Body mass index in young adulthood and mid-life cardiovascular risk factors in South Asian American adults: The MASALA study

The association of self-reported BMI at age 20, at age 40, the highest BMI within the past 3 years, and current BMI with current mid-life cardiovascular risk factors and coronary artery calcium (CAC) was evaluated among 1148 South Asian American participants (mean age 57 years) in the MASALA study. A 1 kg/m2 higher BMI at age 20 was associated with higher odds of hypertension (aOR 1.07, 95% CI 1.03 e1.12), pre-diabetes/diabetes (aOR 1.05 [1.01e1.09]), and prevalent CAC (aOR 1.06 [1.02e1.11]) in midlife. Associations were similar for all BMI measures. Weight across young adulthood is associated with mid-life cardiovascular health in South Asian American adults

Altered circulating adipokines and heart rate variability: A biomarker for autonomic imbalance in obese individuals

Background: Evidences indicate altered circulating adipokine levels in obesity could increase the risk for cardiovascular disease (CVD). Hence, it is crucial to determine cardiovascular health by assessing heart rate variability (HRV) and its association with circulating adipokines. Aim and Objectives: The aim of the study was to assess the adipokines level and its association with HRV in obese population. Materials and Methods: A cross-sectional comparative study was conducted on 45 obese (body mass index [BMI] > 25–29.9 kg/m2) and 45 non-obese (BMI: 18.5–22.9 kg/m2) age-gender-matched participants. Lead-II electrocardiogram was recorded and HRV parameters were obtained. Biochemical parameters, that is, fasting blood glucose, fasting insulin, HOMA-IR, lipid profile, leptin, and adiponectin levels were estimated. Group comparisons were done by independent student’s t-test, whereas the association between the parameters was done by Pearson’s correlation using SPSS 20v. P < 0.05 was considered statistically significant. Results: There was a significant increase in low frequency: high frequency (LF: HF) ratio (<0.001), fasting insulin (<0.001), HOMA-IR (<0.001), leptin (<0.001), Leptin-Adiponectin ratio (L/A ratio) (<0.001), total cholesterol (<0.001), triglycerides (<0.001), and low-density lipoproteins (<0.001), whereas significant decrease in total power (TP) of HRV (TP) (<0.001), adiponectin (<0.001), and high-density lipoproteins. A significant positive correlation between leptin, L/A ratio with LF: HF ratio (r = 0.793, P < 0.001) and a negative correlation with TP (–0.463, P < 0.001) was observed. Conclusion: Altered adipokines and its association with HRV in obese individuals could be an indicator of CVD. Hence, the current study suggests that the L/A ratio might be considered as a biomarker for cardiovascular health in obese individuals.

Asociación de factores de riesgo cardiovascular modificables y la capacidad cardio-vascular en población universitaria de 18 a 29 años / Association of modifiable cardiovascular risk factors and functional capacity in university populations aged 18 to 29

Contexto. Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial; el tabaquismo, sedentarismo y hábitos alimenticios son los principales factores de riesgo cardiovascular modificables. Objetivo. Identificar el nivel de riesgo cardiovascular que presentan los estudiantes universitarios y, establecer la asociación de los factores de riesgo cardiovascular modificables con la capacidad cardio-vascular determinada mediante la "caminata de seis minutos".Material y Métodos. Estudio observacional, transversal, de campo, no experimental y correlacional. La población fue de 421 sujetos y la muestra de 229 estudiantes universitarios (adultos jóvenes) de ambos géneros (30,6% masculino, 69,4% femenino), de 18 a 29 años. Los sujetos analizados se encuentran a 2.850m de altitud. El muestreo fue probabilístico estratificado proporcional. Las técnicas aplicadas fue-ron: la encuesta, diseñada a partir del cuestionario base: "Instrumento STEPS de la OMS", Cuestionario de Identificación de los Trastornos Debidos al Consumo de Alcohol y Cuestionario Internacional de Actividad Física; y la "caminata de seis minutos". Los instrumentos usados tienen validación internacional. Resultados. El 93% de los sujetos presentan uno o más factores de riesgo cardiovascular modificables; los predominantes fueron: consumo de alcohol (84,7%) y sedentarismo (81,7%). El 62% presentan riesgo cardiovascular moderado. El nivel de riesgo cardiovascular tiene una correlación débil con el consumo de oxígeno (VO2) (r=0.20); existe una relación estadísticamente significativa entre el nivel de actividad física y VO2 (p=0,02). Discusión. Los principales factores de riesgo cardiovascular modificables identificados fueron el consumo de alcohol y el sedentarismo; no existió asociación estadísticamente significativa entre los factores de riesgo cardiovascular modificables con la capacidad cardiovascular; pero la capacidad cardiovascular tiene relación estadísticamente significativa con el nivel de actividad física.

