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Azagew AW, Abate HK, Mekonnen CK, Mekonnen HS, Tezera ZB, Jember G. Diabetic dyslipidemia and its predictors among people with diabetes in Ethiopia: systematic review and meta-analysis. Syst Rev 2024; 13:190. [PMID: 39033198 PMCID: PMC11264949 DOI: 10.1186/s13643-024-02593-2] [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: 11/06/2023] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Dyslipidemia is an imbalance of lipid profiles. It increases the chance of clogged arteries and may cause heart attacks, strokes, and other circulatory disorders. Dyslipidemia affects the general population, but its severity is higher in diabetic populations. As a result, the chance of dyslipidemia-associated morbidity and mortality is highest in diabetic patients. In Ethiopia, around 2 to 6.5% of the population live with diabetes, but their lipid profiles are inconsistent across the studies. Therefore, this study aimed to estimate the pooled prevalence of diabetic dyslipidemia and its predictors among people with diabetes in Ethiopia. METHOD A systematic review and meta-analysis was conducted. The searches were carried out in MEDLINE via PubMed and OVID, EBSCO, Embase, and other supplementary gateways such as Google and Google Scholar, for articles published up to June 2023. The articles were searched and screened by title (ti), abstract (ab), and full text (ft). The quality of the eligible studies was assessed by the Newcastle-Ottawa scale. The heterogeneity was detected by the Cochrane Q statistic test and the I-squared (I2) test. Then subgroup analysis and meta-regression analysis were used to identify the source of the variations. A random or fixed-effect meta-analysis model was used to estimate the overall pooled prevalence and average effects. The publication bias was assessed by the funnel plot asymmetry test and/or Begg and Mazumdar's test for rank correlation (p-value < 0.05). The protocol has been registered in an international database, the prospective register of systematic reviews (PROSPERO), with reference number CRD42023441572. RESULT A total of 14 articles with 3662 participants were included in this review. The pooled prevalence of diabetic dyslipidemia in Ethiopia was found to be 65.7% (95% confidence interval (CI): 57.5, 73.9), I2 = 97%, and p-value < 0.001. The overall prevalence of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) were found to be 51.8% (95% CI: 45.1, 58.6) and 44.2% (95% CI: 32.8, 55.7), respectively, among lipid profiles. In meta-regression analysis, the sample size (p value = 0.01) is the covariate for the variation of the included studies. Being female (adjusted odds ratio (AOR): 3.9, 95% CI: 1.5, 10.1), physical inactivity (AOR: 2.6, 95% CI: 1.5, 4.3), and uncontrolled blood glucose (AOR: 4.2, 95% CI: 1.9, 9.4) were found to be the determinants of dyslipidemia among diabetic patients. CONCLUSION This review revealed that the prevalence of diabetic dyslipidemia is high among people with diabetes in Ethiopia. Being female, having physical inactivity, and having uncontrolled blood glucose were found to be predictors of dyslipidemia among people with diabetes. Therefore, regular screening of lipid profiles and the provision of lipid-lowering agents should be strengthened to reduce life-threatening cardiovascular complications. Furthermore, interventions based on lifestyle modifications, such as regular physical activity and adequate blood glucose control, need to be encouraged.
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Affiliation(s)
- Abere Woretaw Azagew
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Hailemichael Kindie Abate
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Sewunet Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewdu Baye Tezera
- Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Heydarzadeh F, Mohammadi F, Yadegar A, Mohammadi Naeini A, Nabipoorashrafi SA, Rabizadeh S, Esteghamati A, Nakhjavani M. Increased high-density lipoprotein cholesterol in patients with type 2 diabetes and its correlates: a cross-sectional, matched case-control survey. Eur J Med Res 2024; 29:355. [PMID: 38956709 PMCID: PMC11218062 DOI: 10.1186/s40001-024-01950-0] [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: 03/18/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND So far, high-density lipoprotein cholesterol (HDL-C) levels and mortality were shown to have a U-shaped relationship. Additionally, high HDL-C levels increase the risk of developing a variety of diseases. However, a paucity of data exists regarding the characteristics of people with high HDL-C levels. The aim of this study was to assess the demographics and characteristics of patients with high HDL-C levels and compare their features with normal and low HDL-C groups. METHODS As a cross-sectional, matched case-control study, a total of 510 patients with type 2 diabetes (T2D) were enrolled in the study and categorized into three matched groups according to their HDL-C concentrations. The studied groups were matched by their age and gender. Restricted cubic spline (RCS) curves were designed to evaluate the relationship between height, blood pressure, triglyceride, and vitamin D concentrations with the probability of having high HDL-C levels. Furthermore, violin plots were conducted to illustrate the distribution of continuous variables within each group. RESULTS This study showed that having high HDL-C (more than 70 mg/dL) compared to having low HDL-C (less than 40 mg/dL in men and 50 mg/dL in women) was significantly associated with height (OR 0.918, 95% CI 0.866-0.974), systolic blood pressure (SBP) (0.941, 0.910-0.972), vitamin D (0.970, 0.941-0.999), and triglyceride (0.992, 0.987-0.998) serum concentrations. Further analysis investigated that having high HDL-C levels compared to desired HDL-C levels (40 ≤ HDL-C levels < 70 in men and 50 ≤ HDL-C levels < 70 in women) was inversely associated with having SPB values greater than 130 mmHg. Besides, sufficient vitamin D levels (above 20 ng/ml) could 0.349 times decrease the odds of having high HDL-C versus normal HDL-C levels. CONCLUSION Sufficient vitamin D levels, SPB values higher than 130 mmHg, as well as increased triglyceride levels, were inversely associated with having high HDL levels. However, higher height values were associated with a decreased likelihood of having high HDL.
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Affiliation(s)
- Fatemeh Heydarzadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadi Naeini
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Nabipoorashrafi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Ekpor E, Addo-Mensah D, Akyirem S. Prevalence of dyslipidemia among persons with type 2 diabetes in Africa: a systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:3468-3477. [PMID: 38846843 PMCID: PMC11152840 DOI: 10.1097/ms9.0000000000002122] [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: 03/12/2024] [Accepted: 04/20/2024] [Indexed: 06/09/2024] Open
Abstract
Background Dyslipidemia is an established cardiovascular risk factor in persons with type 2 diabetes (T2D), yet the extent to which these conditions co-occur in Africa is unknown. This systematic review and meta-analysis aimed to determine the prevalence of dyslipidemia among persons with T2D in Africa. Methods Medline, Embase, Global Health, Scopus, and Web of Science were searched on 5 December 2023. This review adhered to the PRISMA guidelines and was prospectively registered on PROSPERO. The prevalence data for dyslipidemia was pooled through a random-effects meta-analysis. The authors assessed heterogeneity and publication bias using I 2 statistics and Egger's test, respectively. Results Our search identified 8035 records, of which 60 articles involving 20 034 individuals with T2D were included in this review. The pooled prevalence of dyslipidemia recorded 38.6% (95% CI: 34.1-43.4) for high TC (≥ 5.2 mmol/l), 52.7% (95% CI: 44.2-61.1) for high low-density lipoprotein cholesterol (LDL-C) (≥ 2.6 mmol/l), 43.5% (95% CI: 37.1-50.0) for low high-density lipoprotein cholesterol (HDL-C) (< 1.0 mmol/l in men and less than 1.3 mmol/l in women), and 37.4% (95% CI: 32.2-42.9) for high triglycerides (TG) (≥ 1.7 mmol/l). Subgroup analysis based on gender indicated a notably higher prevalence of dyslipidemia among females compared to males. Conclusion Dyslipidemia is prevalent among persons with T2D in Africa. This highlights the need for early screening, diagnosis, and management of dyslipidemia to mitigate the risk of cardiovascular complications in this population.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing and Midwifery, University of Ghana, Legon
- Christian Health Association of Ghana, Accra, Ghana
| | - Dorothy Addo-Mensah
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Flack KA, Rainey ES, Urasa SJ, Koipapi S, Kalaria RN, Howlett WP, Mukaetova-Ladinska EB, Dekker MCJ, Gray WK, Walker RW, Dotchin CL, Mtwaile H, Lewis TCD, Stone LG, McNally RJQ, Makupa PC, Paddick SM. Lack of Association of Vascular Risk Factors with HIV-Associated Neurocognitive Disorders in cART-Treated Adults Aged ≥ 50 Years in Tanzania. Viruses 2024; 16:819. [PMID: 38932112 PMCID: PMC11209468 DOI: 10.3390/v16060819] [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: 01/08/2024] [Revised: 05/07/2024] [Accepted: 05/16/2024] [Indexed: 06/28/2024] Open
Abstract
HIV-associated neurocognitive disorders (HAND) are highly prevalent in those ageing with HIV. High-income country data suggest that vascular risk factors (VRFs) may be stronger predictors of HAND than HIV-disease severity, but data from sub-Saharan Africa are lacking. We evaluated relationships of VRFs, vascular end-organ damage and HAND in individuals aged ≥ 50 in Tanzania. c-ART-treated individuals were assessed for HAND using consensus criteria. The prevalence of VRFs and end organ damage markers were measured. The independent associations of VRFs, end organ damage and HAND were examined using multivariable logistic regression. Data were available for 153 individuals (median age 56, 67.3% female). HAND was highly prevalent (66.7%, 25.5% symptomatic) despite well-managed HIV (70.5% virally suppressed). Vascular risk factors included hypertension (34%), obesity (10.5%), hypercholesterolemia (33.3%), diabetes (5.3%) and current smoking (4.6%). End organ damage prevalence ranged from 1.3% (prior myocardial infarction) to 12.5% (left ventricular hypertrophy). Measured VRFs and end organ damage were not independently associated with HAND. The only significant association was lower diastolic BP (p 0.030, OR 0.969 (0.943-0.997). Our results suggest that vascular risk factors are not major drivers of HAND in this setting. Further studies should explore alternative aetiologies such as chronic inflammation.
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Affiliation(s)
- Katherine A. Flack
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Emma S. Rainey
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Sarah J. Urasa
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro PO Box 2240, Tanzania
| | - Sengua Koipapi
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro PO Box 2240, Tanzania
| | - Rajesh N. Kalaria
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - William P. Howlett
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro PO Box 2240, Tanzania
| | - Elizabeta B. Mukaetova-Ladinska
- Department of Neuroscience, Behaviour and Psychology, University of Leicester, Leicester LE1 7HA, UK
- The Evington Centre, Leicester General Hospital, Leicester LE5 4QF, UK
| | - Marieke C. J. Dekker
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro PO Box 2240, Tanzania
| | - William K. Gray
- Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields NE29 8NH, UK
| | - Richard W. Walker
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields NE29 8NH, UK
| | - Catherine L. Dotchin
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields NE29 8NH, UK
| | - Himidi Mtwaile
- Department of Radiology, NSK Hospital, Arusha P.O. Box 3114, Tanzania
| | - Thomas C. D. Lewis
- Department of Old Age Psychiatry, Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne NE4 6BE, UK
| | - Lydia G. Stone
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | | | - Philip C. Makupa
- HIV Care and Treatment Centre (CTC), Mawenzi Regional Referral Hospital, Moshi, Kilimanjaro P.O Box 3054, Tanzania
| | - Stella-Maria Paddick
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Gateshead NE8 4YL, UK
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Belete AM, Melese DM, Bewket B, Tegegne B, Shiferaw WS, Aynalem YA, Asefa A, Yazie TS. Dyslipidemia among adult HIV patients on antiretroviral therapy and its association with age and body mass index in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0298525. [PMID: 38722964 PMCID: PMC11081291 DOI: 10.1371/journal.pone.0298525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/26/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Dyslipidemia is a common public health problem in people living with human immunodeficiency virus (HIV) who are receiving antiretroviral therapy and increases the risk of cardiovascular disease. Although evidence indicates that the prevalence of dyslipidemia is high, estimated pooled data are not well documented. Therefore, we aimed to estimate the pooled prevalence of dyslipidemia in adult people living with HIV receiving antiretroviral therapy in Ethiopia. METHOD We conducted a systematic review and meta-analysis of the literature. The following databases and grey literature were searched: PubMed, WorldCat, ScienceDirect, DOAG, African Journals Online, Google Scholar, and African Index Medicine. We included all comparative epidemiological studies that reported the prevalence of high concentration of total cholesterol, triglycerides, and low density lipoprotein, and low concentration of high density lipoprotein cholesterol that were published between January 2003 and July 2023. The random effects model was used to pool the outcome of interest. Additionally, subgrouping, sensitivity analyses, and funnel plots were performed. R software Version 4.2.1 was used for statistical analysis. RESULT Seventeen studies with a total of 3929 participants were included in the meta-analysis. The pooled prevalence of dyslipidemia, high total cholesterol, high triglyceride, elevated level of low density lipoprotein and low level of high density lipoprotein cholesterol were 69.32% (95% CI: 63.33, 74.72), 39.78% (95%CI: 32.12, 47.96), 40.32% (95%CI: 34.56, 46.36), 28.58% (95%CI: 21.81, 36.46), and 36.17% (95%CI: 28.82, 44.24), respectively. Age and body mass index were associated with high total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels. CONCLUSION The authors concluded that the prevalence of dyslipidemia in Ethiopia is high in people living with HIV receiving antiretroviral therapy. Early detection of dyslipidemia and its integration into treatment are essential for preventing cardiovascular disease. TRIAL REGISTRATION Protocol registered with PROSPERO (CRD42023440125).
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Affiliation(s)
- Abebe Muche Belete
- Department of Biomedical Science, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Daniel Molla Melese
- Department of Biomedical Science, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bekalu Bewket
- Department of Nursing, College of Health Science, Injibara University, Injibara, Ethiopia
| | - Belachew Tegegne
- Department of Nursing, College of Health Science, Injibara University, Injibara, Ethiopia
| | - Wondimeneh Shibabaw Shiferaw
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Department of Nursing, Asrat Weldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Adisu Asefa
- Department of Non communicable disease, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Taklo Simeneh Yazie
- Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Diawara A, Coulibaly DM, Kone D, Traore MA, Konaté D, Bazi DS, Kassogue O, Sylla D, Fofana FG, Diabaté O, Traore M, Nieantao IA, Keїta K, Diarra M, Smith O, Li J, Cisse C, Abbas TY, Zheng C, Fatumo S, Traore K, Wele M, Diakité M, Doumbia SO, Shaffer JG. Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study. JOURNAL OF DIABETES MELLITUS 2024; 14:133-152. [PMID: 38938445 PMCID: PMC11210374 DOI: 10.4236/jdm.2024.142012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.
