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Huang X, Hui H, Zhu W, Chen N, Wei Y, Wang Z, Shi J. Effect of the interaction between alcohol and meat consumption on the hyperlipidaemia risk among elderly individuals: Evidence from Shanghai, China. Front Nutr 2022; 9:982626. [PMID: 36324622 PMCID: PMC9618893 DOI: 10.3389/fnut.2022.982626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022] Open
Abstract
Background Diet and other lifestyle habits may have an increased effect on blood lipids in older people. This study aimed to examine the associations between diet (meat, fish, and egg), alcohol consumption and blood lipids. Methods Surveillance data on chronic diseases and their risk factors were collected from Shanghai during 2017–2018. A Kish table was used for sampling 438 older adults, of whom 71 consumed alcohol. Logistic regression was used to test the relationships between diet, alcohol consumption and blood lipid levels in elderly individuals, and the marginal effects (MEs) were estimated. Results Dyslipidaemia was more common among drinkers than among nondrinkers (P < 0.01). Alcohol consumption was associated with dyslipidaemia (OR = 2.667, P < 0.01 for TC; OR = 1.919, P < 0.05 for LDL; OR = 3.412, P < 0.01 for TG), and consumption of more than 50 g of meat per day showed similar associations (OR = 3.227, P < 0.01 for TC; OR = 3.263, P < 0.01, for LDL; OR = 2.329, P < 0.01 for TG). The MEs of alcohol drinking and excessive meat consumption on the rate of dyslipidaemia were 0.324 for TC (P < 0.01), 0.255 for LDL (P < 0.05), and 0.174 for TG (P < 0.01). Discussion The risk of hyperlipidaemia was increased among elderly individuals with excessive meat and alcohol consumption, which also had an interactive effect.
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Affiliation(s)
- Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Hong Hui
- General Department, Shanghai Baoshan District Gucun Town Community Health Service Center, Shanghai, China
| | - Wenqing Zhu
- Executive Office, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Wei
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Yan Wei
| | - Zhaoxin Wang
- Health Management Center, First Affiliated Hospital of Hainan Medical University, Hainan, China
- School of Management, Hainan Medical University, Hainan, China
- Zhaoxin Wang
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Jianwei Shi
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2
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Dritsas E, Trigka M. Machine Learning Methods for Hypercholesterolemia Long-Term Risk Prediction. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22145365. [PMID: 35891045 PMCID: PMC9322993 DOI: 10.3390/s22145365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 06/12/2023]
Abstract
Cholesterol is a waxy substance found in blood lipids. Its role in the human body is helpful in the process of producing new cells as long as it is at a healthy level. When cholesterol exceeds the permissible limits, it works the opposite, causing serious heart health problems. When a person has high cholesterol (hypercholesterolemia), the blood vessels are blocked by fats, and thus, circulation through the arteries becomes difficult. The heart does not receive the oxygen it needs, and the risk of heart attack increases. Nowadays, machine learning (ML) has gained special interest from physicians, medical centers and healthcare providers due to its key capabilities in health-related issues, such as risk prediction, prognosis, treatment and management of various conditions. In this article, a supervised ML methodology is outlined whose main objective is to create risk prediction tools with high efficiency for hypercholesterolemia occurrence. Specifically, a data understanding analysis is conducted to explore the features association and importance to hypercholesterolemia. These factors are utilized to train and test several ML models to find the most efficient for our purpose. For the evaluation of the ML models, precision, recall, accuracy, F-measure, and AUC metrics have been taken into consideration. The derived results highlighted Soft Voting with Rotation and Random Forest trees as base models, which achieved better performance in comparison to the other models with an AUC of 94.5%, precision of 92%, recall of 91.8%, F-measure of 91.7% and an accuracy equal to 91.75%.
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3
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Nowak-Lis A, Nowak Z, Gabrys T, Szmatlan-Gabrys U, Batalik L, Knappova V. The Use of Vibration Training in Men after Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063326. [PMID: 35329010 PMCID: PMC8951545 DOI: 10.3390/ijerph19063326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 02/07/2023]
Abstract
The aim of the study was to evaluate the effects of the applied whole-body vibration training (WBV) as additional training to standard rehabilitation programme on exercise tolerance, evaluated through an exercise test, blood lipid profile, and the changes in selected echocardiographic parameters of patients after myocardial infarction. The study involved 63 males. The subjects were divided into two groups: standard—ST (27) and with vibration training—ST + WBV (36). All the subjects had undergone angioplasty with stent implantation. The standard and with vibration training group carried out a 24-day improvement program comprising 22 training units. Each session consisted of endurance, general stamina, and resistance training. Instead of resistance training, the experimental group performed exercises on the vibration platform. Statistically significant changes in both groups were observed in the parameters of the echocardiographic exercise test, such as test duration (p < 0.001), distance covered (p < 0.001), MET (p < 0.001), VO2max (p < 0.001), and HRrest (p < 0.01). The echocardiographic test revealed significant improvement of Left Ventricular Ejection Fraction in both groups (ST + WBV group p = 0.024, ST group p = 0.005). There were no statistically significant changes in blood lipid profile and body mass and composition.
