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Huang Y, Shi W, He Q, Tan J, Tong J, Yu B. Racial and ethnic influences on carotid atherosclerosis: Epidemiology and risk factors. SAGE Open Med 2024; 12:20503121241261840. [PMID: 39045542 PMCID: PMC11265241 DOI: 10.1177/20503121241261840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Carotid atherosclerosis-related stenosis, marked by atherosclerotic plaque formation in the carotid artery, significantly increases ischemic stroke risk. Its prevalence varies across ethnic groups, reflecting racial disparities. Epidemiological studies have highlighted different susceptibilities to carotid stenosis among racial groups. Native Americans and Whites show greater vulnerability, indicating genetic and environmental influences. The impact of carotid stenosis is more severe in Hispanic and Black populations, with a higher incidence of related brain injuries, underscoring the need for targeted interventions. Comparative imaging studies between Chinese and White individuals reveal unique patterns of carotid stenosis, enhancing understanding of its pathophysiology and management across ethnicities. This review also categorizes risk factors, distinguishing those with racial disparity (such as genetic loci, sleep apnea, and emotional factors, socioeconomic status) from those without. In summary, racial disparities affect carotid stenosis, leading to varying susceptibilities and outcomes among ethnic groups. Recognizing these differences is essential for developing effective prevention, diagnosis, and management strategies. Addressing these disparities is critical to reducing ischemic stroke's burden across populations. Continued research and targeted interventions are crucial to improve outcomes for individuals at risk of carotid stenosis and its complications.
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Affiliation(s)
- Yijun Huang
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Weihao Shi
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Qing He
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jinyun Tan
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jindong Tong
- Department of Vascular Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Bo Yu
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
- Department of Vascular Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
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Huang XW, Pang SW, Zhang T, Huang CW. Assessment of causal associations between obesity and peripheral artery disease: a bidirectional Mendelian randomization study. Front Cardiovasc Med 2024; 11:1332530. [PMID: 38774660 PMCID: PMC11107290 DOI: 10.3389/fcvm.2024.1332530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/17/2024] [Indexed: 05/24/2024] Open
Abstract
Background Several observational studies have documented a potential link between obesity and peripheral artery disease (PAD), although conflicting findings exist. The causal relationship between obesity and PAD continues to be a subject of ongoing debate in the medical community. Objectives In this study, we employed a bidirectional Mendelian randomization (MR) analysis to explore the potential causal relationship between obesity and the risk of PAD. Methods To investigate these causal relationships, we conducted bidirectional MR analysis using publicly available genome-wide association study (GWAS) data. Effect estimates were calculated using the random-effects inverse variance-weighted (IVW) method. Results We identified eight independent single nucleotide polymorphisms (SNPs) associated with obesity in 218,735 samples involving 16,380,465 SNPs, all of which met the genome-wide significance threshold (p < 5 × 10-⁸). The IVW analysis indicates a significant positive association between genetic obesity and multiple datasets with PAD as the outcome: Queue-1 (GWAS ID: finn-b-I9_PAD) (OR = 1.138, 95% CI: 1.027-1.261, p = 0.013), Queue-2 (GWAS ID: bbj-a-144) (OR = 1.190, 95% CI: 1.019-1.390, p = 0.028), Queue-3 (GWAS ID: ebi-a-GCST90018670) (OR = 1.174, 95% CI: 1.014-1.360, p = 0.032), and Queue-4 (GWAS ID: ebi-a-GCST90018890) (OR = 1.194, 95% CI: 1.099-1.296, p < 0.001). However, we did not observe a significant genetic-level association between obesity and PAD for Queue-5 (GWAS ID: ukb-d-I9_PAD) (OR = 1.001, 95% CI: 1.000-1.002, p = 0.071). Furthermore, we conducted a reverse causal MR analysis to explore the potential reverse causal relationship between obesity and PAD. This comprehensive analysis did not provide evidence of a reverse causal association between these two factors. Conclusions In summary, our study offers genetic evidence suggesting a possible causal link between obesity and PAD. While we did not find evidence supporting the "obesity paradox", prudent weight management remains crucial, as lower weight does not necessarily guarantee better outcomes. As with any study, caution is required in interpreting the findings. Further research is essential to assess the clinical relevance of weight in preventing PAD, which could inform the development of more precise intervention strategies.
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Affiliation(s)
- Xi-wei Huang
- Department of Emergency Medicine, Puning People’s Hospital, Jieyang, Guangdong Province, China
| | - Shu-wen Pang
- Department of Hygiene and Health, Guangzhou South China Business School, Guangzhou, Guangdong Province, China
| | - Tao Zhang
- Department of Graduate Studies, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China
- Department of Cardiology, General Hospital of the Southern Theater Command of the People’s Liberation Army of China, Guangzhou, Guangdong Province, China
| | - Chuang-wei Huang
- Department of Emergency Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
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Agbonlahor O, DeJarnett N, Hart JL, Bhatnagar A, McLeish AC, Walker KL. Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:783-807. [PMID: 36976513 PMCID: PMC10044132 DOI: 10.1007/s40615-023-01561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Racial discrimination has been identified as a risk factor for cardiometabolic diseases, the leading cause of morbidity and mortality among racial/ethnic minority groups; however, there is no synthesis of current knowledge on the association between discrimination and cardiometabolic diseases. The objective of this systematic review was to summarize evidence linking racial/ethnic discrimination and cardiometabolic diseases. METHODS The review was conducted based on studies identified via electronic searches of 5 databases (PubMed, Google Scholar, WorldWideScience.org, ResearchGate and Microsoft Academic) using terms related to discrimination and cardiometabolic disease. RESULTS Of the 123 eligible studies included in the review, 87 were cross-sectional, 25 longitudinal, 8 quasi-experimental, 2 randomized controlled trials and 1 case-control. Cardiometabolic disease outcomes discussed were hypertension (n = 46), cardiovascular disease (n = 40), obesity (n = 12), diabetes (n = 11), metabolic syndrome (n = 9), and chronic kidney disease (n = 5). Although a variety of discrimination measures was employed across the studies, the Everyday Discrimination Scale was used most often (32.5%). African Americans/Blacks were the most frequently studied racial/ethnic group (53.1%), and American Indians the least (0.02%). Significant associations between racial/ethnic discrimination and cardiometabolic disease were found in 73.2% of the studies. DISCUSSION Racial/ethnic discrimination is positively associated with increased risk of cardiometabolic disease and higher levels of cardiometabolic biomarkers. Identifying racial/ethnic discrimination as a potential key contributor to the health inequities associated with cardiometabolic diseases is important for addressing the significant burden borne by racial/ethnic minorities.
