk in Hyperlipidemic Men and Women

    Directory of Open Access Journals (Sweden)

    Michael Leutner

    2016-01-01

    Full Text Available Objective. The aim of this study was to evaluate sex specific differences of metabolic and clinical characteristics of treated hyperlipidemic men and women (HL-men and HL-women. Methods. In this study vascular and metabolic characteristics of 35 HL-women and 64 HL-men were assessed. In addition a sex specific analysis of metabolic and nutritional habits of HL-patients with prediabetes (HL-IGR was done. Results. HL-women were older and had favourable concentrations of high density lipoprotein cholesterol (HDL-cholesterol, triglycerides (TG, and triglyceride/HDL-cholesterol ratio (TG/HDL-ratio but were also shown to have higher concentrations of lipoprotein-a compared to HL-men. HL-men were characterized as having higher levels of liver-specific parameters and body weight as well as being more physically active compared to HL-women. Brain natriuretic peptide (pro-BNP was higher in HL-women than HL-men, while no differences in metabolic syndrome and glycemic parameters were shown. HL-IGR-women were also older and still had a better profile of sex specific lipid parameters, as well as a lower body weight compared to HL-IGR-men. No differences were seen in vascular parameters such as the intima media thickness (IMT. Conclusion. HL-women were older and had overall more favourable concentrations of lipid parameters and liver enzymes but did not differ regarding vascular morphology and insulin sensitivity compared to HL-men of comparable body mass index (BMI.

  14. New factors of cardiometabolic risk in severely obese children: influence of pubertal status Nuevos factores de riesgo cardiometabólico en niños con obesidad severa: influencia del estado puberal

    Directory of Open Access Journals (Sweden)

    P. Codoñer-Franch

    2010-10-01

    Full Text Available The aim of this prospective study was to evaluate the utility of new biochemical markers to assess cardiometabolic risk in severely obese children and adolescents. A total of 107 subjects aged 7 to 14 years, were clinically assessed and anthropometric measures and percentage of fat mass by single frequency bioimpedance analysis were recorded. Of these, 44 were non-overweight and 63 severely obese (body mass index Z-score >2.5 which were stratified by Tanner stages. To estimate the metabolic risk the following variables were considered for analysis: Waist circumference/height >0.5, fasting glucose >100 mg/dL, triglycerides >110 mg/dL, HDL-C 95th percentile for age and gender. Fasting insulinemia, apoprotein A1 and B, high-sensitive C-reactive protein, alanine aminotransferase, homocysteine, and folic and uric acids were determined. In severely obese children, metabolic risk was present more frequently in mid puberty. The normalized anthropometric parameters with respect to 50th percentile for age and gender did not differ in the presence of metabolic risk. Insulin resistance was an independent determinant of metabolic risk, adjusted by Tanner stages. Elevated high-sensitive C-reactive protein was noted without any effect of metabolic risk or pubertal stage. Homocysteine, apoprotein B, and alanine aminotransferase values increased with metabolic risk and were not influenced by puberty. Although insulin resistance remains the main factor influencing metabolic risk, biochemical markers as homocysteine, apoprotein B, and alanine aminotransferase, may be useful for identifying severe obese pubertal subjects particularly prone to comorbidities.El objetivo de este estudio prospectivo ha sido evaluar la utilidad de nuevos marcadores bioquímicos para evaluar el riesgo cardiometabólico en niños y adolescentes extremadamente obesos. Un total de 107 sujetos de entre 7 a 14 años, se valoraron clínicamente registrando sus medidas antropométricas y el

  15. Neuraminidase inhibitors during pregnancy and risk of adverse neonatal outcomes and congenital malformations

    DEFF Research Database (Denmark)

    Graner, Sophie; Svensson, Tobias; Beau, Anna-Belle

    2017-01-01

    of gestation or later were included. Infants were defined as exposed if the women filled a prescription during pregnancy for either of the two neuraminidase inhibitors oseltamivir or zanamivir.Main outcomes Low birth weight, low Apgar score, preterm birth, small for gestational age birth, stillbirth, neonatal...... and their infants and 692 232 who were not exposed. Exposure to neuraminidase inhibitors in utero was not associated with increased risks of any of the investigated neonatal outcomes, including low birth weight (adjusted odds ratio 0.77, 95% confidence interval 0.65 to 0.91), low Apgar score (adjusted odds ratio 0...

  16. Econometric modelling of risk adverse behaviours of entrepreneurs in the provision of house fittings in China

    Directory of Open Access Journals (Sweden)

    Rita Yi Man Li

    2012-03-01

    Full Text Available Entrepreneurs have always born the risk of running their business. They reap a profit in return for their risk taking and work. Housing developers are no different. In many countries, such as Australia, the United Kingdom and the United States, they interpret the tastes of the buyers and provide the dwellings they develop with basic fittings such as floor and wall coverings, bathroom fittings and kitchen cupboards. In mainland China, however, in most of the developments, units or houses are sold without floor or wall coverings, kitchen  or bathroom fittings. What is the motive behind this choice? This paper analyses the factors affecting housing developers’ decisions to provide fittings based on 1701 housing developments in Hangzhou, Chongqing and Hangzhou using a Probit model. The results show that developers build a higher proportion of bare units in mainland China when: 1 there is shortage of housing; 2 land costs are high so that the comparative costs of providing fittings become relatively low.

  17. Can postponement of an adverse outcome be used to present risk reductions to a lay audience? A population survey

    Directory of Open Access Journals (Sweden)

    Kristiansen Ivar

    2007-03-01

    Full Text Available Abstract Background For shared decision making doctors need to communicate the effectiveness of therapies such that patients can understand it and discriminate between small and large effects. Previous research indicates that patients have difficulties in understanding risk measures. This study aimed to test the hypothesis that lay people may be able to discriminate between therapies when their effectiveness is expressed in terms of postponement of an adverse disease event. Methods In 2004 a random sample of 1,367 non-institutionalized Danes aged 40+ was interviewed in person. The participants were asked for demographic information and asked to consider a hypothetical preventive drug treatment. The respondents were randomized to the magnitude of treatment effectiveness (heart attack postponement of 1 month, 6 months, 12 months, 2 years, 4 years and 8 years and subsequently asked whether they would take such a therapy. They were also asked whether they had hypercholesterolemia or had experienced a heart attack. Results In total 58% of the respondents consented to the hypothetical treatment. The proportions accepting treatment were 39%, 52%, 56%, 64%, 67% and 73% when postponement was 1 month, 6 months, 12 months, 2 years, 4 years and 8 years respectively. Participants who thought that the effectiveness information was difficult to understand, were less likely to consent to therapy (p = 0.004. Conclusion Lay people can discriminate between levels of treatment effectiveness when they are presented in terms of postponement of an adverse event. The results indicate that such postponement is a comprehensible measure of effectiveness.

  18. Low body weight in females is a risk factor for increased tenofovir exposure and drug-related adverse events.

    Directory of Open Access Journals (Sweden)

    Cristina Gervasoni

    Full Text Available Treatment with tenofovir sometimes leads to non-reversible kidney and/or bone diseases. Factors associated with these drug-related adverse events are poorly characterized. Our objective was to investigate such factors in patients treated long term with daily tenofovir. One-hundred Caucasian HIV-positive patients with basal creatinine clearance >80 mL/min treated with tenofovir for at least 6 months and with at least one assessment of tenofovir plasma trough concentrations were considered. Tenofovir-associated adverse events were defined as the appearance of pathological proteinuria, worsening of renal function or bone demineralization. By multivariate regression analysis, we found that serum creatinine (p = 0.003 and body weight (p = 0.002 were the factors independently associated with plasma tenofovir concentrations. In particular, women with body weight50 Kg (160±93 vs.71±52 ng/mL, p<0.001. High tenofovir plasma trough concentrations and the age of the patients were independently associated with the development of drug-related kidney and bone toxicity. In this retrospective study we have shown that HIV-infected women with low body weight are at risk to be exposed to high tenofovir plasma trough concentrations, ultimately resulting in a significant hazard to develop long-term tenofovir complications.

  19. Early Life Adversity as a Risk Factor for Fibromyalgia in Later Life

    Directory of Open Access Journals (Sweden)

    Lucie A. Low

    2012-01-01

    Full Text Available The impact of early life events is increasingly becoming apparent, as studies investigate how early childhood can shape long-term physiology and behaviour. Fibromyalgia (FM, which is characterised by increased pain sensitivity and a number of affective co-morbidities, has an unclear etiology. This paper discusses risk factors from early life that may increase the occurrence or severity of FM in later life: pain experience during neonatal life causes long-lasting changes in nociceptive circuitry and increases pain sensitivity in the older organism; premature birth and related stressor exposure cause lasting changes in stress responsivity; maternal deprivation affects anxiety-like behaviours that may be partially mediated by epigenetic modulation of the genome—all these adult phenotypes are strikingly similar to symptoms displayed by FM sufferers. In addition, childhood trauma and exposure to substances of abuse may cause lasting changes in developing neurotransmitter and endocrine circuits that are linked to anxiety and stress responses.

  20. Paraoxonase 1 Polymorphism and Prenatal Pesticide Exposure Associated with Adverse Cardiovascular Risk Profiles at School Age

    DEFF Research Database (Denmark)

    Andersen, Helle R.; Wohlfahrt-Veje, Christine; Dalgard, Christine

    2012-01-01

    Background: Prenatal environmental factors might influence the risk of developing cardiovascular disease later in life. The HDL-associated enzyme paraoxonase 1 (PON1) has anti-oxidative functions that may protect against atherosclerosis. It also hydrolyzes many substrates, including organophosphate...... prenatally exposed to pesticides. Methods: Pregnant greenhouse-workers were categorized as high, medium, or not exposed to pesticides. Their children underwent a standardized examination at age 6-to-11 years, where blood pressure, skin folds, and other anthropometric parameters were measured. PON1-genotype...... was determined for 141 children (88 pesticide exposed and 53 unexposed). Serum was analyzed for insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP3), insulin and leptin. Body fat percentage was calculated from skin fold thicknesses. BMI results were converted to age and sex...

