Status de vitamina D e risco cardiovascular em indivíduos com síndrome metabólica / Vitamin D status and cardiovascular risk in individuals with metabolic syndrome

Introdução: A síndrome metabólica é um conjunto de desordens metabólicas, consideradas fatores de risco cardiovascular. Estima-se que indivíduos com síndrome metabólica apresentam probabilidade três vezes maior de desenvolver doenças cardiovasculares. O status inadequado de vitamina D tem apresentado múltiplos mecanismos fisiopatológicos que sugerem um envolvimento no desenvolvimento de doenças cardiovasculares. Objetivo: avaliar a associação entre o status de vitamina D e o risco de doenças cardiovasculares em indivíduos com síndrome metabólica. Métodos: Estudo do tipo transversal realizado com 161 indivíduos adultos, diagnosticados com síndrome metabólica. Foram realizadas as medidas antropométricas, pressão arterial, e as análises bioquímicas, incluindo a dosagem de 25(OH)D no soro. O critério estabelecido para classificação do status de 25(OH)D foi deficiente < 20 ng/mL; insuficiente≤ 29 ng/mL e suficiente ≥ 30 ng/mL. Ademais, avaliou-se o risco absoluto de desenvolver doenças cardiovasculares usando o Escore de Risco de Framingham. Resultados: A mediana da concentração de 25(OH)D foi 29,7 (21-34) ng/mL, indicando status de 25(OH)D insuficiente na população. Não houve associação entre status de vitamina D e o risco cardiovascular em indivíduos com síndrome metabólica (p > 0,05). Conclusão: Não se observou associação entre status 25(OH)D inadequado e maior risco cardiovascular nos indivíduos com síndrome metabólica. Entretanto,esses resultados reforçam a importância do monitoramento clínico para prevenir os impactos da hipovitaminose D nos indivíduos com síndrome metabólica e o desenvolvimento de novos estudos para avaliar a relação entre status de 25(OH)D e risco cardiovascular.

Introduction: Metabolic syndrome is a set of metabolic disorders that are considered cardiovascular risk factors. It is estimated that individuals with metabolic syndrome are three times more likely to develop cardiovascular disease. Inadequate vitamin D status has shown multiple pathophysiological mechanisms that suggest an involvement in the development of cardiovascular disease. Objective: To evaluate the association between vitamin D status and the risk of cardiovascular disease in individuals with metabolic syndrome. Methods: This is a cross-sectional study carried out with 161 adult individuals diagnosed with metabolic syndrome. Anthropometric measurements, blood pressure, and biochemical analyzes were performed, including serum 25(OH)D status. The established criterion for classifying 25(OH)D status was deficient < 20 ng/mL; insufficient ≤ 29 ng/mL and sufficient ≥ 30 ng/mL. Furthermore, the absolute risk of developing cardiovascular disease was assessed using the Framingham Risk Score. Results: The mean 25(OH)D concentration was 29.7 (21-34) ng/mL, indicating insufficient 25(OH)D status in the population. There was no association between vitamin D status and cardiovascular risk in subjects with metabolic syndrome (p > 0.05). Conclusion: There was no association between inadequate 25(OH)D status and increased cardiovascular risk in individuals with metabolic syndrome. However, these results reinforce the importance of clinical monitoring to prevent the impacts of hypovitaminosis D in individuals with metabolic syndrome and the development of new studies to assess the relationship between 25(OH)D status and cardiovascular risk.

