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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 124] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Koutsonida M, Koskeridis F, Markozannes G, Kanellopoulou A, Mousas A, Ntotsikas E, Ioannidis P, Aretouli E, Tsilidis KK. Metabolic syndrome and cognitive deficits in the Greek cohort of Epirus Health Study. Neurol Sci 2023; 44:3523-3533. [PMID: 37162663 PMCID: PMC10495510 DOI: 10.1007/s10072-023-06835-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/28/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Metabolic syndrome is considered an important risk factor for cognitive decline and dementia. However, the evidence in middle-aged individuals is still conflicting. The aim of the study was to explore the association between metabolic syndrome and its individual components with cognitive function and to investigate possible interaction between sex, age and genetic predisposition for metabolic syndrome and Alzheimer's disease in a middle-aged Greek cohort. METHODS A total of 2,077 healthy adults (mean age: 46.7 years) were included in the primary cross-sectional analysis and 305 of them in secondary prospective analyses. Metabolic syndrome was defined by the revised National Cholesterol Education-Adult Treatment Panel III and the International Diabetes Federation criteria. Cognitive function was measured primarily with the Trail Making, Verbal fluency and Logical Memory test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, Corsi block-tapping task and Stroop task. RESULTS Multivariable linear regressions showed an association of metabolic syndrome with lower performance in attention (β=1.62 seconds, 95% CI=0.20, 3.04) and memory (β=-0.62 words, 95% CI=-1.19, -0.05) that could be driven by associations with elevated fasting glucose and abdominal obesity. Similar associations were observed in the secondary prospective analyses. CONCLUSION In summary, metabolic syndrome was associated with cognitive deficits in domains related with the cognitive profile of vascular cognitive impairment.
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Affiliation(s)
- Myrto Koutsonida
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Fotios Koskeridis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Abdou Mousas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Evangelos Ntotsikas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Panagiotis Ioannidis
- B' Department of Neurology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece.
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1337] [Impact Index Per Article: 1337.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2536] [Impact Index Per Article: 1268.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3133] [Impact Index Per Article: 1044.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Sin S, Lee CH, Choi SM, Han KD, Lee J. Metabolic Syndrome and Risk of Lung Cancer: An Analysis of Korean National Health Insurance Corporation Database. J Clin Endocrinol Metab 2020; 105:5899082. [PMID: 32860708 DOI: 10.1210/clinem/dgaa596] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Metabolic syndrome is known to increase the risk of several cancers. However, the association between lung cancer and metabolic syndrome remains unclear. Thus, we investigated the impact of metabolic syndrome on the incidence of lung cancer. METHODS This study enrolled participants in a health screening program provided by the Korean National Health Insurance Service between January 2009 and December 2012. The incidence of lung cancer was observed until December 2016. We analyzed the risk of lung cancer according to the presence of metabolic syndrome, metabolic syndrome components, and number of metabolic syndrome components. RESULTS During the study, 45 635 new cases of lung cancer were recorded among 9 586 753 participants. The presence of metabolic syndrome and all its components was positively associated with the risk of lung cancer in men after multivariate adjustment (hazard ratio [HR] of metabolic syndrome 1.15; 95% confidence interval [CI], 1.12-1.18). The risk of lung cancer increased with the number of components present. The effect of metabolic syndrome on the increasing risk of lung cancer is may be higher in underweight male ever-smokers than in other participants. CONCLUSION Metabolic syndrome was associated with an increased risk of lung cancer in men. Moreover, the higher the number of metabolic syndrome components, the higher the risk of lung cancer.
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Affiliation(s)
- Sooim Sin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Mi Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinwoo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4876] [Impact Index Per Article: 1219.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Bijani A, Hosseini SR, Ghadimi R, Mouodi S. Association of Metabolic Syndrome and Its Components with Survival of Older Adults. Int J Endocrinol Metab 2020; 18:e91837. [PMID: 32308697 PMCID: PMC7144244 DOI: 10.5812/ijem.91837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) as an important risk factor arising from insulin resistance accompanying abnormal adipose deposition and function has become a major challenge to public health around the world. OBJECTIVES This research was conducted to evaluate the association of MetS and its components with survival of older adults. METHODS This prospective study is a part of the Amirkola Health and Ageing Cohort Project (2011 - 2017) conducted among 1562 older adults (aged 60 years and over) living in Amirkola, north of Iran. MetS was defined according to four sets of definition: Iranian definition, International Diabetes Federation (IDF) definition, 2001 Adult Treatment Panel (ATP) III and 2005 Adult Treatment Panel (ATP) III. RESULTS Eight hundred sixty-three (55.2%) males and 699 (44.8%) females with a mean age of 69.3 ± 7.4 years were included in the research. The results showed that 71.9%, 74.3%, 68.8% and 66.7% of older adults had MetS based on 2005 ATP III, Iranian, IDF and 2001 ATP III diagnostic criteria, respectively. Only raised fasting plasma glucose (FPG) had a significant association with a five-year survival rate of older adults (FPG ≥ 110mg/dL: adjusted HR: 2.05; 95% CI: 1.51 - 2.78; P < 0.001). Other MetS components did not show any significant associations with survival (P > 0.05). Nevertheless, MetS itself significantly decreased the survival rate of older adults after adjusting age, gender and number of chronic diseases (HR = 1.67; 95% CI: 1.16 - 2.41; P = 0.006). CONCLUSIONS MetS and one of its components, high FPG, have significant associations with survival of older adults.
