Lower Cut off Point for Blood Lead and Risk of Myocardial Infarction at a Tertiary Hospital in Malaysia: A Case-Control Study

@#Introduction Lead (Pb) is one of the pollutants that can cause adverse effects on human health. Exposure to Pb has received much attention in the past decades due to its nearly persistent properties in the environment. Blood Pb measurement is the most convenient as well as most feasible to indicate toxicity exceeded the standard limit of 10 μg/dL. This study aimed to assess the association between blood Pb and myocardial infarction. Methods This was a case-control study conducted at a tertiary hospital in Kuala Lumpur, Malaysia. This study enrolled about 109 respondents; 71 cases of myocardial infarction and 38 non-cases of myocardial infarction. Study instruments include questionnaires on demographic factors (age, gender, and ethnicity), socioeconomic factors (education, household income, occupation), and venous blood lead level. The blood Pb was measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Results The median (IQR) of blood Pb among the case group was higher compared to the control groups, 3.72 (0.04 – 96.09) μg/dL and 2.81 (0.73 – 6.23) μg/dL respectively. No difference between high (> 10 μg/dL) and normal (<10 μg/dL) blood Pb with CVD. However, there was a significant association between high normal blood Pb concentration (≥ 5.00 µg/dL) and myocardial infarction (χ2 = 4.397; p = 0.036). Conclusions There is a relationship between lower blood Pb level and the occurrence of myocardial infarction. No difference was found between the blood Pb limit of 10 μg/dL and CVD. The findings of this study are very important and provide new information regarding the lower cut off point for blood Pb and outcome of CVD especially myocardial infarction..

Sex differences in cardiovascular risk factors among people with type two diabetes

Background: Type 2 Diabetes Mellitus is associated with various risk factors, which accelerates the development of cardiovascular disease (CVD). The increased relative risk for CVD due to diabetes is greater in women than in men. Aims and objectives of this study were to study the prevalence of cardiovascular risk factors among type 2 diabetes patients and to assess the sex differences in the prevalence of cardiovascular risk factors among type 2 diabetes patients.Methods: A cross-sectional study was performed among the 500 adult (>15 years) patients of type 2 diabetes who attended Department of Medicine, SGRDIMSR, Amritsar and were assessed for the presence of various CVD risk factors and the prevalence of these was compared between both sexes.Results: The most prevalent CVD risk factor among 500 patients of type 2 DM was high HBA1C levels which was present in 67.2% of the study population. It was followed by obesity (which had prevalence of 66.2%), dyslipidaemia (i.e. high triglyceride levels - 64.8% and low HDL levels - 65.6%) and microalbuminuria along with macroalbuminuria (65.4%). Diabetic males had microalbuminuria (along with macroalbuminuria) as the most prevalent CVD risk factor (69.03%), followed by alcohol consumption (63.18%) and abnormal waist circumference (61%). On the other hand, the most prevalent CVD risk factor among female diabetics was high HBA1C (77.4%) followed by obesity (77.0%) and dyslipidaemia-hypertriglyceridemia (75.1%) and low HDL levels (70.5%).Conclusions: Cardiovascular risk factors were highly prevalent among patients with type 2 diabetes attending department of medicine, SGRDIMSR, Amritsar with different risk profiles among diabetic male and females. A gender-sensitive approach is required in planning interventions (counselling and treatment) to reduce the risk of cardiovascular disease in diabetes.

Relationship between fruit and fish intakes and cardiovascular disease risk factors in Korean women with type 2 diabetes mellitus: Based on the 4th and 5th Korea National Health and Nutrition Examination Surveys / 한국영양학회지

