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Gilhooley SK, Bauman WA, La Fountaine MF, Cross GT, Kirshblum SC, Spungen AM, Cirnigliaro CM. Cardiometabolic risk factor clustering in persons with spinal cord injury: A principal component analysis approach. J Spinal Cord Med 2023:1-13. [PMID: 37695205 DOI: 10.1080/10790268.2023.2215998] [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] [Indexed: 09/12/2023] Open
Abstract
CONTEXT/OBJECTIVE To identify cardiometabolic (CM) measurements that cluster to confer increased cardiovascular disease (CVD) risk using principal component analysis (PCA) in a cohort of chronic spinal cord injury (SCI) and healthy non-SCI individuals. APPROACH A cross-sectional study was performed in ninety-eight non-ambulatory men with chronic SCI and fifty-one healthy non-SCI individuals (ambulatory comparison group). Fasting blood samples were obtained for the following CM biomarkers: lipid, lipoprotein particle, fasting glucose and insulin concentrations, leptin, adiponectin, and markers of inflammation. Total and central adiposity [total body fat (TBF) percent and visceral adipose tissue (VAT) percent, respectively] were obtained by dual x-ray absorptiometry (DXA). A PCA was used to identify the CM outcome measurements that cluster to confer CVD risk in SCI and non-SCI cohorts. RESULTS Using PCA, six factor-components (FC) were extracted, explaining 77% and 82% of the total variance in the SCI and non-SCI cohorts, respectively. In both groups, FC-1 was primarily composed of lipoprotein particle concentration variables. TBF and VAT were included in FC-2 in the SCI group, but not the non-SCI group. In the SCI cohort, logistic regression analysis results revealed that for every unit increase in the FC-1 standardized score generated from the statistical software during the PCA, there is a 216% increased risk of MetS (P = 0.001), a 209% increased risk of a 10-yr. FRS ≥ 10% (P = 0.001), and a 92% increase in the risk of HOMA2-IR ≥ 2.05 (P = 0.01). CONCLUSION Application of PCA identified 6-FC models for the SCI and non-SCI groups. The clustering of variables into the respective models varied considerably between the cohorts, indicating that CM outcomes may play a differential role on their conferring CVD-risk in individuals with chronic SCI.
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Affiliation(s)
- Shawn K Gilhooley
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - William A Bauman
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael F La Fountaine
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, New Jersey, USA
- Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey, USA
| | - Gregory T Cross
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Steven C Kirshblum
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ann M Spungen
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
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King DLO, Henson RN, Kievit R, Wolpe N, Brayne C, Tyler LK, Rowe JB, Tsvetanov KA. Distinct components of cardiovascular health are linked with age-related differences in cognitive abilities. Sci Rep 2023; 13:978. [PMID: 36653428 PMCID: PMC9849401 DOI: 10.1038/s41598-022-27252-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Cardiovascular ageing contributes to cognitive impairment. However, the unique and synergistic contributions of multiple cardiovascular factors to cognitive function remain unclear because they are often condensed into a single composite score or examined in isolation. We hypothesized that vascular risk factors, electrocardiographic features and blood pressure indices reveal multiple latent vascular factors, with independent contributions to cognition. In a population-based deep-phenotyping study (n = 708, age 18-88), path analysis revealed three latent vascular factors dissociating the autonomic nervous system response from two components of blood pressure. These three factors made unique and additive contributions to the variability in crystallized and fluid intelligence. The discrepancy in fluid relative to crystallized intelligence, indicative of cognitive decline, was associated with a latent vascular factor predominantly expressing pulse pressure. This suggests that higher pulse pressure is associated with cognitive decline from expected performance. The effect was stronger in older adults. Controlling pulse pressure may help to preserve cognition, particularly in older adults. Our findings highlight the need to better understand the multifactorial nature of vascular aging.
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Affiliation(s)
- Deborah L O King
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK.