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Affiliation(s)
- Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Simin Mouodi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Corresponding Author: Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Duangrithi D, Wattanasermkit R, Rungwijee S, Khunsom N. Thai CV risk score and primary prevention in impaired fasting plasma glucose or diabetes mellitus versus normoglycemia in patients with metabolic syndrome. Int J Prev Med 2020; 11:139. [PMID: 33088467 PMCID: PMC7554559 DOI: 10.4103/ijpvm.ijpvm_12_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Impaired fasting plasma glucose (IFG) as well as diabetes mellitus (DM) may influence the presence of another metabolic syndrome (MetS) components resulting in the different risk of cardiovascular (CV) morbidity and mortality. This study aimed to determine the impact of IFG as well as DM on the 10-year CV risk using Thai CV risk score and primary prevention in complying with CV risk score in these patients. Methods: This cross-sectional study was conducted at the internal medicine clinic, Pathum Thani Hospital, Thailand. The study was approved by the hospital ethics committee and written informed consent was obtained from all patients. Patients having MetS according to the criteria of the International Diabetes Federation were enrolled while those with a history of CVD were excluded. The 10-year CV risk was assessed using the Thai CV risk score. Results: The total of 112 patients were enrolled in the study. They were in old age and female sex was a significantly higher proportion (61.70% vs 35.50%, P = 0.013). Of these, 72.32% had IFG or DM. Proportions of patients with moderate and high CV risk score were significantly greater in IFG/DM group and only 34.48% and 79.31% of patients with moderate or high CV risk score received aspirin and statin. IFG or DM significantly elevated CV risk score (OR = 6.66, 95% CI = 2.29, 19.58). Conclusions: IFG/DM significantly elevated CV risk score in these patients with the strongest impact. The assessment of CV risk is highly recommended for primary prevention and long-term CVD benefit.
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5341] [Impact Index Per Article: 1068.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Cavero-Redondo I, Martínez-Vizcaíno V, Álvarez-Bueno C, Agudo-Conde C, Lugones-Sánchez C, García-Ortiz L. Metabolic Syndrome Including Glycated Hemoglobin A1c in Adults: Is It Time to Change? J Clin Med 2019; 8:jcm8122090. [PMID: 31805696 PMCID: PMC6947260 DOI: 10.3390/jcm8122090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 12/25/2022] Open
Abstract
(1) Background: To assess the suitability of replacing conventional markers used for insulin resistance and dysglycemia by HbA1c in both the quantitative and qualitative metabolic syndrome (MetS) definition criteria; (2) Methods: Confirmatory factorial analysis was used to compare three quantitative definitions of MetS that consisted of many single-factor models, one of which included HbA1c as the dysglycemia indicator. After that, the model with the better goodness-of-fit was selected. Furthermore, a new MetS qualitative definition was proposed by replacing fasting plasma glucose with HbA1c > 5.7% in the International Diabetes Federation (IDF) definition. The clinical performance of these two MetS criteria (IDF and IDF-modified including HbA1c as the dysglycemia indicator) to predict vascular damage (pulse wave velocity [PWv], intima media thickness [IMT] and albumin-to-creatinine ratio [ACR]) was estimated; (3) Results: The single-factor model including HbA1c showed the better goodness-of-fit (χ2 = 2.45, df = 2, p = 0.293, CFI = 0.999, SRMR = 0.010). Additionally, the IDF-modified criteria gained in clinical performance to predict vascular damage (diagnostic Odds Ratio: 6.94, 1.34 and 1.90) for pulse wave velocity (PWv), intima media thickness (IMT) and albumin-to-creatinine ratio (ACR), respectively; and (4) Conclusions: These data suggest that HbA1c could be considered as a useful component to be included in the MetS definition.
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Affiliation(s)
- Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain; (I.C.-R.); (V.M.-V.)
- Universidad Politécnica y Artísitica del Paraguay, 001518 Asunción, Paraguay
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain; (I.C.-R.); (V.M.-V.)
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, 3460000 Talca, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain; (I.C.-R.); (V.M.-V.)
- Universidad Politécnica y Artísitica del Paraguay, 001518 Asunción, Paraguay
- Correspondence:
| | - Cristina Agudo-Conde
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain; (C.A.-C.); (C.L.-S.); (L.G.-O.)
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain; (C.A.-C.); (C.L.-S.); (L.G.-O.)
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain; (C.A.-C.); (C.L.-S.); (L.G.-O.)
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37003 Salamanca, Spain
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Ye Z, Lu H, Su Q, Long M, Li L. Efficacy and safety of nicorandil on perioperative myocardial injury in patients undergoing elective percutaneous coronary intervention: results of the PENMIPCI trial. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:2591-2599. [PMID: 30174413 PMCID: PMC6110631 DOI: 10.2147/dddt.s173931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Previous studies have indicated that nicorandil can reduce perioperative myocardial injury (PMI) in patients undergoing elective percutaneous coronary intervention (ePCI), but this conclusion is still controversial. Additionally, studies reporting on the safety of nicorandil are lacking. Therefore, we performed this prospective study to evaluate the efficacy and safety of nicorandil on PMI in patients undergoing ePCI. Methods One hundred and forty-six patients with coronary heart disease (CHD) scheduled to undergo ePCI were randomly assigned to the nicorandil group (n=74) or control group (n=72). The primary outcomes were the change in cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) at 12 and 24 hours after surgery. The secondary outcome was the incidence of major adverse cardiac events (MACE), which was a composite of cardiac death, nonfatal myocardial infarction, new heart failure or coronary revascularization. Results There was no difference in age (54.76±5.93 vs 56.35±5.22) between the nicorandil group and the control group. In addition, no differences were observed in the cTnT and CK-MB levels between the two groups at admission (all P⩾0.05). Compared with those in the control group, the cTnT (0.15±0.12 vs 0.12±0.10 at 12 hours and 0.17±0.12 vs 0.13±0.10 at 24 hours) and CK-MB (15.35±8.23 vs 12.31±7.93 at 12 hours and 13.63±8.87 vs 11.13±5.71 at 24 hours) levels in the nicorandil group were significantly decreased after surgery (all P⩽0.05). Furthermore, nicorandil did not increase the incidence of MACE in the nicorandil group compared with the control group (12.16% vs 12.50%). Conclusions Nicorandil can reduce PMI in patients undergoing ePCI and does not increase the incidence of MACE. Clinical Trial Registration URL: http://www.chictr.org.cn/. Unique Identifier: ChiCTR-IOR-17012056.
