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Dziegielewska-Gesiak S. Metabolic Syndrome in an Aging Society - Role of Oxidant-Antioxidant Imbalance and Inflammation Markers in Disentangling Atherosclerosis. Clin Interv Aging 2021; 16:1057-1070. [PMID: 34135578 PMCID: PMC8200137 DOI: 10.2147/cia.s306982] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/23/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The prevalence of metabolic syndrome among the elderly population is growing. The elements of metabolic syndrome in an aging society are currently being researched. Atherosclerosis is a slow process in which the first symptoms may be observed after many years. The mechanisms underlying the progression of atherosclerosis are oxidative stress and inflammation. Inflammation and oxidative stress are associated with the increased incidence of metabolic syndrome. Taking the above into consideration, metabolic syndrome is thought to be a clinical equivalent of atherosclerosis. AIM The aim of this paper is to review the impact of the interplay of oxidant-antioxidant and inflammation markers in metabolic syndrome in general as well as its components in the pathophysiology which underlies development of atherosclerosis in elderly individuals. METHODS A systematic scan of online resources designed for elderly (≥65 years) published from 2005 to the end of 2020 were reviewed. This was supplemented with grey literature and then all resources were narratively analyzed. The analysis included the following terms: "atherosclerosis or metabolic syndrome" and "oxidative stress or inflammation" and "elderly" to find reports of atherosclerotic disease from asymptomatic to life-threatening among the elderly population with metabolic syndrome . RESULTS The work summarizes articles that were applicable to this study, including systematic reviews, qualitative studies and opinion pieces. Current knowledge focuses on monitoring the inflammation and oxidant-antioxidant imbalance in disentangling atherosclerosis in patients diagnosed with metabolic syndrome. The population-based studies described inflammation, increased oxidative stress and weak antioxidant defense systems as the mechanisms underlying atherosclerosis development. Moreover, there are discussions that these targets could potentially be a point of intervention to reduce the development of atherosclerosis in the elderly, especially those with altered glucose and lipid metabolism. Specific markers may be used as an approach for the prevention and lifestyle modification of atherosclerotic disease in such population. CONCLUSION Metabolic syndrome and its components are important contributors in the progression of atherosclerotic disease in the elderly population but constant efforts should be made to broaden our knowledge of elderly groups who are the most susceptible for the development of atherosclerosis complications.
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Daghestani MH, Daghestani MH, Daghistani MH, Bjørklund G, Chirumbolo S, Warsy A. The influence of the rs1137101 genotypes of leptin receptor gene on the demographic and metabolic profile of normal Saudi females and those suffering from polycystic ovarian syndrome. BMC WOMENS HEALTH 2019; 19:10. [PMID: 30635060 PMCID: PMC6329086 DOI: 10.1186/s12905-018-0706-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 12/28/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is of frequent occurrence in Saudi females and is often associated with obesity, insulin resistance, hypogonadotropic hypogonadism, and infertility. Since these features are also associated with leptin receptor (LEP-R) deficiency, several studies have attempted to link LEP-R gene polymorphisms to PCOS. METHODS The purpose of this study is to assess the possible association of LEP-R gene polymorphism (rs1137101) with the main obesity-linked metabolic parameters in Saudi female patients affected by PCOS. A cohort of 122 Saudi female subjects, attending the outpatient's clinics at Makkah, Saudi Arabia and diagnosed with PCOS was investigated. Metabolic parameters in serum samples, including lipidogram, glucose, leptin, ghrelin and insulin and obesity markers (BMI, W/H ratio, HOMA) were assayed and compared with values from 130 healthy female volunteers (controls). The genotyping of rs1137101 polymorphism in the leptin receptor gene by amplification (PCR) followed by DNA sequencing, was conducted in both groups (PCOS and controls). RESULTS Waist/hip ratio (W/H ratio), leptin serum levels and triglycerides appeared to be associated with PCOS but, aside from W/H ratio (AA s GG p = 0.009), this association also occurred for controls. No significant association in the leptin gene polymorphic locus rs1137101 with PCOS was seen in the results of the present study. In the control group, BMI, W/H ratio, leptin, Insulin, and HOMA-IR were significantly higher in the GG genotype compared to AA. CONCLUSION Despite previous suggestion about a relationship between rs1137101, serum leptin levels, and PCOS, our studies do not show any statistical association and further investigations; possibly by also evaluating obese patients should be needed to elucidate this issue better.
