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Weitzner ZN, Kim KH, Kim Y, Seo KW, Choi YS, Dutson EP. Comparison of Eastern and Western patients undergoing bariatric surgery at two US and Korean institutions: a retrospective analysis of differing bariatric patient populations. Surg Endosc 2024; 38:129-135. [PMID: 37934296 DOI: 10.1007/s00464-023-10549-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/15/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Currently, there are differences in both demographics and indications for bariatric surgery between Eastern and Western countries. We compared postoperative outcomes between Korean and American bariatric programs in order to assess how bariatric surgery differently affects these populations. METHODS We enrolled 540 patients who underwent bariatric surgery at University of California, Los Angeles (UCLA) and 85 patients who underwent surgery at Kosin University Gospel Hospital (KUGH) between January 2019 and December 2020. We compared demographics, complications, weight loss, and metabolic parameters between these groups. RESULTS There was a difference in age between the UCLA and KUGH patient groups (44.3 years vs 37.6 years, P < 0.01). Frequencies of T2DM and OSA were also different (4.2% vs 50.6%, 34.1% vs 85.9% P < 0.01. Length of hospital stay varied (1.55 days vs 6.68 days, P < 0.01), but there was no difference in operating time and complications. There was no difference in percent of excess weight loss between the two groups at 6 months (29.7 vs 33.8, P = 0.13). Hepatic steatosis index (HSI) was higher in the UCLA group both before (54.2 vs 51.5, P < 0.01) and after (44.4 vs 40.0, P = 0.02) surgery. LSG was the most frequently performed operation, and robotic surgery and revisions were performed only in the UCLA program. CONCLUSION There were differences in age, BMI, length of stay, and choice of operation between Korean and American bariatric patients. Also, there were differences in the degree of fatty liver disease using HSI and liver enzymes before and after surgery. There was no significant differences in operation time and complications. These findings suggest differences in bariatric practices and reactions to bariatric surgery in Eastern and Western settings.
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Affiliation(s)
- Zachary N Weitzner
- Department of Surgery, UCLA Section of Minimally Invasive and Bariatric Surgery, David Geffen School of Medicine at University of California, 72-239 CHS, BOX 956904, Los Angeles, CA, 90095, USA
| | - Ki Hyun Kim
- Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea
| | - Yoonhong Kim
- Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea
| | - Kyung Won Seo
- Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea.
| | - Young Sik Choi
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Republic of Korea
| | - Erik P Dutson
- Department of Surgery, UCLA Section of Minimally Invasive and Bariatric Surgery, David Geffen School of Medicine at University of California, 72-239 CHS, BOX 956904, Los Angeles, CA, 90095, USA.
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Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population. Sci Rep 2022; 12:13769. [PMID: 35962047 PMCID: PMC9374724 DOI: 10.1038/s41598-022-17961-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/03/2022] [Indexed: 11/08/2022] Open
Abstract
The best obesity index for myocardial infarction or angina pectoris (MIAP) risk assessment remains controversial. Furthermore, the association between biochemical indices and these diseases is unclear. This study examined associations of obesity and biochemical indices with MIAP in the Korean population. This large-scale cross-sectional study was based on the Korea National Health and Nutrition Survey dataset from 2010 to 2019. A total of 22,509 subjects (9452 men and 13,057 women) aged ≥ 50 years were included. Participants consisted of 21,426 individuals without MIAP (men = 8869, women = 12,557) and 1083 with MIAP (men = 583, women = 500). Binary logistic regression was performed to examine the association of MIAP with obesity and biochemical indices. The prevalence of MIAP in Korean adults aged ≥ 50 years was 4.81% (6.57% among men, 3.98% among women). MIAP was more strongly associated with total cholesterol than other variables in men (adjusted OR = 0.436 [0.384-0.495], adjusted p < 0.001) and women (adjusted OR = 0.541 [0.475-0.618], adjusted p < 0.001). The waist-to-height ratio (adjusted OR = 1.325 [1.082-1.623], adjusted p = 0.007) and waist circumference (adjusted OR = 1.290 [1.072-1.553], adjusted p = 0.007) showed a significant association with MIAP in men, with no association between obesity indices and MIAP in women after adjustment. The association between biochemical indices and MIAP differed slightly according to sex. Only total cholesterol, creatinine, and platelets were associated with MIAP in both men and women.
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Sagris D, Harrison SL, Lip GYH. Lipids and atrial fibrillation: New insights into a paradox. PLoS Med 2022; 19:e1004067. [PMID: 35951513 PMCID: PMC9371346 DOI: 10.1371/journal.pmed.1004067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In this Perspective, Dimitrios Sagris, Stephanie Harrison, and Gregory Lip discuss new evidence concerning the paradoxical relationship between circulating lipids and atrial fibrillation.
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Affiliation(s)
- Dimitrios Sagris
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Stephanie L. Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- * E-mail:
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Chen Y, Chang Z, Liu Y, Zhao Y, Fu J, Zhang Y, Liu Y, Fan Z. Triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular events in the general population: A systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2022; 32:318-329. [PMID: 34953633 DOI: 10.1016/j.numecd.2021.11.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/20/2021] [Accepted: 11/11/2021] [Indexed: 01/06/2023]
Abstract
AIMS The ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) has been regarded as a novel surrogate indicator of insulin resistance and the atherogenic index of plasma. This meta-analysis aimed to evaluate the association between the TG/HDL-C ratio and the incidence of cardiovascular events in the general population. DATA SYNTHESIS Cohort studies reporting the association between the TG/HDL-C ratio and cardiovascular events in the general population were obtained by a systematic literature search of PubMed, Embase and Web of Science databases until April 11, 2021. 13 cohort studies with a total of 207,515 participants were included in this meta-analysis. In a random-effects model, compared with those with the lowest category of the TG/HDL-C ratio, participants with the highest category were independently associated with a higher risk of cardiovascular events (pooled HR: 1.43, 95%CI: 1.26-1.62, I2 = 72.9%). For the presence of publication bias detected by the Egger's test (p = 0.011), correction for publication bias using the trim-and-fill method reduced the HR to 1.26 (95%CI: 1.11-1.44). This result was consistent with the finding of the TG/HDL-C ratio analyzed as a continuous variable (pooled HR per unit increment of the TG/HDL-C ratio: 1.08, 95%CI: 1.04-1.12, I2 = 67.0%). Subgroup analyses indicated that population gender, geographical region, duration of follow-up, adjustment for other lipid parameters, adjustment for diabetes and categorical number did not significantly vary the relationship. CONCLUSION Elevated TG/HDL-C ratio may be independently associated with an increased risk of cardiovascular events in the general population. More well-designed studies are needed to confirm the current findings. REGISTRATION NUMBER IN PROSPERO CRD42021244583.
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Affiliation(s)
- Yuxiong Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Zhen'ge Chang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yijie Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China.
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Taheri A, Mirzababaei A, Setayesh L, Yarizadeh H, Shiraseb F, Imani H, C T Clark C, Mirzaei K. The relationship between Dietary approaches to stop hypertension diet adherence and inflammatory factors and insulin resistance in overweight and obese women: A cross-sectional study. Diabetes Res Clin Pract 2021; 182:109128. [PMID: 34785301 DOI: 10.1016/j.diabres.2021.109128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although there is abundant evidence for an association between dietary pattern, weight, and other related factors, such as homeostatic model assessment for insulin resistance (HOMA-IR) and inflammatory markers; there is limited information pertaining to levels of plasminogen activator inhibitor-1 (PAI-1) and Monocyte Chemoattractant Protein -1 (MCP-1). Therefore, this study sought to examine the association between adherence to the dietary approaches to stop hypertension (DASH) diet and levels of inflammatory factors PAI-1, MCP-1, and HOMA-IR. METHODS This cross-sectional study was performed on 305 obese and overweight women. The typical food intake of individuals was assessed using the 147 items semi-quantitative food frequency questionnaire (FFQ). Body components were measured for all participants. Insulin resistance was estimated by homeostasis model assessment (HOMA), and biochemical parameters were examined. RESULTS No significant relationship was observed between the DASH diet and MCP-1 (P-trend = 0.70), PAI-1 (P-trend = 0.92), or HOMA-IR (P-trend = 0.08) in the crude model. However, there was a significant inverse relationship between the DASH diet and HOMA-IR (P-trend = 0.03) after adjusting for age, BMI, and physical activity. CONCLUSION This study showed that higher adherence to DASH pattern is inversely correlated with HOMA-IR in overweight and obese women.
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Affiliation(s)
- Akram Taheri
- Department of Nutrition, Faculty of Medicine, Sciences and Research Branch, Islamic Azad, University, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Leila Setayesh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Habib Yarizadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Trabert B, Hathaway CA, Rice MS, Rimm EB, Sluss PM, Terry KL, Zeleznik OA, Tworoger SS. Ovarian Cancer Risk in Relation to Blood Cholesterol and Triglycerides. Cancer Epidemiol Biomarkers Prev 2021; 30:2044-2051. [PMID: 34404683 PMCID: PMC8568658 DOI: 10.1158/1055-9965.epi-21-0443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/14/2021] [Accepted: 08/03/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The association between circulating cholesterol and triglyceride levels and ovarian cancer risk remains unclear. METHODS We prospectively evaluated the association between cholesterol [total, low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C)] and triglycerides and ovarian cancer incidence in a case-control study nested in the Nurses' Health Study (NHS) and NHSII cohorts and a longitudinal analysis in the UK Biobank. RESULTS A total of 290 epithelial ovarian cancer cases in the NHS/NHSII and 551 cases in UK Biobank were diagnosed after blood collection. We observed a reduced ovarian cancer risk comparing the top to bottom quartile of total cholesterol [meta-analysis relative risk (95% confidence interval): 0.81 (0.65-1.01), P trend 0.06], with no heterogeneity across studies (P heterogeneity = 0.74). Overall, no clear patterns were observed for HDL-C, LDL-C, or triglycerides and ovarian cancer risk. Comparing triglyceride levels at clinically relevant cut-off points (>200 vs. ≤200 mg/dL) for cases diagnosed more than 2 years after blood draw saw a positive relationship with risk [1.57 (1.03-2.42); P heterogeneity = 0.003]. Results were similar by serous/non-serous histotype, menopausal status/hormone use, and body mass index. CONCLUSIONS Data from two large cohorts in the United States and United Kingdom suggest that total cholesterol levels may be inversely associated with ovarian cancer risk, while triglycerides may be positively associated with risk when assessed at least 2 years before diagnosis, albeit both associations were modest. IMPACT This analysis of two large prospective studies suggests that circulating lipid levels are not strongly associated with ovarian cancer risk. The positive triglyceride-ovarian cancer association warrants further evaluation.
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Affiliation(s)
- Britton Trabert
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland.
