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Zhang Z, Zhang L, Sun L, Wang B, Yuan Y, Gao H, Fu L. Relative children's lipid accumulation with hypertension in Chinese children and adolescents. BMC Public Health 2021; 21:1884. [PMID: 34663277 PMCID: PMC8524786 DOI: 10.1186/s12889-021-11868-5] [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: 04/09/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to develop a novel indicator associated with hypertension in Chinese children and adolescents, the relative children’s lipid accumulation product (RCLAP). Methods A cross-sectional study was conducted in 2018. A total of 683 students aged 8–15 years were recruited via a stratified cluster sampling Methods. Anthropometric indexes (waist circumference (WC), Body mass index (BMI), Waist-height ratio (WHtR), logarithm children LAP (LnCLAP), RCLAP per height (RCLAP-H)) were standardized using a z-score method (standardized variables: SWC, SBMI, SWHtR, SLnCLAP, SRCLAP-H). A logistic regression model was performed to evaluate the association of the above indicators with the outcome of hypertension. Results The overall prevalence of hypertension was 5.7% (5.5% in boys, 6.0% in girls). SWC ≥ P75, SBMI ≥ P75, SWHtR ≥ P75, SlnCLAP ≥ P75 and SRCLAP-H ≥ P75 significantly increased risk of hypertension, with odds ratios (OR) of 2.21 (95% confidence interval (CI): 1.13, 4.30), 2.30 (1.18, 4.49), 2.64 (1.35, 5.14), 4.43 (2.28, 8.61), and 4.49 (2.31, 8.71), respectively. Conclusion RCLAP is a novel indicator associated with hypertension in Chinese children and adolescents, and it performs better than WC, BMI, WHtR and children LAP.
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Affiliation(s)
- Zizhe Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Li Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Lili Sun
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Bangxuan Wang
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Yongting Yuan
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Huaiquan Gao
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China.
| | - Lianguo Fu
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China.
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Kim JJ, Yoon J, Lee YJ, Park B, Jung DH. Predictive Value of the Atherogenic Index of Plasma (AIP) for the Risk of Incident Ischemic Heart Disease among Non-Diabetic Koreans. Nutrients 2021; 13:3231. [PMID: 34579107 PMCID: PMC8471973 DOI: 10.3390/nu13093231] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 12/18/2022] Open
Abstract
The atherogenic index of plasma (AIP), composed of triglycerides and high-density lipoprotein cholesterol, is a novel critical marker for assessing the risk of atherogenicity and cardiometabolic health. We aimed to prospectively study the association between AIP and incident ischemic heart disease (IHD) risk in a large cohort of non-diabetic Korean adults. Data were assessed from 17,944 participants without diabetes from the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to AIP quartiles, calculated as log (triglyceride/high-density lipoprotein cholesterol). We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazard regression models over a 50-month period that followed the baseline survey. During the follow-up period, 332 participants (1.9%) developed IHD. HRs of IHD for AIP quartiles 2-4 were 1.58 (95% CI, 1.03-2.43), 1.82 (95% CI, 1.20-2.78), and 2.11 (95% CI, 1.37-3.24) after adjusting for age, sex, body mass index, smoking status, alcohol intake, physical activity, mean arterial blood pressure, fasting plasma glucose, high-sensitivity C-reactive protein level, and hypertension medication. Higher AIP levels may precede and predict the development of IHD in non-diabetic Korean adults.
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Affiliation(s)
- Julie J. Kim
- Department of Family Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (J.J.K.); (J.Y.)
| | - Jihyun Yoon
- Department of Family Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (J.J.K.); (J.Y.)
