Association between Dietary Patterns and Cardiometabolic Risks in Malaysian Punjabi Adults

@#Introduction: Globally, the prevalence of cardiovascular diseases (CVD) is high in Punjabi population. This could due to the increased cardiometabolic risks associated with diets high in dietary fats and refined grains. However, studies on the relationship between dietary pattern and cardiometabolic risks involving Malaysian Punjabis population are scarce. Hence, this study aims to determine the associations between dietary patterns and cardiometabolic risks in Malaysian Punjabi adults. Methods: Socio-demographic, lifestyle and dietary intake information was collected using self-administered questionnaire. Anthropometric measurements: weight and height for body mass index (BMI) calculation, waist circumference (WC); systolic (SBP) and diastolic blood pressure (DBP); and biomarkers: blood glucose, glycated haemoglobin A1c (HbA1c), triglycerides, total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), apolipoprotein A1 and B100 were obtained. Major dietary patterns were derived using principal component analysis. Association between dietary patterns and cardiometabolic risk factors were performed using ANCOVA and Kruskal-Wallis tests. Results: A total of 164 (35.4% males and 64.6% females) Punjabis were included in this study. Four dietary patterns were extracted, namely ‘fruits and vegetables diet’ (FVD), ‘whole grains, condiments and beverages diet’ (WCBD), ‘protein diet’ (PD) and ‘rice, noodles, cereals and meat diet’ (RNCMD). Significant associations were obtained for FVD with BMI (p=0.012), WC (p=0.011), SBP (p=0.020) and DBP (p=0.009); WCBD with TC (p=0.010), LDL-C (p=0.015) and apolipoprotein B100 (p=0.038). Conclusion: Dietary pattern comprised of fruits, vegetables and beverages containing antioxidant-rich spices, ginger, and black tea may lower cardiometabolic risks in Malaysian Punjabis, particularly in obesity, high blood pressure and hyperlipidaemia.

Predictores de riesgo cardiometabólico en adolescentes de Quito / Predictors of cardiometabolic risk in adolescents in Quito

Introducción: Obesidad en la adolescencia se asocia con trastornos cardiometabólicos en la edad adulta. Es necesario contar con un índice de obesidad fácilmente aplicable para predecir riesgo cardiometabólico en adolescentes. Objetivo: Comparar la utilidad de los índices radio Cintura/Talla (r-CT), circunferencia de cintura (CC) y el índice de masa corporal (IMC) para determinar obesidad y predecir riesgos cardiometabólicos en adolescentes. Métodos: En este estudio trasversal, bajo criterios de la International Diabetes Federation (IDF) se determinó obesidad mediante tres índices, hipertensión arterial, hiperglicemia, hipertrigliceridemia y bajo HDL en 931 adolescentes mestizos ecuatorianos. La asociación de los índices de obesidad (r-CT, IMC y CC) con los factores de riesgo cardiometabólico se determinaron mediante radios de Odds ajustados y áreas bajo la curva (AUC, siglas en inglés) ROC (Característica Operativa del Receptor, siglas en inglés). Resultados: El r-CT ≥0.5 determinó mayor porcentaje de obesidad (36.6%) respecto a CC (17.4%) e IMC (6.7%). IMC ≥95 percentil se asoció significativamente con los cuatro factores de riesgo cardiometabólico, mientras que CC y r-CT se asociaron con tres de los cuatro factores. Los tres índices de obesidad determinan la concurrencia de tres o más factores de riesgo cardiometabólico con alta sensibilidad y especificidad con un AUC mayor de 0.80. Conclusiones: El IMC ≥ al percentil 95 es mejor predictor de riesgo cardiometabólico, pero no determina bien obesidad. El r-CT parece ser el indicador antropométrico más adecuado para detectar obesidad y predecir riesgo cardiometabólico en adolescentes mestizos debido a su fácil determinación y uso.

Background: Obesity in adolescence is associated with cardiometabolic problems in adulthood. It is necessary to have an easily applicable obesity index to predict cardiometabolic risk in adolescents. Objective: To compare the usefulness of waist to-height ratio (WHtR), waist circumference (WC), and body mass index (BMI) to determine obesity and predict cardiometabolic risks in adolescents. Methods: In this cross-sectional study, under the criteria of the International Diabetes Federation (IDF), obesity, hypertension, hyperglycemia, hypertriglyceridemia and low HDL rates were determined in 931 Ecuadorian mestizo adolescents. The association of the three obesity indices with the cardiometabolic risk factors was determined by means of adjusted Odds radios and area under the Receiver Operating Characteristic curve (AUC-ROC). Results: WHtR ≥0.5 determined the highest percentage of obesity (36.6%) with respect to WC (17.4%) and BMI (6.7%). BMI ≥95 percentile was significantly associated with the four cardiometabolic risk factors, while WC and WHtR were associated with three out of four factors. The three obesity indices determine the concurrence of three or more cardiometabolic risk factors with high sensitivity and specificity with an AUC greater than 0.80. Conclusions: BMI ≥95th percentile is a better predictor of cardiometabolic risk, but it is not a good determinant of obesity. The WHtR seems to be the most suitable anthropometric indicator to detect obesity and predict cardiome- tabolic risk in mestizo adolescents due to its easy determination and use.

Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital

OBJECTIVE: To determine the activities of oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome (PCOS) in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. METHODS: This was a nested case-control study consisting of 50 PCOS patients and 50 healthy women of the same age range without any evidence of PCOS. The study measured the levels of malondialdehyde (MDA), activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (TAC); concentrations of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), as well as high-density lipoprotein cholesterol (HDL-C) using standard spectrophotometric methods. Anthropometric indices were also assessed. P-values of <0.05 were taken to be statistically significant. RESULTS: There were significantly higher levels of MDA (P=0.002), lower activity of SOD (P<0.001), and lower TAC (P=0.001) in PCOS patients when compared with the controls. There were higher concentrations of TC (P=0.017) and LDL-C P=0.012) in PCOS patients than in controls. Significant differences were not observed between the 2 groups in terms of the activity of GSH-Px, as well as the concentrations of HDL-C and TG. The body mass index, waist circumference, and waist-hip ratio were all significantly higher in PCOS patients. CONCLUSION: This study revealed higher levels of MDA, as well as lower activity of SOD and TAC, among PCOS patients. Furthermore, there were higher levels of TC and LDL-C among the PCOS patients. Hence, monitoring these parameters may improve the clinical management of PCOS.

Contribution of insulin resistance to decreased baroreceptor sensitivity & cardiometabolic risks in pre-obesity & obesity

Background & objectives: Although insulin resistance (IR) is a known complication in obesity, the physiological mechanisms linking IR with cardiometabolic risks in obesity have not been well studied. This study was conducted to assess the difference in cardiovascular (CV) risk profile in IR and non-IR (NIR) conditions, and contribution of IR to cardiometabolic risks in pre-obese and obese individuals. Methods: Basal CV, blood pressure variability, autonomic function test and cardiometabolic parameters were recorded in pre-obese (n=86) and obese (n=77) individuals during 2012 and 2015. The association of altered cardiometabolic parameters with homeostatic model for IR (HOMA-IR) in pre-obese and obese groups and with baroreceptor sensitivity (BRS) in IR and NIR groups was calculated by appropriate statistical analysis. Results: Decreased BRS, a known CV risk and cardiometabolic parameters were significant in IR (pre-obese and obese) group compared to the NIR group. Sympathovagal imbalance in the form of increased sympathetic and decreased parasympathetic activities was observed in individuals with IR. There was no significant difference in the level of independent contribution of HOMA-IR to cardiometabolic parameters in pre-obese and obese groups. Adiponectin and inflammatory markers had an independent contribution to BRS in IR group. Interpretation & conclusions: Findings of the present study demonstrated that the intensity of cardiometabolic derangements and CV risk were comparable between IR, pre-obese and obese individuals. Pro-inflammatory state, dyslipidaemia and hypoadiponectinaemia might contribute to CV risk in these individuals with IR. IR could possibly be the link between altered metabolic profile and increased CV risks in these individuals independent of the adiposity status.

Abdominal obesity and cardiometabolic risk in children and adolescents, are we aware of their relevance?

Obesity prevalence has increased worldwide over the last decades and has reached alarming rates in low middle-income countries. Childhood has been affected by this epidemic, leading to premature dramatic health problems. Adipose tissue is currently considered as an endocrine organ modulating an inflammatory state and important metabolic processes (insulin resistance, hypertension, glucose intolerance) leading to consequences of the cardiovascular system. This situation may be worst if the excess of body fat distribution such as abdominal obesity (AO) is involved because it is associated with a more atherogenic risk profile determining the cardiometabolic risks mainly in children and adolescents. Hence, the knowledge regarding the association between AO and cardiometabolic factors aims to prevent and treat the obesity in this young population, avoiding early harmful consequences of adulthood health.