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Affiliation(s)
- Ziliang Ye
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China, ; 3224014648@.com
| | - Haili Lu
- Department of Orthodontics, The Affiliated Dental Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Qiang Su
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China, ; 3224014648@.com
| | - Manyun Long
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China, ; 3224014648@.com
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China, ; 3224014648@.com
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13
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Liu C, Sun X, Lin H, Zheng R, Ruan L, Sun Z, Zhu Y. Association between hyperhomocysteinemia and metabolic syndrome with early carotid artery atherosclerosis: A cross-sectional study in middle-aged Chinese population. Nutrition 2018; 53:115-119. [PMID: 29778949 DOI: 10.1016/j.nut.2018.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 02/11/2018] [Accepted: 02/12/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Homocysteine is a modifiable, independent risk factor for cardiovascular disease. The association between hyperhomocysteinemia and metabolic syndrome with the presence of early carotid artery atherosclerosis remains unknown in middle-aged Chinese adults. METHODS Chinese adults (n = 1607) of Han ethnicity, age 35 to 65 y, and living in their communities >2 y were surveyed. Hyperhomocysteinemia was defined as homocysteine concentrations >15 µmol/L. Carotid intima-media thickness and carotid plaque were examined by ultrasonography. All participants were classified into four groups by hyperhomocysteinemia and metabolic syndrome status. RESULTS Participants with both hyperhomocysteinemia and metabolic syndrome had the highest levels of waist circumference and systolic blood pressure compared with the three other groups. The highest proportion of increased carotid intima-media thickness (61.3%) was in the subgroup of both hyperhomocysteinemia and metabolic syndrome. After adjustments for the covariates, the risk of increased carotid intima-media thickness was only significantly higher in the group with metabolic syndrome but without hyperhomocysteinemia (odds ratio: 1.47; 95% confidence interval, 1.13-1.93) compared with people without hyperhomocysteinemia and metabolic syndrome. Furthermore, statistically significant variances of prevalence of plaque among the four subgroups were not discovered. CONCLUSIONS Our study demonstrated that metabolic syndrome had a strong effect on carotid intima-media thickness However, the increased homocysteine levels were not significantly associated with early carotid artery atherosclerosis in middle-aged Chinese people.
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Affiliation(s)
- Chengguo Liu
- Department of Endocrinology and Institute of Cardiovascular Diseases, Zhejiang Putuo Hospital, Zhoushan, Zhejiang, China
| | - Xiaohui Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hanli Lin
- Department of Cardiology, Zhejiang Putuo Hospital, Zhoushan, Zhejiang, China
| | - Ruizhi Zheng
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liansheng Ruan
- Department of Endocrinology and Institute of Cardiovascular Diseases, Zhejiang Putuo Hospital, Zhoushan, Zhejiang, China
| | - Zhanhang Sun
- Department of Endocrinology and Institute of Cardiovascular Diseases, Zhejiang Putuo Hospital, Zhoushan, Zhejiang, China
| | - Yimin Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China.
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14
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4525] [Impact Index Per Article: 754.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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15
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Cinza Sanjurjo S, Llisterri Caro JL, Segura Fragoso A, Prieto Díaz MÁ, Escobar Cervantes C, Barquilla García A, Rodríguez Padial L, Pallarés Carratalá V, Vidal Pérez R, Miravet Jiménez S, Rodríguez Roca GC, Badimón JJ, in representation of the IBERICAN S. Characteristics of the Metabolic Syndrome in the Patients of IBERICAN Study (Identification of the Spanish Population at Cardiovascular and Renal Risk). Metab Syndr Relat Disord 2017. [DOI: 10.1089/met.2017.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Antonio Segura Fragoso
- Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | | | | | | | | | | | - Rafael Vidal Pérez
- Servicio de Cardiología, Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | | | - Juan Jose Badimón
- Atherothrombosis Research Unit, Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York
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16
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Khosravi A, Sadeghi M, Barghikar M. Which Components of Metabolic Syndrome have a Greater Effect on Mortality, CVA and Myocardial Infarction, Hyperglycemia, High Blood Pressure or Both? Adv Biomed Res 2017; 6:121. [PMID: 28989914 PMCID: PMC5627565 DOI: 10.4103/abr.abr_249_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study aims to evaluate the incidence of stroke, ischemic heart disease (IHD), and cardiovascular disease (CVD) mortality in clusters containing hypertension (HTN), clusters containing diabetes (diabetes mellitus [DM]), cluster with both HTN, DM, and cluster without HTN, DM in patients with metabolic syndrome (MetS). MATERIALS AND METHODS The association between MetS and outcomes was examined in 2257 patients with MetS that were divided into four groups includes patients with MetS with hyperglycemia (Cluster 1), patients with MetS with HTN (Cluster 2), patients with MetS with HTN and hyperglycemia (Cluster 3) and patients with MetS without HTN and hyperglycemia (Cluster 4). To assess the risk ratio and incidence of CVA, myocardial infarction, and mortality with the use multivariate Cox proportional hazards models. RESULTS As it shown the lowest prevalence of events was in Cluster 1 and against in Cluster 3 the prevalence of stroke with 34 (38.2%) cases and the prevalence of IHD and CVD mortality in Cluster 2 with, respectively, 168 (54.7%) and 51 patients (49%) had the most frequencies (P < 0.001), and hence that the lowest prevalence of events was seen in Cluster 1, but stroke in Cluster 3 with 34 cases (38.2%) and the prevalence of IHD and CVD mortality in Cluster 2, respectively, with 168 (54.7%) and 51 patients (49%) had the most frequencies (P < 0.001). CONCLUSION More intensive changes in lifestyle and management protocols may be required in these patients for controlling the components of the syndrome, with the aim of preventing not only type II diabetes and CVD but also ischemic cerebrovascular events.