Context. Cardiovascular diseases are the major cause of death worldwide; smoking, sedentary lifestyle and eating habits are the main modicable cardiovascular risk factors.Objective. To identify the modifiable cardiovascular risk factors presented by university students and, establish the association between cardiovascular modificable risk factors and the cardiovascular capa-city determined by the "six minute walk". Material and Methods. Observational, cross-sectional, field, non-experimental and correlational study. The population was 421 subjects and the sample was 229 university students (young adults) of both genders (30.6% male, 69.4% female), from 18 to 29 years old. The subjects analyzed are located at an altitude of 2,850m. Sampling was proportional stratified probabilistic. The techniques applied were: the survey, designed based on the basic questionnaire: "WHO STEPS Instrument", Questionnaire for the Identification of Disorders Due to Alcohol Consumption and International Questionnaire on Physical Activity; and the "six minute walk". The instruments used have international validation.Results. 93% of the subjects present one or more modifiable cardiovascular risk factors; the predomi-nant ones were: alcohol consumption (84.7%) and sedentary lifestyle (81.7%). 62% present moderate cardiovascular risk. The level of cardiovascular risk has a weak correlation with oxygen consumption (VO2) (r=0.20); there is a statistically significant relationship between the level of physical activity and VO2 (p=0.02).Discussion. The main modifiable cardiovascular risk factors identified were alcohol consumption and a sedentary lifestyle; there was no statistically significant association between modifiable cardiovascular risk factors with cardiovascular capacity; but cardiovascular capacity has a statistically significant rela-tionship with the level of physical activity

Risk factors for cardiovascular disease among people with mental illness in Namibia

Objectives: To determine the prevalence of risk factors for cardiovascular disease (CVD) among people with mental illness attending the Mental Health Care Centre, Windhoek, Namibia Design: Observational, cross-sectional study. Setting: Mental health Care Centre, Windhoek Central Hospital. Namibia Participants: Adult patients with a mental illness attending the Mental Health Care Centre, Windhoek. Data collection: Within a systematic random sampling method, 385 adult patients with mental illness were recruited between May and December 2017. Statistical analysis: Validated assessment tools were used. Descriptive summary statistics and Chi-squared tests of association were conducted. Results: One-third (31.7%) of participants used alcohol, 21% used nicotine, 21.3% had hypertension, 55% were overweight or obese, 59.2% of females and 11.5% of males had abdominal obesity. About twenty per cent (19.9%) of participants did meet the World Health Organisation recommended level of activity, while more than two-thirds of participants did not participate in moderate or vigorous physical activities. The patient's psychiatric condition was significantly associated with alcohol use (Chi-square=20.450, p=0.002) and physical activity (Chi-square=20.989, p=0.002). The psychiatric condition was not associated with the waist circumference and gender of the participant. Conclusions: The increased prevalence of CVD risk factors in people with mental illness calls for mental health practitioners to screen, monitor and manage these risk factors regularly. Systematically screening and monitoring for cardiovascular risk factors is likely to contribute to National targets and significantly impact cardiovascular morbidity and mortality in people with mental illness

Effects of volume overload and ectopic fat on cardiovascular risk in the patients with type 2 diabetes mellitus——Inspiration from the Golgi Prize of the 56th European Association for the Study of Diabetes (EASD) Conference / 中华内分泌代谢杂志

Cardiovascular disease is the main cause of death in patients with diabetes. Cardiovascular disease and risk management in patients with diabetes has always been a hot topic in the field of diabetes. At the 56th Annual Meeting of the European Association for the Study of Diabetes (EASD), Professor Naveed Sattar, recipient of the Camillo Golgi Prize and from the University of Glasgow, UK, expounded the role of volume overload and ectopic fat in cardiovascular risk of patients with type 2 diabetes, which brought new enlightenment for future research and comprehensive management.