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Affiliation(s)
- Maha H Daghestani
- Department of Zoology, College of Science. Director of Central Laboratory, Female Center for Scientific & Medical Colleges, King Saud University, Riyadh, Saudi Arabia
| | - Mazin H Daghestani
- Department of Obstetrics and Gynecology, Umm Al-Qura University, P.O. Box 424, Makkah, 21955, Saudi Arabia
| | - Mamoon H Daghistani
- Department of Surgery, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Arjumand Warsy
- Central Laboratory, Female Center for Scientific and Medical Colleges, King Saud University, Riyadh, Saudi Arabia.
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Jahanlou AS, Kouzekanani K. The interaction effect of body mass index and age on fat-free mass, waist-to-hip ratio, and soft lean mass. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:86. [PMID: 28919913 PMCID: PMC5553238 DOI: 10.4103/jrms.jrms_335_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/30/2015] [Accepted: 04/23/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Research has shown that body mass index (BMI) does not take into consideration the gender and ethnicity. The primary purpose of this study was to examine the interaction effect of the BMI and age on fat-free mass (FFM), waist-to-hip ratio (WHR), and soft lean mass (SLM). The secondary purpose was to evaluate the practical significance of the findings by examining effect sizes. MATERIALS AND METHODS The study was comparative in nature and employed a factorial design. Due to nonexperimental nature of the investigation, no causal inferences were drawn. The nonprobability sample consisted of 19,356 adults. Analysis of the data included factorial analysis of variance, analysis of simple effects, calculation of mean difference effect sizes, and data transformation. The Statistical Package for the Social Sciences version 22 was employed for the purpose of data manipulation and analysis. RESULTS The BMI by age interaction effects on FFM, F (10, 19,338) = 28.26, P < 0.01, on WHR, F (10, 19,338) = 18.46, P < 0.01, and on SLM, F (10, 19,338) = 14.65, P < 0.01, was statistically significant and ordinal in nature. Analysis of the effect sizes, ranging from 0.30 to 1.20, showed that the BMI and age influenced the WHR but their interaction effects on FFM and SLM, ranging from 0.04 to 0.36 and 0.03 to 0.33, respectively, were mainly negligible. CONCLUSION Based on the examination of the statistical and practical significance of the results, it is concluded that the BMI and age together can influence the WHR but their interaction effect on the FFM and SLM is questionable.
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Affiliation(s)
| | - Kamiar Kouzekanani
- Department of Educational Leadership, Curriculum and Instruction, Texas A&M University-Corpus Christi, Corpus Christi, TX, USA
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Rosa M, Paris C, Sottejeau Y, Corseaux D, Robin E, Tagzirt M, Juthier F, Jashari R, Rauch A, Vincentelli A, Staels B, Van Belle E, Susen S, Dupont A. Leptin induces osteoblast differentiation of human valvular interstitial cells via the Akt and ERK pathways. Acta Diabetol 2017; 54:551-560. [PMID: 28314924 DOI: 10.1007/s00592-017-0980-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/01/2017] [Indexed: 11/29/2022]
Abstract
AIMS Calcific aortic valve disease (CAVD) affects 2-6% of the population over 65 years, and age, gender, smoking, overweight, dyslipidemia, diabetes contribute to the development of this disease. CAVD results, in part, from the osteoblast differentiation of human valvular interstitial cells (VICs). This study aims to elucidate the effects of leptin on osteoblast phenotype of VICs and the signalling pathways involved. METHODS Patients who underwent aortic valve replacement for CAVD (n = 43) were included in this study. Patients with coronary artery disease (CAD) without CAVD (n = 129) were used as controls. RESULTS Patients with CAVD had higher serum leptin concentrations than CAD patients (p = 0.002). Leptin was found in calcific aortic valves, with higher concentrations in calcified versus non-calcified zones (p = 0.01). Chronic leptin stimulation of human VICs enhanced alkaline phosphatase (ALP) activity and ALP, BMP-2 and RUNX2 expression and decreased osteopontin expression. Moreover, inhibiting Akt or ERK during leptin stimulation lowered the expression of osteoblast markers in VIC. CONCLUSIONS Taken together, these findings indicate that leptin plays a critical role in CAVD development by promoting osteoblast differentiation of human aortic VICs in an Akt- and ERK-dependent manner. This study highlights the role of leptin in CAVD development, and further studies are needed to determine whether reducing circulating leptin levels or blocking leptin actions on VICs is efficient to slow CAVD progression.
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Affiliation(s)
- Mickael Rosa
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Camille Paris
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Yoann Sottejeau
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Delphine Corseaux
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Emmanuel Robin
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Madjid Tagzirt
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Francis Juthier
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Ramadan Jashari
- European Homograft Bank, c/o Clinique Saint Jean, Brussels, Belgium
| | - Antoine Rauch
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - André Vincentelli
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Bart Staels
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Eric Van Belle
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Sophie Susen
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France.
