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Huang F, Zhou Y, Li T, Lin Z, Lu Y, Zhu L, Lu Z, Peng W, Zhu Y. Association between vitamin D and cardiovascular health in Chinese children and adolescents: Basing on Life's Essential 8. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00240-0. [PMID: 39069467 DOI: 10.1016/j.numecd.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/29/2024] [Accepted: 06/17/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND AND AIMS The relationship between vitamin D and cardiovascular health (CVH) in children remains unclear. We aimed to explore the association between vitamin D and CVH metrics using the latest Life's Essential 8 (LE8) among Chinese children and adolescents. METHODS AND RESULTS A cross-sectional study containing 2680 participants aged 7-18 years (1340 boys and 1340 girls) was performed in South China in 2013. Vitamin D levels were categorized as follows: ≥20 ng/mL (sufficiency), 12 - < 20 ng/mL (inadequacy), and <12 ng/mL (deficiency). The CVH metrics of LE8 was assessed by overall CVH score, health behavior score, health factor score and high CVH, among which the health behaviors included diet, physical activity, nicotine exposure, and sleep health, as well as the health factors contained body mass index, blood lipids, blood glucose, and blood pressure. Different regression models were used to assess the associations between vitamin D levels and CVH metrics of LE8. Results showed that the prevalence of vitamin D deficiency and inadequacy was 7.5% and 44.4%, respectively. Boys had lower levels in overall CVH score, health behavior score, and health factor score than girls. After adjusting for potential confounds, upward trends in diet score, health behavior score, and high CVH were observed with increasing vitamin D levels. CONCLUSION Vitamin D levels were positively associated with high CVH based on LE8, and more attention should be paid on boys due to whose lower levels in CVH metrics.
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Affiliation(s)
- Fenglian Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Yueqin Zhou
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Tianze Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Zongyu Lin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Yeling Lu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Lewei Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Zhijun Lu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Wei Peng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
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Kwok MK, Leung GM, Xu L, Tse HF, Lam TH, Schooling CM. Effect of puerarin supplementation on cardiovascular disease risk factors: A randomized, double-blind, placebo-controlled, 2-way crossover trial. Biomed Pharmacother 2022; 153:113472. [DOI: 10.1016/j.biopha.2022.113472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/15/2022] Open
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Hai JJ, Chan PH, Huang D, Ho MH, Ho CW, Cheung E, Lau CP, Tse HF, Siu CW. Clinical Characteristics, Management, and Outcomes of Hospitalized Heart Failure in a Chinese Population—The Hong Kong Heart Failure Registry. J Card Fail 2016; 22:600-8. [DOI: 10.1016/j.cardfail.2016.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 03/02/2016] [Accepted: 03/15/2016] [Indexed: 01/10/2023]
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Heterozygous familial hypercholesterolemia in Hong Kong Chinese. Study of 252 cases. Int J Cardiol 2013; 167:762-7. [DOI: 10.1016/j.ijcard.2012.03.048] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 03/03/2012] [Indexed: 01/30/2023]
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Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, Stalenhoef AFH. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97:2969-89. [PMID: 22962670 PMCID: PMC3431581 DOI: 10.1210/jc.2011-3213] [Citation(s) in RCA: 534] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim was to develop clinical practice guidelines on hypertriglyceridemia. PARTICIPANTS The Task Force included a chair selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), five additional experts in the field, and a methodologist. The authors received no corporate funding or remuneration. CONSENSUS PROCESS Consensus was guided by systematic reviews of evidence, e-mail discussion, conference calls, and one in-person meeting. The guidelines were reviewed and approved sequentially by The Endocrine Society's CGS and Clinical Affairs Core Committee, members responding to a web posting, and The Endocrine Society Council. At each stage, the Task Force incorporated changes in response to written comments. CONCLUSIONS The Task Force recommends that the diagnosis of hypertriglyceridemia be based on fasting levels, that mild and moderate hypertriglyceridemia (triglycerides of 150-999 mg/dl) be diagnosed to aid in the evaluation of cardiovascular risk, and that severe and very severe hypertriglyceridemia (triglycerides of > 1000 mg/dl) be considered a risk for pancreatitis. The Task Force also recommends that patients with hypertriglyceridemia be evaluated for secondary causes of hyperlipidemia and that subjects with primary hypertriglyceridemia be evaluated for family history of dyslipidemia and cardiovascular disease. The Task Force recommends that the treatment goal in patients with moderate hypertriglyceridemia be a non-high-density lipoprotein cholesterol level in agreement with National Cholesterol Education Program Adult Treatment Panel guidelines. The initial treatment should be lifestyle therapy; a combination of diet modification and drug therapy may also be considered. In patients with severe or very severe hypertriglyceridemia, a fibrate should be used as a first-line agent.
