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Wang Z, Barinas-Mitchell E, Brooks MM, Crawford SL, Leis AM, Derby CA, Thurston RC, Hedderson MM, Janssen I, Jackson EA, McConnell DS, El Khoudary SR. HDL-C criterion of the metabolic syndrome and future diabetes and atherosclerosis in midlife women: The SWAN Study. Am J Prev Cardiol 2024; 19:100687. [PMID: 39070021 PMCID: PMC11279330 DOI: 10.1016/j.ajpc.2024.100687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/21/2024] [Accepted: 06/12/2024] [Indexed: 07/30/2024] Open
Abstract
Objective High-density lipoprotein cholesterol (HDL-C) is one of 5 components [high blood pressure, glucose, triglycerides, waist circumference, low HDL-C], 3 of which, needed to diagnose metabolic syndrome (MetS). Evolving research shows that higher HDL-C is not necessarily cardioprotective in midlife women, supporting a need to re-evaluate HDL-C's contribution to risks related to MetS. We tested whether risk of future diabetes and higher carotid intima-media thickness (cIMT) differ by HDL-C status in midlife women diagnosed with MetS based on the other 4 components. Methods Midlife women were classified into 3 groups 1) no MetS, 2) MetS with HDL-C ≥ 50 mg/dL (MetS hiHDL), and 3) MetS with HDL-C < 50 mg/dL (MetS loHDL). cIMT was measured 13.8 ± 0.6 years post baseline. Incident diabetes was assessed yearly. Results Among 2773 women (1350 (48 %) of them had cIMT), 2383 (86 %) had no MetS, 117 (4 %) had MetS hiHDL, 273 (10 %) had MetS loHDL. Compared with no MetS, both MetS- hiHDL and loHDL groups had higher cIMT and diabetes risk. Risk of having high cIMT did not differ between MetS loHDL vs. hiHDL groups. Adjusting for levels of MetS criteria other than HDL-C at baseline explained the associations of each of the two MetS groups with cIMT. Conversely, after adjustment, associations of MetS hiHDL and MetS loHDL with incident diabetes persisted. Conclusions In midlife women, HDL-C status matters for predicting risk of incident diabetes but not higher cIMT beyond other MetS components.
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Affiliation(s)
- Ziyuan Wang
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
| | - Maria M. Brooks
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
| | - Sybil L. Crawford
- Tan Chingfen Graduate School of Nursing, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Aleda M. Leis
- Department of Epidemiology, The University of Michigan, Ann Arbor, MI, USA
| | - Carol A. Derby
- Departments of Neurology, and of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rebecca C. Thurston
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Monique M. Hedderson
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA, USA
| | - Imke Janssen
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Elizabeth A. Jackson
- Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Samar R. El Khoudary
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
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Gierach M, Junik R. The Level of Intima-Media Thickness in Patients with Metabolic Syndrome in Poland Depending on the Prevalence of Type 2 Diabetes. Biomedicines 2023; 11:1510. [PMID: 37371604 DOI: 10.3390/biomedicines11061510] [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: 03/06/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), increasingly diagnosed among the Polish population, is a combination of factors that are associated with an increased risk of atherosclerosis and cardiovascular diseases. Intima-media thickness (IMT) of the common carotid artery has been suggested as, simply, a non-invasive and reproducible marker of the early stages of the atherosclerotic process. The carotid IMT can also be a strong predictor of future cerebral and cardiovascular events. The aim of our study was to evaluate atherosclerotic lesions in carotid vessels in patients with MetS depending on the presence of DMt2 and to assess which demographic factors affect the level of IMT. The study involved 335 subjects diagnosed with MetS, including 211 females (65%) and 124 males (37%) aged 37-82. The diagnosis of MetS was made on the basis of the International Diabetes Federation (IDF) criteria. The patients were divided into two subgroups: with DMt2 and without DMt2. The value of IMT depended on gender, education, and smoking status. We noticed that patients with DMt2 had the highest measurement of IMT compared with other groups (1.01 vs. 0.98). Additionally, a statistically significant difference between the subgroup with DMt2 and those without DMt2 was found (1.01 vs. 0.92; p < 0.005). Ultrasound assessment of the carotid IMT should be used more often in the diagnosis and monitoring of high cardiovascular risk and early progression of atherosclerosis, especially in patients with MetS with current DMt2.