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Affiliation(s)
- Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
| | - Natasha DeJarnett
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Alison C. McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY USA
| | - Kandi L. Walker
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
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Kowalsky RJ, Farney TM, Hearon CM. Resistance Exercise Breaks Improve Ratings of Discomfort and Sleepiness in College Students. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:210-215. [PMID: 35089851 DOI: 10.1080/02701367.2021.1959508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/20/2021] [Indexed: 06/14/2023]
Abstract
Background: Emerging research suggests using resistance exercises to interrupt prolonged sitting may increase physical activity and reduce fatigue, sleepiness, and muscular discomfort, yet it is unclear if these improvements occur in college students. Methods: Twenty-four students (age 23.1 ± 3.4 years, BMI 27.4 ± 5.0 kg∙m-2) completed two 7-day assessments of discomfort, physical fatigue, mental fatigue, and sleepiness while wearing an ActivPAL. Each week (CON vs REX) followed normal activities while completing assessments in the morning (M), mid-day (MD), and evening (E). During REX, hourly resistance exercise breaks (1 exercise per break, 8 breaks per day) for 2 sets of 15 repetitions. Paired t-tests evaluated difference in physical activity variables. Repeated measures ANOVA (0 between, 3 within) evaluated differences in discomfort, physical fatigue, mental fatigue, and sleepiness variables across treatment (CON vs. REX). Results: Comparison of physical activity resulted in no statistical significance between treatments for all outcomes (p ≥ 0.05). A main effect for treatment was observed for overall discomfort (CON: 2.97, REX: 1.72; p = .042) and for sleepiness (CON: 4.38, REX: 3.89; p = .011). Conclusion: Hourly simple resistance breaks resulted in no compensation in steps or sedentary time while reducing muscular discomfort and sleepiness in a relatively healthy and active population.
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Braschi C, Liu JK, Moazzez A, Petrie BA. Presentation, Outcomes, and Non-elective Surgical Management of Diverticulitis: Is There an Ethnic Divide? J Gastrointest Surg 2023:10.1007/s11605-023-05638-4. [PMID: 36853521 PMCID: PMC10366017 DOI: 10.1007/s11605-023-05638-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/18/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Caitlyn Braschi
- Division of Colon & Rectal Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA
| | - Jessica K Liu
- Division of Colon & Rectal Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA
| | - Ashkan Moazzez
- Division of General & Bariatric Surgery, Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Bldg F10, Torrance, CA, 90505, USA.
| | - Beverley A Petrie
- Division of Colon & Rectal Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA
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Weerakoon SM, Chen B, Harrell MB, Vidot DC, Messiah SE. Racial and ethnic disparities in chronic disease risk in adolescence after prenatal polydrug exposure: Examination of the Hispanic paradox. J Ethn Subst Abuse 2023:1-18. [PMID: 36840527 DOI: 10.1080/15332640.2023.2181257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Racial disparities exist in fetal development which in turn can influence growth and development of chronic disease later in life. The purpose of this study was to explore potential racial and ethnic differences in chronic disease risk factors throughout the pediatric years given prenatal exposure to substance use. Data from the Maternal Lifestyle Study cohort was used for this analysis. Urine toxicology confirmed maternal substance use (y/n) and offspring height, weight, and systolic blood pressure (SBP) data at 16 years was analyzed. Linear mixed effects modeling with an interaction term for adolescent race/ethnicity and maternal drug use assessed growth trajectories (body mass index (BMI) percentile) and cardiovascular disease risk factors (elevated SBP). Of the sample (n = 1,388 mother/infant dyads), 23% (n = 319) of mothers used three substances during pregnancy and 14% (n = 200) used four or five. Controlling for BMI, Hispanic adolescents prenatally exposed to any singular substance had 13 mmHg higher SBP at age 16 than their unexposed counterparts (95% Confidence Interval [CI]: 12.24, 14.01). Prenatal exposure to >1 substance significantly lowered SBP in Hispanic adolescents only. Results here showed that Hispanic adolescents exposed to singular substance are at higher risk of elevated SBP in adolescence, but SBP decreased when exposed to >1 substance. The Hispanic paradox may play a role; future studies should continue to explore this. Additionally, barriers to prenatal care for Hispanic women should be addressed in order to prevent substance use during pregnancy which can reduce chronic disease risk in offspring adolescence.
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Affiliation(s)
- Sitara M Weerakoon
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas
| | | | | | - Denise C Vidot
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida
| | - Sarah E Messiah
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas
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Luna P, Harris K, Castro-Dominguez Y, Algara M, Severiche-Mena C, Smolderen KG, Mena-Hurtado C. Risk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease. J Vasc Surg 2023; 77:216-224.e15. [PMID: 36037965 DOI: 10.1016/j.jvs.2022.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Previous studies have shown that Hispanics have worse clinical outcomes for lower extremity peripheral artery disease (PAD) than non-Hispanic White (NHWs). Using a national database, this study aimed to document the contemporary burden of PAD in Hispanics by evaluating their risk profiles, access to care, and outcomes compared with NHWs. METHODS Hospitalizations of Hispanics and NHWs with a primary diagnosis of PAD were identified using 2011-2017 National Inpatient Sample data. Patient sociodemographic characteristics, comorbidities, whether the admission was through the emergency department (ED) or elective, length of stay, and costs accrued were compared by ethnicity. Temporal trends in revascularizations, amputations, and ED admissions by year were evaluated with the Cochran-Mantel-Haenszel test and stratified by ethnicity. Data were combined across years and multivariable logistic regression was used to evaluate the association of ethnicity with inpatient revascularization, amputation, and mortality, adjusting for sociodemographic and cardiovascular risk factors. RESULTS From 2011 to 2017, there were a total of 1,018,220 PAD hospitalizations among Hispanics (13.9%) and NHWs (86.1%) between 2011 and 2017. Hispanics were more often low income and uninsured and presented with higher burden of comorbidities including diabetes, renal failure, prior amputations, and chronic limb-threatening ischemia compared with NHWs. Most Hispanics were admitted via the ED compared with NHWs (58.0% vs 36.7%; d = 0.48), and median length of stay was almost a day longer (4.5 days vs 3.7 days). Hispanic ethnicity was associated with lower odds of surgical (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.57-0.67) and endovascular revascularization (OR, 0.94; 95% CI, 0.89-0.996) and mortality (OR, 0.83; 95% CI, 0.75-0.93), but higher odds of minor (OR, 1.25; 95% CI, 1.20-1.31) and major (OR, 1.08; 95% CI, 1.03-1.14) amputation. CONCLUSIONS Two tiers of health care consumption for inpatient PAD care and outcomes manifested among Hispanics and NHWs. First, Hispanics with PAD had a more vulnerable socioeconomic profile and presented with more severe PAD than NHWs. Second, they sought care more disproportionately through the ED and underwent more amputations than NHWs. To eradicate these inequities in PAD care and risk, strategies that improve access to outpatient care and expand health care coverage, as well as targeted management of risk factors in these vulnerable minority groups are needed.