| | - Yong-Jae Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea;
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, Yongin 16995, Korea
| | - Dong-Hyuk Jung
- Department of Family Medicine, Yongin Severance Hospital, Yongin 16995, Korea
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Svarovskaya AV, Garganeeva AA. Anthropometric indices obesity and cardiometabolic risk: is there a link? КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Adipose tissue is currently regarded as a key organ for excess dietary lipids, which determine whether the body will maintain normal homeostasis or whether inflammation and insulin resistance will develop. In recent years, there is more information about novel prognostic models — the visceral adiposity index and the lipid accumulation product. The aim of this review was to analyze the results of studies examining the relationship between various indices of obesity and cardiometabolic risk. We analyzed 105 literature sources, 53 of which were ruled out, becausethe processes of interest were not described in detail or included anassessment of the relationship of various obesity indices with metabolic parameters. The results obtained indicate the advisability of using novel obesity indices, which have a good predictive ability and are simple and convenient to use. It is necessary to use additional methods of anthropometric and clinical examination in order to assess the metabolic phenotype of obesity, which will make it possible to stratify patients by the level of cardiometabolic risk.
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Affiliation(s)
- A. V. Svarovskaya
- Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
| | - A. A. Garganeeva
- Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
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Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension. Sci Rep 2021; 11:11095. [PMID: 34045594 PMCID: PMC8159997 DOI: 10.1038/s41598-021-90648-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/05/2021] [Indexed: 01/11/2023] Open
Abstract
Among the many factors considered relevant to hypertension, obesity and metabolic disturbances play an important role in the development of this pathology. Therefore, lipid accumulation product (LAP), an index of visceral adiposity, is a simple and effective indicator of hypertension risk. To date, the reference and cut-off values for LAP have not been defined. The aim of the study was to determine the age-adjusted optimal cut-off values of LAP for the prediction of hypertension risk. This cross-sectional case–control study comprised 1960 subjects ranging from 20 to 64 years of age. The participants underwent anthropometric tests, blood pressure measurements, questionnaire surveys and laboratory examinations. The cut-off values of LAP were determined using receiver operating characteristic (ROC) curve analysis. According to our study results, LAP values in healthy subjects increased with age, whereas there was no effect of age on LAP values in patients with hypertension. These two findings determine the presence of age-adjusted cut-off values of LAP for diagnosing hypertension. Increasing age is associated with an increase in the cut-off values of LAP to detect hypertension. In conclusion, hypertension risk should be estimated using the age-adjusted cut-off values of LAP; otherwise, the risk of hypertension might be overestimated or underestimated.
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Yang G, Qian T, Sun H, Xu Q, Hou X, Hu W, Zhang G, Drummond GR, Sobey CG, Witting PK, Denton KM, Charchar FJ, Golledge J, Wang Y. Adjustment for body mass index changes inverse associations of HDL-cholesterol with blood pressure and hypertension to positive associations. J Hum Hypertens 2021; 36:570-579. [PMID: 33976343 DOI: 10.1038/s41371-021-00548-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/16/2021] [Accepted: 04/26/2021] [Indexed: 11/09/2022]
Abstract
The associations between high-density lipoprotein cholesterol (HDL-C) and blood pressure (BP) or hypertension are inconsistent in previous studies. This study aimed to assess these associations in a large cohort of Chinese adults and across different age groups. This cross-sectional association study included 22,081 Chinese adults. Associations of HDL-C with BP and hypertension were analyzed using linear or logistic regression, with or without adjustment for confounding factors. HDL-C was inversely associated with BP and hypertension. These associations were still apparent after adjustment for age, sex, fasting plasma glucose, and low-density lipoprotein cholesterol. Sub-analyses revealed: (1) in the whole cohort and females alone, HDL-C was inversely associated with BP and hypertension in young and middle-aged but not older participants; (2) in males alone, HDL-C was not associated with systolic BP or hypertension. However, HDL-C was either inversely, or not, or positively associated with BP in young, middle-aged, and older males, respectively. After further adjustment for body mass index (BMI), the negative associations of HDL-C with BP and hypertension in the whole cohort became positive ones, and the positive associations only presented in males. These findings suggest that further adjustment for BMI changes inverse associations of HDL-cholesterol with BP and hypertension to positive associations in a cohort of Chinese adults.