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK.
| | - Richard N Henson
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Rogier Kievit
- Donders Research Institute for Brain, Cognition and Behaviour, Radboud University, 6525 AJ, Nijmegen, The Netherlands
| | - Noham Wolpe
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, UK
- Department of Physical Therapy, The Stanley Steer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Carol Brayne
- Cambridge Public Health, Cambridge Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Lorraine K Tyler
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
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Tsvetanov KA, Henson RNA, Jones PS, Mutsaerts H, Fuhrmann D, Tyler LK, Rowe JB. The effects of age on resting-state BOLD signal variability is explained by cardiovascular and cerebrovascular factors. Psychophysiology 2021; 58:e13714. [PMID: 33210312 PMCID: PMC8244027 DOI: 10.1111/psyp.13714] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 07/27/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022]
Abstract
Accurate identification of brain function is necessary to understand neurocognitive aging, and thereby promote health and well-being. Many studies of neurocognitive aging have investigated brain function with the blood-oxygen level-dependent (BOLD) signal measured by functional magnetic resonance imaging. However, the BOLD signal is a composite of neural and vascular signals, which are differentially affected by aging. It is, therefore, essential to distinguish the age effects on vascular versus neural function. The BOLD signal variability at rest (known as resting state fluctuation amplitude, RSFA), is a safe, scalable, and robust means to calibrate vascular responsivity, as an alternative to breath-holding and hypercapnia. However, the use of RSFA for normalization of BOLD imaging assumes that age differences in RSFA reflecting only vascular factors, rather than age-related differences in neural function (activity) or neuronal loss (atrophy). Previous studies indicate that two vascular factors, cardiovascular health (CVH) and cerebrovascular function, are insufficient when used alone to fully explain age-related differences in RSFA. It remains possible that their joint consideration is required to fully capture age differences in RSFA. We tested the hypothesis that RSFA no longer varies with age after adjusting for a combination of cardiovascular and cerebrovascular measures. We also tested the hypothesis that RSFA variation with age is not associated with atrophy. We used data from the population-based, lifespan Cam-CAN cohort. After controlling for cardiovascular and cerebrovascular estimates alone, the residual variance in RSFA across individuals was significantly associated with age. However, when controlling for both cardiovascular and cerebrovascular estimates, the variance in RSFA was no longer associated with age. Grey matter volumes did not explain age differences in RSFA, after controlling for CVH. The results were consistent between voxel-level analysis and independent component analysis. Our findings indicate that cardiovascular and cerebrovascular signals are together sufficient predictors of age differences in RSFA. We suggest that RSFA can be used to separate vascular from neuronal factors, to characterize neurocognitive aging. We discuss the implications and make recommendations for the use of RSFA in the research of aging.
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Affiliation(s)
- Kamen A. Tsvetanov
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - Richard N. A. Henson
- Medical Research Council Cognition and Brain Sciences UnitCambridgeUK
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - P. Simon Jones
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - Henk Mutsaerts
- Department of Radiology and Nuclear MedicineAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Delia Fuhrmann
- Medical Research Council Cognition and Brain Sciences UnitCambridgeUK
| | - Lorraine K. Tyler
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - Cam‐CAN
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - James B. Rowe
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Medical Research Council Cognition and Brain Sciences UnitCambridgeUK
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Christian Flemming GM, Bussler S, Körner A, Kiess W. Definition and early diagnosis of metabolic syndrome in children. J Pediatr Endocrinol Metab 2020; 33:821-833. [PMID: 32568734 DOI: 10.1515/jpem-2019-0552] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/06/2020] [Indexed: 12/25/2022]
Abstract
With this review, we aim to focus the attention on some established as well as new concepts for the metabolic syndrome (MetS) in children and adolescents spanning from definition to recommendations for the diagnostic approach. Even though there is no international commonly used definition of the metabolic syndrome in children and adolescents, all definitions include obesity as precondition for the development of MetS even in children. Obesity is one of the major cardiometabolic risk factors and it is strongly linked to other metabolic diseases like hyperlipidemia, hyperinsulinemia as well as hypertension. The metabolic syndrome is commonly known as a constellation of the mentioned morbidities. Pediatricians and researchers agree that early diagnosis and early interventions of the MetS are important to improve the prevention of cardiovascular disease and type 2 diabetes in adulthood. However, this requires appropriate screening tools for children and adolescents at risk for the MetS and its comorbidities. Due to controversies regarding the definition of MetS and the lack of consensus thresholds for the single components in children and adolescents, there is no internationally accepted diagnostic pathway for MetS available. However, several consensus statements and national guidelines for the assessment of obesity and its comorbidities in children and adolescents are available. Obesity seems to be the driving factor for the development of the other risk factors of MetS. In order to avoid conflicts concerning the definition of overweight and obesity, we recommend using the WHO definition of overweight (one standard deviation body mass index for age and sex and obesity; two standard deviations body mass index for age and sex) in children and adolescents.