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Affiliation(s)
- Paulina Luna
- Yale University School of Medicine, New Haven, CT; Weill Cornell Medicine, New York, NY
| | | | - Yulanka Castro-Dominguez
- Yale University School of Medicine, New Haven, CT; Case Western Reserve University, Cleveland, OH
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Piero R, Papastratakos E, Castellanos DC, Crecelius AR. Sugar-sweetened beverage consumption and vascular function in Hispanic and non-Hispanic males. Nutr Health 2022:2601060221144130. [PMID: 36523263 DOI: 10.1177/02601060221144130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Introduction: Hispanic men have one of the highest consumptions of sugar-sweetened beverages in the United States. Frequent sugar-sweetened beverage consumption has been associated with higher incidence of cardiovascular disease through altered vascular function. Cardiovascular disease is the second leading cause of death in the Hispanic population. The purpose of this study is to assess the difference in vascular function between Hispanic men and non-Hispanic men and whether this difference is attributed to ethnic predisposition (i.e. ethnicity) or other risk factors, such as sugar-sweetened beverage consumption. Method: Reactive hyperemia forearm blood flow of 11 Hispanic males and 11 non-Hispanic males was measured via venous occlusion plethysmography. Interview-administered questionnaires gathered anthropometric, medical, dietary, and physical activity data for participants. Results: No significant differences were found in peak or total reactive hyperemia forearm blood flow between matched pairs (p = 0.924). Significant differences were also not observed in dietary factors, sugar-sweetened beverage consumption (p = 0.693), or physical activity (0.720). Conclusion: No statistical differences in body composition, dietary intake, physical activity, and vascular function were observed between Hispanic and non-Hispanic males. Environmental and lifestyle factors may play a larger role than ethnicity in the development of cardiovascular disease. Recruitment based on ethnicity alone yielded a population that was similar regarding SSB consumption and vascular function.
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Affiliation(s)
- Rachel Piero
- 2824Health and Sport Science, University of Dayton, Dayton, OH, USA
| | | | | | - Anne R Crecelius
- 2824Health and Sport Science, University of Dayton, Dayton, OH, USA
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Zuercher MD, Harvey DJ, Au LE, Shadyab AH, Nassir R, Robbins JA, Seldin MF, Garcia L. Genetic admixture and cardiovascular disease risk in postmenopausal Hispanic women. Int J Cardiol 2022; 367:99-104. [PMID: 35961613 PMCID: PMC10639166 DOI: 10.1016/j.ijcard.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hispanics are a heterogeneous population with differences in the prevalence of cardiovascular disease (CVD) and its related risk factors among ethnic sub-groups. This study evaluated the association of genetic admixture and CVD in self-identified Hispanic women from the Women's Health Initiative (WHI). METHODS Data came from the WHI Observational Study and the Clinical Trial Components conducted among postmenopausal women. The CVD outcomes included coronary heart disease (CHD) and stroke. The proportions of European (EUR), sub-Saharan African (AFR), and Amerindian (AMI) admixture were estimated using 92 ancestry-informative markers. Cox regression models were used to assess the relationship between genetic admixture and CVD adjusting for age, lifestyle risk factors, known risk factors, and neighborhood socioeconomic status. RESULTS Among 5195 participants EUR ancestry was associated with a lower CHD risk after adjusting for age (HR 0.41, p = 0.02), and in the fully adjusted model (HR 0.40, p = 0.03). AFR ancestry was associated with a higher CHD risk after adjusting for age (HR 2.91, p = 0.03), but it only showed a trend in in the fully adjusted model (HR 2.46, p = 0.10). AMI ancestry was not statistically significantly associated with CHD and none of the genetic admixture proportions were statistically significantly associated with stroke (p > 0.05). CONCLUSION EUR ancestry was associated with a lower risk of CHD in Hispanic women. This highlights the need to account for genetic admixture in future CVD studies to consider different heritage groups to understand the role that genetic, neighborhood socioeconomic status, and environmental factors contribute to CVD health disparities in Hispanic women.
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Affiliation(s)
| | | | - Lauren E Au
- University of California Davis, Davis, CA, United States
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Rami Nassir
- Department of Pathology, School of Medicine, Umm Al-Quraa University, Saudi Arabia
| | - John A Robbins
- University of California Davis, Davis, CA, United States
| | | | - Lorena Garcia
- University of California Davis, Davis, CA, United States.
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Khalafi S, Evans J, Lumbreras T, Tiula K, Helmsdoerfer K, Dwivedi AK, Dihowm F. Effects of statins on outcomes in Hispanic patients with COVID-19. J Investig Med 2022; 70:1697-1703. [PMID: 35973730 DOI: 10.1136/jim-2022-002487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/03/2022]
Abstract
The Hispanic population is regarded among those who are at greater risk of adverse prognoses due to higher rates of diabetes and obesity in the USA during the COVID-19 pandemic. Statin medications are speculated to help treat the infection by decreasing inflammation caused by COVID-19. In this retrospective, observational study, outcomes of statin use were assessed among Hispanic patients with COVID-19 by screening all patients hospitalized between March, 2020 and March, 2021 at a tertiary care hospital in El Paso, Texas, resulting in a total of 1039 patients. The patients were categorized into a group of either being on statins or not. The considered outcomes were mechanical ventilation, intensive care unit (ICU) hospitalization, oxygen supplementation at discharge, hospital length of stay, and mortality. Patients receiving statins were observed to be older with more comorbidities. In the propensity-scores adjusted analysis, no association was found between statin use and: mortality (adjusted risk ratio (aRR)=0.96, p=0.754), mechanical ventilation (aRR=0.91, p=0.503), ICU transfer (aRR=0.96, p=0.395), and O2 supplementation at discharge (aRR=1.03, p=0.729). These outcomes were also evaluated in patients who had myocardial infarction and stroke with COVID-19. Among these patients, association was found between statin use and: a reduced risk of mortality (aRR=0.61, p=0.005), mechanical ventilation (aRR=0.53, p=0.012) and ICU transfers (aRR=0.81, p=0.005). These results may not give us a reason to start patients on statins for the specific treatment of COVID-19, but it may be sufficient evidence to suggest statins should not be discontinued during hospitalization due to COVID-19.