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Affiliation(s)
- Abdoulaye Diawara
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Drissa Kone
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mama A. Traore
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Drissa Konaté
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Dicko S. Bazi
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Oumar Kassogue
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Djeneba Sylla
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Oudou Diabaté
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mariam Traore
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Kaly Keїta
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mamadou Diarra
- National Federation of Community Health Associations, Bamako, Mali
| | - Olivia Smith
- Department of Tropical Medicine, Medical Microbiology, & Pharmacology, John A. Burns School of Medicine, University of Hawaii Manoa, Honolulu, USA
| | - Jian Li
- Department Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - Cheickna Cisse
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Talib Yusuf Abbas
- Department of Biotechnology and Computer Science, Burhani College, Mazgaon, Mumbai, India
| | - Crystal Zheng
- School of Medicine, Tulane University, New Orleans, USA
| | - Segun Fatumo
- Medical Research Council, Uganda Virus Research Institute, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kassim Traore
- Departement of Biochemistry and Genetics Duquesne, University College of Medicine, Pittsburgh, USA
| | - Mamadou Wele
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Diakité
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Seydou O. Doumbia
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Jeffrey G. Shaffer
- Department Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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Feng YH, Guo WX, Li ZL, Hu LF, Liu Y, Jing LY, Wang J, Shahbazi MA, Chen BZ, Guo XD. Assessing the structural stability and drug encapsulation efficiency of poly(ethylene glycol)-poly(L-lactic acid) nanoparticles loaded with atorvastatin calcium: Based on dissipative particle dynamics. Int J Biol Macromol 2024; 267:131436. [PMID: 38593897 DOI: 10.1016/j.ijbiomac.2024.131436] [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: 11/24/2023] [Revised: 03/09/2024] [Accepted: 04/04/2024] [Indexed: 04/11/2024]
Abstract
Block polymer micelles have been proven highly biocompatible and effective in improving drug utilization for delivering atorvastatin calcium. Therefore, it is of great significance to measure the stability of drug-loading nano micelles from the perspective of block polymer molecular sequence design, which would provide theoretical guidance for subsequent clinical applications. This study aims to investigate the structural stability of drug-loading micelles formed by two diblock/triblock polymers with various block sequences through coarse-grained dissipative particle dynamics (DPD) simulations. From the perspectives of the binding strength of poly(L-lactic acid) (PLLA) and polyethylene glycol (PEG) in nanoparticles, hydrophilic bead surface coverage, and the morphological alteration of nanoparticles induced by shear force, the ratio of hydrophilic/hydrophobic sequence length has been observed to affect the stability of nanoparticles. We have found that for diblock polymers, PEG3kda-PLLA2kda has the best stability (corresponding hydrophilic coverage ratio is 0.832), while PEG4kda-PLLA5kda has the worst (coverage ratio 0.578). For triblock polymers, PEG4kda-PLLA2kda-PEG4kda has the best stability (0.838), while PEG4kda-PLLA5kda-PEG4kda possesses the worst performance (0.731), and the average performance on stability is better than nanoparticles composed of diblock polymers.
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Affiliation(s)
- Yun Hao Feng
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Wei Xin Guo
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Zhuo Lin Li
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Liu Fu Hu
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yue Liu
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Li Yue Jing
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jianhao Wang
- School of Pharmacy, Changzhou University, Changzhou, Jiangsu 213164, China.
| | - Mohammad-Ali Shahbazi
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands; Department of Pharmaceutical Biomaterials, School of Pharmacy, Zanjan University of Medical Sciences, 45139-56184 Zanjan, Iran; W.J. Kolff Institute for Biomedical Engineering and Materials Science, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands.
| | - Bo Zhi Chen
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China.
| | - Xin Dong Guo
- State Key Laboratory of Organic-Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China; Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China.
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González Fernández L, Firima E, Gupta R, Sematle MP, Khomolishoele M, Molulela M, Bane M, Meli R, Tlahali M, Lee T, Chammartin F, Gerber F, Lejone TI, Ayakaka I, Weisser M, Amstutz A, Labhardt ND. Prevalence and determinants of cardiovascular risk factors in Lesotho: a population-based survey. Int Health 2024; 16:313-324. [PMID: 37593886 PMCID: PMC11062187 DOI: 10.1093/inthealth/ihad058] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND There are no recent data on the prevalence of cardiovascular risk factors (CVDRFs) in Lesotho. This study aims to assess the prevalence of CVDRFs and their determinants. METHODS We conducted a household-based, cross-sectional survey among adults ≥18 y of age in 120 randomly sampled clusters in two districts. RESULTS Among 6061 participants, 52.2% were female and their median age was 39 y (interquartile range 27-58). The overall prevalence of overweight, diabetes, elevated blood pressure (BP) and tobacco use was 39.9%, 5.3%, 21.6% and 24.9%, respectively. Among participants, 34.6% had none, 45.2% had one and 20.2% had two or more CVDRFs. Women were more likely to have two or more CVDRFs (20.7% vs 12.3%). Overall, 7.5% of participants had elevated total cholesterol, 52.7% had low high-density lipoprotein cholesterol and 1.6% had elevated low-density lipoprotein cholesterol. Among younger participants (18-29 y), 16.1% reported tobacco use, 28.6% were overweight, 1.5% had diabetes and 3.5% had elevated BP. Household wealth positively correlated with the prevalence of elevated BP, overweight and diabetes, whereas tobacco use was higher among people in the lowest three wealth quintiles. CONCLUSIONS CVDRFs are highly prevalent in Lesotho across age and sex groups, underlining the importance of strengthening prevention and care programs in Lesotho and similar settings in southern Africa.
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Affiliation(s)
- Lucia González Fernández
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Basel, 4051, Switzerland
- University of Basel, Basel, Switzerland
- SolidarMed, Partnerships for Health, Luzern, Switzerland
| | - Emmanuel Firima
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Basel, 4051, Switzerland
- University of Basel, Basel, Switzerland
| | - Ravi Gupta
- SolidarMed, Partnerships for Health, Maseru, Lesotho
| | | | | | | | | | - Raphaela Meli
- SolidarMed, Partnerships for Health, Luzern, Switzerland
| | - Mosa Tlahali
- Mokhotlong District Health Management Team, Mokhotlong, Ministry of Health Lesotho
| | - Tristan Lee
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Basel, 4051, Switzerland
- University of Basel, Basel, Switzerland
| | - Frédérique Chammartin
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Felix Gerber
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Basel, 4051, Switzerland
- University of Basel, Basel, Switzerland
| | - Thabo Ishmael Lejone
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Irene Ayakaka
- SolidarMed, Partnerships for Health, Maseru, Lesotho
| | - Maja Weisser
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Basel, 4051, Switzerland
- University of Basel, Basel, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Alain Amstutz
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Niklaus Daniel Labhardt
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Abissegue G, Yakubu SI, Ajay AS, Niyi-Odumosu F. A systematic review of the epidemiology and the public health implications of stroke in Sub-Saharan Africa. J Stroke Cerebrovasc Dis 2024; 33:107733. [PMID: 38663647 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107733] [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: 01/24/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND With approximately 11 million strokes occurring annually worldwide, and over 6.5 million deaths annually, stroke has made its place as one of the major killers in the world. Although developing countries make up more than 4/5 of the global stroke burden, well-grounded information on stroke epidemiology remains lacking there. AIMS This systematic review study aimed to provide a synthesis of studies on the incidence and prevalence of stroke among adults in sub-Saharan Africa (SSA), subsequently deduce the associated risk factors and public health implications (mortality rates and economic costs) of the disease on the population of this region. METHODS A systematic review of studies carried out in the region and published on PUBMED. Eligibility criteria were established using the PEO (Population/Patient, Exposure, Outcome) format. Research articles investigating either (or all) of the following: ischemic or haemorrhagic stroke, incidence, prevalence, and risk factors of stroke in adults (≥ 18 years old), in at least one region of SSA were included. Exclusion criteria comprised studies involving populations younger than 18 years old, research conducted outside the designated research region, and articles inaccessible in full text. The PRISMA guidelines were used for the search strategy. RESULTS Fifty-two studies were included review. Among them, over 11 studies investigated the prevalence of the disease. Some older studies within the continent (Nigeria, 2011) showed a prevalence of 1.3 per 100 while more recent studies (Zambia, 2021) showed a prevalence of 4.3 per 1000. The highest prevalence noted in this region was in Madagascar (2017) with 48.17 per 100, while the lowest was recorded in (Zimbabwe, 2017) with 0.61 per 100. The study in Tanzania showed a crude incidence of 94·5 per 100 000 (76·0-115·0) while the study in Ghana in 2018 showed an incidence of 14.19 events per 1000 person-years [10.77-18.38]. The identified risk factors included hypertension, diabetes, smoking, alcohol consumption, physical inactivity, poor diets (more salt, less vegetables), dyslipidaemia, HIV/AIDS co-infection, heart disease (cardiomyopathies, cardiac arrhythmias), obesity, previous stroke and/or family history of stroke. Over 21 studies investigated the mortality rates due to stroke in SSA, with most of the studies being in West Africa. These studies revealed mortality rates as high as 43.3% in Ghana, and as low as 10.9% in Cameroon. Few studies reported on the economic costs of stroke in the region; two in Benin, two in Nigeria and one in Tanzania. CONCLUSION The increasing incidence/prevalence, lifestyle factors and interactions with other diseases, including major communicable diseases, stroke is becoming a pressing public health problem for SSA. Reducing the incidence of stroke in Africa will surely lower mortality, morbidity, disability, and the neurological as well as cognitive aftereffects of stroke, as is clear from the experience of higher-income nations. We recommend a collective intervention involving the governments of nations, international organizations, civil society, and the private sector for greater impact and sustainable outcomes reducing the epidemiology and implications of stroke in SSA.
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Affiliation(s)
- Gisele Abissegue
- Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | | | - Aiswarya Seema Ajay
- Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Faatihah Niyi-Odumosu
- School of Applied Sciences, University of the West of England, Bristol, United Kingdom.
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10
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Mohammadi F, Yadegar A, Rabizadeh S, Ayati A, Seyedi SA, Nabipoorashrafi SA, Esteghamati A, Nakhjavani M. Correlates of normal and decreased HDL cholesterol levels in type 2 diabetes: a cohort-based cross-sectional study. Lipids Health Dis 2024; 23:18. [PMID: 38243302 PMCID: PMC10797913 DOI: 10.1186/s12944-024-02010-6] [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: 10/19/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The literature describes an inverse association between the values of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). This survey was designed to exhibit the features of people with type 2 diabetes (T2D) who display this inverse association and identify potential contributing factors to having normal HDL-C values. METHODS A total of 6127 persons with T2D were assigned to the present survey. Demographic features and clinical status data were compared between subjects with a substantial inverse association of TG and HDL-C and those without. Logistic regressions were performed to ascertain the role of different factors related to normal HDL-C. Moreover, the restricted cubic spline (RCS) functions were conducted to scrutinize the underlying relationships between the studied variables and low HDL-C levels. RESULTS Patients with high TG (150 ≤ TG < 400) compared to patients with normal TG (TG < 150) were less likely to have normal HDL-C. Younger age, narrow hip, lower levels of blood pressure, two-hour postprandial glucose (2hPP), fasting blood sugar (FBS), hemoglobinA1C (HbA1C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and non-HDL-C, higher atherogenic index of plasma (AIP), and TG/HDL-C ratio correlate with an inverse connection between the values of HDL-C and TG (all P < 0.05). Age greater than 65 years (odds ratio (OR) 1.260, 95% confidence intervals (CI) 1.124-1.413) had a positive association, whereas female sex (OR 0.467, CI 0.416-0.523) , 25 kg/m2 < body mass index (BMI) (OR 0.786, CI 0.691-0.894), and higher serum creatinine levels (OR 0.481, CI 0.372-0.621) had an inverse association with having normal HDL-C. CONCLUSIONS Patients with an inverse connection between TG and HDL-C values had considerably different anthropometric features, lipid profiles, and glucose indices compared to those without this relationship. Furthermore, patients who aged less than 65 years, had female gender, BMI more than 25 kg/m2, and higher serum creatinine levels were less likely to exhibit normal HDL-C levels.
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Affiliation(s)
- Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Aryan Ayati
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Arsalan Seyedi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Nabipoorashrafi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Molefe-Baikai OJ, Kebotsamang K, Modisawakgomo P, Tlhakanelo JT, Motlhatlhedi K, Moshomo T, Youssouf NF, Masupe T, Gaolathe T, Tapela N, Lockman S, Mosepele M. Self-reported cardiovascular disease risk factor screening among people living with HIV vs. members of the general population in Botswana: a community-based study. BMC Public Health 2024; 24:198. [PMID: 38229024 PMCID: PMC10792864 DOI: 10.1186/s12889-024-17651-6] [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: 06/28/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Morbidity and mortality due to cardiovascular diseases (CVDs) are high and increasing in low- and middle-income countries. People living with HIV (PLWH) are more likely to experience CVD than members of the general population. Therefore, we aimed to assess whether PLWH were more likely to have previously been screened for cardiovascular disease risk factors (CVDRFs) than people without HIV. METHODS A population-based, cross-sectional study was conducted among individuals aged 16 to 68 years across 22 communities in Botswana from February to August 2017 as part of a larger community-based cluster randomized HIV treatment-as-prevention trial. Participants were asked if they had been screened for and counselled on cardiovascular disease risk factors (history of hypertension or blood pressure check, blood glucose and cholesterol measurements, weight check and weight control, tobacco smoking and cessation, alcohol use and physical activity) in the preceding 3 years. HIV testing was offered to those with an unknown HIV status. Multiple logistic regression analysis controlling for age and sex was used to assess the relationship between CVDRF screening and HIV status. RESULTS Of the 3981 participants enrolled, 2547 (64%) were female, and 1196 (30%) were PLWH (93% already on antiretroviral therapy [ART]). PLWH were more likely to report previous screening for diabetes (25% vs. 19%, p < 0.001), elevated cholesterol (17% vs. 12%, p < 0.001) and to have had their weight checked (76% vs. 55%, p < 0.001) than HIV-uninfected participants. PLWH were also more likely to have received counselling on salt intake (42% vs. 33%, p < 0.001), smoking cessation (66% vs. 46%, p < 0.001), weight control (38% vs. 29%, p < 0.001), physical activity (46% vs. 34%, p < 0.001) and alcohol consumption (35% vs. 23%, p < 0.001) than their HIV-uninfected counterparts. Overall, PLWH were more likely to have received screening for and/or counselling on CVDRFs (adjusted odds ratio 1.84, 95% CI: 1.46-2.32, p < 0.001). CONCLUSION PLWH were almost two times more likely to have been previously screened for CVDRFs than those without HIV, indicating a need for universal scale-up of integrated management and prevention of CVDs in the HIV-uninfected population.
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Affiliation(s)
- Onkabetse Julia Molefe-Baikai
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana.
| | - Kago Kebotsamang
- Faculty of Social Sciences, Department of Statistics, University of Botswana, Gaborone, Botswana
| | | | - John Thato Tlhakanelo
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
| | - Keneilwe Motlhatlhedi
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
| | - Thato Moshomo
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana
| | - Nabila Farah Youssouf
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- London School of Hygiene and Tropical Medicine, London, UK
| | - Tiny Masupe
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
| | - Tendani Gaolathe
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Neo Tapela
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- International Consortium for Health Outcomes Measurement, Boston, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, USA
| | - Shahin Lockman
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, USA
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, USA
| | - Mosepele Mosepele
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, USA
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12
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Mohammed O, Alemayehu E, Debash H, Belete MA, Gedefie A, Tilahun M, Ebrahim H, Gebretsadik Weldehanna D. Dyslipidemia among HIV-infected patients in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:27. [PMID: 38166636 PMCID: PMC10763320 DOI: 10.1186/s12879-023-08910-9] [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: 08/04/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Dyslipidemia is responsible for more than half of the global ischemic heart disease (IHD) and more than 4 million deaths annually. Assessing the prevalence of dyslipidemia can be crucial in predicting the future disease development and possible intervention strategies. Therefore, this systematic review and meta-analysis was aimed at assessing the pooled prevalence of dyslipidemia in HIV-infected patients. METHODS Electronic databases such as EMBASE, Google Scholar, PubMed, Web of Science, ResearchGate, Cochrane Library, and Science Direct were searched for articles and grey literature. All relevant studies found until our search period of May 24, 2023 were included. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The data were extracted in Microsoft Excel. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran's Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger's test statistics. Moreover, subgroup analysis, and sensitivity analysis were also done. RESULTS A total of nine studies that reported the prevalence of dyslipidemia were included. The overall pooled prevalence of dyslipidemia among HIV-infected patients in Ethiopia was 67.32% (95% CI = 61.68%-72.96%). Furthermore, the overall pooled estimates of dyslipidemia among ART-taking and treatment-naïve HIV-infected patients were 69.74% (95% CI: 63.68-75.8, I2 = 87.2) and 61.46% (95% CI: 45.40-77.52, I2 = 90.3), respectively. Based on lipid profile fractionations, the pooled estimates for high total cholesterol (TC) were 39.08% (95% CI: 31.16-46.99), high triglycerides were 38.73% (95% CI: 28.58-48.88), high low density lipoprotein (LDL-c) was 28.40% (95% CI: 17.24-39.56), and low high density lipoprotein (HDL-c) was 39.42% (95% CI: 30.47-48.38). CONCLUSION More than two-thirds of HIV-infected patients experienced dyslipidemia. Therefore, it's critical to regularly evaluate lipid alterations in HIV-infected patients in order to prevent the onset of atherosclerosis and other cardiovascular problems.
