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Gallagher C, Lambert K, Pirkis J, Abramson MJ, Barton C, Lodge CJ, Perret JL, Idrose NS, Bennett CM, Waidyatillake NT, Sundararajan V, Walters EH, Dharmage SC, Erbas B. BMI trajectories from infancy to 18 years and mental health in emerging adulthood. J Affect Disord 2024:S0165-0327(24)01589-1. [PMID: 39293605 DOI: 10.1016/j.jad.2024.09.101] [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] [Received: 03/26/2024] [Revised: 09/11/2024] [Accepted: 09/14/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Studies exploring early life-course BMI trajectories and subsequent mental health outcomes are limited but may provide important insights for early intervention. We investigated associations between BMI trajectories from 0 to 18 years and mental health outcomes in emerging adulthood. METHODS Data were obtained from 434 participants in the Melbourne Atopy Cohort Study (MACS). Anthropometric data were collected across 26 timepoints from infancy to age 25 and group-based trajectory modelling used to develop BMI trajectories from 0.1 to 18 years. Moderate-to-severe psychological distress (MSPD) and likely depression were assessed at age 18 and 25 years. Associations between BMI trajectories and mental health at 25 years and change in mental health between 18 and 25 years were estimated using logistic regression. History of asthma, hay fever or eczema were independently examined as potential effect modifiers. RESULTS Five BMI trajectories were identified from 1 month to 18 years. When compared to the stable average BMI trajectory, we found increased risk of MSPD (OR = 2.97; 95%CI: 1.09,8.06) and likely depression (3.56; 1.39,9.12) at age 25 in the average increasing to high trajectory. This group also had a greater likelihood of new-onset depression (4.82; 1.54,15.0) from 18 to 25 years of age. LIMITATIONS MACS participants are not representative of the general population and mental health data was not available before 18 years of age. CONCLUSION Excessive weight gain across the childhood transition was associated with poorer mental health in emerging adulthood, highlighting the importance of monitoring growth to allow for early identification and stratification of individuals are risk of poor mental health.
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Affiliation(s)
- Claire Gallagher
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Katrina Lambert
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Chris Barton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - N Sabrina Idrose
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine M Bennett
- Institute for Health Transformation, Deakin University, Waurn Ponds, Australia
| | - Nilakshi T Waidyatillake
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Vijaya Sundararajan
- Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - E Haydn Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; School of Medicine, University of Tasmania, Hobart, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Violet Vines Marshman, Centre for Rural Health Research, La Trobe University, Bendigo 3550, Victoria, Australia
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Firouzi F, Ramezani Tehrani F, Kaveh A, Mousavi M, Azizi F, Behboudi-Gandevani S. Adiposity trajectories and cardiovascular disease risk in women: a population-based cohort study with a focus on menopausal status. Front Endocrinol (Lausanne) 2024; 15:1389330. [PMID: 38854691 PMCID: PMC11157004 DOI: 10.3389/fendo.2024.1389330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/25/2024] [Indexed: 06/11/2024] Open
Abstract
Objectives A single measurement of adiposity indices could predict the incidence of cardiovascular disease (CVD); nonetheless their long-term pattern and its association with incident CVD are rarely studied. This study aimed to determine distinct trajectories of adiposity indices among participants of Tehran Lipid and Glucose Study (TLGS) and their association with incident CVD. Furthermore, this study aimed to investigate whether this association differed among individuals according to their menopausal status. Method A total of 6840 women participated in TLGS, aged 20 years and older were included in this study; they were followed for a median of 16 years. Body mass index (BMI), waist circumference (WC), conicity index (CI) and body roundness index (BRI) were included in the analysis as adiposity indices. The cohort outcome panel of medical specialists identified the CVD outcomes. Trajectory analyses were used to identify homogeneous distinct clusters of adiposity indices trajectories. The association between the trajectory group membership and incident CVD were explored by Cox proportional hazard models, with unadjusted and adjusted model for baseline age, physical activity, smoking status, menopause and family history of CVD. Results Three BMI trajectory groups of low, medium, and high and two trajectories for WC, BRI and CI were identified. Adjusted cox proportional hazard models revealed significant associations between the hazard of CVD experience and the high trajectory group of the BMI (HR: 2.06, 95% CI: 1.38-3.07), WC (HR: 2.71, 95% CI: 1.98-3.70), CI (HR: 1.87, 95% CI: 1.26-2.77) and BRI (HR: 1.55-95% CI: 1.12-2.15), compared to the low trajectory group. Subgroup analysis based on the menopausal status of participants showed that the HR of CVD incidences for all of trajectories adiposity indices, except BMI, was statistically significant. Adjusted cox proportional hazard models, in those women not reached menopause during study, revealed that the HR (95% CI) of CVD incidences for high trajectory of BMI, WC, CI and BRI were 2.80 (1.86-7.05); 2.09 (1.40-6.16); 1.72 (1.42-5.61), and 3.09 (1.06-9.01), respectively. These values for those were menopause at the initiation of the study were 1.40 (1.11, 2.53); 1.65 (1.04-2.75); 1.69 (1.01-2.87), and 1.61 (0.98-2.65), respectively. Conclusion Our findings suggest that adiposity trajectories, particularly central adiposity index of CI, could precisely predict the CVD risk. Consequently, preventive strategies should be tailored accordingly.
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Affiliation(s)
- Faegheh Firouzi
- Tehran Medical Branch, Islamic Azad University, Tehran, Iran
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Foundation for Research & Education Excellence, Vestaria Hills, AL, United States
| | - Alireza Kaveh
- Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Mousavi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhang J, Zhu S, Liu C, Hu Y, Yang A, Zhang Y, Hong Y. Global, regional and national burden of ischemic stroke attributed to high low-density lipoprotein cholesterol, 1990-2019:A decomposition analysis and age-period-cohort analysis. J Cereb Blood Flow Metab 2024; 44:527-541. [PMID: 37891501 PMCID: PMC10981397 DOI: 10.1177/0271678x231211448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/11/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
High levels of low-density lipoprotein cholesterol (LDL-C) have been associated with an augmented mortality of ischemic stroke. The yearly deaths and mortality data of IS-hLDL-C were derived from the global burden of disease 2019 dataset. The joinpoint, age-period-cohort and decomposition analysis were utilized to evaluate the long-term patterns in the disease burden of IS-hLDL-C, and the effects of population growth and aging. Globally, in 2019, 0.61 million ischemic stroke-related deaths were attributable to high LDL-C, with the highest death burden in the high-middle socio-demographic index (SDI) region. From 1990 to 2019, the age-standardized death rate (ASDR) for IS-hLDL-C exhibited a downward trend, with an average annual percentage change of -1.69 [95% confidence interval: -1.90, -1.48)]. The fastest decreasing trends in ASDR were experienced in the high SDI region. In 119 (58.33%) countries, aging increased the disease burden of hLDL-IS, and population growth increased the disease burden of IS-hLDL-C in 163 (79.90%) countries. The trend in disease burden of IS-hLDL-C exhibited variation across countries and regions, particularly in territories with high to middle high SDI. Aging in upper to middle-income countries and population growth in low to middle-income countries further offset endeavors to reduce the burden of ischemic stroke deaths.