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Affiliation(s)
- Seyed Khalafi
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Justin Evans
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Tyson Lumbreras
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Kira Tiula
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Kristen Helmsdoerfer
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Alok Kumar Dwivedi
- Department of Molecular and Transnational Medicine, Division of Biostatistics & Epidemiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Fatma Dihowm
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
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Chan ML, Eng CW, Gilsanz P, Whitmer RA, Mungas D, Meyer O, Farias ST. Prevalence of Instrumental Activities of Daily Living Difficulties and Associated Cognitive Predictors Across Racial/Ethnic Groups: Findings From the KHANDLE Study. J Gerontol B Psychol Sci Soc Sci 2022; 77:885-894. [PMID: 34486659 PMCID: PMC9071392 DOI: 10.1093/geronb/gbab163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Cognitive functioning is associated with instrumental activity of daily living (IADL) performance among older adults. The present study examines potential differences in the prevalence of IADL difficulty and association with cognition across diverse groups. METHOD Participants included 455 non-Hispanic Whites, 395 Blacks, 370 Asians, and 296 Latinos aged 65 years and older without a current dementia diagnosis from the Kaiser Healthy Aging and Diverse Life Experience cohort. Participants' self-reported IADL functioning and cognition was measured across episodic memory and executive functioning. RESULTS Older age, male gender, and being Black were associated with more IADL difficulties. Executive functioning showed a stronger association with IADLs than memory, and it was independent of health status, whereas memory was not. In joint models including both cognitive domains, executive functioning remained a significant predictor of IADL difficulty, but memory did not. Results for both cognitive domains were attenuated with self-rated health added to the joint model. These relationships did not significantly differ across racial/ethnic groups. CONCLUSIONS Our study supports previous work suggesting that Black older adults are at increased risk for IADL disability. This is the first study we are aware of that examined the association between specific cognitive domains and IADL performance across multiple racial/ethnic groups. Findings indicate that cognitive functioning has similar associations with self-reported IADL disability across diverse groups, and that executive functioning plays a particularly important role in IADL disability among older adults without dementia; however, health status largely attenuates the relationship between IADL difficulty and cognition.
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Affiliation(s)
- Michelle L Chan
- Department of Neurology, University of California, Davis, California, USA
| | - Chloe W Eng
- Department of Epidemiology and Translational Science, University of California, San Francisco, California, USA
| | - Paola Gilsanz
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Rachel A Whitmer
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Dan Mungas
- Department of Neurology, University of California, Davis, California, USA
| | - Oanh Meyer
- Department of Neurology, University of California, Davis, California, USA
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Vidal TM, Williams CA, Ramoutar UD, Haffizulla F. Type 2 Diabetes Mellitus in Latinx Populations in the United States: A Culturally Relevant Literature Review. Cureus 2022; 14:e23173. [PMID: 35444916 PMCID: PMC9009996 DOI: 10.7759/cureus.23173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) affects a large number of the American population. When compared to their representation in the general American population, a disproportionate number of Latinx individuals are affected. Within the Latinx American population, T2DM prevalence rates vary among individuals based on their country of origin. Deaths from T2DM among Latinx American population are also more compared to other ethnicities. This disparity underlines the importance of understanding the cultural considerations of T2DM disease presentation and management in Latinx communities, including risk factors, socioeconomic variables, and other social determinants of health such as access to care. There are various modifiable and non-modifiable risk factors for the development of T2DM, regardless of race. Staple foods in the diet of Latinx American communities, such as tortillas, rice, and beans, can cause spikes in blood sugar levels and can lead to obesity, which predisposes patients to develop T2DM. Latinx American populations suffer from lower access to healthcare than the general population due to many reasons, including language proficiency, immigration status, socioeconomic status, and level of acculturation. This study utilized the format of a commentary, while incorporating elements of a scoping review for data collection, to further explore these disparities and their impact on these populations. Understanding the cultural beliefs of Latinx individuals and how these beliefs contribute to the perceived development of T2DM is essential to properly treat these unique populations. Despite high rates of T2DM affecting Latinx individuals, non-adherence to prescribed diabetes medications is high among these populations. Interventions in the form of culturally tailored preventative education, in addition to active T2DM management, are necessary to combat the toll of this disease on Latinx Americans. Generic interventional techniques and methods should be replaced entirely by those that acknowledge, highlight, and utilize the sociocultural characteristics of Latinx Americans.
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Kazemi M, Kim JY, Wan C, Xiong JD, Parry SA, Azziz R, Lujan ME. Comprehensive evaluation of disparities in cardiometabolic and reproductive risk between Hispanic and White women with polycystic ovary syndrome in the United States: a systematic review and meta-analysis. Am J Obstet Gynecol 2022; 226:187-204.e15. [PMID: 34384776 DOI: 10.1016/j.ajog.2021.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to comprehensively compare cardiometabolic and reproductive health risk between Hispanic and White women with polycystic ovary syndrome in the United States in response to the call by the international guideline for polycystic ovary syndrome to delineate health disparities. DATA SOURCES Databases of MEDLINE, Web of Science, and Scopus were initially searched through October 25, 2020, and confirmed on February 1, 2021. STUDY ELIGIBILITY CRITERIA Observational studies comparing glucoregulatory, lipid profile, anthropometric, blood pressure, androgen, ovarian morphology, oligoanovulation, and infertility status between Hispanic and White women with polycystic ovary syndrome were included. The primary outcome was metabolic syndrome risk. Furthermore, major cardiovascular events (stroke, coronary heart disease, and heart failure) and mortality rate (cardiovascular death and total mortality) data were evaluated. Studies on adolescents (<2 years after menarche), pregnant, or menopausal-aged women (>50 years) were excluded. METHODS Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Risk of bias was assessed by the Newcastle-Ottawa Scale. RESULTS A total of 11 studies (n=2267; 589 Hispanic and 1678 White women) were eligible. All studies, including both White and Hispanic women, had high-quality assessment (Newcastle-Ottawa Scale score of ≥8). Hispanic women exhibited comparable metabolic syndrome prevalence (7% [95% confidence interval, -1 to 14]; P=.06; I2=0%); however, Hispanic women exhibited higher modified Ferriman-Gallwey score (0.60 [95% confidence interval, -0.01 to 1.21]; P=.05; I2=0%), fasting insulin (5.48 μIU/mL [95% confidence interval, 3.11-7.85]; P≤.01; I2=40.0%), and homeostatic model assessment of insulin resistance (1.20 [95% confidence interval, 0.50-1.89]; P≤.01; I2=43.0%) than White women. The 2 groups had comparable glucose, lipid profile, waist circumference, blood pressure, and androgen status (all P≥.08). Findings about group differences in certain reproductive outcomes (ie, ovarian dysmorphology and infertility) were contradictory and described only narratively as inclusion in the meta-analyses was not possible. No study reported on cardiovascular events or mortality. CONCLUSION Hispanic women with polycystic ovary syndrome exhibited greater impairments in glucoregulatory status than White women. Disparities in reproductive risks could not be concluded. The degree to which glucoregulatory aberrations translate into patient-pressing diseases (diabetes mellitus and infertility) remains a major roadblock given the paucity of available evidence. Our observations have supported the consideration of these disparities in the diagnostic, monitoring, and management practices for polycystic ovary syndrome and reinforced the need to elucidate mechanisms that account for the observed disparities to foster equity in polycystic ovary syndrome care.