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Affiliation(s)
- Marcin Gierach
- Department of Endocrinology and Diabetology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. M. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
- Cardiometabolic Center Gierach-Med, ul. Bydgoskich Olimpijczyków 5/39-40, 85-796 Bydgoszcz, Poland
| | - Roman Junik
- Department of Endocrinology and Diabetology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. M. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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3
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Pafili K, Paschou SA, Armeni E, Polyzos SA, Goulis DG, Lambrinoudaki I. Non-alcoholic fatty liver disease through the female lifespan: the role of sex hormones. J Endocrinol Invest 2022; 45:1609-1623. [PMID: 35303270 DOI: 10.1007/s40618-022-01766-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022]
Abstract
The prevalence of non-alcoholic fatty liver disease (NAFLD) differs between various stages of the female lifespan. The aim of this review is to summarize current evidence on the association of NAFLD and circulating sex hormones and to explore the pathogenesis of NAFLD within the context of (1) sex hormone changes during the reproductive, post-reproductive female life and beyond and (2) the in vitro and in vivo evidence on pharmacological modulation in women on menopausal hormone treatment (MHT) or endocrine therapy after breast cancer. The fluctuation in estrogen concentrations, the relative androgen excess, and the age-related reduction in sex hormone-binding globulin are related to increased NAFLD risk. Moreover, the peri-menopausal changes in body composition and insulin resistance might contribute to the increased NAFLD risk. Whether MHT prevents or improves NAFLD in this population remains an open question. Studies in women with breast cancer treated with tamoxifen or non-steroidal aromatase inhibitors point to their adverse effects on NAFLD development, although a more pronounced effect of tamoxifen is reported. Future studies focusing on the underlying pathogenesis should identify subgroups with the highest risk of NAFLD development and progression into more aggressive forms, as well as elucidate the role of hormone therapies, such as MHT.
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Affiliation(s)
- K Pafili
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Munich-Neuherberg, Germany
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - S A Paschou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Menopause Unit, 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E Armeni
- Menopause Unit, 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S A Polyzos
- First Laboratory of Pharmacology, Medical School, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - D G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - I Lambrinoudaki
- Menopause Unit, 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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Tardelli LP, Duchatsch F, Herrera NA, Ruiz TFR, Pagan LU, Vicentini CA, Okoshi K, Amaral SL. Benefits of combined exercise training on arterial stiffness and blood pressure in spontaneously hypertensive rats treated or not with dexamethasone. Front Physiol 2022; 13:916179. [PMID: 36045742 PMCID: PMC9420846 DOI: 10.3389/fphys.2022.916179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Dexamethasone (DEX)-induced arterial stiffness is an important side-effect, associated with hypertension and future cardiovascular events, which can be counteracted by exercise training. The aim of this study was to evaluate the mechanisms induced by combined training to attenuate arterial stiffness and hypertension in spontaneously hypertensive rats treated or not with dexamethasone. Spontaneously hypertensive rats (SHR) underwent combined training for 74 days and were treated with dexamethasone (50 µg/kg s. c.) or saline solution during the last 14 days. Wistar rats were used as controls. Echocardiographic parameters, blood pressure (BP) and pulse wave velocity (PWV), as well as histological analyses of the heart and aorta, carotid and femoral arteries were performed. At the beginning, SHR had higher BP and PWV compared with Wistar rats. After 60 days, while BP increased in sedentary SHR, combined exercise training decreased BP and PWV. After 74d, the higher BP and PWV of sedentary SHR was accompanied by autonomic imbalance to the heart, cardiac remodeling, and higher arterial collagen deposition. DEX treatment did not change these parameters. On the other hand, trained SHR had reduced BP and PWV, which was associated with better autonomic balance to the heart, reduced myocardial collagen deposition, as well as lower arterial collagen deposition. The results of this study suggest that combined training, through the reduction of aortic collagen deposition, is an important strategy to reduce arterial stiffness in spontaneously hypertensive rats, and these lower responses were maintained regardless of dexamethasone treatment.