Cardiovascular disease risk in diabetes patients aged 40 years old and above in China / 中华心血管病杂志

Objective: To evaluate the incidence of cardiovascular disease (CVD), ischemic and hemorrhagic cardiovascular events among Chinese diabetic patients aged 40 years and above with different CVD risk levels. Methods: This study enrolled participants aged 40 years and above in 15 provinces from a prospective cohort study, the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China). Participants were categorized into two groups according to the presence or absence of diabetes at baseline. Individuals were further classified into low (0-4.9%), moderate (5%-9.9%) and high risk groups (≥10%), based on predicted ten-year CVD risk using the China-PAR equations. Two followed-up surveys were conducted between 2007 and 2015 to identify CVD events, which were defined as nonfatal acute myocardial infarction, or death due to coronary heart disease, or stroke. Ischemic cardiovascular events included nonfatal acute myocardial infarction, or death due to coronary heart disease, or ischemic stroke. Hemorrhagic cardiovascular events included subarachnoid hemorrhage and intracerebral hemorrhage. The incidences of CVD, ischemic and hemorrhagic cardiovascular events were compared in diabetes and non-diabetes population with different CVD risk levels. Results: This study included 89 209 participants aged 40 years and above, the average follow-up period was 8.5 years. The age was (54.8±9.4) years, and 36 794 (41.2%) were men, and 5 730 (6.4%) were diabetic patients. In diabetes patients aged 40 years and above, 53.7% (3 075/5 730) were at high risk of CVD. Age-and sex-adjusted incidence of CVD, ischemic and hemorrhagic cardiovascular events (1 066.93/100 000 person-years, 824.23/100 000 person-years, and 211.56/100 000 person-years) were significantly lower in diabetes patients than those in non-diabetes population with high CVD risk (1 773.73/100 000 person-years, 1 228.18/100 000 person-years, and 446.49/100 000 person-years) (all P<0.001). Among high CVD risk populations, incidence of ischemic events was significantly higher in diabetic patients than in non-diabetes population (1 638.47/100 000 person-years vs. 1 228.18/100 000 person-years, P<0.001), but incidence of hemorrhagic events tended to be lower in diabetic patients than in non-diabetes population (415.70/100 000 person-years vs. 446.49/100 000 person-years, P=0.635). Incidence of ischemic and hemorrhagic events were similar between diabetes patients and non-diabetes population at low or moderate CVD risk groups (all P>0.05). Conclusions: More than half of diabetes patients aged 40 years and above in China have high CVD risk. The incidence of CVD, ischemic and hemorrhagic cardiovascular events are different in diabetic patients with different CVD risk levels.

Association between Coronary Atherosclerotic Plaque Composition and Cardiovascular Disease Risk / 生物医学与环境科学（英文）

OBJECTIVE@#The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease (CVD) risk in Chinese adults.@*METHODS@#We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography (CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score (FRS) and the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score.@*RESULTS@#Among the 549 participants, 267 (48.6%) had no coronary plaques, 201 (36.6%) had noncalcified coronary plaques, and 81 (14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio (OR) 2.41; 95% confidence interval (CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score (OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment.@*CONCLUSION@#Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.

The Analysis between the Socioeconomic Factor and the Atherosclerotic Cardiovascular Disease Risk: The 7th Korea National Health and Nutrition Examination Survey (1st Year), 2016

BACKGROUND: The purpose of this study was to analyze the socioeconomic factors that affect atherosclerotic cardiovascular disease risk.METHODS: We used data from 3,704 individuals between 40 and 79 years of age, who participated in the Korean National Health Examination and Nutrition Survey in 2016. Socioeconomic groups were categorized by income and education level. We analyzed the odds ratios and 95% confidence intervals (CIs) from logistic regression for the atherosclerotic cardiovascular disease risk in each group.RESULTS: Using logistic regression analysis, the odds ratios and 95% CIs of atherosclerotic cardiovascular disease risk based on high, middle, and low socioeconomic factors were 1.0, 1.597 (95% CI, 1.279–1.993), and 5.689 (95% CI, 4.030–8.032), respectively. The results after adjusting for covariates (age, gender, obesity, alcohol consumption) also showed statistical significance.CONCLUSION: We conclude that socioeconomic factors such as income and education level are correlated with increased atherosclerotic cardiovascular disease risk.