  1. Soy and cardio-metabolic abnormalities: an update

    Directory of Open Access Journals (Sweden)

    Leila Azadbakht

    2008-04-01

    Full Text Available

    • Soy protein contains beneficial components like complex carbohydrates, unsaturated fatty acids, vegetable protein, soluble fiber, oligosaccharides, vitamins, minerals, inositol-derived substances and phytoestrogens, particularly the isoflavones  genistein, diadzein, and glycitein, which might affect different cardio-metabolic abnormalities. Soy consumption has been reported to beneficially affect features of the metabolic syndrome in animal models and also in humans to some extent. There are inconsistent reports regarding the hypothesis of the effectiveness of soy protein on obesity. While some studies have shown that soy consumption can improve the features of the metabolic syndrome without affecting body weight, others showed that soy consumption has beneficial role in weight management and might improve the metabolic syndrome by affecting body weight control. Several studies have consistently reported the effects of soy on cardiovascular risks. Beneficial role of soy intake on diabetes is another aspect of soy inclusion in the diet. The present study discusses the effects of soy consumption on different cardio-metabolic abnormalities and provides information regarding the possible mechanisms by which soy protein might exert its beneficial roles.
    • KEY WORDS: Soy, cardiovascular disease, diabetes, obesity, metabolic syndrome.

  2. The association between obesity, cardiometabolic disease biomarkers, and innate immunity-related inflammation in Canadian adults

    Directory of Open Access Journals (Sweden)

    Da Costa LA

    2012-10-01

    Full Text Available Laura A Da Costa,1,2,*Paul Arora,2,3,* Bibiana García-Bailo,1,2 Mohamed Karmali,1,2 Ahmed El-Sohemy,1 Alaa Badawi2 1Department of Nutritional Sciences, University of Toronto; 2Office of Biotechnology and Population Health, Public Health Agency of Canada; 3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada *These authors contributed equally to this article Introduction: Obesity is associated with a state of chronic inflammation, and increased cardiometabolic disease risk. The present study examined the relationship between body mass index (BMI and cardiometabolic and inflammatory biomarkers among normal weight, overweight, and obese Canadian adults.Methods: Subjects (n = 1805, aged 18 to 79 years from the Canadian Health Measures Survey (CHMS were examined for associations between BMI, cardiometabolic markers (apolipoprotein [Apo] A1, ApoB, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], total cholesterol, total cholesterol/HDL ratio [total:HDL-C ratio], triglycerides, and glycosylated hemoglobin [HbA1c], inflammatory factors (C-reactive protein [CRP], fibrinogen, and homocysteine, and 25-hydroxyvitamin D [25(OHD]. Bootstrap weights for variance and sampling weights for point estimates were applied to account for the complex survey design. Linear regression models adjusted for age, sex, physical activity, smoking status, and ethnicity (in addition to season of clinic visit, for vitamin D analyses only were used to examine the association between cardiometabolic markers, inflammatory factors, and BMI in Canadian adults.Results: All biomarkers were significantly associated with BMI (P ≤ 0.001. ApoA1 (β = −0.31, P < 0.0001, HDL-C (β = −0.61, P < 0.0001, and 25(OHD (β = −0.25, P < 0.0001 were inversely associated with BMI, while all other biomarkers showed positive linear associations. Distinct patterns of association were noted among normal weight, overweight

  3. Risk of Crew Adverse Health Event Due to Altered Immune Response

    Science.gov (United States)

    Crucian, Brian; Kunz, Hawley; Sams, Clarence F.

    2015-01-01

    . Ground analog testing of humans and animals, as well as microgravity-analog cell culture, has demonstrated utility. However, in all cases, it is not known with certainty if these data would reflect similar testing during space travel. Given their ready availability, ground analogs may be extremely useful for assay development and the evaluation of potential countermeasures. In general, the evidence base suffers from widely disparate studies on small numbers of subjects that do not directly correlate well with each other or spaceflight itself. Also lacking are investigations of the effect of gender on adaption to spaceflight. This results in significant knowledge 'gaps' that must be filled by future studies to completely determine any clinical risk related to immunity for human exploration-class space missions. These gaps include a significant lack of in-flight data, particularly during long-duration space missions. The International Space Station represents an excellent science platform with which to address this knowledge gap. Other knowledge gaps include lack of a single validated ground analog for the phenomenon and a lack of flight-compatible laboratory equipment capable of monitoring astronauts (for either clinical or research purposes). However, enough significant data exist, as described in this manuscript, to warrant addressing this phenomenon during the utilization phase of the ISS. A recent Space Shuttle investigation has confirmed the 31 in-flight nature of immune dysregulation, demonstrating that it is not merely a post-flight phenomenon. Several current studies are ongoing onboard the ISS that should thoroughly characterize the phenomenon. NASA recognizes that if spaceflight-associated immune dysregulation persists during exploration flights in conjunction with other dangers, such as high-energy radiation, the result may be a significant clinical risk. This emphasizes the need for a continued integrated comprehensive approach to determining the effect of

  4. Family-based risk factors for non-suicidal self-injury: Considering influences of maltreatment, adverse family-life experiences, and parent-child relational risk.

    Science.gov (United States)

    Martin, Jodi; Bureau, Jean-François; Yurkowski, Kim; Fournier, Tania Renaud; Lafontaine, Marie-France; Cloutier, Paula

    2016-06-01

    The current investigation addressed the potential for unique influences of perceived childhood maltreatment, adverse family-life events, and parent-child relational trauma on the lifetime occurrence and addictive features of non-suicidal self-injury (NSSI). Participants included 957 undergraduate students (747 females; M = 20.14 years, SD = 3.88) who completed online questionnaires regarding the key variables under study. Although self-injuring youth reported more experiences with each family-based risk factor, different patterns of association were found when lifetime engagement in NSSI or its addictive features were under study. Perceived parent-child relational trauma was uniquely linked with NSSI behavior after accounting for perceived childhood maltreatment; adverse family-life events had an additional unique association. In contrast, perceived paternal maltreatment was uniquely related with NSSI's addictive features. Findings underline the importance of studying inter-related family-based risk factors of NSSI simultaneously for a comprehensive understanding of familial correlates of NSSI behavior and its underlying features.

  5. A Risk-Scoring Model to Predict One-year Major Adverse Cardiac Events after Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Seyed-Ebrahim Kassaian

    2015-12-01

    Full Text Available Background: The aim of the present study was to develop a scoring system for predicting 1-year major adverse cardiac events (MACE, including mortality, target vessel or target lesion revascularization, coronary artery bypass graft surgery, and non-fatal myocardial infarction after percutaneous coronary intervention (PCI.Methods: The data were extracted from a single center PCI registry. The score was created based on the clinical, procedural, and laboratory characteristics of 8206 patients who underwent PCI between April 2004 and October 2009. Consecutive patients undergoing PCI between November 2009 and February 2011 (n= 2875 were included as a validation data set. Results: Diabetes mellitus, increase in the creatinine level, decrease in the left ventricular ejection fraction, presentation with the acute coronary syndrome, number of diseased vessels, primary PCI, PCI on the left anterior descending artery and saphenous vein graft, and stent type and diameter were identified as the predictors of the outcome and used to develop the score (R² = 0.795. The models had adequate goodness of fit (Hosmer-Lemeshow statistic; p value = 0.601 and acceptable ability of discrimination (c-statistics = 0.63. The score categorized the individual patients as low-, moderate-, and high-risk for the occurrence of MACE. The validation of the model indicated a good agreement between the observed and expected risks.Conclusion: An individual risk-scoring system based on both clinical and procedural variables can be used conveniently to predict 1-year MACE after PCI. Risk classification based on this score can assist physicians in decision-making and postprocedural health care. 

