[Anthropometric and dietary determinants of blood levels of HDL cholesterol in a population-based study. The REGICOR study. Researchers of the REGICOR study]

Lipid profile and serum folate, vitamin B12 and homocysteine levels in patients with retinal vein occlusion

BACKGROUND

Retinal vein occlusion (RVO) is mainly related with vascular risk factors (VRF).

OBJECTIVES

To analyze the lipid profile and serum folate, vitamin B₁₂ and homocysteine levels, in patients with RVO and a population-based control group.

PATIENTS AND METHODS

Case-control study. Patients with RVO were assessed during an 11-year period.

RESULTS

We included 368 patients and 325 controls of similar age and sex. HDL cholesterol and folate levels were lower (52 [43-63] mg/dL vs. 55 [46-66]; p = 0.016 and 7 [5-10] ng/mL vs. 9 [7-13]; p < 0.0001, respectively) and non-HDL cholesterol and homocysteine levels higher (148.9 ± 37.3 mg/dL vs. 142.9 ± 34.5; p = 0.03 and 13.4 [11.2-18.2] μmol/L vs. 11.1 [9.0-14.4]; p < 0.001) in patients with RVO than controls. Although total cholesterol, LDL-C, and triglyceride levels were higher and serum vitamin B₁₂ levels were lower in RVO patients, these differences did not reach statistical significance.

CONCLUSIONS

RVO-patients have lower serum HDL-C and folate levels and higher non-HDL-C and serum homocysteine levels than population-based controls of similar age and sex. In patients with RVO, apart from the lipid profile, determination of serum homocysteine, folate and vitamin B₁₂ levels might be useful, as well as the treatment of their alterations.

Peripheral Arterial Disease study (PERART): prevalence and predictive values of asymptomatic peripheral arterial occlusive disease related to cardiovascular morbidity and mortality

BACKGROUND

The early diagnosis of atherosclerotic disease is essential for developing preventive strategies in populations at high risk and acting when the disease is still asymptomatic. A low ankle-arm index (AAI) is a good marker of vascular events and may be diminished without presenting symptomatology (silent peripheral arterial disease). The aim of the PERART study (PERipheral ARTerial disease) is to determine the prevalence of peripheral arterial disease (both silent and symptomatic) in a general population of both sexes and determine its predictive value related to morbimortality (cohort study).

METHODS/DESIGN

This cross-over, cohort study consists of 2 phases: firstly a descriptive, transversal cross-over study to determine the prevalence of peripheral arterial disease, and secondly, a cohort study to evaluate the predictive value of AAI in relation to cardiovascular morbimortality. From September 2006 to June 2007, a total of 3,010 patients over the age of 50 years will be randomly selected from a population adscribed to 24 healthcare centres in the province of Barcelona (Spain). The diagnostic criteria of peripheral arterial disease will be considered as an AAI < 0.90, determined by portable Doppler (8 Mhz probe) measured twice by trained personnel. Cardiovascular risk will be calculated with the Framingham-Wilson tables, with Framingham calibrated by the REGICOR and SCORE groups. The subjects included will be evaluted every 6 months by telephone interview and the clnical history and death registries will be reviewed. The appearance of the following cardiovascular events will be considered as variables of response: transitory ischaemic accident, ictus, angina, myocardial infartction, symptomatic abdominal aneurysm and vascular mortality.

DISCUSSION

In this study we hope to determine the prevalence of peripheral arterial disease, especially the silent forms, in the general population and establish its relationship with cardiovascular morbimortality. A low AAI may be a better marker of arterial disease than the classical cardiovascular risk factors and may, therefore, contribute to improving the predictive value of the equations of cardiovascular risk and thereby allowing optimisation of multifactorial treatment of atherosclerotic disease.

Mediterranean diet and metabolic syndrome: a cross-sectional study in the Canary Islands

Objective

Assessment of relation between metabolic syndrome (MS) and Mediterranean diet (MD) adherence.

Design

Cross-sectional study. ATP III definition of MS was used. Adherence to MD was assessed with a Food Frequency Questionnaire. Intakes of cereal, fruit, legumes, vegetables, fish, nuts, monounsaturated to saturated ratio, alcohol from red wine, whole-fat dairy products and red meat were considered.

Setting

Representative sample of population from the Canary Islands (Spain) participating in the Canarian Nutrition Survey (ENCA).

Subjects

578 adults>18 years.