Risk assessment of cardiovascular disease in hypertensive patients in Tongxiang / 预防医学

Objective @#To evaluate the risk of cardiovascular disease in hypertensive patients managed by communities in Tongxiang in the next 10 years,and to provide evidence for the development of cardiovascular disease prevention strategies. @*Methods@#The information about hypertensive patients managed by communities was collected from Tongxiang resident health records management system. The risk of ischemic cardiovascular disease（ICVD）in the next 10 years was assessed by the Assessment Scale of 10-Year ICVD Risk in Chinese.@*Results@# A total of 27 173 hypertensive patients managed by communities with complete data were recruited,including 11 868 males,accounting for 43.68%,and 15 305 females,accounting for 56.32%. The median（inter-quartile range）of the total scores of 10-year ICVD risk in hypertensive patients was 8.00（3.00）,with 9.00（2.00）in males and 8.00（2.00）in females. The total scores of 10-year ICVD risk in males was significantly higher than those in females（P<0.05）. A total of 8 764 patients had high 10-year ICVD risk,accounting for 32.25%. The proportion of high10-year ICVD risk in females with hypertension was higher than that in males（P<0.05）. The weights of ICVD risk factors in males were 54.58% in age,17.42% in systolic blood pressure,14.27% in smoking,7.77% in body mass index,4.51% in total cholesterol and 1.45% in diabetes;the ones in females were 63.57% in age,14.63% in systolic blood pressure,9.81% in body mass index,6.00% in total cholesterol,5.88% in diabetes and 0.11% in smoking.@*Conclusion @#The ICVD risk of hypertensive patients managed by communities in Tongxiang is higher in the next 10 years. Male patients should focus on the control of blood pressure and smoking,while female patients should focus on the control of blood pressure and body weight.

Cardiovascular Health and Disease Risk Status in Type II Diabetics

Often linked with several complications and comorbidities, studies have shown Diabetes mellitus (DM) as a common, chronic disease across the globe. This study was designed to explore the CVD risk factors among Type 2 DM patients in a tertiary hospital in South-East, Nigeria. Seventy two (72) participants [36 hyperglycaemics (Type II DM) and 36 normoglycaemics (control)] were drawn from the University of Nigeria Teaching Hospital, Enugu State. Socio-demographic data, anthropometric parameters, percentage body fat and ankle-brachial indices were obtained. Other Variables such as age, height, weight, heart rate, body mass index (BMI) and waist-hip ratios (WHR) were recorded as well. The study found, using the one-way Analysis of variance (ANOVA), a significant difference (p < .05) in percentage body fat and heart rate between groups (hyperglycaemics and normoglycaemics). A gender-dependent significant difference was also observed in ankle-brachial index between normoglycaemics, with an accompanying insignificant difference for ankle-brachial index, BMI and WHR in both groups. Life style patterns with increased physical activity levels that will combat cardiovascular risks is highly recommended. The continuous monitoring of cardiovascular (Blood pressure, pulse rates) health indicators is also encouraged.

La resistina se asocia con la proteína C reactiva y marcadores de riesgo cardiovascular en niños obesos / Resistin is associated with C reactive protein and cardiovascular risk markers in obese children / A resistina associa-se à proteína C reativa e aos marcadores de risco cardiovascular em crianças obesas

El objetivo del trabajo fue evaluar los niveles de resistina sérica y su asociación con la proteína C reactiva (PCR-hs), óxido nítrico (NO) y lípidos plasmáticos (LP) en sujetos de edad pediátrica. Participaron 366 niños y adolescentes (10-16 años), agrupados en eutróficos (n=162) y obesos (n=204). Se les estudió peso, talla, circunferencia de la cintura, resistina sérica, glucosa e insulina basal, LP, NO, PCR-hs, malondialdehído y tensión arterial. Se calculó el IMC, el índice cintura-talla (IC/T) y el HOMA-IR. Se utilizaron las pruebas t de Student, ANOVA, U de Mann y Whitney o Kruskal- Wallis para comparar entre grupos y la correlación de Spearman para determinar asociación entre variables. Los obesos masculinos presentaron niveles superiores de resistina (p<0,05). El género femenino presentó valores más altos de resistina en eutróficos (p=0,012) y con IC/T normal (p=0,011). A mayor concentración de resistina los eutróficos presentaron niveles más altos de triacilglicéridos, pero los obesos mostraron niveles más bajos de triacilglicéridos, HDLc y NO, más altos de PCR-hs y mayor IMC. Los resultados sugieren que la resistina podría ser un factor de riesgo para la enfermedad cardiovascular por su asociación positiva con la PCR-hs e inversa con el NO y la HDLc, parámetros involucrados en la inflamación y la disfunción endotelial.