Síndrome metabólico y factores de riesgo cardiometabólico en adolescentes de la ciudad de Quito: descubriendo una epidemia oculta / Metabolic syndrome and risk factors cardiometabolic in adolescents from the city of Quito: uncovering a hidden epidemic

Contexto: el síndrome metabólico (SM) en adolescentes constituye un problema de salud pública mundial; los estudios sobre este síndrome y sus factores de riesgo cardiometabólico en población adolescente ecuatoriana son limitados. Objetivo: determinar la prevalencia de SM y los factores de riesgo cardiometabólico en adolescentes escolares de la ciudad de Quito. Métodos: se realizó un estudio transversal en 220 adolescentes con edades entre 11 a 18 años de edad, estudiantes de la "Unidad Educativa Santiago de Guayaquil" de la ciudad de Quito, una institución pública. Se midió peso, talla, perímetro abdominal, presión arterial y se dosificó concentraciones séricas de glucosa, triglicéridos y HDL en ayunas. La presencia de SM y los factores de riesgo cardiometabólico se determinaron de acuerdo con la definición de la Federación International de Diabetes (IDF) para niños y adolescentes. Resultados: la prevalencia del SM fue 2,3% (5/220), con predominio no significativo en hombres (60%). El 46% (102/215) de los participantes sin SM presentaron 1 o más factores de riesgo cardiometabólico siendo el factor de riesgo más frecuente la hiperglucemia. El perímetro de cintura demostró ser el predictor de hipertensión arterial y de baja concentración de HDL (regresión lineal múltiple). La presencia de obesidad central se asoció con un riesgo 6 veces mayor de hipertensión sistólica o diastólica (regresión logística). Conclusiones: el SM está presente en adolescentes de la ciudad de Quito; los adolescentes sin SM exhiben alta prevalencia de factores de riesgo cardiometabólico, sin embargo, se requiere ampliar los estudios para afianzar estos hallazgos.

Background: metabolic syndrome (MetS) in adolescents is a worldwide public health problem. However, little is known about this syndrome and the cardiometabolic factors in Ecuadorian adolescents. Objective: to determine the prevalence of MetS and cardio metabolic factors in Ecuadorians adolescents. Methods: we performed a cross-sectional study in 220 adolescents (11-18 y) who studied at "Unidad Educativa Santiago de Guayaquil de Quito", a public institution. Weight, height, waist circumference, and blood pressure were obtained. Fasting glucose, triglycerides. and HDL serum concentrations were determined. Mets and cardiometabolic risk factors were defined according to the International Diabetes Federation (IDF) criteria for children and adolescents. Results: mets was prevalent in 2.3% (5/220) of adolescents, with no significant predominance in males (60% vs 40%). Additionally, 46% (102/215) of subjects without MetS showed one or more cardiometabolic risk factors. Hyperglycemia was the most frequent risk factor among those without MetS. Waist circumference showed to be a predictor of both hypertension and low HDL concentrations (Multiple linear regression). Central obesity was associated with 6 times risk of both systolic and diastolic hypertension (Logistic regression). Conclusions: mets is present in adolescents of Quito, and those without MetS exhibit high prevalence of cardio metabolic risk factors; however, more studies are required to strengthen these findings.

Effects of daily quercetin-rich supplementation on cardiometabolic risks in male smokers

Limited information from human studies indicates that dietary quercetin supplementation influences blood lipid profiles, glycemic response, and inflammatory status, collectively termed cardiometabolic risks. We tested the hypothesis that quercetin-rich supplementation, derived from onion peel extract, improves cardiometabolic risk components in healthy male smokers in a randomized, double blinded, placebo-controlled parallel design. Randomly assigned subjects were instructed to take either the placebo (n = 43) or 100 mg quercetin capsules each day (n = 49) for 10 weeks. Anthropometric parameters and blood pressure were measured, and blood lipids, glucose, interleukin-6, and soluble vascular cell adhesion molecule-1 (sVCAM-1) were determined at baseline and after 10 weeks of quercetin supplementation. Quercetin-rich supplementation significantly reduced serum concentrations of total cholesterol (P < 0.05) and LDL-cholesterol (P < 0.01), whereas these effects were not shown in the placebo group. Furthermore, significant increases were observed in serum concentrations of HDL-cholesterol both in the placebo (P < 0.005) and quercetin-rich supplementation group (P < 0.001); however, changes in HDL-cholesterol were significantly greater in subjects receiving quercetin-rich supplementation than the placebo. Both systolic (P < 0.05) and diastolic blood pressure (P < 0.01) decreased significantly in the quercetin-rich supplementation group. Glucose concentrations decreased significantly after 10 weeks of quercetin-rich supplementation (P < 0.05). In contrast, no effects of quercetin-rich supplementation were observed for the inflammatory markers-IL-6 and sVCAM-1. Daily quercetin-rich supplementation from onion peel extract improved blood lipid profiles, glucose, and blood pressure, suggesting a beneficial role for quercetin as a preventive measure against cardiovascular risk.