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Affiliation(s)
- Lars Berglund
- University of California, Davis, Sacramento, California 95817, USA
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Lee VWY, Fan CSY, Li AWM, Chau ACY. Clinical impact of a pharmacist-physician co-managed programme on hyperlipidaemia management in Hong Kong. J Clin Pharm Ther 2009; 34:407-14. [DOI: 10.1111/j.1365-2710.2009.01024.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Cheung BMY, Li M, Ong KL, Wat NMS, Tam S, Pang RWC, Thomas GN, Woo J, Janus ED, Lau CP, Lam TH, Lam KSL. High density lipoprotein-cholesterol levels increase with age in American women but not in Hong Kong Chinese women. Clin Endocrinol (Oxf) 2009; 70:561-8. [PMID: 18715284 DOI: 10.1111/j.1365-2265.2008.03361.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES High-density lipoprotein (HDL) cholesterol is a powerful cardiovascular risk factor. Important gender and ethnic differences in plasma HDL levels exist and warrant investigation. DESIGN Cross-sectional survey in two different general populations. Patients 7700 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and 1944 participants of the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS2) 2000-2004. MEASUREMENTS Plasma HDL levels. RESULTS Plasma HDL levels were higher in women than in men in both populations. In the United States women, it increased with age, whereas in Chinese women, it declined with age and converged with male HDL levels. In the United States, 37.1 +/- 1.2% men and 38.9 +/- 1.1% women had low HDL levels. In Hong Kong, 34.3 +/- 1.6% men and 34.5 +/- 1.5% women had low HDL levels. In Americans, the independent predictors of low HDL levels were lower age, being non-Mexican Hispanic, waist circumference, triglycerides and not drinking alcohol in men, and lower age, being Hispanic, waist circumference, triglycerides, current smoking and not drinking alcohol in women. In Hong Kong Chinese, the independent predictors of low HDL levels were body mass index, triglycerides, current smoking and not drinking alcohol in men, and lower age, waist circumference, triglycerides, diabetes and former smoking in women. CONCLUSIONS The decline in plasma HDL with age in Chinese women is opposite to that seen in American women. The increased cardiovascular risk in elderly Chinese women requires further study.
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Affiliation(s)
- Bernard M Y Cheung
- Department of Clinical Pharmacology, School of Clinical and Experimental Medicine, University of Birmingham, England.
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Ojji DB, Ajayi SO, Mamven MH, Atherton J. Prevalence of dyslipidemia in normoglycemic subjects with newly diagnosed high blood pressure in Abuja, Nigeria. J Clin Lipidol 2009; 3:51-6. [PMID: 21291789 DOI: 10.1016/j.jacl.2008.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2008] [Revised: 11/18/2008] [Accepted: 12/01/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND High blood pressure and dyslipidemia additively increases the risk of cardiovascular disease. There is a high prevalence of high blood pressure in Nigeria, but there are little data regarding the prevalence of dyslipidemia in subjects with high blood pressure. OBJECTIVE In this observational prospective study, we examined the prevalence of dyslipidemia in newly diagnosed normoglycemic subjects with high blood pressure. METHODS A total of 171 subjects presenting with high blood pressure for the first time in the cardiology and nephrology clinics at the University of Abuja Teaching Hospital were studied. Height, weight, and blood pressure were measured. Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined in fasting plasma. The total cholesterol/HDL-C and non-HDL-C values were calculated. These measures were then classified according to the 2001 report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. RESULTS Of the 171 subjects studied, 84 (49%) were male and 87 (51%) were female. Low HDL-C was present in 71 (45.8%), elevated LDL-C in 29 (17%), elevated total cholesterol in 19 (11.1%), and elevated triglyceride in 13 (7.6%), whereas eight (4.7%) of the study population had combined elevated total cholesterol and triglyceride. Female subjects had higher total cholesterol and lower HDL-C than male subjects, but these differences were not statistically significant. Obese subjects, compared to the nonobese, had significantly higher LDL-C and total cholesterol/HDL-C ratios in males and significantly higher triglyceride levels in females. CONCLUSIONS Given the prevalence of dyslipidemia seen in this study, we suggest that fasting lipid measurements should be performed in all Nigerians with high blood pressure. These data suggest the need for health education and lifestyle modifications in hypertensive Nigerians to reduce both types of risk factors.