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Affiliation(s)
| | - Sarah Bussler
- Hospital for Children and Adolescents, Leipzig University, Leipzig, Germany
| | - Antje Körner
- Hospital for Children and Adolescents, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany.,Centre of Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany.,Centre of Pediatric Research (CPL), Leipzig University, Leipzig, Germany
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Hassan NE, El Ashmawi AA, El-Masry SA, Zarouk WA, Mira MF, El-Saeed GS, Dwidar OH. Metabolic syndrome in a sample of Egyptian adolescent girls and its association with apolipoprotein E. J Paediatr Child Health 2019; 55:1344-1350. [PMID: 30895669 DOI: 10.1111/jpc.14419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/21/2019] [Accepted: 02/10/2019] [Indexed: 11/28/2022]
Abstract
AIM Obesity and its metabolic complications are increasing in childhood and extend to adulthood. The aims of this study were to assess the prevalence of metabolic syndrome (MS) in a sample of Egyptian adolescent girls and investigate its association with apolipoprotein E. METHODS A cross-sectional study design was used, including 200 Egyptian adolescent girls aged between 12 and 18 years. They were subjected to blood pressure (BP) measurement, anthropometric measurements (weight, height and waist circumference (WC)), laboratory investigations (fasting glucose and lipid profile) and molecular analysis (Apo E). RESULTS Overweight/obese girls were suffering significantly, more than normal-weight girls, from hypertension (66.7 vs. 40.8%), diabetes diagnosed by elevated fasting blood glucose (46.7 vs. 31.2%) and low high-density lipoprotein (HDL) (64 vs. 59.2%). Girls with MS had significantly higher values of body mass index Z-score, WC, BP, cholesterol and triglycerides and significantly lower HDL. Allele E3 (59.1 vs. 55.1%) was more frequent among girls with MS, while allele E4 (41 vs. 36.4) was more frequent among girls without MS. MS was the most prominent among girls with the E3/E4 genotype (35.7%), who had the highest frequency of elevated cholesterol, triglycerides, low-density lipoprotein and blood glucose, while girls with the E2/E4 genotype, which was rare among both groups, had the highest frequency of elevated BP (68.8%) and low HDL (71.4%). CONCLUSION MS was significantly more prominent among overweight/obese adolescent girls with the E3/E4 genotype, who had the highest frequency of disturbed lipid profile and blood glucose.
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Affiliation(s)
- Nayera E Hassan
- Biological Anthropology Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | | | - Sahar A El-Masry
- Biological Anthropology Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Waheba A Zarouk
- Molecular Genetics and Enzymology Department, Human Genetics Division, National Research Centre, Cairo, Egypt
| | - Marwa F Mira
- Pediatrics Department, Cairo University, Cairo, Egypt
| | - Gamila Sm El-Saeed
- Medical Biochemistry Department, Medical Research Division, National Research Centre, Cairo, Egypt
| | - Omar H Dwidar
- Biological Anthropology Department, Medical Research Division, National Research Centre, Cairo, Egypt
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6
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Stoner L, Weatherall M, Skidmore P, Castro N, Lark S, Faulkner J, Williams MA. Cardiometabolic Risk Variables in Preadolescent Children: A Factor Analysis. J Am Heart Assoc 2017; 6:e007071. [PMID: 29021277 PMCID: PMC5721889 DOI: 10.1161/jaha.117.007071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/09/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Atherosclerosis begins during preadolescence and is occurring at an accelerated rate. This acceleration has been linked to poor lifestyle behaviors and subsequent cardiometabolic complications. Although the clustering of cardiometabolic risk factors has been recognized for over 2 decades, previous studies in children have predominantly examined the relationships between atherosclerosis and individual cardiometabolic risk factors or have grouped together preadolescent and adolescent children. Further, no known studies have included glycated hemoglobin or central hemodynamic measures such as central systolic blood pressure and augmentation index. METHODS AND RESULTS Principal component analysis was performed on a cross-sectional sample of 392 children (aged 9.5 years, 50% girls) from 3 representative sample sites across New Zealand. Four factors explained 60% of the variance in the measured variables. In order of variance explained, the factors were: blood pressure (central systolic blood pressure and peripheral systolic and diastolic blood pressure), adiposity (waist circumference, body mass index, and glycated hemoglobin), lipids (total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol), and vascular (augmentation index, heart rate, and fasting blood glucose). CONCLUSIONS In accordance with previous findings in adults and adolescents, one common factor is unlikely to define cardiometabolic health in preadolescent children. Each of the factors, except vascular, which was predominantly explained by augmentation index, are in agreement with previous findings in adolescents. An additional novel finding was that glycated hemoglobin and fasting blood glucose loaded onto different factors, supporting previous work suggesting that fasting blood glucose indicates short-term glycemic control, whereas glycated hemoglobin reflects chronic glycemic control. CLINICAL TRIAL REGISTRATION URL: www.anzctr.org.au/. ID: ACTRN12614000433606.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Paula Skidmore