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Affiliation(s)
- Guang Yang
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China.
| | - Tingting Qian
- Department of Geriatric Medicine, School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Hui Sun
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Qun Xu
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Xujuan Hou
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Wenqi Hu
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Guang Zhang
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Grant R Drummond
- Centre for Cardiovascular Biology and Disease Research and Department of Physiology, Anatomy & Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Christopher G Sobey
- Centre for Cardiovascular Biology and Disease Research and Department of Physiology, Anatomy & Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Paul K Witting
- Discipline of Pathology, School of Medical Sciences, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Kate M Denton
- Department of Physiology, Monash University, Melbourne, VIC, Australia.,Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Fadi J Charchar
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.,Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, QLD, Australia
| | - Yutang Wang
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia.
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Shi WY, Wang ZT, Sun FR, Ma YH, Xu W, Shen XN, Dong Q, Tan L, Yu JT, Yu Y. High pulse pressure is a risk factor for prodromal Alzheimer's disease: a longitudinal study. Aging (Albany NY) 2020; 12:18221-18237. [PMID: 32960784 PMCID: PMC7585106 DOI: 10.18632/aging.103678] [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: 02/18/2020] [Accepted: 06/29/2020] [Indexed: 01/24/2023]
Abstract
It has been increasingly evident that pulse pressure (PP) is associated with Alzheimer's disease (AD) but whether PP increases AD risk and the mechanism responsible for this association remains unclear. To investigate the effects of PP in the process of AD, we have evaluated the cross-sectional and longitudinal associations of PP with AD biomarkers, brain structure and cognition and have assessed the effect of PP on AD risk in a large sample (n= 1,375) from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Multiple linear regression and mixed-model regression were employed in cross-sectional and longitudinal analyses respectively. Clinical disease progression was assessed using Cox proportional hazards models. High PP was associated with lower β-amyloid 42 (Aβ42) (P= .015), and higher total tau (T-tau) (P= .011), phosphorylated tau (P-tau) (P= .003), T-tau/Aβ42 (P= .004) and P-tau/Aβ42 (P = .001), as well as heavier cortical amyloid-beta burden (P= .011). Longitudinally, baseline high PP was significantly associated with hippocampal atrophy (P= .039), entorhinal atrophy (P= .031) and worse memory performance (P= .058). Baseline high PP showed more rapid progression than those with normal PP (P <.001). These results suggest PP elevation could increase AD risk, which may be driven by amyloid plaques and subclinical neurodegeneration.
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Affiliation(s)
- Wen-Yan Shi
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian, China
| | - Zuo-Teng Wang
- College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Fu-Rong Sun
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xue-Ning Shen
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian, China,College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China,Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yang Yu
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Huang J, Bao X, Xie Y, Zhang X, Peng X, Liu Y, Cheng M, Ma J, Wang P. Interaction of lipid accumulation product and family history of hypertension on hypertension risk: a cross-sectional study in the Southern Chinese population. BMJ Open 2019; 9:e029253. [PMID: 31784431 PMCID: PMC6924775 DOI: 10.1136/bmjopen-2019-029253] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES This study aimed at investigating the applicability of a novel index based on waist circumference (WC) and triglyceride (TG) which was named lipid accumulation product (LAP) in the Southern Chinese population, and compared the predictive effects of LAP and other obesity indicators on hypertension risk. Moreover, this study investigated the interactive effects of LAP and family history of hypertension. METHODS A total number of 2079 of community-dwelling adults in Southern China were enrolled in this cross-sectional study. The participants underwent questionnaire surveys, anthropometric tests and laboratory examinations. Themultinomial logistic regression model and receiver operating characteristic curves, including LAP, body mass index (BMI), waist-to-hip ratio (WHR), WC and TG, were used to assess the association between hypertension risk and obesity indexes. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS Higher LAP levels have a relatively higher risk of having hypertension in both sexes (males: adjusted OR=2.79 per SD increase, 95% CI 1.43 to 5.44, p<0.001; females: adjusted OR=3.15, 95% CI 1.56 to 6.39, p<0.001). LAP (area under the curve=0.721; 95% CI 0.680 to 0.761) is a better indicator in identifying hypertension risk than BMI, WHR and TG in females, but WC performed better in males. A significant interaction between LAP and family history of hypertension was observed in males (RERI=1.652, 95% CI 0.267 to 3.037; AP=0.516, 95% CI 0.238 to 0.794; SI=3.998, 95% CI 0.897 to 17.820), but there is no statistically significant difference in females. CONCLUSIONS LAP significantly associates with hypertension risk in the Southern Chinese population. It has better performance than BMI, WHR and TG on predicting hypertension risk of the Southern Chinese female population. Moreover, LAP and family history of hypertension might synergistically increase the risk of hypertension.