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Megan S Rice
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Patrick M Sluss
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kathryn L Terry
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Oana A Zeleznik
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Amin M, Fatema K, Arefin S, Hussain F, Bhowmik D, Hossain M. Obesity, a major risk factor for immunity and severe outcomes of COVID-19. Biosci Rep 2021; 41:BSR20210979. [PMID: 34350941 PMCID: PMC8380923 DOI: 10.1042/bsr20210979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022] Open
Abstract
An influenza-like virus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for COVID-19 disease and spread worldwide within a short time. COVID-19 has now become a significant concern for public health. Obesity is highly prevalent worldwide and is considered a risk factor for impairing the adaptive immune system. Although diabetes, hypertension, cardiovascular disease (CVD), and renal failure are considered the risk factors for COVID-19, obesity is not yet well-considered. The present study approaches establishing a systemic association between the prevalence of obesity and its impact on immunity concerning the severe outcomes of COVID-19 utilizing existing knowledge. Overall study outcomes documented the worldwide prevalence of obesity, its effects on immunity, and a possible underlying mechanism covering obesity-related risk pathways for the severe outcomes of COVID-19. Overall understanding from the present study is that being an immune system impairing factor, the role of obesity in the severe outcomes of COVID-19 is worthy.
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Affiliation(s)
- Mohammad Tohidul Amin
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
| | - Kaniz Fatema
- Department of Applied Chemistry and Chemical Engineering, Noakhali Science and Technology University, Noakhlai-3814, Bangladesh
| | - Sayema Arefin
- Department of Pharmacy, Mawlana Bhashani Science and Technology University, Santosh, Tangail-1902, Bangladesh
| | - Fahad Hussain
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
| | - Dipty Rani Bhowmik
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
| | - Mohammad Salim Hossain
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali-3814, Bangladesh
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Lelis DDF, Calzavara JVS, Santos RD, Sposito AC, Griep RH, Barreto SM, Molina MDCB, Schmidt MI, Duncan BB, Bensenor I, Lotufo PA, Mill JG, Baldo MP. Reference values for the triglyceride to high-density lipoprotein ratio and its association with cardiometabolic diseases in a mixed adult population: The ELSA-Brasil study. J Clin Lipidol 2021; 15:699-711. [PMID: 34389285 DOI: 10.1016/j.jacl.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/11/2021] [Accepted: 07/23/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Among several lipid ratios available, the triglyceride/HDL-cholesterol (TG/HDL-C) may detect individuals at risk of cardiometabolic diseases. However, its reference values for different ethnicities are not well established. OBJECTIVE To define sex- and ethnicity-specific reference values for TG/HDL-C ratio in a large sample of healthy multiethnic adults and test its association with cardiometabolic conditions. METHODS An apparently healthy sample (n = 2,472), aged 35-74, free of major cardiovascular risk factors, was used to generate the reference values for the TG/HDL-C. Exclusion criteria were diabetes, elevated blood pressure, obesity, hypercholesterolemia, severe hypertriglyceridemia, and smoking history. Cut-offs based on the reference values were tested in the whole ELSA Brasil study (n = 13,245), stratified by sex and ethnicity, to identify cardiometabolic conditions. RESULTS TG/HDL-C ratio was higher in men than women, and did not change significantly with age, regardless of sex and ethnicity. Also, black individuals showed lower levels of TG/HDL-C as compared to other ethnic groups. ROC curve showed that the cut-off based on the 75th percentile displayed better sensitivities and specificities for men and women, regardless of ethnicity. Also, the sex- and ethnicity-specific cut-offs based on the 75th percentile were significantly associated with all tested cardiometabolic conditions (hypertension, diabetes, obesity, metabolic syndrome, and insulin resistance). Also, we observed that the use of a single sex-specific cut-off (men: 2.6; women: 1.7) could be used for the different ethnicities with good reliability. CONCLUSION The defined TG/HDL-C cut-offs (men: 2.6; women: 1.7) are reliable and showed good clinical applicability to detect cardiometabolic conditions in a multiethnic population.
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Affiliation(s)
- Deborah de Farias Lelis
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, MG, Brazil
| | - João Vitor S Calzavara
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, MG, Brazil
| | - Raul D Santos
- Lipid Clinic Heart Institute (Incor) University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andrei C Sposito
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, RJ, Brazil
| | - Sandhi Maria Barreto
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Maria Inês Schmidt
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruce B Duncan
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Isabella Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, SP, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, SP, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, MG, Brazil.
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Van Schaik L, Kettle C, Green R, Irving HR, Rathner JA. Effects of Caffeine on Brown Adipose Tissue Thermogenesis and Metabolic Homeostasis: A Review. Front Neurosci 2021; 15:621356. [PMID: 33613184 PMCID: PMC7889509 DOI: 10.3389/fnins.2021.621356] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
The impact of brown adipose tissue (BAT) metabolism on understanding energy balance in humans is a relatively new and exciting field of research. The pathogenesis of obesity can be largely explained by an imbalance between caloric intake and energy expenditure, but the underlying mechanisms are far more complex. Traditional non-selective sympathetic activators have been used to artificially elevate energy utilization, or suppress appetite, however undesirable side effects are apparent with the use of these pharmacological interventions. Understanding the role of BAT, in relation to human energy homeostasis has the potential to dramatically offset the energy imbalance associated with obesity. This review discusses paradoxical effects of caffeine on peripheral adenosine receptors and the possible role of adenosine in increasing metabolism is highlighted, with consideration to the potential of central rather than peripheral mechanisms for caffeine mediated BAT thermogenesis and energy expenditure. Research on the complex physiology of adipose tissue, the embryonic lineage and function of the different types of adipocytes is summarized. In addition, the effect of BAT on overall human metabolism and the extent of the associated increase in energy expenditure are discussed. The controversy surrounding the primary β-adrenoceptor involved in human BAT activation is examined, and suggestions as to the lack of translational findings from animal to human physiology and human in vitro to in vivo models are provided. This review compares and distinguishes human and rodent BAT effects, thus developing an understanding of human BAT thermogenesis to aid lifestyle interventions targeting obesity and metabolic syndrome. The focus of this review is on the effect of BAT thermogenesis on overall metabolism, and the potential therapeutic effects of caffeine in increasing metabolism via its effects on BAT.
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Affiliation(s)
- Lachlan Van Schaik
- Department of Pharmacy and Biomedical Sciences, La Trobe Institute for Molecular Science, La Trobe University, Bendigo, VIC, Australia
| | - Christine Kettle
- Department of Pharmacy and Biomedical Sciences, La Trobe Institute for Molecular Science, La Trobe University, Bendigo, VIC, Australia
| | - Rodney Green
- Department of Pharmacy and Biomedical Sciences, La Trobe Institute for Molecular Science, La Trobe University, Bendigo, VIC, Australia
| | - Helen R. Irving
- Department of Pharmacy and Biomedical Sciences, La Trobe Institute for Molecular Science, La Trobe University, Bendigo, VIC, Australia
| | - Joseph A. Rathner
- Department of Pharmacy and Biomedical Sciences, La Trobe Institute for Molecular Science, La Trobe University, Bendigo, VIC, Australia
- Department of Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Sacks FM, Liang L, Furtado JD, Cai T, Davidson WS, He Z, McClelland RL, Rimm EB, Jensen MK. Protein-Defined Subspecies of HDLs (High-Density Lipoproteins) and Differential Risk of Coronary Heart Disease in 4 Prospective Studies. Arterioscler Thromb Vasc Biol 2020; 40:2714-2727. [PMID: 32907368 PMCID: PMC7577984 DOI: 10.1161/atvbaha.120.314609] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/26/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE HDL (high-density lipoprotein) contains functional proteins that define single subspecies, each comprising 1% to 12% of the total HDL. We studied the differential association with coronary heart disease (CHD) of 15 such subspecies. Approach and Results: We measured plasma apoA1 (apolipoprotein A1) concentrations of 15 protein-defined HDL subspecies in 4 US-based prospective studies. Among participants without CVD at baseline, 932 developed CHD during 10 to 25 years. They were matched 1:1 to controls who did not experience CHD. In each cohort, hazard ratios for each subspecies were computed by conditional logistic regression and combined by meta-analysis. Higher levels of HDL subspecies containing alpha-2 macroglobulin, CoC3 (complement C3), HP (haptoglobin), or PLMG (plasminogen) were associated with higher relative risk compared with the HDL counterpart lacking the defining protein (hazard ratio range, 0.96-1.11 per 1 SD increase versus 0.73-0.81, respectively; P for heterogeneity <0.05). In contrast, HDL containing apoC1 or apoE were associated with lower relative risk compared with the counterpart (hazard ratio, 0.74; P=0.002 and 0.77, P=0.001, respectively). CONCLUSIONS Several subspecies of HDL defined by single proteins that are involved in thrombosis, inflammation, immunity, and lipid metabolism are found in small fractions of total HDL and are associated with higher relative risk of CHD compared with HDL that lacks the defining protein. In contrast, HDL containing apoC1 or apoE are robustly associated with lower risk. The balance between beneficial and harmful subspecies in a person's HDL sample may determine the risk of CHD pertaining to HDL and paths to treatment.
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Affiliation(s)
- Frank M. Sacks
- Corresponding author: Frank M. Sacks, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115; ; 617-432-1420
| | | | | | - Tianxi Cai
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - W. Sean Davidson
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Zeling He
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Robyn L. McClelland
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Eric B. Rimm
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Majken K. Jensen
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
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11
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Zhou L, Mai J, Li Y, Guo M, Wu Y, Gao X, Wu Y, Liu X, Zhao L. Triglyceride to high-density lipoprotein cholesterol ratio and risk of atherosclerotic cardiovascular disease in a Chinese population. Nutr Metab Cardiovasc Dis 2020; 30:1706-1713. [PMID: 32811737 DOI: 10.1016/j.numecd.2020.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio may play a role in predicting cardiovascular events. We aimed to prospectively explore the association between the TG/HDL-C ratio and atherosclerotic cardiovascular disease (ASCVD), ischemic stroke, as well as coronary heart disease (CHD) in a Chinese population. METHODS AND RESULTS This prospective cohort study included 9368 participants from four Chinese populations in the People's Republic of China-United States of America (PRC-USA) Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology. Over a follow-up period of 20 years, 624 cases of ASCVD events including 458 ischemic stroke events and 166 CHD events were recorded. The relationship between the TG/HDL-C ratio and the endpoints was evaluated through multivariate Cox proportional hazard models adjusted for potential confounding variables, including age, sex, urban or rural residence, northern or southern China, occupational type, education, physical exercise, smoking status, drinking status, body mass index, hypertension, high low-density lipoprotein cholesterol, diabetes, and antihypertensive medication use at baseline. With the lowest TG/HDL-C tertile as the reference, the middle and highest tertiles had the hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.13 (0.91, 1.40), 1.36 (1.10, 1.67) respectively for ASCVD (p for trend = 0.0028), and 1.19 (0.93, 1.54),1.47 (1.15, 1.87) respectively for ischemic stroke (p for trend = 0.0016). However, no significant association was found for CHD events. CONCLUSION TG/HDL-C ratio was positively associated with the risk of ASCVD and ischemic stroke events in the Chinese population.