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Affiliation(s)
- Lidieli P. Tardelli
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Francine Duchatsch
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Naiara A. Herrera
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Thalles Fernando R. Ruiz
- Joint Graduate Program in Animal Biology, São Paulo State University (UNESP), São José do Rio Preto, SP, Brazil
| | - Luana U. Pagan
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Carlos A. Vicentini
- Department of Biological Sciences, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Katashi Okoshi
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Sandra L. Amaral
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
- *Correspondence: Sandra L. Amaral,
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Sequí-Domínguez I, Cavero-Redondo I, Álvarez-Bueno C, Saz-Lara A, Mesas AE, Martínez-Vizcaíno V. Association between arterial stiffness and the clustering of metabolic syndrome risk factors: a systematic review and meta-analysis. J Hypertens 2021; 39:1051-1059. [PMID: 33323912 DOI: 10.1097/hjh.0000000000002754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Metabolic syndrome (MetS) is a cluster of different cardiometabolic risk factors (CMRFs), and its different combinations with other CMRFs, such as arterial stiffness have been hypothesized to explain, at least partially, increased risk of cardiovascular disease. Thus, in this systematic review and meta-analysis, we aimed to synthesize the evidence regarding the association between the clustering of MetS-related CMRFs and arterial stiffness measured using pulse wave velocity (PWV). METHODS Original studies analysing the association between arterial stiffness, measured using PWV, and MetS were systematically searched. Pooled effect size estimates and their respective 95% confidence intervals (CI) were calculated using the DerSimonian and Laird method for two separate analyses: the diagnosis of MetS and PWV values and the number of CMRFs and PWV values. RESULTS Moderate effect size estimates were observed between MetS and PWV (0.68, 95% CI: 0.54-0.82) with a slightly higher effect size for the low-risk compared with the high-risk population group (0.75, 95% CI: 0.58-0.92; and 0.51, 95% CI: 0.32-0.82, respectively). A trend between the number of MetS-related CMRFs and PWV was found with the pooled effect size nearly doubling as the number of MetS-related CMRFs increased, 0.11 (95% CI: 0.04-0.17) for one MetS-related CMRF, 0.26 (95% CI: 0.13-0.4) for two, and 0.4 (95% CI: 0.2-0.6) for three or more. CONCLUSION These results demonstrated a clinically relevant association between MetS and PWV and an increasing trend in PWV values, such as a MetS-related CMRF increase. Although these results should be considered cautiously because of the considerable heterogeneity, our findings reinforce the rationale of MetS as an aggregation of risk factors with common causes, which could provide additional useful information to guide clinical management.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Arthur E Mesas
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidade Estadual de Londrina, Department of Public Health, Paraná, Brazil
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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6
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Tolstov SN, Salov IA, Kiselev AR, Rebrov AP. Evaluating daily profile of central aortic pressure and reflected pulse wave parameters in climacteric women. BMC Cardiovasc Disord 2021; 21:246. [PMID: 34011280 PMCID: PMC8136159 DOI: 10.1186/s12872-021-02064-9] [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: 11/02/2020] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Structural and functional changes of the vascular wall in women occur already at the very early stages of reproductive aging. An emergence of applanation tonometry made it possible to evaluate arterial stiffness and central hemodynamic parameters non-invasively, which considerably expanded the information that had been provided previously by invasive methods used for studying these parameters during cardiac catheterization. Whereas a few studies have assessed central aortic pressure (CAP) parameters and reflected pulse wave in women at different phases of their reproductive aging, none investigated the daily profile of CAP and reflected pulse wave parameters in women undergoing different stages of the menopause. Background: assessment of the daily variability in CAP and daily profile of amplification and augmentation of pulse blood pressure (PBP) in women at different menopause phases. Methods The study involved 384 climacteric women. The first group included 168 women undergoing perimenopause, the second group comprised of 216 women in their early postmenopausal stage. A 24-h blood pressure (BP) monitoring in the brachial artery and aorta (BPLab® Vasotens® system, Petr Telegin LLC, Russia) was performed via the measurements of the following indicators: systolic blood pressure (SBP), pulse blood pressure (PBP), central aortic systolic pressure (CASP), central aortic pulse pressure (CAPP), aortic augmentation index (AIxao), and pulse pressure amplification (PPA). Results When investigating PPA values in the brachial artery and aorta, we detected smaller amplification and higher aortic augmentation index at night than in daytime, which reflected a disproportionately higher CAP level during night hours. This pattern was more pronounced in postmenopausal women. We calculated the logistic regression equation (adjusted R2 = 0.49, log-likelihood = − 50.3, chi-square (19) = 97.6, p < 0.001), in which dependent variable was represented by the menopausal status, whereas body mass index with all indicators of a 24-h BP monitoring represented independent variables. In this model, two indicators (body mass index and AIxao) were, independently of each other, associated significantly with the menopause phases. Differences among women at various climacteric phases in terms of remaining indicators of a 24-h BP monitoring, apparently, matched the differences in their body mass index values. Conclusion Rising CAP, in combination with declining PPA and augmenting reflected pulse wave amplitude, may be associated with an increased risk of cardiovascular complications.