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Affiliation(s)
- Jian Zhang
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China
- Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Chunlong Liu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Yaofeng Hu
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Aoran Yang
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yonghui Zhang
- Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun, China
| | - Yang Hong
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China
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Tikhonoff V, Casiglia E, Virdis A, Grassi G, Angeli F, Arca M, Barbagallo CM, Bombelli M, Cappelli F, Cianci R, Cicero AFG, Cirillo M, Cirillo P, Dell'oro R, D'elia L, Desideri G, Ferri C, Galletti F, Gesualdo L, Giannattasio C, Iaccarino G, Mallamaci F, Maloberti A, Masi S, Masulli M, Mazza A, Mengozzi A, Muiesan ML, Nazzaro P, Palatini P, Parati G, Pontremoli R, Quarti‐Trevano F, Rattazzi M, Reboldi G, Rivasi G, Russo E, Salvetti M, Temporelli PL, Tocci G, Ungar A, Verdecchia P, Viazzi F, Volpe M, Borghi C. Prognostic Value and Relative Cutoffs of Triglycerides Predicting Cardiovascular Outcome in a Large Regional-Based Italian Database. J Am Heart Assoc 2024; 13:e030319. [PMID: 38293920 PMCID: PMC11056112 DOI: 10.1161/jaha.123.030319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Despite longstanding epidemiologic data on the association between increased serum triglycerides and cardiovascular events, the exact level at which risk begins to rise is unclear. The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension has conceived a protocol aimed at searching for the prognostic cutoff value of triglycerides in predicting cardiovascular events in a large regional-based Italian cohort. METHODS AND RESULTS Among 14 189 subjects aged 18 to 95 years followed-up for 11.2 (5.3-13.2) years, the prognostic cutoff value of triglycerides, able to discriminate combined cardiovascular events, was identified by means of receiver operating characteristic curve. The conventional (150 mg/dL) and the prognostic cutoff values of triglycerides were used as independent predictors in separate multivariable Cox regression models adjusted for age, sex, body mass index, total and high-density lipoprotein cholesterol, serum uric acid, arterial hypertension, diabetes, chronic renal disease, smoking habit, and use of antihypertensive and lipid-lowering drugs. During 139 375 person-years of follow-up, 1601 participants experienced cardiovascular events. Receiver operating characteristic curve showed that 89 mg/dL (95% CI, 75.8-103.3, sensitivity 76.6, specificity 34.1, P<0.0001) was the prognostic cutoff value for cardiovascular events. Both cutoff values of triglycerides, the conventional and the newly identified, were accepted as multivariate predictors in separate Cox analyses, the hazard ratios being 1.211 (95% CI, 1.063-1.378, P=0.004) and 1.150 (95% CI, 1.021-1.295, P=0.02), respectively. CONCLUSIONS Lower (89 mg/dL) than conventional (150 mg/dL) prognostic cutoff value of triglycerides for cardiovascular events does exist and is associated with increased cardiovascular risk in an Italian cohort.
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Affiliation(s)
- Valérie Tikhonoff
- Department of MedicineUniversità degli Studi di PadovaVia Giustiniani 8Padua35128Italy
| | - Edoardo Casiglia
- Studium Patavinum, Department of MedicineUniversità degli Studi di PadovaPaduaItaly
| | - Agostino Virdis
- Department of Clinical and Experimental MedicineUniversity of PisaItaly
| | - Guido Grassi
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
| | - Fabio Angeli
- Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | - Marcello Arca
- Department of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Carlo M. Barbagallo
- Biomedical Department of Internal Medicine and SpecialisticsUniversity of PalermoItaly
| | - Michele Bombelli
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
- Internal Medicine, Pio XI Hospital of Desio, ASST BrianzaDesioItaly
| | - Federica Cappelli
- Department of Clinical and Experimental MedicineUniversity of PisaItaly
| | - Rosario Cianci
- Department of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Arrigo F. G. Cicero
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences DepartmentAlma Mater Studiorum University of BolognaBolognaItaly
- IRCCS AOU S.Orsola di BolognaBolognaItaly
| | - Massimo Cirillo
- Department of Medicine “Scuola Medica Salernitana”University of SalernoBaronissi (SA)Italy
| | - Pietro Cirillo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation“Aldo Moro” University of BariBariItaly
| | - Raffaella Dell'oro
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
| | - Lanfranco D'elia
- Department of Clinical Medicine and Surgery“Federico II” University of Naples Medical SchoolNaplesItaly
| | | | - Claudio Ferri
- Department of Life, Health and Environmental SciencesUniversity of L’AquilaItaly
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery“Federico II” University of Naples Medical SchoolNaplesItaly
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation“Aldo Moro” University of BariBariItaly
| | - Cristina Giannattasio
- Cardiology IV, “A.De Gasperi’s” DepartmentNiguarda Ca’ Granda HospitalMilanItaly
- School of Medicine and SurgeryMilano‐Bicocca UniversityMilanItaly
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences“Federico II” University of NaplesNaplesItaly
| | - Francesca Mallamaci
- CNR‐IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal UnitReggio CalabriaItaly
| | - Alessandro Maloberti
- Cardiology IV, “A.De Gasperi’s” DepartmentNiguarda Ca’ Granda HospitalMilanItaly
- School of Medicine and SurgeryMilano‐Bicocca UniversityMilanItaly
| | - Stefano Masi
- Department of Clinical and Experimental MedicineUniversity of PisaItaly
| | - Maria Masulli
- Department of Clinical Medicine and Surgery“Federico II” University of Naples Medical SchoolNaplesItaly
| | - Alberto Mazza
- Department of Internal MedicineSanta Maria della Misericordia General Hospital, AULSS 5 PolesanaRovigoItaly
| | | | | | - Pietro Nazzaro
- Department of Medical Basic Sciences, Neurosciences and Sense OrgansUniversity of Bari Medical SchoolBariItaly
| | - Paolo Palatini
- Studium Patavinum, Department of MedicineUniversità degli Studi di PadovaPaduaItaly
| | - Gianfranco Parati
- S. Luca HospitalIstituto Auxologico Italiano and University of Milan‐BicoccaMilanItaly
| | - Roberto Pontremoli
- Department of Internal MedicineUniversity of Genoa, and Policlinico San MartinoGenoaItaly
| | | | - Marcello Rattazzi
- Department of MedicineUniversità degli Studi di PadovaVia Giustiniani 8Padua35128Italy
- Medicina Interna ICa’ Foncello University HospitalTrevisoItaly
| | - Gianpaolo Reboldi
- Department of Medical and Surgical ScienceUniversity of PerugiaItaly
| | - Giulia Rivasi
- Department of Geriatric and Intensive Care MedicineCareggi Hospital and University of FlorenceItaly
| | - Elisa Russo
- Department of Internal MedicineUniversity of Genoa, and Policlinico San MartinoGenoaItaly
| | - Massimo Salvetti