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Affiliation(s)
- Alireza Khosravi
- From the Department of Cardiology, Sedigheh Tahereh Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- From the Department of Cardiology, Sedigheh Tahereh Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrzad Barghikar
- From the Department of Cardiology, Sedigheh Tahereh Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6094] [Impact Index Per Article: 870.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18
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Younis A, Younis A, Tzur B, Peled Y, Shlomo N, Goldenberg I, Fisman EZ, Tenenbaum A, Klempfner R. Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease. Cardiovasc Diabetol 2016; 15:149. [PMID: 27793156 PMCID: PMC5084328 DOI: 10.1186/s12933-016-0466-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/20/2016] [Indexed: 02/06/2023] Open
Abstract
Background Data regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD). Methods Our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program–Third Adult Treatment Panel (NCEP). Results According to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan–Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p < 0.001) as well as NCEP (67 vs. 54%; log rank-p < 0.001) criteria. Multivariate adjusted mortality risk was 17% greater [Hazard Ratio (HR) 1.17; 95% Confidence Interval (CI) 1.07–1.28] in patients with MetS according to IDF and 21% (HR 1.21; 95% CI 1.13–1.29) using the NCEP definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction < 0.05). Conclusions Metabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registered Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0466-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Arwa Younis
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.
| | - Anan Younis
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Boaz Tzur
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Yael Peled
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Nir Shlomo
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Ilan Goldenberg
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.,Heart Research Follow-up Program, University of Rochester, Rochester, NY, USA
| | - Enrique Z Fisman
- Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.,Cardiovascular Diabetology Research Foundation, Holon, Israel
| | - Alexander Tenenbaum
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.,Cardiovascular Diabetology Research Foundation, Holon, Israel
| | - Robert Klempfner
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel
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19
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Wiley JF, Carrington MJ. A metabolic syndrome severity score: A tool to quantify cardio-metabolic risk factors. Prev Med 2016; 88:189-95. [PMID: 27095322 DOI: 10.1016/j.ypmed.2016.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/01/2016] [Accepted: 04/12/2016] [Indexed: 11/30/2022]
Abstract
Metabolic syndrome is a cluster of cardio-metabolic risk factors and is associated with increased mortality. There is no standard, validated way to assess the severity of aggregated metabolic syndrome risk factors. Cardiovascular and diabetes risk factor data came from two studies conducted in Australia from 2006 to 2010 in adults aged 18 or above. In medication free adults, sex-specific clinical thresholds and Principal Component Analysis were used to develop a formula to calculate a metabolic syndrome severity score (MetSSS). These scores were compared to scores derived using the same process in subgroups by sex, age, medication status, and time. We also examined the MetSSS in relation to other known risk factors. In 2125 adults (57.6±14.7years of age), the MetSSS ranged from 0 to 8.7 with a mean of 2.6. There were strong correlations (.95-.99) between the MetSSS in medication free adults and the MetSSS calculated from subgroups. MetSSS predicted medication initiation for hypertension, hyperlipidemia and hyperglycemia over six months (OR=1.31, 95% CI [1.00-1.70], per MetSSS unit, p=.043). Lower education, medication prescription, history of smoking and age were associated with higher MetSSS (all p<.05). Higher physical but not mental health quality of life was associated with lower MetSSS (p<.001). A standardized formula to measure cardio-metabolic risk factor severity was constructed and demonstrated expected relations with known risk factors. The use of the MetSSS is recommended as a measure of change within individuals in cardio-metabolic risk factors and to guide treatment and management.