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Affiliation(s)
- Sergey N Tolstov
- Department of Therapy with Courses in Cardiology, Functional Diagnostic and Geriatrics, Saratov State Medical University, Saratov, Russia
| | - Igor A Salov
- Department of Obstetrics and Gynecology, Saratov State Medical University, Saratov, Russia
| | - Anton R Kiselev
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia. .,Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia.
| | - Andrey P Rebrov
- Department of Hospital Therapy, Saratov State Medical University, Saratov, Russia
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7
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Solanki JD, Bhatt DN, Patel RK, Mehta HB, Shah CJ. Effect of Menopause on Arterial Stiffness and Central Hemodynamics: A Pulse Wave Analysis-Based Cross-sectional Study from Gujarat, India. J Midlife Health 2021; 12:46-52. [PMID: 34188426 PMCID: PMC8189333 DOI: 10.4103/jmh.jmh_106_19] [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: 08/11/2020] [Revised: 11/21/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Menopause, a cardiovascular risk in mid-life women, is studied in terms of blood pressure mostly. Arterial stiffness (AS) and central hemodynamics (CH) are direct surrogates measured by pulse wave analysis (PWA) with no study from our region. Objective: We studied AS, CH in relation to menopause using PWA. Materials and Methods: A cross-sectional study was performed in 134 middle-aged females divided into groups with or without menopause. Oscillometric PWA done by Mobil-o-Graph (IEM, Germany) gave – AS like augmentation pressure, augmentation index at heart rate (HR) 75, aortic pulse wave velocity (aPWV), and total AS pulse pressure amplification; CH like aortic blood pressure, cardiac output and related parameters, peripheral resistance, stroke work, prevalent brachial/central hypertension, and raised central pulse pressure. They were further compared between groups, in relation to body mass index (BMI) and by multiple regressions with P < 0.05 as statistical significance. Results: Postmenopausal women were significantly elder, physically inactive with comparable BMI and showed higher AS (only aPWV was significantly different) and CH. BMI was unrelated to AS or CH in postmenopausal group. Age (except for aPWV), BMI, and HR (except for AIx@75) were insignificant predictors, while systolic blood pressure (SBP) in premenopausal and diastolic blood pressure (DBP) in postmenopausal group was major AS predictors. Age, HR, and BMI were insignificant predictors, while SBP more than DBP was significant predictors of CH. Conclusions: In obese, predominantly sedentary midlife Gujarati women, menopause negatively affects AS and hemodynamics, central more than peripheral. Menopause accelerates cardiovascular aging, independent of BMI, and age that calls for further studies.