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Affiliation(s)
- Long Zhou
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Jinzhuang Mai
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Li
- Department of Epidemiology, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Guo
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Wu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiangmin Gao
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Beijing, China
| | - Xiaoqing Liu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
| | - Liancheng Zhao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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12
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Lamar M, Durazo-Arvizu RA, Rodriguez CJ, Kaplan RC, Perera MJ, Cai J, Espinoza Giacinto RA, González HM, Daviglus ML. Associations of Lipid Levels and Cognition: Findings from the Hispanic Community Health Study/Study of Latinos. J Int Neuropsychol Soc 2020; 26:251-262. [PMID: 31543086 PMCID: PMC7083682 DOI: 10.1017/s1355617719001000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Hispanics/Latinos in the United States are less aware of their cholesterol levels and have a higher burden of associated adverse cardiovascular and cerebrovascular outcomes than non-Latino whites. Investigations of the associations between cholesterol levels and cognition in this population have often occurred within the context of metabolic syndrome and are limited to select lipids despite the fact that triglycerides (TGs) may be more relevant to the health of Hispanics/Latinos. METHODS Baseline data from the Hispanic Community Health Study/Study of Latinos, collected from 2008 to 2011, was used to investigate the associations of lipid levels (i.e., TG, total cholesterol, TC; low-density and high-density lipoprotein cholesterol, LDL-C and HDL-C) with cognition (i.e., learning, memory, verbal fluency, and digit symbol substitution, DSS), adjusting for relevant confounders. RESULTS In 7413 participants ages 45 to 74 years from Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds, separate, fully adjusted linear regression models revealed that TG levels were inversely associated with DSS performance; however, this relationship was no longer significant once additional cardiovascular disease risk factors were added to the model (p = .06). TC and LDL-C levels (separately) were positively associated with learning and verbal fluency regardless of adjustments (p-values < .05). Separate analyses investigating the effect modification by background and sex revealed a particularly robust association between TC levels and DSS performance for Puerto Ricans and Central Americans (albeit in opposite directions) and an inverse relationship between TG levels and DSS performance for women (p-values < .02). CONCLUSIONS It is important to consider individual lipid levels and demographic characteristics when investigating associations between cholesterol levels and cognition in Hispanics/Latinos.
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Affiliation(s)
- Melissa Lamar
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
- Rush Alzheimer’s Disease Center and Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
- Department of Public Health Sciences, Loyola University, Chicago, IL
| | - Carlos J. Rodriguez
- Department of Epidemiology & Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA 98109
| | | | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC
| | - Rebeca A. Espinoza Giacinto
- Department of Psychology, University of California San Diego, San Diego, CA
- Division of Health Promotion and Behavioral Sciences, University of California San Diego, San Diego, CA
| | - Hector M. González
- Department of Neuroscience, Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA
| | - Martha L. Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
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13
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Wei F, Lamichhane S, Orešič M, Hyötyläinen T. Lipidomes in health and disease: Analytical strategies and considerations. Trends Analyt Chem 2019. [DOI: 10.1016/j.trac.2019.115664] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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14
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Gorji Z, Varkaneh HK, Talaei S, Nazary-Vannani A, Clark CCT, Fatahi S, Rahmani J, Salamat S, Zhang Y. The effect of green-coffee extract supplementation on obesity: A systematic review and dose-response meta-analysis of randomized controlled trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 63:153018. [PMID: 31398662 DOI: 10.1016/j.phymed.2019.153018] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Given that the most recent systematic review investigating Green-Coffee Extract (GCE) as a weight loss facilitator was nearly a decade ago and that the authors reported there no consensus on the effect of GCE/CGA (Chlorogenic acids) on body composition indices, a comprehensive systematic review and dose-response meta-analysis of all available randomized controlled trial (RCTs) was undertaken to examine the effect of GCE and CGA intervention on body weight (BW), body mass index (BMI) and waist circumference (WC) in adults. METHODS We conducted a systematic search of all available randomized controlled trials (RCTs) performed up to June 2019 in the following electronic databases: PubMed, Scopus and Google Scholar. RCTs that investigated the effect GCE/CGA Supplementation on BW, BMI and WC in adults were included for final analysis. The pooled weight mean difference (WMD) of included studies was estimated using a random-effects model. RESULTS A total of 13 articles with 16 RCTs were included in the meta-analysis. Results revealed significant reduction in BMI (WMD: -0.403 kg/m2, 95% CI: -0.800, -0.005, p = 0.047) and no significant change in BW (WMD: -0.585 kg, 95% CI: -1.498, 0.329, p = 0.210) and WC (WMD: -0.847 cm, 95% CI: -1.764, 0.071, p = 0.070). In the subgroup analysis, studies that were conducted on baseline BMI ≥25 kg/m2 revealed a significant greater reduction in body weight and BMI than those performed on baseline BMI <25 kg/m2. Moreover, short supplementation periods of less than 4 weeks had no effect. CONCLUSION The results of current meta-analysis study support the use of GCE supplementation for the improvement of obesity indices, with sub-group analysis highlighting greater improvements in individuals with a starting BMI ≥25 kg/m2.
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Affiliation(s)
- Zahra Gorji
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamed Kord Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sam Talaei
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Nazary-Vannani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C T Clark
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, CV15FB, UK
| | - Somaye Fatahi
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Jamal Rahmani
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Salamat
- Nutrition and Metabolic Disease Research Center, Ahvaz Jundishapour University of Medical Sciences, Iran
| | - Yong Zhang
- Department of Nutrition and Food Hygiene, School of Public Health and Health Management, Chongqing Medical University, Chongqing, China.
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15
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Abdullah SM, Defina LF, Leonard D, Barlow CE, Radford NB, Willis BL, Rohatgi A, McGuire DK, de Lemos JA, Grundy SM, Berry JD, Khera A. Long-Term Association of Low-Density Lipoprotein Cholesterol With Cardiovascular Mortality in Individuals at Low 10-Year Risk of Atherosclerotic Cardiovascular Disease. Circulation 2019; 138:2315-2325. [PMID: 30571575 DOI: 10.1161/circulationaha.118.034273] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The associations of low-density lipoprotein cholesterol (LDL-C) with cardiovascular disease (CVD) and coronary heart disease mortality in an exclusively low estimated 10-year risk group are not well delineated. We sought to determine the long-term associations of various LDL-C and non-high-density lipoprotein cholesterol (HDL-C) thresholds and CVD and coronary heart disease mortality in a large, low 10-year risk cohort. METHODS The study sample included participants of the CCLS (Cooper Center Longitudinal Study) without a history of CVD or diabetes mellitus and defined as low risk (<7.5%) for 10-year atherosclerotic CVD events at baseline based on Pooled Cohort Risk Assessment Equations. The associations of fasting LDL-C and non-HDL-C with CVD mortality were tested with Cox proportional hazards models. RESULTS In 36 375 participants (72% men, median age 42) followed for a median of 26.8 years, 1086 CVD and 598 coronary heart disease deaths occurred. Compared with LDL-C <100 mg/dL, LDL-C categories 100 to 129 mg/dL, 130 to 159 mg/dL, 160 to 189.9 mg/dL, and ≥190 mg/dL were associated with a significantly higher risk of CVD death, with hazard ratios of 1.4 (95% CI, 1.1-1.7), 1.3 (95% CI, 1.1-1.6), 1.9 (95% CI, 1.5-2.4), and 1.7 (95% CI, 1.3-2.3), and mean reductions in years free of CVD death of 1.8, 1.1, 4.3, and 3.9, respectively. After adjustment for atherosclerotic CVD risk factors, LDL-C categories 160 to 189 mg/dL and ≥190 mg/dL remained independently associated with CVD mortality, with hazard ratios of 1.7 (95% CI, 1.4-2.2) and 1.5 (95% CI, 1.2-2.1), respectively. In multivariable-adjusted models using non-HDL-C <130 mg/dL as the reference, non-HDL-C 160 to 189 mg/dL, 190 to 219 mg/dL, and ≥220 mg/dL were significantly associated with CVD death, with hazard ratios of 1.3 (95% CI, 1.1-1.6), 1.8 (95% CI, 1.4-2.2), and 1.5 (95% CI, 1.2-2.0), respectively. Restricting the cohort to those with 10-year risk <5% did not diminish the associations of LDL-C and non-HDL-C with CVD mortality. CONCLUSIONS In a low 10-year risk cohort with long-term follow-up, LDL-C and non-HDL-C ≥160 mg/dL were independently associated with a 50% to 80% increased relative risk of CVD mortality. These findings may have implications for future cholesterol treatment paradigms.
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Affiliation(s)
- Shuaib M Abdullah
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.).,Veteran's Affairs North Texas Medical Center, Dallas (S.M.A., S.M.G.)
| | - Laura F Defina
- The Cooper Institute, Dallas, TX (L.F.D., D.L., C.E.B., B.L.W.)
| | - David Leonard
- The Cooper Institute, Dallas, TX (L.F.D., D.L., C.E.B., B.L.W.)
| | | | | | | | - Anand Rohatgi
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.)
| | - Darren K McGuire
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.)
| | - James A de Lemos
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.)
| | - Scott M Grundy
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.).,Veteran's Affairs North Texas Medical Center, Dallas (S.M.A., S.M.G.)
| | - Jarett D Berry
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.)
| | - Amit Khera
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (S.M.A., A.R., D.K.M., J.A.D., S.M.G., J.D.B., A.K.)