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Affiliation(s)
- JunXuan Huang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China
| | - XinYu Bao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - YiXian Xie
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - XiaoXia Zhang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Xin Peng
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yan Liu
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - MengJiao Cheng
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - JinXiang Ma
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - PeiXi Wang
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China
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Zhang X, Li Y, Wang Y, Hu K, Tu R, Zhang H, Tian Z, Qiao D, Zhang G, Wang C. Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study. BMJ Open 2019; 9:e029179. [PMID: 31699722 PMCID: PMC6858237 DOI: 10.1136/bmjopen-2019-029179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the relationship between mean arterial pressure (MAP) and coronary heart disease (CHD) in Chinese rural population. In addition, we hypothesised that this relationship might be mediated by some degree of serum lipids. DESIGN This is a cross-sectional study. SETTING The participants were from the Henan Rural Cohort Study, initiated in five rural areas (Tongxu county of Kaifeng city, Yima county of Sanmenxia city, Suiping county of Zhumadian city, Xinxiang county of Xinxiang city and Yuzhou county of Xuchang city) in Henan Province, China, during July 2015 and September 2017. PARTICIPANTS The study included 39 020 subjects aged 18-79 years as current research population. OUTCOME MEASURES Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using an electronic sphygmomanometer. MAP was calculated by one-third SBP plus two-thirds DBP. The study used restricted cubic splines and logistic regression models to evaluate the ORs and 95% CIs. Mediation analysis using bootstrap was performed to examine the contribution of serum lipids to MAP-related CHD. RESULTS The adjusted OR (95% CI) for the highest MAP quartile with the risk of CHD was 1.45 (1.24 to 1.69) compared with the lowest quartile. Simultaneously, each 1-SD increment in MAP was significantly associated with a 12% increased risk of CHD. A linear dose-response relationship between MAP and CHD was found (p value for non-linear=0.1169) in the fully adjusted model. We further reported that 36.07% of proportion explained risk of CHD was mediated through serum lipids. CONCLUSIONS Increased MAP was a significant marker of CHD in Chinese rural population. Meanwhile, the relationship was mediated by some degree of serum lipids, and triglyceride was the strongest mediator. TRIAL REGISTRATION NUMBER Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (ChiCTR-OOC-15006699) and the stage it relates to is Post-results.
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Affiliation(s)
- Xia Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, China
| | - Yanhua Wang
- Department of Encephalopathy District, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Kai Hu
- Department of health policy research, Henan Academy of Medical Sciences, Zhengzhou, Henan, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhongyan Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dou Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Gongyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Lipid Indices, Elastin Turnover and the Development of Microvascular Complications – A Study in Diabetic Patients with Arterial Hypertension. ACTA MEDICA BULGARICA 2019. [DOI: 10.2478/amb-2019-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background and Aims: An important factor in the development of vascular wall lesions is the degradation of the elastic fiber major protein – elastin. Elastin peptides (EDP) derived from this degradation are present in the circulation and are a stimulus for the production of anti-elastin antibodies (AEAbs) IgM, IgG and IgA. The aim of this study was to investigate the possible association between AEAbs, lipid indices and the development of microvascular complications.
Material and Methods: Sera of 93 patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) were investigated (mean age 61,4 ± 11,3 years, diabetes duration 9,88 ± 3,12 years; hypertension duration 9,28 ± 4,98). ELISA was used for determination of anti-elastin antibodies. These levels were compared to serum AEAbs in 42 age- and sex-matched controls. Diabetic patients were divided in two groups according to the presence – Group 1 (n = 67) or absence – Group 2 (n = 26) of microangiopathy. The lipid profile and lipid indices (log TG/HDL, LDL/HDL, TC/HDL and TG/HDL) were also studied.