Assessment of Cardiovascular Disease Risk among Perimenopausal Women :A Cross-sectional Study in a Rural Area of West Bengal

Introduction :Cardiovascular disease (CVD) has become the leading cause of mortality in the world, more so in the perimenopausal age group due to decreased levels of estrogen and diminished ovarian function because of ageing. To find out the magnitude of CVD risk among perimenopausalObjective: women residing in rural Bengal and its associated determinants. A cross-sectional study wasMethod: conducted in a rural area of Barasat block I during April-July 2021 on 150 peri-menopausal women selected by cluster sampling. A pre-designed pretested questionnaire was used for data collection and a 10-year probability of CVD risk was assessed using Framingham Risk Score. Logistic regression analysis was done to find out the associated factors. Intermediate & high CVD risk was present in 28 (18.7%) and 63Results: (42%) participants respectively. Among 150 participants, 62% were hypertensive, 44.7% were diabetic,, 51.3% with borderline high total cholesterol and 76% had low HDL cholesterol. Factors significantly associated with intermediate to high CVD risk were high mental stress [AOR=6.96, 95%CI=2.17-22.31], family history of chronic illness [AOR=14.46, 95% CI=4.26-49.06] and presence of chronic morbidities [AOR=6.84, 95%CI=1.93-24.22]. A significant proportion of perimenopausal women were atConclusion: risk of developing CVD. Thus, awareness campaigns in the community would help in empowering women in maintaining their health through regular screening and timely intervention when deemed necessary

Escore de risco de Framingham em pacientes diabéticos da estratégia de saúde da família / Framingham risk score among diabetic patients in the family health strategy / Puntuación de riesgo de Framingham en pacientes diabéticos de la estrategia de salud familiar

A maioria dos indivíduos com diabetes mellitus também apresenta obesidade, hipertensão arterial sistêmica (HAS) e dislipidemia. Por esse motivo, preconiza-se a Estratificação de Risco de Framingham (ERF), de modo a identificar o risco de desenvolvimento de doenças cardiovasculares (DCV) em dez anos. Este estudo analisa a prevalência de diabetes mellitus para determinar o risco cardiovascular pelo ERF na Estratégia de Saúde da Família (ESF), visando um cuidado integral para a prevenção de DCV. Trata-se de uma pesquisa de corte transversal com população (n = 746) dividida em 150 indivíduos diabéticos (apenas quatro do tipo 1) e 596 não diabéticos a partir de 3.325 prontuários. Foi identificado 57,9% (n = 432) de indivíduos com baixo risco (ERF < 10%); 24,7% (n = 185) em médio risco (ERF 10-20%), e 17,2% (n = 129) em alto risco (ERF > 20%). Os diabéticos de baixo risco representam 23,3% (n = 35/150); 36,6% (n = 55/150) com médio risco e 40% (n = 60/150) com alto risco. Os grupos são significativamente distintos entre si quanto ao ERF (P < 0, 0001) ao comparar os subgrupos de risco (baixo, médio, alto), assim como as taxas de glicemia (P < 0,0001). A prevalência de médio e alto risco aumenta a partir dos 48 anos de idade; o sexo feminino prevalece em todos os níveis de risco e faixas etárias. O risco cardiovascular para diabéticos é 2,5 vezes maior; há impacto aumentado se concomitante com hipertensão, tabagismo, obesidade, sedentarismo e etilismo. O panorama do risco cardiovascular, determinado pelo ERF, é relevante para o uso clínico pela equipe de saúde básica ao lidar com pacientes diabéticos.

Most individuals with diabetes mellitus also present obesity, hypertension and dyslipidemia. Hence, the Framingham Risk Stratification (ERF) is recommended to identify the risk of developing cardiovascular diseases (CVD) in 10 years. This study analyzes the prevalence of diabetes mellitus to determine cardiovascular risk using the ERF in the Family Health Strategy, aiming at comprehensive care for CVD prevention. Cross-sectional research was conducted with 746 patients divided into 150 diabetic individuals (only four with type 1) and 596 non-diabetic individuals, identified from 3,325 medical records. Of the total, 57.9% (n = 432) were low-risk individuals (ERF < 10%), 24.7% (n = 185) medium risk (ERF 10-20%), and 17.2% (n = 129) high risk (ERF > 20%). Among diabetics, 23.3% (n = 35/150) were at low risk, 36.6% (n = 55/150) at medium risk, and 40% (n = 60/150) at high risk. The groups are significantly different regarding ERF (P < 0.0001), and when comparing risk subgroups (low, medium, high) and blood glucose rates (P < 0.0001). The prevalence of medium and high risk increases from 48 years of age. Women prevails at all risk levels and age groups. Diabetics have a 2.5 times higher cardiovascular risk, presenting an increased impact if concomitant with hypertension, smoking, obesity, sedentary lifestyle, and alcoholism. The panorama of cardiovascular risk determined by the ERF is relevant for clinical use by primary care staff when treating diabetic patients.