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Affiliation(s)
- Joshua F Wiley
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Melinda J Carrington
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
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20
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Michel JP, Dreux C, Vacheron A. Healthy ageing: Evidence that improvement is possible at every age. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.04.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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21
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van Herpt TTW, Dehghan A, van Hoek M, Ikram MA, Hofman A, Sijbrands EJG, Franco OH. The clinical value of metabolic syndrome and risks of cardiometabolic events and mortality in the elderly: the Rotterdam study. Cardiovasc Diabetol 2016; 15:69. [PMID: 27117940 PMCID: PMC4847340 DOI: 10.1186/s12933-016-0387-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 04/13/2016] [Indexed: 02/06/2023] Open
Abstract
Background To evaluate the clinical value of metabolic syndrome based on different definitions [American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), International Diabetes Federation (IDF) and European Group for the Study of Insulin Resistance (EGIR)] in middle-aged and elderly populations. Methods We studied 8643 participants from the Rotterdam study (1990–2012; mean age 62.7; 57.6 % female), a large prospective population-based study with predominantly elderly participants. We performed cox-proportional hazards models for different definitions, triads within definitions and each separate component for the risk of incident type 2 diabetes mellitus, coronary heart disease, stroke, cardiovascular- and all-cause mortality. Results In our population of 8643 subjects, metabolic syndrome was highly prevalent (prevalence between 19.4 and 42.4 %). Metabolic syndrome in general was associated with incident type 2 diabetes mellitus (median follow-up of 6.8 years, hazard ratios 3.13–3.78). The associations with coronary heart disease (median follow-up of 7.2 years, hazard ratios 1.08–1.32), stroke (median follow-up of 7.7 years, hazard ratios 0.98–1.32), cardiovascular mortality (median follow-up of 8.2 years, ratios 0.95–1.29) and all-cause mortality (median follow-up of 8.7 years, hazard ratios 1.05–1.10) were weaker. AHA/NHLBI- and IDF-definitions showed similar associations with clinical endpoints compared to the EGIR, which was only significantly associated with incident type 2 diabetes mellitus. All significant associations disappeared after correcting metabolic syndrome for its individual components. Conclusions Large variability exists between and within definitions of the metabolic syndrome with respect to risk of clinical events and mortality. In a relatively old population the metabolic syndrome did not show an additional predictive value on top of its individual components. So, besides as a manner of easy identification of high risk patients, the metabolic syndrome does not seem to add any predictive value for clinical practice. Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0387-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thijs T W van Herpt
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Mandy van Hoek
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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22
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Devers MC, Campbell S, Simmons D. Influence of age on the prevalence and components of the metabolic syndrome and the association with cardiovascular disease. BMJ Open Diabetes Res Care 2016; 4:e000195. [PMID: 27158519 PMCID: PMC4853802 DOI: 10.1136/bmjdrc-2016-000195] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/11/2016] [Accepted: 03/20/2016] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The significance of the metabolic syndrome (MS) is debated. We investigated whether MS component (by ATPIII and IDF definitions) clustering and any association between MS and prevalent cardiovascular disease (CVD) varied with age. RESEARCH DESIGN AND METHODS In all, 1429 adults (≥25 years) from randomly selected households in rural Victoria, Australia, were assessed for components of MS and prevalent CVD. The expected prevalence of MS was calculated following a simple probabilistic model using the prevalence of each MS component. RESULTS The observed prevalence of MS was greater than expected: 27.0% vs 21.2% (ATPIII) and 36.0% vs 30.1% (IDF; p<0.0001), based on the prevalence of individual components. There was significant clustering of 4 and 5 MS components in participants <65 years (p<0.0001). CVD was more prevalent in MS participants, 13.5% (IDF), 14.5% (ATPIII) versus 5.3% (no MS) p<0.0001. The OR for CVD in MS participants was greatest in those <45 years OR (95% CI): IDF 17.5 (1.8 to 172); ATPIII 24.3(2.4 to 241), p<0.001 for both, and was not significant in those >65 years. The prevalence of MS (ATPIII) with normal waist circumference (WC) was less than expected (4.8% vs 7.9%, p<0.002). Low levels of high-density lipoprotein and high triglyceride were less common in older MS participants. CONCLUSIONS ATPIII MS is rare among those with a normal WC. MS components cluster most markedly among those aged <65 years, who also experience substantially greater rates of CVD. Younger patients with MS may warrant more aggressive CVD preventative treatment than suggested by the summation of their individual risk factors.
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Affiliation(s)
- Marion C Devers
- Department of Diabetes, Monklands Hospital, Airdrie, Lanarkshire, UK
| | - Stewart Campbell
- Department of Medicine, Hairmyres Hospital, East Kilbride, South Lanarkshire, UK
| | - David Simmons
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
- University of Western Sydney School of Medicine, Campbelltown, New South Wales, Australia
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23
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Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2015; 133:e38-360. [PMID: 26673558 DOI: 10.1161/cir.0000000000000350] [Citation(s) in RCA: 3736] [Impact Index Per Article: 415.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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24
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Buchmann N, Norman K, Steinhagen-Thiessen E, Demuth I, Eckardt R. Lung function in elderly subjects with metabolic syndrome and type II diabetes : Data from the Berlin Aging Study II. Z Gerontol Geriatr 2015:10.1007/s00391-015-0958-0. [PMID: 26508108 DOI: 10.1007/s00391-015-0958-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 07/15/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous studies have indicated a relationship between type II diabetes (T2D), metabolic syndrome (MetS) and pulmonary function but the pathological mechanism responsible remains unclear. The aim of the current analysis within the Berlin Aging Study II (BASE-II) was to investigate the influence of abdominal obesity and muscle mass on pulmonary function in subjects with T2D and MetS. MATERIAL AND METHODS A prebronchodilator pulmonary function test was carried out in 1369 subjects from the BASE-II (mean age 69 ± 4 years, 51.6 % women) where T2D was defined according to the German Diabetes Association (DDG) criteria, MetS according to the criteria of the International Diabetes Foundation (IDF), American Heart Association (AHA) and National Heart, Lung and Blood Institute (NHLBI) criteria from 2009 and pulmonary obstruction (obstructive lung disease, OLD) by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of a forced expiratory volume in 1 s (FEV1 and forced vital capacity (FVC) ratio < 70 %. RESULTS Of the subjects 50.9 % achieved a sufficient level of quality according to the GOLD guidelines and were analyzed with respect to the research question. The FEV1 and FVC were decreased in study participants with T2D and MetS and the lung volume decreased with an increasing number of MetS criteria. Parameters of body composition, such as waist circumference and muscle mass had a significant influence on lung volumes, independent of MetS or T2D. DISCUSSION In this study MetS and T2D were associated with decreased lung volumes; however, muscle mass and abdominal obesity proved to be the most important factors influencing pulmonary function and could thus form the link between pulmonary function and MetS or T2D. Measurement of grip strength for the determination of muscle mass and waist circumference for determining abdominal obesity could contribute to the interpretation of the results of pulmonary function tests.