Results

Of the subjects, 24.4% presented MS. Once adjusted, MD adherence was not related to MS prevalence, but subjects in the third tertile of adherence presented 70% lower prevalence of the blood pressure criteria and 2.5 times more prevalence of the glycaemia criteria with respect to the first tertile. Red meat intake was associated with higher prevalence of blood pressure criteria. Moderate alcohol intake from red wine was associated with lower prevalence of these criteria in women and lower prevalence of HDL cholesterol criteria in men. Fruit intake showed a protective effect on triglyceride criteria, whereas vegetable intake was associated with higher prevalence of this criterion. Cereals' intake showed a protective effect over insulin resistance measured by high insulinaemia level. Fruit intake showed a significative protective effect over high Homeostasis Model Assessment index. Whole-fat dairy products showed a significant protective effect on the glycaemia criteria. High monounsaturated to saturated fatty acid intake showed a protective effect on insulin resistance.

Conclusions

Some components of the MD showed a protective effect on the MS and its components.

[Coronary risk in the population of the Canary Islands, Spain, using the Framingham function]

BACKGROUND AND OBJECTIVE

Although ischemic cardiopathy mortality in the Canary Islands is among the highest in Spain, the specific coronary risk for its population has not been estimated. This study presents the first cardiovascular risk charts for the Canarian adult population and compares them with those previously published on Gerona, Spain.

SUBJECTS AND METHOD

A cross-sectional study of 4915 subjects, aged 25-74, that had been enrolled in the cohort study CDC of the Canary Islands. The standardized prevalence of obesity, overweight, smoking, hypertension and diabetes were estimated with the information obtained from personnel interviews, physical exams and blood samples. Those prevalences were used to calibrate the Framingham coronary function and to elaborate coronary risk charts.

RESULTS

The crude prevalence of obesity was 30% (95% confidence interval [CI], 28.7-31.3), overweight 39% (95% CI, 37.6-40.4), smoking 26% (95% CI, 24.8-27.2), hypertension 40% (95% CI, 38.6-41.4) and diabetes 12% (95% CI, 11.1-12.9). In most of the factors, these prevalences were higher than Gerona's population in every age group and gender. On average, the estimated coronary risk of the islanders was 89% higher than Gerona's risk (94% higher in males and 87% in females), which is concordant with the distance between both populations in the national mortality statistics.

CONCLUSIONS

The high prevalence of obesity and other factors in the Canarian population implies important coronary risks and it explains the position of the Canary Islands in the Spanish statistics of ischemic cardiopathy mortality. The use of these calibrated risk charts would be helpful to intensify the prevention of cardiovascular diseases.

Consistently high plasma high-density lipoprotein-cholesterol levels in children in Spain, a country with low cardiovascular mortality

Coronary heart disease (CHD) mortality is relatively low in Spain compared with other developed countries and has remained low despite an apparent increase in mean plasma cholesterol concentration in adults over the last several years. It is accepted that pathologic processes related to arteriosclerosis development begin in childhood and seem to be related to the presence of cardiovascular risk factors at this age. High-density lipoprotein-cholesterol (HDL-C) levels in children have been inversely correlated with the incidence of coronary heart disease in the different countries studied. Childhood plasma lipoprotein profile might contribute to the low coronary heart disease mortality in Spain. Thus, we analyzed data on lipid levels over time in schoolchildren in Spain in the last decade. Plasma lipid levels were analyzed in prepuberal children (6 to 8 years) in 3 school-based surveys performed by our group in Madrid in 1987, 1993, and 1999. A significant increase in plasma total cholesterol (P < .05) and low-density lipoprotein-cholesterol (LDL-C) (P < .01) levels in prepuberal children was observed over the last decade. However, the mean concentration of plasma HDL-C remained stable and very high. These high levels of plasma HDL-C in Spanish school children may help to explain why the coronary heart disease mortality rate in Spain is low compared with that in other developed countries.

Long-term evolution of blood lipid profiles and glycemic levels in patients after spinal cord injury

OBJECTIVE

To analyze the lipid and glycemic profiles in relation to age, time elapsed post injury and the level of injury in a group of patients with SCI.

SUBJECTS

2135 subjects with SCI were recruited during the annual routine health check-up carried out at the Institut Guttmann of Badalona, in Spain. The patients were classified according to the level of SCI and their age.

METHODS

Serum lipid profiles and glycemic (glucose) levels were determined. Data was collected between 1996 and 2001, all biochemical analysis being performed by the same laboratory.

RESULTS

Serum cholesterol levels show a statistically significant correlation with patient's age(P<0.001) and with time elapsed after injury (P<0.05). Differences can be observed between the values obtained from the different injury level groups (F=22.14; P<0.001). LDL-c shows a statistically significant difference between the four different age groups (F=3.51, P<0.05). There is an increase in plasma triglycerides related to the increase in age of the patients without observable differences between the injury level groups. The concentration of serum glucose increases with age (P<0.001) and also with the time elapsed after injury (P<0.05).

CONCLUSION

There is a direct relationship between various biochemical parameters (total cholesterol, LDL-c and glucose) and the age of the patients, but not with the severity or time of evolution of the spinal cord injury.