Results: Patients with T2DM and AH showed statistically significant higher levels of serum AEAbs IgA than healthy controls – 0,338 (0,133÷0,452) vs. 0,006 (0,052÷0,068) (KW = 19,54; P < 0.0001). Group 1 showed statistically significant higher levels of AEAbs IgA than patients without microangiopathy – 0,353 (0,173÷0,471) vs. 0,235 (0,098÷0,377) (KW = 3,36; p = 0.05) and healthy controls – 0,353 (0,173÷0,471) vs. 0,006 (0,052÷0,068) (KW = 20,37; p < 0,0001) (0.37 ± 0,03 vs. 0.06÷0.01) (p = 0.0001). Patients from Group 2 showed significantly higher levels of AEAbs IgA than controls 0,235 (0,098÷0,377) vs. 0,006 (0,052÷0,068) (KW = 8,54; P = 0.003). AEAbs IgA showed correlation with insulin dose (r = −0.35); (p = 0.01), SBP (r = 0.31); (p = 0.001), HbA1c (r = 0.21); (p = 0.04), BMI (r = 0.22); (p = 0.01). AEAbs IgA correlated with log TG/HDL (r = 0.28); (p = 0.001), LDL/HDL (r = 0.22); (p = 0.01) TC/HDL (r = 0.22); (p = 0.01) and with TG/HDL (r = 0.15); (p = 0.05).
Conclusion: Our study proved a relationship between elevation of AEAb IgA, high lipid indices and the development of microvascular complications in patients with type 2 diabetes mellitus and arterial hypertension.
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Buda VA, Ciobanu DM, Roman G. Pulse pressure is more relevant than systolic and diastolic blood pressure in patients with type 2 diabetes and cardiovascular disease. Med Pharm Rep 2018; 91:408-413. [PMID: 30564016 PMCID: PMC6296723 DOI: 10.15386/cjmed-972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/12/2018] [Accepted: 06/25/2018] [Indexed: 12/21/2022] Open
Abstract
Background and aims The parameters evaluated during 24-hour ambulatory blood pressure monitoring were reported to be predictors of cardiovascular events. We aimed to investigate mean blood pressure, blood pressure variability and pulse pressure during 24-hour ambulatory blood pressure monitoring in type 2 diabetes patients and to establish their relationship with the presence of atherosclerotic cardiovascular disease (CVD). Methods The observational study included type 2 diabetes patients randomly selected and distributed in 2 study groups depending on the presence of atherosclerotic cardiovascular disease: CVD(−), n=90, and CVD(+), n=87. Daytime, nighttime and 24-hour systolic and diastolic blood pressure were monitored and mean blood pressure, blood pressure variability and pulse pressure were calculated. Results The study groups were comparable as age, gender ratio, smoking status, body mass index and abdominal circumference. Diabetes and hypertension duration were significantly higher in the CVD(+) group. Mean systolic and diastolic blood pressure, blood variability, dipper prevalence did not differ between study groups. Pulse pressure was significantly higher in the CVD(+) group compared to CVD(−) group (daytime pulse pressure 56.2±13.1 vs. 50.6±11.3 mmHg, p=0.003; nighttime pulse pressure 56.5±14.2 vs. 50.7±12.4 mmHg, p=0.005; 24-hour pulse pressure 54.7±13.6 vs. 49.0±12.0 mmHg, p=0.003). Conclusions Ambulatory pulse pressure was significantly higher in patients with type 2 diabetes and atherosclerotic cardiovascular disease compared to those without cardiovascular disease, although mean systolic and diastolic blood pressure and blood pressure variability were similar.