The aim of this study was to evaluate seric levels of resitin and their association with high-sensitivity C Reactive Protein (hs-CRP), nitric oxide (NO) and plasmatic lipids (PL) in a pediatric age population. A total of 366 children and adolescents (between 10-16 years old) participated, and were grouped into eutrophic (n=162) and obese (n=204). Weight, height, waist circumference, resistin, fasting blood glucose and insulin levels, PL, hs-CRP, NO, malondialdehyde and blood pressure were measured. BMI, waist to height ratio (W/HR) and HOMA-IR were calculated. T-student, ANOVA, Mann-Whitney U-value or Kruskal-Wallis were used to compare between groups and Spearman correlation was used to determine association among variables. Male obese subjects showed higher resistin levels (p<0.05). Female subjects showed higher resistin values in the eutrophic group (p=0.012) and in the normal W/HR (p=0.011). At higher levels of resistin, the eutrophic group showed higher levels of triacylglycerides, but the obese group showed lower triacylglycerides, HDLc and NO levels and higher hs-CRP levels and BMI. These results suggest that resistin could be a risk factor for cardiovascular disease because of its positive association with hs-CRP and inverse association with NO and HDLc, parameters involved in inflammation and endothelial dysfunction.

O objetivo da pesquisa foi avaliar os níveis séricos de resistina sérica e sua associação com a proteína C-reativa (PCR-hs), óxido nítrico (NO) e lipídios plasmáticos (LP) em crianças e adolescentes. O estudo envolveu 366 crianças e adolescentes (10-16 anos), agrupados em eutróficos (n=162) e obesos (n=204). Os sujeitos foram estudados em relação ao peso, altura, circunferência da cintura, resistina sérica, glicose e insulina basal, LP, NO, PCR-hs, malondialdeído e pressão arterial. Os IMC, índice cintura-altura (IC/A) e HOMA-IR foram calculados. Foram utilizados os Testes t de Student, ANOVA, U de Mann e Whitney ou Kruskal-Wallis para comparar entre os grupos e a correlação de Spearman para verificar a associação entre variáveis. Os obesos masculinos mostraram níveis mais elevados de resistina (p<0,05). O sexo feminino apresentou valores mais altos de resistina em eutróficos (p=0,012) e com IC/T normal (p=0,011). À maior concentração de resistina, os eutróficos apresentaram maiores níveis de triacilglicerídeos, mas os obesos apresentaram níveis mais baixos de triacilglicerídeos, HDLc e NO, mais altos de PCR-hs e maior IMC. Os resultados sugerem que a resistina poderia ser um fator de risco para a doença cardiovascular devido à sua associação positiva com a PCR-hs e inversa com o NO e a HDLc, parâmetros envolvidos na inflamação e disfunção endotelial.

Research on the association between sex hormone binding globulin and the risk of developing cardiovascular diseases in community elderly population / 复旦学报（医学版）

Objective To explore the correlation between sex hormone binding globulin (SHBG) and cardiovascular disease (CVD) in community elderly population.Methods In 2014,1916 elderly people (796 males,and 1 120 females) were selected from Baoshan District Friendship Community,Shanghai.We collected basic epidemiological data and fasting venous blood samples to carry out the detection of biomarkers,and then calculated their ten-year Framingham risk score.In this study,obesity,systolic blood pressure,fasting blood glucose,lipid concentration,and high-sensitive C-reactive protein were considered as CVD risk factors;Framingham risk score was considered as a CVD event prediction risk score.We analyzed the correlations of these factors with SHBG.Results SHBG mean values in the population with a history of CVD were lower than those without a history of CVD (P＜0.001).The correlation coefficient between male SHBG and waist circumference,hip circumference,BMI,systolic pressure,cholesterol,triglycerides,high density lipoprotein cholesterol,apolipoprotein A,high sensitive C-reactive protein were-0.312,-0.307,-0.266,-0.113,0.155,-0.277,0.510,0.394 and-0.130,respectively (P＜0.01).The correlation coefficient between female SHBG and waist circumference,hip circumference,BMI,fasting glucose,cholesterol,triglycerides,high density lipoprotein cholesterol,apolipoprotein A,high-sensitive C-reactive protein were-0.236,-0.248,-0.168,-0.183,0.135,-0.264,0.445,0.358 and-0.295,respectively (P＜0.001).The decrease of SHBG level was consistent with the increase of Framingham score (κ =0.062,P＜0.001).Elevated level of SHBG would reduce the risk of CVD in ten years (P＜0.01).Conclusions There was a negative correlation between baseline SHBG level and CVD risk factors,positive correlation between baseline SHBG level and CVD protection factors in community elderly population;lower SHBG level indicated higher risk of developing CVD events.