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Affiliation(s)
- Agata Nowak-Lis
- Department of Physiotherapy, Jerzy Kukuczka’s Academy of Physical Education, 40-065 Katowice, Poland;
- Correspondence: ; Tel.: +48-501-773-925
| | - Zbigniew Nowak
- Department of Physiotherapy, Jerzy Kukuczka’s Academy of Physical Education, 40-065 Katowice, Poland;
| | - Tomasz Gabrys
- Department of Physical Education and Sport Science, Faculty of Pedagogy, University of West Bohemia, 30100 Pilsen, Czech Republic; (T.G.); (V.K.)
| | - Urszula Szmatlan-Gabrys
- Department Anathomy, Faculty of Rehabilitation, University of Physical Education, 31-571 Krakow, Poland;
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic;
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Vera Knappova
- Department of Physical Education and Sport Science, Faculty of Pedagogy, University of West Bohemia, 30100 Pilsen, Czech Republic; (T.G.); (V.K.)
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Varga TV, Xu T, Kivimäki M, Mehta AJ, Rugulies R, Rod NH. Organizational Justice and Long-term Metabolic Trajectories: A 25-Year Follow-up of the Whitehall II Cohort. J Clin Endocrinol Metab 2022; 107:398-409. [PMID: 34596687 PMCID: PMC8764354 DOI: 10.1210/clinem/dgab704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Indexed: 12/24/2022]
Abstract
CONTEXT Organizational justice has been linked to lower risk of several chronic conditions among employees, but less is known about the long-term mechanisms underlying this risk reduction. OBJECTIVE To assess whether self-reported organizational justice is associated with individual and composite long-term metabolic trajectories. DESIGN Twenty-five-year follow-up of the Whitehall II prospective cohort study. SETTING Middle-aged public servants from the United Kingdom. PARTICIPANTS Data on 8182 participants were used. MAIN OUTCOME MEASURES Levels of 11 anthropometric, glycemic, lipid, and blood pressure biomarkers were measured at 5 timepoints (1991-2013). We used generalized estimating equations and group-based trajectory modeling to investigate the relationship between organizational justice and biomarker trajectories. RESULTS High vs low organizational justice were associated with lower waist (-1.7 cm) and hip (-1 cm) circumference, body mass index (-0.6 kg/m2), triglycerides (-1.07 mmol/L), and fasting insulin (-1.08 µIU/mL) trajectories. Two latent metabolic trajectory clusters were identified: a high- and a low-risk cluster. High organizational justice (vs low) were associated with belonging to the low-risk cluster (pooled odds ratio = 1.47). The low-risk cluster demonstrated lower baseline levels of most biomarkers and better glycemic control, whereas the high-risk cluster showed higher baseline levels of most biomarkers, glycemic deterioration, but also greater improvements in lipid levels over time. CONCLUSIONS People with high organizational justice had more favorable long-term cardiometabolic biomarker patterns than those with low organizational justice, indicating a potential mechanism contributing to the lower risk of chronic diseases in the first group. Further intervention studies are warranted to determine whether improvement of organizational justice might improve long-term health.
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Affiliation(s)
- Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tianwei Xu
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Reiner Rugulies
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Gloc D, Nowak Z, Nowak-Lis A, Gabryś T, Szmatlan-Gabrys U, Valach P, Pilis A. Indoor cycling training in rehabilitation of patients after myocardial infarction. BMC Sports Sci Med Rehabil 2021; 13:151. [PMID: 34844646 PMCID: PMC8628460 DOI: 10.1186/s13102-021-00379-w] [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] [Received: 05/07/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Standard endurance training used from the second stage of cardiac rehabilitation has many common features with indoor cycling training which is used in fitness clubs. In the study, an attempt was made to evaluate the usefulness of this form of training in a 24-day rehabilitation program for patients after myocardial infarction. The study examined a group of 64 patients (51.34 ± 8.02 years) who were divided into two groups: the IC group (32 patients aged 53.40 ± 4.31 years) with indoor cycling training instead of standard endurance training; and the ST group (32 patients aged 55.31 ± 6.45 years) performing standard training. The level of exercise tolerance (cardiopulmonary exercise testing on a treadmill-Bruce's protocol), hemodynamic indicators of the left ventricle (echocardiography) and blood lipid profile (laboratory test) were assessed. RESULTS In the IC group there was a significant increase in the test duration (9.21 ± 2.02 vs 11.24 ± 1.26 min; p < 0.001), the MET value (9.16 ± 1.30 vs 10.73 ± 1.23; p = 0.006) and VO2max (37.27 ± 3.23 vs 39.10 ± 3.17 ml/kg/min; p < 0.001). Parallel changes were observed in the ST group, where the following parameters improved: the test duration (9.41 ± 0.39 vs 10.91 ± 2.22; p < 0.001), MET value (8.65 ± 0.25 vs 9.86 ± 1.12; p = 0.002) and VO2max (36.89 ± 6.22 vs 38.76 ± 3.44; p < 0.001). No statistically significant changes were found in the hemodynamic indices of the left ventricle and the lipid profile. Also, the intergroup analysis did not show any statistical significance. CONCLUSION Based on the research results, it was found that indoor cycling training in the second phase of cardiac rehabilitation is a safe form of therapy and therefore may be an interesting alternative method to the classic bicycle ergometer exercise in the stage of early cardiac rehabilitation.
