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Zhu K, Walsh JP, Hunter M, Murray K, Hui J, Hung J. Longitudinal associations of DXA-measured visceral adipose tissue and cardiometabolic risk in middle-to-older aged adults. Nutr Metab Cardiovasc Dis 2024; 34:2519-2527. [PMID: 39098379 DOI: 10.1016/j.numecd.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/06/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND AND AIMS DXA-measured visceral adipose tissue (VATDXA) is associated with adverse cardiometabolic risk profiles in cross-sectional studies, but longitudinal associations have not been investigated. We examined the longitudinal associations of baseline and change in VATDXA with future cardiometabolic risk in Australian participants of the Busselton Healthy Ageing study. METHODS AND RESULTS We studied 3569 participants (54.7% female, aged 46-70 years) with data on VATDXA (GE Lunar Prodigy) and cardiometabolic risk factors at baseline and 6 years follow-up. The associations were examined using logistic and linear regression models, adjusting for baseline age and lifestyle factors. Mean baseline VATDXA mass was 1653 ± 880 g and 855 ± 580 g, and mean change in VATDXA +99 ± 500 g and +58 ± 312 g in males and females, respectively. Among all participants, 182 males (11.3%) and 197 females (10.1%) developed incident metabolic syndrome (MetS). Baseline VATDXA was associated with incident MetS with an adjusted odds ratio of 2.53 (95% CI: 2.03, 3.15) in males and 2.78 (2.30, 3.36) in females per SD increment. There was a graded positive association between longitudinal change in VATDXA and MetS severity z score in both sexes adjusted for baseline VAT (P < 0.001). All the above associations remained significant after further adjustment for baseline or change in BMI, waist circumference or waist-to-hip ratio in respective models (all P < 0.001). CONCLUSIONS Higher baseline and greater longitudinal increase in VATDXA are independently associated with raised cardiometabolic risk over time, and may serve as useful markers for identifying middle-aged individuals at increased cardiometabolic risk.
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Affiliation(s)
- Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, University of Western Australia, Perth, Australia.
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Perth, Australia; Busselton Population Medical Research Institute, Busselton, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Jennie Hui
- School of Population and Global Health, University of Western Australia, Perth, Australia; Busselton Population Medical Research Institute, Busselton, Australia; Department of Diagnostic Genomics, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Australia
| | - Joseph Hung
- Medical School, University of Western Australia, Perth, Australia
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Maitland SB, Brauer P, Mutch DM, Royall D, Klein D, Tremblay A, Rheaume C, Jeejeebhoy K. Exploratory analysis of the variable response to an intensive lifestyle change program for metabolic syndrome. BMC PRIMARY CARE 2024; 25:357. [PMID: 39354341 PMCID: PMC11443702 DOI: 10.1186/s12875-024-02608-w] [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: 10/29/2023] [Accepted: 09/23/2024] [Indexed: 10/03/2024]
Abstract
BACKGROUND Substantial variability in response to lifestyle interventions has been recognized for many years, and researchers have begun to disentangle sources of error from inherent differences in individual responsiveness. The objective of this secondary analysis of an intensive lifestyle intervention (diet and exercise) for metabolic syndrome (MetS) was to identify potentially important differences among study completers grouped by treatment response as measured by change in a continuous metabolic syndrome score (Gurka/MetS). METHODS All study completers from a 12-month primary care study were categorized into one of five groups according to change in the Gurka/MetS score. A change of 0.4 in z-score defined clinically relevant change in line with results of previous studies. Repeated measures analysis of variance was used to examine cardiovascular disease risk and individual clinical indicators of MetS over 12 months, looking for differences in response over time by the five groups. RESULTS Of 176 participants, 50% (n = 88) had stable scores, 10% (n = 18) had relevant change scores in the first 3 months only and reverted toward baseline, 20% (n = 35) achieved meaningful change over the whole study, 11% (n = 20) had a delayed response at 3-12 months, and 9% (n = 15) demonstrated worsening scores. Significant differential patterns were noted for groups over the duration of the intervention (p < .001). Improvement in diet quality and fitness scores were similar across all groups. Other available variables were tested and did not account for the differences. CONCLUSION Work is needed to identify key factors that account for differences in responses to lifestyle interventions that can be used to guide treatment decisions for intensive lifestyle interventions for this common condition. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01616563; first registered June 12, 2012.
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Affiliation(s)
- Scott B Maitland
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, ON, N1G 2W1, Canada
| | - Paula Brauer
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, ON, N1G 2W1, Canada.
| | - David M Mutch
- Department of Human and Health Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Dawna Royall
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, ON, N1G 2W1, Canada
| | - Doug Klein
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Centre de recherche Nutrition, Santé et Société (NUTRISS), INAF, Quebec City, QC, Canada
| | - Caroline Rheaume
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Khursheed Jeejeebhoy
- Departments of Nutritional Sciences and Physiology, University of Toronto, Toronto, ON, Canada
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Costa-Santos C, Mattar GGCD, Fuziwara RA, de Araújo Peres JA, Queiroz MS. Screen Time and Hours of Sleep Influence the Estimate Risk of Diabetes Mellitus and Metabolic Syndrome in Healthy Young Males. Metab Syndr Relat Disord 2024; 22:626-635. [PMID: 38848280 DOI: 10.1089/met.2024.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Objective: Screen time (ST) has shown negative effects on physical and mental health, with an increase in the prevalence of overweight, metabolic syndrome (MetS), and obesity. The time spent in front of the screens was also associated with higher odds of selecting indicators of cardiometabolic disease in adulthood. In view of this, the aim of this study was to identify the risk of MetS and type 2 diabetes mellitus (T2DM) in healthy young males and relate it to ST and sleep time. Methods: We evaluated physical and laboratory characteristics, dichotomous diagnosis criteria, and continuous scores to assess MetS and Finnish Diabetes Risk Score questionnaire to measure the T2DM risk. Results: The means of MetS dichotomous and continuous severity criteria, among individuals with <7 hr of sleep, were higher than those with adequate sleep. We did not observe a direct impact of ST on the risk of MetS; nevertheless, >8 hr of ST increased 1.22 points in the T2DM risk. Conclusion: Excessive ST increased the risk of T2DM, but not of MetS. Moreover, sleeping <7 hr was associated with a higher mean of dichotomous and continuous severity criteria for MetS.
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Affiliation(s)
- Carolina Costa-Santos
- Programa de Pós-Graduação em Medicina, Universidade Nove de Julho (UNINOVE), Rua Vergueiro, São Paulo, Brazil
- Hospital de Força Aérea de São Paulo, São Paulo, Brazil
| | | | | | - Jorge Alexandre de Araújo Peres
- Programa de Pós-Graduação em Medicina, Universidade Nove de Julho (UNINOVE), Rua Vergueiro, São Paulo, Brazil
- Hospital de Força Aérea de São Paulo, São Paulo, Brazil
| | - Márcia Silva Queiroz
- Programa de Pós-Graduação em Medicina, Universidade Nove de Julho (UNINOVE), Rua Vergueiro, São Paulo, Brazil
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Wu PW, Chin YT, Lin WT, Tsai S, Lee CY, Tsai WC, Seal DW, Lee CH. Fructose intake, endogenous biomarkers and latent metabolic construct in adolescents: Exploring path associations and mediating effects. Pediatr Obes 2024:e13176. [PMID: 39340256 DOI: 10.1111/ijpo.13176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 07/08/2024] [Accepted: 08/21/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Uric acid (UA) and homeostatic model assessment of insulin resistance (HOMA-IR) are endogenous biomarkers implicated in metabolic disorders and dysfunction. OBJECTIVES To investigate the structural associations between sugar-sweetened beverage intake (SSB), UA, HOMA-IR and adolescent latent MetS construct (MetsC) representing paediatric metabolic syndrome (MetS). METHODS A population-based representative adolescent cohort (n = 1454) was evaluated for risk profiles of MetS. Structural equation modelling was performed to identify multifactor structural associations between study parameters and evaluate mediating effects. RESULTS Adolescents had a single-factor latent construct representing MetS. Increased SSB intake was associated with higher UA and HOMA-IR levels, and the two biomarkers were positively associated with the MetsC score. UA and HOMA-IR exerted three mediating effects on the association between fructose-rich tea beverage (FTB) intake of >500 mL/day and MetsC: adjusted standardized coefficient and mediating effect (%), FTB → UA → MetsC: 0.071, 23.1%; FTB → HOMA-IR → MetsC: 0.034, 11.0%; FTB → UA → HOMA-IR → MetsC: 0.010, 3.1%. The UA-associated pathways accounted for 31.1% of the overall mediation on the association between bottled sugar-containing beverage intake and MetsC. After accounting for the UA- and HOMA-IR-derived detrimental effects, the fructose-rich tea beverage intake of >500 mL/day had a tea-related beneficial effect on MetsC, with an adjusted standardized coefficient of -0.103. CONCLUSIONS UA and HOMA-IR individually and jointly mediate the adverse effects of high fructose-rich SSB intake on the mechanisms underlying paediatric MetS. Fructose-free tea-based beverages may have a beneficial effect on latent MetS structure in adolescents.
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Affiliation(s)
- Pei-Wen Wu
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ting Chin
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Ting Lin
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Sharon Tsai
- Department of Laboratory Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chun-Ying Lee
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chung Tsai
- Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - David W Seal
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Chien-Hung Lee
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Amouzegar A, Honarvar M, Masoumi S, Agahi S, Azizi F, Mehran L. Independent association of metabolic syndrome severity score and risk of diabetes: findings from 18 years of follow-up in the Tehran Lipid and Glucose Study. BMJ Open 2024; 14:e078701. [PMID: 39260837 PMCID: PMC11409262 DOI: 10.1136/bmjopen-2023-078701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the association between age-specific and sex-specific continuous metabolic syndrome severity score (cMetS-S) and the risk of developing type 2 diabetes mellitus (T2DM). Additionally, the study aimed to assess the added value of cMetS-S in predicting T2DM compared with traditional MetS criteria. DESIGN The study used a longitudinal cohort design, following participants for 18 years. SETTING The research was conducted within the Tehran Lipid and Glucose Study, a community-based study in Tehran, Iran. PARTICIPANTS A total of 6957 participants aged 20-60 years were included in the study. INTERVENTIONS/EXPOSURES The cMetS-S of each participant was determined using age-specific and sex-specific equations and Cox proportional hazard regression models were used to analyse the association between cMetS-S and T2DM using continuous and quantile approaches. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome measure was the association between cMetS-S and the development of T2DM during the 18-year follow-up. RESULTS A total of 1124 T2DM cases were recorded over 18 years of follow-up. In the fully adjusted model, a 1-SD increase in the cMetS-S was associated with future T2DM (HR 1.72; 95% CI 1.54 to 1.91). Men and women had HRs of 1.65 (95% CI 1.40 to 1.95) and 1.83 (95% CI 1.59 to 2.10) for T2DM per 1-SD increase in cMetS-S, respectively. Higher cMetS-S was associated with increased risk of diabetes in both prediabetic (HR 1.42;95% CI 1.23 to 1.64) and normoglycaemic individuals (HR 2.11;95% CI 1.76 to 2.54); this association was more significant in normoglycaemic individuals. Unlike the traditional-based MetS definitions, the cMetS-S improved diabetes prediction (p<0.001). CONCLUSIONS The cMetS-S is strongly associated with future diabetes in prediabetic and normoglycaemic individuals independent of MetS components during a long term. As the relationship between cMetS-S and T2DM is more pronounced in normoglycaemic individuals than in those with pre-diabetes, implementing the evaluation of cMetS-S can serve as an early identification tool for individuals at risk of T2DM prior to the onset of pre-diabetes.
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Affiliation(s)
- Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohmmadjavad Honarvar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safdar Masoumi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadaf Agahi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ladan Mehran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Höchsmann C, Dorling JL, Lavie CJ, Katzmarzyk PT. Healthy Lifestyle and Cardiac Rehabilitation for Weight Loss. Curr Cardiol Rep 2024:10.1007/s11886-024-02130-6. [PMID: 39230618 DOI: 10.1007/s11886-024-02130-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE OF REVIEW Considerable current interest is directed at pharmacological agents for producing significant weight loss. However, healthy lifestyle choices can also lead to clinically meaningful weight loss and improvements in cardiovascular disease (CVD) risk factors. RECENT FINDINGS In this review, we summarize the recent research from our PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) randomized controlled trial and review previous data on the potential benefits of cardiac rehabilitation and exercise training (CRET) programs to produce weight loss and improvements in CVD risk factors. Although obesity medications are becoming extremely attractive for secondary and even primary CVD prevention, high-intensity non-pharmacological therapies with healthy lifestyle choices reviewed herein can also lead to substantial health improvements in patients with obesity, including improvements in body weight and other body composition parameters as well as overall CVD risk.
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Affiliation(s)
- Christoph Höchsmann
- Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, 80809, Munich, Germany.
| | - James L Dorling
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA
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Kaze AD, Bertoni AG, Fox ER, Hall ME, Mentz RJ, Echouffo-Tcheugui JB. Metabolic dysfunction and incidence of heart failure subtypes among Black individuals: The Jackson Heart Study. Eur J Heart Fail 2024. [PMID: 39225160 DOI: 10.1002/ejhf.3447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/12/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
AIMS The extent to which metabolic syndrome (MetS) severity influences subclinical myocardial remodelling, heart failure (HF) incidence and subtypes, remains unclear. We assessed the association of MetS with incident HF (including ejection fraction subtypes) among Black individuals. METHODS AND RESULTS We included 4069 Jackson Heart Study participants (mean age 54.4 years, 63.8% women, 37.2% with MetS) without HF. We categorized participants based on MetS status and MetS severity scores (based on waist circumference [MetS-Z-WC] and body mass index [MetS-Z-BMI]). We assessed the associations of MetS indices with echocardiographic parameters, biomarkers of myocardial damage (high-sensitivity cardiac troponin I [hs-cTnI] and B-type natriuretic peptide [BNP]) and incident HF hospitalizations including HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). MetS severity was associated with subclinical cardiac remodelling (assessed by echocardiographic measures and biomarkers of myocardial damage). Over a median of 12 years, 319 participants developed HF (157 HFpEF, 149 HFrEF and 13 HF of unknown type). MetS was associated with a twofold greater risk of HF (hazard ratio [HR] 2.07, 95% confidence interval [CI] 1.64-2.61). Compared to the lowest quartile (Q1) of MetS-Z-WC, the highest quartile (Q4) conferred a higher risk of HF (HR 2.35, 95% CI 1.67-3.30), with a stronger association for HFpEF (Q4 vs. Q1: HR 4.94, 95% CI 2.67-9.14) vs. HFrEF (HR 1.69, 95% CI 1.06-2.70). CONCLUSIONS Metabolic syndrome severity was associated with both HF subtypes among Black individuals, highlighting the importance of optimal metabolic health for preventing HF.