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Affiliation(s)
- Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtu Debash
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik Weldehanna
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Badacho AS, Mahomed OH. Facilitators and barriers to integration of noncommunicable diseases with HIV care at primary health care in Ethiopia: a qualitative analysis using CFIR. Front Public Health 2023; 11:1247121. [PMID: 38145060 PMCID: PMC10748758 DOI: 10.3389/fpubh.2023.1247121] [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: 06/25/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background The rise in non-communicable diseases (NCD), such as hypertension and diabetes among people living with human immunodeficiency virus (PLWH), has increased the demand for integrated care due to multiple chronic care needs. However, there is a dearth of evidence on contextual factors implementing integrated hypertension and diabetes care with HIV care. This study aimed to identify facilitators and barriers that could affect the integration of hypertension and diabetes with HIV care at primary health care in Ethiopia. Methods Five primary health facilities from five districts of the Wolaita zone of South Ethiopia were included in the qualitative study. Fifteen key informant interviews were conducted with healthcare providers and managers from the zonal, district, and facility levels from October to November 2022. Data collection and analysis were guided by a consolidated framework of implementation research (CFIR). Results Ten CFIR constructs were found to influence the integration. Perceived benefit of integration to patients, healthcare providers, and organization; perceived possibilities of integration implementation; availability of NCD guidelines and strategies; a supportive policy of decentralization and integration; perceived leaders and healthcare provider commitment were found to be facilitators. Perceived increased cost, insufficient attention to NCD care needs, inadequate number of trained professionals, inadequate equipment and apparatus such as blood pressure measurement, glucometers, strips, and NCD drugs, inadequate allocation of budget and weak health financing system and poor culture of data capturing and reporting were identified as barriers to integration. Conclusion It is important to address contextual barriers through innovative implementation science solutions to address multiple chronic care needs of PLWH by implementing integrated hypertension and diabetes with HIV care in primary healthcare. Training and task shifting, pairing experienced professionals, and strengthening the health care financing system to implement evidence-based integration of hypertension and diabetes are recommended.
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Affiliation(s)
- Abebe Sorsa Badacho
- School Public Health, Wolaita Sodo University, Sodo, Ethiopia
- School of Nursing and Public Health, Public Health Medicine Discipline, Durban, South Africa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Ozayr Haroon Mahomed
- School of Nursing and Public Health, Public Health Medicine Discipline, Durban, South Africa
- Dasman Diabetes Institute, Kuwait City, Kuwait
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Li X, Wang L. Highland barley attenuates high fat and cholesterol diet induced hyperlipidemia in mice revealed by 16S rRNA gene sequencing and untargeted metabolomics. Life Sci 2023; 334:122142. [PMID: 37797689 DOI: 10.1016/j.lfs.2023.122142] [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: 05/25/2023] [Revised: 09/20/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
AIMS In this study, highland barley (HB), HB bran (HBB) and whole grain HB (WGHB) alleviating hyperlipemia and liver inflammation in high fat and cholesterol diet (HFCD) mice was investigated. METHODS All 50 ICR mice were randomly allocated to 5 treatment groups: Normal control group, HFCD group, HB group, HBB group and WGHB group. The serum lipid profiles, liver and epididymal adipocyte histology, gut microbiota and untargeted metabolomics were adopted. KEY FINDINGS The results suggested that HB especially HBB supplement could obviously decrease BW and BWG. Serum lipid profiles showed that HB especially HBB decreased TG, TC, LDL-C, ALT and AST levels while increased HDL-C level. Liver and epididymal adipocyte H&E staining also confirmed that hepatic injury and adipose accumulation were alleviated by HB especially HBB. Gut microbiota analysis indicated that HBB increased Bacteroidetes/Firmicutes ratio, Lactobacillus and Akkermansia muciniphila abundances while decreased Proteobacteria and Shigella abundances. Untargeted metabolomics results showed that HBB significantly increased deoxycholic acid levels compared with HFCD mice and HBB regulated arachidonic acid metabolism pathway. SIGNIFICANCE The obtained results provided important information about the processing of highland barley to retain its hypolipidemic effect and improve its acceptability and biosafety, and had a guiding effect on the development of HB products.
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Affiliation(s)
- Xiang Li
- State Key Laboratory of Food Science and Resources, Jiangnan University, Lihu Road 1800, Wuxi 214122, China
| | - Li Wang
- Key Laboratory of Carbohydrate Chemistry and Biotechnology Ministry of Education, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; State Key Laboratory of Food Science and Resources, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Provincial Engineering Research Center for Bioactive Product Processing, Jiangnan University, Lihu Road 1800, Wuxi 214122, China.
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Helegbe GK, Abdullah SJ, Mohammed BS. Dyslipidemias: Prevalence and Associated Factors among Lactating Women in a Lower- and Middle-Income Country, Ghana. J Lipids 2023; 2023:6280494. [PMID: 38022868 PMCID: PMC10676279 DOI: 10.1155/2023/6280494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/21/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Dyslipidemia, an abnormally high level of lipids in the blood, has a negative impact on the health status of the individual and has lately emerged as a major public health concern, especially for low- and middle-income countries (LMIC) globally, including Ghana. However, it is still unclear what the burden and drivers of these lipid abnormalities are, especially among lactating women in the Upper West of Ghana. Thus, this study is aimed at determining the prevalence of dyslipidemia and its associated factors among lactating mothers in the Wa Municipality of Ghana. Methodology. A cross-sectional study was conducted from May to June 2020 in 8 health facilities within the Wa Municipality. Multistage and simple random sampling methods were used to select the facilities and the 200 study subjects. Sociodemographic data were collected using questionnaires, while blood samples were taken to determine the lipid profile of participants. Dietary patterns were also assessed using the Food Frequency Questionnaire (FFQ). Data were processed and analyzed using SPSS 17 software (SPSS, Inc., Chicago, IL). The chi-square test and multiple regression analysis were performed to determine the predictors associated with the various types of dyslipidemia, with statistical significance set at a p value < 0.05. Results The prevalence of hypercholesterolemia (LDL-C), hypo-HDL-cholesterolemia, and hypertriglyceridemia (TG) was 57%, 59%, and 22%, respectively. Chi-square and multinomial regression analysis revealed that duration of lactation (X2 = 3.95, p = 0.047), religion (AOR = 0.375, 95% CI 0.144-0.978, p = 0.045), low income (AOR = 0.116, 95% CI 0.026-0.514, p = 0.005), middle income (AOR = 0.163, 95% CI 0.044-0.600, p = 0.006), and alcohol intake (AOR = 6.312, 95% CI 1.108-35.949, p = 0.038) were associated with LDL-C, while age (AOR = 0.963, 95% CI 0.910-1.019, p < 0.001) and educational status (AOR = 0.365, 95% CI 0.140-0.954, p = 0.040) predicted HDL status. Conclusion Dyslipidemia is common among lactating mothers of Wa Municipality, and it is predicted by lifestyle factors. Furthermore, future research to look at a larger sample size on dyslipidemia during lactation is recommended.
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Affiliation(s)
- Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Ghana
| | - Saeed Jabactey Abdullah
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Ghana
| | - Baba Sulemana Mohammed
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, University for Development Studies, Ghana
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Filisa-Kaphamtengo F, Ngoma J, Mukhula V, Matemvu Z, Kapute D, Banda P, Phiri T, Mipando M, Hosseinipour MC, Katundu KGH. Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi. BMC Cardiovasc Disord 2023; 23:548. [PMID: 37946116 PMCID: PMC10636904 DOI: 10.1186/s12872-023-03589-x] [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: 08/15/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Dyslipidaemia among individuals with diabetes is a significant modifiable risk factor for atherosclerotic cardiovascular diseases (ASCVDs). ASCVDs are a major cause of mortality and morbidity globally, especially in people with diabetes. In Malawi, limited data exist on the prevalence and biochemical characteristics of diabetic dyslipidaemia. This study investigated the prevalence and biochemical characteristics of dyslipidaemia in individuals attending the diabetes clinic at Kamuzu Central Hospital, the largest tertiary referral hospital in Central Malawi. METHODS Using a cross-sectional design, sociodemographic, medical and anthropometric data were collected from 391 adult participants who were enrolled in the study. Blood samples were analysed for glycosylated haemoglobin (HBA1c) and fasting lipid profiles. The prevalence of dyslipidaemia was calculated, and the biochemical characteristics of the dyslipidaemia were defined. The associations between dyslipidaemia and risk factors such as sociodemographic characteristics, obesity, and HBA1c levels were evaluated using logistic regression analysis. RESULTS Prevalence of dyslipidaemia was observed in 71% of the participants, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality among the study participants. None of the participants were receiving any lipid-lowering therapy. On bivariate analysis, dyslipidemia was positively associated with female sex [OR 1.65 (95% CI 1.05- 2.58); p = 0.09], age ≥ 30 years [OR 3.60 (95% CI 1.17-7.68); p = 0.001] and overweight and obesity [OR 2.11 (95% CI 1.33-3.34); p = 0.002]. On multivariate analysis, being overweight or obese was an independent predictor of dyslipidaemia [AOR 1.8;(95% CI 1.15- 3.37); p = 0.04]. CONCLUSION Dyslipidaemia was highly prevalent among individuals with diabetes in this study, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality. Overweight and obesity were also highly prevalent and positively predicted dyslipidaemia. This study highlights the importance of appropriately addressing dyslipidaemia, overweight and obesity among individuals with diabetes in Malawi and other similar settings in Africa as one of the significant ways of reducing the risk of ASCVDs among this population.
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Affiliation(s)
- Florence Filisa-Kaphamtengo
- Kamuzu Central Hospital, Lilongwe, Malawi
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Victoria Mukhula
- Malawi-Liverpool Wellcome Clinical Research Program, Blantyre, Malawi
- Blantyre to Blantyre Research Facility, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | - Peter Banda
- Department of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Tamara Phiri
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Mwapatsa Mipando
- Blantyre to Blantyre Research Facility, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Biomedical Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Kondwani G H Katundu
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
- Malawi-Liverpool Wellcome Clinical Research Program, Blantyre, Malawi.
- Blantyre to Blantyre Research Facility, Kamuzu University of Health Sciences, Blantyre, Malawi.
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Motuma A, Shiferaw K, Gobena T, Teji Roba K, Berhane Y, Worku A. Dyslipidemia and its predictors among adult workers in eastern Ethiopia: An institution-based cross-sectional study. PLoS One 2023; 18:e0291665. [PMID: 37812638 PMCID: PMC10561842 DOI: 10.1371/journal.pone.0291665] [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: 12/22/2022] [Accepted: 09/03/2023] [Indexed: 10/11/2023] Open
Abstract
INTRODUCTION Dyslipidemia is a modifiable major risk factor for coronary heart disease. Although, the prevalence of dyslipidemia in high-income countries has been well documented, there is dearth of information about the dyslipidemia among working adults in sub-Saharan African countries including Ethiopia. Therefore, this study aimed to determine the magnitude of dyslipidemia and its associated factors among Haramaya University employees, in Eastern Ethiopia. METHODS A cross-sectional study was conducted among 1,200 university employees aged 20 to 60 years. Study participants were selected using a simple random sampling method. Data were collected face-to-face interview using a semi-structured questionnaire. Dyslipidemia was defined as unhealthy levels of one or more lipid profile such as high-density lipoprotein, low-density lipoprotein, triglycerides or total cholesterol. Data were entered into Epidata version 3.1 and analyzed using STATA version 16.1 software. Modified Poisson regression with robust variance was used to estimate adjusted prevalence ratios (APR) with its 95% confidence intervals. Statistical significance was declared at P-value < 0.05. RESULTS Of 1,164 participants, 59.6% participants had at least one lipid abnormality (i.e., 57.9% among men and 61.5% among women). Of which, 36.8% had high total cholesterol (TC), 21.6% had low high density lipoprotein cholesterol (HDL-c), 22.4% had high low density lipoprotein cholesterol (LDL-c), and 32.6% had high triglyceride (TG). We found that overweight/obesity, sedentary behavior, alcohol consumption, having hypertension and age 45 and above years were significant predictors of dyslipidemia. However, those who served fruit and vegetables more than five per day had significantly reduced prevalence ratio of dyslipidemia. CONCLUSIONS The high prevalent dyslipidemia among university employees is an important public health problem. Hence, tailored interventions to reduce overweight/obesity, hypertension, alcohol consumption and low fruit and vegetable intake have paramount importance to tackle dyslipidemia particularly among older age.
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Affiliation(s)
- Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kasiye Shiferaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Gobena
- Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Filisa-Kaphamtengo F, Ngoma J, Mukhula V, Matemvu Z, Kapute D, Banda P, Phiri T, Mipando M, Hosseinipour MC, Katundu KGH. Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi. RESEARCH SQUARE 2023:rs.3.rs-3262287. [PMID: 37674703 PMCID: PMC10479448 DOI: 10.21203/rs.3.rs-3262287/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background Dyslipidaemia among individuals with diabetes is a significant modifiable risk factor for atherosclerotic cardiovascular diseases (ASCVDs). ASCVDs are a major cause of mortality and morbidity globally, especially in people with diabetes. In Malawi, limited data exist on the prevalence and biochemical characteristics of diabetic dyslipidaemia. This study investigated the prevalence and biochemical characteristics of dyslipidaemia in individuals attending the diabetes clinic at Kamuzu Central Hospital, the largest tertiary referral hospital in Central Malawi. Methods Using a cross-sectional design, sociodemographic, medical and anthropometric data were collected from 391 adult participants who were enrolled in the study. Blood samples were analysed for glycosylated haemoglobin (HBA1c) and fasting lipid profiles. The prevalence of dyslipidaemia was calculated, and the biochemical characteristics of the dyslipidaemia were defined. The associations between dyslipidaemia and risk factors such as sociodemographic characteristics, obesity, and HBA1c levels were evaluated using logistic regression analysis. Results Prevalence of dyslipidaemia was observed in 71% of the participants, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality among the study participants. On bivariate analysis, dyslipidemia was positively associated with female sex [OR 1.65 (95% CI 1.05-2.58); p = 0.09], age ≥ 30 years [OR 3.60 (95% CI 1.17-7.68); p = 0.001] and overweight and obesity [OR 2.11 (95% CI 1.33-3.34); p = 0.002]. On multivariate analysis, being overweight or obese was an independent predictor of dyslipidaemia [AOR 1.8 ;( 95% CI 1.15-3.37); p = 0.04]. Conclusion Dyslipidaemia was highly prevalent among individuals with diabetes in this study, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality. Overweight and obesity were also highly prevalent and positively predicted dyslipidaemia. This study highlights the importance of appropriately addressing dyslipidaemia, overweight and obesity among individuals with diabetes in Malawi and other similar settings in Africa as one of the significant ways of reducing the risk of ASCVDs among this population.