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Affiliation(s)
- Dagmara Gloc
- Silesian Center for Rehabilitation and Prevention, 43-450 Ustron, Poland
| | - Zbigniew Nowak
- Department of Physiotherapy, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Agata Nowak-Lis
- Department of Physiotherapy, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Tomasz Gabryś
- Sport Centrum Faculty of Pedagogy, University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - Urszula Szmatlan-Gabrys
- Department of Anatomy, Faculty of Rehabilitation, University of Physical Education, 31-571 Kraków, Poland
| | - Peter Valach
- Sport Centrum Faculty of Pedagogy, University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - Anna Pilis
- Faculty of Health Science, Jan Dlugosz University, 42-200 Czestochowa, Poland
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Knittle K, Charman SJ, O'Connell S, Avery L, Catt M, Sniehotta FF, Trenell MI. Movement as medicine for cardiovascular disease prevention: A pilot feasibility study of a physical activity promotion intervention for at-risk patients in primary care (Preprint). JMIR Cardio 2021; 6:e29035. [PMID: 35767316 PMCID: PMC9280491 DOI: 10.2196/29035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 12/08/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration
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Affiliation(s)
- Keegan Knittle
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sarah J Charman
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sophie O'Connell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom
| | - Leah Avery
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- School of Health & Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Michael Catt
- National Innovation Centre for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Falko F Sniehotta
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael I Trenell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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7
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Vasankari V, Halonen J, Vasankari T, Anttila V, Airaksinen J, Sievänen H, Hartikainen J. Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review. Am J Prev Cardiol 2021; 5:100146. [PMID: 34327489 PMCID: PMC8315618 DOI: 10.1016/j.ajpc.2021.100146] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/05/2020] [Accepted: 01/06/2021] [Indexed: 12/13/2022] Open
Abstract
Comprehensive management of coronary artery disease (CAD) includes physical exercise as a part of daily lifestyle therapy. Still CAD patients generally have low physical activity (PA) and high sedentary behaviour (SB). This review summarizes the effect of exercise training and habitual PA and SB on physical fitness and quality of life (QoL) as well as on rehospitalizations and mortality in patients with stable CAD, recent acute coronary syndrome (ACS) or recent revascularization. A literature review of the influence of exercise, and PA and SB profiles in secondary prevention of CAD was performed using PubMed. All articles published between January 2001 and April 2019, meeting the inclusion criteria were considered. A total of 25 cross-sectional or prospective studies or randomized controlled trials (RCT) were included to this review. Exercise training was found to improve maximal oxygen consumption, QoL, and to reduce rehospitalizations and mortality among patients with established CAD. Remote PA interventions have not been as effective as the supervised exercise sessions in reducing the clinical endpoints. High SB, especially when combined to low PA, is associated with poor cardiorespiratory fitness and worse long-term prognosis among patients with ACS. In conclusion, exercise training and high PA are beneficial for patients with stable CAD, recent ACS or recent revascularization. High SB is associated with poor cardiopulmonary fitness and increased mortality in ACS patients. Novel tools using online applications and smart devices are promising means to offer remote guidance for PA among patients unable to participate in regular exercise sessions.