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Nicholas Castro
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Sally Lark
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - James Faulkner
- Department of Sport & Exercise, University of Winchester, United Kingdom
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Farrag NS, Cheskin LJ, Farag MK. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis. ADVANCES IN PEDIATRIC RESEARCH 2017; 4:8. [PMID: 29354689 PMCID: PMC5773115 DOI: 10.12715/apr.2017.4.8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Obesity rates are rising globally, but there is evidence that young people in the Middle East and North Africa (MENA) region are at particularly high risk. We systematically searched the literature to map the MENA region for prevalence of childhood overweight and obesity, and examine the underlying risk factors and adverse effects associated with obesity in this region. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies demonstrated an increasing prevalence of obesity among many countries in the MENA region, especially in the Gulf area. Notably, in Kuwait, prevalence rates of overweight and obesity were 25.6% and 34.8% among young males and 20.8% and 20.5% among females. A meta-analysis revealed that physical inactivity, increased screen time, and higher social status were risk factors for childhood obesity. Childhood and adolescent obesity is a major challenge facing countries of the MENA region. Further research is needed to fully investigate the role of nutrition and other specific risk factors and evaluate various interventions to manage this pervasive and growing health problem.
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Affiliation(s)
- Nesrine S. Farrag
- Department of Public Health and Community Medicine, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Lawrence J. Cheskin
- Department of Health, Behavior & Society, and Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohamed K. Farag
- Epidemiology Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Farrag NS, Cheskin LJ, Farag MK. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Health impact and management. ADVANCES IN PEDIATRIC RESEARCH 2017; 4:6. [PMID: 29104941 PMCID: PMC5667657 DOI: 10.12715/apr.2017.4.6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Childhood obesity has serious consequences both immediately and in adulthood. The rates of obesity in children and adolescents are rising rapidly in the Middle East and North Africa (MENA) region. We systematically searched the literature to explore adverse effects associated with childhood obesity in this region and the management efforts for dealing with it. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies that examined adverse effects of childhood obesity gave fairly consistent results, revealing associations with higher blood pressure, pre-diabetes, metabolic abnormalities, and cardiovascular risk. Little or no overall effect on rates of childhood obesity has yet been demonstrated by interventions used to manage the problem. Obesity has a considerable impact on the health of children and adolescents, and the countries of the MENA region should endorse strategies and programs to prevent and manage this problem in an effective way.
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Affiliation(s)
- Nesrine S. Farrag
- Department of Public Health and Community Medicine, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Lawrence J. Cheskin
- Department of Health, Behavior & Society, and Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohamed K. Farag
- Epidemiology Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hsu MI. Clinical characteristics in Taiwanese women with polycystic ovary syndrome. Clin Exp Reprod Med 2015; 42:86-93. [PMID: 26473107 PMCID: PMC4604298 DOI: 10.5653/cerm.2015.42.3.86] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 08/14/2015] [Accepted: 08/15/2015] [Indexed: 11/06/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common hormonal endocrine disorders in women of reproductive age. It consists of a heterogeneous collection of signs and symptoms that together form a disorder spectrum. The diagnosis of PCOS is principally based on clinical and physical findings. The extent of metabolic abnormalities in women with PCOS varies with phenotype, body weight, age, and ethnicity. For general population, the prevalence of hyperandrogenism and oligomenorrhea decreases with age, while complications such as insulin resistance and other metabolic disturbances increase with age. Obese women with PCOS have a higher risk of developing oligomenorrhea, amenorrhea, hyperandrogenemia, insulin resistance, and lower luteinizing hormone (LH) to follicle stimulation hormone (FSH) ratios than non-obese women with PCOS. The LH to FSH ratio is a valuable diagnostic tool in evaluating Taiwanese women with PCOS, especially in the diagnosis of oligomenorrhea. Overweight/obesity is the major determinant of cardiovascular and metabolic disturbances in women of reproductive age.