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Affiliation(s)
- Dike B Ojji
- Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
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Prevalence and association with diabetes and obesity of lipid phenotypes among the hypertensive Chinese rural adults. Heart Lung 2009; 38:17-24. [PMID: 19150527 DOI: 10.1016/j.hrtlng.2008.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 01/20/2008] [Accepted: 02/08/2008] [Indexed: 11/21/2022]
Abstract
BACKGROUND Both dyslipidemia and hypertension are important risk factors for cardiovascular disease. Studies have found that there is a higher risk of dyslipidemia among hypertensive patients. This study was designed to investigate the epidemiologic features of some forms of dyslipidemia in rural hypertensive adults in China. METHODS A cross-sectional survey was conducted during 2004 to 2006 through a cluster multistage sampling of a resident group of 6412 hypertensive individuals (2805 men and 3607 women), aged >/= 35 years, in the countryside of Liaoning, China. The cutpoints of lipid phenotypes were based on the 1992 recommendations of the European Atherosclerosis Society. RESULTS The most prevalent abnormality was isolated hypercholesterolemia (34.1% for men and 37.3% for women). Mixed dyslipidemias was the second most prevalent abnormality (14.3%). Isolated hypertriglyceridemia was observed in 5.6% of the sample. The prevalence of normotriglyceridemic hypoalphalipoproteinemia and severe dyslipidemia was 2.0% and 3.3%, respectively. Only a few samples had the abnormality of hypertriglyceridemia/hypoalphalipoproteinemia (.8% for men and .3% for women). The prevalence of isolated hypertriglyceridemia, mixed dyslipidemias, and severe dyslipidemia was higher in diabetic patients compared with nondiabetic patients, in either men or women. Compared with those of normal weight, obese men had a higher prevalence of mixed dyslipidemias and hypertriglyceridemia/hypoalphalipoproteinemia, whereas isolated hypertriglyceridemia was prevalent in both genders. CONCLUSION The prevalence of lipid phenotypes among these hypertensive patients was relatively high, even in rural China. Diabetes and obesity, the modifiable risk factors, increased the likelihood of having several forms of an atherogenic lipid profile.
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Briand F, Bailhache E, Andre A, Magot T, Krempf M, Nguyen P, Ouguerram K. The hyperenergetic-fed obese dog, a model of disturbance of apolipoprotein B-100 metabolism associated with insulin resistance: kinetic study using stable isotopes. Metabolism 2008; 57:966-72. [PMID: 18555839 DOI: 10.1016/j.metabol.2008.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 02/15/2008] [Indexed: 01/18/2023]
Abstract
The hyperenergetic-fed beagle dog model of obesity-associated insulin resistance has previously demonstrated lipoprotein abnormalities similar to those of obese insulin-resistant humans. The aim of this study was to check, in the insulin-resistant dog, the mechanism leading to abnormalities in the mass of apolipoprotein B-100 (apo B-100) containing lipoproteins. Six healthy male beagle dogs were overfed with a high-fat diet for 28 +/- 2.5 weeks. Obesity was associated with insulin resistance as assessed by the euglycemic hyperinsulinemic clamp technique. The kinetics of very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) apo B-100 were recorded in dogs, at healthy and insulin-resistant states, using a primed constant infusion of [5,5,5-D(3)]leucine. Isotopic enrichment was measured by gas chromatography-mass spectrometry (GC-MS). A multicompartmental model was used for the analysis of tracer kinetics data. Apolipoprotein B-100 concentration was higher in VLDL (2.8-fold, P < .05) but lower in LDL (2-fold, P < .05) in the insulin-resistant compared to the healthy state. Kinetic analysis showed a higher VLDL apo B-100 production (1.7-fold, P < .05). The fractional catabolic rate of VLDL did not change significantly, but the lipolysis was decreased significantly (3-fold, P < .05). The lower LDL apo B-100 level in insulin-resistant dogs was explained by a higher LDL fractional catabolic rate (2.5-fold, P < .05). The mechanisms leading to hypertriglyceridemia (higher production rate and lower lipolysis of VLDL) in insulin-resistant dogs were similar to those described in the insulin-resistant humans.