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Ndaba L, Mutyaba A, Mpanya D, Tsabedze N. In-Hospital Mortality Outcomes of ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study from a Tertiary Academic Hospital in Johannesburg, South Africa. J Cardiovasc Dev Dis 2023; 10:348. [PMID: 37623361 PMCID: PMC10455389 DOI: 10.3390/jcdd10080348] [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: 07/17/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
In sub-Saharan Africa, the burden of atherosclerotic cardiovascular disease (ASCVD) is increasing. This study aimed to describe the clinical characteristics of patients with ST-segment elevation myocardial infarction (STEMI) and estimate the in-hospital all-cause mortality rate. We conducted a cross-sectional retrospective single-centre study of STEMI patients who underwent diagnostic coronary angiography with or without percutaneous coronary intervention (PCI) between January 2015 and December 2019. We compared demographic and clinical parameters between survivors and non-survivors with descriptive statistics. Univariable and multivariable logistic regression analyses were performed to determine the predictors of all-cause mortality. The study population consisted of 677 patients with a mean age of 55.5 ± 11.3 years. The in-hospital all-cause mortality rate was 6.2% [95% confidence interval (CI): 4.5-8.3%]. Risk factors for ASCVD included smoking (56.1%), hypertension (52.8%), dyslipidemia (40.0%), and a family history of coronary artery disease (32.7%). A pharmaco-invasive management strategy (treatment with thrombolytic therapy and PCI) was implemented in 36.5% of patients and reduced all-cause mortality risk (OR: 0.16; CI: 0.04-0.71, p = 0.015). The in-hospital all-cause mortality rate in STEMI patients was 6.2%, and a pharmaco-invasive management strategy proved to be an effective approach.
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Affiliation(s)
| | | | | | - Nqoba Tsabedze
- Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (L.N.); (A.M.); (D.M.)
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20
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Soko ND, Muyambo S, Dandara MTL, Kampira E, Blom D, Jones ESW, Rayner B, Shamley D, Sinxadi P, Dandara C. Towards Evidence-Based Implementation of Pharmacogenomics in Southern Africa: Comorbidities and Polypharmacy Profiles across Diseases. J Pers Med 2023; 13:1185. [PMID: 37623436 PMCID: PMC10455498 DOI: 10.3390/jpm13081185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/26/2023] Open
Abstract
Pharmacogenomics may improve patient care by guiding drug selection and dosing; however, this requires prior knowledge of the pharmacogenomics of drugs commonly used in a specific setting. The aim of this study was to identify a preliminary set of pharmacogenetic variants important in Southern Africa. We describe comorbidities in 3997 patients from Malawi, South Africa, and Zimbabwe. These patient cohorts were included in pharmacogenomic studies of anticoagulation, dyslipidemia, hypertension, HIV and breast cancer. The 20 topmost prescribed drugs in this population were identified. Using the literature, a list of pharmacogenes vital in the response to the top 20 drugs was constructed leading to drug-gene pairs potentially informative in translation of pharmacogenomics. The most reported morbidity was hypertension (58.4%), making antihypertensives the most prescribed drugs, particularly amlodipine. Dyslipidemia occurred in 31.5% of the participants, and statins were the most frequently prescribed as cholesterol-lowering drugs. HIV was reported in 20.3% of the study participants, with lamivudine/stavudine/efavirenz being the most prescribed antiretroviral combination. Based on these data, pharmacogenes of immediate interest in Southern African populations include ABCB1, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, SLC22A1, SLCO1B1 and UGT1A1. Variants in these genes are a good starting point for pharmacogenomic translation programs in Southern Africa.
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Affiliation(s)
- Nyarai Desiree Soko
- Platform for Pharmacogenomics Research and Translation (PREMED), University of Cape Town, South African Medical Research Council, Cape Town 7935, South Africa
- Department of Pharmaceutical Technology, School of Allied Health Sciences, Harare Institute of Technology, Harare, Zimbabwe
- Pharmacogenomics and Drug Metabolism Research Group, Division of Human Genetics, Department of Pathology and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Sarudzai Muyambo
- Department of Biological Sciences and Ecology, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Michelle T. L. Dandara
- Platform for Pharmacogenomics Research and Translation (PREMED), University of Cape Town, South African Medical Research Council, Cape Town 7935, South Africa
| | - Elizabeth Kampira
- Medical Laboratory Sciences, School of Life Sciences and Health Professionals, Kamuzu University of Health Sciences (KUHES), Blantyre, Malawi
| | - Dirk Blom
- Platform for Pharmacogenomics Research and Translation (PREMED), University of Cape Town, South African Medical Research Council, Cape Town 7935, South Africa
- Division of Lipidology and Cape Heart Institute, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Erika S. W. Jones
- Platform for Pharmacogenomics Research and Translation (PREMED), University of Cape Town, South African Medical Research Council, Cape Town 7935, South Africa
- Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Brian Rayner
- Platform for Pharmacogenomics Research and Translation (PREMED), University of Cape Town, South African Medical Research Council, Cape Town 7935, South Africa
| | - Delva Shamley
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Phumla Sinxadi
- Platform for Pharmacogenomics Research and Translation (PREMED), University of Cape Town, South African Medical Research Council, Cape Town 7935, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Collet Dandara
- Department of Pharmaceutical Technology, School of Allied Health Sciences, Harare Institute of Technology, Harare, Zimbabwe
- Pharmacogenomics and Drug Metabolism Research Group, Division of Human Genetics, Department of Pathology and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
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Mohamed-Yassin MS, Rosman N, Kamaruddin KN, Miptah HN, Baharudin N, Ramli AS, Abdul-Razak S, Lai NM. A systematic review and meta-analysis of the prevalence of dyslipidaemia among adults in Malaysia. Sci Rep 2023; 13:11036. [PMID: 37419924 PMCID: PMC10328969 DOI: 10.1038/s41598-023-38275-7] [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: 12/20/2022] [Accepted: 07/06/2023] [Indexed: 07/09/2023] Open
Abstract
Dyslipidaemia is an established cardiovascular risk factor. This study aimed to determine the pooled prevalence of dyslipidaemia in Malaysian adults. A systematic review and meta-analysis of all cross-sectional, longitudinal observational studies which reported the prevalence of elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), and reduced high-density lipoprotein cholesterol (HDL-c) in adults 18 years old and older, was conducted. A comprehensive search of PubMed and Cochrane Central Register of Controlled Trials (which included Medline, EMBASE and major trial registers) from inception to October 18, 2022, was performed. Risk-of-bias was evaluated using the Johanna-Briggs Institute Prevalence Critical Appraisal Tool, while certainty of evidence was assessed using an adapted version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Random-effects meta-analyses were performed using MetaXL. This report follows the PRISMA reporting guidelines. The protocol was registered with PROSPERO (CRD42020200281). 26 556 studies were retrieved and 7 941 were shortlisted initially. From this, 70 Malaysian studies plus two studies from citation searching were shortlisted; 46 were excluded, and 26 were included in the review (n = 50 001). The pooled prevalence of elevated TC (≥ 5.2 mmol/L), elevated LDL-c (≥ 2.6 mmol/L), elevated TG (≥ 1.7 mmol/L), and low HDL-c (< 1.0 mmol/L in men and < 1.3 mmol/L in women) were 52% (95% CI 32-71%, I2 = 100%), 73% (95% CI 50-92%, I2 = 100%), 36% (95% CI 32-40%, I2 = 96%), and 40% (95% CI 25-55%, I2 = 99%), respectively. This review found that the prevalence of all dyslipidaemia subtypes is high in Malaysian adults. Ongoing efforts to reduce cardiovascular diseases in Malaysia should integrate effective detection and treatment of dyslipidaemia.
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Affiliation(s)
- Mohamed-Syarif Mohamed-Yassin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia.
| | - Norhidayah Rosman
- Unit of Pathology, Faculty of Medicine, AIMST University, 08100, Bedong, Kedah, Malaysia
| | - Khairatul Nainey Kamaruddin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
| | - Hayatul Najaa Miptah
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
| | - Noorhida Baharudin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Anis Safura Ramli
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
| | - Suraya Abdul-Razak
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
- Cardio Vascular and Lungs Research Institute (CaVaLRI), Hospital Universiti Teknologi MARA (HUiTM), Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University, 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
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Fentie D, Yibabie S. Magnitude and associated factors of dyslipidemia among patients with severe mental illness in dire Dawa, Ethiopia: neglected public health concern. BMC Cardiovasc Disord 2023; 23:298. [PMID: 37312056 DOI: 10.1186/s12872-023-03327-3] [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: 01/25/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Lipid metabolism abnormalities are an emerging risk factor for cardiovascular diseases. Due to the nature of the condition and their unhealthy lifestyles, patients with mental illnesses have a doubled risk of morbidity and mortality from dyslipidemia compared to the general population. To our knowledge the magnitude of dyslipidemia in patients with mental illnesses in the eastern Ethiopia has not been reported in the literature to date. Therefore, the aim of the study was to assess and compare the magnitude of dyslipidemia and its predictors among patients with severe mental illnesses and non-mentally ill control patients. METHODS Nighty six subjects with serious psychiatric disorders and nighty six matched non-psychiatric control subjects who had no history of psychiatric illness were underwent a lipid profile test in Dire Dawa referral hospital, Ethiopia. The mentally ill clients were 18 years of age and older with schizophrenia, major depression, and bipolar disorders. Exposed study subjects were matched to control by age and sex. The data were cleaned and analyzed using SPSS software. A binary logistic regression model was used to determine the factors related to the magnitude of dyslipidemia. Both the crude odds ratio and the adjusted odds ratio with a 95% confidence interval were estimated. RESULTS The magnitude of dyslipidemia among mentally ill patients was significantly higher (63.54%) compared to non-exposed controls (31.9%) in the subjects studied. In multiple logistic regression, urban dwellers were six times (AOR = 6.14, 95% CI: 1.2, 16) more likely at risk of developing dyslipidemia compared to rural participants. Similarly, physically inactive participants were nearly two-times (AOR = 1.8, 95% CI: 1.1, 12.9) more likely to develop dyslipidemia compared to physically active study participants. Moreover, study participants who had raised body mass index were 2.1 times (AOR = 2.1, 95% CI: 1.17, 15.3) more likely having dyslipidemia than their counterparts. CONCLUSIONS This study revealed that the prevalence of dyslipidemia is higher among mentally ill patients compared to non-mentally ill control study participants. Place of residence, physical inactivity, and raised BMI were significantly associated with dyslipidemia. Therefore, intensive screening of patients for dyslipidemia and its components is necessary during follow-up.
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Affiliation(s)
- Dilnessa Fentie
- Medical department, medical and health sciences college, Dire Dawa University, Dire Dawa, Ethiopia.
| | - Shegaye Yibabie
- Medical department, medical and health sciences college, Dire Dawa University, Dire Dawa, Ethiopia
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Assefa A, Abiye AA, Tadesse TA, Woldu M. Prevalence and Factors Associated with Dyslipidemia Among People Living with HIV/AIDS on Follow-Up Care at a Tertiary Care Hospital in Ethiopia: A Cross-Sectional Study. Drug Healthc Patient Saf 2023; 15:93-102. [PMID: 37546170 PMCID: PMC10397381 DOI: 10.2147/dhps.s395037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/18/2023] [Indexed: 08/08/2023] Open
Abstract
Background Despite its importance as a major risk factor for cardiovascular disease, dyslipidemia remains poorly characterized in the African population. Objective To assess the prevalence and factors associated with dyslipidemia in people with HIV/AIDS in follow-up at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Materials and Methods A hospital-based retrospective cross-sectional study evaluated the charts of 288 people living with HIV/AIDS who had received Highly Active Antiretroviral Treatment for at least six months at Zewditu Memorial Hospital from July to September 2021. Sociodemographic and clinical data were collected from the patient's charts. Statistical analysis was performed using the Statistical Package for Social Sciences software version 25. Results The overall prevalence of dyslipidemia was 55.2% in people living with HIV/AIDS. The prevalence of high-density lipoprotein cholesterol <40 mg/dl in men and <50 in women was 46.9%; total cholesterol ≥200 mg/dl was 22.6%; triglycerides ≥150 mg/dl was 18.8%, and low-density lipoprotein ≥130 mg/dl was 4.9%. Sex [Female adjusted odds ratio (AOR) = 0.595, 95% CI: 0.37-0.956], age greater than 40 years (AOR = 1.026, 95% CI: 1.005-1.048), body mass index >25 kg/m2 (AOR = 1.767, 95% CI: 1.099-2.84), viral load >50 (AOR = 0.477, 95% CI: 0.27-0.842), and CD4 <500 (AOR = 1.938, 95% CI: 1.18-3.183) were identified as determinants of dyslipidemia. Conclusion There was a high prevalence of dyslipidemia among study participants compared to several studies published in a similar population. Being male, older age, higher BMI, low CD4 count, and viral load of < 50 copies/mL were associated with dyslipidemia in people living with HIV/AIDS. Therefore, lipid profile measurements at baseline must be part of routine care to prevent the devastating effects of dyslipidemia.
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Affiliation(s)
- Alemayehu Assefa
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alfoalem Araba Abiye
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Assefa Tadesse
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Minyahil Woldu
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Russell JBW, Koroma TR, Sesay S, Samura SK, Lakoh S, Bockarie A, Abir OT, Kanu JS, Coker J, Jalloh A, Conteh V, Conteh S, Smith M, Mahdi OZ, Lisk DR. Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey. BMJ Open 2023; 13:e067643. [PMID: 37192807 DOI: 10.1136/bmjopen-2022-067643] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE To investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage (TOD) and its associated factors among adults in Freetown, Sierra Leone. DESIGN This community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants. SETTING The health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Sierra Leone. PARTICIPANTS A total of 2394 adult Sierra Leoneans aged 20 years or older were enrolled. OUTCOME MEASURE Anthropometric data, fasting lipid profiles, fasting plasma glucose, TOD, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to TOD. RESULTS The prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidaemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by ECG, 14.2% had LVH by two-dimensional echo and 11.4% had chronic kidney disease (CKD). The odds of developing ECG-LVH were higher with diabetes (OR=1.255, 95% CI (0.822 to 1.916) and dyslipidaemia (OR=1.449, 95% CI (0.834 to 2.518). Associated factors for higher odds of Left Ventricular Mass Index by echo were dyslipidaemia (OR=1.844, 95% CI (1.006 to 3.380)) and diabetes mellitus (OR=1.176, 95% CI (0.759 to 1.823)). The odds of having CKD were associated with diabetes mellitus (OR=1.212, 95% CI (0.741 to 1.983)) and hypertension (OR=1.163, 95% CI (0.887 to 1.525)). A low optimal cut-off point for ECG-LVH (male 24.5 mm vs female 27.5 mm) was required to maximise sensitivity and specificity by a receiver operating characteristics curve since the odds for LVH by ECG were low. CONCLUSIONS This study provides novel data-driven information on the burden of CMRF and its association with preclinical TOD in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management in Sierra Leonean.