La mayoría de las personas que padecen diabetes mellitus también tiene obesidad, hipertensión arterial sistémica (HAS) y dislipidemia. Por este motivo, se recomienda la Estratificación de Riesgo de Framingham (ERF) para identificar el riesgo de desarrollar enfermedades cardiovasculares (ECV) en 10 años. Este estudio busca analizar la prevalencia de la diabetes mellitus para determinar el riesgo cardiovascular utilizando la ERF en la Estrategia de Salud Familiar, con el objetivo de proporcionar una atención integral para la prevención de las ECV. Este es un estudio de corte transversal con una población (n = 746) dividida en 150 individuos diabéticos (solo 4 de tipo 1) y 596 individuos no diabéticos desde 3.325 historias clínicas. Se identificaron un 57,9% (n = 432) de individuos de bajo riesgo (ERF <10%); el 24,7% (n = 185) de riesgo medio (ERF 10-20%) y el 17,2% (n = 129) de alto riesgo (ERF > 20%). Los diabéticos de bajo riesgo constituyen el 23,3% (n = 35/150); con riesgo medio el 36,6% (n = 55/150) y con riesgo alto el 40% (n = 60/150). Los grupos son significativamente diferentes entre sí con respecto a la ERF (P < 0,0001) al comparar subgrupos de riesgo (bajo, medio, alto) y las tasas de glucosa en sangre (P < 0,0001). La prevalencia de riesgo medio y alto aumenta a partir de los 48 años; el género femenino predomina en todos los niveles de riesgo y grupos de edad. El riesgo cardiovascular para los diabéticos es 2,5 veces mayor; hay un mayor impacto si es concomitante con hipertensión, tabaquismo, obesidad, inactividad física y alcoholismo. El panorama de riesgo cardiovascular, determinado por la ERF, es relevante para el uso clínico por parte del equipo básico de salud cuando se trata de pacientes diabéticos.

High sensitivity C-reactive protein (hsCRP): Its relationship with metabolic syndrome and Framingham Risk Score

@#Introduction: Cardiovascular disease (CVD) remains the leading cause of death in Malaysia. Identification of asymptomatic at-risk individuals is often achieved by means of a risk prediction algorithm. Traditional CVD risk factors and their associated algorithms are, however, limited by residual CVD risk. High sensitivity C-reactive protein (hsCRP) has emerged as a novel CVD risk factor. This study aimed to evaluate hsCRP as an adjunct CVD risk marker among the adult Malaysian population by determining its correlation with the Framingham Risk Score (FRS). Comparison analyses were done according to sociodemographic, clinical and laboratory factors and between subjects with and without Metabolic Syndrome (MetS). Method: This cross-sectional study involved eighty-three (n=83) adults attending a health screening program at Universiti Putra Malaysia (UPM). Demographic data, anthropometric measurements and blood samples for fasting blood glucose (FBG), fasting lipid profile (FSL), glycated haemoglobin (HbA1c) and hsCRP were taken. Respondents were grouped according toFRSand the Joint Interim Statementinto 10-year CVD risk categories (low, intermediate and high) and MetS, respectively. Results: hsCRP was significantly increased in patients with high body mass index (BMI) (p=0.001), at-risk waist circumference (WC) (p=0.001) and MetS (p=0.009). Spearman’s correlation coefficient showed a significant positive correlation between hsCRP level and total FRS score (r=0.26, p<0.05) and HDL-C score (r=0.22, p<0.05). Conclusion: The significant difference of hsCRP levels across obesity levels and MetS with its modest correlation with FRS scores supported the adjunctive role of hsCRP in CVD risk prediction, most likely capturing the inflammatory pathological aspect and thus partly accounting for the residual CVD risk.