- Department of Clinical and Experimental SciencesUniversity of BresciaItaly
| | - Pier Luigi Temporelli
- Division of Cardiac RehabilitationIstituti Clinici Scientifici Maugeri, IRCCS, Gattico‐VerunoItaly
| | - Giuliano Tocci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and PsychologyUniversity of Rome Sapienza, Sant’Andrea HospitalRomeItaly
| | - Andrea Ungar
- Department of Geriatric and Intensive Care MedicineCareggi Hospital and University of FlorenceItaly
| | | | - Francesca Viazzi
- Department of Internal MedicineUniversity of Genoa, and Policlinico San MartinoGenoaItaly
| | - Massimo Volpe
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and PsychologyUniversity of Rome Sapienza, Sant’Andrea HospitalRomeItaly
- IRCCS San Raffaele RomeRomeItaly
| | - Claudio Borghi
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences DepartmentAlma Mater Studiorum University of BolognaBolognaItaly
- IRCCS AOU S.Orsola di BolognaBolognaItaly
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Disparities in Sexually Transmitted Infection/HIV Testing, Contraception, and Emergency Contraception Care Among Adolescent Sexual Minority Women Who Are Racial/Ethnic Minorities. J Adolesc Health 2023; 72:214-221. [PMID: 36369111 DOI: 10.1016/j.jadohealth.2022.08.030] [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] [Received: 03/12/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Sexual minority women and racial/ethnic minority women in the United States are at increased risk for sexually transmitted infections (STIs) and unintended pregnancy. Yet, we know little about STI/HIV testing and contraceptive care among women who have sex with women only and women who have sex with both women and men, and who are racial/ethnic minorities. This study examined receipt of STI/HIV testing and contraceptive care among sexually active adolescent women by sex of sexual contact(s) and race/ethnicity. METHODS Our sample included 2,149 sexually active adolescent women from the National Survey of Family Growth (2011-2019). We examined receipt of sexual and reproductive health (SRH) services by sex of sexual contact(s) and race/ethnicity: STI and HIV testing, contraceptive counseling, contraceptive method, emergency contraception (EC) counseling, and EC method. RESULTS Service receipt was low for all adolescent women, with disparities by sex of sexual contact(s) and by race/ethnicity. Women who have sex with women only had the lowest rates across all services; women who have sex with both women and men had higher rates of STI and HIV testing and EC counseling than women who have sex with men only. Non-Hispanic Black women had higher rates of STI and HIV testing than non-Hispanic White peers, and non-Hispanic Black and Hispanic women had lower rates of contraception method receipt than their non-Hispanic White peers. Racial/ethnic disparities persisted when results were stratified by sex of sexual contact(s). DISCUSSION There is an unmet need for improved SRH service delivery for all adolescent women and for services that are not biased by sex of sexual contact(s) and race/ethnicity.
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Cabriales JA, Hernandez N, Taylor T, Cooper TV. A three wave assessment of a tobacco free campus policy within a minority serving institution. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 36260809 DOI: 10.1080/07448481.2022.2129978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/01/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study assessed changes (in relation to smoking status) in tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge by applying a three Wave repeated cross-sectional assessment. PARTICIPANTS Participants were students at Wave 1 (n = 2,169), Wave 2 (n = 2,576), and Wave 3 (n = 2,169) and faculty at Wave 1 (n = 256), Wave 2 (n = 204), and Wave 3 (n = 180). METHODS Measures regarding sociodemographics, tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge were completed. RESULTS Compared with Wave 1, more students reported having quit smoking within the last six months at Waves 2 and 3. The negative attitudes toward TFC policies of those who reported quitting in the last six months aligned with those of nonsmokers. CONCLUSIONS Study findings suggest smoking status as a relevant covariate to focus on to further strengthen and refine existing TFC policies.
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Affiliation(s)
- José Alonso Cabriales
- Fine Arts, Humanities & Social Sciences, The University of New Mexico-Gallup, Gallup, New Mexico
| | - Nora Hernandez
- Office of Research and Sponsored Projects, The University of Texas at El Paso, El Paso, Texas, USA
| | - Thom Taylor
- Department of Psychology, The University of Texas at El Paso, El Paso, Texas, USA
| | - Theodore V Cooper
- Department of Psychology, The University of Texas at El Paso, El Paso, Texas, USA
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Bucholz EM, Butala NM, Allen NB, Moran AE, de Ferranti SD. Age, Sex, Race/Ethnicity, and Income Patterns in Ideal Cardiovascular Health Among Adolescents and Adults in the U.S. Am J Prev Med 2022; 62:586-595. [PMID: 35012831 PMCID: PMC9279114 DOI: 10.1016/j.amepre.2021.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Ideal cardiovascular health is present in <50% of children and <1% of adults, yet its prevalence from adolescence through adulthood has not been fully evaluated. This study characterizes the association of age with ideal cardiovascular health and compares these associations across sex, race/ethnicity, and SES subgroups. METHODS This study, conducted in 2020, analyzed adolescents and adults aged 12-79 years from the cross-sectional National Health and Nutrition Examination Survey 2005-2016 (N=38,706). Polynomial models were used to model the association of age with ideal cardiovascular health, defined using the American Heart Association's Life's Simple 7 criteria (scales 0-14, with higher values indicating better cardiovascular health). RESULTS Mean cardiovascular health was lower with increasing age, starting in early adolescence and dropping to a nadir by age 60 years before stabilizing. At age 20 years, only 45% of adults had ideal cardiovascular health (≥5 ideal cardiovascular health metrics), and >50% of adults had poor cardiovascular health (≤2 ideal cardiovascular health metrics) at age 53 years. Women had higher mean cardiovascular health than men in early life but lower mean cardiovascular health from age 60 years onward. Mean cardiovascular health scores were highest for non-Hispanic White and higher-income adults and lowest for non-Hispanic Black and low-income adults across all ages. Mean cardiovascular health scores fell from intermediate to poor levels approximately 30 years earlier for non-Hispanic Black than for non-Hispanic White adults and approximately 35 years earlier for low-income adults than in higher-income adults. CONCLUSIONS Cardiovascular health scores are lower with increasing age from early adolescence through adulthood. Race/ethnicity and income disparities in cardiovascular health are observed at young ages and are more profound at older ages.