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Affiliation(s)
- Arnaud D Kaze
- Department of Medicine, Division of Cardiology, Banner-University Medical Center Phoenix, The University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ervin R Fox
- Department of Medicine, Division of Cardiology, University of Mississippi Medical Center Jackson, Jackson, MS, USA
| | - Michael E Hall
- Department of Medicine, Division of Cardiology, University of Mississippi Medical Center Jackson, Jackson, MS, USA
| | - Robert J Mentz
- Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Justin B Echouffo-Tcheugui
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Welch Prevention Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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Brown RCC, Coombes JS, Conley MM, Webb L, Mayr HL, Isbel NM, Jegatheesan DK, Macdonald GA, Burton NW, Kelly JT, Hickman IJ, Keating SE. Evaluating the Potential of a Novel Metabolic Syndrome Severity Score to Inform Exercise Interventions for People with Complex Chronic Conditions. Metab Syndr Relat Disord 2024; 22:516-524. [PMID: 38801006 DOI: 10.1089/met.2024.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Aims: Exercise interventions positively affect numerous cardiometabolic risk factors. To better evaluate the health effects of exercise training, it may be more appropriate to evaluate risk factors together. The Metabolic Syndrome Severity Score (MetSSS) is a composite score representing cardiometabolic risk. Purpose: To evaluate the relationships between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS in a heterogenous sample of people with complex chronic disease. Material and Methods: Fifty-three people with kidney or liver disease and at least one feature of the metabolic syndrome (MetS) were included. Pearson correlations were conducted between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS. Linear regressions were performed for multi-level categorical variables. Independent variables with an association with MetSSS (P ≤ 0.2) were included in a multiple regression analysis. Results: The 6-minute walk test (6MWT) distance was inversely and independently associated with MetSSS [standardized beta coefficient (β) = -0.31, P = 0.04]. No relationship was found between MetSSS and physical activity or neuromuscular fitness. Mean 6MWT in the highest tertile was 550 m (range: 505-620 m) and 346 m (range: 233-408 m) in the lowest. The analysis showed a medium-large between-group effect for the difference in MetSSS for the lowest and highest tertile of 6MWT [Eta squared (η2) = 0.16, P = 0.01]. Conclusions: Exercise capacity was inversely and independently associated with MetSSS in people with complex chronic disease. Clinical trials with exercise interventions are needed to further investigate if improvements in exercise capacity result in clinically significant changes in the MetSSS.
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Affiliation(s)
- Riley C C Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Centre for Research on Exercise, Physical Activity & Health, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Centre for Research on Exercise, Physical Activity & Health, The University of Queensland, Brisbane, Australia
| | - Marguerite M Conley
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Lindsey Webb
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Hannah L Mayr
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Nicole M Isbel
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Dev K Jegatheesan
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Graeme A Macdonald
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Ingrid J Hickman
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Centre for Research on Exercise, Physical Activity & Health, The University of Queensland, Brisbane, Australia
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Medina Inojosa BJ, Somers VK, Lara-Breitinger K, Johnson LA, Medina-Inojosa JR, Lopez-Jimenez F. Prediction of presence and severity of metabolic syndrome using regional body volumes measured by a multisensor white-light 3D scanner and validation using a mobile technology. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2024; 5:582-590. [PMID: 39318693 PMCID: PMC11417481 DOI: 10.1093/ehjdh/ztae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/17/2024] [Accepted: 06/25/2024] [Indexed: 09/26/2024]
Abstract
Aims To test whether an index based on the combination of demographics and body volumes obtained with a multisensor 3D body volume (3D-BV) scanner and biplane imaging using a mobile application (myBVI®) will reliably predict the severity and presence of metabolic syndrome (MS). Methods and results We enrolled 1280 consecutive subjects who completed study protocol measurements, including 3D-BV and myBVI®. Body volumes and demographics were screened using the least absolute shrinkage and selection operator to select features associated with an MS severity score and prevalence. We randomly selected 80% of the subjects to train the models, and performance was assessed in 20% of the remaining observations and externally validated on 133 volunteers who prospectively underwent myBVI® measurements. The mean ± SD age was 43.7 ± 12.2 years, 63.7% were women, body mass index (BMI) was 28.2 ± 6.2 kg/m2, and 30.2% had MS and an MS severity z-score of -0.2 ± 0.9. Features β coefficients equal to zero were removed from the model, and 14 were included in the final model and used to calculate the body volume index (BVI), demonstrating an area under the receiving operating curve (AUC) of 0.83 in the validation set. The myBVI® cohort had a mean age of 33 ± 10.3 years, 61% of whom were women, 10.5% MS, an average MS severity z-score of -0.8, and an AUC of 0.88. Conclusion The described BVI model was associated with an increased severity and prevalence of MS compared with BMI and waist-to-hip ratio. Validation of the BVI had excellent performance when using myBVI®. This model could serve as a powerful screening tool for identifying MS.
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Affiliation(s)
- Betsy J Medina Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Virend K Somers
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Kyla Lara-Breitinger
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Dan Abraham Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Lynne A Johnson
- Dan Abraham Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Dan Abraham Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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10
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Zeng P, Li M, Cao J, Zeng L, Jiang C, Lin F. Association of metabolic syndrome severity with frailty progression among Chinese middle and old-aged adults: a longitudinal study. Cardiovasc Diabetol 2024; 23:302. [PMID: 39152431 PMCID: PMC11329990 DOI: 10.1186/s12933-024-02379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/25/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND The binary diagnosis of Metabolic Syndrome(MetS) fails to accurately evaluate its severity, and the association between MetS severity and frailty progression remains inadequately elucidated. This study aims to clarify the relationship between the severity of MetS and the progression of frailty among the middle-aged and elderly population in China. METHOD Participants from the 2011-2018 China Health and Retirement Longitudinal Study(CHARLS) were included for a longitudinal analysis. The study employs a frailty index(FI) based on 32 health deficits to diagnose frailty and to assess FI trajectories. An age-sex-ethnicity-specific MetS scoring model (MetS score) was used to assess metabolic syndrome severity in Chinese adults. The Cumulative MetS score from 2012 to 2015 was calculated using the formula: (MetS score in wave 1 + MetS score in wave 3) / 2 × time(2015 - 2012). The association between MetS score, Cumulative MetS score, and the risk and trajectory of frailty were evaluated using Cox regression/logistic regression, and linear mixed models. Restricted Cubic Splines(RCS) models were utilized to detect potential non-linear associations. RESULTS A higher MetS score was significantly associated with an increased risk of frailty(HR per 1 SD increase = 1.205; 95%CI: 1.14 to 1.273) and an accelerated FI trajectory(β per 1 SD increase = 0.113 per year; 95%CI: 0.075 to 0.15 per year). Evaluating changes in MetS score using a Cumulative MetS score indicated that each 1 SD increase in the Cumulative MetS score increased the risk of frailty by 22.2%(OR = 1.222; 95%CI: 1.133 to 1.319) and accelerated the rate of increase in FI(β = 0.098 per year; 95%CI: 0.058 to 0.138 per year). RCS model results demonstrated a dose-response curve relationship between MetS score and Cumulative MetS score with frailty risk. Stratified analysis showed consistency across subgroups. The interaction results indicate that in males and individuals under aged 60, MetS score may accelerate the increase in FI, a finding consistent across both models. CONCLUSIONS Our findings underscore the positive correlation between the severity of MetS and frailty progression in the middle-aged and elderly, highlighting the urgent need for early identification of MetS and targeted interventions to reduce the risk of frailty.
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Affiliation(s)
- Peng Zeng
- Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
- Department of Geriatrics, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China
| | - Minjie Li
- Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
- The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xi'an, 712000, China
| | - JiXing Cao
- Department of Ophthalmology, Shenzhen People's Hospital & Second Affiliated Hospital of Jinan University, 518020, Shenzhen, China
| | - Long Zeng
- Department of Cardiology, Shangrao People's Hospital, Shangrao, 334000, Jiangxi, China
| | - Cheng Jiang
- Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
- Department of Geriatrics, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China.
| | - Feng Lin
- Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
- Department of Geriatrics, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China.
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11
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García-Villegas EA, Vargas-de-León C, Villa-Romero AR, Ibarra Valdovinos I, Márquez-González H. [Study of the metabolic syndrome severity index as a predictive factor of a major cardiovascular event in premenopausal women with systemic lupus erythematosus]. Med Clin (Barc) 2024; 163:62-69. [PMID: 38697892 DOI: 10.1016/j.medcli.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Patients with systemic lupus erythematosus (SLE) have an increased risk of metabolic syndrome (MS) and cardiovascular (CV) disease. MS is evaluated binary, limiting the understanding of each component's severity individually. Therefore, severity scores for MS that evaluate them separately have been developed. This study aims to determine the prognosis between MS severity and the occurrence of major adverse cardiovascular events (MACE) in SLE patients. METHODS Ten-year follow-up cohort study. Premenopausal>18-year-old women with a previous diagnosis of SLE were included. Patients with recent CV events, pregnancy, thyroid disease, and liposuction were excluded. The variables of interest were CV events; the confounding variables, and the MS severity indexes were examined. Hazard ratios and Kaplan-Meier survival curves were estimated through Cox regression. RESULTS A total of 238 women were analyzed: 22 presented MACE, and 216 did not. MS prevalence, measured according to consensus and ATP-III criteria, was higher in MACE patients (50 and 40,95%, respectively). The MetSx-IMC severity index was higher within the MACE group. Cox analysis showed an increase in the MetSx-IMC associated with the risk of suffering MACE in a 1.107 ratio. CONCLUSIONS The MetSx-IMC severity index, contrary to the binary approaches, is recommended to evaluate MS as a predictor of MACE in SLE patients. Offering improved and more accurate prognosis in patients at risk of developing MCE.
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Affiliation(s)
- Elsy Aidé García-Villegas
- Departamento de Vigilancia Epidemiológica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Cruz Vargas-de-León
- División de Investigación, Hospital Juárez de México, Ciudad de México, México; Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México
| | | | - Itzelly Ibarra Valdovinos
- Departamento de Vigilancia Epidemiológica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Horacio Márquez-González
- Investigación Clínica, Hospital Infantil de México Federico Gómez, Ciudad de México, México; Departamento de Cardiopatías Congénitas, Hospital de Cardiología Centro Médico Nacional Siglo XXI, Ciudad de México, México.
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12
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Graybeal AJ, Brandner CF, Wise HL, Henderson A, Aultman RS, Vallecillo-Bustos A, Newsome TQA, Stanfield D, Stavres J. Near-infrared reactance spectroscopy-derived visceral adipose tissue for the assessment of metabolic syndrome in a multi-ethnic sample of young adults. Am J Hum Biol 2024:e24141. [PMID: 39034709 DOI: 10.1002/ajhb.24141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVES Visceral adipose tissue (VAT) is highly associated with metabolic syndrome (MetS), which is rapidly increasing in young adults. However, accessible VAT measurement methods are limited, restricting the use of VAT in early detection. This cross-sectional study sought to determine if near-infrared reactance spectroscopy (NIRS)-derived VAT (VATNIRS) was associated with MetS in a multi-ethnic sample of young adults. METHODS A total of 107 male and female (F:62, M:45) participants (age: 23.0 ± 4.3y; BMI: 27.1 ± 6.6 kg/m2) completed measurements of fasting blood pressure, blood glucose (FBG), blood lipids, and anthropometric assessments including waist circumference and VATNIRS. MetS severity (MetSindex) was calculated from the aforementioned risk factors using sex and race-specific equations. RESULTS VATNIRS was higher in participants with, and at risk for, MetS compared to those with lower risks (all p < .001). VATNIRS was positively associated with MetSindex for all groups (all p < .001). VATNIRS showed positive associations with systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP), LDL-C and LDL-C-related biomarkers, and FBG; and negative associations with HDL-C and HDL-C-to-total cholesterol ratio (all p < .050). Associations between VATNIRS and blood pressure for females, and LDL-C and LDL-C-related biomarkers for males, were nonsignificant (all p > .050). VATNIRS was positively associated with DBP in African-American participants, and SBP in White participants, resulting in positive associations with MAP for both groups (all p < .050). CONCLUSIONS VATNIRS is associated with MetS and individual MetS risks factors in a multi-ethnic sample of young adults; providing a noninvasive, cost-effective, portable, and accessible method that may assist in the early detection of MetS and other cardiometabolic abnormalities.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Caleb F Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Havens L Wise
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Ryan S Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | | | - Ta' Quoris A Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
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13
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Hashemi L, Marijic Buljubasic A, Budoff MJ, Copeland LA, Jackson NJ, Jasuja GK, Gornbein J, Reue K. Gender-Affirming Hormone Treatment and Metabolic Syndrome Among Transgender Veterans. JAMA Netw Open 2024; 7:e2419696. [PMID: 38954413 PMCID: PMC11220566 DOI: 10.1001/jamanetworkopen.2024.19696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/30/2024] [Indexed: 07/04/2024] Open
Abstract
Importance Gender-affirming hormone treatment (GAHT) is a common therapy for transgender individuals to reduce gender dysphoria and improve quality of life. Clarifying the long-term effects of GAHT remains a priority in transgender health research. Objective To explore whether sex hormones (estradiol and testosterone) are associated with the development of metabolic syndrome in transgender veterans compared with cisgender veterans. Design, Setting, and Participants This retrospective, longitudinal cohort study used International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes for gender dysphoria from the Veterans Health Administration national database to identify transfeminine and transmasculine veterans receiving documented feminizing (estradiol) or masculinizing (testosterone) treatment from January 1, 2006, to December 31, 2019, and for whom the GAHT initiation date and metabolic syndrome component-related data were available. Transgender veterans were matched to cisgender referents. Exposure Gender-affirming hormone treatment. Main Outcomes and Measures Metabolic syndrome z-scores were calculated based on body mass index, systolic blood pressure, and levels of high-density lipoprotein cholesterol, triglycerides, and blood glucose. Changes in mean z-scores were compared among the transgender and cisgender groups before and after the index date (corresponding to GAHT initiation) using a repeated-measures analysis of variance model. Results The cohort included 1290 participants: 645 transgender (494 [38.3%] transfeminine, 151 [11.7%] transmasculine) and 645 cisgender (280 [21.7%] female, 365 [28.3%] male). Mean (SD) age at the index date was 41.3 (13.2) years. Metabolic syndrome z-scores changed significantly over time and differed significantly across groups. Overall, transmasculine veterans had the greatest percentage increase in mean (SEM) z-scores after vs before the index date (298.0% [57.0%]; P < .001), followed by cisgender females (108.3% [27.5%]; P < .001), cisgender males (49.3% [27.5%]; P = .02), and transfeminine persons (3.0% [10.7%]; P = .77). Conclusions and Relevance In this cohort study, in both cisgender and transgender veterans, estradiol was associated with reduced metabolic syndrome risk, whereas testosterone was associated with increased risk. However, transmasculine individuals had the greatest risk and transfeminine individuals had the lowest risk of metabolic syndrome associated with these hormones. This is relevant for the management of metabolic syndrome risk factors in cisgender and transgender individuals and to potentially predict the risk of atherosclerotic cardiovascular disease, type 2 diabetes, systolic hypertension, insulin resistance, and nonalcoholic fatty liver disease.