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Affiliation(s)
- Ming-I Hsu
- Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan. ; Department of Obstetrics and Gynecology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Pathophysiological domains underlying the metabolic syndrome: an alternative factor analytic strategy. Ann Epidemiol 2014; 24:762-70. [PMID: 25238942 DOI: 10.1016/j.annepidem.2014.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 07/28/2014] [Accepted: 07/29/2014] [Indexed: 11/23/2022]
Abstract
PURPOSE Factor analysis (FA) has become part and parcel in metabolic syndrome (MBS) research. Both exploration- and confirmation-driven factor analyzes are rampant. However, factor analytic results on MBS differ widely. A situation that is at least in part attributable to misapplication of FA. Here, our purpose was (i) to review factor analytic efforts in the study of MBS with emphasis on misusage of the FA model and (ii) to propose an alternative factor analytic strategy. METHODS The proposed factor analytic strategy consists of four steps and confronts weaknesses in application of the FA model. At its heart lies the explicit separation of dimensionality and pattern selection and the direct evaluation of competing inequality-constrained loading patterns. A high-profile MBS data set with anthropometric measurements on overweight children and adolescents is reanalyzed using this strategy. RESULTS The reanalysis implied a more parsimonious constellation of pathophysiological domains underlying phenotypic expressions of MBS than the original analysis (and many other analyses). The results emphasize correlated factors of impaired glucose metabolism and impaired lipid metabolism. CONCLUSIONS Pathophysiological domains underlying phenotypic expressions of MBS included in the analysis are driven by multiple interrelated metabolic impairments. These findings indirectly point to the possible existence of a multifactorial etiology.
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Tzeng CR, Chang YCI, Chang YC, Wang CW, Chen CH, Hsu MI. Cluster analysis of cardiovascular and metabolic risk factors in women of reproductive age. Fertil Steril 2014; 101:1404-10. [DOI: 10.1016/j.fertnstert.2014.01.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 01/23/2023]
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Spazzafumo L, Olivieri F, Abbatecola AM, Castellani G, Monti D, Lisa R, Galeazzi R, Sirolla C, Testa R, Ostan R, Scurti M, Caruso C, Vasto S, Vescovini R, Ogliari G, Mari D, Lattanzio F, Franceschi C. Remodelling of biological parameters during human ageing: evidence for complex regulation in longevity and in type 2 diabetes. AGE (DORDRECHT, NETHERLANDS) 2013; 35:419-429. [PMID: 22174010 PMCID: PMC3592946 DOI: 10.1007/s11357-011-9348-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 11/30/2011] [Indexed: 05/28/2023]
Abstract
Factor structure analyses have revealed the presence of specific biological system markers in healthy humans and diseases. However, this type of approach in very old persons and in type 2 diabetes (T2DM) is lacking. A total sample of 2,137 Italians consisted of two groups: 1,604 healthy and 533 with T2DM. Age (years) was categorized as adults (≤65), old (66-85), oldest old (>85-98) and centenarians (≥99). Specific biomarkers of routine haematological and biochemical testing were tested across each age group. Exploratory factorial analysis (EFA) by principal component method with Varimax rotation was used to identify factors including related variables. Structural equation modelling (SEM) was applied to confirm factor solutions for each age group. EFA and SEM identified specific factor structures according to age in both groups. An age-associated reduction of factor structure was observed from adults to oldest old in the healthy group (explained variance 60.4% vs 50.3%) and from adults to old in the T2DM group (explained variance 57.4% vs 44.2%). Centenarians showed three-factor structure similar to those of adults (explained variance 58.4%). The inflammatory component became the major factor in old group and was the first one in T2DM. SEM analysis in healthy subjects suggested that the glucose levels had an important role in the oldest old. Factorial structure change during healthy ageing was associated with a decrease in complexity but showed an increase in variability and inflammation. Structural relationship changes observed in healthy subjects appeared earlier in diabetic patients and later in centenarians.
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Affiliation(s)
- Liana Spazzafumo
- Biostatistical Center, Polo Scientifico Tecnologico, I.N.R.C.A., Via Birarelli, 8, Ancona, Italy.
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