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Affiliation(s)
- Ville Vasankari
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland (UEF), Finland
- Corresponding author. Heart Center, Kuopio University Hospital, PO box 100, 70029, KYS, Finland.
| | - Jari Halonen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland (UEF), Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Vesa Anttila
- Heart Center, Turku University Hospital (TUH), Turku, Finland
| | | | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Juha Hartikainen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland (UEF), Finland
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Wagner R, Heni M, Tabák AG, Machann J, Schick F, Randrianarisoa E, Hrabě de Angelis M, Birkenfeld AL, Stefan N, Peter A, Häring HU, Fritsche A. Pathophysiology-based subphenotyping of individuals at elevated risk for type 2 diabetes. Nat Med 2021; 27:49-57. [PMID: 33398163 DOI: 10.1038/s41591-020-1116-9] [Citation(s) in RCA: 152] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/01/2020] [Indexed: 12/13/2022]
Abstract
The state of intermediate hyperglycemia is indicative of elevated risk of developing type 2 diabetes1. However, the current definition of prediabetes neither reflects subphenotypes of pathophysiology of type 2 diabetes nor is predictive of future metabolic trajectories. We used partitioning on variables derived from oral glucose tolerance tests, MRI-measured body fat distribution, liver fat content and genetic risk in a cohort of extensively phenotyped individuals who are at increased risk for type 2 diabetes2,3 to identify six distinct clusters of subphenotypes. Three of the identified subphenotypes have increased glycemia (clusters 3, 5 and 6), but only individuals in clusters 5 and 3 have imminent diabetes risks. By contrast, those in cluster 6 have moderate risk of type 2 diabetes, but an increased risk of kidney disease and all-cause mortality. Findings were replicated in an independent cohort using simple anthropomorphic and glycemic constructs4. This proof-of-concept study demonstrates that pathophysiological heterogeneity exists before diagnosis of type 2 diabetes and highlights a group of individuals who have an increased risk of complications without rapid progression to overt type 2 diabetes.
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Affiliation(s)
- Robert Wagner
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tübingen, Tübingen, Germany.
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tübingen, Tübingen, Germany
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Adam G Tabák
- Department of Epidemiology and Public Health, University College London, London, UK
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Budapest, Hungary
- Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- University Department of Radiology, Section on Experimental Radiology, Eberhard-Karls University Tübingen, Tübingen, Germany
| | - Fritz Schick
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- University Department of Radiology, Section on Experimental Radiology, Eberhard-Karls University Tübingen, Tübingen, Germany
| | - Elko Randrianarisoa
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Martin Hrabě de Angelis
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Institute of Experimental Genetics and German Mouse Clinic, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Experimental Genetics, TUM School of Life Sciences (SoLS), Technische Universität München, Freising, Germany
| | - Andreas L Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tübingen, Tübingen, Germany
| | - Norbert Stefan
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tübingen, Tübingen, Germany
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Andreas Peter
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tübingen, Tübingen, Germany
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Polygenic Markers in Patients Diagnosed of Autosomal Dominant Hypercholesterolemia in Catalonia: Distribution of Weighted LDL-c-Raising SNP Scores and Refinement of Variant Selection. Biomedicines 2020; 8:biomedicines8090353. [PMID: 32942679 PMCID: PMC7554998 DOI: 10.3390/biomedicines8090353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022] Open
Abstract
Familial hypercholesterolemia (FH) is associated with mutations in the low-density lipoprotein (LDL) receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin 9 (PCSK9) genes. A pathological variant has not been identified in 30-70% of clinically diagnosed FH patients, and a burden of LDL cholesterol (LDL-c)-raising alleles has been hypothesized as a potential cause of hypercholesterolemia in these patients. Our aim was to study the distribution of weighted LDL-c-raising single-nucleotide polymorphism (SNP) scores (weighted gene scores or wGS) in a population recruited in a clinical setting in Catalonia. The study included 670 consecutive patients with a clinical diagnosis of FH and a prior genetic study involving 250 mutation-positive (FH/M+) and 420 mutation-negative (FH/M-) patients. Three wGSs based on LDL-c-raising variants were calculated to evaluate their distribution among FH patients and compared with 503 European samples from the 1000 Genomes Project. The FH/M- patients had significantly higher wGSs than the FH/M+ and control populations, with sensitivities ranging from 42% to 47%. A wGS based only on the SNPs significantly associated with FH (wGS8) showed a higher area under the receiver operating characteristic curve, and higher diagnostic specificity and sensitivity, with 46.4% of the subjects in the top quartile. wGS8 would allow for the assignment of a genetic cause to 66.4% of the patients if those with polygenic FH are added to the 37.3% of patients with monogenic FH. Our data indicate that a score based on 8 SNPs and the75th percentile cutoff point may identify patients with polygenic FH in Catalonia, although with limited diagnostic sensitivity and specificity.