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Affiliation(s)
| | | | | | - Hemant B Mehta
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
| | - Chinmay J Shah
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
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8
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Augoulea A, Armeni E, Paschou SA, Georgiopoulos G, Stamatelopoulos K, Lambrinoudaki I. Breastfeeding is associated with lower subclinical atherosclerosis in postmenopausal women. Gynecol Endocrinol 2020; 36:796-799. [PMID: 32584151 DOI: 10.1080/09513590.2020.1782374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Objective: To evaluate the association between a personal history of lactation and indices of subclinical atherosclerosis in postmenopausal women.Methods: We evaluated the association between a history of breastfeeding and indices of subclinical atherosclerosis (pulse wave velocity, PWV; intima-media thickness [IMT]; atherosclerotic plaque presence) in 197 parous postmenopausal women with history of breastfeeding.Results: Women who reported breastfeeding ≥6 months when compared with women who reported breastfeeding for 1-5 months exhibited significantly lower values of common carotid artery IMT (Model R2=15.7%, b-coefficient = -0.170, 95% CI: -0.208-0.001, p-value = .019) and lower odds of subclinical atherosclerosis (Model X2=28.127, OR = 0.491, 95% CI 0.318-0.999, p-value = .049), adjusting for traditional cardiovascular risk factors.Conclusions: Postmenopausal women with a history of breastfeeding for at least 6 months have a lower prevalence of subclinical atherosclerosis, independently of traditional cardiovascular risk factors. A longer duration of breastfeeding may have a beneficial effect on subclinical atherosclerosis later in life.
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Affiliation(s)
- Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Stavroula A Paschou
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Georgios Georgiopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Athens, Greece
| | - Kimon Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece
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9
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Stamatelopoulos K, Tsoltos N, Armeni E, Paschou SA, Augoulea A, Kaparos G, Rizos D, Karagouni I, Delialis D, Ioannou S, Apostolakis M, Makrakis E, Lambrinoudaki I. Physical activity is associated with lower arterial stiffness in normal‐weight postmenopausal women. J Clin Hypertens (Greenwich) 2020; 22:1682-1690. [DOI: 10.1111/jch.13954] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/15/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Kimon Stamatelopoulos
- Vascular Laboratory Department of Therapeutics Alexandra Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Nikolaos Tsoltos
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Stavroula A. Paschou
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Areti Augoulea
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Georgios Kaparos
- Hormonal and Biochemical Laboratory Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Demetrios Rizos
- Hormonal and Biochemical Laboratory Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Iliana Karagouni
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Dimitris Delialis
- Vascular Laboratory Department of Therapeutics Alexandra Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Sophia Ioannou
- Vascular Laboratory Department of Therapeutics Alexandra Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Michail Apostolakis
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Evangelos Makrakis
- Third Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology Aretaieio Hospital, National and Kapodistrian University of Athens Athens Greece
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10
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Geovanini GR, Pinheiro de Sousa I, Teixeira SK, Francisco Neto MJ, Gómez Gómez LM, Del Guerra GC, Pereira AC, Krieger JE. Carotid intima-media thickness and metabolic syndrome in a rural population: Results from the Baependi Heart Study. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION 2020; 6:100043. [PMID: 33447769 PMCID: PMC7803066 DOI: 10.1016/j.ijchy.2020.100043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/06/2020] [Accepted: 07/17/2020] [Indexed: 01/16/2023]
Abstract
Background and aims Carotid intima-media thickness (cIMT) is a strong predictor of cardiovascular events and associated with metabolic syndrome (MetS). MetS is a cluster of cardiovascular risk factors, but the association structure between specific factors and disease development is not well-established in rural populations. We described the association structure between MetS factors and cIMT in a sample from rural Brazil. Methods We studied 1937 participants from the Baependi Heart Study who underwent carotid ultrasound exam. We used ATP–III–2001 for MetS definition and linear mixed-effects models, adjusting by the family structure, to assess independent associations between the cardiovascular risk factors which define MetS and cIMT. Results The sample's mean age was 46 ± 16y, 61% female, 73% white, mean body-mass-index 26±5 kg/m2, mean cIMT 0.53 ± 0.16 mm, with 35% of the sample classified with MetS. As expected, cIMT demonstrated a linear relationship with increasing age, and cIMT higher values were observed for MetS (0.58 ± 0.16 mm) compared to non-MetS (0.49 ± 0.14 mm). Considering models for cIMT with MetS and all of its factors, we found that blood pressure, glucose and obesity were independently associated with cIMT, but not HDL or triglycerides. Conclusions cIMT showed a linear relationship with increasing age. Blood pressure, obesity, and glucose were independently associated with cIMT, but not HDL-cholesterol or triglycerides. In a rural population, hypertension, diabetes and obesity play a more important role than lipids in determining cIMT interindividual variability. Metabolic Syndrome (MetS) is independently associated with cIMT in a rural sample. Age showed a linear relationship with cIMT. Blood pressure, glucose, and obesity measurements are independently associated with cIMT, but not cholesterol fractions.