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Affiliation(s)
- James Baligeh Walter Russell
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Theresa Ruba Koroma
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Santigie Sesay
- Directorate of Non-Communicable Diseases and Mental Health, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Sallieu Kabay Samura
- Department of Mathematics and Statistics, Fourah Bay College, University of Sierra Leone, Freetown, Sierra Leone
| | - Sulaiman Lakoh
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ansumana Bockarie
- School of Medical Sciences, Department of Internal Medicine, University of Cape Coast, Cape Coast, Ghana
| | - Onome Thomas Abir
- Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joseph Sam Kanu
- Department of Community Health, Faculty of Clinical Sciences, College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joshua Coker
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Abdul Jalloh
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Victor Conteh
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Sorie Conteh
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Smith
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Othman Z Mahdi
- Department of Internal Medicine, Choithrams Memorial Hospital, Freetown, Sierra Leone
| | - Durodami R Lisk
- Department of Internal Medicine, College of Medicine And Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Azeez TA, Yaria J, Adetunji TA. Stroke and dyslipidaemia in Africa: a meta-analysis of case-control studies. J Thromb Thrombolysis 2023:10.1007/s11239-023-02823-9. [PMID: 37148438 DOI: 10.1007/s11239-023-02823-9] [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] [Accepted: 04/22/2023] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Stroke is an acute neurological disorder characterized by an abrupt reduction in blood flow to the brain, spinal cord, or retina. There is a complex relationship between stroke and dyslipidaemia. The objective of the study was to determine the likelihood of dyslipidaemia in African stroke patients. METHODS AND RESULTS This study is a systematic review and meta-analysis of case-control studies to determine the odds ratio of dyslipidaemia among stroke patients in Africa. It followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The sources of data included Google Scholar, PubMed, SCOPUS, African Journal Online (AJOL), Research Square, SciELO, and medRxiv databases. The case-control studies eligible were conducted in Africa. The meta-analysis was carried out with Meta XL version 5.3, using the random effect model. RESULTS Ten studies met the eligibility criteria and the total sample size was 9599. The odds ratio of dyslipidaemia in all stroke cases in Africa was 1.61 (95% CI: 1.28-2.03) while that of ischaemic stroke and haemorrhagic stroke are 1.27 (0.54-2.98) and 1.71 (1.43-2.05) respectively. CONCLUSION Although not particularly substantial, there is an association between dyslipidaemia and stroke in Africa.
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Affiliation(s)
- Taoreed Adegoke Azeez
- Department of Medicine, Reddington Multi-Specialist Hospital, 12, Idowu Martins Street, Victoria Island, Lagos, Nigeria.
| | - Joseph Yaria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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Belete AK, Kassaw AT, Yirsaw BG, Taye BA, Ambaw SN, Mekonnen BA, Sendekie AK. Prevalence of Hypercholesterolemia and Awareness of Risk Factors, Prevention and Management Among Adults Visiting Referral Hospital in Ethiopia. Vasc Health Risk Manag 2023; 19:181-191. [PMID: 37020462 PMCID: PMC10069426 DOI: 10.2147/vhrm.s408703] [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: 02/15/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Background Unhealthy lifestyles and physical inactivity are among the contributing factors of hypercholesterolemia. This study assessed the prevalence, awareness of risk factors, and prevention and treatment of hypercholesterolemia among adults who visited Woldia referral hospital, Northeast Ethiopia. Methods A cross-sectional survey was conducted among adults who visited Woldia referral hospital from May to August 2022. Data was collected using a structured questionnaire through a face-to-face interview and patient medical record review. Logistic regression analysis was employed to determine the association between hypercholesterolemia and other variables. A p-value at a 95% confidence level was statistically significant. Results A total of 1180 eligible adults were included in the study. The magnitude of hypercholesterolemia was 26.4%. The majority of the respondents were aware of some risk factors, such as higher fat intake (82.3%), obesity (67.2%), and lack of adequate exercise (56.1%). However, the majority of the respondents were not aware that smoking, alcohol consumption, and age (86.8% for all) had cardiovascular risk. The majority of the respondents were aware that eating a limited amount of saturated fat (56.5%), maintaining a healthy weight (67.2%), and taking prescribed medications properly (86.8%) can prevent the risk of hypercholesterolemia. However, a larger proportion of respondents were unaware that smoking cessation (86.8%), exercise (55.3%), alcohol restriction (86.8%), and stress avoidance (75.3%) can prevent cardiovascular risks. Age (p = 0.036), smoking (p = 0.007), alcohol use (p = 0.013), fruit consumption (p = 0.019), saturated oil use (p = 0.031), level of physical activity (p < 0.001), and body mass index (p = 0.03) were significantly associated with hypercholesterolemia. Conclusion This study concluded that more than one-fourth of adults had hypercholesterolemia. The majority of the respondents did not have an awareness of common cardiovascular risk factors and prevention and treatment techniques regarding unhealthy lifestyles and physical inactivity.
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Affiliation(s)
- Aychew Kassa Belete
- Department of Sport Science, Faculty of Natural and Computational Science, Woldia University, Woldia, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Bantie Getnet Yirsaw
- Department of Statistics, Faculty of Natural and Computational Science, Woldia University, Woldia, Ethiopia
| | - Birhan Ambachew Taye
- Department of Statistics, Faculty of Natural and Computational Science, Woldia University, Woldia, Ethiopia
| | - Samueal Nigatie Ambaw
- Department of Sport Science, Faculty of Natural and Computational Science, Woldia University, Woldia, Ethiopia
| | - Biset Asrade Mekonnen
- Department of Pharmaceutical Analysis, School of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Ashenafi Kibret Sendekie, Email
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Mohammed O, Alemayehu E, Ebrahim E, Fiseha M, Gedefie A, Ali A, Ebrahim H, Tilahun M. Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast Ethiopia. PLoS One 2023; 18:e0277185. [PMID: 36787318 PMCID: PMC9928121 DOI: 10.1371/journal.pone.0277185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/21/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND One of the major risk factors for cardiovascular disease is atherogenic dyslipidemia. There was, however, little information available in Ethiopia. Therefore, the purpose of this study was to estimate the prevalence of atherogenic dyslipidemia and related risk factors in Northeast Ethiopian hypertension patients. MATERIALS AND METHODS A systematic random sampling technique was used to perform a cross-sectional study at an institution with 384 chosen participants. A structured questionnaire was used to collect the socio-demographic, anthropometric, lifestyle, and clinical characteristics of the respondents. Student's t-test, Mann-Whitney test, and Pearson's Chi-square test were employed to compare groups based on the type of data. Furthermore, Bivariate and multivariable logistic regression analyses were performed to identify factors independently associated with dyslipidemia. Crude and adjusted odds ratios and their corresponding 95% Confidence Intervals (CI) were computed. In all cases, statistical significance was declared at p <0.05. RESULTS The majority (93.2%; 95%CI: 90.6-95.6) of patients had at least one atherogenic dyslipidemia. The prevalence of elevated total cholesterol (TC), elevated triglyceride (TG), raised low-density lipoprotein cholesterol (LDL-c), and reduced high-density lipoprotein cholesterol (HDL-c) were 47.7%, 50.3%, 44.3%, and 59.6%, respectively. Being≥ 40 years were at higher risk for having elevated levels of TC (AOR: 3.22, 95% CI: 2.40-4.32), TG (AOR: 2.30, 95% CI: 1.61-3.79), and LDL-c (AOR: 4.68, 95% CI: 2.0-10.95) than those who were below 40years. Obese participants were more likely to have high concentrations of TC (AOR: 2.57, 95%CI: 2.10-3.22), LDL-c (AOR: 3.13, 95% CI: 1.97-5.10), HDL-c (AOR: 2.71, 95% CI: 1.77-4.58), and TG (AOR: 2.23, 95%CI: 1.79-4.16). CONCLUSION This study revealed that a high prevalence of atherogenic dyslipidemia. Thus, to prevent atherogenic dyslipidemia, it is crucial to create routine blood lipid testing programs and carry out suitable intervention programs focused on risk factor reduction.
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Affiliation(s)
- Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Endris Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mesfin Fiseha
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abdurrahman Ali
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Wyszyńska J, Łuszczki E, Sobek G, Mazur A, Dereń K. Association and Risk Factors for Hypertension and Dyslipidemia in Young Adults from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:982. [PMID: 36673736 PMCID: PMC9858900 DOI: 10.3390/ijerph20020982] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
Hypertension and dyslipidemia are major risk factors for cardiovascular disease. Studies on the association between abnormal levels of lipids and hypertension have yielded inconsistent results. The aim of this study was to examine the prevalence of hypertension and dyslipidemia and its risk factors in young Polish adults. Furthermore, the association between plasma lipid levels and the risk of hypertension was determined. A cross-sectional study was conducted among 115 volunteer participants. Blood pressure was measured using an automated oscillometric sphygmomanometer. Blood lipids were analyzed from a fasting blood sample received by finger prick. Body fat percentage was assessed using a bioelectrical impedance analysis device. Socioeconomic and lifestyle factors (age, date of birth, place of residence, screen time, and tobacco use) were self-reported by the participant. The prevalence of hypertension was higher in men than in women (61.5 vs. 21.3%). The prevalence of elevated TC, TG, high LDL, and low HDL was 22.6%, 7.8%, 38.3%, and 13.9%, respectively. Spending more than 2 h daily in front of a computer was identified as a significant predictor of hypertension and elevated TG levels (p < 0.05). A high number of cigarettes smoked daily was a significant risk factor for hypertension (p = 0.047). Hypertension contributed to a higher risk of abnormal values of TC (OR = 5.89), LDL (OR = 5.38), and TG (OR = 9.75). Participants with hypertension were more likely than normotensive subjects to have elevated levels of TC, LDL, and TG. The prevalence of hypertension was significantly higher in young men than in women. BMI was associated with the prevalence of hypertension and elevated TC levels. Spending more than 2 h per day in front of a computer contributed to the prevalence of hypertension and elevated TG levels. Participants with hypertension smoked a higher number of cigarettes daily compared to those with normotension.
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Affiliation(s)
- Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Grzegorz Sobek
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Artur Mazur
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Katarzyna Dereń
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
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Liu X, Chen F, Liu L, Zhang Q. Prevalence of osteoporosis in patients with diabetes mellitus: a systematic review and meta-analysis of observational studies. BMC Endocr Disord 2023; 23:1. [PMID: 36597121 PMCID: PMC9809067 DOI: 10.1186/s12902-022-01260-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/22/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Osteoporosis (OP) and diabetes mellitus (DM) are two major healthcare issues in the world. Numerous population based-studies have reported an increased prevalence of OP among individuals with DM, though, estimates vary significantly. PURPOSE The objective of this study is to estimate the prevalence of OP in patients with DM. METHODS To identify relevant literature, PubMed, Embase, Medline, CBM and Cochrane Library were searched for studies published from inception till July 2022, The search was conducted, and studies were included without countries and language restrictions. For full-text articles included in the study, the references were also independently searched. Random inverse variance-weighted models were used by Stata version 17.0 to estimate the prevalence of OP in patients with diabetes across studies. The heterogeneity was examined with I2 via the χ2 test on Cochrane's Q statistic. Subgroup analysis and meta-regression were used to explore potential sources of heterogeneity. Egger's test was used to assess publication bias. RESULTS A high OP prevalence of 27.67% (95% confidence interval (CI) 21.37-33.98%) was found in a pooled analysis of 21 studies involving 11,603 T2DM patients. Methodological value of the included articles was high, with only three medium-quality studies and no low-quality studies. A significantly high heterogeneity (I2 = 98.5%) was observed. CONCLUSIONS Worldwide, a high prevalence of OP was found in patients with T2DM. Therefore, strong measures to prevent and treat osteoporosis in diabetic patients are required. TRIAL REGISTRATION This study has been registered on PROSPERO, number CRD42021286580 .
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Affiliation(s)
- Xueying Liu
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
| | - Fuhua Chen
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
| | - Lei Liu
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
| | - Qiu Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
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Bonnechère B, Liu J, Thompson A, Amin N, van Duijn C. Does ethnicity influence dementia, stroke and mortality risk? Evidence from the UK Biobank. Front Public Health 2023; 11:1111321. [PMID: 37124771 PMCID: PMC10140594 DOI: 10.3389/fpubh.2023.1111321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/10/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction The number of people with dementia and stroke is increasing worldwide. There is increasing evidence that there are clinically relevant genetic differences across ethnicities. This study aims to quantify risk factors of dementia, stroke, and mortality in Asian and black participants compared to whites. Methods 272,660 participants from the UK Biobank were included in the final analysis, among whom the vast majority are white (n = 266,671, 97.80%), followed by Asian (n = 3,790, 1.35%), and black (n = 2,358, 0.84%) participants. Cumulative incidence risk was calculated based on all incident cases occurring during the follow-up of the individuals without dementia and stroke at baseline. We compared the allele frequency of variants in Asian and black participants with the referent ethnicity, whites, by chi-square test. Hierarchical cluster analysis was used in the clustering analysis. Significance level corrected for the false discovery rate was considered. Results After adjusting for risk factors, black participants have an increased risk of dementia and stroke compared to white participants, while Asians has similar odds to the white. The risk of mortality is not different in blacks and white participants but Asians have a decreased risk. Discussion The study provides important insights into the potential differences in the risk of dementia and stroke among different ethnic groups. Specifically, the study found that black individuals had a higher incidence of dementia and stroke compared to white individuals living in the UK. These findings are particularly significant as they suggest that there may be underlying factors that contribute to these differences, including genetic, environmental, and social factors. By identifying these differences, the study helps to inform interventions and policies aimed at reducing the risk of dementia and stroke, particularly among high-risk populations.
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Affiliation(s)
- Bruno Bonnechère
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | - Jun Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alexander Thompson
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Najaf Amin
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Cornelia van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- *Correspondence: Cornelia van Duijn,
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Katundu KGH, Mukhula V, Phiri T, Phiri C, Filisa-Kaphamtengo F, Chipewa P, Chirambo G, Mipando M, Mwandumba HC, Muula AS, Kumwenda J. High prevalence of dyslipidaemia among persons with diabetes mellitus and hypertension at a tertiary hospital in Blantyre, Malawi. BMC Cardiovasc Disord 2022; 22:557. [PMID: 36544081 PMCID: PMC9771776 DOI: 10.1186/s12872-022-03011-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dyslipidaemia drives the process of atherosclerosis, and hence a significant modifiable risk factor complicating hypertension and diabetes. In Malawi, the prevalence, screening and management of dyslipidaemia among persons with diabetes mellitus have not been reported. This study aimed to investigate the prevalence, biochemical characteristics, screening and management practices for dyslipidaemia among persons with diabetes mellitus, hypertension, and diabetes mellitus and hypertension comorbidity at Queen Elizabeth Central hospital in Blantyre, Malawi. METHODS This was a cross-sectional study conducted in 2021. A total of 256 adult participants (diabetes mellitus = 100); hypertension = 100; both conditions = 56) were included. Medical data and anthropometric measurements were recorded. Blood samples were analysed for HbA1C and serum lipids. Associated risk factors for dyslipidaemia were also assessed. RESULTS Dyslipidaemia was prevalent in 58%, 55%, and 70% of participants with diabetes mellitus, hypertension, and both conditions. Low-density lipoprotein cholesterol (LDL-C) dyslipidaemia was the most common in all participant groups. Participants with both diabetes and hypertension had 2.4 times (95% CI 1.2-4.6) increased risk of LDL-C dyslipidaemia than those with diabetes alone (p < 0.02). Being overweight or obese and age over 30 years were risk factors for dyslipidaemia in participants with diabetes mellitus alone (OR 1.3 (95% CI 1.1-1.6), p < 0.04, and OR 2.2 (95% CI 1.2-4.7) (p < 0.01), respectively. Overweight and obesity predicted LDL-C dyslipidaemia in hypertensive patients (OR 3.5 (95% CI 1.2-9.9) p < 0.001). Poorly controlled hypertension and the use of beta-blockers and thiazide diuretics predicted dyslipidaemia among patients with both diabetes mellitus and hypertension (OR 6.50 CI 1.45-29.19; and OR 5.20 CI 1.16-23.36 respectively). None of the participants had a lipogram performed before the study or were on lipid-lowering therapy. CONCLUSIONS Dyslipidaemia with LDL-C derangement was highly prevalent, especially in individuals with both diabetes mellitus and hypertension, and there was absent use of lipid-lowering therapy. Screening and managing dyslipidaemia should be reinforced to reduce the risk of cardiovascular complications in this population at increased risk.
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Affiliation(s)
- Kondwani G H Katundu
- Department of Biomedical Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi.