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10
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Yerramalla MS, Fayosse A, Dugravot A, Tabak AG, Kivimäki M, Singh-Manoux A, Sabia S. Association of moderate and vigorous physical activity with incidence of type 2 diabetes and subsequent mortality: 27 year follow-up of the Whitehall II study. Diabetologia 2020; 63:537-548. [PMID: 31792574 PMCID: PMC6997261 DOI: 10.1007/s00125-019-05050-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
AIMS/HYPOTHESIS This work examined the role of physical activity in the course of diabetes using data spanning nearly three decades. Our first aim was to examine the long-term association of moderate and vigorous physical activity with incidence of type 2 diabetes. Our second aim was to investigate the association of moderate-to-vigorous physical activity post-diabetes diagnosis with subsequent risk of all-cause and cardiovascular disease mortality. METHODS A total of 9987 participants from the Whitehall II cohort study free of type 2 diabetes at baseline (1985-1988) were followed for incidence of type 2 diabetes, based on clinical assessments between 1985 and 2016 and linkage to electronic health records up to 31 March 2017. We first examined the association of moderate and vigorous physical activity measured by questionnaire in 1985-1988 (mean age 44.9 [SD 6.0] years; women, 32.7%) with incident type 2 diabetes, using the interval-censored, illness-death model, a competing risk analysis that takes into account both competing risk of death and intermittent ascertainment of diabetes due to reliance on data collection cycles (interval-censored). The second analysis was based on individuals with type 2 diabetes over the follow-up period where we used Cox regression with inverse probability weighting to examine the association of moderate-to-vigorous physical activity after diagnosis of type 2 diabetes with risk of all-cause and cardiovascular disease mortality. RESULTS Of the 9987 participants, 1553 developed type 2 diabetes during a mean follow-up of 27.1 (SD 6.3) years. Compared with participants who were inactive in 1985-1988, those who undertook any duration of moderate-to-vigorous physical activity had a lower risk of type 2 diabetes (HR 0.85 [95% CI 0.75, 0.97], p = 0.02; analysis adjusted for sociodemographic, behavioural and health-related factors). In 1026 participants with a diagnosis of type 2 diabetes over the follow-up period, data on moderate-to-vigorous physical activity after diabetes diagnosis were available; 165 all-cause deaths and 55 cardiovascular disease-related deaths were recorded during a mean follow-up of 8.8 (SD 6.1) years. In these participants with diabetes, any duration of moderate-to-vigorous physical activity was associated with lower all-cause mortality (HR 0.61 [95% CI 0.41, 0.93], p = 0.02) while the association with cardiovascular mortality was evident only for physical activity undertaken at or above recommendations (≥2.5 h per week of moderate-to-vigorous physical activity or ≥1.25 h per week of vigorous physical activity; HR 0.40 [95% CI 0.16, 0.96], p = 0.04) in fully adjusted models. CONCLUSIONS/INTERPRETATION Moderate-to-vigorous physical activity plays an important role in diabetes, influencing both its incidence and prognosis. A protective effect on incidence was seen for durations of activity below recommendations and a marginal additional benefit was observed at higher durations. Among individuals with type 2 diabetes, any duration of moderate-to-vigorous physical activity was associated with reduced all-cause mortality while recommended durations of physical activity were required for protection against cardiovascular disease-related mortality. DATA AVAILABILITY Whitehall II data, protocols and other metadata are available to the scientific community. Please refer to the Whitehall II data sharing policy at https://www.ucl.ac.uk/epidemiology-health-care/research/epidemiology-and-public-health/research/whitehall-ii/data-sharing.
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Affiliation(s)
- Manasa S Yerramalla
- Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, 75010, Paris, France
| | - Aurore Fayosse
- Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, 75010, Paris, France
| | - Aline Dugravot
- Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, 75010, Paris, France
| | - Adam G Tabak
- Department of Epidemiology and Public Health, University College London, London, UK
- 1st Department of Medicine, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, 75010, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Séverine Sabia
- Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, 75010, Paris, France.
- Department of Epidemiology and Public Health, University College London, London, UK.
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Baik I. Dietary and modifiable factors contributing to hyper-LDL-cholesterolemia prevalence in nationwide time series data and the implications for primary prevention strategies. Nutr Res Pract 2020; 14:62-69. [PMID: 32042375 PMCID: PMC6997138 DOI: 10.4162/nrp.2020.14.1.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/13/2019] [Accepted: 11/14/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND/OBJECTIVES A number of studies examined secular trends in blood lipid profiles using time series data of national surveys whereas few studies investigated individual-level factors contributing to such trends. The present study aimed to examine secular trends in dietary and modifiable factors and hyper-LDL-cholesterolemia (HC) prevalence and evaluate their associations using time series data of nationwide surveys. SUBJECTS/METHODS The study included 41,073 Korean adults aged ≥ 30 years from the 2005, 2007–2009, 2010–2012, 2013–2015, and 2016 Korea National Health and Nutrition Examination Surveys. Stepwise logistic regression analysis was performed to select significant factors associated with HC, which was defined as serum LDL cholesterol levels ≥130 mg/dL. RESULTS The following factors showed a positive association with HC (P < 0.05): for men having higher body mass index (BMI), being married, having an office job, and consuming higher dairy and vegetable oil products; for women having higher age or BMI, having no job or a non-office job, not in a low-income household, and consuming higher dairy products. In the given model, the 2016 survey data showed that a 2 kg/m2 reduction in BMI of obese persons resulted in a decreased HC prevalence from 30.8% to 29.3% among men and from 33.6% to 32.5% among women. CONCLUSIONS Based on these findings, it is suggested that primary prevention programs should advocate having proper BMI for Korean adults with a high-risk of HC. However, whether discouraging consumption of dairy and vegetable oil products can reduce HC prevalence warrants further studies with a prospective longitudinal design.