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16
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Gender Dictates the Relationship between Serum Lipids and Leukocyte Counts in the National Health and Nutrition Examination Survey 1999⁻2004. J Clin Med 2019; 8:jcm8030365. [PMID: 30875952 PMCID: PMC6463027 DOI: 10.3390/jcm8030365] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Abstract
Dyslipidemias and leukocytosis are associated with cardiovascular disease and immune disorders. Mechanistic studies have shown lipoprotein metabolism to play a significant role in the regulation of atherosclerosis development and leukocyte activation, whereas lipid-lowering treatments have been shown to exert beneficial anti-inflammatory and immunomodulatory effects in clinical trials. However, the relationship between clinical markers of lipid metabolism and leukocyte counts has not been extensively evaluated at the population level. We aimed to determine whether clinical blood lipid measures are associated with leukocyte counts in the general U.S. population represented in the National Health and Nutrition Examination Survey (NHANES) 1999–2004, and whether differences exist between men and women (n = 5647). We observed a strong positive linear trend between serum triglycerides vs. blood lymphocyte and basophil counts in both men and women, whereas a positive trend between monocytes vs. triglycerides and lymphocytes vs. total cholesterol and LDL-cholesterol (LDL-C) was only detected in women. Conversely, HDL-C was inversely associated with a greater number of leukocyte subsets in men, whereas inverse trends between HDL-C vs. lymphocytes were observed in both men and women. In multiple regression models, a 10% increase in total cholesterol, LDL-C, and triglycerides was associated with a predicted 1.6%, 0.6%, and 1.4% increase in blood lymphocyte counts in women, respectively, whereas no relationship was observed in men. In both men and women, a 10% increase in triglycerides was additionally associated with higher lymphocyte, neutrophil, and basophil counts, whereas 10% increases in HDL-cholesterol were associated with significantly lower lymphocyte, neutrophil, eosinophil, and basophil counts in men, in addition to lower lymphocyte and monocyte counts in women. These findings suggest that clinical lipid markers may be used to predict blood leukocyte distributions, and that a gender-specific relationship exists between distinct classes of serum lipids and immune cell subsets.
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17
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Mousavi SM, Rahmani J, Kord-Varkaneh H, Sheikhi A, Larijani B, Esmaillzadeh A. Cinnamon supplementation positively affects obesity: A systematic review and dose-response meta-analysis of randomized controlled trials. Clin Nutr 2019; 39:123-133. [PMID: 30799194 DOI: 10.1016/j.clnu.2019.02.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/16/2018] [Accepted: 02/09/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Data about the effects of cinnamon supplementation on obesity measures are conflicting. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effects of cinnamon intake on body weight (BW), Body Mass Index (BMI), Waist Circumference (WC), and fat mass (FM) in adults. METHODS Online electronic search engines including PubMed, SCOPUS, Cochrane Library, and Google Scholar were searched to find pertinent articles until September 2018. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). The non-linear association was assessed using fractional polynomial modeling. RESULTS Out of 679 records, 12 trials that enrolled 786 subjects were included. The pooled results showed that cinnamon administration significantly decreased BW (WMD: -1.02 kg, 95% CI: -1.66 to -0.38, P = 0.002), BMI (WMD: -0.51 kg/m2, 95% CI: -0.74, -0.28, P < 0.001), WC (WMD: -2.40 cm, 95% CI: -4.48, -0.33, P = 0.02), and FM (WMD: -1.02%, 95% CI: -1.80, -0.24, P = 0.01). Greater effects on BW were observed in subjects aged <50 years old and those with a baseline BMI of ≥30 kg/m2. The cinnamon administrations significantly reduced FM at the dosages of ≥2 g/d, when administered for ≥12 weeks. Cinnamon administration resulted in BW and WC reduction in non-linear fashion (P = 0.04). CONCLUSIONS Cinnamon supplementation significantly affects obesity measures. It could be recommended as a weight-reducing supplement in obesity management.
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Affiliation(s)
- Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Jamal Rahmani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Kord-Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular - Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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18
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Pantoja-Torres B, Toro-Huamanchumo CJ, Urrunaga-Pastor D, Guarnizo-Poma M, Lazaro-Alcantara H, Paico-Palacios S, Del Carmen Ranilla-Seguin V, Benites-Zapata VA. High triglycerides to HDL-cholesterol ratio is associated with insulin resistance in normal-weight healthy adults. Diabetes Metab Syndr 2019; 13:382-388. [PMID: 30641729 DOI: 10.1016/j.dsx.2018.10.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the association between high triglyceride/HDL-cholesterol (TG/HDL-C) ratio and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in normal-weight healthy adults. METHODS We carried out an analytical cross-sectional study in euthyroid non-diabetic adults, who attended the outpatient service of a private clinic in Lima-Peru from 2012 to 2016. Participants were divided in two groups according to the presence or absence of high TG/HDL-C ratio, IR or hyperinsulinemia after OGTT. TG/HDL-C ratio values ≥ 3 were considered as high. IR was defined as a Homeostasis Model Assessment (HOMA-IR) value ≥ 2.28 and hyperinsulinemia after OGTT as a serum insulin value ≥ 80μU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson generalized linear models to evaluate the association between high TG/HDL-C ratio and IR or hyperinsulinemia after OGTT and reported the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed the data of 118 individuals. Prevalence of high TG/HDL-C ratio was 17.8% (n = 21) while the prevalence of IR and hyperinsulinemia after OGTT was 24.6% (n = 29) and 17.0% (n = 20), respectively. TG/HDL-C-ratio values were positively correlated with HOMA-IR (r = 0.498; p < 0.01) and serum insulin after OGTT (r = 0.326; p < 0.001). In the adjusted model, high TG/HDL-C ratio was associated with both IR (aPR = 3.16; 95%CI: 1.80-5.77) and hyperinsulinemia after OGTT (aPR = 2.36; 95%CI: 1.20-4.63). CONCLUSIONS High TG/HDL-C ratio was associated with both IR markers used in our study, appearing to be a clinically useful tool to assess IR in euthyroid normal-weight adults without type 2 diabetes mellitus.
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Affiliation(s)
| | - Carlos J Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | | | | | | | | | - Vicente A Benites-Zapata
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
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19
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Wan GX, Xia WB, Ji LH, Qin HL, Zhang YG. Triglyceride to high density lipoprotein cholesterol ratio may serve as a useful predictor of major adverse coronary event in female revascularized ST-elevation myocardial infarction. Clin Chim Acta 2018; 485:166-172. [PMID: 29969621 DOI: 10.1016/j.cca.2018.06.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Elevated triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio has been identified as a surrogate marker of insulin resistance and an independent predictor for cardiovascular events in the general population. However, the prognostic value of TG/HDL-C ratio in revascularized ST-elevation myocardial infarction(STEMI) patients remains unclear. We examined the association between TG/HDL-C ratio and clinical outcome of revascularized STEMI patients in the Chinese population. METHODS 464 STEMI patients who underwent successful revascularization were enrolled to determine the relationship between TG/HDL-C ratio and major adverse coronary events(MACEs) with a 30-month follow-up. The Kaplan-Meier analysis and Cox regression proportional hazard model were applied to assess the prognostic value of TG/HDL-C ratio. RESULTS TG/HDL-C ratio was found to be significantly associated with age (p = 0.017), history of diabetes(p = 0.017), heart rate(p = 0.011), TG(p < 0.001), HDL-C(p < 0.001) and Gensini score(p = 0.034). The multivariate Cox regression analysis revealed that elevated TG/HDL-C ratio was an independent prognostic factor for MACE in female patients (HR = 2.624,95%CI = 1.211-5.687,p = 0.014) but not in male patients(HR = 0.756, 95%CI = 0.484-1.179,p = NS) after adjustment with other MACE-related prognostic factors. CONCLUSION The TG/HDL-C ratio may be independently associated with MACEs in female revascularized STEMI patients in the Chinese population.
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Affiliation(s)
- Guo-Xing Wan
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Wen-Bin Xia
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Li-Hua Ji
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Hai-Lun Qin
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Yong-Gang Zhang
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China.
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Avocado Fruit on Postprandial Markers of Cardio-Metabolic Risk: A Randomized Controlled Dose Response Trial in Overweight and Obese Men and Women. Nutrients 2018; 10:nu10091287. [PMID: 30213052 PMCID: PMC6164649 DOI: 10.3390/nu10091287] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 08/29/2018] [Accepted: 09/08/2018] [Indexed: 12/24/2022] Open
Abstract
Avocados are distinctive fruits having both fats and fibers along with various micronutrients and bioactive phytochemicals. This study aimed to assess the effects of replacing carbohydrate energy in meals with half or whole avocado on postprandial indices of metabolic and vascular health. A single-center, randomized, controlled, 3-arm, 6 h, crossover study was conducted in overweight/obese middle-aged adults (n = 31). Participants consumed energy-matched breakfast meals containing 0 g (Control), 68 g (Half-A) or 136 g (Whole-A) fresh Hass avocado on 3 separate occasions. Post-meal glycemic (p < 0.0001), insulinemic (p < 0.0001) and flow mediated vasodilation (FMD) responses were reduced compared to Control meal (p < 0.01), independent of dose. Nuclear magnetic resonance analyses indicated lower concentrations of triglyceride-rich lipoproteins and higher concentrations of larger high-density lipoprotein (HDL) particles after the Whole-A vs. the Control meal (p = 0.02, p < 0.05, respectively). Race/ethnicity influenced sub-class lipoprotein concentrations (p < 0.05). Oxidized low-density-lipoproteins, monocyte chemoattractant protein-1, and interleukin-6 were not different among meals. Tumor necrosis factor-α tended to be lower after Whole-A vs. Control meal (p = 0.07). Replacing carbohydrate components with avocados in a meal improved FMD, a measure of endothelial function, and improved glycemic and lipoprotein profiles in overweight/obese adults. The study provides insight on the acute cardio-metabolic benefits of incorporating avocados into a meal.
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Sung JH, Lee JE, Lee JY. Biomarker Differences between Controlled and Uncontrolled Hypertension among US Adults: National Health and Nutrition Examination Survey 2005-2010. INTERNATIONAL JOURNAL OF ADVANCED RESEARCH IN SCIENCE, ENGINEERING AND TECHNOLOGY 2018; 5:6790-6797. [PMID: 31467942 PMCID: PMC6715317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
UNLABELLED This study aims to determine biomarker differences between controlled and uncontrolled hypertension using nationally representative samples. Those in the uncontrolled hypertension group were more likely to have CVD (p=0.0258) and diabetes (p=0.0004), less likely to meet the recommended waist circumference (p=0.0039) and BMI (p=0.0209), and less likely to drink alcohol (p=0.0002) than those in the controlled hypertension group, after controlling for demographic variables. Upon controlling for demographic variables, risk factors and diseases related to hypertension, those in the uncontrolled hypertension group had higher total cholesterol (p<.0001), HDL (p=0.0702, marginally significant), LDL (p<.0001), triglycerides (p=0.0702, marginally significant), apolipoprotein B (p<.0001), transferrin receptor (p=0.0692, marginally significant), and ACR (p<.0001) than those in the controlled hypertension group. CONCLUSION Our study found that ACR, total cholesterol, HDL, LDL, triglycerides, apolipoprotein B, and transferrin receptor are biomarkers associated with the risk of uncontrolled hypertension compared to controlled hypertension. Since uncontrolled hypertension is linked to very high risks of cardiovascular disease and chronic kidney disease, our findings may provide a partial answer to why antihypertensive treatment is ineffective for certain groups of patients. Further studies are warranted to examine the cause of uncontrolled hypertension.