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Affiliation(s)
- Glaucylara Reis Geovanini
- Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil.,HCor Research Institute-Hospital do Coracão (HCor), São Paulo, SP, Brazil
| | - Iguaracy Pinheiro de Sousa
- Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil
| | - Samantha Kuwada Teixeira
- Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil
| | - Miguel José Francisco Neto
- Department of Imaging of Hospital Israelita Albert Einstein - HIAE, São Paulo, Brazil.,Institute of Radiology - InRad, Medical School, University of São Paulo - USP, São Paulo, Brazil
| | - Luz Marina Gómez Gómez
- Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil
| | | | - Alexandre Costa Pereira
- Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil
| | - Jose Eduardo Krieger
- Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil
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The Effect of Whole Blood Lead (Pb-B) Levels on Changes in Peripheral Blood Morphology and Selected Biochemical Parameters, and the Severity of Depression in Peri-Menopausal Women at Risk of Metabolic Syndrome or with Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145033. [PMID: 32668760 PMCID: PMC7400500 DOI: 10.3390/ijerph17145033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023]
Abstract
The aim of our study was to assess the impact of whole blood lead (Pb-B) levels on changes in peripheral blood morphology and selected biochemical parameters, and the severity of depression in peri-menopausal women at risk of metabolic syndrome (pre-MetS) or with metabolic syndrome (MetS). The study involved 233 women from the general population of the West Pomeranian Province (Poland) aged 44–65 years. The intensity of menopausal symptoms and the severity of depression was examined using the Blatt–Kupperman Index (KI) and the Beck Depression Inventory (BDI). C-reactive protein (CRP), insulin, glucose, glycated hemoglobin (HbA1C), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglyceride levels (TG), cortisol, morphology of blood cells and homeostasis model assessment for insulin resistance (HOMA-IR) and Pb-B was measured. Women with MetS had higher levels of glucose, HbA1C, HDL, LDL, TG, cortisol, insulin and higher HOMA-IR. No significant differences in Pb-B were observed between pre-MetS and the control group, and between pre-MetS and the MetS group. A significant correlation was noticed between Pb-B vs. the percentage of monocytes in blood, and blood cortisol levels in women with MetS; Pb-B vs. lymphocyte count and HbA1C in the pre-MetS group, as well as in the BDI scores between the MetS and pre-MetS group. We cannot clearly state that exposure to Pb is an environmental factor that can be considered as a risk factor for MetS in this studied group.
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Yang X, Luo W, Han S, Zha L, Zhang J, Li X, Zhao H, Liang S, Zhao R. Prevalence of high-risk coronary plaques in patients with and without metabolic syndrome and the relationship with prognosis. BMC Cardiovasc Disord 2020; 20:73. [PMID: 32046639 PMCID: PMC7011281 DOI: 10.1186/s12872-020-01358-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/24/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MS) is a disorder, characterized by clusters of cardiovascular risk factors such as central obesity, insulin resistance, dyslipidemia and hypertension. Patients with MS may have a higher plaque burden that increases their risk of major adverse cardiovascular events (MACEs). This study aimed to analyze the prevalence of high-risk coronary plaques in patients with and without MS by coronary computed tomography angiography (CCTA) and to investigate the relationship between MS, high-risk coronary plaques, and their prognosis. METHODS This was a retrospective cohort study of 1136 patients who underwent CCTA due to chest pain without obstructive heart disease (≥50% coronary stenosis) between January 2014 and December 2015 in our hospital. The relationships between high risk coronary plaques, MS, and other clinical factors were assessed. Multicollinearity analysis was performed to identify the collinearity between the variables. The proportional hazard assumption was checked and using Schoenfeld residual test. Cox proportional hazards model and Kaplan-Meier survival analysis assessed the relationship between MS, high-risk coronary plaques and MACEs. RESULTS High-risk plaques were more frequent in the MS group than non-MS group (P = 0.004). MS (HR = 2.128, 95%CI: 1.524-2.970, P < 0.001), presence of high-risk plaques (HR = 11.059, 95%CI: 7.749-57.232, P < 0.001) and high sensitivity C-reactive protein (hsCRP) (HR = 1.629, 95%CI: 1.128-2.352, P = 0.009) were related with an increased risk of MACEs in patients with risk factors for coronary heart disease. In patients with high-risk plaques, MS (HR = 2.265, 95%CI: 1.629-3.150, P < 0.001) and hsCRP (HR = 1.267, 95%CI: 1.191-1.348, P = 0.004) were related with an increased risk of MACEs. Kaplan-Meier analysis showed differences in MACEs between the MS and non-MS groups in the whole population and those with high-risk plaques (both P < 0.0001). CONCLUSIONS High-risk plaques were more common in patients with MS. MS and the presence of high-risk plaques were independent risk factors for MACEs.