Predicted 10-year Cardiovascular Disease Risk and Its Association with Sleep Duration among Adults in Beijing-Tianjin-Hebei Region, China / 生物医学与环境科学（英文）

Objective@#The study aims to predict 10-year cardiovascular disease (CVD) risk and explore its association with sleep duration among Chinese urban adults.@*Methods@#We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling. The simplified Pittsburgh Sleep Quality Index (PSQI) and Framingham 10-year risk score (FRS) were used to measure sleep duration and CVD risk. Demographic characteristics, personal history of chronic diseases, lifestyle factors were collected using a questionnaire. Height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were also measured. Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.@*Results@#We included 31, 135 participants (median age 44 years, 53.02% males) free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 14.05%, and 25.55% of participants were at medium and high predicted CVD risk, respectively. Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males ( @*Conclusion@#A substantial number of adults free of CVD were at high 10-year CVD risk. Short sleep was associated with increased odds of predicted CVD risk.

Concordance between two versions of world health organization/international society of hypertension risk prediction chart and framingham risk score among postmenopausal women in a rural area of Bangladesh

Background: Prevention of cardiovascular disease (CVD) among postmenopausal women with limited resource is a great challenge for a country like Bangladesh. Objectives: This study aimed to evaluate the level of agreement among different risk prediction tools to find out the cost-effective and suitable one that can be applied in a low-resource setting. Methods: This was a cross-sectional study conducted from February through December 2016 among 265 postmenopausal women of 40–70 years age. Data were collected from the outpatient department of a rural health-care center situated in the village Karamtola of Gazipur district, Bangladesh. The CVD risk was estimated using the World Health Organization/International Society of Hypertension (WHO/ISH) “with” and “without” cholesterol risk charts and the Framingham Risk Score (FRS). Concordance among the tools was evaluated using Cohen's kappa (?), prevalence-adjusted bias-adjusted kappa (PABAK), and first-order agreement coefficient (AC1). Results: The “without” cholesterol version showed 79% concordance against the “with” cholesterol and 75.4% concordance against the FRS. In between the WHO/ISH risk charts, slight-to-substantial levels of agreement (? = 0.14, PABAK = 0.58, and AC1 = 0.72; P = 0.023) were observed. With FRS, the “without” cholesterol version showed higher agreement (? = 0.38, fair; PABAK = 0.50, moderate; and AC1 = 0.60, moderate; P = 0.000) compared to “with” cholesterol version (? = 0.13, slight; PABAK = 0.30, fair; and AC1 = 0.44, moderate; P = 0.013). Predictability of CVD risk positive (?10%) cases was similar for both the versions of WHO/ISH risk charts. Conclusion: In a low-resource setting, the “without” cholesterol version of WHO/ISH risk chart is a good option to detect and target the population with high CVD risk.

Comparison between metabolic syndrome and framingham risk score as predictor of cardiovascular disease among Kazakhs population / 中华内分泌代谢杂志

Objective@#To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease(CVD)among Kazakhs population.@*Methods@#The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve.@*Results@#The incidence of CVD was 13.87%. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59% vs 11.10%, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001); the area under the curve of MS risk score was close to that of Framingham risk score(0.732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61, 9.33, 14.15, 22.29 vs 3.69, 6.36, 8.47, 16.99).@*Conclusion@#MS risk score that included age may be a better predictor of CVD among Kazakhs population.