Randomized Control Trial Study On The Effect Of Wet Cupping On Lipid Profile

Dyslipidaemia is one of the risk factors contributing to the pathogenesis of cardiovascular diseases (CVDs). This study was conducted to investigate the effect of wet cupping on lipid profile. Methods: This randomized controlled trial was conducted in 2012 at the School of Medical Sciences, Universiti Sains Malaysia, Malaysia. Sixty-two healthy volunteers ranging from 30 to 60 years old were randomized into control and intervention groups. Subjects in the intervention group were assigned to two sessions of wet cupping at the beginning of the study and at the third month; individuals in the control group did not undergo any cupping procedure. Venous blood sample was collected for serum lipid profile: Total Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C), and triglycerides; measured at baseline, first, third and fourth month. Results: Subjects in the cupping group had significant improvements from baseline to third and fourth month for TC (MD=-0.56, P=0.004), HDL-C (MD=-0.22, P<0.001) and LDL-C (MD=0.58, P=0.001). There was also a significant reduction from baseline to one month for triglycerides (MD=0.38, P<0.001). Subjects in the cupping group had significantly better values in HDL-C and LDL-C as compared with the control group at the third and fourth month. Significantly lower levels of TC and triglycerides in the cupping group of the fourth month. In the control group, there were no significant changes in any serum lipid profiles. Conclusion: After two sessions of wet cupping, TC, HDL-C, LDL-C and triglycerides were significantly improved by 8.2%, 13.7%, 16.4% and 20.8% respectively.

Could Low Birth Weight be Associated with Cardiovascular Disease in Adolescence? / Poderia o baixo peso ao nascimento ser associado com risco cardiovascular na adolescência?

Abstract Purpose Previous studies have shown that low birth weight (LBW) is associated with cardiovascular risk in late adulthood. Recent studies in adolescents suggest that modifiable factors may have greater influence on increased cardiovascular risk. This study aims to investigate the association between LBW and changes in anthropometric and biochemical risk factors during adolescence in a population with low average socioeconomic status. Methods In a retrospective double cohort, data of birth weight were extracted from hospital records of children born on the same day between 1992 and 2002. According to the World Health Organization, we classified the children as having LBW or normal birth weight. A total of 172 subjects among children, adolescents and adults were researched. We measured anthropometric and clinical data, lipid profile and glucose after an overnight fasting. The low and normal weight groups were compared using Mann-Whitney U, Fischer exact, Chi-square (2) and Student's t tests. Results Pregnant women with preeclampsia delivered more newborns with LBW (p< 0.001). Anthropometric and clinical parameters were similar between groups. No differences were found in the family history of cardiovascular diseases (p= 0.1), family incomes (p= 0.8) and maternal school education (p= 0.8) between groups. Conclusion In this study, LBW did not increase cardiovascular disease risk factors in adolescents. We observed absence of association between low birth weight and poor health outcomes among adolescents with low socioeconomic status from an urban city in the Brazilian northeast.

Resumo Objetivo Estudos mostram que o baixo peso ao nascer está associado ao risco cardiovascular na idade adulta. Estudos recentes em adolescentes sugerem que fatores modificáveis podem ter grande influência no aumento do risco cardiovascular. Este estudo busca investigar a associação entre baixo peso ao nascer com mudanças nos fatores de risco antropométricos e bioquímicos durante a adolescência em uma população com baixo nível socioeconômico. Métodos Em um estudo retrospectivo de coorte, dados de peso ao nascimento foram extraídos de registros de hospitais, de crianças que nasceram no mesmo dia, entre 1992 e 2002. De acordo com a Organização Mundial da Saúde, classificamos as crianças como baixo peso e peso normal. Um total de 172 pessoas, com idades entre 10 e 20 anos, foram pesquisadas. Avaliamos dados clínicos e antropométricos, perfil lipídico e glicemia de jejum. Os grupos de baixo peso e de peso normal foram comparados pelos testes de Mann-Whitney, Exato de Fisher, Qui-quadrado e t-Student. Resultados Gestantes com pré-eclâmpsia tiveram mais partos de recém-nascidos com baixo peso (p< 0,001). Parâmetros clínicos e antropométricos foram similares em ambos os grupos. Não houve diferença na história familiar de doença cardiovascular (p= 0,1), renda familiar (p= 0,8) e nível educacional materno (p= 0,8) entre os grupos. Conclusão Neste estudo, o baixo peso ao nascimento não aumentou o risco de doença cardiovascular na adolescência. Observou-se ausência de associação entre o baixo peso ao nascer e adversos resultados de saúde entre os adolescentes com baixo nível socioeconômico de um centro urbano no Nordeste brasileiro.