- Malawi-Liverpool Wellcome Clinical Research Program, Kamuzu University of Health Sciences, Blantyre, Malawi.
| | - Victoria Mukhula
- Malawi-Liverpool Wellcome Clinical Research Program, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Tamara Phiri
- Department of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Chimota Phiri
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Pascal Chipewa
- Department of Biomedical Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - George Chirambo
- Department of Biomedical Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
- Blantyre to Blantyre Research Facility, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Mwapatsa Mipando
- Department of Biomedical Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
- Blantyre to Blantyre Research Facility, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Henry C Mwandumba
- Malawi-Liverpool Wellcome Clinical Research Program, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Adamson S Muula
- Department of Community and Environmental Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Johnstone Kumwenda
- Department of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
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Agongo G, Raal F, Nonterah EA, Debpuur C, Oduro AR, Ramsay M, Crowther NJ. Non-HDL-C and LDL-C/HDL-C are associated with self-reported cardiovascular disease in a rural West African population: Analysis of an array of lipid metrics in an AWI-Gen sub-study. PLoS One 2022; 17:e0278375. [PMID: 36477684 PMCID: PMC9728928 DOI: 10.1371/journal.pone.0278375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Few studies have compared the utility of serum levels of lipid fractions in cardiovascular disease (CVD) risk assessment in sub-Saharan Africa (SSA). The current study interrogated this question among men and women aged 40-60 years in rural northern Ghana. This was a cross-sectional study in which data was collected on socio-demography, behaviour, health history, anthropometry and lipid levels. Adjusted multivariable logistic regression models were used to assess the association of various lipid metrics with CVD. All tests were considered statistically significant at P<0.05. Data were available for 1839 participants. The prevalence of self-reported CVD was 1.6% (n = 29). Non-HDL-C (median (interquartile range): 2.4 (1.9-3.0) vs 2.0 (1.6-2.5) mmol/L; P = 0.009), LDL-C/HDL-C (1.8 (1.4-2.4) vs 1.5 (1.1-2.6); P = 0.019) and TC/HDL-C (3.3 (2.9-3.9) vs 2.9 (2.4-3.5); P = 0.003) were all significantly higher in participants with self-reported CVD compared to those without. However, after adjusting for socioeconomic status (SES) and meals from vendors in a logistic regression model, only non-HDL-C (odds ratio [95% CIs]): (1.58 [1.05, 2.39]), P = 0.029 and LDL-C/HDL-C levels (odds ratio [95% CIs]): (1.26 [1.00, 1.59]), P = 0.045 remained significantly associated with self-reported CVD. While our findings suggest non-HDL-C and LDL-C/HDL-C measures may be appropriate biomarkers for assessing CVD risk in this population, further studies using established clinical endpoints are required to validate these findings in sub-Saharan Africans.
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Affiliation(s)
- Godfred Agongo
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C.K Tedam University of Technology and Applied Sciences, Navrongo, Ghana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- * E-mail:
| | - Frederick Raal
- Division of Endocrinology and Metabolism, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Engelbert A. Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cornelius Debpuur
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Abraham R. Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Bahadorpour S, Hajhashemy Z, Saneei P. Serum 25-hydroxyvitamin D levels and dyslipidemia: a systematic review and dose-response meta-analysis of epidemiologic studies. Nutr Rev 2022; 81:1-25. [PMID: 35831956 DOI: 10.1093/nutrit/nuac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
CONTEXT Findings of previous observational studies that examined the association between circulating vitamin D levels and lipid profiles have been inconsistent. OBJECTIVE A dose-response meta-analysis of epidemiologic studies was conducted to investigate the relationship between serum 25-hydroxyvitamin D levels and dyslipidemia in adults. DATA SOURCES Electronic databases were searched systematically for articles published up to June 2021. DATA EXTRACTION Fifty-seven observational studies and 2 cohort studies that reported odds ratios (ORs) or relative risks (RRs) with 95%CIs for dyslipidemia in relation to serum 25-hydroxyvitamin D levels in adults were included. DATA ANALYSIS A high level, vs a low level, of serum 25-hydroxyvitamin D was related to a significant 19% decrease in the odds of hypertriglyceridemia (OR 0.81; 95%CI, 0.74-0.89), an 18% reduction in low high-density lipoprotein cholesterol (HDL-C) (OR 0.82; 95%CI, 0.76-0.89), and an 18% reduction in dyslipidemia (OR 0.82; 95%CI, 0.75-0.91). No significant association was found between a high vs a low level of serum 25-hydroxyvitamin D and risk of high low-density lipoprotein cholesterol (LDL-C) levels (OR 0.86; 95%CI, 0.62-1.19) or hypercholesterolemia (OR 1.03; 95%CI, 0.93-1.15). Dose-response analyses demonstrated that each 10 ng/mL increase in the serum 25-hydroxyvitamin D level was linked, respectively, to a 7% (OR 0.93;95%CI, 0.85-1.02), a 3% (OR 0.97; 95%CI, 0.90-1.05), and a 4% (OR 0.96; 95%CI, 0.92-1.00) marginally significant decrease in the odds of hypertriglyceridemia, low HDL-C, and dyslipidemia. CONCLUSION Higher serum 25-hydroxyvitamin D levels are associated with significant reductions in the odds of hypertriglyceridemia, low HDL-C, and dyslipidemia in a dose-response trend. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021219484.
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Affiliation(s)
- Sedigheh Bahadorpour
- are with the Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,are with the Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- are with the Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,are with the Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- are with the Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Estimating the changing disease burden attributable to raised low-density lipoprotein cholesterol in South Africa for 2000, 2006 and 2012. S Afr Med J 2022; 112:607-616. [DOI: 10.7196/samj.2022.v112i8b.16489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background. Low-density lipoprotein cholesterol (LDL-C) is the most important contributor to atherosclerosis, a causal factor for ischaemic heart disease (IHD) and ischaemic stroke. Although raised LDL-C is a key contributor to cardiovascular disease (CVD), the exact attributable disease risk in South Africa (SA) is unknown. The the first SA comparative risk assessment (SACRA1) study assessed the attributable burden of raised total cholesterol, and not specifically LDL-C.
Objectives. To estimate the national mean serum LDL-C by age, year and sex and to quantify the burden of disease attributable to LDL-C in SA for 2000, 2006 and 2012.
Methods. The comparative risk assessment (CRA) method was used. Estimates of the national mean of LDL-C, representing the 3 different years, were derived from 14 small observational studies using a meta-regression model. A theoretical minimum risk exposure level (TMREL) of 0.7 - 1.3 mmol/L was used. LDL-C estimates together with the relative risks from the Global Burden of Disease Study 2017 were used to calculate a potential impact fraction (PIF). This was applied to IHD and ischaemic stroke estimates sourced from the Second National Burden of Disease Study. Attributable deaths, years of life lost, years lived with disability and disability-adjusted life years (DALYs) were calculated. Uncertainty analysis was performed using Monte Carlo simulation.
Results. LDL-C declined from 2.74 mmol/L in 2000 to 2.58 mmol/L in 2012 for males, while in females it declined from 3.05 mmol/L in 2000 to 2.91 mmol/L in 2012. The PIFs for LDL-C showed a slight decline over time, owing to the slight decrease in LDL-C levels. Attributable DALYs increased between 2000 (n=286 712) and 2006 (n=315 125), but decreased thereafter in 2012 (n=270 829). Attributable age-standardised death rates declined between 2000 and 2012 in both sexes: in males from 98 per 100 000 members of the population in 2000 to 78 per 100 000 in 2012, and in females from 81 per 100 000 in 2000 to 58 per 100 000 in 2012.
Conclusions. Mean LDL-C levels were close to 3 mmol/L, which is the recommended level at which cholesterol-lowering treatment should be initiated for people at low and moderate risk for cardiovascular outcomes. The decreasing trend in the age-standardised attributable burden due to LDL-C is encouraging, but it can be lowered further with the introduction of additional population-based CVD prevention strategies. This study highlights the fact that high LDL-C concentration in relation to the TMREL in SA is responsible for a large proportion of the emerging CVD, and should be targeted by health planners to reduce disease burden.
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Pharmacological Effects of Hydrocotyle bonariensis Comm. ex Lam (Araliaceae) Extract on Cardiac Activity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1961352. [PMID: 36212942 PMCID: PMC9536924 DOI: 10.1155/2022/1961352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/19/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022]
Abstract
Hydrocotyle bonariensis is one of the medicinal plants used in traditional medicine for the management of hypertension in Africa, Asia, and Latin America. However, the real impact of the traditional use of this plant on arterial hypertension has not yet been the subject of conclusive scientific information in the literature. This study aimed essentially to evaluate the potential cardiomodulatory effect of the hydroethanolic extract of Hydrocotyle bonariensis. In other to do so, the hydroethanolic extract of H. bonariensis was studied in vivo on the Wistar rat ECG and then in vitro on the isolated perfused Wistar rat heart using the Langendorff system. The extract was also tested on isolated guinea pig atria kept alive in the organ-specific vessel under physiological conditions similar to those of a living organism. At the cellular level, the effects of the extract were evaluated on the human cardiac sodium current INav1.5 and on the human cardiac pacemaker current If. We noted that the extract caused a decrease in P wave and T wave amplitudes and heart rate and an increase in the duration of the RR interval on the in vivo rat ECG. On the isolated perfused Langendorff heart as well as on the isolated atria, a decrease in the RR interval and in the heart rate was noted. The extract had no effect on human cardiac sodium current, but it did reduce human cardiac pacemaker current. In conclusion, the present study demonstrated that Hydrocotyle bonariensis, a medicinal plant traditionally used to prevent and treat hypertension, has an overall cardiomoderating effect. This effect would contribute to the reduction of blood pressure.
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Mansfield BS, Bhana S, Raal FJ. Dyslipidemia in South African patients with hypothyroidism. J Clin Transl Endocrinol 2022; 29:100302. [PMID: 35898802 PMCID: PMC9309410 DOI: 10.1016/j.jcte.2022.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/21/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Brett S. Mansfield
- Division of Endocrinology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Corresponding author at: Division of Endocrinology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
| | - Sindeep Bhana
- Division of Endocrinology, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Frederick J. Raal
- Division of Endocrinology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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George C, Echouffo-Tcheugui JB, Jaar BG, Okpechi IG, Kengne AP. The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries-a review of the current literature. BMC Med 2022; 20:247. [PMID: 35915501 PMCID: PMC9344711 DOI: 10.1186/s12916-022-02438-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/14/2022] [Indexed: 12/30/2022] Open
Abstract
Chronic kidney disease (CKD) in people with diabetes is becoming an increasing major public health concern, disproportionately burdening low- and middle-income countries (LMICs). This rising burden is due to various factors, including the lack of disease awareness that results in late referral and the cost of screening and consequent treatment of the comorbid conditions, as well as other factors endemic to LMICs relating to inadequate management of risk factors. We critically assessed the extant literature, by performing searches of Medline via PubMed, EBSCOhost, Scopus, and Web of Science, for studies pertaining to screening, diagnosis, and prediction of CKD amongst adults with diabetes in LMICs, using relevant key terms. The relevant studies were summarized through key themes derived from the Wilson and Jungner criteria. We found that screening for CKD in people with diabetes is generally infrequent in LMICs. Also, LMICs are ill-equipped to appropriately manage diabetes-associated CKD, especially its late stages, in which supportive care and kidney replacement therapy (KRT) might be required. There are acceptable and relatively simple tools that can aid diabetes-associated CKD screening in these countries; however, these tools come with limitations. Thus, effective implementation of diabetes-associated CKD screening in LMICs remains a challenge, and the cost-effectiveness of such an undertaking largely remains to be explored. In conclusion, for many compelling reasons, screening for CKD in people with diabetes should be a high policy priority in LMICs, as the huge cost associated with higher mortality and morbidity in this group and the cost of KRT offers a compelling economic incentive for improving early detection of diabetes in CKD.
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Affiliation(s)
- Cindy George
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, PO Box 19070, Cape Town, South Africa.
| | - Justin B Echouffo-Tcheugui
- Department of Medicine, Division of Diabetes Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bernard G Jaar
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA.,Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Nephrology Center of Maryland, Baltimore, MD, USA
| | - Ikechi G Okpechi
- Division of Nephrology and Hypertension, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.,Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, PO Box 19070, Cape Town, South Africa
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Lokpo SY, Laryea R, Osei-Yeboah J, Owiredu WKBA, Ephraim RKD, Adejumo EN, Ametepe S, Appiah M, Peter N, Affrim P, Kwadzokpui PK, Abeka OK. The pattern of dyslipidaemia and factors associated with elevated levels of non-HDL-cholesterol among patients with type 2 diabetes mellitus in the Ho municipality: A cross sectional study. Heliyon 2022; 8:e10279. [PMID: 36046539 PMCID: PMC9421188 DOI: 10.1016/j.heliyon.2022.e10279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/02/2022] [Accepted: 08/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background Dyslipidaemia is a key comorbid condition of type 2 diabetes mellitus that increases the risk of cardiovascular disease. This study describes the pattern of dyslipidaemia and factors associated with elevated levels of non-high density lipoprotein cholesterol (HDL-C) among patients with type 2 diabetes mellitus in Ho. Methods This hospital-based cross-sectional study enrolled 210 patients with type 2 diabetes mellitus from Ho municipality. A semi-structured questionnaire was used to obtain demographic and other relevant parameters. Anthropometric, haemodynamic, and biochemical variables were obtained using standard methods. Dyslipidaemia was defined according to the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria while elevated levels of non-HDL-C was defined as non-HDL-C level ≥3.37 mmol/L. A Chi-square test and multivariate logistic regression analyses were performed to determine factors associated with elevated non-HDL-C levels. Results Overall, dyslipidaemia and elevated levels of non-HDL-C prevalence was 67.1% and 64.3%, respectively. The frequency of atherogenic, isolated, and mixed dyslipidaemias were 10.5%, 58.09% and 53.33 %, respectively. Females were four times more likely to develop elevated levels of non-HDL-C after adjustment for age (AOR: 4.07; CI: 2.20-7.51; p < 0.0001). Likewise, overweight (AOR: 3.1; CI: 1.45-6.61; p = 0.0035), grade 1 obesity (AOR: 2.8; CI: 1.20-6.49; p = 0.0168), and truncal obesity (AOR: 3.09; CI: 1.54-6.19; p < 0.0001) were three times each more likely to develop elevated levels of non HDL-C after adjustment for age and gender. However, alcohol intake was 66% unlikely to develop elevated levels of non-HDL-C (COR: 0.34; CI: 0.16-0.73; p = 0.006). Conclusion Dyslipidaemia and elevated levels of non-HDL-C were common in our study participants. Hypercholesterolaemia and co-occurrence of high TG and high LDL-C levels were the most prevalent isolated and mixed dyslipidaemias, respectively. The female gender, overweight, grade 1 obesity and truncal obesity, as well as alcohol intake were significant predictors of elevated levels of non-HDL-C.