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Affiliation(s)
- Maryam Kazemi
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Joy Y Kim
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Cynthia Wan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Julia D Xiong
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL; Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York, Albany, NY
| | - Marla E Lujan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY.
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“Prevalence of Abdominal Aortic Aneurysms in four different metropolitan areas in Mexico”. Ann Vasc Surg 2022; 84:218-224. [DOI: 10.1016/j.avsg.2021.12.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 11/20/2022]
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15
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Chen L, Zhang D, Shi L, Kalbaugh CA. Disparities in Peripheral Artery Disease Hospitalizations Identified Among Understudied Race-Ethnicity Groups. Front Cardiovasc Med 2021; 8:692236. [PMID: 34109228 PMCID: PMC8180581 DOI: 10.3389/fcvm.2021.692236] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background: To assess racial/ethnic differences in disease severity, hospital outcomes, length of stay and healthcare costs among hospitalized patients with peripheral artery disease (PAD). Methods: This study used data from the National Inpatient Sample (NIS) to explore the racial/ethnic disparities in PAD-related hospitalizations including presence of PAD with chronic limb threatened ischemia (CLI), amputation, in-hospital mortality, length of hospital stays and estimated medical costs. Race-ethnicity groups included non-Hispanic White, Black, Hispanic, Asian or Pacific Islander, Native American, and others (multiple races). Regression analyses adjusted for age, gender, Charlson Comorbidity Index, primary payer, patient location, bed size of the admission hospital, geographic region of the hospital, and rural/urban location of the hospital. Results: A total of 341,480 PAD hospitalizations were identified. Compared with non-Hispanic Whites, Native Americans had the highest odds of PAD with CLI (OR = 1.77, 95% CI: 1.61, 1.95); Black (OR = 1.71, 95% CI: 1.66, 1.76) and Hispanic (OR = 1.36, 95% CI: 1.31,1.41) patients had higher odds of amputation; Asian or Pacific Islanders had a higher mortality (OR = 1.20, 95% CI: 1.01,1.43), whereas Black (OR = 0.81, 95% CI: 0.76, 0.87) patients has a lower mortality; Asian or Pacific Islanders incurred higher overall inpatient costs (Margin = 30093.01, 95% CI: 28827.55, 31358.48) and most prolonged length of stay (IRR = 0.14, 95% CI: 0.09, 0.18). Conclusions: Our study identified elevated odds of amputation among Hispanic patients hospitalized with PAD as well as higher hospital mortality and medical expenses among Asian or Pacific Islander PAD inpatients. These two demographic groups were previously thought to have a lower risk for PAD and represent important populations for further investigation.
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Affiliation(s)
- LaiTe Chen
- Department of Cardiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Donglan Zhang
- Department of Health Policy and Management, University of Georgia, Athens, GA, United States
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Corey A Kalbaugh
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
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Haw JS, Shah M, Turbow S, Egeolu M, Umpierrez G. Diabetes Complications in Racial and Ethnic Minority Populations in the USA. Curr Diab Rep 2021; 21:2. [PMID: 33420878 PMCID: PMC7935471 DOI: 10.1007/s11892-020-01369-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Racial and ethnic minority populations have a higher burden of diabetes-related complications. There have been many epidemiologic studies to better define these racial/ethnic disparities in diabetes outcomes with additional studies offering interventions to mitigate them. This narrative review highlights the epidemiologic trends in diabetes complications specific to racial and ethnic minorities and underscores differences in microvascular and macrovascular complications of diabetes, health care utilization, and diabetes prevention efforts and also reviews interventions aimed to reduce racial/ethnic disparities and their limitations. RECENT FINDINGS While we have seen in general an overall improvement in complication rates for all people with diabetes, the disparities between Black and Hispanic compared to non-Hispanic White people with diabetes seem to persist. There is a continued need to better understand the underlying causes of and strategies to mitigate race/ethnicity disparities in diabetes complications in the USA.
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Affiliation(s)
- J Sonya Haw
- Division of Endocrinology, Metabolism & Lipids, School of Medicine, Emory University, 69 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA.
| | - Megha Shah
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, USA
| | - Sara Turbow
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, USA
- Division of General Internal Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | | | - Guillermo Umpierrez
- Division of Endocrinology, Metabolism & Lipids, School of Medicine, Emory University, 69 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA
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Ajrouch KJ, Vega IE, Antonucci TC, Tarraf W, Webster NJ, Zahodne LB. Partnering with Middle Eastern/Arab American and Latino Immigrant Communities to Increase Participation in Alzheimer's Disease Research. Ethn Dis 2020; 30:765-774. [PMID: 33250623 DOI: 10.18865/ed.30.s2.765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose Recruitment and retention of US ethnic groups traditionally underrepresented in research continues to pose challenges. The Michigan Center for Contextual Factors in Alzheimer's Disease (MCCFAD) engages with two underserved immigrant communities in Michigan - Middle Eastern/Arab Americans in metro-Detroit and Latinos in the Grand Rapids area - to recruit and retain two Participant Resource Pools (PRP). Procedures We adapt an existing community-based participatory research (CBPR) approach to recruit Middle Eastern/Arab American and Latino adults of all ages for Alzheimer's disease and related dementia (ADRD) research. Using American Community Survey (2014-2018) data, we compare socio-demographic characteristics of Middle Eastern/Arab Americans and Latinos living in Michigan to our PRPs. Assessment tools and community advisory board feedback identified missteps and culturally sensitive solutions. Main Findings In the first year of MCCFAD activities, 100 Middle Eastern/Arab Americans and 117 Latinos joined the MCCFAD PRPs. Comparisons to state-level data showed that PRP participants were on average older and more likely to be female than the Middle Eastern/Arab American and Latino populations in Michigan. Further, Middle Eastern/Arab Americans in the PRP reported higher education levels while Latinos reported lower education levels than their respective statewide populations. Community partnerships/feedback identified the importance of connecting with community leaders, attending to matters of within-group diversity, as well as language and semantics. Conclusion Partnership with communities to develop culturally targeted and sensitive community health events can fill a significant gap in addressing ADRD health disparities by establishing sustainable relationships to increase participation in ADRD research.