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Affiliation(s)
- Vlad Alexandru Buda
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Mihaela Ciobanu
- Department of Diabetes and Nutrition, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriela Roman
- Department of Diabetes and Nutrition, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Rivera-Mancía S, Colín-Ramírez E, Cartas-Rosado R, Infante O, Vargas-Barrón J, Vallejo M. Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study. Medicine (Baltimore) 2018; 97:e11869. [PMID: 30142781 PMCID: PMC6113050 DOI: 10.1097/md.0000000000011869] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Recently, prehypertension has been considered as a risk factor for cardiovascular disease because it can progress to hypertension. The association between obesity and dyslipidemia with raised blood pressure has been reported in some studies; however, the ability of indicators of such conditions to predict prehypertension has been scarcely explored. In this cross-sectional study, we compared the ability of indicators of accumulated and circulating fat to discriminate between prehypertensive and normotensive Mexico City residents (n = 1377). The indicators were classified based on the parameters needed for their calculation: including only circulating fat (IOCFi) (e.g., Castelli risk indexes), including only accumulated fat (IOAFi) (e.g., waist circumference [WC]), and mixed (e.g., lipid accumulation product [LAP]). We compared the areas under the receiving operating characteristic curves (AURCs) and estimated the cutoff points for each indicator and their associated risk of prehypertension. The IOAFi had the greatest AURCs, followed by mixed and IOCFi; the AURCs for WC were the highest (AURC = 0.688 and 0.666 for women and men, respectively). The highest odds ratios for prehypertension were those associated with the cutoff points for IOAFi and LAP (e.g., OR = 2.8 for women with WC > 83.5 cm and OR = 2.6 for men with WC > 87.5 cm). Early detecting people at risk of cardiovascular disease is a necessity and given that WC had a better performance than the other indexes and it is relatively easy to measure, it has the potential of being used as a complementary measure in routine clinical examinations and by the general population as an auto-screening measurement to detect prehypertension.
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Affiliation(s)
| | | | | | | | | | - Maite Vallejo
- Department of Social Medicine Research, National Institute of Cardiology “Ignacio Chávez,” Mexico City, Mexico
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Song J, Zhao Y, Nie S, Chen X, Wu X, Mi J. The effect of lipid accumulation product and its interaction with other factors on hypertension risk in Chinese Han population: A cross-sectional study. PLoS One 2018; 13:e0198105. [PMID: 29874254 PMCID: PMC5991403 DOI: 10.1371/journal.pone.0198105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/14/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Lipid accumulation product (LAP) is a simple and effective indicator that reflects visceral obesity. This study aimed to compare the significance of LAP in predicting hypertension risk with other obesity indices, and to evaluate the interactive effects of LAP and smoking, family history of hypertension on hypertension risk in Chinese Han adults. METHODS A community based cross-sectional study was performed in Bengbu, China. Participants received face-to-face questionnaire survey, anthropometric tests and laboratory examinations. Relevant indicators that reflect obesity including BMI (body mass index), waist-to-height ratio (WHtR) and LAP were calculated. Multivariate logistic regression analysis was applied to explore the association between LAP and hypertension risk. The area under the receiver-operating characteristics curves (AUC) of LAP, BMI, and WHtR were calculated and then compared. Interactive effect was evaluated by relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS A total of 1777 participants were enrolled, and the prevalence of hypertension was 24.4% (n = 433). There was a significant increase in hypertension risk with LAP levels in the fourth quartile as compared with the bottom quartile (OR: 3.31, 95%CI: 1.76-6.25). The AUC of LAP was significantly different than that of BMI in males (Z = 2.158, p = 0.0309) and females (Z = 3.570, p = 0.0004), while only performed better in females as compared with that of WHtR (Z = 2.166, p = 0.0303). LAP was significantly interacted with family history of hypertension on hypertension risk both in males (RERI: 1.07, 95%CI: 0.09-2.05; AP: 0.33, 95%CI: 0.23-0.44; SI: 1.92, 95%CI: 1.53-2.41) and females (RERI: 0.80, 95%CI: 0.07-1.53; AP: 0.25, 95%CI: 0.11-0.39; SI: 1.59, 95%CI: 1.16-2.19). However, a significant interaction between LAP and smoking was only observed in males (RERI: 1.32, 95%CI: 0.15-2.75; AP: 0.40, 95% CI: 0.14-0.73). CONCLUSION Increased LAP was significantly associated with a higher risk of hypertension in Chinese Han adults. Moreover, the effect of LAP on predicting hypertension risk was better than that of other obesity indices. Our results also demonstrated interactive effects of LAP with smoking, family history of hypertension on hypertension risk.