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Affiliation(s)
- Inkyung Baik
- Department of Foods and Nutrition, College of Science and Technology, Kookmin University, 77, Jeongnung-ro, Seongbuk-gu, Seoul 02707, Korea
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Johnson W, Bell JA, Robson E, Norris T, Kivimäki M, Hamer M. Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study. Int J Obes (Lond) 2019; 43:1578-1589. [PMID: 30108269 PMCID: PMC6268092 DOI: 10.1038/s41366-018-0192-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To describe 20-year risk factor trajectories according to initial weight/health status and investigate the extent to which baseline differences explain greater mortality among metabolically healthy obese (MHO) individuals than healthy non-obese individuals. METHODS The sample comprised 6529 participants in the Whitehall II study who were measured serially between 1991-1994 and 2012-2013. Baseline weight (non-obese or obese; body mass index (BMI) ≥30 kg/m2) and health status (healthy or unhealthy; two or more of hypertension, low high-density lipoprotein cholesterol (HDL-C), high triglycerides, high glucose, and high homeostatic model assessment of insulin resistance (HOMA-IR)) were defined. The relationships of baseline weight/health status with 20-year trajectories summarizing ~25,000 observations of systolic and diastolic blood pressures, HDL-C, triglycerides, glucose, and HOMA-IR were investigated using multilevel models. Relationships of baseline weight/health status with all-cause mortality up until July 2015 were investigated using Cox proportional hazards regression. RESULTS Trajectories tended to be consistently worse for the MHO group compared to the healthy non-obese group (e.g., glucose by 0.21 (95% CI 0.09, 0.33; p < 0.001) mmol/L at 20-years of follow-up). Consequently, the MHO group had a greater risk of mortality (hazard ratio 2.11 (1.24, 3.58; p = 0.006)) when the referent group comprised a random sample of healthy non-obese individuals. This estimate, however, attenuated (1.34 (0.85, 2.13; p = 0.209)) when the referent group was matched to the MHO group on baseline risk factors. CONCLUSIONS Worse baseline risk factors may explain any difference in mortality risk between obese and non-obese groups both labelled as healthy, further challenging the concept of MHO.
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Affiliation(s)
- William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Ellie Robson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tom Norris
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mark Hamer
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Omar A, Husain MN, Jamil AT, Nor NSM, Ambak R, Fazliana M, Zamri NLA, Aris T. Effect of physical activity on fasting blood glucose and lipid profile among low income housewives in the MyBFF@home study. BMC Womens Health 2018; 18:103. [PMID: 30066645 PMCID: PMC6069292 DOI: 10.1186/s12905-018-0598-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Regular physical activity has always been strongly recommended for good cardiovascular health. This study aimed to determine the effect of physical activity on fasting blood glucose and lipid profile among low income housewives in Klang Valley. METHODS Data of 328 eligible housewives who participated in the MyBFF@Home study was used. Intervention group of 169 subjects were provided with an intervention package which includes physical activity (brisk walking, dumbbell exercise, physical activity diary, group exercise) and 159 subjects in control group received various health seminars. Physical activity level was assessed using short-International Physical Activity Questionnaire. The physical activity level was then re-categorized into 4 categories (active intervention, inactive intervention, active control and inactive control). Physical activity, blood glucose and lipid profile were measured at baseline, 3rd month and 6th month of the study. General Linear Model was used to determine the effect of physical activity on glucose and lipid profile. RESULTS At the 6th month, there were 99 subjects in the intervention and 79 control group who had complete data for physical activity. There was no difference on the effect of physical activity on the glucose level and lipid profile except for the Triglycerides level. Both intervention and control groups showed reduction of physical activity level over time. CONCLUSION The effect of physical activity on blood glucose and lipid profile could not be demonstrated possibly due to physical activity in both intervention and control groups showed decreasing trend over time.