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Affiliation(s)
- Kristine J Ajrouch
- Department of Sociology, Anthropology, Criminology, Eastern Michigan University, Ypsilanti, MI
| | - Irving E Vega
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI
| | - Toni C Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Noah J Webster
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI
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Ponce de León-Ballesteros G, Sánchez-Aguilar HA, Velázquez-Fernández D, Nava-Ponce T, Herrera MF. Roux-en-Y Gastric Bypass in Patients >60 Years of Age: Morbidity and Short-Term Outcomes. Obes Surg 2020; 30:5033-5040. [PMID: 32902775 DOI: 10.1007/s11695-020-04957-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Obesity is a common disease in the elderly population, and bariatric surgery is the most effective intervention to achieve significant and sustainable weight loss. Many bariatric programs have established an arbitrary cutoff at the age of 60 to 65 years. The aim of this study was to evaluate the safety and short-term outcomes of Roux-en-Y gastric bypass (RYGB) in patients older than 60 years. PATIENTS AND METHODS We conducted a retrospective cohort study of patients who underwent RYGB from 2004 to 2019 in a single center. Logistic and linear multivariate regressions were made to compare complications and short-term outcomes between patients aged > 60 years and < 60 years. The statistical significance was set at p ≤ 0.05. RESULTS From 849 patients who underwent a primary RYGB, 57 were > 60 years of age. Overall, early and late complications were similar in both groups, except for unexpected intensive care unit (ICU) admission which was more frequent in the > 60 years group. Excess body weight loss (%EWL) and percentage total weight loss (%TWL) at 1 year in patients > 60 years old were 76.6 ± 21.8% and 30.73 ± 6.8%, respectively. Figures for the same parameters in the control group were 81.7 ± 19.9% (p = 0.09) and 34.3 ± 7.2 (p = 0.001), respectively. CONCLUSIONS In our experience, an age > 60 is not related to higher rates of overall early and late complications after RYGB. Comorbidity remission rates are similar to those in younger patients. Elderly patients had lower total weight loss at 1 year, but the %EWL was similar in both groups.
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Affiliation(s)
| | - Hugo A Sánchez-Aguilar
- Clinic for Nutrition and Obesity, ABC Medical Center, 116, Sur 136, Las Américas, Álvaro Obregón, 01120, Mexico City, Mexico
| | - David Velázquez-Fernández
- Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Tania Nava-Ponce
- Clinic for Nutrition and Obesity, ABC Medical Center, 116, Sur 136, Las Américas, Álvaro Obregón, 01120, Mexico City, Mexico
| | - Miguel F Herrera
- Clinic for Nutrition and Obesity, ABC Medical Center, 116, Sur 136, Las Américas, Álvaro Obregón, 01120, Mexico City, Mexico. .,Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Misialek JR, Van't Hof JR, Oldenburg NC, Jones C, Eder M, Luepker RV, Duval S. Aspirin Use and Awareness for Cardiovascular Disease Prevention Among Hispanics: Prevalence and Associations with Health Behavior Beliefs. J Community Health 2020; 45:820-827. [PMID: 32112236 PMCID: PMC7319883 DOI: 10.1007/s10900-020-00798-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cardiovascular disease (CVD) persists as the leading cause of death and disability in many Americans including Hispanics. Primary prevention for CVD may be achieved through regular aspirin use in high risk individuals. This study examined regular aspirin use and specific attitudes and social norms toward CVD and aspirin use within an urban Hispanic population in Minnesota. A sample of primary prevention Hispanics aged 45-79 years were surveyed about CVD history and risk factors, aspirin use, demographic characteristics, and health beliefs and social norms in relation to CVD and aspirin. Relative risk estimation using Poisson regression with robust error variance was used to examine associations with aspirin use. In this sample of 152 Hispanics (55% women), the mean age was 53 years, 70% had a regular healthcare provider, and 22% used aspirin. Aspirin discussions with a regular healthcare provider were strongly associated with aspirin use (adjusted risk ratio 3.02, 95% CI 1.20-7.60). There was a positive association between health beliefs and social norms that affirm preventive behaviors and aspirin use (adjusted linear risk ratio 1.23, 95% CI 1.04-1.45) while uncertainty about the role of aspirin for individual use and in the community was negatively associated with aspirin use (adjusted linear risk ratio 0.85, 95% CI 0.70-1.03). This growing population may benefit from health education about CVD risk and the role of aspirin in prevention.
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Affiliation(s)
- Jeffrey R Misialek
- Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Jeremy R Van't Hof
- Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA
| | - Niki C Oldenburg
- Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA
| | | | - Milton Eder
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, 55455, USA
| | - Russell V Luepker
- Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sue Duval
- Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA.
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Karnes JH, Wiener HW, Schwantes-An TH, Natarajan B, Sweatt AJ, Chaturvedi A, Arora A, Batai K, Nair V, Steiner HE, Giles JB, Yu J, Hosseini M, Pauciulo MW, Lutz KA, Coleman AW, Feldman J, Vanderpool R, Tang H, Garcia JGN, Yuan JXJ, Kittles R, de Jesus Perez V, Zamanian RT, Rischard F, Tiwari HK, Nichols WC, Benza RL, Desai AA. Genetic Admixture and Survival in Diverse Populations with Pulmonary Arterial Hypertension. Am J Respir Crit Care Med 2020; 201:1407-1415. [PMID: 31916850 PMCID: PMC7258627 DOI: 10.1164/rccm.201907-1447oc] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Rationale: Limited information is available on racial/ethnic differences in pulmonary arterial hypertension (PAH).Objectives: Determine effects of race/ethnicity and ancestry on mortality and disease outcomes in diverse patients with PAH.Methods: Patients with Group 1 PAH were included from two national registries with genome-wide data and two local cohorts, and further incorporated in a global meta-analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for transplant-free, all-cause mortality in Hispanic patients with non-Hispanic white (NHW) patients as the reference group. Odds ratios (ORs) for inpatient-specific mortality in patients with PAH were also calculated for race/ethnic groups from an additional National Inpatient Sample dataset not included in the meta-analysis.Measurements and Main Results: After covariate adjustment, self-reported Hispanic patients (n = 290) exhibited significantly reduced mortality versus NHW patients (n = 1,970) after global meta-analysis (HR, 0.60 [95% CI, 0.41-0.87]; P = 0.008). Although not significant, increasing Native American genetic ancestry appeared to account for part of the observed mortality benefit (HR, 0.48 [95% CI, 0.23-1.01]; P = 0.053) in the two national registries. Finally, in the National Inpatient Sample, an inpatient mortality benefit was also observed for Hispanic patients (n = 1,524) versus NHW patients (n = 8,829; OR, 0.65 [95% CI, 0.50-0.84]; P = 0.001). An inpatient mortality benefit was observed for Native American patients (n = 185; OR, 0.38 [95% CI, 0.15-0.93]; P = 0.034).Conclusions: This study demonstrates a reproducible survival benefit for Hispanic patients with Group 1 PAH in multiple clinical settings. Our results implicate contributions of genetic ancestry to differential survival in PAH.