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Affiliation(s)
- Xu Yang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Wei Luo
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Shan Han
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Lei Zha
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Jing Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Xiaowei Li
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Hui Zhao
- Department of Radiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Shuo Liang
- Department of Radiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China
| | - Ru Zhao
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China.
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Anık İlhan G, Yıldızhan B. Visceral adiposity indicators as predictors of metabolic syndrome in postmenopausal women. Turk J Obstet Gynecol 2019; 16:164-168. [PMID: 31673468 PMCID: PMC6792061 DOI: 10.4274/tjod.galenos.2019.62558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 07/18/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the importance of visceral adiposity indicators on metabolic parameters in postmenopausal women. MATERIALS AND METHODS This cross-sectional study included 200 postmenopausal subjects. Postmenopausal women were divided into two groups based on the presence of metabolic syndrome (MetS) as MetS+ and MetS-. Comparisons of clinical and metabolic characteristics were performed between the groups. RESULTS The current study included 200 postmenopausal women and 63 subjects were diagnosed as having MetS. Postmenopausal women with MetS demonstrated significantly higher values with respect to systolic and diastolic blood pressures, body mass index (BMI), waist-hip ratio (WHR), triglyceride (TG), lipid ratios, Homeostasis Model Assessment Insulin Resistance (HOMA) index, TG glucose (TyG), Visceral Adiposity Index (VAI), and lipid accumulation product (LAP) when compared with women without MetS. Correlation analyses showed that LAP and VAI were positively correlated with waist circumference, WHR, BMI, TG, lipid ratios, TyG and HOMA index, and with each other. LAP was also positively correlated with blood pressures. CONCLUSION Visceral adiposity indicators may be useful as predictors of MetS in postmenopausal women.
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Affiliation(s)
- Gökçe Anık İlhan
- Marmara University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Begüm Yıldızhan
- Marmara University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
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14
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Kim HY, Kim Y. Associations of obesity with osteoporosis and metabolic syndrome in Korean postmenopausal women: a cross-sectional study using national survey data. Arch Osteoporos 2019; 14:64. [PMID: 31218525 DOI: 10.1007/s11657-019-0615-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/04/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED In a representative sample of 3058 Korean postmenopausal women, we studied which types of obesity were more or less desirable for developing concomitant osteoporosis and metabolic syndrome (MS), with the goal of helping clinicians identify steps to reduce patients' risk. Different definitions of obesity showed different relationships with osteoporosis and MS in this population. PURPOSE To examine sample characteristics, prevalence, and the risk of osteoporosis and metabolic syndrome among four groups of postmenopausal women classified by obesity. METHODS Data from the Korea National Health and Nutrition Examination Survey were analyzed using the Rao-Scott chi-square test, analysis of variance, and multinomial logistic regression analysis. The four groups included body mass index (BMI)-based obese, waist circumference (WC)-based obese, BMI-, and WC-based obese, and non-obese women, using BMI and WC cutoffs for obesity of ≥ 25 kg/m2 and ≥ 80 cm, respectively. RESULTS The prevalence of osteoporosis and MS was 40.8% and 48.5%, respectively. Age, socioeconomic status, smoking status, and hormone therapy use differed among the obese groups. The odds ratios of simultaneously having both osteoporosis and MS in the BMI- and WC-based obese, BMI-based obese, WC-based obese, and non-obese groups were 7.39 (95% confidence interval [CI] = 4.83-11.31), 0.74 (95% CI = 0.27-1.98), 7.07 (95% CI = 4.72-10.58), and 1, respectively. CONCLUSIONS The findings demonstrate the most and the least desirable types of obesity in terms of risk for both osteoporosis and MS. Public health practitioners may consider the type of obesity to reduce or prevent both conditions in postmenopausal women.