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Affiliation(s)
- Azahadi Omar
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Normazlan Husain
- Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Taufik Jamil
- Faculty of Medicine, Universiti Teknologi Mara, UiTM Sg Buloh Campus, Sungai Buloh, Selangor Malaysia
| | - Noor Safiza Mohamad Nor
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rashidah Ambak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mansor Fazliana
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nur Liyana Ahamad Zamri
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Sarkar S, Ellahi B, Zotor F, Amuna P. Decreasing Physical Activity Levels across Religious Sikh Male South Asian Migrant Population in Kent, UK. JOURNAL OF HEALTH MANAGEMENT 2017. [DOI: 10.1177/0972063417727612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S. Sarkar
- School of Science, University of Greenwich at Medway, Chatham, UK
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - B. Ellahi
- Faculty of Health and Social Care, University of Chester, Chester, UK
| | - F.B. Zotor
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- These authors contributed equally to this work
| | - P. Amuna
- Faculty of Engineering and Science, University of Greenwich at Medway, Chatham, UK
- Research Section, Department of clinical Affairs, Primary Health care Corporation, Doha, Qatar
- These authors contributed equally to this work
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15
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Ou SM, Chen YT, Shih CJ, Tarng DC. Impact of physical activity on the association between lipid profiles and mortality among older people. Sci Rep 2017; 7:8399. [PMID: 28827666 PMCID: PMC5567179 DOI: 10.1038/s41598-017-07857-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/03/2017] [Indexed: 12/19/2022] Open
Abstract
High serum lipid levels are independent predictors of mortality risk in the general population. Recent data suggest that this may not apply in the older populations, and even acts in the opposite direction. In consideration of the frail state, minimum amount of physical activity (60–100 minutes each week) may be more suitable for older individuals but its role in lipid profiles has never been explored. Between 2006 and 2010, we conducted a cohort study of 83,820 participants aged ≥65 years using the Taipei City Elderly Health Examination Database. Participants were classified as inactive, low or high in their level of physical activity. Older individuals with lowest quintile of total cholesterol, non-HDL and HDL were associated with increased risk of all-cause mortality compared to those with other quintile of these lipid profiles. Compared to inactive older individuals, both low (adjusted hazard ratios [aHR] 0.75, 95% confidence interval [CI] 0.70–0.81) and high active older individuals (aHR 0.55, 95% CI 0.51–0.59) were associated with lower risks of mortality. Physical activity, even minimum volume of exercise, in older people has to be encouraged to reduce the increased risk of mortality from low serum lipid levels.
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Affiliation(s)
- Shuo-Ming Ou
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Tai Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan
| | - Chia-Jen Shih
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan
| | - Der-Cherng Tarng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan.
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Sabia S, Dugravot A, Dartigues JF, Abell J, Elbaz A, Kivimäki M, Singh-Manoux A. Physical activity, cognitive decline, and risk of dementia: 28 year follow-up of Whitehall II cohort study. BMJ 2017; 357:j2709. [PMID: 28642251 PMCID: PMC5480222 DOI: 10.1136/bmj.j2709] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective To test the hypotheses that physical activity in midlife is not associated with a reduced risk of dementia and that the preclinical phase of dementia is characterised by a decline in physical activity.Design Prospective cohort study with a mean follow-up of 27 years.Setting Civil service departments in London (Whitehall II study).Participants 10 308 participants aged 35-55 years at study inception (1985-88). Exposures included time spent in mild, moderate to vigorous, and total physical activity assessed seven times between 1985 and 2013 and categorised as "recommended" if duration of moderate to vigorous physical activity was 2.5 hours/week or more.Main outcome measures A battery of cognitive tests was administered up to four times from 1997 to 2013, and incident dementia cases (n=329) were identified through linkage to hospital, mental health services, and mortality registers until 2015.Results Mixed effects models showed no association between physical activity and subsequent 15 year cognitive decline. Similarly, Cox regression showed no association between physical activity and risk of dementia over an average 27 year follow-up (hazard ratio in the "recommended" physical activity category 1.00, 95% confidence interval 0.80 to 1.24). For trajectories of hours/week of total, mild, and moderate to vigorous physical activity in people with dementia compared with those without dementia (all others), no differences were observed between 28 and 10 years before diagnosis of dementia. However, physical activity in people with dementia began to decline up to nine years before diagnosis (difference in moderate to vigorous physical activity -0.39 hours/week; P=0.05), and the difference became more pronounced (-1.03 hours/week; P=0.005) at diagnosis.Conclusion This study found no evidence of a neuroprotective effect of physical activity. Previous findings showing a lower risk of dementia in physically active people may be attributable to reverse causation-that is, due to a decline in physical activity levels in the preclinical phase of dementia.