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Affiliation(s)
- Nikolaus Buchmann
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany.
| | - Kristina Norman
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany
| | | | - Ilja Demuth
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany
- Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany
| | - Rahel Eckardt
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany
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Buchmann N, Norman K, Steinhagen-Thiessen E, Demuth I, Eckardt R. Lungenfunktion bei älteren Probanden mit metabolischem Syndrom und Typ-2-Diabetes. Z Gerontol Geriatr 2015; 49:405-15. [DOI: 10.1007/s00391-015-0959-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 07/15/2015] [Indexed: 01/01/2023]
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A multifunctional diet improves cardiometabolic-related biomarkers independently of weight changes: an 8-week randomized controlled intervention in healthy overweight and obese subjects. Eur J Nutr 2015; 55:2295-306. [DOI: 10.1007/s00394-015-1039-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/04/2015] [Indexed: 01/21/2023]
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Lonardo A, Ballestri S, Marchesini G, Angulo P, Loria P. Nonalcoholic fatty liver disease: a precursor of the metabolic syndrome. Dig Liver Dis 2015; 47:181-90. [PMID: 25739820 DOI: 10.1016/j.dld.2014.09.020] [Citation(s) in RCA: 480] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/19/2014] [Accepted: 09/21/2014] [Indexed: 02/07/2023]
Abstract
The conventional paradigm of nonalcoholic fatty liver disease representing the "hepatic manifestation of the metabolic syndrome" is outdated. We identified and summarized longitudinal studies that, supporting the association of nonalcoholic fatty liver disease with either type 2 diabetes mellitus or metabolic syndrome, suggest that nonalcoholic fatty liver disease precedes the development of both conditions. Online Medical databases were searched, relevant articles were identified, their references were further assessed and tabulated data were checked. Although several cross-sectional studies linked nonalcoholic fatty liver disease to either diabetes and other components of the metabolic syndrome, we focused on 28 longitudinal studies which provided evidence for nonalcoholic fatty liver disease as a risk factor for the future development of diabetes. Moreover, additional 19 longitudinal reported that nonalcoholic fatty liver disease precedes and is a risk factor for the future development of the metabolic syndrome. Finally, molecular and genetic studies are discussed supporting the view that aetiology of steatosis and lipid intra-hepatocytic compartmentation are a major determinant of whether fatty liver is/is not associated with insulin resistance and metabolic syndrome. Data support the novel paradigm of nonalcoholic fatty liver disease as a strong determinant for the development of the metabolic syndrome, which has potentially relevant clinical implications for diagnosing, preventing and treating metabolic syndrome.
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Affiliation(s)
- Amedeo Lonardo
- AUSL Modena and University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Division of Internal Medicine, NOCSAE - Baggiovara, Modena, Italy.
| | - Stefano Ballestri
- AUSL Modena, Department of Internal Medicine, Division of Internal Medicine, Hospital of Pavullo, Pavullo nel Frignano, Italy
| | - Giulio Marchesini
- "Alma Mater Studiorum" University, Unit of Metabolic Diseases and Clinical Dietetics, Bologna, Italy
| | - Paul Angulo
- University of Kentucky, Division of Digestive Diseases & Nutrition, Section of Hepatology, Medical Center, Lexington, KY, USA
| | - Paola Loria
- AUSL Modena and University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Division of Internal Medicine, NOCSAE - Baggiovara, Modena, Italy
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Diabetes and Heart Disease. Coron Artery Dis 2015. [DOI: 10.1007/978-1-4471-2828-1_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2014; 131:e29-322. [PMID: 25520374 DOI: 10.1161/cir.0000000000000152] [Citation(s) in RCA: 4464] [Impact Index Per Article: 446.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Esteghamati A, Hafezi-Nejad N, Zandieh A, Sheikhbahaei S, Ebadi M, Nakhjavani M. Homocysteine and metabolic syndrome: From clustering to additional utility in prediction of coronary heart disease. J Cardiol 2014; 64:290-6. [DOI: 10.1016/j.jjcc.2014.02.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 01/08/2014] [Accepted: 02/03/2014] [Indexed: 11/17/2022]
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Zuliani G, Morieri ML, Volpato S, Maggio M, Cherubini A, Francesconi D, Bandinelli S, Paolisso G, Guralnik JM, Ferrucci L. Insulin resistance and systemic inflammation, but not metabolic syndrome phenotype, predict 9 years mortality in older adults. Atherosclerosis 2014; 235:538-45. [PMID: 24956526 PMCID: PMC4156965 DOI: 10.1016/j.atherosclerosis.2014.05.959] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 05/28/2014] [Accepted: 05/29/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although metabolic syndrome (MS) is a typical condition of middle-aged/older person, the association between MS and mortality risk has not been confirmed in people over 65 years. We hypothesized that while in the elderly MS phenotype might lose its value in predicting mortality risk, the two core factors of MS, i.e. insulin resistance (IR) and low grade systemic inflammation (LGSI) would not. METHODS 1011 community-dwelling older individuals (InCHIANTI study) were included. MS phenotype was defined by NCEP-ATP-III criteria. IR was calculated by HOMA; high-sensitivity C reactive protein was measured by ELISA. Subjects were divided into four groups based on presence/absence of IR (HOMA ≥ 2.27) and LGSI (hs-CRP ≥ 3 g/L): Group 1: no IR/LGSI (reference); Group 2: LGSI only; Group 3: IR only; Group 4: IR + LGSI. Hazard Ratios (HR) for 9-years cardiovascular (CVD) and total mortality, according to IR/LGSI groups, were estimated in subjects with (n.311) and without MS by Cox model. RESULTS 31.8% of subjects with MS phenotype had no IR, 45.3% had no LGSI; moreover, 51% of subjects with both IR and LGSI didn't display the MS phenotype. MS phenotype was not associated with CVD (HR: 1.29; 95%C.I.:0.92-1.81) or total (HR: 1.07; 95%C.I.:0.86-1.34) mortality risk, whereas the presence of IR plus LGSI was associated with increased CVD (no MS: HR 2.07, 95%CI: 1.12-3.72; MS: HR 9.88, 95%CI: 2.18-4), and overall (no MS: HR 1.72, 95%CI: 1.001-3.17; MS: HR 1.51, 95%CI: 1.02-2.28) mortality risk. The presence of IR (HR: 6.90, 95%CI: 1.45-32) or LGSI (HR 7.56, 95%CI: 1.63-35) was associated with CVD mortality, only among individuals with MS phenotype. CONCLUSIONS Among community-dwelling older individuals, IR and LGSI, but not MS phenotype, was associated with 9-years overall and CVD mortality risk. Since a reduced "overlap" between MS phenotype and its physiopathological core (IR and LGSI) might be present with aging, we suggest that the definition of MS might be more holistic in advanced age, and probably comprise the measurement of IR and LGSI.