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Affiliation(s)
- Leila Hashemi
- VA Greater Los Angeles Health Care System, Department of General Internal Medicine, David Geffen School of Medicine, Los Angeles, California
| | | | - Matthew J. Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, California
| | | | - Nicholas J. Jackson
- Statistics Core, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Guneet K. Jasuja
- Center for Healthcare Organization & Implementation Research, US Department of Veterans Affairs, VA Bedford Health Care System, Bedford, Massachusetts
- Section of General Internal Medicine, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts
- Department of Health Law, Policy and Management, School of Public Health, Boston University, Boston, Massachusetts
| | - Jeffery Gornbein
- Statistics Core, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Karen Reue
- Human Genetics, David Geffen School of Medicine, University of California, Los Angeles
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14
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Franke WD, Lefferts EC, Lefferts WK, Keren N, Flynn MH, Lutrick LD, Hinkhouse JJ, Ramey SL, Lang JA. Law Enforcement Officers Have an Increased Prevalence of Subclinical Cardiovascular Disease That Is Not Explained by Traditional Risk Factors. J Occup Environ Med 2024; 66:590-596. [PMID: 38626785 DOI: 10.1097/jom.0000000000003119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
OBJECTIVES The aim of the study is to determine if law enforcement officers develop subclinical atherosclerotic cardiovascular disease (ASCVD) earlier than nonofficers and, if so, the extent to which conventional risk factors explain this difference. Methods: Estimated pulse wave velocity (ePWV) was the marker of subclinical ASCVD. EPWV, ASCVD risk factors, metabolic syndrome (MetS), and 10-year risk for ASCVD were compared among 408 law enforcement officers and a civilian cohort. Results: EPWV, 10-year ASCVD risk, and MetS prevalence increased significantly with age. All but the officers age 55 and older had higher ePWV cohort than the civilian cohort ( P < 0.001). Ten-year ASCVD risk explained the most variability of ePWV ( R2 = 0.49, P < 0.001). Conclusions: Officers develop subclinical ASCVD earlier than nonofficers. Conventional ASCVD risk factors only explain about half of this increase. Occupational factors may play a role in contributing to this increased ASCVD risk.
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Affiliation(s)
- Warren D Franke
- From the Department of Kinesiology, Iowa State University, Ames, Iowa (W.D.F., E.C.L., W.K.L., M.H.F., L.L., J.J.H., J.A.L.); Department of Agriculture & Biosystems Engineering, Iowa State University, Ames, Iowa (N.K.); Black Men Teach, Hopkins, Minnesota (M.H.F.); College of Osteopathic Medicine, Des Moines University, Des Moines, Iowa (L.L.); and College of Nursing, University of Iowa, Iowa City, Iowa (S.L.R.)
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15
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Wang M, Wang C, Zhao M, Wu S, Xue H, Liu H. BMI-based metabolic syndrome severity score and arterial stiffness in a cohort Chinese study. Nutr Metab Cardiovasc Dis 2024; 34:1761-1768. [PMID: 38555245 DOI: 10.1016/j.numecd.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND AIMS To investigate the relationship between metabolic syndrome severity z score(MetS-Z) and arterial stiffness(AS). METHODS AND RESULTS A total of 7621 participants who took three physical examination and brachial-ankle pulse wave velocity(ba-pwv) test from 2006 were enrolled. Cumulative MetS-Z(cMetS-Z) was calculated by using blood pressure, triglycerides, HDL cholesterol, blood glucose and BMI. AS was assessed by ba-pwv. Cox regression model was used to evaluate the risk of AS. All participants were divided into four groups according to cMetS-Z(Q1-Q4). The average age of the participants was 43.06 ± 8.91 years old. During a median follow-up of 6.27 years, 1831cases of AS were identified. The incident rate of AS increased gradually from group Q1 to Q4. Compared with the lowest cMetS-Z(group Q1), the adjusted hazard ratio (HR) and 95% confidence interval (CI) of group Q2-Q4 for AS were 1.27 (1.09-1.47),1.28(1.10-1.48) and 1.45 (1.24-1.69) respectively. The cubic spline model indicated cMetS-Z had a liner relationship with AS and the cut-off value was lower than zero. Sub-group analysis suggested cMetS-Z was related to AS especially among participants who were younger and without obesity or hypertension or diabetes. CONCLUSION Higher cMetS-Z was associated with an increased risk of AS in this cohort community study, and this relationship seemed to be stronger among normal healthy subjects. REGISTRATION NUMBER ChiCTR-TNC-11001489. CLINICAL TRIAL January 1st 2006, ChiCTR-TNC-11001489 and 2011.
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Affiliation(s)
- Miao Wang
- The School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin 300071, China; Department of Cardiology, Chinese People's Liberation Army General Hospital, No.28 Fuxing Road, Beijing 100853, China
| | - Chi Wang
- Department of Cardiology, Chinese People's Liberation Army General Hospital, No.28 Fuxing Road, Beijing 100853, China
| | - Maoxiang Zhao
- Department of Cardiology, Chinese People's Liberation Army General Hospital, No.28 Fuxing Road, Beijing 100853, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan 063001, China
| | - Hao Xue
- The School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin 300071, China; Department of Cardiology, Chinese People's Liberation Army General Hospital, No.28 Fuxing Road, Beijing 100853, China.
| | - Hongbin Liu
- The School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin 300071, China; Department of Cardiology, Chinese People's Liberation Army General Hospital, No.28 Fuxing Road, Beijing 100853, China.
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16
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Graybeal AJ, Compton AT, Swafford SH, Brandner CF, Thorsen T, Renna ME, Stavres J. Measurements of Abdominal Obesity are Associated with Metabolic Syndrome Severity Independent of Hypertensive Phenotype in White but not Black Young Adults. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02051-8. [PMID: 38902464 DOI: 10.1007/s40615-024-02051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE This study sought to determine if metabolic syndrome severity (MetSindex) was differentially associated with abdominal obesity based on waist circumference (WC) site and the presentation of hypertensive phenotypes in a group of young White and Black adults. METHODS A total of 139 young adult (22.5 ± 3.3 years) non-Hispanic White (n = 73) and non-Hispanic Black (n = 66) males and females (M 53, 86 F) completed this cross-sectional evaluation. Participants had their WC measured at three distinct locations along the abdomen which were used to calculate waist-to-hip and waist-to-height ratios. Systolic (SBP) and diastolic blood pressure (DBP) were collected and used to calculate mean arterial pressure (MAP). In addition to traditional metabolic syndrome (MetS) risk factors, BP values were individually used to produce three separate MetSindex scores representing three specific hypertensive phenotypes (MetSSBP, MetSDBP, MetSMAP), and each of these were evaluated against each abdominal obesity estimate. RESULTS MetSDBP and MetSSBP were significantly higher than all other indices for females (all p ≤ 0.002) and males (all p < 0.001), respectively. MetSDBP was significantly higher than MetSMAP for White females (p = 0.039), and MetSSBP was significantly higher than MetSDBP and MetSMAP (both p < 0.001) for Black males. Standalone and joint estimates of abdominal obesity were uniquely associated with MetSindex across hypertensive phenotypes for White, but not Black males and females. CONCLUSIONS Specific hypertensive phenotypes may differentially determine MetSindex, but these estimates are not associated with abdominal obesity in young Black adults regardless of measurement location. Healthcare professionals should address this disparity by providing more comprehensive MetS screening procedures for young Black adults. CLINICAL TRIALS REGISTRATION NCT05885672.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Abby T Compton
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Sydney H Swafford
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Caleb F Brandner
- Department of Kinesiology and Health, Iowa State University, Ames, IA, 50011, USA
| | - Tanner Thorsen
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Megan E Renna
- School of Psychology, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
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17
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Gómez-Ambrosi J, Catalán V, Ramírez B, Salmón-Gómez L, Marugán-Pinos R, Rodríguez A, Becerril S, Aguas-Ayesa M, Yárnoz-Esquíroz P, Olazarán L, Perdomo CM, Silva C, Escalada J, Frühbeck G. Cardiometabolic risk stratification using a novel obesity phenotyping system based on body adiposity and waist circumference. Eur J Intern Med 2024; 124:54-60. [PMID: 38453570 DOI: 10.1016/j.ejim.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The estimation of obesity-associated cardiometabolic risk does not usually take into account body composition or the distribution of adiposity. The aim of the present study was to assess the clinical usefulness of a novel obesity phenotyping system based on the combination of actual body fat percentage (BF%) and waist circumference (WC) according to the cardiometabolic risk estimation. METHODS A classification matrix combining BF% and WC as measures of both amount and distribution of adiposity establishing nine body phenotypes (3 BF% x 3 WC) was developed. Individuals were grouped in five different cardiometabolic risk phenotypes. We conducted a validation study in a large cohort of White subjects from both genders representing a wide range of ages and adiposity (n = 12,754; 65 % females, aged 18-88 years). RESULTS The five risk groups using the matrix combination of BF% and WC exhibited a robust linear distribution regarding cardiometabolic risk, estimated by the Metabolic Syndrome Severity Score, showing a continuous increase between groups with significant differences (P < 0.001) among them, as well as in other cardiometabolic risk factors. An additional 24 % of patients at very high risk was detected with the new classification system proposed (P < 0.001) as compared to an equivalent matrix using BMI and WC instead of BF% and WC. CONCLUSIONS A more detailed phenotyping should be a priority in the diagnosis and management of patients with obesity. Our classification system allows to gradually estimate the cardiometabolic risk according to BF% and WC, thus representing a novel and useful tool for both research and clinical practice.
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Affiliation(s)
- Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain.
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Beatriz Ramírez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Laura Salmón-Gómez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
| | - Rocío Marugán-Pinos
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
| | - Amaia Rodríguez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Sara Becerril
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Maite Aguas-Ayesa
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Patricia Yárnoz-Esquíroz
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Laura Olazarán
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Carolina M Perdomo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Camilo Silva
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Escalada
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain; Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
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Sbraccia P. Obesity phenotyping at the "heart" of risk stratification. Eur J Intern Med 2024; 124:42-43. [PMID: 38614817 DOI: 10.1016/j.ejim.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Affiliation(s)
- Paolo Sbraccia
- Department of Systems Medicine, University of Rome Tor Vergata, Italy; Unit of Internal Medicine - Obesity Center, Policlinico Tor Vergata, Rome, Italy.
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Kim HJ, Kim BS, Lee Y, Ahn SB, Kim DW, Shin JH. Harnessing Metabolic Indices as a Predictive Tool for Cardiovascular Disease in a Korean Population without Known Major Cardiovascular Event. Diabetes Metab J 2024; 48:449-462. [PMID: 38310879 PMCID: PMC11140393 DOI: 10.4093/dmj.2023.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/18/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGRUOUND This study evaluated the usefulness of indices for metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR), as predictive tools for cardiovascular disease in middle-aged Korean adults. METHODS The prospective data obtained from the Ansan-Ansung cohort database, excluding patients with major adverse cardiac and cerebrovascular events (MACCE). The primary outcome was the incidence of MACCE during the follow-up period. RESULTS A total of 9,337 patients were included in the analysis, of whom 1,130 (12.1%) experienced MACCE during a median follow-up period of 15.5 years. The metabolic syndrome severity Z-score, metabolic syndrome severity score, hepatic steatosis index, and NAFLD liver fat score were found to significantly predict MACCE at values above the cut-off point and in the second and third tertiles. Among these indices, the hazard ratios of the metabolic syndrome severity score and metabolic syndrome severity Z-score were the highest after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) of the 10-year atherosclerotic cardiovascular disease (ASCVD) score for predicting MACCE was 0.716, and the metabolic syndrome severity Z-score had an AUC of 0.619. CONCLUSION The metabolic syndrome severity score is a highly reliable indicator and was closely associated with the 10-year ASCVD risk score in predicting MACCE in the general population. Given the specific characteristics and limitations of metabolic syndrome severity scores as well as the indices of NAFLD and IR, a more practical scoring system that considers these factors is essential to achieve greater accuracy in forecasting cardiovascular outcomes.