- Institut Pasteur de Lille, 59000, Lille, France.
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France.
- INSERM U 1011, Amphi J&K, Boulevard du Professeur Jules Leclercq, 59008, Lille Cedex, France.
| | - Annabelle Dupont
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
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Wang LH, Liu YC, Wang JH, Lee CJ, Hsu BG. Serum leptin level positively correlates with metabolic syndrome among elderly Taiwanese. Tzu Chi Med J 2017; 29:159-164. [PMID: 28974910 PMCID: PMC5615996 DOI: 10.4103/tcmj.tcmj_60_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: Leptin is an adipocyte-derived hormone and has shown positive correlation with obesity and metabolic syndrome (MetS) in many studies. However, there are few studies investigating this relation in elderly people. Therefore, we aimed to investigate the correlation between the fasting serum leptin level and MetS among older Taiwanese. Materials and Methods: The fasting serum leptin level was obtained from 62 Taiwanese participants over 65 years old and was measured using a commercially available enzyme immunoassay kit. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. Results: Thirty elderly participants (48.4%) had MetS. The serum leptin level was positively correlated with MetS (P < 0.001). Multivariate logistic regression analysis of the factors significantly associated with MetS showed that logarithmically transformed leptin (log-leptin, each increase 0.1 ng/mL log-leptin, odds ratio: 1.276, 95% confidence interval: 1.015–1.603, P = 0.037) was still an independent predictor of MetS in elderly persons. Univariable linear analysis showed that body weight (r = 0280, P = 0.028), body mass index (r = 0.417, P = 0.001), waist circumference (r = 0.419, P = 0.001), blood urea nitrogen (r = 0255, P = 0.046), log-insulin (r = 0436, P < 0.001), and logarithmically transformed homeostasis model assessment of insulin resistance (r = 0359, P = 0.004) positively correlated with fasting serum log-leptin levels. Multivariate forward stepwise linear regression analysis of the factors significantly associated with fasting serum log-leptin levels revealed that waist circumference (adjusted R2 = 0.083, P = 0.002), statin use (adjusted R2 = 0.058, P = 0.016), and female gender (adjusted R2 = 0.041, P = 0.034) were independent predictors of fasting serum log-leptin levels among elderly participants. Conclusion: In elderly Taiwanese, the serum leptin level was positively correlated with MetS. Waist circumference, statin use, and female gender were independent predictors of the fasting serum leptin level in elderly participants.
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Affiliation(s)
- Li-Hsuan Wang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yao-Chang Liu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ji-Hung Wang
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chung-Jen Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
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Spahillari A, Mukamal KJ, DeFilippi C, Kizer JR, Gottdiener JS, Djoussé L, Lyles MF, Bartz TM, Murthy VL, Shah RV. The association of lean and fat mass with all-cause mortality in older adults: The Cardiovascular Health Study. Nutr Metab Cardiovasc Dis 2016; 26:1039-1047. [PMID: 27484755 PMCID: PMC5079822 DOI: 10.1016/j.numecd.2016.06.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Understanding contributions of lean and fat tissue to cardiovascular and non-cardiovascular mortality may help clarify areas of prevention in older adults. We aimed to define distributions of lean and fat tissue in older adults and their contributions to cause-specific mortality. METHODS AND RESULTS A total of 1335 participants of the Cardiovascular Health Study (CHS) who underwent dual-energy x-ray absorptiometry (DEXA) scans were included. We used principal components analysis (PCA) to define two independent sources of variation in DEXA-derived body composition, corresponding to principal components composed of lean ("lean PC") and fat ("fat PC") tissue. We used Cox proportional hazards regression using these PCs to investigate the relationship between body composition with cardiovascular and non-cardiovascular mortality. Mean age was 76.2 ± 4.8 years (56% women) with mean body mass index 27.1 ± 4.4 kg/m2. A greater lean PC was associated with lower all-cause (HR = 0.91, 95% CI 0.84-0.98, P = 0.01) and cardiovascular mortality (HR = 0.84, 95% CI 0.74-0.95, P = 0.005). The lowest quartile of the fat PC (least adiposity) was associated with a greater hazard of all-cause mortality (HR = 1.24, 95% CI 1.04-1.48, P = 0.02) relative to fat PCs between the 25th-75th percentile, but the highest quartile did not have a significantly greater hazard (P = 0.70). CONCLUSION Greater lean tissue mass is associated with improved cardiovascular and overall mortality in the elderly. The lowest levels of fat tissue mass are linked with adverse prognosis, but the highest levels show no significant mortality protection. Prevention efforts in the elderly frail may be best targeted toward improvements in lean muscle mass.