  6. Graded Maximal Exercise Testing to Assess Mouse Cardio-Metabolic Phenotypes.

    Directory of Open Access Journals (Sweden)

    Jennifer M Petrosino

    Full Text Available Functional assessments of cardiovascular fitness (CVF are needed to establish animal models of dysfunction, test the effects of novel therapeutics, and establish the cardio-metabolic phenotype of mice. In humans, the graded maximal exercise test (GXT is a standardized diagnostic for assessing CVF and mortality risk. These tests, which consist of concurrent staged increases in running speed and inclination, provide diagnostic cardio-metabolic parameters, such as, VO2max, anaerobic threshold, and metabolic crossover. Unlike the human-GXT, published mouse treadmill tests have set, not staged, increases in inclination as speed progress until exhaustion (PXT. Additionally, they often lack multiple cardio-metabolic parameters. Here, we developed a mouse-GXT with the intent of improving mouse-exercise testing sensitivity and developing translatable parameters to assess CVF in healthy and dysfunctional mice. The mouse-GXT, like the human-GXT, incorporated staged increases in inclination, speed, and intensity; and, was designed by considering imitations of the PXT and differences between human and mouse physiology. The mouse-GXT and PXTs were both tested in healthy mice (C57BL/6J, FVBN/J to determine their ability to identify cardio-metabolic parameters (anaerobic threshold, VO2max, metabolic crossover observed in human-GXTs. Next, theses assays were tested on established diet-induced (obese-C57BL/6J and genetic (cardiac isoform Casq2-/- models of cardiovascular dysfunction. Results showed that both tests reported VO2max and provided reproducible data about performance. Only the mouse-GXT reproducibly identified anaerobic threshold, metabolic crossover, and detected impaired CVF in dysfunctional models. Our findings demonstrated that the mouse-GXT is a sensitive, non-invasive, and cost-effective method for assessing CVF in mice. This new test can be used as a functional assessment to determine the cardio-metabolic phenotype of various animal models or

  7. 图书馆的逆向选择和道德风险的研究%Research on the Library' s Adverse Selection And Moral Risk

    Institute of Scientific and Technical Information of China (English)

    殷菲菲; 俞紫梅

    2012-01-01

    First, The author introduces the concept of the adverse selection and the moral risk. Second, the author analyzes the phenomenon of the adverse selection and the moral risk, which happens in the library. Lastly, the author proposes some countermeasure and suggestion.%首先提出逆向选择和道德风险的概念,然后对图书馆中存在的逆向选择和道德风险进行分析和研究,并针对这些提出了图书馆工作的一些对策和建议。

  8. Proton pump inhibitor use and risk of adverse cardiovascular events in aspirin treated patients with first time myocardial infarction: nationwide propensity score matched study

    DEFF Research Database (Denmark)

    Charlot, Mette; Grove, Erik; Hansen, Peter Riis;

    2011-01-01

    OBJECTIVE: To examine the effect of proton pump inhibitors on adverse cardiovascular events in aspirin treated patients with first time myocardial infarction. DESIGN: Retrospective nationwide propensity score matched study based on administrative data. Setting All hospitals in Denmark. PARTICIPANTS...... analysis showed no increase in risk related to use of H(2) receptor blockers (1.04, 0.79 to 1.38; P=0.78). Conclusion In aspirin treated patients with first time myocardial infarction, treatment with proton pump inhibitors was associated with an increased risk of adverse cardiovascular events....

  9. Propensity-Weighted Comparison of Long-Term Risk of Urinary Adverse Events in Elderly Women Treated For Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Sean P., E-mail: selliott@umn.edu [Department of Urology, University of Minnesota, Minneapolis, Minnesota (United States); Fan, Yunhua; Jarosek, Stephanie [Department of Urology, University of Minnesota, Minneapolis, Minnesota (United States); Chu, Haitao [Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Downs, Levi [Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota (United States); Dusenbery, Kathryn [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Geller, Melissa A. [Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota (United States); Virnig, Beth A. [Department of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota (United States)

    2015-07-01

    Purpose: Cervical cancer treatment is associated with a risk of urinary adverse events (UAEs) such as ureteral stricture and vesicovaginal fistula. We sought to measure the long-term UAE risk after surgery and radiation therapy (RT), with confounding controlled through propensity-weighted models. Methods and Materials: From the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified women ≥66 years old with nonmetastatic cervical cancer treated with simple surgery (SS), radical hysterectomy (RH), external beam RT plus brachytherapy (EBRT+BT), or RT+surgery. We matched them to noncancer controls 1:3. Differences in demographic and cancer characteristics were balanced by propensity weighting. Grade 3 to 4 UAEs were identified by diagnosis codes plus treatment codes. Cumulative incidence was measured using Kaplan-Meier methods. The hazard associated with different cancer treatments was compared using Cox models. Results: UAEs occurred in 272 of 1808 cases (17%) and 222 of 5424 (4%) controls; most (62%) were ureteral strictures. The raw cumulative incidence of UAEs was highest in advanced cancers. UAEs occurred in 31% of patients after EBRT+BT, 25% of patients after RT+surgery, and 15% of patients after RH; however, after propensity weighting, the incidence was similar. In adjusted Cox models (reference = controls), the UAE risk was highest after RT+surgery (hazard ratio [HR], 5.07; 95% confidence interval [CI], 2.32-11.07), followed by EBRT+BT (HR, 3.33; 95% CI, 1.45-7.65), RH (HR, 3.65; 95% CI, 1.41-9.46) and SS (HR, 0.99; 95% CI, 0.32-3.01). The higher risk after RT+surgery versus EBRT+BT was statistically significant, whereas, EBRT+BT and RH were not significantly different from each other. Conclusions: UAEs are common after cervical cancer treatment, particularly in patients with advanced cancers. UAEs are more common after RT, but these women tend to have the advanced cancers. After propensity weighting, the risk after RT was similar

  10. Cardiometabolic treatment decisions in patients with type 2 diabetes : the role of repeated measurements and medication burden

    NARCIS (Netherlands)

    Voorham, J.; Haaijer-Ruskamp, F. M.; Wolffenbuttel, B. H. R.; Stolk, R. P.; Denig, P.

    2010-01-01

    Purpose Clinical guidelines for cardiometabolic risk management indicate a simple threshold-based strategy for treatment, but physicians and their patients may be reluctant to modify drug treatment after a single elevated measurement. We determined how repeated measurements of blood pressure, choles

  11. Early Life Fructose Exposure and Its Implications for Long-Term Cardiometabolic Health in Offspring

    OpenAIRE

    Jia Zheng; Qianyun Feng; Qian Zhang; Tong Wang; Xinhua Xiao

    2016-01-01

    It has become increasingly clear that maternal nutrition can strongly influence the susceptibility of adult offspring to cardiometabolic disease. For decades, it has been thought that excessive intake of fructose, such as sugar-sweetened beverages and foods, has been linked to increased risk of obesity, type 2 diabetes, and cardiovascular disease in various populations. These deleterious effects of excess fructose consumption in adults are well researched, but limited data are available on th...

  12. Fructose and Cardiometabolic Health: What the Evidence from Sugar-Sweetened Beverages Tells Us

    OpenAIRE

    Malik, Vasanti S; Hu, Frank B.

    2015-01-01

    Recent attention has focused on fructose as having a unique role in the pathogenesis cardiometabolic diseases. However since we rarely consume fructose in isolation, the major source of fructose in the diet comes from fructose-containing sugars, sucrose and high fructose corn syrup, in sugar sweetened beverages. Intake of these beverages has been consistently linked to increased risk of obesity, type 2 diabetes and cardiovascular disease in various populations. Putative underlying mechanisms ...

  13. Comparison of Predictive Value of Cardiometabolic Indices for Subclinical Atherosclerosis in Chinese Adults

    OpenAIRE

    Ying Xu; Fang-fang Zeng; Li-ping He; Wen-hua Ling; Wei-qing Chen; Yu-ming Chen

    2014-01-01

    Objectives Metabolic disturbances are well-known risk factors for atherosclerosis, but it remains unclear which cardiometabolic components are the predominant determinants. This study aimed to compare and identify the key determinants of carotid atherosclerosis in asymptomatic middle-aged and elderly Chinese. Methods A community-based cross-sectional study including 3,162 apparently healthy residents aged 37–75 years was performed from July 2008 to June 2010 in Guangzhou, China. Carotid arter...

  14. Adverse trends of cardiovascular risk factors among low risk populations (1983-1994 - a cohort study of workers and farmers in Guangzhou, China

    Directory of Open Access Journals (Sweden)

    Liu Xiaoqing

    2011-12-01

    Full Text Available Abstract Background The levels and trends of cardiovascular risk factors vary greatly throughout China. We examine 10-year trends of cardiovascular risk factors (1983-1994 and the factors related to these trends among low-risk cohorts of workers and farmers in Guangzhou, China. Methods This is a cohort study of 3,131 workers and 3,493 farmers aged 25-64 years at baseline with 10 years of follow-up. We performed a longitudinal analysis to account for the aging of the cohorts and the repeated measures of the same individual. Results At baseline the prevalence of overweight (including obese ranged from 1.0% to 11.8%, hypertension ranged from 3.8% to 10.5%, and mean serum total cholesterol (TC ranged from 155.4 mg/dl to 187.2 mg/dl. Although prevalence of smoking declined, blood pressure levels and body mass index (BMI increased significantly, and lipid profiles changed unfavorably during the 10-year follow-ups. The prevalence of hypertension increased from 5.0 percentage points (female farmers to 12.3 percentage points (male farmers. Mean TC increased significantly (e.g., +22.8 mg/dl and +17.0 mg/dl in male and female farmers, respectively. In the longitudinal data analyses, increase in BMI was associated with increase in blood pressure levels and TC. Significant adverse trends of risk factors persisted after adjustment for aging, education, BMI, smoking, and alcohol intake. Conclusion Urgent action is needed to prevent and reverse the unhealthy trends occurring among these low risk Chinese workers and farmers.

  15. Adverse life events as risk factors for behavioural and emotional problems in a 7-year follow-up of a population-based child cohort

    DEFF Research Database (Denmark)

    Rasmussen, Cathrine Skovmand; Nielsen, Louise Gramstrup; Petersen, Dorthe Janne

    2014-01-01

    Background and aim: The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events. Methods: Data...... on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change. Results: Parental divorce...... significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers...

  16. Evaluation of risk profiles for gastrointestinal and cardiovascular adverse effects in nonselective NSAID and COX-2 inhibitor users - A cohort study using pharmacy dispensing data in the Netherlands

    NARCIS (Netherlands)

    Layton, Deborah; Souverein, Patrick C.; Heerdink, Eibert R.; Shakir, Saad A. W.; Egberts, Antoine C. G.