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Affiliation(s)
- Emily M Bucholz
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Neel M Butala
- Harvard Medical School, Boston, Massachusetts; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Andrew E Moran
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Sarah D de Ferranti
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Peter RS, Föger B, Concin H, Nagel G. Effect of Secular Trend, Age, and Length of Follow-up on Optimum Body Mass Index From 1985 Through 2015 in a Large Austrian Cohort. J Epidemiol 2021; 31:601-607. [PMID: 33012774 PMCID: PMC8593575 DOI: 10.2188/jea.je20200012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Obesity and its health consequences will dominate health care systems in many countries during the next decades. However, the body mass index (BMI) optimum in relation to all-cause mortality is still a matter of debate. Material and Methods Data of the Vorarlberg Health Monitoring & Prevention Program (VHM&PP, 1985–2005) and data provided by the Main Association of Austrian Social Security Institutions (MAASSI, 2005–2015) were analyzed. Information was available on age, sex, smoking status, measured height and weight, and mortality. Generalized additive models were used to model mortality as a function of BMI, calendar time, age, and follow-up. Results In MAASSI (N = 282,216, 46.0% men), men and women were on average 2.7 years older than in VHM&PP (N = 185,361, 46.1% men). Average BMI was slightly higher in men (26.1 vs 25.7 kg/m2) but not in women (24.6 vs 24.7 kg/m2). We found an interactive effect of age and follow-up on the BMI optimum. Over age 35 years in men and 55 years in women, the BMI optimum decreased with length of follow-up. While keeping covariates fixed, BMI optimum increased slightly between 1985 and 2015 in men and women, 24.9 (95% CI, 23.9–25.9) to 26.4 (95% CI, 25.3–27.3), and 22.4 (95% CI, 21.7–23.1) to 23.3 (95% CI, 22.6–24.5) kg/m2, respectively. Conclusion Age and length of follow-up have a pronounced effect on the BMI associated with the lowest all-cause mortality. After controlling for age and length of follow-up, the BMI optimum increased slightly over 30 years in this large study sample.
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Affiliation(s)
| | | | - Hans Concin
- Agency for Preventive and Social Medicine (aks)
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University.,Agency for Preventive and Social Medicine (aks)
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Abstract
Dyslipidaemias are alterations to the plasma lipid profile that are often associated with clinical conditions. Dyslipidaemias, particularly elevated plasma LDL-cholesterol levels, are major risk factors for cardiovascular disease, but some forms, such as hypertriglyceridaemia, are associated with severe diseases in other organ systems, including non-alcoholic fatty liver disease and acute pancreatitis. Dyslipidaemias can be genetically determined (primary or familial dyslipidaemias) or secondary to other conditions (such as diabetes mellitus, obesity or an unhealthy lifestyle), the latter being more common. Hypercholesterolaemia is the most common form of dyslipidaemia and is associated with an increased risk of cardiovascular disease, with elevated plasma LDL-cholesterol levels being the 15th leading risk factor for death in 1990, rising to 11th in 2007 and 8th in 2019. The global burden of dyslipidaemias has increased over the past 30 years. Furthermore, the combination of high triglyceride levels and low HDL-cholesterol levels (together with the presence of small, dense LDL particles), referred to as atherogenic dyslipidaemia, is highly prevalent in patients with diabetes or metabolic syndrome and increases their risk of cardiovascular disease. Given the increasing prevalence of diabetes worldwide, treating lipid abnormalities in these patients might reduce their risk of cardiovascular disease.
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10
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van Zutphen EM, Rijnhart JJM, Rhebergen D, Muller M, Huisman M, Beekman A, Kok A, Appelman Y. Do Cardiovascular Risk Factors and Cardiovascular Disease Explain Sex Differences in Cognitive Functioning in Old Age? J Alzheimers Dis 2021; 80:1643-1655. [PMID: 33720886 PMCID: PMC8150475 DOI: 10.3233/jad-201173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Sex differences in cognitive functioning in old age are known to exist yet are still poorly understood. Objective: This study examines to what extent differences in cardiovascular risk factors and cardiovascular disease between men and women explain sex differences in cognitive functioning. Methods: Data from 2,724 older adults from the Longitudinal Aging Study Amsterdam were used. Information processing speed and episodic memory, measured three times during six years of follow-up, served as outcomes. The mediating role of cardiovascular risk factors and cardiovascular disease was examined in single and multiple mediator models. Determinant-mediator effects were estimated using linear or logistic regression, and determinant-outcome and mediator-outcome effects were estimated using linear mixed models. Indirect effects were estimated using the product-of-coefficients estimator. Results: Women scored 1.58 points higher on information processing speed and 1.53 points higher on episodic memory. Several cardiovascular risk factors had small mediating effects. The sex difference in information processing speed was mediated by smoking, depressive symptoms, obesity, and systolic blood pressure. The sex difference in episodic memory was mediated by smoking, physical activity, and depressive symptoms. Effects of smoking, LDL cholesterol, and diabetes mellitus on information processing speed differed between men and women. Conclusion: Differences in cardiovascular risk factors between women and men partially explained why women had better cognitive functioning. A healthy cardiovascular lifestyle seems beneficial for cognition and sex-specific strategies may be important to preserve cognitive functioning at older age.
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Affiliation(s)
- Elisabeth Maria van Zutphen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Judith Johanna Maria Rijnhart
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Didericke Rhebergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Mental Health Care Institute GGZ Centraal, Amersfoort, The Netherlands
| | - Majon Muller
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands
| | - Martijn Huisman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Aartjan Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Almar Kok
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Yolande Appelman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, The Netherlands
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11
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Hansen CS, Jørgensen ME, Malik M, Witte DR, Brunner EJ, Tabák AG, Kivimäki M, Vistisen D. Heart Rate and Heart Rate Variability Changes Are Not Related to Future Cardiovascular Disease and Death in People With and Without Dysglycemia: A Downfall of Risk Markers? The Whitehall II Cohort Study. Diabetes Care 2021; 44:1012-1019. [PMID: 33526428 PMCID: PMC7985416 DOI: 10.2337/dc20-2490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/27/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Higher resting heart rate (rHR) and lower heart rate variability (HRV) are associated with increased risk of cardiovascular disease (CVD) and all-cause mortality in people with and without diabetes. It is unknown whether temporal changes in rHR and HRV may contribute to this risk. We investigated associations between 5-year changes in rHR and HRV and risk of future CVD and death, taking into account participants' baseline glycemic state. RESEARCH DESIGN AND METHODS In this prospective, population-based cohort study we investigated 4,611 CVD-free civil servants (mean [SD] age, 60 [5.9] years; 70% men). We measured rHR and/or six indices of HRV. Associations of 5-year change in 5-min rHR and HRV with fatal and nonfatal CVD and all-cause mortality or the composite of the two were assessed, with adjustments made for relevant confounders. Effect modification by glycemic state was tested. RESULTS At baseline, 63% of participants were normoglycemic, 29% had prediabetes, and 8% had diabetes. During a median (interquartile range) follow-up of 11.9 (11.4; 12.3) years, 298 participants (6.5%) experienced a CVD event and 279 (6.1%) died of non-CVD-related causes. We found no association between 5-year changes in rHR and HRV and future events. Only baseline rHR was associated with all-cause mortality. A 10 bpm-higher baseline HR level was associated with an 11.4% higher rate of all-cause mortality (95% CI 1.0-22.9%; P = 0.032). Glycemic state did not modify associations. CONCLUSIONS Changes in rHR and HRV and possibly also baseline values of these measures are not associated with future CVD or death in people with or without dysglycemia.