Role of γ-glutamyl transferase levels in prediction of high cardiovascular risk among patients with non-alcoholic fatty liver disease.

Background & objectives: Non-alcoholic fatty liver disease (NAFLD) is an important cause of elevated liver functions. There is evidence showing an association between NAFLD and subclinical atherosclerosis independent of traditional risk factors. We undertook this retrospective study to determine the association of Framingham cardiovascular risk scoring system with liver function tests and inflammatory markers and to find the role of liver function tests in determination of CVD risk among non-obese and non-diabetic subjects with non-alcoholic fatty liver disease. Methods: A total of 2058 patients were included in the study. Framingham cardiovascular risk scoring was done of all patients according to the age, gender, systolic blood pressure, serum total cholesterol and HDL cholesterol levels, smoking and antihypertensive medication history. Liver function test, lipid profile, insulin, uric acid, ferritin levels, etc. were determined. Results: According to the ultrasonography findings, patients were grouped as without any fatty infiltration of the liver (control group) (n=982), mild (n= 473), moderate (n=363) and severe fatty liver disease (n= 240) groups. In severe fatty liver disease group, the mean Framingham cardiovascular risk score was significantly higher than that of other groups. There was a positive correlation between GGT, uric acid and ferritin levels with Framingham cardiovascular score. In multivariate analysis, high GGT levels were positively associated with high-risk disease presence (OR: 3.02, 95% CI: 2.62-3.42) compared to low GGT levels independent of the age and sex. Interpretation & conclusions: Cardiovascular disease risk increases with the presence and stage of fatty liver disease. Our findings showed a positive correlation between elevated GGT levels and Framingham cardiovascular risk scoring system among non-diabetic, non-obese adults which could be important in clinical practice. Though in normal limits, elevated GGT levels among patients with fatty liver disease should be regarded as a sign of increased cardiovascular disease risk. Larger studies are warranted to elucidate the role of GGT in prediction of cardiovascular risk.

Sarcopenia and Sarcopenic Obesity and Their Association with Cardiovascular Disease Risk in Postmenopausal Women: Results for the 2008-2011 Korea National Health and Nutrition Examination Survey / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. METHODS: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. RESULTS: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher (3.82 ± 0.22%) than the normal group (2.73 ± 0.09%) and sarcopenia group (3.17 ± 0.22%) (p < 0.000). The odd ratios (ORs) for the ≥7.5% 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). CONCLUSIONS: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

Relationship between estimated glomerular filtration rate and 10-year cardiovascular disease risk in Chongqing college staff / 重庆医学

Objective To analyze the relationship between the estimated glomerular filtration rate (eGFR) and 10-year car‐diovascular disease risk (10y CVDR) in Chongqing college staff .Methods The physical examination data of the staff in two univer‐sities including 2630 persons were collected in April 2013 .The eGFR and 10y CVDR of each staff were calculated according to the standardized formula .The differences of 10y CVDR among different eGFR level groups were analyzed .Results The average age of all the staff were (51 .76 ± 14 .53) years old ,which in males was significant higher than that in females (P<0 .01) .The smokers , hypertension patients and diabetes patients accounted for 16 .00% ,15 .20% and 4 .10% respectively .The smokers ,hypertension and diabetes patients in males were significantly more than than those in females (P<0 .05) .The height ,weight ,BMI ,systolic pressure , diastolic pressure ,serum creatinine ,triglyceride ,LDL and blood glucose in males were significantly higher than those in females (P=0 .000) ,while HDL in males was significantly lower than that in females (P=0 .000) .The median of 10y CVDR was 1 .25% , males were significantly higher than females (2 .85% vs .0 .40% ,P<0 .01) .The median of 10y CVDR for the following groups were 0 .74% ,2 .25% ,5 .58% and 14 .39% respectively :eGFR≥90 mL · min-1 · 1 .73 m2 ,75 mL · min-1 · 1 .73 m2 ≤eGFR<90 mL · min-1 · 1 .73 m2 ,60 mL · min-1 · 1 .73 m2 ≤eGFR<75 mL · min-1 · 1 .73 m2 ,and eGFR<60 mL · min-1 · 1 .73 m2 .The results of the one‐way analysis of variance showed that compared to the 10y CVDR of the group with eGFR≥90 mL · min-1 · 1 .73 m2 ,which of the other three groups were all significantly increased .Conclusion eGFR is a significant factor impacting 10y CVDR . The lower the eGFR level ,the higher the risk of the 10y CVDR .