    2008-01-01

    Background: Newly approved drugs, in comparison with older drugs, are more often prescribed to patients who have not responded satisfactorily to established related drugs or as first-line therapy to patients with a high baseline risk for adverse outcomes (i.e. channelling). However, these patients a

  17. Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Raushan Alibekova

    Full Text Available OBJECTIVES: To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility. STUDY DESIGN: A retrospective cohort study. METHODS: Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertility matched to the study sample by maternal age. A conditional logistic regression analysis was performed for the analysis. RESULTS: Women diagnosed with infertility respectively had 1.39 (95% CI, 1.06~1.83, 1.15 (95% CI, 1.08~1.24, 1.13 (95% CI, 1.08~1.18, and 1.08 (95% CI, 1.05~1.12 higher odds of having very low birth weight (VLBW babies, preterm births, labor complications, and cesarean sections (CSs compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of prenatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a VLBW baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile women with adequate care. CONCLUSIONS: Study findings suggest that adequate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility.

  18. Defining the residual risk of adverse perinatal outcome in growth restricted fetuses with normal umbilical artery blood flow.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2014-07-25

    To determine the cause of adverse perinatal outcome in fetal growth restriction(FGR) where umbilical artery Doppler(UA) was normal, as identified from the Prospective Observational Trial to Optimize Pediatric Health(PORTO). We compared cases of adverse outcome where UA Doppler was normal and abnormal.

  19. Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

    Science.gov (United States)

    Flynn-Evans, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra

    2016-01-01

    Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk as follows: Sleep loss is apparent during spaceflight. Astronauts consistently average less sleep during spaceflight relative to on the ground. The causes of this sleep loss remain unknown, however ground-based evidence suggests that the sleep duration of astronauts is likely to lead to performance impairment and short and long-term health consequences. Further research is needed in this area in order to develop screening tools to assess individual astronaut sleep need in order to quantify the magnitude of sleep loss during spaceflight; current and planned efforts in BHP's research portfolio address this need. In addition, it is still unclear whether the conditions of spaceflight environment lead to sleep loss or whether other factors, such as work overload lead to the reduced sleep duration. Future data mining efforts and continued data collection on the ISS will help to further characterize factors contributing to sleep loss. Sleep inertia has not been evaluated during spaceflight. Ground-based studies confirm that it takes two to four hours to achieve optimal performance after waking from a sleep episode. Sleep inertia has been associated with increased accidents and reduced performance in operational environments. Sleep inertia poses considerable risk during spaceflight when emergency

  20. Early Life Fructose Exposure and Its Implications for Long-Term Cardiometabolic Health in Offspring

    Directory of Open Access Journals (Sweden)

    Jia Zheng

    2016-11-01

    Full Text Available It has become increasingly clear that maternal nutrition can strongly influence the susceptibility of adult offspring to cardiometabolic disease. For decades, it has been thought that excessive intake of fructose, such as sugar-sweetened beverages and foods, has been linked to increased risk of obesity, type 2 diabetes, and cardiovascular disease in various populations. These deleterious effects of excess fructose consumption in adults are well researched, but limited data are available on the long-term effects of high fructose exposure during gestation, lactation, and infancy. This review aims to examine the evidence linking early life fructose exposure during critical periods of development and its implications for long-term cardiometabolic health in offspring.

  1. Frequent Mental Distress, Chronic Conditions, and Adverse Health Behaviors in the Behavioral Risk Factor Surveillance Survey, Jordan, 2007

    Directory of Open Access Journals (Sweden)

    Mohannad Al-Nsour, MD, MSc

    2013-08-01

    Full Text Available Introduction Recent evidence indicates that chronic diseases and mental illness are associated. In the Middle Eastern country of Jordan, chronic diseases and frequent mental distress (FMD are increasing; however, the capacity for mental health care is limited. The objective of this study was to determine the association between FMD, chronic conditions, and adverse health behaviors in Jordan. Methods The third cycle of the Jordan Behavioral Risk Factor Surveillance Survey (2007 served as the data source for this study. The sample consisted of 3,612 noninstitutionalized Jordanian adults aged 18 years or older. Logistic regression was used to obtain odds ratios for the association between chronic conditions, health behaviors, and FMD adjusted for age, sex, marital status, education, income, and employment. Results In the adjusted models, people with hypertension (adjusted odds ratio [AOR], 2.0; 95% confidence interval [CI], 1.6–2.7, high cholesterol (AOR, 2.3; 95% CI, 1.6–3.2, diabetes (AOR, 1.6; 95% CI, 1.1–2.4, and asthma (AOR, 2.2; 95% CI, 1.5–3.1 and smokers (AOR, 1.5; 95% CI, 1.1–2.0 were more likely to have FMD than people without each of these conditions. Adults who reported vigorous physical activity were less likely to have FMD (AOR, 0.6; 95% CI, 0.4–0.9 than their less active counterparts. Conclusions In Jordan, FMD was associated with several chronic conditions. As a result, we suggest additional research to examine the complex relationship between FMD and chronic conditions. More doctors in the primary health care system should be trained in mental health.

  2. Health Outcomes of Information System Use Lifestyles among Adolescents: Videogame Addiction, Sleep Curtailment and Cardio-Metabolic Deficiencies.

    Directory of Open Access Journals (Sweden)

    Ofir Turel

    Full Text Available Obesity is a rising problem among adolescents in modern societies; it results in long-term cardio-metabolic problems. Possible overlooked drivers of obesity and its consequent cardio-metabolic deficits include videogame addiction and the resulting curtailed sleep; both are growing problems among adolescents. The objective of this study is to examine possible associations among these concepts in adolescents, as a means to point to plausible interventions.Data were collected from 94 adolescents who play videogames and are enrolled in outpatient clinics, using surveys, wearable sleep monitors (FitBit, physical exams, and blood tests at three points in time. These data were subjected to structural equation modeling (SEM analyses and bootstrapping-based mediation testing procedures.Videogame addiction among adolescents was negatively associated with sleep duration (β = -0.24. Sleep duration was negatively associated with obesity (β = -0.30, which in turn was associated with elevated blood pressure (β = 0.26, low high-density lipoprotein cholesterol (β = -0.18, high triglycerides (β = 0.61, and high insulin resistance (β = 0.39. The model explained 36.2% of the variation in sleep duration, 32.7% of the variation in obesity, and between 12.8% and 28.1% of the variation in cardio-metabolic indicators. Post-hoc analyses indicated that curtailed sleep is a possible full mediator of the association between videogame addiction, abdominal obesity and the associated cardio-metabolic deficits.The findings point to possible information systems use lifestyle-health links, which behooves researchers and practitioners to pay closer attention to possible adverse health outcomes of technology-related addictions. Interventions that target problematic video-gaming and sleep should be devised as a possible means for improving adolescents' long-term cardio-metabolic health.

  3. Cardiometabolic and reproductive benefits of early dietary energy restriction and voluntary exercise in an obese PCOS-prone rodent model.

    Science.gov (United States)

    Diane, Abdoulaye; Kupreeva, Maria; Borthwick, Faye; Proctor, Spencer D; Pierce, W David; Vine, Donna F

    2015-09-01

    Polycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic disorders in women of reproductive age characterized by ovulatory dysfunction, hyperandrogenism and cardiometabolic risk. The overweight-obese PCOS phenotype appears to have exacerbated reproductive dysfunction and cardiometabolic risk. In overweight-obese adult women with PCOS, exercise and energy restricted diets have shown limited and inconsistent effects on both cardiometabolic indices and reproductive outcomes. We hypothesized that an early lifestyle intervention involving exercise and dietary energy restriction to prevent or reduce the propensity for adiposity would modulate reproductive indices and cardiometabolic risk in an obese PCOS-prone rodent model. Weanling obese PCOS-prone and Lean-Control JCR:LA-cp rodents were given a chow diet ad libitum or an energy-restricted diet combined with or without voluntary exercise (4  h/day) for 8 weeks. Dietary energy restriction and exercise lowered total body weight gain and body fat mass by 30% compared to free-fed sedentary or exercising obese PCOS-prone animals (Pexercise intensity compared to free-feeding plus exercise conditions. Energy restriction and exercise decreased fasting plasma triglycerides and apoB48 concentrations in obese PCOS-prone animals compared to free-fed and exercise or sedentary groups. The energy restriction and exercise combination in obese PCOS-prone animals significantly increased plasma sex-hormone binding globulin, hypothalamic cocaine-and amphetamine-regulated transcript (CART) and Kisspeptin mRNA expression to levels of the Lean-Control group, and this was further associated with improvements in estrous cyclicity. The combination of exercise and dietary energy restriction when initiated in early life exerts beneficial effects on cardiometabolic and reproductive indices in an obese PCOS-prone rodent model, and this may be associated with normalization of the hypothalamic neuropeptides, Kisspeptin and CART.

  4. Maternal obesity in females born small: Pregnancy complications and offspring disease risk.

    Science.gov (United States)

    Mahizir, Dayana; Briffa, Jessica F; Hryciw, Deanne H; Wadley, Glenn D; Moritz, Karen M; Wlodek, Mary E

    2016-01-01

    Obesity is a major public health crisis, with 1.6 billion adults worldwide being classified as overweight or obese in 2014. Therefore, it is not surprising that the number of women who are overweight or obese at the time of conception is increasing. Obesity during pregnancy is associated with the development of gestational diabetes and preeclampsia. The developmental origins of health and disease hypothesis proposes that perturbations during critical stages of development can result in adverse fetal changes that leads to an increased risk of developing diseases in adulthood. Of particular concern, children born to obese mothers are at a greater risk of developing cardiometabolic disease. One subset of the population who are predisposed to developing obesity are children born small for gestational age, which occurs in 10% of pregnancies worldwide. Epidemiological studies report that these growth-restricted children have an increased susceptibility to type 2 diabetes, obesity, and hypertension. Importantly during pregnancy, growth-restricted females have a higher risk of developing cardiometabolic disease, indicating that they may have an exacerbated phenotype if they are also overweight or obese. Thus, the development of early pregnancy interventions targeted to obese mothers may prevent their children from developing cardiometabolic disease in adulthood.