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Affiliation(s)
- Christian S Hansen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark .,National Institute of Public Health, Southern Denmark University, Odense, Denmark
| | | | - Marek Malik
- National Heart and Lung Institute, Imperial College, London, U.K.,Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Daniel R Witte
- National Institute of Public Health, Southern Denmark University, Odense, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark.,Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, U.K
| | - Adam G Tabák
- Department of Epidemiology and Public Health, University College London, London, U.K.,Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Budapest, Hungary.,Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, U.K
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12
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Khajavi A, Zayeri F, Ramezankhani A, Nazari A, Azizi F, Hadaegh F. Age and aging effects on blood pressure: 15 years follow-up of Tehran lipid and glucose study. J Clin Hypertens (Greenwich) 2021; 23:1205-1211. [PMID: 33720477 PMCID: PMC8678670 DOI: 10.1111/jch.14238] [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: 01/06/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
Age is a known predictor of blood pressure (BP); however, the literature mostly includes cross‐sectional investigations. This prospective cohort study aimed to decompose the cross‐sectional and longitudinal age effects on BP. The secondary data were obtained from the Tehran lipid and glucose study, which comprised six repeated measurements of participants, with median follow‐up of 15.8 (interquartile range of 14.2‐16.9) years. The sample is representative of the metropolitan area of Tehran, Iran, containing 7,460 participants aged 20‐70. The cross‐sectional and longitudinal effects of age (age at baseline and aging, respectively) were fitted in the mixed effects models, taking systolic, diastolic, and pulse BPs as response, adjusting for adiposity, smoking, diabetes, and antihypertensive medication, and stratifying for sex and 10‐year age‐groups. The mean age at baseline was 41.3 (SD = 12.9) years, and 41.7% of the participants were male. Age at baseline and aging were directly associated with BP, aging owned the weaker effect, and the largest distinction were for systolic blood pressure of men aged 40‐49 years (0.75 vs 0.10, p‐value < .001). Moreover, the aging effects on systolic and diastolic BPs were higher in men than women, in the age groups 40‐49 and 30‐39 years (0.35 vs 0.10 and 0.30 vs 0.07, p‐values < .001), respectively. Adjusting for adiposity remarkably declined the impact of aging on BP, among the < 50 years old.
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Affiliation(s)
- Alireza Khajavi
- Student Research Committee, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Department of Biostatistics, Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Nazari
- Barcelona School of Management, Pompeu Fabra University, Barcelona, Spain
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Brunner EJ, Maruyama K, Shipley M, Cable N, Iso H, Hiyoshi A, Stallone D, Kumari M, Tabak A, Singh-Manoux A, Wilson J, Langenberg C, Wareham N, Boniface D, Hingorani A, Kivimäki M, Llewellyn C. Appetite disinhibition rather than hunger explains genetic effects on adult BMI trajectory. Int J Obes (Lond) 2021; 45:758-765. [PMID: 33446837 PMCID: PMC8005371 DOI: 10.1038/s41366-020-00735-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/19/2020] [Accepted: 12/16/2020] [Indexed: 11/17/2022]
Abstract
Background/objectives The mediating role of eating behaviors in genetic susceptibility to weight gain during mid-adult life is not fully understood. This longitudinal study aims to help us understand contributions of genetic susceptibility and appetite to weight gain. Subjects/methods We followed the body-mass index (BMI) trajectories of 2464 adults from 45 to 65 years of age by measuring weight and height on four occasions at 5-year intervals. Genetic risk of obesity (gene risk score: GRS) was ascertained, comprising 92 BMI-associated single-nucleotide polymorphisms and split at a median (=high and low risk). At the baseline, the Eating Inventory was used to assess appetite-related traits of ‘disinhibition’, indicative of opportunistic eating or overeating and ‘hunger’ which is susceptibility to/ability to cope with the sensation of hunger. Roles of the GRS and two appetite-related scores for BMI trajectories were examined using a mixed model adjusted for the cohort effect and sex. Results Disinhibition was associated with higher BMI (β = 2.96; 95% CI: 2.66–3.25 kg/m2), and accounted for 34% of the genetically-linked BMI difference at age 45. Hunger was also associated with higher BMI (β = 1.20; 0.82–1.59 kg/m2) during mid-life and slightly steeper weight gain, but did not attenuate the effect of disinhibition. Conclusions Appetite disinhibition is most likely to be a defining characteristic of genetic susceptibility to obesity. High levels of appetite disinhibition, rather than hunger, may underlie genetic vulnerability to obesogenic environments in two-thirds of the population of European ancestry.
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Affiliation(s)
- Eric J Brunner
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Koutatsu Maruyama
- Institute of Epidemiology and Health Care, University College London, London, UK. .,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan. .,Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan.
| | - Martin Shipley
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Noriko Cable
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Meena Kumari
- Institute of Epidemiology and Health Care, University College London, London, UK.,Institute for Social and Economic Research, University of Essex, Colchester, UK
| | - Adam Tabak
- Institute of Epidemiology and Health Care, University College London, London, UK.,Department of Internal Medicine and Ocology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.,Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Archana Singh-Manoux
- Institute of Epidemiology and Health Care, University College London, London, UK.,Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, Paris, France
| | - John Wilson
- North Devon Medical Education Centre, North Devon District Hospital, Barnstaple, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Nick Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - David Boniface
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Aroon Hingorani
- Institute of Cardiovascular Science, University College London, London, UK
| | - Mika Kivimäki
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Clare Llewellyn
- Institute of Epidemiology and Health Care, University College London, London, UK
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14
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Markovitz AR, Haug EB, Horn J, Fraser A, Tilling K, Rimm EB, Missmer SA, Williams PL, Romundstad PR, Åsvold BO, Rich-Edwards JW. Normotensive preterm delivery and maternal cardiovascular risk factor trajectories across the life course: The HUNT Study, Norway. Acta Obstet Gynecol Scand 2020; 100:425-435. [PMID: 33022746 DOI: 10.1111/aogs.14016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/23/2020] [Accepted: 09/29/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Preterm delivery (<37 weeks) predicts later cardiovascular disease risk in mothers, even among normotensive deliveries. However, development of subclinical cardiovascular risk before and after preterm delivery is not well understood. We sought to investigate differences in life course cardiovascular risk factor trajectories based on preterm delivery history. MATERIAL AND METHODS The HUNT Study (1984-2008) linked with the Medical Birth Registry of Norway (1967-2012) yielded clinical measurements and pregnancy outcomes for 19 806 parous women with normotensive first deliveries. Women had up to three measurements of body mass index, waist-to-hip ratio, blood pressure, lipids, non-fasting glucose, and C-reactive protein during follow up between 21 years before to 41 years after first delivery. Using mixed effects models, we compared risk factor trajectories for women with preterm vs term/postterm first deliveries. RESULTS Trajectories overlapped for women with preterm compared with term/postterm first deliveries for all cardiovascular risk factors examined. For instance, the mean difference in systolic blood pressure in women with preterm first deliveries compared with those with term deliveries was 0.2 mm Hg (95% CI -1.8 to 2.3) at age 20 and 1.5 mm Hg (95% CI -0.5 to 3.6) at age 60. CONCLUSIONS A history of preterm delivery was not associated with different life course trajectories of common cardiovascular risk factors in our study population. This suggests that the robust association between preterm delivery and cardiovascular end points in Norway or similar contexts is not explained by one or more commonly measured cardiovascular risk factors. Overall, we did not find evidence for a single cardiovascular disease prevention strategy that would reduce risk among the majority of women who had preterm delivery.