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Affiliation(s)
- A Spahillari
- Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - K J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - C DeFilippi
- Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - J R Kizer
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA.
| | - J S Gottdiener
- Department of Medicine, University of Maryland Medical School, Baltimore, MD, USA.
| | - L Djoussé
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - M F Lyles
- Department of Medicine, Section on Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - T M Bartz
- Department of Biostatistics, University of Washington, Seattle, WA, USA.
| | - V L Murthy
- Frankel Cardiovascular Center and Department of Medicine (Cardiovascular Medicine Division), University of Michigan, Ann Arbor, MI, USA.
| | - R V Shah
- Department of Medicine (Division of Cardiology), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Clark DO, Unroe KT, Xu H, Keith NR, Callahan CM, Tu W. Sex and Race Differences in the Relationship between Obesity and C-Reactive Protein. Ethn Dis 2016; 26:197-204. [PMID: 27103770 DOI: 10.18865/ed.26.2.197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
C-reactive protein (CRP) is a risk factor for cardiovascular disease and mortality; it is known to be positively associated with obesity but there is some evidence that this association differs by race or sex. We used nationally representative data of adults aged >50 years to investigate sex and race modifiers of the associations between obesity and CRP in non-Hispanic White males (n=3,517) and females (n=4,658), and non-Hispanic Black males (n=464) and females (n=826). Using multiple linear regression models with the natural logarithm of CRP as the dependent variable, we sequentially included body mass index (BMI), a body shape index (ABSI), and socioeconomic, health and health behavior covariates in the model. The association between BMI and CRP was significantly stronger in females than males. Obese White females had mean CRP values slightly above 3 mg/liter (vs 2 for White males) and Black females had mean CRP values >4 mg/liter (vs 3 for Black males). More than 50% of Black females in the United States have obesity. Continued research into racial and sex differences in the relationship between obesity, inflammation, and health risks may ultimately lead to more personalized weight loss recommendations.
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Affiliation(s)
- Daniel O Clark
- Indiana University Center for Aging Research, Indianapolis, Indiana; Regenstrief Institute, Inc., Indianapolis, Indiana
| | - Kathleen T Unroe
- Indiana University Center for Aging Research, Indianapolis, Indiana
| | - Huiping Xu
- Department of Biostatistics, Indiana University
| | | | | | - Wanzhu Tu
- Department of Biostatistics, Indiana University
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Clark DO, Gao S, Lane KA, Callahan CM, Baiyewu O, Ogunniyi A, Hendrie HC. Obesity and 10-year mortality in very old African Americans and Yoruba-Nigerians: exploring the obesity paradox. J Gerontol A Biol Sci Med Sci 2014; 69:1162-9. [PMID: 24694355 DOI: 10.1093/gerona/glu035] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To compare the effect of obesity and related risk factors on 10-year mortality in two cohorts of older adults of African descent; one from the United States and one from Nigeria. METHODS Study participants were community residents aged 70 or older of African descent living in Indianapolis, Indiana (N = 1,269) or Ibadan, Nigeria (1,197). We compared survival curves between the two cohorts by obesity class and estimated the effect of obesity class on mortality in Cox proportional hazards models controlling for age, gender, alcohol use, and smoking history, and the cardiometabolic biomarkers blood pressure, triglycerides, high-density lipoprotein, low-density lipoprotein, and C-reactive protein. RESULTS We found that underweight was associated with an increased risk of death in both the Yoruba (hazards ratio = 1.35, 95% confidence interval: 1.12-1.63) and African American samples (hazards ratio = 2.49, 95% confidence interval: 1.40-4.43) compared with those with normal weight. The overweight and obese participants in both cohorts experienced survival similar to the normal weight participants. Controlling for cardiometabolic biomarkers had little effect on the obesity-specific hazard ratios in either cohort. CONCLUSIONS Despite significant differences across these two cohorts in terms of obesity and biomarker levels, overall 10-year survival and obesity class-specific survival were remarkably similar.
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Affiliation(s)
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis
| | - Kathleen A Lane
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis
| | | | | | - Adesola Ogunniyi
- Department of Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Hugh C Hendrie
- Department of Medicine, Indiana University Center for Aging Research, Indianapolis. Department of Medicine, Regenstrief Institute, Inc., Indianapolis, Indiana. Department of Psychiatry, Indiana University School of Medicine, Indianapolis
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