  5. Effect of an inpatient nursing risk early warning and control system in Shanghai: A retrospective study of adverse events

    Directory of Open Access Journals (Sweden)

    Qian Wu

    2015-06-01

    Conclusion: The establishment of an inpatient early warning and control system could effectively avoid nursing risk, improve risk prevention abilities, improve patient safety, and improve nursing quality.

  6. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Bijaya K Padhi

    2015-07-01

    Full Text Available The importance of maternal sanitation behaviour during pregnancy for birth outcomes remains unclear. Poor sanitation practices can promote infection and induce stress during pregnancy and may contribute to adverse pregnancy outcomes (APOs. We aimed to assess whether poor sanitation practices were associated with increased risk of APOs such as preterm birth and low birth weight in a population-based study in rural India.A prospective cohort of pregnant women (n = 670 in their first trimester of pregnancy was enrolled and followed until birth. Socio-demographic, clinical, and anthropometric factors, along with access to toilets and sanitation practices, were recorded at enrolment (12th week of gestation. A trained community health volunteer conducted home visits to ensure retention in the study and learn about study outcomes during the course of pregnancy. Unadjusted odds ratios (ORs and adjusted odds ratios (AORs and 95% confidence intervals for APOs were estimated by logistic regression models. Of the 667 women who were retained at the end of the study, 58.2% practiced open defecation and 25.7% experienced APOs, including 130 (19.4% preterm births, 95 (14.2% births with low birth weight, 11 (1.7% spontaneous abortions, and six (0.9% stillbirths. Unadjusted ORs for APOs (OR: 2.53; 95% CI: 1.72-3.71, preterm birth (OR: 2.36; 95% CI: 1.54-3.62, and low birth weight (OR: 2.00; 95% CI: 1.24-3.23 were found to be significantly associated with open defecation practices. After adjustment for potential confounders such as maternal socio-demographic and clinical factors, open defecation was still significantly associated with increased odds of APOs (AOR: 2.38; 95% CI: 1.49-3.80 and preterm birth (AOR: 2.22; 95% CI: 1.29-3.79 but not low birth weight (AOR: 1.61; 95% CI: 0.94-2.73. The association between APOs and open defecation was independent of poverty and caste. Even though we accounted for several key confounding factors in our estimates, the

  7. Chronic administration of grape-seed polyphenols attenuates the development of hypertension and improves other cardiometabolic risk factors associated with the metabolic syndrome in cafeteria diet-fed rats.

    Science.gov (United States)

    Pons, Zara; Margalef, Maria; Bravo, Francisca I; Arola-Arnal, Anna; Muguerza, Begoña

    2017-01-01

    The effects of grape-seed polyphenols against the development of hypertension and other cardiometabolic conditions associated with the metabolic syndrome (MetS) were studied in rats fed a high-fat, high-carbohydrate diet, known as the cafeteria (CAF) diet. Two groups of Wistar rats were fed standard (STD) or CAF diets for 12 weeks. The CAF diet-fed rats were administered different doses of a low-molecular-weight grape-seed polyphenol extract (LM-GSPE) (25, 100 and 200 mg/kg per d) or vehicle daily, and the STD diet-fed rats were administered LM-GSPE (100 mg/kg per d) or vehicle using ten animals per group. Body weight (BW), waist perimeter (WP) and systolic and diastolic blood pressures (BP) by the tail-cuff method were recorded weekly. The animals were housed in metabolic chambers every 2 weeks to estimate daily food and liquid intakes and to collect faeces and urine samples. The plasma lipid profile was analysed at time 0 and on the 4th, 7th, 10th and 12th weeks of the experiment. Moreover, plasma leptin was measured at the end of the experiment. Results demonstrated that LM-GSPE, when administered with the CAF diet, attenuated the increase in BP, BW, WP and improved lipid metabolism in these animals. However, although the 25- and 100-mg/kg per d doses were sufficient to produce beneficial effects on BP and lipid metabolism, a 200-mg/kg per d dose was necessary to have an effect on BW and WP. The present findings suggest that LM-GSPE is a good candidate for a BP-lowering agent that can also ameliorate other conditions associated with the MetS.

  8. Impact of early psychosocial factors (childhood socioeconomic factors and adversities on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

    Directory of Open Access Journals (Sweden)

    Tamayo Teresa

    2010-09-01

    Full Text Available Abstract Background Psychological factors and socioeconomic status (SES have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of

  9. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies.

    Science.gov (United States)

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Tucker, Patrick S; Fenning, Andrew S

    2017-03-01

    The current review clarifies the cardiometabolic health effects of high-intensity interval training (HIIT) in adults. A systematic search (PubMed) examining HIIT and cardiometabolic health markers was completed on 15 October 2015. Sixty-five intervention studies were included for review and the methodological quality of included studies was assessed using the Downs and Black score. Studies were classified by intervention duration and body mass index classification. Outcomes with at least 5 effect sizes were synthesised using a random-effects meta-analysis of the standardised mean difference (SMD) in cardiometabolic health markers (baseline to postintervention) using Review Manager 5.3. Short-term (ST) HIIT (HIIT (≥12 weeks) significantly improved waist circumference (SMD -0.20, 95% CI -0.38 to -0.01; pHIIT demonstrated no effect on insulin, lipid profile, C reactive protein or interleukin 6 in overweight/obese populations. In normal weight populations, ST-HIIT and LT-HIIT significantly improved VO2 max, but no other significant effects were observed. Current evidence suggests that ST-HIIT and LT-HIIT can increase VO2 max and improve some cardiometabolic risk factors in overweight/obese populations.

  10. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.

    LENUS (Irish Health Repository)

    Hamilton, Hilary

    2011-06-13

    Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.

  11. Cocoa, glucose tolerance, and insulin signaling: cardiometabolic protection.

    Science.gov (United States)

    Grassi, Davide; Desideri, Giovambattista; Mai, Francesca; Martella, Letizia; De Feo, Martina; Soddu, Daniele; Fellini, Emanuela; Veneri, Mariangela; Stamerra, Cosimo A; Ferri, Claudio

    2015-11-18

    Experimental and clinical evidence reported that some polyphenol-rich natural products may offer opportunities for the prevention and treatment of type 2 diabetes, due to their biological properties. Natural products have been suggested to modulate carbohydrate metabolism by various mechanisms, such as restoring β-cell integrity and physiology and enhancing insulin-releasing activity and glucose uptake. Endothelium is fundamental in regulating arterial function, whereas insulin resistance plays a pivotal role in pathophysiological mechanisms of prediabetic and diabetic states. Glucose and insulin actions in the skeletal muscle are improved by insulin-dependent production of nitric oxide, favoring capillary recruitment, vasodilatation, and increased blood flow. Endothelial dysfunction, with decreased nitric oxide bioavailability, is a critical step in the development of atherosclerosis. Furthermore, insulin resistance has been described, at least in part, to negatively affect endothelial function. Consistent with this, conditions of insulin resistance are usually linked to endothelial dysfunction, and the exposure of the endothelial cells to cardiovascular risk factors such as hypertension, dyslipidemia, and hyperglycemia is associated with reduced nitric oxide bioavailability, resulting in impaired endothelial-dependent vasodilatation. Moreover, endothelial dysfunction has been described as an independent predictor of cardiovascular risk and events. Cocoa and cocoa flavonoids may positively affect the pathophysiological mechanisms involved in insulin resistance and endothelial dysfunction with possible benefits in the prevention of cardiometabolic diseases.

  12. Concomitant use of clopidogrel and statins and risk of major adverse cardiovascular events following coronary stent implantation

    DEFF Research Database (Denmark)

    Schmidt, Morten; Johansen, Martin B; Mæng, Michael

    2012-01-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The CYP3A4 inhibition by lipophilic statins may attenuate the effectiveness of clopidogrel. • No studies have measured drug exposure in a time-varying manner that detects discontinuation and restart of clopidogrel and statin therapy, allowing clinical...... quantification of the interaction effect. WHAT THIS STUDY ADDS • Clopidogrel and CYP3A4-metabolizing statin use were each associated with a substantially reduced rate of major adverse cardiovascular events within 12 months after coronary stent implantation. • Although we observed an interaction between use...... of clopidogrel and statins, statin use vs. non-use was not associated with an increased rate of major adverse cardiovascular events in patients using clopidogrel after coronary stent implantation. AIMS To examine whether CYP3A4-metabolizing statin use modified the association between clopidogrel use and major...