Cardiovascular Risk Assessment in Polycystic Ovary Syndrome Based on Framingham Score / 实用妇产科杂志

Objective:To investigate the association between polycystic ovary syndrome (PCOS) and cardiovascular risk factors and evaluate 10-year risk of cardiovascular disease (CVD) in women with PCOS.Methods:239 PCOS patients (PCOS group) and 134 age-matched non-PCOS participants (control) were enrolled in this retrospective study.The general data was collected and biochemical test, glucose tolerance, sex hormones were detected.The Framingham score (FRS) for all women was evaluated according to age, systolic blood pressure (SBP), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and history of smoking.The clinical features, laboratory parameters and FRS of PCOS patients and non-PCOS controls were compared.The correlation between FRS and metabolic indicators and sex hormones was analyzed.Results:①Compared with those of the control group, SBP and diastolic blood pressure (DBP) significantly increased, the glucose and lipid metabolism was moredisordered, and the androgen level was higher in PCOS group (P＜0.05).② The FRS of the PCOS group was higher than that of the control women (P＜0.01).③ FRS were positively correlated with BP, FPG, PBG, FIns, PIns, HOMA-IR, TC, TG, LDL-C.FRS was negatively correlated with HDL-C and SHBG (P＜0.05).Conclusions:PCOS is correlated with major cardiovascular risk factors, such as hypertension, hyperglycemia, and hyperlipidemia.PCOS show a higher risk of 10-year CVD events than individuals without PCOS.The phenomenonis mainly related to blood pressure and glycolipid metabolism but not androgen.

Serum Alanine Aminotransferase Level as a Risk Factor for Coronary Heart Disease Prediction in Koreans: Analysis of the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011) / 가정의학회지

BACKGROUND: The blood level of alanine aminotransferase (ALT) is associated with increased coronary heart disease (CHD) risk. However, its use as an independent factor for CHD risk prediction remains unclear in Asian populations. The purpose of this study was to examine the association between serum ALT levels and CHD risk in Koreans. METHODS: This was a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011). The ALT levels of 3,215 individuals were analyzed. The Framingham Risk Score (FRS) modified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) was used to compute the 10-year CHD risk prediction. RESULTS: Positive correlations were established between log-transformed ALT concentration and FRS (r=0.433, P<0.001). After adjusting for body mass index, low-density lipoprotein cholesterol, the amount of alcohol intake, and gamma-glutamyl transferase, the odds ratio (95% confidence interval) for intermediate or greater risk of 10- year CHD prediction (10-year risk ≥10%) for the lowest quartile of participants was 2.242 (1.405–3.577) for the second quartile, 2.879 (1.772–4.679) for the third quartile, and 3.041 (1.789–5.170) for the highest quartile. CONCLUSION: In Koreans, a higher serum ALT concentration was significantly correlated with 10-year CHD risk prediction according to NCEP ATP III guidelines.

The Relationship between 10 Years Risk of Cardiovascular Disease and Schizophrenia Symptoms: Preliminary Results

OBJECTIVE: Previous research shows that patients with schizophrenia have increased cardiovascular disease risk than general population. Increased cardiovascular risk in schizophrenia patients have been associated with many reasons such as antipsychotic drugs, genetic predisposition, andlifestyle. In this study, we aimed to investigate the relationship between the risk of heart disease and schizophrenia symptomatology.METHODS: The 10-year cardiovascular risk was assessed by the Framingham Risk Score (FRS) in 103 patients with schizophrenia and in 39 healthy controls. Sociodemographic characteristics, age at schizophrenia onset, duration of illness, number of hospitalizations, the course of the disease and antipsychotic medications were recorded. Patients’ symptoms were evaluated via The Scale for the Assessment of Negative Symptoms (SANS), The Scale for the Assessment of Positive Symptoms (SAPS), and Calgary Depression Scale for Schizophrenia (CDSS).RESULTS: Ten-year cardiovascular risk was 5.16% inpatients with schizophrenia, and 3.02% in control group (p=0.030). No significant correlation was found between FRS scores, SANS, SAPS, and CDSS scores. However, FRS scores were significantly correlated with age, number of hospitalizations and duration of disease (r=0.300, 0.261, 0.252, respectively). Moreover FRS scores were higher (p=0.008) and high-density lipoprotein (HDL) levels were lower (p=0.048) in patients using multiple antipsychotics.CONCLUSION: Our findings suggest a relationship between the risk of cardiovascular disease and the duration and overall severity of schizophrenia and also highlights the role of antipsychotics in this relationship.