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Affiliation(s)
- Jian Song
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | | | - Sumei Nie
- Bengbu health board, Bengbu, Anhui Province, China
| | - Xue Chen
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | - Xuesen Wu
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | - Jing Mi
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
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Ye J, Li Z, Lv Y, An L, Yu J, Guo X, Yao Y, Yu Y, Jin L. Associations of Blood Pressure with the Factors among Adults in Jilin Province: A Cross-Sectional Study Using Quantile Regression Analysis. Sci Rep 2017; 7:13613. [PMID: 29051578 PMCID: PMC5648827 DOI: 10.1038/s41598-017-14045-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/05/2017] [Indexed: 01/17/2023] Open
Abstract
Hypertension has become a major public health challenge. However, numerous research results reported in the literature focus primarily on risk factors of hypertension, little is known about how the whole continuum of blood pressure (BP) is associated with risk factors of hypertension. This study aims to reveal quantile-specific associations of BP with its risk factors. A cross-sectional survey based on a sample of 23,050 adults aged 18 to 79 years was conducted in Jilin Province in 2012, and some subjects were excluded due to missing values in BP or having BP control according to the purpose of this study. Quantile regression (QR) was employed to investigate the associations between systolic/diastolic blood pressure (SBP/DBP) and the risk factors. The SBP and DBP in males presented statistically higher than females (P < 0.001). High-salt diet for males manifested a slightly increasing positive association with higher SBP only for high quantiles (≥70), but with a higher DBP for middle part of the quantiles (30~75), compared with bland diet. High-salt diet, drinking and high-density lipoprotein cholesterol (HDL-C) were positively associated with BP measures in males. And the coefficient of total cholesterol (TC) in QR increased with BP in females who used to live in town.
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Affiliation(s)
- Junsen Ye
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Zhongmin Li
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yaogai Lv
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Lan An
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Jianxing Yu
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Xin Guo
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yan Yao
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yaqin Yu
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021.
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14
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Visceral adiposity index, lipid accumulation product and intracranial atherosclerotic stenosis in middle-aged and elderly Chinese. Sci Rep 2017; 7:7951. [PMID: 28801558 PMCID: PMC5554161 DOI: 10.1038/s41598-017-07811-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 06/30/2017] [Indexed: 01/25/2023] Open
Abstract
We investigated the association of the newly established lipid accumulation product (LAP) and visceral adiposity index (VAI) with intracranial atherosclerotic stenosis (ICAS) in middle-aged and elderly Chinese. From June 2012 to January 2013, consecutive patients ≥40 years of age who underwent cerebral vascular imaging for various medical reasons were enrolled in this study. Multivariate logistic regression models were used to evaluate the correlation of VAI and LAP with the risk of ICAS. In total, 845 patients were included in the study. The prevalence of ICAS gradually increased in females and in all patients with advancing tertiles of VAI or LAP. After adjusting for potential risks, both the VAI and LAP were related to ICAS in females [VAI: odds ratio (OR) = 3.25, 95% confidence interval (95%CI) = 1.17–9.03, P = 0.024; LAP: OR = 4.11, 95%CI = 1.39–12.12, P = 0.011; tertiles 3 vs. 1]. The sensitivity, specificity, and positive predictive value (PPV) were 74.7%, 45.5%, and 84.4% for VAI (cut-off: 1.71) and 79.3%, 40.5%, and 84.1% for LAP (cut-off: 23.99). The same relationships in males were not significant. Both VAI and LAP were closely associated with an increased risk of ICAS in middle-aged and elderly Chinese females.
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