  13. Risk of adverse events with bevacizumab addition to therapy in advanced non-small-cell lung cancer: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Lai XX

    2016-04-01

    Full Text Available Xi-Xi Lai, Ren-Ai Xu, Yu-Ping Li, Han Yang Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China Background: Bevacizumab, a monoclonal antibody against vascular endothelial growth factor ligand, has shown survival benefits in the treatment of many types of malignant tumors, including non-small-cell lung cancer (NSCLC. We conducted this systematic review and meta-analysis to investigate the risk of the most clinically relevant adverse events related to bevacizumab in advanced NSCLC.Methods: Databases from PubMed, Web of Science, and Cochrane Library up to August 2015, were searched to identify relevant studies. We included prospective randomized controlled Phase II/III clinical trials that compared therapy with or without bevacizumab for advanced NSCLC. Summary relative risk (RR and 95% confidence intervals were calculated using random effects or fixed effects according to the heterogeneity among included trials.Results: A total of 3,745 patients from nine clinical trials were included in the meta-analysis. Summary RRs showed a statistically significant bevacizumab-associated increased risk in three of the adverse outcomes studied: proteinuria (RR =7.55, hypertension (RR =5.34, and hemorrhagic events (RR =2.61. No statistically significant differences were found for gastrointestinal perforation (P=0.60, arterial and venous thromboembolic events (P=0.35 and P=0.92, respectively, or fatal events (P=0.29.Conclusion: The addition of bevacizumab to therapy in advanced NSCLC did significantly increase the risk of proteinuria, hypertension, and hemorrhagic events but not arterial/venous thromboembolic events, gastrointestinal perforation, or fatal adverse events. Keywords: toxicities, angiogenesis inhibitors, non-small-cell lung carcinoma, meta-analysis, safety

  14. Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection to obese adults in mid-life?

    DEFF Research Database (Denmark)

    Howe, Laura D; Zimmermann, Esther; Weiss, Ram

    2014-01-01

    that rapid BMI growth in childhood or early-onset obesity was associated with either MHO or the MANW phenotype, for example, among obese men in mid-life, the OR for MHO comparing early-onset obesity with non-early-onset obesity was 0.97 (95% CI 0.85 to 1.10). CONCLUSIONS: We found no robust evidence......OBJECTIVE: Some obese individuals have no cardiometabolic abnormalities; they are 'metabolically healthy, but obese' (MHO). Similarly, some non-obese individuals have cardiometabolic abnormalities, that is, 'metabolically at risk, normal weight' (MANW). Previous studies have suggested that early...... evidence...

  15. A dietary biomarker approach captures compliance and cardiometabolic effects of a healthy nordic diet in individuals with metabolic syndrome

    DEFF Research Database (Denmark)

    Marklund, Matti; Magnusdottir, Ola K; Rosqvist, Fredrik;

    2014-01-01

    compared with the whole study population. From a recently conducted isocaloric randomized trial, SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies), in 166 individuals with metabolic syndrome, several DBs were assessed to reflect different key components of the ND: canola oil......Assessment of compliance with dietary interventions is necessary to understand the observed magnitude of the health effects of the diet per se. To avoid reporting bias, different dietary biomarkers (DBs) could be used instead of self-reported data. However, few studies investigated a combination...... of DBs to assess compliance and its influence on cardiometabolic risk factors. The objectives of this study were to use a combination of DBs to assess compliance and to investigate how a healthy Nordic diet (ND) influences cardiometabolic risk factors in participants with high apparent compliance...

  16. Hepatic function and the cardiometabolic syndrome

    Directory of Open Access Journals (Sweden)

    Wiernsperger N

    2013-10-01

    Full Text Available Nicolas WiernspergerINSERM French Institute of Health and Medical Research, U1060, National Institute of Applied Sciences, Lyon, University of Lyon, Villeurbanne, FranceAbstract: Despite skeletal muscle being considered by many as the source of insulin resistance, physiology tells us that the liver is a central and cardinal regulator of glucose homeostasis. This is sometimes underestimated because, in contrast with muscle, investigations of liver function are technically very difficult. Nevertheless, recent experimental and clinical research has demonstrated clearly that, due in part to its anatomic position, the liver is exquisitely sensitive to insulin and other hormonal and neural factors, either by direct intrahepatic mechanisms or indirectly by organ cross-talk with muscle or adipose tissue. Because the liver receives absorbed nutrients, these have a direct impact on liver function, whether via a caloric excess or via the nature of food components (eg, fructose, many lipids, and trans fatty acids. An emerging observation with a possibly great future is the increase in intestinal permeability observed as a consequence of high fat intake or bacterial modifications in microbiota, whereby substances normally not crossing the gut gain access to the liver, where inflammation, oxidative stress, and lipid accumulation leads to fatty liver, a situation observed very early in the development of diabetes. The visceral adipose tissue located nearby is another main source of inflammatory substances and oxidative stress, and also acts on hepatocytes and Kupffer cells, resulting in stimulation of macrophages. Liberation of these substances, in particular triglycerides and inflammation factors, into the circulation leads to ectopic fat deposition and vascular damage. Therefore, the liver is directly involved in the development of the prediabetic cardiometabolic syndrome. Treatments are mainly metformin, and possibly statins and vitamin D. A very promising

  17. Risk of infection and adverse outcomes among pregnant working women in selected occupational groups: A study in the Danish National Birth Cohort

    Directory of Open Access Journals (Sweden)

    Llopis-González Agustín

    2010-11-01

    Full Text Available Abstract Background Exposure to infectious pathogens is a frequent occupational hazard for women who work with patients, children, animals or animal products. The purpose of the present study is to investigate if women working in occupations where exposure to infections agents is common have a high risk of infections and adverse pregnancy outcomes. Methods We used data from the Danish National Birth Cohort, a population-based cohort study and studied the risk of Infection and adverse outcomes in pregnant women working with patients, with children, with food products or with animals. The regression analysis were adjusted for the following covariates: maternal age, parity, history of miscarriage, socio-occupational status, pre-pregnancy body mass index, smoking habit, alcohol consumption. Results Pregnant women who worked with patients or children or food products had an excess risk of sick leave during pregnancy for more than three days. Most of negative reproductive outcomes were not increased in these occupations but the prevalence of congenital anomalies (CAs was slightly higher in children of women who worked with patients. The prevalence of small for gestational age infants was higher among women who worked with food products. There was no association between occupation infections during pregnancy and the risk of reproductive failures in the exposed groups. However, the prevalence of CAs was slightly higher among children of women who suffered some infection during pregnancy but the numbers were small. Conclusion Despite preventive strategies, working in specific jobs during pregnancy may impose a higher risk of infections, and working in some of these occupations may impose a slightly higher risk of CAs in their offspring. Most other reproductive failures were not increased in these occupations.

  18. Not all fats are created equal: adipose vs. ectopic fat, implication in cardiometabolic diseases.

    Science.gov (United States)

    Gaggini, Melania; Saponaro, Chiara; Gastaldelli, Amalia

    2015-04-01

    Adipose tissue is a recognized endocrine organ that acts not only as a fuel storage but also is able to secrete adipokines that can modulate inflammation. Most of the fat is composed of white adipocytes (WAT), although also brown/beige adipocytes (BAT/BeAT) have been found in humans. BAT is located close to the neck but also among WAT in the epicardial fat and perivascular fat. Adipocyte hypertrophy and infiltration of macrophages impair adipose tissue metabolism determining "adiposopathy" (i.e., sick fat) and increasing the risk to develop metabolic and cardiovascular diseases. The purpose of this review was to search and discuss the available literature on the impact of different types of fat and fat distribution on cardiometabolic risk. Visceral fat, but also ectopic fat, either in liver, muscle and heart, can increase the risk to develop insulin resistance, type 2 diabetes and cardiovascular diseases. Results recently published showed that BAT could have an impact on cardiometabolic risk, not only because it is implicated in energy metabolism but also because it can modulate glucose and lipid metabolism. Therapeutical interventions that can increase energy expenditure, successfully change fat distribution and reduce ectopic fat, also through BAT activation, were discussed.

  19. Sugar-containing beverage intake at the age of 1 year and cardiometabolic health at the age of 6 years: The Generation R Study

    NARCIS (Netherlands)

    E.T.M. Leermakers (Lisan); J.F. Felix (Janine); V.W.V. Jaddoe (Vincent); H. Raat (Hein); O.H. Franco (Oscar); J.C. Kiefte-de Jong (Jessica)

    2015-01-01

    textabstractBackground: Consumption of sugar-containing beverages (SCBs) in adults has been associated with an increased risk of metabolic syndrome. Although the effect of SCB on body weight in children is well established, little is known about the cardiometabolic effects in young children. We stud

  20. A combined supplementation of vitamin B12 and omega-3 fatty acids across two generations improves cardiometabolic variables in rats.

    Science.gov (United States)

    Khaire, Amrita; Rathod, Richa; Randhir, Karuna; Kale, Anvita; Joshi, Sadhana

    2016-09-14

    Our earlier studies indicate that micronutrients (vitamin B12, folic acid) and omega-3 fatty acids especially docosahexaenoic acid (DHA) are interlinked in one carbon cycle. The present study examines the effects of a sustained vitamin B12 deficiency/supplementation in the presence of omega-3 fatty acids across two generations on the pregnancy outcome and cardiometabolic profile [blood pressure, plasma lipid profile (cholesterol and triglycerides), plasma/liver fatty acid profile and hepatic lipid metabolism] in the second generation adult Wistar rat offspring. Two generations of animals were fed the following diets: control; vitamin B12 deficient; vitamin B12 supplemented; vitamin B12 deficient diet supplemented with omega-3 fatty acids; vitamin B12 and omega-3 fatty acid supplemented diets. Male offspring were sacrificed at 3 months of age. Vitamin B12 deficiency lowered the weight gain (p B12 supplementation showed weight gain, blood pressure and the fatty acid profile similar to the control. However, it increased (p B12 deficient group lowered the weight gain although the levels of cardiometabolic variables were comparable to the control. Omega-3 fatty acid supplementation in the presence of vitamin B12 improved the pregnancy outcome and all cardio-metabolic variables. Our study highlights the adverse effects of sustained vitamin B12 deficiency across two generations on the pregnancy outcome, fatty acid profile and blood pressure while a combined supplementation of vitamin B12 and omega-3 fatty acids is beneficial.

  1. Normal karyotype mosaicism in adult AML patients with adverse-risk and undefined karyotype: preliminary report of treatment outcomes after hematopoietic stem cell transplantation.