Comparison between metabolic syndrome and framingham risk score as predictor of cardiovascular disease among Kazakhs / 中华内分泌代谢杂志

Objective To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease( CVD) among Kazakhs. Methods The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve. Results The incidence of CVD was 13.87％. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59％ vs 11.10％, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001);the area under the curve of MS risk score was close to that of Framingham risk score ( 0. 732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61、9.33、14.15、22.29对3.69、6.36、8.47、16.99) . Conclusion MS risk score that included age may be a better predictor of CVD among Kazakhs.

Comparison of risk-assessment tools for cardio-cerebrovascular diseases (CVD) in male shipyard workers: a cross-sectional study

BACKGROUND: Periodic revision of assessment tools is essential to ensure risk assessment reliability and validity. Despite the recent revision of the Korea Occupational Safety and Health Agency (KOSHA) 2018, there is no evidence showing that the revision is superior to other cardio-cerebrovascular diseases (CVDs) risk-assessment tools for workplace health management. We conducted a comparative analysis using the Framingham risk score (FRS) as a gold standard to identify the most relevant CVDs risk-assessment tool for workplace health management. METHODS: We included 4,460 shipyard workers who had undergone a workers' health examination during January–December 2016. Risk levels for CVDs were calculated based on the FRS, KOSHA 2013, KOSHA 2017, KOSHA 2018 (2 methods), National Health Screening Program health risk appraisal (NHS HRA) 2017, and NHS HRA 2018. Study participants were categorized into low-risk, moderate-risk, or high-risk groups. Sensitivity, specificity, correlation, and agreement of each risk-assessment tool were calculated compared with the FRS as a gold standard. For statistical analyses, Spearman's rank correlation coefficient and the linearly weighted kappa coefficient were calculated. RESULTS: Sensitivity of the risk assessments was highest in the KOSHA 2018 (health risk appraisal [HRA]). The FRS showed correlation coefficients of 0.354 with the KOSHA 2013, 0.396 with the KOSHA 2017, 0.386 with the KOSHA 2018, 0.505 with the KOSHA 2018 (HRA), 0.288 with the NHS HRA 2017, and 0.622 with the NHS HRA 2018. Kappa values, calculated to examine the agreement in relation to the KOSHA 2013, KOSHA 2017, KOSHA 2018, KOSHA 2018 (HRA), NHS HRA 2017, and NHS HRA 2018 with the FRS, were 0.268, 0.322, 0.352, 0.136, 0.221, and 0.559, respectively. CONCLUSIONS: The NHS HRA 2018 risk calculation method is a useful risk-assessment tool for CVDs, but only when appropriate classification criteria are applied. In order to enhance the risk-group identification capability of the KOSHA guideline, we propose to apply the classification criteria set in this study based on the risk group definition of the 2018 Korean Society of Hypertension guidelines for the management of hypertension instead of the current classification criteria of the KOSHA 2018.

Framingham risk score and risk of incident chronic kidney disease: A community-based prospective cohort study

BACKGROUND: Cardiovascular disease and chronic kidney disease share several common risk factors. The Framingham risk score is hypothesized to predict chronic kidney disease development. We determined if the Framingham risk scoring system can correctly predict incident chronic kidney disease in the general population. METHODS: This study included 9,080 subjects who participated in the Korean Genome and Epidemiology Study between 2001 and 2014 and had normal renal function. The subjects were classified into low- ( 20%) risk groups based on baseline Framingham risk scores. The primary endpoint was de novo chronic kidney disease development (estimated glomerular filtration rate [eGFR], < 60 mL/min/1.73 m²). RESULTS: During a mean follow-up duration of 8.9 ± 4.3 years, 312 (5.3%), 217 (10.8%), and 205 (16.9%) subjects developed chronic kidney disease in the low, intermediate, and high risk groups, respectively (P < 0.001). Multivariable analysis after adjustment for confounding factors showed the hazard ratios for the high- and intermediate risk groups were 2.674 (95% confidence interval [CI], 2.197–3.255) and 1.734 (95% CI, 1.447–2.078), respectively. This association was consistently observed irrespective of proteinuria, age, sex, obesity, or hypertension. The predictive power of this scoring system was lower than that of renal parameters, such as eGFR and proteinuria, but increased when both were included in the prediction model. CONCLUSION: The Framingham risk score predicted incident chronic kidney disease and enhanced risk stratification in conjunction with traditional renal parameters in the general population with normal renal function.