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Affiliation(s)
| | - Howard W. Wiener
- Department of Biostatistics, University of Alabama–Birmingham, Birmingham, Alabama
| | | | - Balaji Natarajan
- Department of Cardiology, University of California Riverside School of Medicine, Riverside, California
| | - Andrew J. Sweatt
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University School of Medicine, Stanford, California,Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford, California
| | | | - Amit Arora
- Department of Epidemiology and Biostatistics
| | | | - Vineet Nair
- Department of Medicine, University of Arizona, Tucson, Arizona
| | | | | | - Jeffrey Yu
- Department of Pharmacy Practice and Science
| | - Maryam Hosseini
- Department of Medicine, University of Arizona, Tucson, Arizona
| | - Michael W. Pauciulo
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Katie A. Lutz
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Anna W. Coleman
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | - Haiyang Tang
- Department of Medicine, University of Arizona, Tucson, Arizona
| | | | - Jason X.-J. Yuan
- Department of Medicine, University of California–San Diego, La Jolla, California; and
| | - Rick Kittles
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Vinicio de Jesus Perez
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University School of Medicine, Stanford, California,Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford, California
| | - Roham T. Zamanian
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University School of Medicine, Stanford, California,Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford, California
| | - Franz Rischard
- Department of Medicine, University of Arizona, Tucson, Arizona
| | - Hemant K. Tiwari
- Department of Biostatistics, University of Alabama–Birmingham, Birmingham, Alabama
| | - William C. Nichols
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Ankit A. Desai
- Department of Medicine, Indiana University, Indianapolis, Indiana
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The Impact of Ethnicity on Cardiovascular Risk Reduction and Heart Age After Bariatric Surgery. Obes Surg 2020; 30:1679-1684. [DOI: 10.1007/s11695-019-04341-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ortega-Rodríguez AC, Marín-Jáuregui LS, Martínez-Shio E, Hernández Castro B, González-Amaro R, Escobedo-Uribe CD, Monsiváis-Urenda AE. Altered NK cell receptor repertoire and function of natural killer cells in patients with acute myocardial infarction: A three-month follow-up study. Immunobiology 2020; 225:151909. [PMID: 32051096 DOI: 10.1016/j.imbio.2020.151909] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/29/2020] [Indexed: 01/09/2023]
Abstract
NK cells are important in the onset of acute myocardial infarction (AMI) by their ability to secrete IFN-γ and other inflammatory cytokines. They also participate in regulating pathological cardiac remodeling after myocardial infarction. Mechanisms of regulation, however, are incompletely understood. Herein, the aim of this study is to explore the possible association between the expression pattern of different NK cell receptors (phenotype), as well as the cytotoxic function of NK cells from AMI patients with their myocardial function after three months follow-up. We analyzed the phenotype and function of both CD56dimCD16+ and CD56brightCD16- NK cells from twenty-one patients within the first 72 h after ST-elevation AMI and three-month follow-up, as well as fifteen healthy controls. Clinical characteristics and ventricular function determined by echocardiography were also evaluated. NK cells from AMI patients showed an activated phenotype, characterized by high TNF-α production and low percentages of the activating receptor NKG2D. Interestingly, AMI patients display higher levels of circulating IL-10+ NK cells. Three-month follow-up showed that NK cells exhibit a diminished cytotoxic function. These data show that NK cells may have a role mediating myocardial remodeling by regulating the inflammatory response, mainly by the production of IL-10. We also propose that NKG2D may have a role in the onset of the inflammatory response immediately after AMI. The precise regulation of NK cells function may represent an important step in recovery of myocardial function.
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Affiliation(s)
- Alma Celeste Ortega-Rodríguez
- Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico
| | - Laura Sherell Marín-Jáuregui
- Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico
| | - Elena Martínez-Shio
- Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico
| | - Berenice Hernández Castro
- Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico
| | - Roberto González-Amaro
- Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico
| | | | - Adriana E Monsiváis-Urenda
- Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico.
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Anaya-Ayala JE, Hernandez-Doño S, Escamilla-Tilch M, Marquez-Garcia J, Hernandez-Sotelo K, Lozano-Corona R, Ruiz-Gomez D, Granados J, Hinojosa CA. Genetic polymorphism of HLA-DRB1 alleles in Mexican mestizo patients with abdominal aortic aneurysms. BMC MEDICAL GENETICS 2019; 20:102. [PMID: 31174489 PMCID: PMC6555914 DOI: 10.1186/s12881-019-0833-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/23/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Multiple factors are implicated in the etiology and pathogenesis of Abdominal Aortic Aneurysms (AAA). Available literature of genetic studies has previously suggested the possible roles of autoimmunity, genetic predisposition and ethnic susceptibility. Due to the association with autoimmune diseases and proven application in population genetics, we aimed to investigate alleles of the Class II Human Leukocyte Antigens (HLA-DRB1) in the Mexican Mestizo population with aortic aneurysms and determine possible associations with susceptibility. METHODS We performed a case Control Study; the HLA molecular typing was completed for DRB1 loci by LabType Sequence-Specific Oligonucleotide (SSO) SSO-OneLambda kit (Applied Biosystems; Thermo Fisher Scientific. Inc.) in the studied individuals. Allele frequencies (af) were determined, associations were assessed by chi square or fisher exact tests at significance level (< 0.05), and Odds Ratios (OR) were calculated using the STATA software version 14. RESULTS The genetic polymorphism of HLA-DRB1 of fifty one patients (70% males with a mean age of 71 years) with atherosclerotic or also known as degenerative AAA were compared with 99 unrelated patients (60% males, mean age 65 years) without the disease [Control group (CG)] from the same ethnic group. We examined a total of 102 Class II HLA-DRB1 alleles of AAA patients and 198 from CG. When comparing af, we observed the HLA-DRB1*01 af of 0.139 in the AAA compared to 0.05 in the CG [p = 0.015, OR 3, 95% confidence interval (CI) 1.29-7.08], the HLA-DRB1*16 af were 0.109 in the AAA and 0.025 in CG (p = 0.006, OR 4.7, 95% CI 1.59-13.98). CONCLUSIONS Our study confirmed increased frequencies of the alleles HLA-DRB1*01 and HLA-DRB1*16 and their association to the development of AAA in Mexican Mestizo patients. The utility of genetic testing may assist in identifying individuals at genetic risk for the development of this disease in different ethnic groups, who might benefit from earlier ultrasound screening and closer imaging surveillance.