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Affiliation(s)
- Jung Hye Sung
- School of Public Health, Jackson State University. Mississippi, USA
| | - Jae Eun Lee
- RTRN DTCC, Jackson State University. Mississippi, USA
| | - Ji-Young Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
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Mousavi SM, Sheikhi A, Varkaneh HK, Zarezadeh M, Rahmani J, Milajerdi A. Effect of Nigella sativa supplementation on obesity indices: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2018; 38:48-57. [PMID: 29857879 DOI: 10.1016/j.ctim.2018.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/08/2018] [Accepted: 04/09/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND & OBJECTIVE(S) No meta-analysis is available on the effect of Nigella sativa (NS) on obesity indices. This systematic review and meta-analysis was conducted to systematically review the available Randomized Clinical Trials (RCTs) that examined the effects of NS on Body Weight (BW), Body Mass index (BMI), and Waist Circumference (WC) in adults. METHODS Relevant articles published up to January 2018 were searched through PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar databases, using relevant keywords. All RCTs that examined the effect of NS supplementation on BW, BMI, or WC were included. RESULTS Overall, thirteen RCTs, including 875 subjects (64% males) were included in this study. Combining effect sizes from ten studies, NS supplementation significantly reduced BW (Weighted Mean Differences (WMD): -1.76 kg, 95% CI: -3.34 to -0.17, I2 = 87.4%), as compared to placebo. Subgroup analysis by the intervention type (I2 = 0.0%), participants' gender (I2 = 0.0%), and age (I2 = 5.5%) removed between-study heterogeneity. A significant reduction was seen in BMI (WMD: -0.85 kg/m2, 95% CI: -1.23, -0.46, I2 = 70.6%) after NS supplementation than placebo among eleven trials. Subgroup analysis based on study duration (I2 = 0.0%), participants' gender (females: I2 = 0.0% & both genders: I2 = 20.9%), an age (I2 = 35.9%) disappeared the heterogeneity. However, no significant reduction was found in WC comparing NS supplementation to placebo (WMD: -4.04 cm, 95% CI: 11.37, 3.27, I2 = 97.8%) in five studies. CONCLUSIONS We find a significant effect of NS supplementation on BW and BMI in adults. However, the effect of NS supplementation on WC was not significant in this meta-analysis.
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Affiliation(s)
- Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ali Sheikhi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamed Kord Varkaneh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Meysam Zarezadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Jamal Rahmani
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Milajerdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Mazidi M, Kengne AP, Katsiki N, Mikhailidis DP, Banach M. Lipid accumulation product and triglycerides/glucose index are useful predictors of insulin resistance. J Diabetes Complications 2018; 32:266-270. [PMID: 29395839 DOI: 10.1016/j.jdiacomp.2017.10.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/02/2017] [Accepted: 10/15/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To investigate the association of triglycerides/glucose index (TyG index), anthropometrically predicted visceral adipose tissue (apVAT), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglycerides (TG):high density lipoprotein-cholesterol (HDL-C) ratio with insulin resistance (IR) in adult Americans. METHODS This study was based on data from three NHANES cycles (2005 to 2010). The TyG index was calculated as ln [TG×fasting glucose/2]. VAI was calculated using gender-specific formulas: men [waist circumference (WC)/39.68+(1.88×body mass index (BMI)]×(TG/1.03)×(1.31/HDL-C); women: [WC/36.58+(1.89×BMI)]×(TG/0.81)×(1.52/HDL-C). LAP index was calculated as [WC-65]×[TG] in men, and [WC-58]×[TG] in women. Correlation and regression analyses accounted for the complex sampling of database. RESULTS A total of 18,318 subjects was included in this analysis [mean age 47.6Years]; 48.7% (n=8918) men]. The homeostatic model assessment of insulin resistance (HOMA-IR) had a significant positive correlation with the TyG index (r=0.502), LAP (r=0.551), apVAT (r=0.454), TG:HDL-C ratio (r=0.441) and VAI (r=451) (p<0.001 for all comparisons). Bland-Altman plots showed no systematic errors. The optimal cut-off to predict HOMA-diagnosed IR was 0.473 (sensitivity=74.5% and specificity=72.7%) for LAP, 0.478 (75.9%, 71.9%) for TyG, 0.391 (70.4%, 67.1%) for VAI, 0.392 (77.1% and 62.0%) for TG:HDL-C ratio and 0.381 (63.8%, 74.8%) for apVAT. CONCLUSIONS The LAP index is a simple, cheap and accurate although not perfect, surrogate marker of HOMA-diagnosed IR among adult Americans. Moreover, it has higher predictability than other screening tools which traditionally applied. Among the markers, apVAT had the highest specificity and the TG:HDL-C ratio had the highest sensitivity.
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Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China; Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China.
| | - Andre-Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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Knowles EEM, Meikle PJ, Huynh K, Göring HHH, Olvera RL, Mathias SR, Duggirala R, Almasy L, Blangero J, Curran JE, Glahn DC. Serum phosphatidylinositol as a biomarker for bipolar disorder liability. Bipolar Disord 2017; 19:107-115. [PMID: 28230325 PMCID: PMC5798864 DOI: 10.1111/bdi.12468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/03/2017] [Accepted: 01/10/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Individuals with bipolar disorder (BPD) exhibit alterations in their phospholipid levels. It is unclear whether these alterations are a secondary consequence of illness state, or if phospholipids and illness risk overlap genetically. If the latter were true, then phospholipids might provide key insights into the pathophysiology of the illness. Therefore, we rank-ordered phospholipid classes by their genetic overlap with BPD risk in order to establish which class might be most informative in terms of increasing our understanding of illness pathophysiology. METHODS Analyses were conducted in a sample of 558 individuals, unselected for BPD, from 38 extended pedigrees (average family size=14.79, range=2-82). We calculated a coefficient of relatedness for all family members of nine individuals with BPD in the sample (N=185); this coefficient was set to be zero in unrelated individuals (N=373). Then, under an endophenotype ranking value (ERV) approach, this scalar index was tested against 13 serum-based phospholipid concentrations in order to rank-order lipid classes by their respective overlap with BPD risk. RESULTS The phosphatidylinositol class was significantly heritable (h2 =0.26, P=6.71 × 10-05 ). It was the top-ranked class, and was significantly associated with BPD risk after correction for multiple testing (β=-1.18, P=2.10 × 10-03 , ERV=0.49). CONCLUSIONS We identified a peripheral biomarker, serum-based phosphatidylinositol, which exhibits a significant association with BPD risk. Therefore, given that phosphatidylinositol and BPD risk share partially common etiology, it seems that this lipid class warrants further investigation, not only in terms of treatment, but also as a promising diagnostic and risk marker.
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Affiliation(s)
- Emma EM Knowles
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA,Correspondence: Emma E. M. Knowles, Department of Psychiatry, Yale University, New Haven, CT, USA.,
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Harald HH Göring
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - Rene L Olvera
- Department of Psychiatry, University of Texas, Health Science Center at San Antonio, San Antonio, TX, USA
| | - Samuel R Mathias
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Ravi Duggirala
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - Laura Almasy
- Department of Genetics, University of Pennsylvania and Department of Biomedical and Health Informatics at Children’s Hospital of Philadelphia, PA, USA
| | - John Blangero
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - Joanne E Curran
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - David C Glahn
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
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Knowles EEM, Huynh K, Meikle PJ, Göring HHH, Olvera RL, Mathias SR, Duggirala R, Almasy L, Blangero J, Curran JE, Glahn DC. The lipidome in major depressive disorder: Shared genetic influence for ether-phosphatidylcholines, a plasma-based phenotype related to inflammation, and disease risk. Eur Psychiatry 2017; 43:44-50. [PMID: 28365467 DOI: 10.1016/j.eurpsy.2017.02.479] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/27/2017] [Accepted: 02/06/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The lipidome is rapidly garnering interest in the field of psychiatry. Recent studies have implicated lipidomic changes across numerous psychiatric disorders. In particular, there is growing evidence that the concentrations of several classes of lipids are altered in those diagnosed with MDD. However, for lipidomic abnormalities to be considered potential treatment targets for MDD (rather than secondary manifestations of the disease), a shared etiology between lipid concentrations and MDD should be demonstrated. METHODS In a sample of 567 individuals from 37 extended pedigrees (average size 13.57 people, range=3-80), we used mass spectrometry lipidomic measures to evaluate the genetic overlap between twenty-three biologically distinct lipid classes and a dimensional scale of MDD. RESULTS We found that the lipid class with the largest endophenotype ranking value (ERV, a standardized parametric measure of pleiotropy) were ether-phosphodatidylcholines (alkylphosphatidylcholine, PC(O) and alkenylphosphatidylcholine, PC(P) subclasses). Furthermore, we examined the cluster structure of the twenty-five species within the top-ranked lipid class, and the relationship of those clusters with MDD. This analysis revealed that species containing arachidonic acid generally exhibited the greatest degree of genetic overlap with MDD. CONCLUSIONS This study is the first to demonstrate a shared genetic etiology between MDD and ether-phosphatidylcholine species containing arachidonic acid, an omega-6 fatty acid that is a precursor to inflammatory mediators, such as prostaglandins. The study highlights the potential utility of the well-characterized linoleic/arachidonic acid inflammation pathway as a diagnostic marker and/or treatment target for MDD.
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Affiliation(s)
- E E M Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - K Huynh
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - P J Meikle
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - H H H Göring
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - R L Olvera
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - S R Mathias
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - R Duggirala
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - L Almasy
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - J Blangero
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - J E Curran
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - D C Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
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Cheung YK, Moon YP, Kulick ER, Sacco RL, Elkind MSV, Willey JZ. Leisure-Time Physical Activity and Cardiovascular Mortality in an Elderly Population in Northern Manhattan: A Prospective Cohort Study. J Gen Intern Med 2017; 32:168-174. [PMID: 27752879 PMCID: PMC5264679 DOI: 10.1007/s11606-016-3884-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/19/2016] [Accepted: 09/19/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies of exercise have focused on measuring physical activity in totality using summary statistics such as metabolic equivalent score for total intensity or total energy count. OBJECTIVE We aimed to examine the multidimensionality of leisure-time physical activity (LTPA) and to identify the specific LTPA components that were associated with cardiovascular mortality in the elderly. DESIGN AND PARTICIPANTS The Northern Manhattan Study (NOMAS) is a multiethnic prospective cohort of elderly stroke-free individuals consisting of a total of 3298 participants recruited between 1993 and 2001, with a median follow-up of 17 years. MAIN MEASURES Physical activity questionnaire data were available in 3293 NOMAS participants, who were categorized into subgroups with similar exercise patterns by model-based cluster analysis. Three subgroup-defining LTPA features were identified and were considered as primary exposures in Cox proportional hazard models: frequency of activity, number of activity types (variety), and energy-to-duration ratio (EDR). We considered cardiovascular mortality and non-cardiovascular mortality as outcomes in Cox cause-specific proportional hazard models, and all-cause mortality as outcome in Cox models. KEY RESULTS A high activity frequency was associated with reduced cardiovascular mortality (hazard ratio, HR = 0.93, P = 0.03), but demonstrated no effect on non-cardiovascular death. A high EDR was associated with increased risk of cardiovascular death (HR = 1.30, P = 0.01). A high number of activity types was beneficial in reducing all-cause mortality (HR = 0.87, P = 0.01). CONCLUSIONS Exercise frequency was protective against cardiovascular mortality, and a high variety of activity was protective against all-cause mortality. The performance of frequent and varied non-intense exercise in an elderly population such as ours is achievable and can reduce the risk of death.