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Affiliation(s)
- Giovanni Zuliani
- Department of Medical Sciences, Section of Internal and CardioRespiratory Medicine, University of Ferrara, Italy.
| | - Mario Luca Morieri
- Department of Medical Sciences, Section of Internal and CardioRespiratory Medicine, University of Ferrara, Italy
| | - Stefano Volpato
- Department of Medical Sciences, Section of Internal and CardioRespiratory Medicine, University of Ferrara, Italy
| | - Marcello Maggio
- Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Italy
| | | | - Daniela Francesconi
- Department of Medical Sciences, Section of Internal and CardioRespiratory Medicine, University of Ferrara, Italy
| | - Stefania Bandinelli
- ASF Geriatric Rehabilitation, Florence, Italy; Tuscany Regional Health Agency, I.O.T., Florence, Italy
| | - Giuseppe Paolisso
- Department of Gerontology, Geriatrics and Metabolic Diseases, Second University of Naples, Italy
| | - Jack M Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, NIH, Baltimore, MD, USA
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Added value of different metabolic syndrome definitions for predicting cardiovascular disease and mortality events among elderly population: Tehran Lipid and Glucose Study. Eur J Clin Nutr 2014; 68:853-8. [DOI: 10.1038/ejcn.2014.91] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/18/2014] [Accepted: 03/13/2014] [Indexed: 01/06/2023]
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Gierach M, Gierach J, Ewertowska M, Arndt A, Junik R. Correlation between Body Mass Index and Waist Circumference in Patients with Metabolic Syndrome. ISRN ENDOCRINOLOGY 2014; 2014:514589. [PMID: 24729884 PMCID: PMC3960736 DOI: 10.1155/2014/514589] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/30/2013] [Indexed: 12/18/2022]
Abstract
Metabolic syndrome is defined as a group of coexisting metabolic risk factors, such as central obesity, lipid disorders, carbohydrate disorders, and arterial hypertension. According to the 2005 IDF criteria, subsequently revised in 2009, abdominal obesity is identified as the waist circumference of ≥80 cm in women and ≥94 cm in men. It is responsible for the development of insulin resistance. The aim of our study was to demonstrate a correlation between waist circumference (WC) and body mass index (BMI) in patients with metabolic syndrome in relation with hypertension, lipid disorders, and carbohydrate disorders. A cross-sectional two-site study was conducted in the Kuyavian-Pomeranian Voivodeship for 24 months. The study group consisted of 839 patients with diagnosed metabolic syndrome: 345 men (41.1%) and 494 women (58.9%) aged 32-80. In the study group, WC was found to be significantly correlated with BMI (R = 0.78, P < 0.01). The presence of overweight in men (BMI 25, 84 kg/m(2)) and even normal body weight in women (BMI 21,62 kg/m(2)) corresponds to an increased volume of visceral tissue in the abdomen. Introduction of primary prophylaxis in those people to limit the development of diabetes mellitus type 2 and cardiovascular diseases should be considered.
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Affiliation(s)
- Marcin Gierach
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland ; Internal Ward in District Hospital in Wabrzezno, 87-200 Wabrzezno, Poland
| | - Joanna Gierach
- Internal Ward in District Hospital in Wabrzezno, 87-200 Wabrzezno, Poland
| | - Marlena Ewertowska
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Adam Arndt
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Roman Junik
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
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Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 2014; 129:e28-e292. [PMID: 24352519 PMCID: PMC5408159 DOI: 10.1161/01.cir.0000441139.02102.80] [Citation(s) in RCA: 3534] [Impact Index Per Article: 353.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Combining functional features of whole-grain barley and legumes for dietary reduction of cardiometabolic risk: a randomised cross-over intervention in mature women. Br J Nutr 2013; 111:706-14. [DOI: 10.1017/s000711451300305x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The usefulness of dietary strategies against cardiometabolic risk is increasingly being acknowledged. Legumes and whole grains can modulate risk markers associated with cardiometabolic diseases, but their possible additive/synergistic actions are unknown. The objective of the present study was to assess, in healthy subjects, the effect of a diet including specific whole-grain barley products and legumes with prior favourable outcomes on cardiometabolic risk parameters in semi-acute studies. A total of forty-six overweight women (50–72 years, BMI 25–33 kg/m2and normal fasting glycaemia) participated in a randomised cross-over intervention comparing a diet rich in kernel-based barley products, brown beans and chickpeas (D1, diet 1 (functional diet)) with a control diet (D2, diet 2 (control diet)) of similar macronutrient composition but lacking legumes and barley. D1 included 86 g (as eaten)/d brown beans, 82 g/d chickpeas, 58 g/d whole-grain barley kernels and 216 g/d barley kernel bread. Both diets followed the Nordic Nutrition Recommendations, providing similar amounts of dietary fibre (D1: 46·9 g/d; D2: 43·5 g/d), with wheat-based products as the main fibre supplier in D2. Each diet was consumed for 4 weeks under weight-maintenance conditions. Both diets decreased serum total cholesterol, LDL-cholesterol and HDL-cholesterol levels, but D1 had a greater effect on total cholesterol and LDL-cholesterol levels (P< 0·001 andP< 0·05, respectively). D1 also reduced apoB (P< 0·001) and γ-glutamyl transferase (P< 0·05) levels, diastolic blood pressure (P< 0·05) and the Framingham cardiovascular risk estimate (P< 0·05). D1 increased colonic fermentative activity, as judged from the higher (P< 0·001) breath hydrogen levels recorded. In conclusion, a specific barley/legume diet improves cardiometabolic risk-associated biomarkers in a healthy cohort, showing potential preventive value beyond that of a nutritionally well-designed regimen.