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Affiliation(s)
- Hyun-Young Kim
- Department of Nursing, Jeonju University, 303 Cheonjam-ro, Wansan-gu, Jeonju-si, 55069, Republic of Korea
| | - Yunmi Kim
- College of Nursing, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam-si, 13135, Republic of Korea.
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Chedraui P, Pérez-López FR. Metabolic syndrome during female midlife: what are the risks? Climacteric 2019; 22:127-132. [DOI: 10.1080/13697137.2018.1561666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- P. Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - F. R. Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano-Blesa University Hospital, Zaragoza, Spain
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Stamatelopoulos K, Papavagelis C, Augoulea A, Armeni E, Karagkouni I, Avgeraki E, Georgiopoulos G, Yannakoulia M, Lambrinoudaki I. Dietary patterns and cardiovascular risk in postmenopausal women: Protocol of a cross-sectional and prospective study. Maturitas 2018; 116:59-65. [DOI: 10.1016/j.maturitas.2018.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/16/2018] [Accepted: 07/18/2018] [Indexed: 11/25/2022]
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Sanchez-Barajas M, Ibarra-Reynoso LDR, Ayala-Garcia MA, Malacara JM. Flow mediated vasodilation compared with carotid intima media thickness in the evaluation of early cardiovascular damage in menopausal women and the influence of biological and psychosocial factors. BMC WOMENS HEALTH 2018; 18:153. [PMID: 30236100 PMCID: PMC6149057 DOI: 10.1186/s12905-018-0648-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/12/2018] [Indexed: 02/21/2023]
Abstract
Background Women after menopause increase risk for cardiovascular disease and several factors may be related. The purpose was to study biological and psychosocial factors associated with early cardiovascular damage in pre- and postmenopausal women, assessed with carotid intima-media thickness vs flow-mediated dilatation. Methods Women 45 to 57 years old were grouped in the pre- (n = 60), early (n = 58) and late post-menopause (n = 59). Anthropometric, metabolic and hormonal data were registered, as well as measures of depression, anxiety, submission, perceived stress, and sleep alterations. Heart Rate Variability was recorded to obtain the information regarding sympathovagal balance. Carotid intima-media thickness and flow-mediated dilatation were assessed by ultrasound. Two-way ANOVA and multiple regression model were used. Results At late postmenopause, the carotid intima-media was thicker (p < 0.001) and flow-mediated dilatation decreased (p < 0.001). Carotid intima-media thickness was associated positively with age (p < 0.001), submission score (p = 0.029), follicle stimulating hormone levels (p < 0.001), and body mass index (p = 0.009). Flow-mediated dilatation was associated only with age (p < 0.001). Regarding heart rate variability, the time domain pNN50 measurement was higher in premenopausal women (p = 0.001), Low Frequency (LF) was higher in the two groups of postmenopausal (p = 0.001) and High Frequency (HF) higher in the early postmenopausal women (p = 0.042). Conclusions Under our conditions carotid intima-media thickness had higher predictive value for early cardiovascular damage at menopause. The finding of the association of the submission score, indicates de influence of stress on vascular damage.
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Affiliation(s)
- Mauricio Sanchez-Barajas
- Department of Internal Medicine, Instituto Mexicano del Seguro Social, General Hospital Zone/MF 21, Leon, Guanajuato, Mexico.,Department of Medical Sciences, University of Guanajuato, León Campus, León, GTO, Mexico
| | | | - Marco Antonio Ayala-Garcia
- Department of General Surgery, Instituto Mexicano del Seguro Social, General Hospital Subzone No 10, Guanajuato, Guanajuato, Mexico
| | - Juan Manuel Malacara
- Department of Medical Sciences, University of Guanajuato, León Campus, León, GTO, Mexico.
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