Cardiovascular Disease Risk Assessment and Treatment of Erectile Dysfunction in Men with Diabetes Mellitus.

Erectile dysfunction (ED) is the persistent inability to attain /or maintain an erection of the penis adequate for satisfactory sexual intercourse. This condition has been found to be more common, to occur earlier and to be more difficult to treat in men with Diabetes mellitus (DM) than those without DM. However, recent developments have led to improvement in the treatment of this condition with attendant reduction in associated psychosocial problems. This review article discusses the various treatment strategies for ED in men with DM, brings to fore the need for prior assessment of cardiovascular status of such patients before commencement of treatment for ED as well as the need for adequate glycaemic control and treatment of other co-morbidities in these patients.

Pattern of Thyroid Dysfunction in Patients with Metabolic Syndrome and Its Relationship with Components of Metabolic Syndrome

BACKGROUND: Thyroid dysfunction (TD) and metabolic syndrome (MetS) are known risk factors for atherosclerotic cardiovascular disease (ASCVD). TD is risk factor for ASCVD mediated by the effects of thyroid hormones on lipid metabolism and blood pressure hence the components of MetS. It is possible that coexistence of these two disease entities and unrecognized TD in patients with MetS might substantially increase ASCVD risk. Moreover, little is known about the relationship between TD and the components of MetS. Thus, the purpose of this study was to evaluate the pattern of TD in patients with MetS and its relationship with components of the MetS. METHODS: A total of 358 previously diagnosed patients with MetS were recruited in the study. The thyroid function test parameters were measured to classify TD at Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal. Statistical analyses were performed using SPSS version 16.0 to evaluate pattern and relationship. RESULTS: The overall prevalence of TD in patients with MetS was 31.84% with high prevalence of subclinical hypothyroidism (29.32%). We found no evidence of a relationship between TD and components of MetS, although there was significant difference in waist circumference between four groups of TD. CONCLUSION: Patients with MetS had subclinical hypothyroidism greatly. Although there was no evidence of any relationship between thyroid status and all components of MetS, TD should be taken into account when evaluating and treating patients with MetS to reduce the impending risk.

Increased Estimated 10-Year Risk for Cardiovascular Disease Assessed Using the Pooled Cohort Equation in Non-Diabetic Subjects According to Increasing HbA1c Levels

OBJECTIVE: In 2013, a new risk calculator known as the Pooled Cohort Equation (PCE) was introduced with the new cholesterol guideline. We aimed to calculate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk using PCE in non-diabetic Korean subjects with glycated hemoglobin (HbA1c) lower than 6.5%. METHODS: A total of 17,519 participants were evaluated in a health screening program. The 10-year ASCVD risk was calculated using the PCE. Subjects with underlying diabetes or HbA1c > or =6.5% were excluded. Subjects were divided into four groups according to fasting blood glucose (FBG) and HbA1c levels: FBG or =120 mg/dL; HbA1c or =5.8%. RESULTS: The mean 10-year ASCVD risk significantly increased as FBG increased from 120 mg/dL in the four divided groups (2.6%, 3.3%, 3.8%, 4.1%; p5.8% (2.4%, 2.7%, 3.0%, 3.6%; p or =10% significantly increased from group I to IV according to FBG and HbA1c levels after adjusting for age, body mass index and fasting insulin level (1.187, 1.753, and 2.390 vs. 1.0 in the lowest FBG group; 1.626, 1.574, and 1.645 vs. 1.0 in the lowest HbA1c group). CONCLUSION: The 10-year ASCVD risk calculated using the PCE significantly increased as the FBG and HbA1c increased even in Korean subjects without underlying diabetes.