    Science.gov (United States)

    Yoon, Jae-Ho; Kim, Hee-Je; Shin, Seung-Hwan; Yahng, Seung-Ah; Cho, Byung-Sik; Eom, Ki-Seong; Kim, Yoo-Jin; Lee, Seok; Min, Chang-Ki; Cho, Seok-Goo; Kim, Dong-Wook; Lee, Jong-Wook; Min, Woo-Sung; Park, Chong-Won

    2013-06-01

    Karyotype analysis in acute myeloid leukemia (AML) is one of the powerful prognostic factors for complete remission (CR), relapse, and overall survival (OS). Cytogenetic mosaicism is considered to be one of the important characteristics in expression of phenotypic manifestations. However, it has not come into focus due to emerging molecular biological approaches and the results of a number of mutation studies. Clinical correlates and prognostic relevance of mosaicism were evaluated in 163 AML patients [adverse-risk karyotypes (n = 72) and undefined karyotypes (n = 91)]. All patients were treated by induction and consolidation chemotherapies and finally went on hematopoietic stem cell transplantations (HSCT). Patients were divided into two subgroups, either with or without normal karyotype (NK) mosaicism. Seventy patients exhibited NK mosaicism and 93 did not. There were no significant differences in age, gender, chemotherapy cycles to achieve CR, HSCT donor type, source or intensity properties between the two subgroups. We found that NK mosaicism remaining in adverse-risk and undefined karyotype at diagnosis significantly correlates with better OS (p = 0.001) and lower CIR (p = 0.021) rate after HSCT. Our data show that the poor prognostic properties of unfavorable risk karyotype can be overcome to a great extent by allogeneic HSCT and chronic GVHD, especially in the subgroup with NK mosaicism. Cytogenetic mosaicism at initial diagnosis can be an influential factor for survival outcomes, even after HSCT.

  2. Periodontal Treatment Reduces Risk of Adverse Respiratory Events in Patients With Chronic Obstructive Pulmonary Disease: A Propensity-Matched Cohort Study.

    Science.gov (United States)

    Shen, Te-Chun; Chang, Pei-Ying; Lin, Cheng-Li; Chen, Chia-Hung; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang; Kao, Chia-Hung

    2016-05-01

    Treatment of periodontal diseases has been associated with benefit outcomes for patients with chronic obstructive pulmonary disease (COPD). However, no population-based cohort study has been conducted. We evaluated this relationship by retrospective cohort study using a large population data.Using the National Health Insurance claims data of Taiwan, we identified 5562 COPD patients with periodontal diseases who had received periodontal treatment as the treatment group. The comparison group was selected at a 1:1 ratio matched by the propensity score estimated with age, sex, date of COPD diagnosis and periodontal treatment, and comorbidities. Both groups were followed up for 5 years to compare risks of acute exacerbation, pneumonia, and acute respiratory failure.The incidence rates of adverse respiratory events were significantly lower in the treatment group than in the comparison group: 3.79 versus 4.21 per 100 person-years for emergency room visits, 2.75 versus 3.65 per 100 person-years for hospitalizations, and 0.66 versus 0.75 per 100 person-years for intensive care unit admissions. The treatment group also had a 37% reduced risk of deaths (1.81 vs 2.87 per 100 person-years), with an adjusted hazard ratio of 0.57 (95% confidence interval 0.52-0.62).Periodontal treatment for COPD patients could reduce the risk of adverse respiratory events and mortality. The adequate periodontal health care is important for COPD patients with periodontal diseases.

  3. The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease.

    Science.gov (United States)

    Kim, Tae Nyun; Choi, Kyung Mook

    2015-07-01

    The important changes in body composition associated with aging are a decline in skeletal muscle mass and an increase in body fat. Body fat distribution also changes with age; subcutaneous fat decreases and visceral abdominal fat increase, which contributes to numerous cardiometabolic diseases (CMDs) such as type 2 diabetes, dyslipidemia, and cardiovascular disease (CVD). Sarcopenia often accompanied by an increase in body fat and vice versa, a scenario termed sarcopenic obesity (SO), which might lead to the cumulative risk of both sarcopenia and obesity. However, there is still no consensus regarding the definition and consequences of SO. The lack of a unified definition for SO might contribute to inconsistent findings about the association of SO with CMD. Complex etiologies are associated with development of SO. A vicious cycle between the loss of muscle and the accumulation of ectopic fat might be associated with CMD via an intricate interplay of factors including proinflammatory cytokines, oxidative stress, mitochondrial dysfunction, insulin resistance, dietary energy, physical activity, mitochondrial dysfunction, and other factors that have yet to be identified. Moreover, recent epidemiological studies suggest that SO is related to CVD and mortality. This review focuses on the current literature with regard to the association between sarcopenia, dynapenia, and obesity, as well as their implications for CMD. The ultimate goal of this Prospects is to encourage conduct of well-designed future studies that elucidate the relationship among sarcopenia, SO, and CMD.

  4. Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Dillon, David G; Gurdasani, Deepti; Riha, Johanna;

    2013-01-01

    Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations....

  5. Exenatide once weekly: sustained improvement in glycemic control and cardiometabolic measures through 3 years

    Directory of Open Access Journals (Sweden)

    MacConell L

    2013-01-01

    Full Text Available Leigh MacConell, Richard Pencek, Yan Li, David Maggs, Lisa PorterAmylin Pharmaceuticals, LLC, San Diego, CA, USABackground: Type 2 diabetes mellitus is a progressive metabolic disease necessitating therapies with sustained efficacy and safety over time. Exenatide once weekly (ExQW, an extended-release formulation of the glucagon-like peptide-1 receptor agonist exenatide, has demonstrated improvements in glycemic and cardiometabolic measures from 30 weeks to 2 years of treatment. Here, the efficacy and safety of treatment with ExQW for 3 years are described.Methods: Patients were initially randomized to receive either ExQW (2 mg or exenatide twice daily for 30 weeks. Following the initial 30 weeks, all patients were treated with ExQW in an open-label extension. Analyses of primary glycemic endpoints, beta-cell function, and cardiometabolic measures were assessed for patients who completed 3 years of ExQW treatment and for the intention-to-treat population. Safety and tolerability analyses were provided for the intention-to-treat population.Results: Sixty-six percent of the intention-to-treat population (n = 295 completed 3 years of treatment (n = 194. At 3 years, a significant reduction in hemoglobin A1c (least squares mean ± standard error of -1.6% ± 0.08% was observed, with 55% and 33% of patients achieving hemoglobin A1c targets of <7% and ≤6.5%, respectively. Consistent with a sustained reduction in hemoglobin A1c, improvements in beta-cell function were also observed. Body weight was significantly reduced by -2.3 ± 0.6 kg. Reductions in blood pressure, total cholesterol, low-density lipoprotein cholesterol, and triglycerides were also observed. Adverse events reported most frequently during both controlled and uncontrolled periods included diarrhea, nausea, and vomiting of mostly mild intensity. The incidence of these adverse events decreased over time. Incidence of minor hypoglycemia was low and no major hypoglycemia was observed

  6. Regular Fat and Reduced Fat Dairy Products Show Similar Associations with Markers of Adolescent Cardiometabolic Health.

    Science.gov (United States)

    O'Sullivan, Therese A; Bremner, Alexandra P; Mori, Trevor A; Beilin, Lawrence J; Wilson, Charlotte; Hafekost, Katherine; Ambrosini, Gina L; Huang, Rae Chi; Oddy, Wendy H

    2016-01-02

    Reduced fat dairy products are generally recommended for adults and children over the age of two years. However, emerging evidence suggests that dairy fat may not have detrimental health effects. We aimed to investigate prospective associations between consumption of regular versus reduced fat dairy products and cardiometabolic risk factors from early to late adolescence. In the West Australian Raine Study, dairy intake was assessed using semi-quantitative food frequency questionnaires in 860 adolescents at 14 and 17-year follow-ups; 582 of these also had blood biochemistry at both points. Using generalized estimating equations, we examined associations with cardiometabolic risk factors. Models incorporated reduced fat and regular fat dairy together (in serves/day) and were adjusted for a range of factors including overall dietary pattern. In boys, there was a mean reduction in diastolic blood pressure of 0.66 mmHg (95% CI 0.23-1.09) per serve of reduced fat dairy and an independent, additional reduction of 0.47 mmHg (95% CI 0.04-0.90) per serve of regular fat dairy. Each additional serve of reduced fat dairy was associated with a 2% reduction in HDL-cholesterol (95% CI 0.97-0.995) and a 2% increase in total: HDL-cholesterol ratio (95% CI 1.002-1.03); these associations were not observed with regular fat products. In girls, there were no significant independent associations observed in fully adjusted models. Although regular fat dairy was associated with a slightly better cholesterol profile in boys, overall, intakes of both regular fat and reduced fat dairy products were associated with similar cardiometabolic associations in adolescents.

  7. Association of β-blocker therapy with risks of adverse cardiovascular events and deaths in patients with ischemic heart disease undergoing noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Mérie, Charlotte; Jørgensen, Mads

    2014-01-01

    IMPORTANCE: Clinical guidelines have been criticized for encouraging the use of β-blockers in noncardiac surgery despite weak evidence. Relevant clinical trials have been small and have not convincingly demonstrated an effect of β-blockers on hard end points (ie, perioperative myocardial infarction......, ischemic stroke, cardiovascular death, and all-cause death). OBJECTIVE: To assess the association of β-blocker treatment with major cardiovascular adverse events (MACE) and all-cause mortality in patients with ischemic heart disease undergoing noncardiac surgery. DESIGN, SETTING, PARTICIPANTS, AND EXPOSURE...... to calculate the 30-day risks of MACE (ischemic stroke, myocardial infarction, or cardiovascular death) and all-cause mortality associated with β-blocker therapy. MAIN OUTCOMES AND MEASURES: Thirty-day risk of MACE and all-cause mortality. RESULTS: Of 28,263 patients with ischemic heart disease undergoing...