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Affiliation(s)
- Amanda Rose Markovitz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Mathematica, Cambridge, MA, USA
| | - Eirin Beate Haug
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Population Health Sciences, Bristol Medical School and MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Julie Horn
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical School and MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences, Bristol Medical School and MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Stacey A Missmer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Pål Richard Romundstad
- Population Health Sciences, Bristol Medical School and MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Bjørn Olav Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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15
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The age-related blood pressure trajectories from young-old adults to centenarians: A cohort study. Int J Cardiol 2019; 296:141-148. [DOI: 10.1016/j.ijcard.2019.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 07/03/2019] [Accepted: 08/05/2019] [Indexed: 02/04/2023]
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16
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Prevalencia de obesidad y comorbilidad cardiovascular asociada en los pacientes incluidos en el estudio IBERICAN (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal). Semergen 2019; 45:311-322. [DOI: 10.1016/j.semerg.2018.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/05/2018] [Accepted: 11/09/2018] [Indexed: 01/24/2023]
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17
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Haug EB, Horn J, Markovitz AR, Fraser A, Vatten LJ, Macdonald‐Wallis C, Tilling K, Romundstad PR, Rich‐Edwards JW, Åsvold BO. Life Course Trajectories of Cardiovascular Risk Factors in Women With and Without Hypertensive Disorders in First Pregnancy: The HUNT Study in Norway. J Am Heart Assoc 2018; 7:e009250. [PMID: 30371249 PMCID: PMC6201453 DOI: 10.1161/jaha.118.009250] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/22/2018] [Indexed: 02/03/2023]
Abstract
Background Women with hypertensive pregnancy disorders have adverse levels of cardiovascular risk factors. It is unclear how this adverse risk factor profile evolves during adult life. We compared life course trajectories of cardiovascular risk factors in women with preeclampsia or gestational hypertension in their first pregnancy to normotensive women. Methods and Results We linked information on cardiovascular risk factors from the population-based HUNT (Nord-Trøndelag Health Study) surveys with pregnancy information from the Medical Birth Registry of Norway. Trajectories of cardiovascular risk factors were constructed for 22 308 women with a normotensive first pregnancy; 1092 with preeclampsia, and 478 with gestational hypertension in first pregnancy. Already before first pregnancy, women with preeclampsia in their first pregnancy had higher measures of adiposity, blood pressure, heart rate, and serum lipids and glucose compared with women with a normotensive first pregnancy. After first pregnancy, there was a parallel development in cardiovascular risk factor levels, but women with a normotensive first pregnancy had a time lag of >10 years compared with the preeclampsia group. There were no clear differences in risk factor trajectories between women with gestational hypertension and women with preeclampsia. Conclusions Women with hypertensive pregnancy disorders in their first pregnancy had an adverse cardiovascular risk factor profile before pregnancy compared with normotensive women, and the differences persisted beyond 50 years of age. Hypertensive disorders in pregnancy signal long-term increases in modifiable cardiovascular risk factors, and may be used to identify women who would benefit from early prevention strategies.
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Affiliation(s)
- Eirin B. Haug
- Department of Public Health and NursingNTNUNorwegian University of Science and TechnologyTrondheimNorway
| | - Julie Horn
- Department of Public Health and NursingNTNUNorwegian University of Science and TechnologyTrondheimNorway
- Department of Obstetrics and GynecologyLevanger HospitalNord‐Trøndelag Hospital TrustLevangerNorway
| | - Amanda R. Markovitz
- Harvard T.H. Chan School of Public HealthHarvard UniversityBostonMA
- Division of Women's HealthBrigham and Women's Hospital and Harvard Medical SchoolBostonMA
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit and Population Health SciencesBristol Medical SchoolUniversity of BristolUnited Kingdom
| | - Lars J. Vatten
- Department of Public Health and NursingNTNUNorwegian University of Science and TechnologyTrondheimNorway
| | - Corrie Macdonald‐Wallis
- MRC Integrative Epidemiology Unit and Population Health SciencesBristol Medical SchoolUniversity of BristolUnited Kingdom
| | - Kate Tilling
- MRC Integrative Epidemiology Unit and Population Health SciencesBristol Medical SchoolUniversity of BristolUnited Kingdom
| | - Pål R. Romundstad
- Department of Public Health and NursingNTNUNorwegian University of Science and TechnologyTrondheimNorway
| | - Janet W. Rich‐Edwards
- Harvard T.H. Chan School of Public HealthHarvard UniversityBostonMA
- Division of Women's HealthBrigham and Women's Hospital and Harvard Medical SchoolBostonMA
| | - Bjørn O. Åsvold
- Department of Public Health and NursingNTNUNorwegian University of Science and TechnologyTrondheimNorway
- Department of EndocrinologySt. Olavs HospitalTrondheim University HospitalTrondheimNorway
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18
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Zhao P, Gu X, Qian D, Yang F. Socioeconomic disparities in abdominal obesity over the life course in China. Int J Equity Health 2018; 17:96. [PMID: 29976205 PMCID: PMC6034274 DOI: 10.1186/s12939-018-0809-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Abdominal obesity has become an important public health issue in China. Socioeconomic disparities are thought to be closely related to the prevalence of abdominal obesity. Exploring socioeconomic disparities in abdominal obesity over the life course in China could inform the design of new interventions to prevent and control abdominal obesity. METHODS The China Health and Nutrition Survey (CHNS) was a prospective household-based study involving seven rounds of surveys between 1993 and 2011. Twenty three thousand, two hundred and forty-three individuals were followed up over an 18-year period. The mixed effects models with random intercepts were used to assess the effects on abdominal obesity. Six key socioeconomic indicators, with age and age-squared added to the models, were used to identify socioeconomic disparities in abdominal obesity over the adult life course. RESULTS Prevalence of abdominal obesity increased non-linearly with age over the adult life course. Abdominal obesity was more prevalent in younger than older birth cohorts. Positive period effects on the prevalence of abdominal obesity were substantial from 1993 to 2011, and were stronger among males than females. Prevalence of abdominal obesity was higher among ethnic Han Chinese and among the married [coefficient (95% confidence intervals): 0.03(0.003, 0.057) and 0.035(0.022, 0.047), respectively], and was lower among males [coefficient (95% confidence intervals): - 0.065(- 0.075,-0.055)]. A higher-level of urbanization and higher household income increased the probability of abdominal obesity [coefficient (95% confidence intervals): 0.160(0.130, 0.191), 3.47E- 4 (2.23E- 4, 4.70E- 4), respectively], while individuals with more education were less likely to experience abdominal obesity [coefficient (95% confidence intervals): - 0.222 (- 0.289, - 0.155)] across adulthood. CONCLUSIONS In China, abdominal obesity increased substantially in more recent cohorts. And people with lower educational attainment, with higher household income, or living in more urbanized communities may be the disadvantaged population of abdominal obesity over the adult life course. Effective interventions targeting the vulnerable population need to be developed.