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Affiliation(s)
- Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Byung Sik Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Yonggu Lee
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Dong Wook Kim
- Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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20
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Lin JJ, Dai PY, Zhang J, Guan YQ, Gong WW, Yu M, Fang L, Hu RY, He QF, Li N, Wang LX, Liang MB, Zhong JM. Association between metabolic syndrome severity score and cardiovascular disease: results from a longitudinal cohort study on Chinese adults. Front Endocrinol (Lausanne) 2024; 15:1341546. [PMID: 38654930 PMCID: PMC11036864 DOI: 10.3389/fendo.2024.1341546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Objective This study aimed to quantify the severity of metabolic syndrome(MetS) and investigate its association with cardiovascular disease(CVD) risk on Chinese adults. Methods 13,500 participants from the Zhejiang Adult Chronic Disease Study were followed up between 2010 and 2021. A continuous MetS severity score derived from the five components of MetS was used to quantify MetS severity, and the association between MetS severity and the risk of incident CVD was assessed using Cox proportional hazard and restricted cubic spline regression. Results Both the presence and severity of MetS were strongly associated with CVD risk. MetS was related to an increased risk of CVD (hazard ratio(HR):1.700, 95% confidence interval(CI): 1.380-2.094). Compared with the hazard ratio for CVD in the lowest quartile of the MetS severity score, that in the second, third, and highest quartiles were 1.812 (1.329-2.470), 1.746 (1.265-2.410), and 2.817 (2.015-3.938), respectively. A linear and positive dose-response relationship was observed between the MetS severity and CVD risk (P for non-linearity = 0.437). Similar results were found in various sensitivity analyses. Conclusion The MetS severity score was significantly associated with CVD risk. Assessing MetS severity and further ensuring intervention measures according to the different severities of MetS may be more useful in preventing CVD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Jie-ming Zhong
- Department of Chronic and Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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21
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Moorehead NR, Goodie JL, Krantz DS. Prospective bidirectional relations between depression and metabolic health: 30-year follow-up from the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) study. Health Psychol 2024; 43:259-268. [PMID: 38095973 PMCID: PMC10939906 DOI: 10.1037/hea0001339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
OBJECTIVE This study investigated prospective bidirectional relationships between depressive symptoms and metabolic syndrome (MetS) and the moderating effects of race, sex, and health behaviors in a diverse cohort followed for 30 years. METHOD Data were analyzed from the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) study, a 30-year prospective study of young adults (N = 5,113; Mage = 24.76 [SD = 3.63] at baseline; 45% male) who were tested every 5 years between 1985 and 2015. Measures included biological assessments of MetS components and self-reported depressive symptoms based on the Center for Epidemiologic Studies Depression (CESD) scale. Data analyses included bidirectional general estimating equations analyses of time-lagged associations between depressive symptoms and MetS. RESULTS There was a consistent, bidirectional relationship between depressive symptoms and MetS over time. Individuals with more CESD depressive symptoms were more likely to develop MetS over time compared to those reporting fewer symptoms, Wald χ²(1) = 7.09, p < .008, and MetS was similarly predictive of CESD. MetS more consistently predicted CESD scores at each 5-year exam than CESD predicted MetS. Race and sex moderated these relationships, with White females, White individuals overall, and females overall demonstrating significant relationships between CESD depressive symptoms and MetS. Health behaviors were not related to associations between CESD and MetS. CONCLUSION In a diverse young adult population prospectively followed into late middle age, MetS more consistently predicted depressive symptoms over time than depressive symptoms predicted MetS. The relation between MetS and depressive symptoms was moderated by race and sex, but not health behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Nicholas R. Moorehead
- 354 Operational Medical Readiness Group, Eielson Air Force Base, Alaska, U.S. Air Force
- Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Jeffrey L. Goodie
- Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
- Department of Family Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - David S. Krantz
- Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
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Wu M, Zhu Z, Wan R, Xu J. Exposure to per- and polyfluoroalkyl substance and metabolic syndrome: A nationally representative cross-sectional study from NHANES, 2003-2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123615. [PMID: 38402937 DOI: 10.1016/j.envpol.2024.123615] [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: 10/13/2023] [Revised: 12/23/2023] [Accepted: 02/18/2024] [Indexed: 02/27/2024]
Abstract
Per- and polyfluoroalkyl substances(PFAS) are widespread organic pollutants with endocrine-disrupting effects on human health, but the association of PFAS exposure with metabolic syndrome remains conflicting. National Health and Nutrition Examination Survey(NHANES) program was utilized to evaluate the association of individual PFAS exposure and metabolic disorders and further determined the joint effect of PFAS co-exposures. 13921 participants and five PFAS exposures(PFHxS, MPAH, PFDE, PFNA, and PFUA) were included for analysis. The association between individual PFAS and metabolic syndrome varied in the specific PFAS and the specific metabolic disorder examined. PFHxS was negatively associated with obesity(Q4; OR = 0.75; P < 0.001), but positively associated with hyperlipidemia (Q3; OR = 1.2; P = 0.013). PFUA was negatively associated with obesity (Q4; OR = 0.6; P < 0.001), hyperlipidemia (Q3; OR = 0.85; P = 0.03), and non-alcoholic fatty liver disease (NAFLD, Q4; OR = 0.64; P = 0.015), but positively associated with hyperglycemia(Q3; OR = 1.27; P = 0.004). Furthermore, PFAS co-exposures were negatively associated with obesity(OR = 0.63; P < 0.001) and NAFLD(OR = 0.85; P = 0.021), and positively associated with hyperlipidemia(OR = 1.05; P = 0.022), but not significantly associated with hyperglycemia or hypertension. Overall, there was a negative association between PFAS co-exposures and metabolic severity score(β = -0.15; P < 0.001). Subgroup analysis stratified by gender and obesity consistently showed the negative association of PFAS co-exposures with metabolic severity score, and the positive association with hyperlipidemia. However, subgroup analysis showed a negative association with NAFLD in females but not in males, and a negative association with hyperglycemia in the obesity group, but not in the non-obesity group. Collectively, our study showed a negative association of PFAS co-exposures with metabolic syndrome severity score, but did not support a consistent association between PFAS co-exposures and individual components of metabolic syndrome. Additionally, there were gender-specific as well as BMI-specific differences in these associations. Further studies are needed to rule out the reverse causality and clarify the relationship of PFAS co-exposures with the specific metabolic disorder.
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Affiliation(s)
- Maolan Wu
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA
| | - Rongjun Wan
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiangyue Xu
- Department of Thyroid Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Balvers M, de Goffau M, van Riel N, van den Born BJ, Galenkamp H, Zwinderman K, Nieuwdorp M, Levin E. Ethnic variations in metabolic syndrome components and their associations with the gut microbiota: the HELIUS study. Genome Med 2024; 16:41. [PMID: 38509598 PMCID: PMC10953122 DOI: 10.1186/s13073-024-01295-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/22/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The occurrence of metabolic syndrome (MetS) and the gut microbiota composition are known to differ across ethnicities yet how these three factors are interwoven is unknown. Also, it is unknown what the relative contribution of the gut microbiota composition is to each MetS component and whether this differs between ethnicities. We therefore determined the occurrence of MetS and its components in the multi-ethnic HELIUS cohort and tested the overall and ethnic-specific associations with the gut microbiota composition. METHODS We included 16,209 treatment naïve participants of the HELIUS study, which were of Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Turkish, and Moroccan descent to analyze MetS and its components across ethnicities. In a subset (n = 3443), the gut microbiota composition (16S) was associated with MetS outcomes using linear and logistic regression models. RESULTS A differential, often sex-dependent, prevalence of MetS components and their combinations were observed across ethnicities. Increased blood pressure was commonly seen especially in Ghanaians, while South-Asian Surinamese and Turkish had higher MetS rates in general and were characterized by worse lipid-related measures. Regarding the gut microbiota, when ethnic-independent associations were assumed, a higher α-diversity, higher abundance of several ASVs (mostly for waist and triglyceride-related outcomes) and a trophic network of ASVs of Ruminococcaceae, Christensenellaceae, and Methanobrevibacter (RCM) bacteria were associated with better MetS outcomes. Statistically significant ethnic-specific associations were however noticed for α-diversity and the RCM trophic network. Associations were significant in the Dutch but not always in all other ethnicities. In Ghanaians, a higher α-diversity and RCM network abundance showed an aberrant positive association with high blood pressure measures compared to the other ethnicities. Even though adjustment for socioeconomic status-, lifestyle-, and diet-related variables often attenuated the effect size and/or the statistical significance of the ethnic-specific associations, an overall similar pattern across outcomes and ethnicities remained. CONCLUSIONS The occurrence of MetS characteristics among ethnicities is heterogeneous. Both ethnic-independent and ethnic-specific associations were identified between the gut microbiota and MetS outcomes. Across multiple ethnicities, a one-size-fits-all approach may thus be reconsidered in regard to both the definition and/or treatment of MetS and its relation to the gut microbiota.
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Affiliation(s)
- Manon Balvers
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Marcus de Goffau
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- HORAIZON Technology BV, Marshallaan 2, Delft, 2625 GZ, The Netherlands
| | - Natal van Riel
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Bert-Jan van den Born
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Koos Zwinderman
- Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Centers, Amsterdam, 1105 AZ, The Netherlands
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Evgeni Levin
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
- HORAIZON Technology BV, Marshallaan 2, Delft, 2625 GZ, The Netherlands.
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Elsaid MI, Bridges JFP, Mumtaz K, Li N, Sobotka L, Rustgi VK, Paskett ED. The impact of metabolic syndrome severity on racial and ethnic disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease. PLoS One 2024; 19:e0299836. [PMID: 38489287 PMCID: PMC10942082 DOI: 10.1371/journal.pone.0299836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/15/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND & AIMS Previous studies have examined the effects of metabolic syndrome (MetS) rather than its severity on race and ethnic disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). We used the MetS severity score, a validated sex-race-ethnicity-specific severity measure, to examine the effects of race/ethnicity on the association between MetS severity and MASLD. METHODS This study included 10,605 adult participants from the Third National Health and Nutrition Examination Survey. The MASLD diagnosis was based on ultrasound findings in patients without excessive alcohol intake or other liver diseases. MetS severity Z-scores were calculated and stratified into four categories low (1st-50th), moderate (>50th-75th), high (>75th-90th), and very high (>90th+)]. Multivariable adjusted logistic regression models with complex survey methods were used to test the effect of MetS severity on MASLD. RESULTS The age-adjusted MASLD prevalence was 17.4%, 25.7%, 42.5, and 54.9% in adults with mild, moderate, high, and very high MetS severities, respectively (P-trend <0.001). MetS severity was significantly higher in patients with MASLD than in those without [mean percentile 60th vs. 44th, P<0.001]. Among patients with MASLD, Mexican-American and Black non-Hispanic females had significantly higher age-adjusted MetS severity (68th and 61st, respectively) than White non-Hispanic females 54th, while Black non-Hispanic males had significantly lower MetS severity (56th) than White non-Hispanic males (70th) (P-Interaction = 0.02). Adults with high and very high MetS severity had 2.27 (95% CI:1.70 to 3.03) and 3.12 (95% CI:2.20 to 4.42), respectively, higher adjusted odds of MASLD than those with mild MetS severity. CONCLUSIONS Racial/ethnic disparities in MetS severity play a pivotal role in the risk of MASLD. Our findings highlight the potential clinical utility of the MetS severity score in identifying at-risk individuals, which will help guide targeted prevention and tailoring management strategies to mitigate the MASLD burden.
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Affiliation(s)
- Mohamed I. Elsaid
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - John F. P. Bridges
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Khalid Mumtaz
- Division of Gastroenterology, Hepatology, & Nutrition, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Na Li
- Division of Gastroenterology, Hepatology, & Nutrition, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Lindsay Sobotka
- Division of Gastroenterology, Hepatology, & Nutrition, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Vinod K. Rustgi
- Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
- Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Electra D. Paskett
- Division of Population Sciences, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
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Thorsen T, Oliveira N, Graybeal A, Stavres J. Exploring gait velocity as a predictor of cardiometabolic disease risk in young adults. Front Sports Act Living 2024; 6:1365717. [PMID: 38516535 PMCID: PMC10955704 DOI: 10.3389/fspor.2024.1365717] [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: 01/04/2024] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
Background The association between poor gait and functional movement ability and metabolic syndrome (MetS) has been well established in older adults. A continuous cardiometabolic risk score, MetSindex, may more easily identify individuals at risk for cardiometabolic disease who do not yet meet the stringent criteria for a formal MetS diagnosis. Although the association between MetS and gait velocity is well established in older adults, no such relationship has been identified in younger adults; a group experiencing a rapid increase in the development of MetS. Methods MetSindex was determined for 21 young adults using standard procedures. Gait velocity was measured as participants completed a ten-meter walk test. Spatiotemporal parameters of gait were also derived using a motion capture system. Simple linear regression was used to determine the relationship between MetSindex and gait velocity, as well as MetSindex and spatiotemporal parameters of gait. Results There was a large inverse relationship between MetSindex and gait velocity. A large inverse relationship was also observed between MetSindex and cadence, and a large positive relationship was observed between stance time and double limb support time. Conclusions Gait velocity slows in young adults who do not necessarily meet the criterion for positive diagnosis of MetS-but demonstrate an increased risk for MetS and cardiovascular disease through higher MetSindex scores. The mechanism underlying reduced gait velocity may be fewer, but not shorter steps. Determining easy-to-use surrogates of MetS (e.g., gait velocity) may help combat the growing prevalence of MetS by increasing access to preventative approaches.