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Affiliation(s)
- Ying Kuen Cheung
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Yeseon P Moon
- Department of Neurology, Columbia University, 710 West 168th street, New York, NY, 10032, USA
| | - Erin R Kulick
- Department of Neurology, Columbia University, 710 West 168th street, New York, NY, 10032, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami, New York, NY, USA
| | - Mitchell S V Elkind
- Department of Neurology, Columbia University, 710 West 168th street, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Joshua Z Willey
- Department of Neurology, Columbia University, 710 West 168th street, New York, NY, 10032, USA.
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Abstract
Obesity continues to be a public health concern across the globe. Obesity has a demonstrated association with health behaviors and health outcomes, such as diabetes, hypertension, and cancer. Over the past 2 decades, obesity has increased worldwide and remains highest in the United States. It is critical to understand the definition of obesity, using body mass index appropriately, recent estimates, and risk factors as a framework within which clinicians should work to help reduce the burden of obesity. This framework, including the Healthy People 2020 place-based approach to social determinants of health, is described in this article.
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Affiliation(s)
- Cassandra Arroyo-Johnson
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St Louis, MO 63110, USA.
| | - Krista D Mincey
- Division of Biological and Public Health Sciences, Xavier University of Louisiana, 1 Drexel Drive, Campus Box V, New Orleans, LA 70125, USA
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Cohn T, Miller A, Fogg L, Braun LT, Coke L. Impact of Individual and Neighborhood Factors on Cardiovascular Risk in White Hispanic and Non-Hispanic Women and Men. Res Nurs Health 2016; 40:120-131. [PMID: 27862050 DOI: 10.1002/nur.21778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2016] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality for adults in the US, regardless of ethnicity. A cross-sectional correlational design was used to describe and compare CVD risk and cardiac mortality in White Hispanic and non-Hispanic women and men. Data from 3,317 individuals (1,523 women and 1,794 men) hospitalized for non-cardiac causes during 2012-2013, and data from the 2010 United States Census were included. The sex-specific 10-year Framingham General Cardiovascular Risk Score (FRS-10) was used to estimate long-term risk for major cardiac events. Approximately three-quarters of the sample was White Hispanic. FRS-10 scores were generally low, but a high prevalence of risk factors not included in the standard FRS-10 scoring formula was seen. White Hispanic women had significantly lower estimated CVD risk scores compared to White Hispanic and non-Hispanic men despite higher non-FRS-10 risks. Neighborhood median household income had a significant negative relationship and Hispanic neighborhood concentration had a significant positive relationship with cardiac mortality. Hispanic concentration was the only predictor of estimated CVD risk in a multilevel model. CVD risk assessment tools that are calibrated for ethnic groups and socioeconomic status may be more appropriate for Hispanic individuals than the FRS-10. Neighborhood-level factors should be included in clinical cardiac assessment in addition to individual characteristics and behavioral risks. Researchers should continue to seek additional risk factors that may contribute to or protect against CVD in order to close the gap between estimated CVD risk and actual cardiac mortality for Hispanics in the US. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Tanya Cohn
- Nurse Scientist, Baptist Health South Florida, 3161 SW 19th Street, Fort Lauderdale, FL 33312
| | - Arlene Miller
- Professor, College of Nursing, Rush University, Chicago, IL
| | - Louis Fogg
- Associate Professor and Statistician, College of Nursing, Rush University, Chicago, IL
| | - Lynne T Braun
- Professor and Clinical Lipid Specialist, College of Nursing, Rush University, Chicago, IL
| | - Lola Coke
- Assistant Professor, College of Nursing, Rush University, Chicago, IL
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Essilfie G, Shavelle DM, Tun H, Platt K, Kobayashi R, Mehra A, Matthews RV, Clavijo L, Gaglia MA. Association of elevated triglycerides and acute myocardial infarction in young Hispanics. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2016; 17:510-514. [PMID: 27432210 DOI: 10.1016/j.carrev.2016.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Previous studies have demonstrated that acute myocardial infarction (AMI) in young patients (age <45years) is associated with a high prevalence of smoking, obesity, hyperlipidemia and single vessel coronary artery disease (CAD). Hispanics represent the largest growing ethnic minority in the United States, yet features of AMI in young Hispanics have not been described. METHODS Patients undergoing percutaneous coronary intervention for AMI at Los Angeles County + University of Southern California Medical Center and Keck Medical Center were studied. We compared young Hispanics (age<45, n=47) with older patients (Hispanics and non-Hispanics age ≥45, n=888) to identify unique features of AMI in young Hispanics. We also compared young Hispanics with young non-Hispanics (n=33) and older Hispanics (n=447) in regards to traditional CAD risk factors, laboratory values and in-hospital outcomes. Multivariable logistic regression was performed to identify variables independently associated with in-hospital mortality. RESULTS Young Hispanics had higher triglyceride levels than young non-Hispanics and older patients (234.5±221.0mg/dL vs. 145.3±67.4mg/dL vs. 156±118.2mg/dL, p<0.0004); and higher triglyceride than older Hispanics (234.5±221.0 vs. 147.0±98.9mg/dL, p<0.02). Body mass index was independently associated with the logarithm (base10) of triglyceride levels (p<0.0001). Hispanic ethnicity and age<45years, however, were not independently associated with in-hospital mortality. CONCLUSIONS Young Hispanics with AMI have higher triglyceride levels than young non-Hispanics and older Hispanics. The elevated triglyceride levels may be related to lifestyle changes experienced by a young immigrant population transitioning to life in the United States.
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Affiliation(s)
- Gilbert Essilfie
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033.
| | - David M Shavelle
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Han Tun
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Kevin Platt
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Ryan Kobayashi
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Anilkumar Mehra
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Ray V Matthews
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Leonardo Clavijo
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
| | - Michael A Gaglia
- Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033
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Balfour PC, Ruiz JM, Talavera GA, Allison MA, Rodriguez CJ. Cardiovascular Disease in Hispanics/Latinos in the United States. ACTA ACUST UNITED AC 2016; 4:98-113. [PMID: 27429866 DOI: 10.1037/lat0000056] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiovascular diseases (CVD) are the leading cause of mortality in the United States and Western world for all groups with one exception: CVDs are the number 2 cause of death for Hispanics/Latinos behind cancer with overall cancer rates lower for Latinos relative to non-Hispanic Whites (NHWs). Despite a significantly worse risk factor profile marked by higher rates of traditional and non-traditional determinants, some CVD prevalence and mortality rates are significantly lower among Latinos relative NHWs. These findings support a need for greater understanding of CVDs specifically among Latinos in order to better document prevalence, appropriately model risk and resilience, and improve targeting of intervention efforts. The current aim is to provide a state-of-the-science review of CVDs amongst Latinos including a review of the epidemiological evidence, risk factor prevalence, and evaluation of the breadth and quality of the data. Questions concerning the generalizability of current risk models, the Hispanic paradox as it relates to CVDs, contributing psychosocial and sociocultural factors, and future directions are discussed.
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Affiliation(s)
- Pelbreton C Balfour
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine
| | - John M Ruiz
- Department of Psychology, University of Arizona
| | - Gregory A Talavera
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University
| | - Matthew A Allison
- Divison of Preventive Medicine, Department of Family and Preventive Medicine, University of California San Diego School of Medicine
| | - Carlos J Rodriguez
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine; Section of Cardiovascular Medicine, Department of Medicine, Wake Forest School of Medicine
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Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, La Forge R, Daniels SR, Wilson DP, Morris PB, Wild RA, Grundy SM, Daviglus M, Ferdinand KC, Vijayaraghavan K, Deedwania PC, Aberg JA, Liao KP, McKenney JM, Ross JL, Braun LT, Ito MK, Bays HE, Brown WV. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol 2015; 9:S1-122.e1. [DOI: 10.1016/j.jacl.2015.09.002] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Llabre MM, Arguelles W, Schneiderman N, Gallo LC, Daviglus ML, Chambers EC, Sotres-Alvarez D, Chirinos DA, Talavera GA, Castaneda SF, Roesch SC, Heiss G. Do all components of the metabolic syndrome cluster together in U.S. Hispanics/Latinos? Results from the Hispanic Community Health study/Study of Latinos. Ann Epidemiol 2015; 25:480-5. [PMID: 25818844 PMCID: PMC4457574 DOI: 10.1016/j.annepidem.2015.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 02/03/2015] [Accepted: 02/16/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE Metabolic syndrome (MetS), the clustering of several risk factors for cardiovascular disease, is highly prevalent in Hispanics/Latinos. We tested whether all components significantly loaded on the syndrome in Hispanics/Latinos and whether their contribution differed by sex and Hispanic ancestry. We also examined associations of MetS with prevalent diabetes and coronary heart disease in Hispanics/Latinos. METHODS Data were obtained from a population-based cohort of n = 15,823 participants in the HCHS/SOL study who self-identified as being of Central American, Cuban, Dominican, Mexican American, Puerto Rican, or South American ancestry and were aged 18 to 74 years at screening. RESULTS A latent variable model of waist circumference, systolic and diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting glucose fit the data in men and women, but the contribution of HDL-C was weak. No difference in the latent model of MetS was detected across Hispanic/Latino ancestry groups. MetS was significantly associated with diabetes and coronary heart disease. CONCLUSIONS Our results indicate that similar criteria for MetS may be applied across Hispanic/Latino ancestry groups but call into question the role of HDL-C in classifying the MetS in Hispanics/Latinos.