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Affiliation(s)
- Sylvester Yao Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Roger Laryea
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - James Osei-Yeboah
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - William K B A Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard K D Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health Sciences, University of Cape-Coast, Cape-Coast, Ghana
| | - Esther Ngozi Adejumo
- Department of Medical Laboratory Science, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Samuel Ametepe
- Faculty of Health and Allied Sciences, Koforidua Technical University, Koforidua, Eastern Region, Ghana
| | - Michael Appiah
- Department of Medical Laboratory Sciences, Accra Technical University, Accra, Greater Accra Region, Ghana
| | - Nogo Peter
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Patrick Affrim
- Laboratory Department, Ho Teaching Hospital, Ho, Volta Region, Ghana
| | | | - Ohene Kweku Abeka
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
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Gannagé-Yared MH, Naous E, Al Achkar A, Issa W, Sleilaty G, Barakett-Hamade V, Abifadel M. Lipid Parameters and Proprotein Convertase Subtilisin/Kexin Type 9 in Healthy Lebanese Adults. Metabolites 2022; 12:metabo12080690. [PMID: 35893257 PMCID: PMC9394379 DOI: 10.3390/metabo12080690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background: High levels of non-HDL cholesterol (non-HDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), and Proprotein convertase subtilisin/kexin type 9 (PCSK9) as well as low levels of HDL-C are strongly associated with cardiovascular disease (CVD). Our study aims to estimate the prevalence of dyslipidemia and high Lp(a) in the Lebanese population and to study the relationship of these variables with gender, age, body mass index (BMI), and PCSK9. Methods: This cross-sectional study was carried out on a sample of healthy volunteers aged 18 to 65. Blood samples were drawn from volunteers for total cholesterol (TC), HDL-C, TG, PCSK9, and Lp(a) measurements. Non-HDL-C was calculated by subtracting HDL-C from TC. Results: In total, 303 volunteer subjects with an average age of 38.9 years were included in the study. Respectively, 44%, 29.8%, and 44% of men had high non-HDL-C and TG with low HDL-C versus 23.5%, 8%, and 37% in women. Non-HDL-C and TG were significantly higher in men than in women, while the reverse was observed for HDL-C (p < 0.0001 for the three comparisons). Non-HDL-C and TG were significantly correlated with age and BMI (p< 0.0001 for all correlations), while HDL-C was inversely correlated with BMI (p < 0.0001) but not with age. Abnormal Lp(a) levels (≥75 nmol/L) were found in 19.1% of the population, predominantly in women (24.1% versus 13.4% in men, p = 0.004). The median PCSK9 and its interquartile was 300 (254−382) ng/L with no gender difference (p = 0.18). None of the following factors: gender, age, BMI, non-HDL-C, HDL-C, or TG, were independently associated with Lp(a), while PCSK9 was significantly correlated with age, non-HDL-C, and TG in both men and women and inversely correlated with HDL-C in men. Dyslipidemia is very common in the Lebanese population and is associated with age, high BMI, and male sex. Lp(a) is higher in women without any correlation with the lipid profile, whereas PCSK9 is associated with non-HDL-C and TG. Further studies are needed to evaluate the potential role of Lp(a) and PCSK9 in predicting CVD in healthy populations.
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Affiliation(s)
- Marie-Hélène Gannagé-Yared
- Department of Endocrinology, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon; (E.N.); (W.I.)
- Laboratory of Hormonology, Hôtel-Dieu de France Hospital, Department of Laboratory Medicine, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon;
- Correspondence: ; Tel.: +961-329-1301; Fax: +961-161-5295
| | - Elie Naous
- Department of Endocrinology, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon; (E.N.); (W.I.)
| | - Anis Al Achkar
- Laboratory of Hormonology, Hôtel-Dieu de France Hospital, Department of Laboratory Medicine, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon;
| | - Wadih Issa
- Department of Endocrinology, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon; (E.N.); (W.I.)
| | - Ghassan Sleilaty
- Department of Biostatistics and Clinical Research Center, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon;
| | - Vanda Barakett-Hamade
- Laboratory of Biochemistry, Hôtel-Dieu de France Hospital, Department of Laboratory Medicine, Faculty of Medicine, Saint-Joseph University, Beirut 11-5076, Lebanon;
| | - Marianne Abifadel
- Laboratory of Biochemistry and Molecular Therapeutics (LBTM), Faculty of Pharmacy, Pole Technologie-Santé (PTS), Saint-Joseph University, Beirut 11-5076, Lebanon;
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Nxasana N, Oladimeji KE, Pulido-Estrada GA, Apalata TR. Prevalence of HIV and Selected Disease Burden in Outpatients of Primary Health Care (PHC) Facilities in Rural Districts of the Eastern Cape Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138003. [PMID: 35805662 PMCID: PMC9265610 DOI: 10.3390/ijerph19138003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 11/26/2022]
Abstract
Assessing underlying illnesses can inform health stakeholders about chronic conditions for targeted enhanced prevention and treatment strategies. Since the Eastern Cape Province has a high disease burden, this study aimed to assess the prevalence of human immunodeficiency virus (HIV) infection and selected disease burden of outpatients from primary health care (PHC) facilities in the districts. From February 2019 to February 2021, a cross-sectional study was conducted. Research Electronic Data Capture (REDCap)-enabled tablets were used to collect data from consenting outpatients over the age of 18 years using an interviewer-administered WHO core and expanded stepwise questionnaire. The statistical analysis was mainly descriptive with the use of counts, frequencies, and summary measures. The study population was predominantly female (86.5%). Prevalent diseases included HIV, hepatitis B virus (HBV) infection, and cardiometabolic diseases. HIV prevalence was 52% and highest in the age group of 30–59 years. In people living with HIV, the nonsuppressed viral load (VL 1000 copies/mL) was highest in the age group of 40–49 years (34.6%). Prevalence of diabetes was highest at the Mhlontlo subdistrict (42.3%), while the King Sabata Dalindyebo (KSD) subdistrict had the highest prevalence of HBV infections (39.1%). Based on the findings, we advocate for intermittent assessments of disease burden in certain settings, such as rural areas, to improve PHC practice and outcomes, especially in the wake of the coronavirus disease (COVID-19) pandemic.
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Affiliation(s)
- Ntombizodumo Nxasana
- Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa; (N.N.); (K.E.O.)
| | - Kelechi E. Oladimeji
- Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa; (N.N.); (K.E.O.)
- College of Graduate Studies, University of South Africa, Pretoria 0001, South Africa
- Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa;
| | | | - Teke R. Apalata
- Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa; (N.N.); (K.E.O.)
- Correspondence: ; Tel.: +27-47-502-1995
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Tang Tsana CD, Sadeu Wafeu G, Ama Moor VJ, Edinga-Melengue BE, Nkeck JR, Nguefack-Tsague G. Validation of lipid profile measurement methods and establishment of reference values in a sub-Saharan African population. Lipids 2022; 57:233-240. [PMID: 35661171 DOI: 10.1002/lipd.12350] [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: 02/02/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/11/2022]
Abstract
Validated reference values and procedures are needed to ensure optimal diagnosis of dyslipidemia in sub-Saharan Africa. We aimed to validate an analysis method and establish reference intervals of lipid profile parameters in Cameroonians using this method. On a cross-sectional study conducted from November 2019 to August 2020 in Yaoundé, we have analyzed blood samples with Cobas® 6000. We subscribed to ASQUALAB's External Quality Assessments (EQA) and Outsourced Internal Quality Controls (IQC). Reproducibility, repeatability, correctness accuracy and uncertainty were evaluated using IQC. Consenting adult participants were conveniently sampled, excluding those with any condition that may affect lipid profile. Descriptive statistics were reported accordingly, agreement was assessed with Bland-Altman analysis, and reference intervals were defined according to CLSI and IFCC recommendations. The coefficients of variation for repeatability, reproducibility, and correctness bias ranged between 0.6% and 6%, with all values within the normal range. Expanded uncertainty of total cholesterol, HDL and triglycerides measurements were, respectively, 0.45, 0.24 and 0.18. We included 422 participants with a mean age of 30.2 (10.9) years and 248 (58.8%) females. Reference intervals for total cholesterol, HDL, triglycerides and LDL were, respectively, 2.94-6.02 mmol/L, 0.90-2.06 mmol/L, 0.35-1.36 mmol/L, 1.37-4.13 mmol/L. These intervals were similar between sex and ethnic groups, but lower in younger participants. Lipid profile measurement with Cobas® 6000 is a reliable and accurate analysis in our context. Specific reference intervals must be used in African population, with further studies need for different age subgroups.
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Affiliation(s)
| | - Guy Sadeu Wafeu
- Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon
| | | | | | - Jan René Nkeck
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
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Noubiap JJ, Nansseu JR, Lontchi-Yimagou E, Nkeck JR, Nyaga UF, Ngouo AT, Tounouga DN, Tianyi FL, Foka AJ, Ndoadoumgue AL, Bigna JJ. Geographic distribution of metabolic syndrome and its components in the general adult population: A meta-analysis of global data from 28 million individuals. Diabetes Res Clin Pract 2022; 188:109924. [PMID: 35584716 DOI: 10.1016/j.diabres.2022.109924] [Citation(s) in RCA: 115] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 03/19/2022] [Accepted: 05/09/2022] [Indexed: 01/13/2023]
Abstract
AIMS Better knowledge of the global metabolic syndrome (MetS) prevalence and its components is a prerequisite to curb the related burden. METHODS We systematically searched PubMed, EMBASE, Web of Knowledge, Africa Journal Online, Global Index Medicus up to May 23, 2021. Prevalence pooling was done with a random-effects meta-analysis. RESULTS In total, 1,129 prevalence data (28,193,768 participants) were included. The MetS global prevalence varied from 12.5% (95 %CI: 10.2-15.0) to 31.4% (29.8-33.0) according to the definition considered. The prevalence was significantly higher in Eastern Mediterranean Region and Americas and increased with country's level of income. The global prevalence was 45.1% (95 %CI: 42.1-48.2) for ethnic-specific central obesity, 42.6% (40.3-44.9) for systolic blood pressure (BP) ≥ 130 mmHg and/or diastolic BP ≥ 85 mmHg, 40.2% (37.8-42.5) for HDL-cholesterol < 1.03 for men or < 1.29 mmol/L for women, 28.9% (27.4-30.5) for serum triglycerides ≥ 1.7 mmol/L, and 24.5% (22.5-26.6) for fasting plasma glucose ≥ 5.6 mmol/L. CONCLUSIONS This study reveals that MetS and its related cardiometabolic components are highly prevalent worldwide. This study calls for more aggressive and contextualized public health interventions to tackle these conditions.
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Affiliation(s)
- Jean Jacques Noubiap
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Jobert Richie Nansseu
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon; Health Information Management and Risk Assessment Unit, World Health Emergencies Programme, World Health Organization Region for Africa, Kinshasa, Democratic Republic of the Congo
| | - Eric Lontchi-Yimagou
- Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY 10461, United States
| | - Jan René Nkeck
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Ulrich Flore Nyaga
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Anderson T Ngouo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Dahlia Noelle Tounouga
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon; Department of General Medicine, Lafe-Baleng Divisional Hospital, Western Regional Delegation, Ministry of Public Health, Bafoussam, Cameroon
| | - Frank-Leonel Tianyi
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Department of Research, Cameroon Society of Epidemiology, Yaoundé, Cameroon
| | - Audrey Joyce Foka
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon; School of Public Health, Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | | | - Jean Joel Bigna
- School of Public Health, Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France; Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
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Jurado-Camacho PA, Cid-Soto MA, Barajas-Olmos F, García-Ortíz H, Baca-Peynado P, Martínez-Hernández A, Centeno-Cruz F, Contreras-Cubas C, González-Villalpando ME, Saldaña-Álvarez Y, Salas-Martinez G, Mendoza-Caamal EC, González-Villalpando C, Córdova EJ, Orozco L. Exome Sequencing Data Analysis and a Case-Control Study in Mexican Population Reveals Lipid Trait Associations of New and Known Genetic Variants in Dyslipidemia-Associated Loci. Front Genet 2022; 13:807381. [PMID: 35669185 PMCID: PMC9164108 DOI: 10.3389/fgene.2022.807381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Plasma lipid levels are a major risk factor for cardiovascular diseases. Although international efforts have identified a group of loci associated with the risk of dyslipidemia, Latin American populations have been underrepresented in these studies.Objective: To know the genetic variation occurring in lipid-related loci in the Mexican population and its association with dyslipidemia.Methods: We searched for single-nucleotide variants in 177 lipid candidate genes using previously published exome sequencing data from 2838 Mexican individuals belonging to three different cohorts. With the extracted variants, we performed a case-control study. Logistic regression and quantitative trait analyses were implemented in PLINK software. We used an LD pruning using a 50-kb sliding window size, a 5-kb window step size and a r2 threshold of 0.1.Results: Among the 34251 biallelic variants identified in our sample population, 33% showed low frequency. For case-control study, we selected 2521 variants based on a minor allele frequency ≥1% in all datasets. We found 19 variants in 9 genes significantly associated with at least one lipid trait, with the most significant associations found in the APOA1/C3/A4/A5-ZPR1-BUD13 gene cluster on chromosome 11. Notably, all 11 variants associated with hypertriglyceridemia were within this cluster; whereas variants associated with hypercholesterolemia were located at chromosome 2 and 19, and for low high density lipoprotein cholesterol were in chromosomes 9, 11, and 19. No significant associated variants were found for low density lipoprotein. We found several novel variants associated with different lipemic traits: rs3825041 in BUD13 with hypertriglyceridemia, rs7252453 in CILP2 with decreased risk to hypercholesterolemia and rs11076176 in CETP with increased risk to low high density lipoprotein cholesterol.Conclusions: We identified novel variants in lipid-regulation candidate genes in the Mexican population, an underrepresented population in genomic studies, demonstrating the necessity of more genomic studies on multi-ethnic populations to gain a deeper understanding of the genetic structure of the lipemic traits.
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Affiliation(s)
- Pedro A. Jurado-Camacho
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
- Posgraduate in Biomedical Sciences, National Autonomous University of Mexico, Mexico City, Mexico
| | - Miguel A. Cid-Soto
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Francisco Barajas-Olmos
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Humberto García-Ortíz
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Paulina Baca-Peynado
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
- Posgraduate in Biomedical Sciences, National Autonomous University of Mexico, Mexico City, Mexico
| | - Angélica Martínez-Hernández
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Federico Centeno-Cruz
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Cecilia Contreras-Cubas
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - María Elena González-Villalpando
- Centro de Estudios en Diabetes, Unidad de Investigación en Diabetes y Riesgo Cardiovascular, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | - Yolanda Saldaña-Álvarez
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Guadalupe Salas-Martinez
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | | | - Clicerio González-Villalpando
- Centro de Estudios en Diabetes, Unidad de Investigación en Diabetes y Riesgo Cardiovascular, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | - Emilio J. Córdova
- Oncogenomics Consortium Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
- *Correspondence: Emilio J. Córdova, ; Lorena Orozco,
| | - Lorena Orozco
- Immunogenomics and Metabolic Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
- *Correspondence: Emilio J. Córdova, ; Lorena Orozco,
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Abstract
Hypertriglyceridemia is a common lipid disorder encountered in clinical practice. Plasma triglycerides are a marker for the concentration of triglycerides carried in chylomicrons and very low-density lipoprotein particles. A fasting triglyceride level <150 mg/dL is accepted widely as the upper limit of normal range. Guidelines for hypertriglyceridemia are variable without a global consensus on classification and goals for triglyceride levels. A general classification of hypertriglyceridemia is mild < 200 mg/dL, moderate = 200 to 500 mg/dL, moderate to severe = 500 to 1000 mg/dL, and severe > 1000 mg/dL. Because moderate hypertriglyceridemia does increase atherosclerotic cardiovascular disease risk, it is important to determine the underlying etiology to guide appropriate and timely management. This article provides stepwise recommendations on the diagnosis and management of moderate hypertriglyceridemia, based on 3 common scenarios encountered in clinical practice. Initial steps in management include evaluating for secondary contributors, especially diabetes mellitus. Based on patient characteristics, appropriate management decisions include lifestyle adjustments aimed at weight loss and decreasing alcohol consumption and use of statin and nonstatin therapies.