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Affiliation(s)
- Tanner Thorsen
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
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26
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Graybeal AJ, Brandner CF, Stavres J. Conflicting Associations among Bioelectrical Impedance and Cardiometabolic Health Parameters in Young White and Black Adults. Med Sci Sports Exerc 2024; 56:418-426. [PMID: 37882087 DOI: 10.1249/mss.0000000000003321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
PURPOSE The purpose of this cross-sectional evaluation was to determine the associations between raw bioelectrical impedance and cardiometabolic health parameters in a sample of young non-Hispanic White and African American adults. METHODS A total of 96 (female: 52, male: 44) non-Hispanic White ( n = 45) and African American adults ( n = 51) between the ages of 19 and 37 yr (22.7 ± 3.83 yr) completed several fasted assessments including resting systolic blood pressure (rSBP), blood glucose (FBG), blood lipids, and bioelectrical impedance spectroscopy. Bioelectrical impedance spectroscopy-derived measurements included phase angle, bioimpedance index (BI), impedance ratio (IR), reactance index (XCi), fat-free mass (FFM), FFM index (FFMi), and absolute (a) and relative (%) total body water (TBW) and extracellular (ECF) and intracellular fluid (ICF). All bioelectric variables were collected at 50 kHz other than IR (250 kHz/5 kHz). Multiple regressions were conducted and adjusted for sex, age, and body mass index. RESULTS rSBP was positively, and HDL was inversely, associated with all bioelectrical impedance and absolute hydration variables (all P ≤ 0.050) other than XCi for rSBP and XCi and FFMi for HDL. rSBP ( P < 0.001) was inversely, and HDL ( P = 0.034) was positively, associated with IR. FBG was positively associated with BI, XCi, FFM, TBWa, and ECFa (all P < 0.050). Metabolic syndrome severity was positively associated with BI, FFM, TBWa, and ECFa for women (all P ≤ 0.050) and with ICFa for African American women ( P = 0.016). CONCLUSIONS Given the rapid increase in the prevalence of cardiometabolic health risks among young adults and the broad use of bioelectrical impedance in practice, the conflicting associations we observed in this age group suggest that bioelectrical impedance parameters should be used with caution in the context of cardiometabolic health risks and age.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS
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Bruns A, Greupner T, Nebl J, Hahn A. Plant-based diets and cardiovascular risk factors: a comparison of flexitarians, vegans and omnivores in a cross-sectional study. BMC Nutr 2024; 10:29. [PMID: 38347653 PMCID: PMC10860304 DOI: 10.1186/s40795-024-00839-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The growing trend towards conscious and sustainable dietary choices has led to increased adoption of flexitarian diets, characterised by plant-based eating habits with occasional consumption of meat and processed meat products. However, the cardiovascular disease (CVD) risk factors associated with flexitarian diets compared to both vegans and omnivores remain underexplored. METHODS In this cross-sectional study, 94 healthy participants aged 25-45 years, categorized into long-term flexitarians (FXs ≤ 50 g/day of meat and meat products, n = 32), vegans (Vs, no animal products, n = 33), and omnivores (OMNs ≥ 170 g/day of meat and meat products, n = 29) were included. Various CVD risk factors were measured, including fasting blood samples for metabolic biomarkers, body composition analysis via bioimpedance, blood pressure measurements, arterial stiffness evaluated through pulse wave velocity (PWV) and metabolic syndrome (MetS) severity was determined using browser-based calculations (MetS-scores). Dietary intake was assessed using a Food Frequency Questionnaire (FFQ), diet quality was calculated with the Healthy Eating Index-flexible (HEI-Flex), while physical activity levels were recorded using the validated Freiburger questionnaire. RESULTS The data showed that FXs and Vs had more beneficial levels of insulin, triglycerides, total cholesterol, and LDL cholesterol compared to OMNs. Notably, FXs revealed the most favorable MetS-score results based on both BMI and waistline, and better PWV values than Vs and OMNs. In addition, FXs and Vs reported higher intake rates of vegetables, fruit, nuts/seeds and plant-based milk alternatives. CONCLUSION The flexitarian diet appears to confer cardiovascular benefits. While Vs had the most favorable results overall, this study supports that reducing meat and processed meat products intake, as in flexitarianism, may contribute to CVD risk factor advantages.
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Affiliation(s)
- Anja Bruns
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany
| | - Theresa Greupner
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany
| | - Josefine Nebl
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, 30159, Germany.
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Farhadi A, Emamat H, Nemati R, Marzban M, Shafiee G, Nabipour I, Ostovar A, Jalaliyan Z, Malekizadeh H, Larijani B. The association between continuous metabolic syndrome score and its components with electrocardiographic abnormalities in community-dwelling older adults: the Bushehr elderly health (BEH) program. BMC Cardiovasc Disord 2024; 24:81. [PMID: 38297215 PMCID: PMC10829232 DOI: 10.1186/s12872-024-03733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/17/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) known as a risk factor for cardiovascular diseases (CVDs) has developed into a major source of health issue, especially for the elderly. In the present study, we investigated the association between continuous MetS (cMetS) score and its components with electrocardiographic (ECG) abnormalities in the community-dwelling older adults. METHODS This cross-sectional study is derived from the second phase of BEH cohort study which is conducted on individuals aged over 60 years old. Standard 12-lead ECGs were recorded and coded by qualified physicians and continuous values of metabolic syndrome risk scores (cMetS) were measured. Data regarding socio-demographic, medical history, and lifestyle variables were collected by trained interviewers. The multinomial regression analysis was used to investigate the relationship between cMetS and its components with ECG abnormalities in the included participants. RESULTS 2426 individuals (mean age ± standard deviation: 69.30 ± 6.33 years) were included in the final analysis. Overall, 22.5% of the participants showed ECG abnormalities. Among these, 8.0% (n = 139) of participants had minor and 14.6% (n = 354) had major ECG abnormalities. In the final models, cMetS (OR = 1.04), mean arterial pressure (MAP((OR = 1.01), and higher fasting blood glucose (FBG) (OR = 1.01) increased the risk of ECG abnormalities (p < 0.05). Also, cMetS (OR = 1.05) and MAP (OR = 1.02) were associated with an increased risk of major ECG abnormalities (p < 0.05). CONCLUSION MetS and MAP were significantly associated with ECG abnormalities. The results of the present study suggest that ECG screening in the older population with MetS could potentially help to detect those at the higher risk of CVDs.
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Affiliation(s)
- Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hadi Emamat
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Nemati
- Department of Medical Emergencies, School of Allied Medical Sciences, Bushehr University of Medical Sciences, Bushehr, Iran
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hasan Malekizadeh
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Xu Z, Lei X, Chu W, Weng L, Chen C, Ye R. Oxidative balance score was negatively associated with the risk of metabolic syndrome, metabolic syndrome severity, and all-cause mortality of patients with metabolic syndrome. Front Endocrinol (Lausanne) 2024; 14:1233145. [PMID: 38283746 PMCID: PMC10811064 DOI: 10.3389/fendo.2023.1233145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
Background The oxidative balance score (OBS), an encompassing scoring mechanism for assessing oxidative stress, is formulated based on nutritional and lifestyle components. The emergence of metabolic syndrome (MetS) is intricately linked to oxidative stress. Nonetheless, the correlation between OBS and MetS displays variability within distinct cohorts. Objective We worked on the relationships between OBS and the risk of MetS, MetS severity, and all-cause mortality of MetS patients. Methods A total of 11,171 adult participants were collected from the U.S. National Health Examination Survey (NHANES) 2007-2018. Employing survey-weighted logistic models, we evaluated the relationship between OBS and MetS risk. Furthermore, survey-weighted linear models were utilized to investigate the connection between OBS and MetS severity. Among the participants, 3,621 individuals had their survival status recorded, allowing us to employ Cox proportional hazards regression models in order to ascertain the association between OBS and the all-cause mortality within the subset of individuals with MetS. The OBS (where a higher OBS signified an increased prevalence of anti- or pro-oxidant exposures) weighed the 20 factors, while the MetS severity score weighed the five factors. Results After multivariable adjustment, individuals with elevated OBS were found to exhibit a decreased susceptibility to MetS [odds ratio (OR) 0.95; 95% CI 0.94-0.96]. The adjusted OR was 0.42 (95% CI 0.33-0.53) for MetS risk in the fourth OBS quartile compared with those in the first OBS quartile (P for trend < 0.001). A one-unit increase in OBS was linked to a 3% reduction in MetS severity score by 3% (mean difference, -0.03; 95% CI, -0.04 to -0.03). Moreover, increased OBS correlated with decreased hazard of all-cause mortality risk among MetS subjects (adjusted hazard ratio, 0.95; 95% CI, 0.93-0.98). These associations retained their strength even subsequent to the introduction of sensitivity analyses. There existed a statistically significant negative correlation between diet/lifestyle OBS and both MetS risk as well as MetS severity. Conclusions An inverse correlation was observed between OBS and the susceptibility to MetS, MetS severity, and all-cause mortality of MetS patients. Health outcomes for MetS patients were positively related to antioxidant diets and lifestyles.
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Affiliation(s)
- Zhixiao Xu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiong Lei
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weiwei Chu
- Department of Pulmonary and Critical Care Medicine, The Lu ‘an People’s Hospital of Anhui Province, The Lu ‘an Hospital Affiliated to Anhui Medical University, Lu ‘an, China
| | - Luoqi Weng
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chengshui Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Ran Ye
- Department of Ultrasonography, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
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Lithander FE, Parry Strong A, Braakhuis A, Worthington A, Foster M, Rolleston A, Davies C, Mullaney J, Ross C, Conroy D, Merry TL, Gearry R, Weatherall M, Krebs JD. He Rourou Whai Painga, an Aotearoa New Zealand dietary pattern for metabolic health and whānau wellbeing: protocol for a randomized controlled trial. Front Nutr 2023; 10:1298743. [PMID: 38148791 PMCID: PMC10750413 DOI: 10.3389/fnut.2023.1298743] [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: 09/22/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
Background Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand. Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved metabolic health. This study aims to test whether an intervention including a Mediterranean dietary pattern incorporating high quality New Zealand foods (NZMedDiet pattern) and behavior change science can improve the metabolic health of participants and their household/whānau. Methods and analysis This is a multi-center, three-stage trial with two parallel group superiority randomized controlled trials (RCTs), and a longitudinal cohort study embedded within the trial design. The first RCT (RCT 1) is a comparison of the NZMedDiet pattern compared to usual diet for 12 weeks. The Behavior Change Wheel was used to select and implement strategies to support participant adherence to the NZMedDiet, such as web-based nutrition education on healthy shopping and cooking. The second (RCT 2) compares online social support to no online social support for 12 weeks, administered to participants immediately following RCT 1. The third stage is a longitudinal cohort study where all participants are followed from the beginning of their start of the active intervention for 12 months in total. The primary outcome measure for each stage is the metabolic syndrome severity score (MetSSS). The duration of enrolment is 12-15 months. The total recruitment target is 200 index participants and their household/whānau members who participate with them, and the primary analyses will be intention to treat on index participants. Discussion The trial will test whether the NZMedDiet pattern and behavior change support improves the cardiometabolic health of people in Aotearoa New Zealand. Clinical trial registration https://www.anzctr.org.au/Default.aspx, identifier ACTRN12622000906752 and https://www.isrctn.com/, identifier ISRCTN89011056 (Spirit 2).
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Affiliation(s)
- Fiona E. Lithander
- New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Amber Parry Strong
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Anna Worthington
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Anna Rolleston
- Centre for Health, Manawa Ora Centre, Tauranga, New Zealand
| | - Cheryl Davies
- Tū Kotahi Māori Asthma and Research Trust, Kōkiri Marae, Lower Hutt, New Zealand
| | - Jane Mullaney
- New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Cecilia Ross
- Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Denise Conroy
- New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand
- The New Zealand Institute for Plant & Food Research Ltd., Auckland, New Zealand
| | - Troy L. Merry
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Richard Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Jeremy D. Krebs
- Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand
- Department of Medicine, University of Otago, Wellington, New Zealand
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Graybeal AJ, Brandner CF, Henderson A, Aultman RA, Vallecillo-Bustos A, Newsome TA, Stanfield D, Stavres J. Associations between eating behaviors and metabolic syndrome severity in young adults. Eat Behav 2023; 51:101821. [PMID: 37866123 DOI: 10.1016/j.eatbeh.2023.101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Metabolic syndrome (MetS), a precursor to cardiovascular disease and type II diabetes, is rapidly increasing in young adults. Accordingly, earlier interventions aimed at combating the onset of MetS in young adults are required. However, current behavioral interventions have failed to consider the eating behaviors that precede disease development, likely contributing to the consistently high failure rates of these interventions. The purpose of this cross-sectional study was to evaluate the associations between eating behaviors and MetS severity (MetSindex) in a sample of young adults. A sample of 104 (non-Hispanic White: 45; non-Hispanic Black: 49; Hispanic White: 5; Asian: 5) young adult (age: 23.1 ± 4.4) males and females (F:61, M:43) completed anthropometric, blood pressure, blood glucose, and blood lipid assessments; each of which were used to calculate a continuous MetSindex score. Participants also completed the revised version of the 18-item Three-factor Eating Questionnaire to measure emotional eating (EmE), uncontrolled eating (UE), and cognitive restraint (CR). EmE was positively associated with MetSindex for young adult females (p = 0.033) and non-Hispanic Black participants (p = 0.050), but not male (p = 0.506) or non-Hispanic White participants (p = 0.558). Additionally, MetSindex was greater in the highest EmE tertile compared to the lowest EmE tertile for the total sample (p = 0.037) and young adult females (p = 0.015). UE and CR were not associated with MetSindex. These data suggest a potential link between EmE and MetS severity in young adults, and that behavioral interventions aimed at MetS prevention should focus on treating the underlying EmE behaviors common in young adults, particularly for young female and Black adults at the greatest risk.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Caleb F Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Ryan A Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Ta'Quoris A Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
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Smith LE, Van Guilder GP, Dalleck LC, Lewis NR, Dages AG, Harris NK. A Preliminary Investigation into the Frequency Dose Effects of High-Intensity Functional Training on Cardiometabolic Health. J Sports Sci Med 2023; 22:688-699. [PMID: 38045746 PMCID: PMC10690508 DOI: 10.52082/jssm.2023.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/17/2023] [Indexed: 12/05/2023]
Abstract
The objective of this study was to explore the effects of three weekly frequency doses of high-intensity functional training (HIFT) on an array of cardiometabolic markers in adults with metabolic syndrome (MetS). Twenty-one men and women, randomized into one (HIFT1), two (HIFT2), or three (HIFT3) days per week of HIFT, completed 3-weeks of familiarization plus a 12-week progressive training program. Pre- and post-intervention, several cardiometabolic, body composition, oxygen consumption, metabolic syndrome severity, and perceptions of fitness measurements were assessed. Additionally, an exercise enjoyment survey was administered post-intervention. A Cohen's d was used to demonstrate within-group change effect size. Although this study was not fully powered, a one-way and two-way ANOVA were used to compare the dose groups to provide provisional insights. No differences were found when frequency dose groups were compared. Many cardiometabolic, body composition, and fitness improvements were seen within each group, with clinically meaningful improvements in the metabolic syndrome severity score (MSSS) (HIFT1: -0.105, d = 0.28; HIFT2: -0.382, d = 1.20; HIFT3: -0.467, d = 1.07), waist circumference (HIFT1: -4.1cm, d = 3.33; HIFT2: -5.4cm, d = 0.89; HIFT3: -0.7cm, d = 0.20), and blood glucose (HIFT1: -9.5mg/dL, d = 0.98; HIFT2: -4.9mg/dL, d = 1.00; HIFT3: -1.7mg/dL, d = 0.23). All three groups similarly reported high exercise enjoyment and likeliness to continue after the intervention. In conclusion, HIFT performed once, twice, or thrice a week elicits improvements in MetS and is considered enjoyable. HIFT, even at a low weekly dose, therefore represents a potential strategy to reduce the global MetS burden.