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.

Correlation of CT Epicardial Adipose Tissue (EAT) thickness with cardiovascular risk using the framingham risk score

BACKGROUND@#Epicardial adipose tissue (EAT) thickness as a marker of cardiovascular risk has not been extensively studied. Though readily seen in CT images, it is often overlooked due to limited information of its significance. This study aims to determine the correlation of CT EAT thickness with cardiovascular risk using the Framingham Risk Score in adult Filipino patients.@*METHODOLOGY@#This study is a cross-sectional study involving 44 Filipinos, 21 to 70 years, who underwent chest CT scan, CT aortogram, CT calcium score, CT coronary angiogram and CT pulmonary angiogram in our institution from January 2017 to June 2018. After undergoing CT scan, patients are recruited to participate in which their Framingham Risk Score (FRS) was determined. EAT thickness measurements will be measured in the right ventricular anterior free wall along the axial plane. Correlation between EAT thickness and FRS will be analyzed using Pearson's Product - Moment Correlation.@*RESULTS@#Findings suggest that FRS has a moderate correlation with EAT thickness (r = 0.6287, p = <0.001).@*CONCLUSION@#CT measured EAT shows moderate correlation with Framingham Risk Score.

Associations between blood glucose level and cardiovascular disease risk in elderly people aged 40 and older in Guiyang City / 中华内分泌代谢杂志

Objective To investigate the association between blood glucose level and cardiovascular disease ( CVD) risk in elderly people aged 40 and older in Guiyang City. Methods Population-based cross-sectional studies on diabetes were performed in 10140 adults, aged 40-78 years, living in the Yunyan Community in Guiyang City, during May, 2011 to August, 2011. The fasting venous blood samples were drawn for the measurements of serum creatinine(Cr), fasting plasma glucose(FPG), OGTT 2hPG, fasting triglyceride(TG), total cholesterol(TC), high-density lipoprotein-cholesterol ( HDL-C ) , low-density lipoprotein-cholesterol ( LDL-C ) , and fasting plasma insulin. The diabetes status and the classification system for diabetes in our study were categorized according to the Diabetes Diagnostic Standard which was issued by WHO in 1999. An estimated 10-year Framingham risk for coronary heart disease was calculated. Results Compared with those in normal glucose regulation( NGR) group, the subjects in abnormal glucose metabolism were associated with higher prevalence of various cardiovascular risk factors, including age, body mass index, blood pressure, HbA1C , HOMA-IR, total cholesterol, triglycerides, waist circumference, waist-hip ratio, and creatinine, as well as 10-year Framingham risks for coronary heart disease. The difference was statistically significant ( all P<0. 05 ) . Men were more likely to have cardiovascular risk than women. Women developing the disease only begins to increase after the age of 59. The difference was statistically significant(P<0.05). Compared with the subjects in NGR group, the 10-year Framingham risk for coronary heart disease in impaired fasting glucose ( IFG ) , impaired glucose tolerance ( IGT ) , and diabetes mellitus ( DM ) groups shown 10％of increase were 1.13( OR=1.13, 95％CI 0.81-1.58, P>0.05) , 1.18( OR=1.18, 95％CI 0.95-1.45, P>0.05), and 1.44(OR=1.44, 95％CI 1.10-1.88, P<0.05), respectively, after adjusting for various influencing factors. Conclusion Diabetic patients and pre-diabetic individuals were independently associated with the increased 10-year risks for CVD.