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Affiliation(s)
- Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL.
| | | | | | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois, Chicago, IL
| | - Earle C Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Gregory A Talavera
- Department of Health Promotion/Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Sheila F Castaneda
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Willey JZ, Moon YP, Sherzai A, Cheung YK, Sacco RL, Elkind MSV. Leisure-time physical activity and mortality in a multiethnic prospective cohort study: the Northern Manhattan Study. Ann Epidemiol 2015; 25:475-479.e2. [PMID: 25982960 PMCID: PMC4457561 DOI: 10.1016/j.annepidem.2015.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/02/2015] [Accepted: 04/09/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE To examine whether the survival benefit of exercise is modified by obesity. METHODS In the Northern Manhattan Study, we collected baseline sociodemographics and cardiovascular disease risk factors. The primary exposure was leisure-time physical activity (LTPA) and the outcomes were total, vascular, and nonvascular deaths (non-VaD). LTPA was defined as any versus none and metabolic equivalent score category (total activity weighted by intensity). We used Cox models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS A total of 3298 participants (mean age 69 years, 52% Hispanic, 63% women) were followed over a mean of 11.8 years with 1589 total deaths (641 vascular, 819 nonvascular). Any activity (adjusted HR: 0.84, 95% CI: 0.75-0.94) was associated with reduced risk of all-cause mortality and non-VaD, but not VaD. We found an interaction (P < .05) of LTPA with body mass index (BMI) less than 30 for all-cause and vascular mortality. Any LTPA was associated with reduced all-cause mortality (adjusted HR: 0.77, 95% CI: 0.68-0.87) and VaD (adjusted HR: 0.79, 95% CI: 0.65-0.97) only among those with BMI less than 30. CONCLUSIONS We found no evidence of an independent survival benefit of LTPA among those with BMI more than 30. The health benefits of exercise should be considered in the context of obesity.
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Affiliation(s)
| | | | - Ayesha Sherzai
- Department of Neurology, Columbia University, New York, NY
| | | | - Ralph L Sacco
- Department of Neurology, University of Miami, Miami, FL
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Rosenstock J, Hernandez-Triana E, Handelsman Y, Misir S, Jones MR. Clinical Effects of Colesevelam in Hispanic Subjects with Primary Hyperlipidemia and Prediabetes. Postgrad Med 2015; 124:14-20. [DOI: 10.3810/pgm.2012.07.2564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Arguelles W, Llabre MM, Sacco RL, Penedo FJ, Carnethon M, Gallo LC, Lee DJ, Catellier DJ, González HM, Holub C, Loehr LR, Soliman EZ, Schneiderman N. Characterization of metabolic syndrome among diverse Hispanics/Latinos living in the United States: Latent class analysis from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Int J Cardiol 2015; 184:373-379. [PMID: 25745986 DOI: 10.1016/j.ijcard.2015.02.100] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVES Empirical investigation of the adequacy of metabolic syndrome (MetS) diagnostic criteria, and whether meaningful subtypes of MetS exist, is needed among Hispanics/Latinos. METHODS In 15,825 US Hispanics/Latinos from HCHS/SOL, latent class analysis of MetS components (waist circumference, systolic and diastolic blood pressure, HDL cholesterol, triglycerides, glucose, and antihypertensive, lipid- and glucose-lowering medication use) was used to investigate (1) whether distinct subtypes of MetS could be identified, and how component levels differed between them, and (2) how identified subtypes related to covariates and cardiovascular disease (CVD) prevalence. RESULTS Two latent clusters emerged in both men (n=6317) and women (n=9508): one characterized by relatively healthy mean levels (Non-MetS cluster, 77.1% of men and 67.1% of women) and the other by clinically elevated mean levels (MetS cluster, 22.9% of men and 32.9% of women) across most MetS components. These clusters showed expected associations with covariates and CVD prevalence. Notable results suggest that (1) HDL cholesterol may poorly differentiate between US Hispanics/Latinos with and without MetS (mean=45.4 vs. 44.6 mg/dL for men and 51.3 vs. 52.0 mg/dL for women in the MetS vs. Non-MetS clusters, respectively) and (2) the NCEP-ATP III 88 cm waist circumference cutoff for US females may not optimize diagnosis among Hispanic/Latino women (MetS cluster mean waist circumference=102.5 cm). CONCLUSIONS Beyond classification into having MetS or not, additional subtypes of MetS do not clearly emerge in US Hispanics/Latinos. Current diagnostic cutoffs for some components may not optimize MetS identification among this population.
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Affiliation(s)
| | | | | | - Frank J Penedo
- Northwestern University Feinberg School of Medicine, United States
| | | | | | | | | | | | | | - Laura R Loehr
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, United States
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Impact of serum nutritional status on physical function in african american and caucasian stroke survivors. Stroke Res Treat 2014; 2014:174308. [PMID: 25530905 PMCID: PMC4229960 DOI: 10.1155/2014/174308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/07/2014] [Indexed: 11/29/2022] Open
Abstract
Background. The purpose of this study is to compare serum nutritional profiles in chronic stroke survivors to a representative sample of US Adults (NHANESIII) and determine whether these serum markers differed by race and impact physical function in stroke. Methods. Fasting serum samples were collected for analysis of lipids, uric acid, and albumin in 145 African American (AA) and 111 Caucasian (C) stroke survivors (age: 60 ± 1 years [mean ± SEM]). A six-minute walk was performed in a subset of stroke survivors (N = 134). Results. Triglycerides were higher and HDL-cholesterol and albumin lower in C than AA women stroke survivors (Ps < 0.05). Uric acid was lower in C than AA stroke survivors (P < 0.05). Compared to NHANESIII, HDL-cholesterol, albumin, and hemoglobin generally were lower (Ps < 0.05) and lipids were more favorable in stroke (Ps < 0.01). Uric acid was related to six-minute walk performance among a subset of stroke survivors (P < 0.05). Conclusion. In stroke, racial differences exist with regard to serum nutritional risk, but these differences are similar to that observed in the general population. Regardless of race, nutritional risk appears elevated above that of the general population with regard to many of the serum markers. As a modifiable biomarker, uric acid should be monitored closely as it may provide insight into the functional risk of stroke survivors.
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Lin J, Reilly MP, Terembula K, Wilson FP. Plasma lipoprotein(a) levels are associated with mild renal impairment in type 2 diabetics independent of albuminuria. PLoS One 2014; 9:e114397. [PMID: 25490096 PMCID: PMC4260843 DOI: 10.1371/journal.pone.0114397] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/06/2014] [Indexed: 02/02/2023] Open
Abstract
Background CKD, an independent risk factor for CV disease, increases mortality in T2DM. Treating modifiable CV risk factors decreases mortality in diabetics with microalbuminuria, but the role of early CV prevention in diabetics with mild CKD by GFR criteria alone remains unclear. The purpose of this study was to probe whether T2DM patients with mild GFR impairment have atherogenic lipid profiles compared to diabetic counterparts with normal renal function. Methods In the Penn Diabetes Heart Study (PDHS), a single-center observational cohort of T2DM patients without clinical CVD, cross-sectional analyses were performed for directly measured lipid fractions in 1852 subjects with eGFR>60 mL/min/1.73 m2 determined by the CKD-EPI equation (n = 1852). Unadjusted and multivariable analyses of eGFR association with log-transformed lipid parameters in incremental linear and logistic regression models (with eGFR 90 mL/min/1.73 m2 as a cut-point) were performed. Results Mild GFR impairment (eGFR 60–90 mL/min/1.73 m2, median urinary ACR 5.25 mg/g) was associated with higher log-transformed Lp(a) values (OR 1.17, p = 0.005) and with clinically atherogenic Lp(a) levels above 30 mg/dL (OR 1.35, p = 0.013) even after full adjustment for demographics, medications, metabolic parameters, and albuminuria. Logistic regression demonstrated a trend towards significance between worse kidney function and apoB (p = 0.17) as well as apoC-III (p = 0.067) in the fully adjusted model. Conclusions Elevated Lp(a) levels have a robust association with mild GFR impairment in type 2 diabetics independent of race, insulin resistance, and albuminuria.
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Affiliation(s)
- Jennie Lin
- Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- * E-mail:
| | - Muredach P. Reilly
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Karen Terembula
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - F. Perry Wilson
- Section of Nephrology, Program of Applied Translational Research Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT, United States of America
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Aminov Z, Haase R, Olson JR, Pavuk M, Carpenter DO. Racial differences in levels of serum lipids and effects of exposure to persistent organic pollutants on lipid levels in residents of Anniston, Alabama. ENVIRONMENT INTERNATIONAL 2014; 73:216-23. [PMID: 25160080 DOI: 10.1016/j.envint.2014.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/24/2014] [Accepted: 07/24/2014] [Indexed: 05/20/2023]
Abstract
Serum lipid levels are major risk factors for cardiovascular disease. In addition to diet, exercise, genetics, age and race, serum concentrations of persistent organic pollutants (POPs) influence concentrations of serum lipids. We investigated associations between fasting concentrations of 35 polychlorinated biphenyl (PCB) congeners and nine organochlorine pesticides in relation to total serum lipids, total cholesterol, low-density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides in 525 Caucasian and African American residents of Anniston, Alabama, who were not on any lipid-lowering medication. In Model 1, data were adjusted for age, age quadratic, gender, BMI, alcohol consumption, smoking and exercise, while in Model 2, additional adjustment was done for other POPs. As compared to Caucasians, African Americans had lower levels of total lipids and triglycerides with higher concentrations of HDL cholesterol, but higher concentrations of PCBs and pesticides. Total pesticides were more strongly associated with elevations in serum lipids than were total PCBs, and the associations were stronger in African Americans. Total DDTs were not associated with serum lipids after adjustment for other POPs in either racial group, while the strongest positive associations were seen for hexachlorobenzene (HCB) in both racial groups. Racial differences in lipid profiles, concentrations of POPs and associations between POP concentrations and serum lipids are relevant to racial differences in rates of cardiovascular disease.
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Affiliation(s)
- Zafar Aminov
- Institute for Health and the Environment, University at Albany, Rensselaer, NY 12144, United States.
| | - Richard Haase
- Institute for Health and the Environment, University at Albany, Rensselaer, NY 12144, United States.
| | - James R Olson
- Pharmacology and Toxicology, University at Buffalo, Buffalo, NY, United States.
| | - Marian Pavuk
- Agency for Toxic Substances and Disease Registry, Atlanta, GA, United States.
| | - David O Carpenter
- Institute for Health and the Environment, University at Albany, Rensselaer, NY 12144, United States.