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Affiliation(s)
- Leslie E Smith
- Recreation, Exercise and Sport Science Department, Western Colorado University, Gunnison, CO, USA
| | - Gary P Van Guilder
- Recreation, Exercise and Sport Science Department, Western Colorado University, Gunnison, CO, USA
| | - Lance C Dalleck
- Recreation, Exercise and Sport Science Department, Western Colorado University, Gunnison, CO, USA
| | - Nicole R Lewis
- Recreation, Exercise and Sport Science Department, Western Colorado University, Gunnison, CO, USA
| | - Allison G Dages
- Recreation, Exercise and Sport Science Department, Western Colorado University, Gunnison, CO, USA
| | - Nigel K Harris
- Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
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Morales-Palomo F, Moreno-Cabañas A, Alvarez-Jimenez L, Mora-Gonzalez D, Ortega JF, Mora-Rodriguez R. Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial. J Physiol 2023. [PMID: 38015017 DOI: 10.1113/jp285366] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/16/2023] [Indexed: 11/29/2023] Open
Abstract
A supervised intense aerobic exercise program improves the health of individuals with metabolic syndrome (MetS). However, it is unclear whether the timing of training within the 24 h day would influence those health benefits. The present study aimed to determine the influence of morning vs. afternoon exercise on body composition, cardiometabolic health and components of MetS. One hundred thirty-nine individuals with MetS were block randomized into morning (AMEX; n = 42) or afternoon (PMEX; n = 59) exercise training groups, or a non-training control group (Control; n = 38). Exercise training was comprised of 48 supervised high-intensity interval sessions distributed over 16 weeks. Body composition, cardiorespiratory fitness (assessed byV ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ ), maximal fat oxidation (FOmax ), blood pressure and blood metabolites were assessed before and after the intervention. Compared with the non-training Control, both exercise groups improved similarly body composition (-0.7% fat loss; P = 0.002), waist circumference (-2.1 cm; P < 0.001), diastolic blood pressure (-3.8 mmHg; P = 0.004) andV ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ (3.5 mL kg-1 min-1 ; P < 0.001) with no differences between training groups. AMEX, in comparison with PMEX, reduced systolic blood pressure (-4% vs. -1%; P = 0.019), plasma fasting insulin concentration (-12% vs. -5%; P = 0.001) and insulin resistance (-14% vs. -4%; P = 0.006). Furthermore, MetS Z score was further reduced in the AMEX compared to PMEX (-52% vs. -19%; P = 0.021) after training. In summary, high-intensity aerobic exercise training in the morning in comparison to training in the afternoon is somewhat more efficient at reducing cardiometabolic risk factors (i.e. systolic blood pressure and insulin sensitivity). KEY POINTS: The effect of exercise time of day on health promotion is an area that has gained interest in recent years; however, large-scale, randomized-control studies are scarce. People with metabolic syndrome (MetS) are at risk of developing cardiometabolic diseases and reductions in this risk with exercise training can be precisely gauged using a compound score sensitive to subtle evolution in each MetS component (i.e. Z score). Supervised aerobic exercise for 16 weeks (morning and afternoon), without dietary restriction, improved cardiorespiratory and metabolic fitness, body composition and mean arterial pressure compared to a non-exercise control group. However, training in the morning, without changes in exercise dose or intensity, reduced systolic blood pressure and insulin resistance further compared to when training in the afternoon. Thus, high-intensity aerobic exercise training in the morning is somewhat more efficient in improving the health of individuals with metabolic syndrome.
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Affiliation(s)
- Felix Morales-Palomo
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - Alfonso Moreno-Cabañas
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
- Centre for Nutrition, Exercise, and Metabolism, University of Bath, Bath, UK
- Department for Health, University of Bath, Bath, UK
| | | | - Diego Mora-Gonzalez
- Department of Nursing, Physiotherapy and Occupational therapy, University of Castilla-La Mancha, Toledo, Spain
| | - Juan F Ortega
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
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Yang S, Yu B, Yu W, Dai S, Feng C, Shao Y, Zhao X, Li X, He T, Jia P. Development and validation of an age-sex-ethnicity-specific metabolic syndrome score in the Chinese adults. Nat Commun 2023; 14:6988. [PMID: 37914709 PMCID: PMC10620391 DOI: 10.1038/s41467-023-42423-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
Metabolic syndrome (MetS) is characterized by metabolic dysfunctions and could predict future risk for cardiovascular diseases (CVDs). However, the traditionally defined dichotomous MetS neither reflected MetS severity nor considered demographic variations. Here we develop a continuous, age-sex-ethnicity-specific MetS score based on continuous measures of the five metabolic dysfunctions (waist circumference [WC], triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], mean arterial pressure [MAP], and fasting blood glucose [FBG]). We find that the weights of metabolic dysfunctions in the score vary across age-sex-ethnicity-specific subgroups, with higher weights for TG, HDL-C, and WC. Each unit increase in the score is associated with increased risks for hyperlipidemia, diabetes, and hypertension, and elevated levels of HbA1c, cholesterol, body mass index, and serum uric acid. The score shows high sensitivity and accuracy for detecting CVD-related risk factors and is validated in different geographical regions. Our study would advance early identification of CVD risks and, more broadly, preventive medicine and sustainable development goals.
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Affiliation(s)
- Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
| | - Bin Yu
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
| | - Wanqi Yu
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Shaoqing Dai
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands
| | - Chuanteng Feng
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
| | - Ying Shao
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaoqing Li
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Tianjing He
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China.
- Hubei Luojia Laboratory, Wuhan, China.
- School of Public Health, Wuhan University, Wuhan, China.
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Driver S, McShan EE, Bennett M, Calhoun S, Callender L, Swank C, Dubiel R. A randomized controlled trial protocol for people with traumatic brain injury enrolled in a telehealth delivered diabetes prevention program (tGLB-TBI). Contemp Clin Trials Commun 2023; 35:101191. [PMID: 37520329 PMCID: PMC10382627 DOI: 10.1016/j.conctc.2023.101191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023] Open
Abstract
Obesity rates after traumatic brain injury (TBI) are high and are associated with greater risk of morbidity (diabetes, hypertension) and mortality when compared to the general population. Evidence-based interventions for this population are needed and our work modifying and examining the efficacy of the Diabetes Prevention Program Group Lifestyle Balance (GLB-TBI) are promising. Our recent randomized controlled trial included 57 adults with TBI who completed the GLB-TBI in-person and lost 17.8 ± 16.4lbs (7.9% body weight) compared to the attention control (0%). To broaden the accessibility of the intervention we will complete an RCT to assess the efficacy of telehealth delivery (tGLB-TBI) by enrolling 88 participants over a 3 year period. Results will provide a scalable telehealth weight-loss program that clinicians and community workers across the country can use to help people with TBI lose weight and improve health. The long-term goal is to reduce health inequities and broaden program dissemination to people with TBI that lack access due to environmental barriers, including living rurally or lacking transportation.
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Affiliation(s)
- Simon Driver
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
- Baylor Scott and White Institute for Rehabilitation, 909 N. Washington, Dallas, TX, 75246, USA
| | - Evan Elizabeth McShan
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
| | - Monica Bennett
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
| | - Stephanie Calhoun
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
| | - Librada Callender
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
| | - Chad Swank
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
- Baylor Scott and White Institute for Rehabilitation, 909 N. Washington, Dallas, TX, 75246, USA
| | - Rosemary Dubiel
- North Texas TBI Model System, USA
- Baylor Scott and White Research Institute, 3434 Live Oak Street, Dallas, TX, 75204, USA
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Palla AH, Fatimi AS, Virani SS, Fatima SS. Cardiovascular disease risk stratification in the Pakistani population with and without metabolic syndrome: A single centre cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002397. [PMID: 37756297 PMCID: PMC10530026 DOI: 10.1371/journal.pgph.0002397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Existing atherosclerotic cardiovascular disease (ASCVD) risk stratification algorithms are predominantly validated only for Western populations, and do not include parameters of metabolic syndrome (MetS) which may increase the relative risk for cardiovascular disease in South Asians. This study aimed to compare the differences between 10-year ASCVD risk by the Framingham Risk Score (FRS), Pooled Cohort Risk Equations (PCE), and QRISK3 calculators in a cohort of apparently healthy Pakistani adults and stratify the ASCVD risk by MetS status.A cross-sectional study recruited 179 subjects between the ages of 40 to 74 years from the outpatient department of the Aga Khan University Hospital between May 2019 to November 2022. Anthropometry, demography, and blood samples were collected from each subject after informed consent. The IDF criteria were used to categorize subjects as MetS positive (n = 122) and MetS negative (n = 57). The mean age of study participants was 51.07±7.38 years. The average 10-year ASCVD risk (%) for our cohort was calculated to be 15.34 ± 11.60, 9.66 ± 10.87, and 17.02 ± 14.66 using the FRS algorithm, PCE calculator, and QRISK3 calculator respectively. MetS status did not show a statistically significant association with the risk categories determined by any of the calculators, although numerical ASCVD risk estimates were significantly higher in the MetS positive group for all calculators.Although ASCVD risk is a useful way to reduce CVD burden by identifying asymptomatic individuals at the highest risk of developing ASCVD, a high proportion of individuals with MetS may still be identified as low risk by the current risk stratification algorithms in South Asians. Powered validation studies with larger sample sizes and longitudinal follow-up are needed in South Asians to modify existing calculators to make them more applicable to South Asian populations.
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Affiliation(s)
- Amber Hanif Palla
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | | | - Salim S. Virani
- Department of Medicine, Aga Khan University, Karachi, Pakistan
- Texas Heart Institute and Center Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX, United States of America
| | - Syeda Sadia Fatima
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
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Hoogervorst MM, van Meijel B, Bruin EKD, Beekman A, Boonstra N, Adriaanse M. The nurse-led GILL eHealth intervention for improving physical health and lifestyle behaviours in clients with severe mental illness: design of a cluster-randomised controlled trial. BMC Psychiatry 2023; 23:672. [PMID: 37715156 PMCID: PMC10504705 DOI: 10.1186/s12888-023-05024-z] [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: 05/22/2023] [Accepted: 07/13/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5-17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the implementation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the effectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. METHODS The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth intervention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants' reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efficacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. DISCUSSION The GILL eHealth intervention is expected to be more effective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven effective, GILL eHealth offers a clinically useful tool to improve physical health and lifestyle behaviours. TRIAL REGISTRATION Clinical trial registration NCT05533749, registration date: 8 September 2022.
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Affiliation(s)
- Meike M Hoogervorst
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Berno van Meijel
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
- Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
| | - Esther Krijnen-de Bruin
- Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Aartjan Beekman
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nynke Boonstra
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- NHL Stenden, University of Applied Sciences, Leeuwarden, The Netherlands
- KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands
| | - Marcel Adriaanse
- Department of Health Sciences, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Stavres J, Aultman RA, Brandner CF, Newsome TA, Vallecillo-Bustos A, Wise HL, Henderson A, Stanfield D, Mannozzi J, Graybeal AJ. Hemodynamic responses to handgrip and metaboreflex activation are exaggerated in individuals with metabolic syndrome independent of resting blood pressure, waist circumference, and fasting blood glucose. Front Physiol 2023; 14:1212775. [PMID: 37608839 PMCID: PMC10441127 DOI: 10.3389/fphys.2023.1212775] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023] Open
Abstract
Introduction: Prior studies report conflicting evidence regarding exercise pressor and metaboreflex responses in individuals with metabolic syndrome (MetS). Purpose: To test the hypotheses that 1) exercise pressor and metaboreflex responses are exaggerated in MetS and 2) these differences may be explained by elevated resting blood pressure. Methods: Blood pressure and heart rate (HR) were evaluated in 26 participants (13 MetS) during 2 min of handgrip exercise followed by 3 min of post-exercise circulatory occlusion (PECO). Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP), along with HR and a cumulative blood pressure index (BPI), were compared between groups using independent samples t-tests, and analyses of covariance were used to adjust for differences in resting blood pressure, fasting blood glucose (FBG), and waist circumference (WC). Results: ΔSBP (∼78% and ∼54%), ΔMAP (∼67% and ∼55%), and BPI (∼16% and ∼20%) responses were significantly exaggerated in individuals with MetS during handgrip and PECO, respectively (all p ≤ 0.04). ΔDBP, ΔMAP, and BPI responses during handgrip remained significantly different between groups after independently covarying for resting blood pressure (p < 0.01), and after simultaneously covarying for resting blood pressure, FBG, and WC (p ≤ 0.03). Likewise, peak SBP, DBP, MAP, and BPI responses during PECO remained significantly different between groups after adjusting for resting blood pressure (p ≤ 0.03), with peak SBP, MAP, and BPI response remaining different between groups after adjusting for all three covariates simultaneously (p ≤ 0.04). Conclusion: These data suggest that exercise pressor and metaboreflex responses are significantly exaggerated in MetS independent of differences in resting blood pressure, FBG, or WC.