  8. Adverse outcomes after colposcopy

    Directory of Open Access Journals (Sweden)

    Damery Sarah L

    2011-01-01

    Full Text Available Abstract Background Colposcopy is an essential part of the National Health Service Cervical Screening Programme (NHSCSP. It is used for both diagnosis and treatment of pre-cancerous cells of the cervix. Despite colposcopy being a commonly performed and relatively invasive procedure, very little research has explored the potential long-term impacts of colposcopic examination upon patient quality of life. The aim of this study is to investigate and quantify any potential reduction in women's quality of life following a colposcopy procedure. More specifically, the degree of female sexual dysfunction and the excess risk of adverse events in those undergoing colposcopy will be explored. If such risks are identified, these can be communicated to women before undergoing colposcopy. It will also assist in identifying whether there are particular sub-groups at greater risk and if so, this may lead to a re-evaluation of current recommendations concerning colposcopically directed treatments. Methods/design Cohort study using postal surveys to assess sexual function and quality of life in women who have attended for colposcopy (cases, compared with those who have not attended colposcopy (controls. The prevalence and excess risk of female sexual dysfunction will be determined. Logistic regression will identify the predictors of adverse outcomes. Discussion There are more than 400,000 colposcopy appointments each year in England, of which 134,000 are new referrals. There is some evidence that there may be long-term implications for women treated under colposcopy with respect to adverse obstetric outcomes, persisting anxiety, increased rates of sexual dysfunction and reduced quality of life. Reliably establishing whether such adverse outcomes exist and the excess risk of adverse events will facilitate informed decision-making and patient choice.

  9. Combined Angiotensin Receptor Modulation in the Management of Cardio-Metabolic Disorders

    DEFF Research Database (Denmark)

    Paulis, Ludovit; Foulquier, Sébastien; Namsolleck, Pawel

    2016-01-01

    Cardiovascular and metabolic disorders, such as hypertension, insulin resistance, dyslipidemia or obesity are linked with chronic low-grade inflammation and dysregulation of the renin-angiotensin system (RAS). Consequently, RAS inhibition by ACE inhibitors or angiotensin AT1 receptor (AT1R......) blockers is the evidence-based standard for cardiovascular risk reduction in high-risk patients, including diabetics with albuminuria. In addition, RAS inhibition reduces the new onset of diabetes mellitus. Yet, the high and increasing prevalence of metabolic disorders, and the high residual risk even....... Therefore, a concept of dual AT1R/AT2R modulation emerges as a putative means for risk reduction in cardio-metabolic diseases. The approach employing simultaneous RAS blockade (AT1R) and RAS stimulation (AT2R) is distinct from previous attempts of double intervention in the RAS by dual blockade. Dual...

  10. Incidence and risk factors of bleeding-related adverse events in patients with chronic lymphocytic leukemia treated with ibrutinib

    DEFF Research Database (Denmark)

    Lipsky, Andrew H; Farooqui, Mohammed Z H; Tian, Xin

    2015-01-01

    , suggesting that the risk of bleeding decreases with continued therapy. At baseline, von Willebrand factor and factor VIII levels were often high and normalized on treatment. Platelet function measured via the platelet function analyzer (PFA-100™) was impaired in 22 patients at baseline and in an additional...

  11. Post-marketing surveillance of the safety profile of iodixanol in the outpatient CT setting. A prospective, multicenter, observational study of patient risk factors, adverse reactions and preventive measures in 9953 patients

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Frank Hugo Heinz [Radiology and Nuclear Medicine Center, Ludwigshafen (Germany)

    2014-11-15

    Non-interventional study in outpatient, contrast-enhanced CT: 1. to determine the extent of preventive measures for risk reduction of adverse drug reactions after contrast-enhanced CT examinations. 2. to prospectively determine the incidence and severity of adverse drug reactions occurring after administration of the iso-osmolar contrast medium iodixanol. 3. to determine a possible influence of preventive measures on the incidence/severity of adverse drug reactions. Evaluable documentation was provided for 9953 patients from 66 radiology centers across Germany. Patient characteristics, aspects of iodixanol administration, and adverse events with an at least 'possible' relationship were documented on a standardized case report form (CRF) and were evaluated up to seven days after contrast medium administration. About 55.5% of patients showed one or more risk factors (e.g. impaired renal function 4.4%, diabetes mellitus 8.5%, hypertension 20.6%). One third of the sites did not implement any preventive measures. Patients with a known risk for an allergy-like reaction were more likely to receive pharmacologic preventive treatment (0.5-50.5%). Oral hydration was the main preventive measure in patients with renal risk factors (<8%) followed by intravenous hydration (1%). Adverse drug reactions, mainly hypersensitivity reactions, occurred in 77 patients (0.74%), but were classified as serious in only 3 patients (0.03%). No statistically significant correlation between risk factors, preventive measures, and adverse reactions could be found. The use of preventive measures for CT examinations in this outpatient setting was generally low with risk patients being pre-medicated more often, depending on their history. In the routine outpatient setting, iso-osmolar iodixanol was very well tolerated in almost 10 000 patients undergoing diagnostic CT. The rate of acute and delayed adverse reactions was low. No correlation could be found between risk factors, preventive

  12. Gonadal function is associated with cardiometabolic health in pre-pubertal boys with Klinefelter syndrome.

    Science.gov (United States)

    Davis, S; Lahlou, N; Bardsley, M; Temple, M-C; Kowal, K; Pyle, L; Zeitler, P; Ross, J

    2016-11-01

    The most common sex chromosome aneuploidy, Klinefelter syndrome (KS), is associated with primary gonadal failure and increased morbidity and mortality from cardiometabolic disorders in adulthood. Children with KS also have a high prevalence of metabolic syndrome (MetS) features. To assess the relationship of gonadal and cardiometabolic function in children with KS, we evaluated serum hormones [gonadotropins, inhibin B (INHB), anti-mullerian hormone (AMH), total testosterone (TT)], and features of MetS (waist circumference, fasting lipid panel, fasting blood glucose (FBG), and blood pressure) in 93 pre-pubertal boys with KS age 4-12 years (mean 7.7 ± 2.5 years). The cohort was grouped by age and tanner stage, and biomarkers were compared to normal ranges. A total of 80% of this pre-pubertal cohort had ≥1 feature of metabolic syndrome (MetS) and 11% had ≥3 features of MetS. Risk of MetS was independent of age and body mass index. Sertoli cell dysfunction was common with 18% having an INHB below the normal range. A low INHB was associated with higher FBG, triglycerides, LDL, and lower HDL (p < 0.05). An INHB <50 ng/dL yielded a sensitivity of 83% and a specificity of 79% for having ≥3 features of MetS. INHB and AMH positively correlated with each other (p < 0.001), and high AMH was protective of MetS. TT was below the lower limit of normal in 49% of subjects, with mean values significantly lower than expected (3.3 ng/dL vs. 4.9 ng/dL, p < 0.0001), however, no convincing relationship between TT and MetS was seen. In conclusion, gonadal and cardiometabolic dysfunction are prevalent in pre-pubertal boys with KS. Although the relationship of testosterone deficiency and MetS is well-known, this study is the first to report an association between impaired Sertoli cell function and cardiometabolic risk.

  13. Risk of Unexpected Adverse Effects Resulting from the Use of a Skin Test with Recombinant Tuberculosis Allergen in Children

    Directory of Open Access Journals (Sweden)

    V. N. Kryvohizh

    2016-01-01

    Full Text Available This report reviews clinical cases, and their possible causes of unexpected local and systemic adverse effects associated with a novel skin test using recombinant tuberculosis allergen (RTA, Diaskintest in 2—11 years old children. This preparation consists of a M. tuberculosis ESAT6/CFP10 fusion protein produced in E. coli, and, in Russia, it has been used as a tool for preventive screening for tuberculosis since 2009. The most common side effects developed within 1 to 12 h after injection and were represented as local or non-life threatening systemic symptoms: fever up to 39°C lasting up to 24 h, painful excessive edema with reddening on the forearm, and, sometimes herpes-like blisters on the skin. In 72 h, the papula at the injection site was moderate, but the hyperemia around it was considerable. We argue that the most likely reason for this type of response could be the development of Type III hypersensitivity (associated with immune complexes, and/or antibody-independent anaphylactoid response to the ESAT6/CFP10 protein or contaminating bacterial culture components. To prevent possible side effects, we recommend to observe the patients for not less than 15 min after the injection of RTA, and to be ready to respond in case of anaphylaxis development.

  14. Consumption of Energy-Dense Diets in Relation to Cardiometabolic Abnormalities among Tehranian Women

    Directory of Open Access Journals (Sweden)

    S.S. Khayatzadeh

    2013-04-01

    Full Text Available Introduction & Objective: This cross-sectional study was undertaken to assess the association between dietary energy density and prevalence of the cardiometabolic risk factors among Te-hranian adult women. Materials & Methods: In this cross-sectional study we assessed habitual dietary intakes of 486 Tehranian adult women by the use of a validated food frequency questionnaire. Dietary en-ergy density (DED was calculated as each individual’s reported daily energy intake (kcal/d into total weight of foods (excluding beverages consumed (g/d. Fasting plasm