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Affiliation(s)
- François Briand
- Centre de Recherche en Nutrition Humaine, Institut national de la santé et de la recherche médicale, INSERM U539, CHU Nantes F-44000, France
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Zhang X, Sun Z, Zheng L, Li J, Liu S, Xu C, Li J, Zhao F, Hu D, Sun Y. Prevalence of dyslipidemia and associated factors among the hypertensive rural chinese population. Arch Med Res 2007; 38:432-9. [PMID: 17416291 DOI: 10.1016/j.arcmed.2006.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Accepted: 12/18/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries. This study was designed to investigate the epidemiological features of dyslipidemia in rural adults with hypertension in China. METHODS A cross-sectional survey was conducted during 2004-2006 through a cluster multistage sampling to a resident group of 6,412 individuals (2,805 men, 3,607 women) with hypertension, aged >/=35 years, in the countryside of Liaoning, China. Serum lipids levels were proposed by National Cholesterol Education Program Adult Treatment Panel III. RESULTS Of the study population 34.4% had borderline high total cholesterol (TC), 16.9% had high TC, and 8.8% had low high-density lipoprotein cholesterol (HDL-C). The population with borderline high, high, and very high low-density lipoprotein cholesterol (LDL-C) was 15.7, 3.5, and 0.9%, respectively. In addition, 15.9% had borderline high triglycerides (TG), 17.8% had high TG and 2.0% had very high TG. After adjusting for independent variables, TC and TG had the same risk with fasting plasma glucose (FPG) and body mass index. Risk factors of TC and LDL-C were women, age and FPG. Mongolia nationality as a protective factor positively correlated with TC, LDL-C, and TG. Women, age, drinking, and classification of blood pressure were protective factors but Mongolia nationality was a risk factor for HDL-C. CONCLUSIONS This study demonstrated that the prevalence of dyslipidemia was relatively high among rural hypertensive patients in China and there were many modifiable risk factors for dyslipidemia such as hypertension, weight, and impaired glucose metabolism. To prevent dyslipidemia and to reduce the increasing burden of cardiovascular disease in rural areas with the undeveloped economy of China, the first aim for us is to reduce these risk factors.
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Affiliation(s)
- Xingang Zhang
- Department of Cardiology, The Second Affiliated Hospital of China Medical University, Shenyang, P.R. China
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Abstract
PURPOSE OF REVIEW The metabolic syndrome, a clustering of abnormalities such as hyperglycemia, insulin resistance, hypertension, dyslipidemia, and central obesity, is a principal risk factor for cardiovascular disease, the leading cause of morbidity and mortality in the Western world. There are several definitions of the metabolic syndrome, all aiming at including as many persons at risk as possible. The assessment and, hence, the identification of such persons in a clinical setting is of utmost importance. RECENT FINDINGS Clinicians should document the presence of central obesity, assessed by waist circumference measurement or determination of body composition using dual X-ray absorptiometry or measurement of visceral fat using computed tomography or magnetic resonance imaging. The presence of dyslipidemia, insulin resistance, and arterial hypertension constitutes the full profile of the metabolic syndrome. Nevertheless, elevated uric acid levels or presence of nonalcoholic fatty liver, or the diagnosis of the polycystic ovary syndrome in women of reproductive age, all are reflected in high risk of later occurrence of the full metabolic syndrome and atherosclerotic cardiovascular disease. SUMMARY Although no unified definition for the metabolic syndrome exists, it is important to identify persons at risk, in order to reduce the resultant high morbidity and mortality rates.
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Affiliation(s)
- Panagiota Pervanidou
- First Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.
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Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy--a review of the evidence. J Intern Med 2006; 259:493-519. [PMID: 16629855 DOI: 10.1111/j.1365-2796.2006.01643.x] [Citation(s) in RCA: 375] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
During the last several years interest has focused on the importance of the lipid-transporting apolipoproteins--apoB transports all potentially atherogenic very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL) and LDL particles, and apoA-I transports and acts as the major antiatherogenic protein in the HDL particles. The evidence for the apoB/apoA-I ratio being a strong, new risk factor for cardiovascular (CV) disease and a target for lipid-lowering therapy is reviewed. Results from clinical prospective studies and lipid-lowering trials in healthy subjects and in patients with different clinical manifestations of atherosclerosis are reported. Risk of nonfatal and fatal myocardial infarction and stroke, and manifestations of atherosclerosis documented by angiographic, ultrasound and other techniques has been related to conventional lipids and apolipoproteins (apo). The cholesterol balance determined as the apoB/apoA-I ratio has repeatedly been shown to be a better marker than lipids, lipoproteins and lipid ratios. The results indicate that the apoB/apoA-I ratio is a simple, accurate and new risk factor for CV disease--the lower the apoB/apoA-I ratio, the lower is the risk. Guidelines should be developed in order to recognize the important clinical risk information embedded in the apoB/apoA-I ratio.
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Affiliation(s)
- G Walldius
- King Gustaf V Research Institute, Karolinska Institute, Stockholm, Sweden.
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