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Kim CS, Choi JS, Bae EH, Ma SK, Ahn YK, Jeong MH, Kim YJ, Cho MC, Kim CJ, Kim SW. Association of metabolic syndrome and renal insufficiency with clinical outcome in acute myocardial infarction. Metabolism 2013; 62:669-76. [PMID: 23218489 DOI: 10.1016/j.metabol.2012.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/07/2012] [Accepted: 11/07/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Metabolic syndrome (MetS) is an independent risk factor for chronic kidney and cardiovascular diseases. However, few studies have examined the combined effects of MetS and renal insufficiency after acute myocardial infarction (AMI). We examined the effect of MetS on clinical outcomes in patients with AMI in the presence or absence of renal insufficiency. METHODS From November 2005 to September 2008, 11,462 patients with AMI were enrolled in the prospective Korean Acute Myocardial Infarction Registry. Participants were analyzed according to the presence or absence of MetS and renal insufficiency, defined by a low estimated glomerular filtration rate (eGFR). The primary endpoints were major adverse cardiac events (MACE), including a composite of all cause-of-death, myocardial infarction, target lesion revascularization, and coronary artery bypass graft during the 1-year follow-up period. RESULTS The prevalence of MetS was higher in AMI patients with low eGFR. In-hospital death and composite MACE were significantly higher in patients with MetS than in those without MetS in the presence of renal insufficiency. Multivariate analysis showed that old age, multi-vessel involvement, high levels of inflammation, diabetes and MetS were associated with 1-year composite MACE in patients with renal insufficiency. After adjusting for multiple covariates, the 1-year mortality rate was higher in patients with both MetS and renal insufficiency than in those with MetS without renal insufficiency or in individuals without MetS. CONCLUSION MetS is associated with poor clinical outcomes and it increases the mortality in patients with AMI, especially in association with renal insufficiency.
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Affiliation(s)
- Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Panayiotou AG, Griffin M, Kouis P, Tyllis T, Georgiou N, Bond D, Nicolaides AN. Association between presence of the metabolic syndrome and its components with carotid intima-media thickness and carotid and femoral plaque area: a population study. Diabetol Metab Syndr 2013; 5:44. [PMID: 23962225 PMCID: PMC3765162 DOI: 10.1186/1758-5996-5-44] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/08/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We aimed to explore the association between presence and number of components of the Metabolic Syndrome (MetS) and subclinical atherosclerosis outcomes (common carotid intima media thickness, plaque presence and sum of plaque area) in both the carotid and femoral bifurcations. METHODS Cross-sectional analysis of 771 volunteers from the ongoing epidemiological Cyprus Study (46% male; mean age = 60.1 ± 9.8). (a) Carotid intima-media thickness (IMTcc), (b) sum of plaque area in the carotid bifurcations (sum of the largest plaques in each carotid bifurcation-SPAcar), (c) sum of plaque area in the femoral bifurcations (sum of the largest plaques in each femoral bifurcation-SPAfem) and (d) sum of plaque area in both carotid and femoral bifurcations (sum of the areas of the largest plaques present in each of the four bifurcations-SPA) were measured at baseline using ultrasound. Presence and number of components of the MetS was ascertained using the National Cholesterol Education Program ATPIII definition and their association tested using multivariable regression models. RESULTS MetS was present in 259 (33.6%) individuals and was associated with a 0.02 mm increase in IMTcc (95% CI: 0.00 to 0.04, p = 0.047) after adjustment for age, sex, family history of CVD, alcohol consumption (BU/week) and smoking (pack-years). Each additional component of the MetS was associated with a 16% higher SPA (95% CI: 6.8% to 25.2%, pfor trend = 0.001), a 10% higher SPAcar (95% CI: 5% to 24%, pfor trend = 0.003) and a 14% higher SPAfem in the adjusted model. CONCLUSIONS We confirm an association between the MetS and IMTcc as well as report for the first time an association between the MetS and its components and femoral plaque area, in a general population over 40 years of age. Having any risk factors for the MetS increases the risk for subclinical atherosclerosis, with the risk increasing with each additional component. Using the dichotomous definition of the MetS may be overlooking the risk for subclinical atherosclerosis -and by inference future cardiovascular events- associated with having less than 3 risk factors.
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Affiliation(s)
- Andrie G Panayiotou
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, P.O. Box: 50329, Limassol, Cyprus
- The Cyprus Cardiovascular Disease Educational and Research Trust, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Maura Griffin
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
| | - Panayiotis Kouis
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, P.O. Box: 50329, Limassol, Cyprus
| | - Theodosis Tyllis
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Niki Georgiou
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Dawn Bond
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
| | - Andrew N Nicolaides
- The Cyprus Cardiovascular Disease Educational and Research Trust, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
- Department of Vascular Surgery, Imperial College, London SW72BX, UK
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