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Affiliation(s)
- Javier E Anaya-Ayala
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Vasco De Quiroga 15, Tlalpan, Sección XVI, 14080, México City, Mexico
- Universidad Nacional Autonoma de Mexico, Faculty of Medicine, Division for Postgraduate Studies, Master and Doctoral Degree Program, Mexico City, Mexico
| | - Susana Hernandez-Doño
- Department of Transplant Surgery, Division of Immunogenetics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | | | - Jose Marquez-Garcia
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Biochemistry Unit, Mexico City, Mexico
| | - Kemberly Hernandez-Sotelo
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Vasco De Quiroga 15, Tlalpan, Sección XVI, 14080, México City, Mexico
| | - Rodrigo Lozano-Corona
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Vasco De Quiroga 15, Tlalpan, Sección XVI, 14080, México City, Mexico
- Universidad Nacional Autonoma de Mexico, Faculty of Medicine, Division for Postgraduate Studies, Master and Doctoral Degree Program, Mexico City, Mexico
| | - Daniela Ruiz-Gomez
- Department of Transplant Surgery, Division of Immunogenetics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Julio Granados
- Universidad Nacional Autonoma de Mexico, Faculty of Medicine, Division for Postgraduate Studies, Master and Doctoral Degree Program, Mexico City, Mexico
- Department of Transplant Surgery, Division of Immunogenetics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Carlos A Hinojosa
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Vasco De Quiroga 15, Tlalpan, Sección XVI, 14080, México City, Mexico.
- Universidad Nacional Autonoma de Mexico, Faculty of Medicine, Division for Postgraduate Studies, Master and Doctoral Degree Program, Mexico City, Mexico.
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Vilches-Moure JG. Embryonic Chicken ( Gallus gallus domesticus) as a Model of Cardiac Biology and Development. Comp Med 2019; 69:184-203. [PMID: 31182184 PMCID: PMC6591676 DOI: 10.30802/aalas-cm-18-000061] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/06/2018] [Accepted: 11/29/2018] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease remains one of the top contributors to morbidity and mortality in the United States. Increasing evidence suggests that many processes, pathways, and programs observed during development and organogenesis are recapitulated in adults in the face of disease. Therefore, a heightened understanding of cardiac development and organogenesis will help increase our understanding of developmental defects and cardiovascular diseases in adults. Chicks have long served as a model system in which to study developmental problems. Detailed descriptions of morphogenesis, low cost, accessibility, ease of manipulation, and the optimization of genetic engineering techniques have made chicks a robust model for studying development and make it a powerful platform for cardiovascular research. This review summarizes the cardiac developmental milestones of embryonic chickens, practical considerations when working with chicken embryos, and techniques available for use in chicks (including tissue chimeras, genetic manipulations, and live imaging). In addition, this article highlights examples that accentuate the utility of the embryonic chicken as model system in which to study cardiac development, particularly epicardial development, and that underscore the importance of how studying development informs our understanding of disease.
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Affiliation(s)
- José G Vilches-Moure
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California,
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Perera MJ, Reina SA, Elfassy T, Potter JE, Sotres Alvarez D, Simon MA, Isasi CR, Stuebe AM, Schneiderman N, Llabre MM. Gestational diabetes and cardiovascular risk factors and disease in U.S. Hispanics/Latinas in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Women Health 2018; 59:481-495. [PMID: 30040600 DOI: 10.1080/03630242.2018.1500415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To compare cardiovascular risk and disease prevalence in U.S. Hispanics/Latinas with and without a history of gestational diabetes mellitus (GDM). Cross-sectional data from 2008 to 2011 were analyzed for 8,262 (305 with GDM history) parous women, aged 20-73 years, from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Women with and without a history of GDM were compared on sociodemographic, cardiovascular risk factor, and disease data from standardized interviews and fasting blood tests, using chi-square tests, t-tests, and logistic regressions to determine odds ratios (ORs) and 95 percent confidence intervals (CIs). Adjusting for covariates, compared to those without a history of GDM, women with a history of GDM were younger (M = 39.1 years [95 percent CI = 37.8, 41.6] vs. 45.5 years [95 percent CI = 44.9, 46.1]) and more likely to have health insurance (68.1 percent [95 percent CI = 60.3 percent, 76.0 percent] vs. 54.9 percent [95 percent CI = 52.8 percent, 57.1 percent]), had greater waist circumference (M = 102.3 cm, [95 percent CI = 100.2, 104.3] vs. 98.1 cm [95 percent CI = 97.4, 98.5]) and higher fasting glucose (116.0 mg/dL [95 percent CI = 107.8, 124.3] vs. 104.2 mg/dL [95 percent CI = 103.4, 105.1]), and had higher odds of having metabolic syndrome (OR = 1.7 [95 percent CI = 1.2, 2.6]) or diabetes (OR = 3.3 [95 percent CI = 2.2, 4.8]). Prevalences of heart and cerebrovascular disease were similar. GDM history was positively associated with diabetes but not with cardiovascular disease.
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Affiliation(s)
- Marisa J Perera
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| | - Samantha A Reina
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| | - Tali Elfassy
- b Miller School of Medicine , University of Miami , Coral Gables , Florida , USA
| | - JoNell E Potter
- b Miller School of Medicine , University of Miami , Coral Gables , Florida , USA
| | - Daniela Sotres Alvarez
- c Department of Biostatistics , University of North Carolina , Chapel Hill , North Carolina , USA
| | - Melissa A Simon
- d Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA
| | - Carmen R Isasi
- e Department of Epidemiology & Population Health , Albert Einstein College of Medicine , Bronx , New York , USA
| | - Alison M Stuebe
- f Department of Obstetrics & Gynecology , University of North Carolina , Chapel Hill , North Carolina , USA
| | - Neil Schneiderman
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| | - Maria M Llabre
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
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Yang SA. Lack of association between glutathione s-transferase mu 1 ( GSTM1) gene polymorphisms and obesity. J Exerc Rehabil 2017; 13:608-612. [PMID: 29114537 PMCID: PMC5667609 DOI: 10.12965/jer.1735128.564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 10/12/2017] [Indexed: 01/24/2023] Open
Abstract
Recent researches suggested that personal individual’s genetic background is contributed to the susceptibility to obesity. The present of this study is to investigate whether single nucleotide polymorphisms (SNPs) of glutathione s-transferase mu 1 (GSTM1) gene are susceptibility to obesity in Korean population. In present study, two SNPs (rs1056806 [Asp142Asp], rs3815029 [promoter]) of GSTM1 gene were genotyped in 117 overweight/obese subjects with a body mass index (BMI)≥23 kg/m2 and 125 nonoverweight/obese with a BMI of 18.5–23.0 kg/m2. Genotyping of two SNPs (rs1056806 and rs3815029) was determined by sequencing after polymerase chain reaction. Logistic regression models (codominant, dominant, recessive, and log-additive models) and allele analysis were used to calculate odds ratio, 95% confidence interval, and P-values. Significant association was considered at P<0.05. Tested two SNPs in GSTM1 genes did not show any significant association with obesity (rs1056806, P=0.24 in codominant 1 model; rs3815029, P=0.59 in codominant 1, P=0.09 in codominant 2, P=0.16 in dominant, P=0.09 in recessive, and P=0.07 in log-additive models). In summary, these results indicate that SNPs of GSTM1 gene did not associated with susceptibility of obesity in the Korean population.
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Affiliation(s)
- Seung-Ae Yang
- College of Nursing, Sungshin Women's University, Seoul, Korea
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