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Willey JZ, Moon YP, Kahn E, Rodriguez CJ, Rundek T, Cheung K, Sacco RL, Elkind MSV. Population attributable risks of hypertension and diabetes for cardiovascular disease and stroke in the northern Manhattan study. J Am Heart Assoc 2014; 3:e001106. [PMID: 25227406 PMCID: PMC4323833 DOI: 10.1161/jaha.114.001106] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 08/07/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Understanding the population-level risk factor contribution to disease incidence is critical for effective allocation of resources for prevention. There are little data on the contribution of cardiovascular disease (CVD) risk factors in multiethnic elderly populations. METHODS AND RESULTS The Northern Manhattan Study (n=3298) is a population-based prospective cohort study of CVD outcomes in a multiethnic urban population. Multivariable Cox's models were used to calculate hazard ratios, population attributable risk (PAR), and 95% confidence intervals (CIs) for (1) combined vascular event (VE) endpoint of stroke/myocardial infarction/vascular death (n=835) and (2) stroke (n=347). The PAR resulting from hypertension (HTN) was 24.3% (95% CI, 13.2 to 35.4) for VE and 29.9% (95% CI, 12.5 to 47.4) for stroke; PAR resulting from diabetes was 12.7% (95% CI, 8.2 to 17.2) for VE and 19.5% (95% CI, 12.4 to 26.5) for stroke. The PAR resulting from HTN and diabetes for stroke differed by race-ethnicity and age (P for differences <0.05). PAR for stroke reslting from HTN was greater among Hispanics (50.6%; 95% CI, 29.2 to 71.9) than non-Hispanic whites (2.6%; 95% CI, -33.2 to 38.6) and in those <80 years of age (35.6%; 95% CI, 18.9 to 52.3) than in those ≥80 (-0.3%; 95% CI, -34.2 to 33.6). Similarly, the PAR for stroke resulting from diabetes was 23.6% among those <80 years of age (95% CI, 15.7 to 31.5) and 2.3% among those ≥80 (95% CI, -8.2 to 12.7; P for difference=0.001). The PAR for VE did not differ by age/sex/race-ethnicity. CONCLUSIONS HTN and diabetes have important effects on the burden of stroke, particularly among those younger than age 80 and Hispanics. Public health campaigns targeted at specific risk factors in specific populations can lead to a greater reduction in CVD.
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Affiliation(s)
- Joshua Z. Willey
- Department of Neurology, Columbia University, New York, USA (J.Z.W., Y.P.M., E.K., M.V.E.)
| | - Yeseon Park Moon
- Department of Neurology, Columbia University, New York, USA (J.Z.W., Y.P.M., E.K., M.V.E.)
| | - Emily Kahn
- Department of Neurology, Columbia University, New York, USA (J.Z.W., Y.P.M., E.K., M.V.E.)
| | - Carlos J. Rodriguez
- Department of Medicine, Wake Forest University, Winston‐Salem, NC, USA (C.J.R.)
| | - Tatjana Rundek
- Department of Neurology, University of Miami, Miami, FL, USA (T.R., R.L.S.)
| | - Ken Cheung
- Department of Biostatistics, Columbia University, New York, USA (K.C.)
| | - Ralph L. Sacco
- Department of Neurology, University of Miami, Miami, FL, USA (T.R., R.L.S.)
| | - Mitchell S. V. Elkind
- Department of Neurology, Columbia University, New York, USA (J.Z.W., Y.P.M., E.K., M.V.E.)
- Department of Epidemiology, Columbia University, New York, USA (M.V.E.)
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Arauz A, Romano JG, Ruiz-Franco A, Shang T, Dong C, Rundek T, Koch S, Hernández-Curiel B, Pacheco J, Rojas P, Ruiz-Navarro F, Katsnelson M, Sacco RL. Differences in lipid profiles in two Hispanic ischemic stroke populations. Int J Stroke 2013; 9:394-9. [PMID: 24898282 DOI: 10.1111/ijs.12239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 10/29/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE The study aims to compare lipid profiles among ischemic stroke patients in a predominantly Caribbean-Hispanic population in Miami and a Mestizo Hispanic population in Mexico City. METHODS We analyzed ischemic stroke Hispanic patients with complete baseline fasting lipid profile enrolled contemporaneously in the prospective registries of two tertiary care teaching hospitals in Mexico City and Miami. Demographic characteristics, risk factors, medications, ischemic stroke subtype, and first fasting lipid profile were compared. Vascular risk factor definitions were standardized. Multiple linear regression analysis was performed to compare lipid fractions. RESULTS A total of 324 patients from Mexico and 236 from Miami were analyzed. Mexicans were significantly younger (58 · 1 vs. 67 · 4 years), had a lower frequency of hypertension (53 · 4% vs. 79 · 7%), and lower body mass index (27 vs. 28 · 5). There was a trend toward greater prevalence of diabetes in Mexicans (31 · 5 vs. 24 · 6%, P = 0 · 07). Statin use at the time of ischemic stroke was more common in Miami Hispanics (18 · 6 vs. 9 · 4%). Mexicans had lower total cholesterol levels (169 · 9 ± 46 · 1 vs. 179 · 9 ± 48 · 4 mg/dl), lower low-density lipoprotein (92 · 3 ± 37 · 1 vs. 108 · 2 ± 40 · 8 mg/dl), and higher triglyceride levels (166 · 9 ± 123 · 9 vs. 149 · 2 ± 115 · 2 mg/dl). These differences remained significant after adjusting for age, gender, hypertension, diabetes, body mass index, smoking, ischemic stroke subtype, and statin use. CONCLUSION We found significant differences in lipid fractions in Hispanic ischemic stroke patients, with lower total cholesterol and low-density lipoprotein, and higher triglyceride levels in Mexicans. These findings highlight the heterogeneity of dyslipidemia among the Hispanic race-ethnic group and may lead to different secondary prevention strategies.
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Affiliation(s)
- A Arauz
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
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Chirinos DA, Medina-Lezama J, Arguelles W, Goldberg R, Schneiderman N, Khan Z, Morey OO, Raja MW, Paz R, Chirinos JA, Llabre MM. Metabolic syndrome as an underlying disease entity and its relationship to subclinical atherosclerosis in Andean Hispanics. Metab Syndr Relat Disord 2013; 12:49-55. [PMID: 24206171 DOI: 10.1089/met.2013.0092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The question of whether the metabolic syndrome truly reflects a single disease entity with a common underlying pathology remains unclear. In this study, we assess whether metabolic syndrome represents an underlying disease construct in a large population-based sample of Andean Hispanic adults and examine its relationship to subclinical atherosclerosis. METHODS The study sample was comprised of 2513 participants. Confirmatory factor analysis (CFA) was used to identify a metabolic syndrome latent factor using waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), and glucose levels as indicators. The relationship with subclinical atherosclerosis, measured by carotid intima media thickness (cIMT), was assessed using structural equation modeling. RESULTS Results supported the proposed structure of the metabolic syndrome latent factor evidenced by adequate fit indexes. HDL-C did not significantly load on the metabolic syndrome latent factor (standardized factor loading=0.01, P=0.88). The metabolic syndrome latent factor was significantly associated with cIMT in women (B=0.007, P<0.001) and men (B=0.008, P<0.001) after controlling for age, low-density lipoprotein cholesterol and smoking. CONCLUSIONS Our findings suggest that metabolic syndrome components, such as waist circumference, blood pressure, TGs, and glucose levels, but not HDL-C, share a common underlying pathophysiology that may contribute to the progression of atherosclerosis in Andean Hispanics. Its longitudinal association with cardiovascular disease should be the focus of future research.
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Affiliation(s)
- Diana A Chirinos
- 1 Behavioral Medicine Research Center, University of Miami , Coral Gables, Florida
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Rosenstock J, Hernandez-Triana E, Handelsman Y, Misir S, Jones MR, Nagendran S. Initial combination therapy with metformin plus colesevelam in drug-naïve Hispanic patients with early type 2 diabetes. Postgrad Med 2012; 124:7-13. [PMID: 22913889 DOI: 10.3810/pgm.2012.07.2560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To evaluate initial combination therapy with metformin plus colesevelam in drug-naïve Hispanic patients with type 2 diabetes mellitus. RESEARCH DESIGN AND METHODS Patients self-identified as Hispanic from a previous study were included in this exploratory post hoc analysis. Patients were randomized to metformin plus colesevelam or metformin plus placebo. The primary efficacy parameter was the mean change in glycated hemoglobin (HbA1c) levels from baseline. RESULTS Metformin plus colesevelam had a greater mean HbA1c reduction (-1.2 ± 0.1%) than metformin plus placebo (-0.8 ± 0.1%; P = 0.001) from mean baselines of 7.7% and 7.6%, respectively. Low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol, total cholesterol, and apolipoprotein (apo) B levels were also reduced (P < 0.0001 for all), while triglyceride (P < 0.0001) and apoA-I (P < 0.05) levels were increased with metformin plus colesevelam treatment compared with metformin plus placebo. With metformin plus colesevelam versus metformin plus placebo, more patients achieved an HbA1c of < 7.0% (75% vs 56%) and LDL-C of < 100 mg/dL (49% vs 14%; both P < 0.05). CONCLUSION Metformin plus colesevelam may be an effective initial treatment option for Hispanic patients with early type 2 diabetes mellitus.
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Affiliation(s)
- Julio Rosenstock
- Dallas Diabetes and Endocrine Center at Medical City, Dallas, TX 75230, USA.
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Current world literature. Curr Opin Cardiol 2012; 27:441-54. [PMID: 22678411 DOI: 10.1097/hco.0b013e3283558773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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McCormick TH, Rudin C, Madigan D. Bayesian hierarchical rule modeling for predicting medical conditions. Ann Appl Stat 2012. [DOI: 10.1214/11-aoas522] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Willey JZ, Rodriguez CJ, Moon YP, Paik MC, Di Tullio MR, Homma S, Sacco RL, Elkind MSV. Coronary death and myocardial infarction among Hispanics in the Northern Manhattan Study: exploring the Hispanic paradox. Ann Epidemiol 2012; 22:303-9. [PMID: 22424967 DOI: 10.1016/j.annepidem.2012.02.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 02/20/2012] [Accepted: 02/21/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE Prior studies have reported that Hispanics have lower cardiovascular disease (CVD) mortality despite a higher burden of risk factors. We examined whether Hispanic ethnicity was associated with a lower risk of nonfatal myocardial infarction (MI) coronary death (CD) and vascular death. METHODS A total of 2671 participants in the Northern Manhattan Study without clinical CVD were prospectively evaluated. Cox models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of race-ethnicity with nonfatal MI, CD, and vascular death after adjusting for demographic and CVD risk factors. RESULTS Mean age was 68.8 (10.4) years; 52.8% were Hispanic (88% Caribbean-Hispanic). Hispanics were more likely to have hypertension (73.1% vs. 62.2%, p < .001) and diabetes (22.0% vs. 13.3%, p < .001), and less likely to perform any physical activity (50.1% vs. 69.2%, p < .001) compared to non-Hispanic whites (NHW). During a mean 10 years of follow-up there were 154 nonfatal MIs, 186 CD, and 386 vascular deaths. In fully adjusted models, Hispanics had a lower risk of CD (adjusted HR = 0.36, 95% CI: 0.21-0.60), and vascular death (adjusted HR = 0.62, 95% CI: 0.43-0.89), but not nonfatal MI (adjusted HR = 0.95, 95% CI: 0.56-1.60) when compared to NHW. CONCLUSIONS We found a "Hispanic paradox" for coronary and vascular deaths, but not nonfatal MI.
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Affiliation(s)
- Joshua Z Willey
- Department of Neurology, Columbia University, New York, NY, USA.
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