PURPOSE: The purpose of the study was to investigate the association between food intakes and cardiovascular disease (CVD) risk factors in Korean women with type 2 diabetes mellitus (T2DM). METHODS: The data were collected from the 2007~2012 Korea National Health and Nutrition Examination Survey (KNHANES). In this study, subjects were divided into two groups, the normal fasting glucose (NFG) group (n = 7,738) and the T2DM group (n = 225). Dietary intake was derived from the nutrition survey, which was collected by trained dietitians using 24-hour dietary recall through the face-to-face interview method in the sample person's home. RESULTS: After adjustment for confounding factors, mean fruit (p = 0.0265), fruit and vegetable without kimchi (p = 0.0295), and fish (p = 0.0112) intakes were significantly lower in the T2DM group than in the NFG group. In the multiple logistic regression analysis, odds ratio (OR) for risk of high systolic blood pressure (≥ 140 mmHg) was lower in the over the median compared to under the median for fruit intakes (OR; 0.657, 95% CI; 0.523~0.824). The OR for the risk of hypertriglyceridemia was lower in the over the median compared to under the median for fruit and vegetable without kimchi (OR; 0.828, 95% CI; 0.7111~0.963) and fish (OR; 0.783, 95% CI; 0.673~0.910) intakes. CONCLUSION: These results show that intakes of fruits, fish, and fruits and vegetables without kimchi have beneficial effects on CVD in Korean women with T2DM.

The association between measurement sites of visceral adipose tissue and cardiovascular risk factors after caloric restriction in obese Korean women

Quantities as well as distributions of adipose tissue (AT) are significantly related to cardiovascular disease (CVD) risk factors and can be altered with caloric restriction. This study investigated which cross-sectional slice location of AT is most strongly correlated with changes in CVD risk factors after caloric restriction in obese Korean women. Thirty-three obese pre-menopausal Korean women (32.4 +/- 8.5 yrs, BMI 27.1 +/- 2.3 kg/m2) participated in a 12 weeks caloric restriction program. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were measured using computed tomography (CT) scans at the sites of L2-L3, L3-L4, and L4-L5. Fasting serum levels of glucose, insulin, triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), leptin and homeostasis model assessment-insulin resistance (HOMA-IR) were observed. Pearson's partial correlation coefficients were used to assess the relationship between AT measurement sites and changes in CVD risk factors after calorie restriction. When calories were reduced by 350 kcal/day for 12 weeks, body weight (-2.7%), body fat mass (-8.2%), and waist circumference (-5.8%) all decreased (P < 0.05). In addition, following caloric restriction, serum levels of glucose (-4.6%), TC (-6.2%), LDL-C (-5.3%), leptin (-17.6%) and HOMA-IR (-18.2%) decreased significantly (P < 0.05) as well. Changes in VAT at the level of L3-L4 were significantly greater than those at other abdominal sites, and these changes were correlated with changes in TC (P < 0.05), LDL-C (P < 0.001), SBP (P < 0.001) and HOMA-IR (P < 0.01). These results show that VAT at L3-L4 had a stronger correlation with CVD risk factors than with other AT measurement sites after caloric restriction.

Associations Between Screen-Based Sedentary Behavior and Cardiovascular Disease Risk Factors in Korean Youth

The purposes of this study were to: 1) describe the patterns of screen-based sedentary behaviors, and 2) examine the association between screen-based sedentary behavior and cardiovascular disease (CVD) risk factors in representative Korean children and adolescents, aged 12 to 18 yr, in the Korean National Health and Nutrition Examination Survey. Screen-based sedentary behavior was measured using self-report questionnaires that included items for time spent watching TV and playing PC/video games. Physical activity was measured using items for frequency and duration of moderate-to-vigorous physical activity (MVPA). CVD risk factors such as body mass index (BMI), waist circumference, LDL cholesterol, HDL cholesterol, total cholesterol, triglycerides, glucose, systolic blood pressure, and diastolic blood pressure were measured. Boys spent more time playing PC/video games, and girls spent more time watching TV. After adjusting for age, gender, annual household income, and MVPA, an additional hour of watching TV was significantly associated with the risk of overweight (OR 1.17 [95% CI 1.03-1.33]), high abdominal adiposity (OR 1.27 [1.06-1.51]), and low HDL cholesterol (OR 1.27 [1.10-1.47]). An additional hour spent playing PC/video games also increased the risk of high abdominal adiposity (OR 1.20 [1.03-1.40]). Prospective observations and interventions are needed to determine causal relationships between screen-based sedentary behavior and CVD risk profiles in Korean youth.