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Affiliation(s)
- Panpan Zhao
- School of Health Policy & Management, Nanjing Medical University, 101 Longmian Avenue, Jianging Districe, Nanjing, 211166, Jiangsu Province, People's Republic of China
| | - Xiaoli Gu
- School of Health Policy & Management, Nanjing Medical University, 101 Longmian Avenue, Jianging Districe, Nanjing, 211166, Jiangsu Province, People's Republic of China
| | - Dongfu Qian
- School of Health Policy & Management, Nanjing Medical University, 101 Longmian Avenue, Jianging Districe, Nanjing, 211166, Jiangsu Province, People's Republic of China.
| | - Fan Yang
- School of Health Policy & Management, Nanjing Medical University, 101 Longmian Avenue, Jianging Districe, Nanjing, 211166, Jiangsu Province, People's Republic of China.
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YANG F, QIAN D, HU D. Life-course and Cohort Trajectories of Chronic Non-communicable Diseases Risk Factors in China. IRANIAN JOURNAL OF PUBLIC HEALTH 2017; 46:591-601. [PMID: 28560188 PMCID: PMC5442270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND NCDs are the leading disease burdens in China and the NCDs risk factors shifts have accelerated at an unprecedented scale over the past 30 years. The aim of this study was to analysis the natural trajectories of NCDs risk factors over the life course. METHODS The large-scale longitudinal data from the CHNS includes nine rounds of surveys between 1989 and 2011. Overall, 145913 observations (29719 individuals) at multiple exams have been followed up over a 23-year period. The mixed-effects models with random intercepts were used to the characterize shifts in the distribution of these risk factors across the whole life course. RESULTS During about 23 years observational period across all age bands, the mean AMC, UAC, TSF, BMI, WC, DBP, SD, DD, and PA trajectory all increased until a certain age. Then decreased in both gender, whereas SBP strictly increased across lifespan; and the secular trend in AMC and WC, SBP, DBP was greater in women than in men; younger generations had higher AMC, UAC, TSF, BMI, WC, WHR, WHtR, SBP, DBP levels across adulthood, whereas younger birth cohorts had lower SD, DD, and PA levels. CONCLUSION We observed in a large and comprehensive longitudinal dataset that provided strong evidence of population-wide secular shifts from childhood onwards, which suggests that promoting healthier lifestyles, body weight, blood pressure and enhancing the primary practitioner's capability should be required to reduce the burden of NCDs in China.
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Koopman C, Vaartjes I, Blokstra A, Verschuren WMM, Visser M, Deeg DJH, Bots ML, van Dis I. Trends in risk factors for coronary heart disease in the Netherlands. BMC Public Health 2016; 16:835. [PMID: 27543113 PMCID: PMC4992244 DOI: 10.1186/s12889-016-3526-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 06/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Favourable trends in risk factor levels in the general population may partly explain the decline in coronary heart disease (CHD) morbidity and mortality. Our aim was to present long-term national trends in established risk factors for CHD. METHODS Data were obtained from five data sources including several large scale population based surveys, cohort studies and general practitioner registers between 1988 and 2012. We applied linear regression models to age-standardized time trends to test for statistical significant trends. Analyses were stratified by sex and age (younger <65 and older ≥65 years adults). RESULTS The results demonstrated favourable trends in smoking (except in older women) and physical activity (except in older men). Unfavourable trends were found for body mass index (BMI) and diabetes mellitus prevalence. Although systolic blood pressure (SBP) and total cholesterol trends were favourable for older persons, SBP and total cholesterol remained stable in younger persons. CONCLUSIONS Four out of six risk factors for CHD showed a favourable or stable trend. The rise in diabetes mellitus and BMI is worrying with respect to CHD morbidity and mortality.
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Affiliation(s)
- C Koopman
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (STR 6.131), P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. .,Dutch Heart Foundation, The Hague, The Netherlands.
| | - I Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (STR 6.131), P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - A Blokstra
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - W M M Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (STR 6.131), P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.,National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - M Visser
- Department of Health Sciences, EMGO+ Institute, VU University, Amsterdam, The Netherlands.,Department of Dietetics and Nutrition Sciences, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - D J H Deeg
- Department of Health Sciences, EMGO+ Institute, VU University, Amsterdam, The Netherlands
| | - M L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (STR 6.131), P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - I van Dis
- Dutch Heart Foundation, The Hague, The Netherlands
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Lai TC, Leung GM, Schooling CM. Maternal Age of Menarche and Blood Pressure in Adolescence: Evidence from Hong Kong's "Children of 1997" Birth Cohort. PLoS One 2016; 11:e0159855. [PMID: 27454175 PMCID: PMC4959736 DOI: 10.1371/journal.pone.0159855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/08/2016] [Indexed: 01/18/2023] Open
Abstract
Background Age of puberty has declined substantially in developed settings and is now declining in the rest of the world with economic development. Early age of puberty is associated with non-communicable diseases in adulthood, and may be a long-term driver of population health with effects over generations. In a non-Western setting, we examined the association of maternal age of menarche with blood pressure in late childhood/adolescence. Methods We used generalised estimating equations to estimate the adjusted association of maternal age of menarche with age-, sex- and height-adjusted blood pressure z-score from 10 to 16 years in Hong Kong’s population-representative birth cohort, “Children of 1997” (n = 8327). We also assessed whether associations were mediated by body mass index (BMI) or pubertal stage. Results Earlier maternal age of menarche was associated with higher systolic blood pressure in adolescence [-0.02 z-score per year older maternal age of menarche, 95% confidence interval (CI) -0.04 to -0.003]. The association of maternal age of menarche with systolic blood pressure was mediated by adiposity and/or pubertal stage at 11 years. Maternal age of menarche was not associated with diastolic blood pressure. Conclusion Earlier maternal age of puberty was associated with higher systolic blood pressure, largely mediated by adiposity, highlighting the importance of tackling childhood obesity as a public health priority in view of the secular trend of declining age of puberty.