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Affiliation(s)
- Savitha Subramanian
- Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle WA, USA
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A community based cross sectional study on the prevalence of dyslipidemias and 10 years cardiovascular risk scores in adults in Asmara, Eritrea. Sci Rep 2022; 12:5567. [PMID: 35368036 PMCID: PMC8976836 DOI: 10.1038/s41598-022-09446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/17/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractDespite the contribution of dyslipidemia to the high and rising burden of arteriosclerotic cardiovascular disease (CVD) in Sub-Saharan Africa; the condition is under-diagnosed, under-treated, and under-described. The objective of this study was to explore the prevalence of dyslipidemias, estimate a 10-year cardiovascular disease risk and associated factors in adults (≥ 35 to ≤ 85 years) living in Asmara, Eritrea. This population-based cross-sectional study was conducted among individuals without overt CVDs in Asmara, Eritrea, from October 2020 to November 2020. After stratified multistage sampling, a total of 386 (144 (37%) males and 242 (63%) females, mean age ± SD, 52.17 ± 13.29 years) respondents were randomly selected. The WHO NCD STEPS instrument version 3.1 questionnaire was used to collect data. Information on socio-demographic variables was collected via interviews by trained data collectors. Measurements/or analyses including anthropometric, lipid panel, fasting plasma glucose, and blood pressure were also undertaken. Finally, data was analyzed by using Statistical Package for Social Sciences version 26.0 for Windows (SPSS Inc., Chicago, IL, USA). All p-values were 2-sided and the level of significance was set at p < 0.05 for all analyses. The frequency of dyslipidemia in this population was disproportionately high (87.4%) with the worst affected subgroup in the 51–60 age band. Further, 98% of the study participants were not aware of their diagnosis. In terms of individual lipid markers, the proportions were as follows: low HDL-C (55.2%); high TC (49.7%); high LDL (44.8%); high TG (38.1%). The mean ± SD, for HDL-C, TC, LDL-C, non-HDL-C, and TG were 45.28 ± 9.60; 205.24 ± 45.77; 130.77 ± 36.15; 160.22 ± 42.09 and 144.5 ± 61.26 mg/dL, respectively. Regarding NCEP ATP III risk criteria, 17.6%, 19.4%, 16.3%, 19.7%, and 54.7% were in high or very high-risk categories for TC, Non-HDL-C, TG, LDL-C, and HDL-C, respectively. Among all respondents, 59.6% had mixed dyslipidemias with TC + TG + LDL-C dominating. In addition, 27.3%, 28.04%, 23.0%, and 8.6% had abnormalities in 1, 2, 3 and 4 lipid abnormalities, respectively. Multivariate logistic regression modeling suggested that dyslipidemia was lower in subjects who were employed (aOR 0.48, 95% CI 0.24–0.97, p = 0.015); self-employed (aOR 0.41, 95% CI 0.17–1.00, p = 0.018); and married (aOR 2.35, 95% CI 1.19–4.66, p = 0.009). A higher likelihood of dyslipidemia was also associated with increasing DBP (aOR 1.04 mmHg (1.00–1.09, p = 0.001) and increasing FPG (aOR 1.02 per 1 mg/dL, 95% CI 1.00–1.05, p = 0.001). Separately, Framingham CVD Risk score estimates suggested that 12.7% and 2.8% were at 10 years CVD high risk or very high-risk strata. High frequency of poor lipid health may be a prominent contributor to the high burden of atherosclerotic CVDs—related mortality and morbidity in Asmara, Eritrea. Consequently, efforts directed at early detection, and evidence-based interventions are warranted. The low awareness rate also points at education within the population as a possible intervention pathway.
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Enriquez R, Ssekubugu R, Ndyanabo A, Marrone G, Gigante B, Chang LW, Reynolds SJ, Nalugoda F, Ekstrom AM, Sewankambo NK, Serwadda DM, Nordenstedt H. Prevalence of cardiovascular risk factors by HIV status in a population-based cohort in South Central Uganda: a cross-sectional survey. J Int AIDS Soc 2022; 25:e25901. [PMID: 35419976 PMCID: PMC9008150 DOI: 10.1002/jia2.25901] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/28/2022] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Cardiovascular disease is one of the leading causes of mortality for people living with HIV, but limited population-based data are available from sub-Saharan Africa. This study aimed to determine the prevalence of key cardiovascular disease risk factors, 10-year risk of cardiovascular disease and type 2 diabetes mellitus through risk scores by HIV status, as well as investigate factors associated with hyperglycaemia, hypertension and dyslipidaemia in South-Central Uganda. METHODS A cross-sectional study was conducted in 37 communities of the population-based Rakai Community Cohort Study from May 2016 to May 2018. In total, 990 people living with HIV and 978 HIV-negative participants aged 35-49 years were included. Prevalence estimates and 10-year cardiovascular and type 2 diabetes risk were calculated by sex and HIV serostatus. Multivariable logistic regression was used to determine associations between socio-demographic, lifestyle and body composition risk factors and hyperglycaemia, hypertension and dyslipidaemia. RESULTS Overweight (21%), obesity (9%), abdominal obesity (15%), hypertension (17%) and low high-density lipoprotein (HDL) (63%) were the most common cardiovascular risk factors found in our population. These risk factors were found to be less common in people living with HIV apart from hypertension. Ten-year risk for cardiovascular and type 2 diabetes mellitus risk was low in this population with <1% categorized as high risk. In HIV-adjusted multivariable analysis, obesity was associated with a higher odds of hypertension (odds ratio [OR] = 2.31, 95% confidence interval [CI] 1.35-3.96) and high triglycerides (OR = 2.08, CI 1.25-3.47), and abdominal obesity was associated with a higher odds of high triglycerides (OR = 2.55, CI 1.55-4.18) and low HDL (OR = 1.36, CI 1.09-1.71). A positive HIV status was associated with a lower odds of low HDL (OR = 0.43, CI 0.35-0.52). CONCLUSIONS In this population-based study in Uganda, cardiovascular risk factors of obesity, abdominal obesity, hypertension and dyslipidaemia were found to be common, while hyperglycaemia was less common. Ten-year risk for cardiovascular and type 2 diabetes mellitus risk was low. The majority of cardiovascular risk factors were not affected by HIV status. The high prevalence of dyslipidaemia in our study requires further research.
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Affiliation(s)
- Rocio Enriquez
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | | | | | - Gaetano Marrone
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Bruna Gigante
- Department of MedicineKarolinska InstitutetStockholmSweden
| | - Larry W. Chang
- Rakai Health Sciences ProgramKalisizoUganda
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Division of Infectious DiseasesDepartment of MedicineJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Steven J. Reynolds
- Rakai Health Sciences ProgramKalisizoUganda
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Division of Infectious DiseasesDepartment of MedicineJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Laboratory of ImmunoregulationDivision of Intramural ResearchNational Institute for Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | | | - Anna Mia Ekstrom
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
- Department of Infectious DiseasesSouth Central HospitalStockholmSweden
| | - Nelson K. Sewankambo
- Rakai Health Sciences ProgramKalisizoUganda
- Department of MedicineMakerere University School of MedicineKampalaUganda
| | - David M. Serwadda
- Rakai Health Sciences ProgramKalisizoUganda
- Department of Disease Control and Environmental HealthMakerere University School of Public HealthKampalaUganda
| | - Helena Nordenstedt
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
- Department of Internal Medicine and Infectious DiseasesDanderyd University HospitalStockholmSweden
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Angassa D, Solomon S, Seid A. Factors associated with dyslipidemia and its prevalence among Awash wine factory employees, Addis Ababa, Ethiopia: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:22. [PMID: 35094687 PMCID: PMC8801105 DOI: 10.1186/s12872-022-02465-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dyslipidemia is a highly prevalent and modifiable risk factor for atherosclerotic cardiovascular diseases. Though the problem is significant in Ethiopia, available data in this regard is very poor among alcoholic beverage industrial workers. This study aimed to assess factors associated with dyslipidemia and its prevalence among Awash wine factory employees in Addis Ababa, Ethiopia. METHODS A cross-sectional study was conducted among 335 randomly selected employees of Awash wine factory, Addis Ababa, Ethiopia from January to February 2021. Data was collected by a face-to-face interview technique using the WHO STEPwise approach. Data were entered and analyzed using Epi Info 7 and SPSS version 26, respectively. Both bivariable and multivariable logistic regression analyses were performed to identify factors associated with dyslipidemia. All statistical tests were declared significant at p-value < 0.05. RESULTS The overall prevalence of dyslipidemia was 67.8% (95% CI 62.5-72.7%). Elevated total cholesterol, elevated triglycerides, reduced high-density lipoprotein, and elevated low-density lipoprotein was found in 25.4%, 33.4%, 50.7%, and 21.5% of participants, respectively. Dyslipidemia was significantly associated with age group 30-39 years (AOR = 2.51; 95% CI 1.16-5.44, p = 0.019), ≥ 40 years (AOR = 6.45; 95% CI 2.01-20.71, p = 0.002), current alcohol consumption (AOR = 3.37; 95% CI 1.70-6.66, p < 0.001), eating vegetables < 2 days per week (AOR = 2.89; 95% CI 1.54-5.43, p = 0.001), sitting duration of > 4 h per day (AOR = 1.96; 95% CI 1.03-3.74, p = 0.041), and raised waist circumference (AOR = 4.56; 95% CI 2.07-10.08, p < 0.001). CONCLUSIONS High prevalence of dyslipidemia was found among Awash wine factory employees in Addis Ababa. Periodic screening of high-risk groups along with effective health promotion and education which encourages a healthy lifestyle is essential.
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Affiliation(s)
| | - Samrawit Solomon
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Awol Seid
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Prevalence, patterns and determinants of dyslipidaemia among South African adults with comorbidities. Sci Rep 2022; 12:337. [PMID: 35013433 PMCID: PMC8748924 DOI: 10.1038/s41598-021-04150-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/16/2021] [Indexed: 11/20/2022] Open
Abstract
The present study assessed the prevalence, patterns and determinants of dyslipidaemia among South African adults with multi-morbidities. In this study, 614 individuals with DM and hypertension were recruited. Dyslipidaemia was defined as elevated levels of total cholesterol (TC) ≥ 5.2 mmol/L and/or low-density lipoprotein cholesterol (LDL-C) ≥ 2.6 mmol/L, triglycerides (TG) ≥ 1.8 mmol/L and low high-density lipoprotein cholesterol (HDL-C) < 1 mmol/L for men and < 1.2 mmol/L for women. Multivariate regression model (adjusted) analysis was used to identify the significant determinants of dyslipidaemia. The prevalence of dyslipidaemia was 76.7% (n = 471), with females showing the highest prevalence 357 (75.79%). Elevated TG (62.21%) was the most prevalent form of dyslipidemia. Only 103 (16.77%) participants were on statin therapy. The multivariate logistic regression model analysis (adjusted) showed that, the Zulu ethnicity (AOR = 2.45; 95%CI 1.48–4.05) was associated with high TC. DM (AOR = 2.00; 95%CI 1.30–3.06) and the female sex (AOR = 2.54; 95%CI 1.56–4.12) were associated with low HDL-C. Obesity (AOR = 1.57; 95%CI 1.12–2.21) and the Zulu ethnicity (AOR = 1.60; 95%CI 1.00–2.54) were associated with elevated LDL-C. DM (AOR = 2.32; 95%CI 1.61–3.34) was associated with elevated TG. We found a high prevalence of dyslipidaemia. The study further demonstrated that prevention and treatment of dyslipidaemia should be prioritised among individuals with multi-morbidities.
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Yang HL, Li FR, Chen PL, Cheng X, Mao C, Wu XB. Tooth Loss, Denture Use, and Cognitive Impairment in Chinese Older Adults: A Community Cohort Study. J Gerontol A Biol Sci Med Sci 2022; 77:180-187. [PMID: 33674815 DOI: 10.1093/gerona/glab056] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Evidence regarding the associations of tooth loss and denture use with incident cognitive impairment is inconclusive in older adults, and few prospective studies have examined the potential interaction between tooth loss and denture use in these specific populations. METHODS Data were assessed from 17 079 cognitively normal older adults aged ≥65 years, participating in the Chinese Longitudinal Healthy Longevity Survey. The outcome of interest was cognitive impairment (assessed by the Chinese version of Mini-Mental State Examination). The number of natural teeth and status of denture use were collected by a structural questionnaire. RESULTS A total of 6456 cases of cognitive impairment were recorded during 88 627 person-years of follow-up. We found that compared with participants with 20+ teeth, those with 10-19, 1-9, and 0 teeth had increased risks of incident cognitive impairment (p-trend < .001). Participants without dentures also had a higher risk of incident cognitive impairment, compared with those who wore dentures. Effect modification by denture use was observed (p-interaction = .010). Specifically, among those without dentures, the adjusted hazard ratio (95% confidence interval) for participants with 10-19, 1-9, and 0 teeth were 1.19 (1.08, 1.30), 1.28 (1.17, 1.39), and 1.28 (1.16, 1.41), respectively, as compared to those with 20+ teeth. In contrary, among denture users, detrimental effect was only observed among those with 0 teeth (hazard ratio 1.14, 95% confidence interval: 1.16, 1.41). CONCLUSIONS In Chinese older adults, maintaining 20+ teeth is important for cognitive health; denture use would attenuate the detrimental effects of tooth loss, especially for partial tooth loss, on cognitive impairment.
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Affiliation(s)
- Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fu-Rong Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Cheng
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
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50
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Roushdy T, Aref H, Kesraoui S, Temgoua M, Nono KP, Gebrewold MA, Peter W, Gopaul U, Belahsen MF, Ben-Adji D, Melifonwu R, Pugazhendhi S, Woodcock N, Mohamed MH, Rossouw A, Matuja S, Ruanda MK, Mhiri C, Saylor D, Nahas NE, Shokri H. Stroke services in Africa: What is there and what is needed. Int J Stroke 2022; 17:972-982. [PMID: 35034522 DOI: 10.1177/17474930211066416] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Over the past few years, the incidence and prevalence of stroke has been rising in most African countries and has been reported as one of the leading causes of morbidity and mortality. To study this problem, we need to realize the quality and availability of stroke care services as a priori to improve them. METHODS AND RESULTS In this study, we investigated the availability of different stroke-related services in 17 countries from different African regions. An online survey was conducted and fulfilled by stroke specialists and included primary prevention, acute management, diagnostic tools, medications, postdischarge services, and stroke registries. The results showed that although medications for secondary prevention are available, yet many other services are lacking in various countries. CONCLUSION This study displays the deficient aspects of stroke services in African countries as a preliminary step toward active corrective procedures for the improvement of stroke-related health services.
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Affiliation(s)
- Tamer Roushdy
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hany Aref
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Selma Kesraoui
- Department of Neurology, Blida Hospital University, Blida, Algeria
| | - Michael Temgoua
- Institute of Applied Neurosciences and Functional Rehabilitation, Bethesda Hospital, Yaoundè, Cameroon
| | - Kiatoko Ponte Nono
- Initiative Plus Hospital Center, Kinshasa, Democratic Republic of the Congo
| | | | - Waweru Peter
- Kenyatta University Teaching, Referral & Research Hospital, Nairobi, Kenya
| | - Urvashy Gopaul
- University of Mauritius, Moka, Mauritius.,KITE-University Health Network (UHN), Toronto, ON, Canada
| | - Mohammed Faouzi Belahsen
- Neurology Department, Hassan II University Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | | | - Rita Melifonwu
- Stroke Rehabilitation, Stroke Action Nigeria, Abuja, Nigeria
| | | | | | | | | | - Sarah Matuja
- Department of Internal Medicine, Bugando Medical Centre/Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mark Koba Ruanda
- Emergency Medicine Department, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Chokri Mhiri
- Department of Neurology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Deanna Saylor
- Department of Medicine, University Teaching Hospital, Lusaka, Zambia.,Department of Neurology, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Nevine El Nahas
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hossam Shokri
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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