Serum Uric Acid is Associated with the Predicted Risk of Prevalent Cardiovascular Disease in a Community-dwelling Population without Diabetes / 生物医学与环境科学（英文）

OBJECTIVE@#To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.@*METHODS@#We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases (ASCVD) among 8,252 participants aged ⪖ 40 years without diabetes from Jiading district, Shanghai, China.@*RESULTS@#Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid (all P trend < 0.05). Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia (all P trend < 0.05). A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios (ORs) [95% confidence intervals (CIs)] for the highest quartiles for high Framingham risk were 3.00 (2.00-4.50) in men and 2.95 (1.08-8.43) in women. The multivariate adjusted ORs (95% CIs) for the highest quartile for high ASCVD risk were 1.93 (1.17-3.17) in men and 4.53 (2.57-7.98) in women.@*CONCLUSION@#Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dyslipidemia, 10-year Framingham risk for coronary heart disease, and 10-year risk for ASCVD among Chinese adults without diabetes.

Association between kidney function and Framingham risk score in an admixed population of Brazil

ABSTRACT Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk development. However, the mechanisms of reduced kidney function with CVD risk are unclear. This study aimed to investigate the association between kidney function and Framingham risk score (FRS) in participants with traditional cardiovascular risk factors and normal estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m² in an admixed population of Brazil. The participants were divided into three groups according to FRS: low risk group with 0% to <10%, moderate risk group with ≥10% to 20% and high risk group with >20%. The eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Data from participants were collected by questionnaire, and blood and urine samples were collected to analyze biochemical markers. A total of 214 subjects aged 53±10 years old was collected. There were 77 individuals in low risk group, 59 in moderate risk group and 78 in high-risk group. Mean eGFRCKD-EPI was 89.39±15.05 mL/min/1.73 m² and 90.74±16.17 mL/min/1.73 m2 when race adjustment. The results indicated that there is an increasing the cardiovascular risk with a decreased of eGFR, conforming to a significant inverse correlation observed between eGFR and FRS with Spearman correlation (R²=-0.256, p<0.001; R²=-0.224, p=0.001, when adjusted for race). There was a statistically significant difference in eGFRCKD-EPI (p<0.001) and eGFRCKD-EPI with race adjustment (p=0.002) among risk groups. The data suggests that the reduction eGFR is associated with elevated FRS among Brazilian adults without CKD. Furthermore, the results suggest that race adjustment it's not necessary in Brazilian population.

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.

Relationship between serum ferritin levels and cardiovascular risk in different genders of Chinese / 中华全科医师杂志

Objective To evaluate the association between serum ferritin and the risk of cardiovascular disease among the Chinese population.Methods Based on the data from China Health and Nutrition Survey 2009, we used the Framingham risk score to calculate the 10-year risk of cardiovascular disease and analyzed the association between serum ferritin and the risk of cardiovascular disease in different gender by logistic regression analysis.Results Among 6 551 respondents, 3 035 (46.3%) were males and 3 516 ( 53.7%) were females whose mean age were ( 49.3 ±13.8 ) and ( 49.2 ±13.7 ) years, respectively.The median level of serum ferritin was 75.08 ( 36.71 -138.75 )μg/L.According to the 10-year risk of cardiovascular disease calculated by the Framingham risk score , the low risk group, middle risk group and high risk group were accounted for 79.5%( n=5 207 ) , 15.7% ( n=1 028 ) and 4.8%( n=316), respectively.The median of serum ferritin (121.61 vs.46.14, P<0.01) and the Framingham risk score (8.6 ±6.0 vs.7.3 ±1.6, P<0.01) of males were higher than those of females.The percentages of the middle risk group ( 30.6% vs.2.8%) and high risk group ( 9.8% vs.0.5%) of 10-year risk of cardiovascular disease in males were higher than those in females ( P <0.01 ).The 10-year risk of cardiovascular disease ≥10%increased with the increasing of serum ferritin in females ( trend P<0.01 ) but not in males.Conclusion Serum ferritin levels are positively correlated with the risk of cardiovascular disease in female Chinese.