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Affiliation(s)
- Tsz Chun Lai
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Gabriel Matthew Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - C. Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- City University of New York, School of Public Health and Hunter College, New York, New York, United States of America
- * E-mail:
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Gupta R, Sharma M, Goyal NK, Bansal P, Lodha S, Sharma KK. Gender differences in 7 years trends in cholesterol lipoproteins and lipids in India: Insights from a hospital database. Indian J Endocrinol Metab 2016; 20:211-218. [PMID: 27042418 PMCID: PMC4792023 DOI: 10.4103/2230-8210.176362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To determine gender differences and secular trends in total, low-density lipoprotein (LDL) and high DL (HDL) cholesterol and triglycerides using a large hospital database in India. METHODS All blood lipid tests evaluated from July 2007 to December 2014 were analyzed. Details of gender and age were available. Statin therapy was obtained at two separate periods. Trends were calculated using linear regression and Mantel-Haenszel X(2). RESULTS Data of 67395 subjects (men 49,904, women 17,491) aged 51 ± 12 years were analyzed. Mean levels (mg/dl) were total cholesterol 174.7 ± 45, LDL cholesterol 110.7 ± 38, non-HDL cholesterol 132.1 ± 44.8, HDL cholesterol 44.1 ± 10, triglycerides 140.8 ± 99, and total: HDL cholesterol 4.44 ± 1.5. Various dyslipidemias in men/women were total cholesterol ≥200 mg/dl 25.4/36.4%, LDL cholesterol ≥130 mg/dl 28.1/35.0% and ≥100 mg/dl 54.4/66.4%, non-HDL cholesterol ≥160 mg/dl 25.5/29.6%, HDL cholesterol <40/50 mg/dl 54.4/64.4%, and triglycerides ≥150 mg/dl 34.0/26.8%. Cholesterol lipoproteins declined over 7 years with greater decline in men versus women for cholesterol (Blinear regression = -0.82 vs. -0.33, LDL cholesterol (-1.01 vs. -0.65), non-HDL cholesterol (-0.88 vs. -0.52), and total: HDL cholesterol (-0.02 vs. -0.01). In men versus women there was greater decline in prevalence of hypercholesterolemia (X(2) trend 74.5 vs. 1.60), LDL cholesterol ≥130 mg/dl (X(2) trend 415.5 vs. 25.0) and ≥100 mg/dl (X(2) trend 501.5 vs. 237.4), non-HDL cholesterol (X(2) trend 77.4 vs. 6.85), total: HDL cholesterol (X(2) trend 212.7 vs. 10.5) and high triglycerides (X(2) trend 10.8 vs. 6.15) (P < 0.01). Use of statins was in 2.6% (36/1405) in 2008 and 9.0% (228/2527) in 2014 (P < 0.01). Statin use was significantly lower in women (5.8%) than men (10.3%). CONCLUSIONS In a large hospital - database we observed greater hypercholesterolemia and low HDL cholesterol in women. Mean levels and prevalence of high total, LDL, non-HDL and total: HDL cholesterol declined over 7 years. A lower decline was observed in women. This was associated with lower use of statins.
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Affiliation(s)
- Rajeev Gupta
- Department of Internal Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India
| | - Madhawi Sharma
- Department of Laboratory Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India
| | - Neeraj Krishna Goyal
- Department of Laboratory Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India
| | - Preeti Bansal
- Department of Laboratory Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India
| | - Sailesh Lodha
- Department of Endocrinology, Fortis Escorts Hospital, Jaipur, Rajasthan, India
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Green MA, Subramanian SV, Razak F. Population-level trends in the distribution of body mass index in England, 1992-2013. J Epidemiol Community Health 2016; 70:832-5. [PMID: 26884595 DOI: 10.1136/jech-2015-206468] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 01/29/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Changes over time of mean body weight or prevalence of overweight and obesity have been well documented. Less consideration has been given to describing the distribution to these changes particularly by socioeconomic status and sex. METHODS We use data from the Health Survey for England for the years 1992-2013 to calculate the median, 5th and 95th centiles, and SD of body mass index (BMI). We tested differences using analysis of variance and quantile regression. Analyses were stratified by sex and level of education. RESULTS There have been increases in the SD of BMI values over the period. While median BMI has increased, there has been a larger increase of the 95th centile. These trends were consistent by sex and level of education, although significant differences were observed in values. CONCLUSIONS Our results demonstrate that changes in median BMI over time do not reflect changes in the distribution of BMI. Failing to understand the distribution of body weight in the population will hamper our projections of future patterns, as well as our ability to design effective public health strategies.
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Affiliation(s)
- M A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - S V Subramanian
- School of Public Health, Harvard T.H. Chan, Boston, Massachusetts, USA Harvard Center for Population and Development Studies, Harvard T.H. Chan, School of Public Health, Cambridge, Massachusetts, USA
| | - F Razak
- Li Na Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Harvard Center for Population and Development Studies, Harvard T.H. Chan, School of Public Health, Cambridge, Massachusetts, USA
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How Has the Age-Related Process of Overweight or Obesity Development Changed over Time? Co-ordinated Analyses of Individual Participant Data from Five United Kingdom Birth Cohorts. PLoS Med 2015; 12:e1001828; discussion e1001828. [PMID: 25993005 PMCID: PMC4437909 DOI: 10.1371/journal.pmed.1001828] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 04/10/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is a paucity of information on secular trends in the age-related process by which people develop overweight or obesity. Utilizing longitudinal data in the United Kingdom birth cohort studies, we investigated shifts over the past nearly 70 years in the distribution of body mass index (BMI) and development of overweight or obesity across childhood and adulthood. METHODS AND FINDINGS The sample comprised 56,632 participants with 273,843 BMI observations in the 1946 Medical Research Council National Survey of Health and Development (NSHD; ages 2-64 years), 1958 National Child Development Study (NCDS; 7-50), 1970 British Cohort Study (BCS; 10-42), 1991 Avon Longitudinal Study of Parents and Children (ALSPAC; 7-18), or 2001 Millennium Cohort Study (MCS; 3-11). Growth references showed a secular trend toward positive skewing of the BMI distribution at younger ages. During childhood, the 50th centiles for all studies lay in the middle of the International Obesity Task Force normal weight range, but during adulthood, the age when a 50th centile first entered the overweight range (i.e., 25-29.9 kg/m2) decreased across NSHD, NCDS, and BCS from 41 to 33 to 30 years in males and 48 to 44 to 41 years in females. Trajectories of overweight or obesity showed that more recently born cohorts developed greater probabilities of overweight or obesity at younger ages. Overweight or obesity became more probable in NCDS than NSHD in early adulthood, but more probable in BCS than NCDS and NSHD in adolescence, for example. By age 10 years, the estimated probabilities of overweight or obesity in cohorts born after the 1980s were 2-3 times greater than those born before the 1980s (e.g., 0.229 [95% CI 0.219-0.240] in MCS males; 0.071 [0.065-0.078] in NSHD males). It was not possible to (1) model separate trajectories for overweight and obesity, because there were few obesity cases at young ages in the earliest-born cohorts, or (2) consider ethnic minority groups. The end date for analyses was August 2014. CONCLUSIONS Our results demonstrate how younger generations are likely to accumulate greater exposure to overweight or obesity throughout their lives and, thus, increased risk for chronic health conditions such as coronary heart disease and type 2 diabetes mellitus. In the absence of effective intervention, overweight and obesity will have severe public health consequences in decades to come.
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Ferrie JE, Ebrahim S. Sun exposure and longevity: a blunder involving immortal time. Int J Epidemiol 2015; 43:639-44. [PMID: 25050434 DOI: 10.1093/ije/dyu108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hulmán A, Witte DR, Kerényi Z, Madarász E, Tänczer T, Bosnyák Z, Szabó E, Ferencz V, Péterfalvi A, Tabák AG, Nyári TA. Heterogeneous effect of gestational weight gain on birth weight: quantile regression analysis from a population-based screening. Ann Epidemiol 2015; 25:133-7, 137.e1. [DOI: 10.1016/j.annepidem.2014.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 10/07/2014] [Accepted: 11/03/2014] [Indexed: 12/23/2022]
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Vistisen D, Færch K. Eighteen year weight trajectories and metabolic markers of diabetes in modernising China: which timescale is most relevant? Diabetologia 2014; 57:2605-6. [PMID: 25277951 DOI: 10.1007/s00125-014-3391-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Dorte Vistisen
- Steno Diabetes Center, Niels Steensens Vej 1, 2829, Gentofte, Denmark,
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