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Affiliation(s)
- Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ryan A. Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Caleb F. Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ta’Quoris A. Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | | | - Havens L. Wise
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Joseph Mannozzi
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Austin J. Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
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Pompeia S, Panjeh S, Louzada FM, D'Almeida V, Hipolide DC, Cogo-Moreira H. Social jetlag is associated with adverse cardiometabolic latent traits in early adolescence: an observational study. Front Endocrinol (Lausanne) 2023; 14:1085302. [PMID: 37469985 PMCID: PMC10352840 DOI: 10.3389/fendo.2023.1085302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/12/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Adolescence is marked by physiological and social changes, such as puberty, increased responsibilities and earlier school start times. This often leads to insufficient sleep on school nights and the need to compensate for lost sleep on weekends, causing a misalignment between biological and social times, which has been termed social jetlag (SJL). SJL triggers stress responses and is associated with several negative health outcomes, including higher cardiometabolic risk in adults. In adolescence, however, SJL has only been consistently related to increases in adiposity but its association with other cardiometabolic indicators are unclear. Method In a sample of 278 healthy early adolescents (9-15 years of age; 168 girls) we investigated: 1) whether self-reported SJL is associated (using path analyses) with a cardiometabolic status latent factor obtained by testing the best fitting model via confirmatory factor analyses from an initial set of eight indicators [body mass index (BMI), waist/height ratio, triglyceride concentration, diastolic and systolic blood pressure, glycated hemoglobin, total cholesterol/high-density lipoprotein ratio (chol/HDL), and % body fat]; and 2) whether age and/or pubertal status influence the association between SJL and cardiometabolic status. Result We found that, for girls, higher SJL was associated with more adverse cardiometabolic latent scores (the shared variance of BMI, waist/height ratio, chol/HDL and systolic blood pressure, which had acceptable model fit indices). However, the role of age and pubertal status in this association was unclear for both sexes. Discussion SJL was associated with adverse cardiometabolic latent traits beyond increases in adiposity in this observational study in early female adolescents. Because disruptions of circadian rhythms are believed to lead to dysregulated energy homeostasis and not vice-versa, our findings highlight the need for sleep interventions in adolescence to help reduce the global burden of cardiometabolic ill health, especially in girls.
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Affiliation(s)
- Sabine Pompeia
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sareh Panjeh
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Vania D'Almeida
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Hugo Cogo-Moreira
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
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Westphal-Nardo G, Chaput JP, Faúndez-Casanova C, Fernandes CAM, de Andrade Gonçalves EC, Utrila RT, Oltramari K, Grizzo FMF, Nardo-Junior N. Exploring New Tools for Risk Classification among Adults with Several Degrees of Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6263. [PMID: 37444110 PMCID: PMC10341139 DOI: 10.3390/ijerph20136263] [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: 05/01/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
The epidemic of obesity worldwide has been recognized as a very important challenge. Within its complexity, the identification of higher-risk patients is essential, as it is unsustainable to offer access to treatment to all people with obesity. Several new approaches have recently been presented as important tools for risk stratification. In this research, we applied several of these tools in a cross-sectional study involving adults with obesity classes I, II, III, and super-obesity. The participants had their cardiometabolic risk profiles assessed. The study included adults with obesity aged 18 to 50 years (n = 404), who were evaluated using anthropometric, body composition, hemodynamic, physical fitness, and biochemical assessments. These variables were used to identify the prevalence of risk factors for cardiometabolic diseases according to the classes of obesity by gender and age group. The results showed high prevalence of risk factors, especially among the upper classes of obesity (BMI > 35 kg/m2) using single parameters as the waist circumference, with almost 90% above the cut-off point. For smaller numbers such as Glycated Hemoglobin, however, the prevalence was around 30%. Indexes such as the atherogenic index of plasma (AIP) had the highest prevalence, with 100% of the male participants identified as being at increased risk for cardiovascular disease.
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Affiliation(s)
- Greice Westphal-Nardo
- Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil; (C.F.-C.); (N.N.-J.)
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
| | - César Faúndez-Casanova
- Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil; (C.F.-C.); (N.N.-J.)
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
- Faculty of Education Sciences, Catholic University of Maule, Talca 34809112, Maule, Chile
| | - Carlos Alexandre Molena Fernandes
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Eliane Cristina de Andrade Gonçalves
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Raquel Tomiazzi Utrila
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Karine Oltramari
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Felipe Merchan Ferraz Grizzo
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Nelson Nardo-Junior
- Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil; (C.F.-C.); (N.N.-J.)
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
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Honarvar M, Masoumi S, Mehran L, Khalili D, Amouzegar A, Azizi F. Development and validation of a continuous metabolic syndrome severity score in the Tehran Lipid and Glucose Study. Sci Rep 2023; 13:7529. [PMID: 37160960 PMCID: PMC10170075 DOI: 10.1038/s41598-023-33294-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023] Open
Abstract
Metabolic syndrome (MetS), defined as the coexistence of interrelated cardiometabolic risk factors, is limited by ignoring the severity of the disease and individuals with a pre-metabolic state. We aimed to develop the first age- and sex-specific continuous MetS severity score in the adult population using confirmatory factor analysis (CFA) based on the MetS components in the Middle East. Using data from the population-based Tehran Lipid and Glucose Study (TLGS) I and II datasets, we conducted CFA of the single factor MetS on 8933 adults (20-60 years old) totally, and in age and sex subgroups. We allowed for different factor loadings across the subgroups to formulate age- and sex-specific continuous MetS severity score equations. Thereafter, we validated these equations in the dataset of TLGS III participants. Triglyceride had the highest factor loading across age and sex subgroups, indicating the most correlation with MetS. Except for women aged 40-60 years, waist circumference was the second most significant factor contributing to MetS. Systolic blood pressure was more closely related to MetS in women than in men. Systolic blood pressure and fasting plasma glucose had the weakest correlation with MetS among the 40-60 age group. Moreover, as women age, the contribution of fasting plasma glucose to MetS tended to decline, while it remained relatively constant in men. The resulting MetS severity score was correlated with age and homeostasis model assessment of insulin resistance. Furthermore, the continuous MetS severity score well predicted the traditional MetS according to receiver operating characteristic analysis in the validation dataset. The age- and sex-specific continuous MetS severity score for the West Asian adult population provides a tangible quantitative measure of MetS enabling clinicians to screen and monitor the individuals at risk and assess their metabolic trends.
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Affiliation(s)
- Mohammadjavad Honarvar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Safdar Masoumi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Ladan Mehran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
- Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Greco G, Bickell NA, Lin S, Yagnik R, LeRoith D, Gallagher EJ. Subjective social status, race, and metabolic syndrome in women with breast cancer. Breast Cancer Res Treat 2023; 199:479-487. [PMID: 37087701 DOI: 10.1007/s10549-023-06949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/06/2023] [Indexed: 04/24/2023]
Abstract
PURPOSE To evaluate the association of subjective social status (SSS) with metabolic syndrome (MetS) severity and its potential contribution to racial health disparities in women with breast cancer. METHODS Multicenter cross-sectional study (10 US hospitals) in women (n = 1206) with primary diagnosis of invasive breast cancer received during Mar/2013-Feb/2020. Participants, self-identified as non-Hispanic White or Black, underwent physical and laboratory examinations and survey questions assessing socioeconomic parameters, medical history, and behavioral risks. SSS was measured with the 10-rung MacArthur scale. MetS severity was measured with a validated Z-Score. Generalized linear mixed modeling was used to analyze the associations. Missing data were handled using multiple imputation. RESULTS Average age was 58 years. On average, the SSS of Black women, given equivalent level of income and education, was lower than the SSS of White women: 6.6 (6.1-7.0) vs 7.7 (7.54-7.79) among college graduates and 6.8 (6.4-7.2) vs 7.6 (7.5-7.8) among women in the high-income category (> $75,000). In multivariable analysis, after controlling for age, income, education, diet, and physical activity, increasing SSS was associated with a decrease in MetS-Z score, - 0.10 (- 0.16 to - 0.04) per every 2 rung increase in the MacArthur scale. CONCLUSION Black women with breast cancer rank their SSS lower than White women with breast cancer do at each level of income and education. As SSS is strongly associated with MetS severity these results identify potentially modifiable factors that contribute to racial disparities.
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Affiliation(s)
- Giampaolo Greco
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nina A Bickell
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sylvia Lin
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Radhi Yagnik
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Derek LeRoith
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, Box 1055, New York, NY, 10029, USA
| | - Emily J Gallagher
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, Box 1055, New York, NY, 10029, USA.
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Summer S, Jenkins T, Inge T, Deka R, Khoury J. The association of sagittal abdominal diameter with metabolic syndrome risk before and after weight-loss surgery in adolescents. Surg Obes Relat Dis 2023; 19:350-355. [PMID: 36414523 PMCID: PMC10040419 DOI: 10.1016/j.soard.2022.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) affects ∼10% of U.S. adolescents. Abdominal obesity is the most prevalent component and may indicate MetS risk in adolescents undergoing weight loss surgery. OBJECTIVES Assess MetS risk/severity and its association with abdominal obesity (measured by sagittal abdominal diameter, SAD) before and after weight loss surgery in adolescents to determine whether SAD predicts MetS risk in this population. SETTING Data were collected in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study at 5 sites (U.S. children's hospitals) performing weight-loss surgery in adolescents. The current study is a secondary analysis of these data. METHODS We examined data collected presurgery through 5 years postsurgery. MetS risk/severity was defined using the MetS severity z score (MetS-z), and MetS prevalence was determined using age-appropriate criteria. Association between SAD and MetS-z was evaluated with an adjusted linear mixed model. RESULTS Among 228 individuals (75% female, 72% White), mean age 16.5 years and body mass index (BMI) 53 kg/m2, 79% met MetS criteria pre-urgery. MetS-z (1.5) and SAD (32cm) were correlated (r = 0.6, P < .0001) presurgery, and both improved significantly at 6 months, 1, and 5 years postsurgery, remaining highly correlated at each timepoint. SAD predicted MetS-z (β = 0.118; 95% CI, 0.109, 0.127) after adjustment for age, visit, surgery type, and caregiver education. CONCLUSIONS Abdominal obesity is a key MetS risk marker in youth undergoing weight loss surgery. Both SAD and Met-z measures may be useful for MetS risk assessment and tracking postsurgery changes in this population, but more research is needed to identify effective lifestyle interventions targeting abdominal obesity.
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Affiliation(s)
- Suzanne Summer
- Center for Clinical and Translational Science and Training, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Todd Jenkins
- Division of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Thomas Inge
- Department of Surgery, Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Ranjan Deka
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jane Khoury
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Moorehead NR, Goodie JL, Krantz DS. Prospective Bidirectional Relations Between Depression and Metabolic Health: 30 Year Follow-up from the NHLBI CARDIA Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.08.23286983. [PMID: 36945452 PMCID: PMC10029061 DOI: 10.1101/2023.03.08.23286983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Objective This study investigated prospective bidirectional relationships between depression and metabolic syndrome (MetS), and the moderating effects of race, sex, and health behaviors in a diverse cohort followed for 30 years. Methods Data were analyzed from the NHLBI CARDIA study, a 30 year-prospective study of young adults (N = 5113; M age = 24.76 (SD = 3.63) at baseline; 45% male) who were tested every 5 years between 1985-2015. Measures included biological assessments of MetS components, and self-reported depressive symptoms based on the Center for Epidemiologic Studies Depression (CESD) scale. Data analyses included bi-directional general estimating equations analyses of time-lagged associations between depressive symptoms and MetS. Results There was a consistent, bi-directional relationship between depressive symptoms and MetS over time. Individuals with more CESD depressive symptoms were more likely to develop MetS over time compared to those reporting fewer symptoms (Wald Chi-Square = 7.09 (1), p < 0.008), and MetS was similarly predictive of CESD. MetS more consistently predicted depressive symptoms at each 5-year exam than depressive symptoms predicted MetS. Race and sex moderated relationships between depression and MetS, with White females, White individuals overall, and females overall demonstrating significant relationships. Health behaviors were not related to depression-MetS associations. Conclusion In a diverse young adult population prospectively followed into late middle age, MetS more consistently predicted depression over time than depression predicted MetS. The relation between MetS and depressive symptoms was moderated by race and sex, but not health behaviors.
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Affiliation(s)
- Nicholas R. Moorehead
- 59 Medical Operations Group, Wilford Hall Ambulatory Surgical Center, U.S. Air Force, Joint Base San Antonio – Lackland, TX 78236
- Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Jeffrey L. Goodie
- Department of Family Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
- Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - David S. Krantz
- Department of Family Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
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Sandsdal RM, Juhl CR, Jensen SBK, Lundgren JR, Janus C, Blond MB, Rosenkilde M, Bogh AF, Gliemann L, Jensen JEB, Antoniades C, Stallknecht BM, Holst JJ, Madsbad S, Torekov SS. Combination of exercise and GLP-1 receptor agonist treatment reduces severity of metabolic syndrome, abdominal obesity, and inflammation: a randomized controlled trial. Cardiovasc Diabetol 2023; 22:41. [PMID: 36841762 PMCID: PMC9960425 DOI: 10.1186/s12933-023-01765-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/03/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Identifying and reducing cardiometabolic risks driven by obesity remains a healthcare challenge. The metabolic syndrome is associated with abdominal obesity and inflammation and is predictive of long-term risk of developing type 2 diabetes and cardiovascular disease in otherwise healthy individuals living with obesity. Therefore, we investigated the effects of adherent exercise, a glucagon-like peptide 1 receptor agonist (GLP-1 RA), or the combination on severity of metabolic syndrome, abdominal obesity, and inflammation following weight loss. METHODS This was a randomized, double-blinded, placebo-controlled trial. During an 8-week low-calorie diet (800 kcal/day), 195 adults with obesity and without diabetes lost 12% in body weight. Participants were then evenly randomized to four arms of one-year treatment with: placebo, moderate-to-vigorous exercise (minimum of 150 min/week of moderate-intensity or 75 min/week of vigorous-intensity aerobic physical activity or an equivalent combination of both), the GLP-1 RA liraglutide 3.0 mg/day, or a combination (exercise + liraglutide). A total of 166 participants completed the trial. We assessed the prespecified secondary outcome metabolic syndrome severity z-score (MetS-Z), abdominal obesity (estimated as android fat via dual-energy X-ray absorptiometry), and inflammation marker high-sensitivity C-reactive protein (hsCRP). Statistical analysis was performed on 130 participants adherent to the study interventions (per-protocol population) using a mixed linear model. RESULTS The diet-induced weight loss decreased the severity of MetS-Z from 0.57 to 0.06, which was maintained in the placebo and exercise groups after one year. MetS-Z was further decreased by liraglutide (- 0.37, 95% CI - 0.58 to - 0.16, P < 0.001) and the combination treatment (- 0.48, 95% CI - 0.70 to - 0.25, P < 0.001) compared to placebo. Abdominal fat percentage decreased by 2.6, 2.8, and 6.1 percentage points in the exercise, liraglutide, and combination groups compared to placebo, respectively, and hsCRP decreased only in the combination group compared with placebo (by 43%, P = 0.03). CONCLUSION The combination of adherent exercise and liraglutide treatment reduced metabolic syndrome severity, abdominal obesity, and inflammation and may therefore reduce cardiometabolic risk more than the individual treatments. Trial registration EudraCT number: 2015-005585-32, ClinicalTrials.gov: NCT04122716.
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Affiliation(s)
- Rasmus M Sandsdal
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Christian R Juhl
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Simon B K Jensen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | | | - Mads Rosenkilde
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Adrian F Bogh
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jens-Erik B Jensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Bente M Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Signe S Torekov
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.
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Mao J, Gan S, Zhou Q, Zhou H, Deng Z. Optimal Anthropometric Indicators and Cut Points for Predicting Metabolic Syndrome in Chinese Patients with Type 2 Diabetes Mellitus by Gender. Diabetes Metab Syndr Obes 2023; 16:505-514. [PMID: 36852179 PMCID: PMC9961221 DOI: 10.2147/dmso.s399275] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/11/2023] [Indexed: 02/22/2023] Open
Abstract
Purpose The best predictors and cut points for metabolic syndrome (MetS) in Chinese patients with type 2 diabetes (T2DM) were determined by comparing six anthropometric measures: body mass index (BMI), triglyceride-glucose (TyG), the product of TyG and waist-to-hip ratio (TyG-WHpR), the product of TyG and waist-to-height ratio (TyG-WHtR), the product of TyG and waist circumference (TyG-WC), and the product of TyG and body mass index (TyG-BMI). Patients and Methods Sixteen hundred and sixty-five adult patients with T2DM were collected, and the ability and cut points of each index to predict MetS were compared by plotting the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) values. Then, logistic regression analysis was used to adjust for confounders, including adjustment for menopause in women, to obtain the odds ratio (OR) and 95% confidence interval (CI). Results MetS was present in 71.60% of T2DM patients, 75.00% of men, and 67.02% of women. BMI was the best predictor of MetS in men with T2DM (AUC = 0.8646, 95% CI: 0.8379-0.8912), with a cut point of 24.5500 kg/m2 (specificity: 0.7714; sensitivity: 0.7533), and TyG-WC was the best predictor of MetS in women with T2DM (AUC = 0.8362, 95% CI: 0.8034-0.8690), with a cut point of 154.1548 (specificity: 0.7455; sensitivity: 0.8076). Conclusion The best predictor of MetS in adults with T2DM is BMI with a cut point of 24.5500 kg/m2 for men and TyG-WC with a cut point of 154.1548 for women.
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Affiliation(s)
- Jing Mao
- Nanhua University, Hengyang, People’s Republic of China
| | - Shenglian Gan
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Haifeng Zhou
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, People’s Republic of China
| | - Zhiming Deng
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, People’s Republic of China
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Driver S, McShan E, Swank C, Calhoun S, Bennett M, Callender L, Holden A, Juengst S, Bell K, Douglas M, Kramer K, Dubiel R. Efficacy of the Diabetes Prevention Program Group Lifestyle Balance Program Modified for Individuals with TBI (GLB-TBI): Results from a 12-month Randomized Controlled Trial. Ann Behav Med 2023; 57:131-145. [PMID: 35775789 DOI: 10.1093/abm/kaac036] [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: 02/07/2023] Open
Abstract
BACKGROUND Obesity after traumatic brain injury (TBI) is a public health issue and no evidence-based weight loss interventions exist to meet the unique needs of individuals after TBI. PURPOSE To (a) examine the efficacy of the Diabetes Prevention Program Group Lifestyle Balance for TBI (GLB-TBI) weight-loss intervention compared to an attention control for primary (weight-loss) and secondary health outcomes; (b) determine participant compliance with the GLB-TBI; and (c) determine if compliance is associated with improved outcomes. METHODS Individuals with moderate to severe TBI, age 18-64 years, ≥6 months postinjury, and body mass index of ≥25 kg/m2 were randomized to a 12-month, 22-session GLB-TBI intervention or attention control condition. Weight-loss (lbs.), anthropometric, biomarkers, and patient-reported outcomes were collected at baseline, 3, 6, and 12 months. RESULTS The GLB-TBI group (n = 27) lost 17.8 ± 41.4lbs (7.9%) over the 12-month program and the attention control group (n = 27) lost 0 ± 55.4lbs (0%). The GLB-TBI group had significant improvements in diastolic blood pressure, triglycerides, and HDL cholesterol. GLB-TBI attendance was 89.6% and weekly self-monitoring of diet and activity was 68.8%. Relative to baseline, the GLB-TBI compliant group (≥80% attendance; ≥85% self-monitoring; n = 10) had a statistically significant decrease in weight at each assessment, the noncompliant group had a significant decrease between 6 and 12 months (n = 17), with no change in weight in the attention control group (n = 27). CONCLUSIONS Findings suggest for adults with TBI who are overweight or obese, participation in the GLB-TBI can significantly reduce weight and metabolic risk factors and increase self-reported habits for diet and exercise.
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Affiliation(s)
- Simon Driver
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Evan McShan
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Chad Swank
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Stephanie Calhoun
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Monica Bennett
- Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Librada Callender
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Alexandria Holden
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Shannon Juengst
- Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA.,Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX, USA
| | - Kathleen Bell
- Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA.,Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX, USA
| | - Megan Douglas
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
| | - Kaye Kramer
- Department of Epidemiology, University of Pittsburgh, PA, USA
| | - Randi Dubiel
- Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA.,Rehabilitation Research Deparment, Baylor Scott and White Research Institute, Dallas, TX, USA.,Research Group, North Texas Traumatic Brain Injury Model System, Dallas, TX, USA
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Lin HYH, Chang LY, Niu SW, Kuo IC, Yen CH, Shen FC, Chen PL, Chang JM, Hung CC. High risk of renal outcome of metabolic syndrome independent of diabetes in patients with CKD stage 1-4: The ICKD database. Diabetes Metab Res Rev 2023; 39:e3618. [PMID: 36731513 DOI: 10.1002/dmrr.3618] [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: 11/10/2022] [Accepted: 12/02/2022] [Indexed: 02/04/2023]
Abstract
AIMS To investigate whether metabolic syndrome (MetS) could predict renal outcome in patients with established chronic kidney disease (CKD). MATERIALS AND METHODS We enroled 2500 patients with CKD stage 1-4 from the Integrated CKD care programme, Kaohsiung for delaying Dialysis (ICKD) prospective observational study. 66.9% and 49.2% patients had MetS and diabetes (DM), respectively. We accessed three clinical outcomes, including all-cause mortality, RRT, and 50% decline in estimated glomerular filtration rate events. RESULTS The MetS score was positively associated with proteinuria, inflammation, and nutrition markers. In fully adjusted Cox regression, the hazard ratio (HR) (95% confidence interval) of MetS for composite renal outcome (renal replacement therapy, and 50% decline of renal function) in the DM and non-DM subgroups was 1.56 (1.15-2.12) and 1.31 (1.02-1.70), respectively, while that for all-cause mortality was 1.00 (0.71-1.40) and 1.27 (0.92-1.74). Blood pressure is the most important component of MetS for renal outcomes. In the 2 by 2 matrix, compared with the non-DM/non-MetS group, the DM/MetS group (HR: 1.62 (1.31-2.02)) and the non-DM/MetS group (HR: 1.33 (1.05-1.69)) had higher risks for composite renal outcome, whereas the DM/MetS group had higher risk for all-cause mortality (HR: 1.43 (1.09-1.88)). CONCLUSIONS MetS could predict renal outcome in patients with CKD stage 1-4 independent of DM.
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Affiliation(s)
- Hugo Y-H Lin
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Yun Chang
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Wen Niu
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Ching Kuo
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Hung Yen
- National Natural Product Libraries and High-Throughput Screening Core Facility, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Feng-Ching Shen
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Phang-Lang Chen
- Department of Biological Chemistry, University of California, Irvine, California, USA
| | - Jer-Ming Chang
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Chih Hung
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Ghanbarnejad A, Kheirandish M, Yousefzade F, Rahimi A, Azarbad A, Nejatizadeh A, Shahmoradi M. Metabolic syndrome severity score in the middle-aged and elderly Iranian population: A cross-sectional survey of Bandare-Kong Cohort Study (the findings of PERSIAN Cohort Study). Front Public Health 2023; 10:1010735. [PMID: 36684931 PMCID: PMC9859414 DOI: 10.3389/fpubh.2022.1010735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
Background Metabolic syndrome (MetS) is defined as the presence of several metabolic risk factors. The traditional MetS criteria have been considered insufficient for evaluating individuals at risk. MetS has always been categorized using binary criteria, which deny that the risk associated with MetS is likely to exist as a continuum. Also, MetS may present differently depending on age, sex, race, or ethnicity. We aimed to derive age-sex-specific equations for MetS severity scores within a southern Iranian population. Methods This study used first-phase data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). After exclusion of the pregnant women, diabetic patients, and individuals taking antihypertensive, antihyperlipidemic, and antidiabetic medications, 2,735 individuals aged 35 to 70 years were selected for analysis. The diagnosis of MetS was based on the National Cholesterol Education Program (NCEP) criteria for the Iranian population. Confirmatory factor analysis (CFA) was performed to formulate MetS severity scores. The receiver operating characteristic (ROC) analysis was performed to validate MetS severity score equations for age-sex-specific categories. Results Triglyceride had the highest factor loading range in all age-sex categories for determining the MetS severity score. Conversely, systolic blood pressure and fasting plasma glucose (FPG) exhibited the lowest factor loadings across all age-sex groups. In both sexes, when age was considered, systolic blood pressure and FPG factor loadings were less significant among subjects aged ≥45 and 35-44 years, respectively. Conclusion MetS severity scores might be more applicable than the current criteria of MetS. Prospective population-based studies should be conducted to assess the accuracy and validity of the MetS severity score for predicting cardiometabolic diseases.
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Affiliation(s)
- Amin Ghanbarnejad
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoumeh Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Feysal Yousefzade
- Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Arash Rahimi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abnoos Azarbad
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Shahmoradi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Chen Y, Wang C, Sun B, Wang B, Lu X, Gao B, Cao Y, Zhou J, Liu X. Associations of follicle-stimulating hormone and luteinizing hormone with metabolic syndrome during the menopausal transition from the National Health and Nutrition Examination Survey. Front Endocrinol (Lausanne) 2023; 14:1034934. [PMID: 36843613 PMCID: PMC9947143 DOI: 10.3389/fendo.2023.1034934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The increased risk of metabolic syndrome (MetS) during the menopausal transition might partly attribute to the changes in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). However, few studies were conducted to examine the associations of FSH and LH concentrations with MetS at the full range of reproductive aging, especially in the US population. The aim of this study is to examine the associations of FSH, LH, and LH/FSH ratio with the risk of MetS and severity score in the US women. METHODS Data were derived from the National Health and Nutrition Examination Survey. Women aged from 35 to 60 years were eligible. MetS was defined as having at least 3 of the following: a waist circumference ≥ 88 cm, a triglycerides level ≥ 150 mg/dL, a high density lipoprotein < 50 mg/dL, a systolic blood pressure ≥ 130 mm Hg or a diastolic blood pressure ≥ 85 mm Hg or taking hypertension medications, or a fasting plasma glucose level ≥100 mg/dL or taking diabetes medications. The MetS severity score was calculated according to race/ethnicity- specific equation. RESULTS There were 3,831 women included in this study. Increases in serum FSH and LH levels per 1 SD were separately linked to a 22.6% (OR: 0.774; 95% CI: 0.646, 0.929; and P= 0.006) and 18.5% (OR: 0.815; 95% CI: 0.690, 0.962; and P= 0.006) lower risk of MetS only in postmenopausal women. Meanwhile, increases in serum FSH and LH levels per 1SD were associated with a decrease of -0.157 (95% CI :-2.967, -2.034) and -0.078 (95% CI: -2.688, -1.806) MetS severity score in perimenopausal women and -0.195 (95% CI: -2.192, -1.023) and -0.098 (95% CI:-1.884, -0.733) in postmenopausal women. However, LH/FSH ratio had no connections with the risk of MetS and MetS severity score across the menopausal transition. CONCLUSIONS Elevated serum FSH and LH levels, but not LH/FSH ratio, were associated with a lower risk of MetS and MetS severity score, especially in postmenopausal women. Therefore, serum FSH and LH levels might be efficient predictors for screening and identifying women at risk of MetS across the menopausal transition.
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