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Affiliation(s)
- Séverine Sabia
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Hôpital Paul Brousse, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Aline Dugravot
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Hôpital Paul Brousse, Paris, France
| | | | - Jessica Abell
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Hôpital Paul Brousse, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Alexis Elbaz
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Hôpital Paul Brousse, Paris, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Hôpital Paul Brousse, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
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Insua A, Monje A, Wang HL, Miron RJ. Basis of bone metabolism around dental implants during osseointegration and peri-implant bone loss. J Biomed Mater Res A 2017; 105:2075-2089. [DOI: 10.1002/jbm.a.36060] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Angel Insua
- Department of Periodontics and Oral Medicine; The University of Michigan; Ann Arbor Michigan
| | - Alberto Monje
- Department of Periodontics and Oral Medicine; The University of Michigan; Ann Arbor Michigan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; The University of Michigan; Ann Arbor Michigan
| | - Richard J. Miron
- Department of Periodontology; Nova Southeastern University; Fort Lauderdale Florida
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18
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Chan T, Dabin B, Hyun K, Ranasinghe I, Neubeck L, Aliprandi-Costa B, Lefkovits J, Devlin G, Juergens C, Chew DP, Brieger D, Freedman SB. Falling cholesterol trend at acute coronary syndrome presentation is strongly related to statin use for secondary prevention. Int J Cardiol 2016; 212:192-7. [DOI: 10.1016/j.ijcard.2016.03.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/27/2016] [Accepted: 03/13/2016] [Indexed: 10/22/2022]
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Patients with dyslipidemia on a self-reported diet have a healthier dietary intake than the general population. The CoLaus study. Clin Nutr ESPEN 2016; 11:e33-e39. [DOI: 10.1016/j.clnesp.2015.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 11/25/2015] [Accepted: 11/28/2015] [Indexed: 11/18/2022]
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Fox KM, Wang L, Gandra SR, Quek RGW, Li L, Baser O. Clinical and economic burden associated with cardiovascular events among patients with hyperlipidemia: a retrospective cohort study. BMC Cardiovasc Disord 2016; 16:13. [PMID: 26769473 PMCID: PMC4714430 DOI: 10.1186/s12872-016-0190-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 01/08/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Annual direct costs for cardiovascular (CV) diseases in the United States are approximately $195.6 billion, with many high-risk patients remaining at risk for major cardiovascular events (CVE). This study evaluated the direct clinical and economic burden associated with new CVE up to 3 years post-event among patients with hyperlipidemia. METHODS Hyperlipidemic patients with a primary inpatient claim for new CVE (myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack, coronary artery bypass graft, percutaneous coronary intervention and heart failure) were identified using IMS LifeLink PharMetrics Plus data from January 1, 2006 through June 30, 2012. Patients were stratified by CV risk into history of CVE, modified coronary heart disease risk equivalent, moderate- and low-risk cohorts. Of the eligible patients, propensity score matched 243,640 patients with or without new CVE were included to compare healthcare resource utilization and direct costs ranging from the acute (1-month) phase through 3 years post-CVE date (follow-up period). RESULTS Myocardial infarction was the most common CVE in all the risk cohorts. During the acute phase, among patients with new CVE, the average incremental inpatient length of stay and incremental costs ranged from 4.4-6.2 days and $25,666-$30,321, respectively. Acute-phase incremental costs accounted for 61-75% of first-year costs, but incremental costs also remained high during years 2 and 3 post-CVE. CONCLUSIONS Among hyperlipidemic patients with new CVE, healthcare utilization and costs incurred were significantly higher than for those without CVE during the acute phase, and remained higher up to 3 years post-event, across all risk cohorts.
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Affiliation(s)
- Kathleen M Fox
- Strategic Healthcare Solutions, LLC, Monkton, MD, USA. .,Strategic Healthcare Solutions, LLC, 133 Cottonwood Creek Lane, Aiken, SC, 29803, USA.
| | - Li Wang
- STATinMED Research, Plano, TX, USA
| | | | | | - Lu Li
- STATinMED Research, Plano, TX, USA
| | - Onur Baser
- Center for Innovation & Outcomes Research, Department of Surgery, Columbia University, New York, NY, USA.,MEF University, Istanbul, Turkey
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Buscot MJ, Magnussen CG, Juonala M, Pitkänen N, Lehtimäki T, Viikari JSA, Kähönen M, Hutri-Kähönen N, Schork NJ, Raitakari OT, Thomson RJ. The Combined Effect of Common Genetic Risk Variants on Circulating Lipoproteins Is Evident in Childhood: A Longitudinal Analysis of the Cardiovascular Risk in Young Finns Study. PLoS One 2016; 11:e0146081. [PMID: 26731281 PMCID: PMC4701181 DOI: 10.1371/journal.pone.0146081] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 12/11/2015] [Indexed: 12/22/2022] Open
Abstract
Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) are modifiable risk factors for cardiovascular disease. Several genetic loci for predisposition to abnormal LDL-C, HDL-C and TG have been identified. However, it remains unclear whether these loci are consistently associated with serum lipid levels at each age or with unique developmental trajectories. Therefore, we assessed the association between genome wide association studies (GWAS) derived polygenic genetic risk scores and LDL-C, HDL-C, and triglyceride trajectories from childhood to adulthood using data available from the 27-year European ‘Cardiovascular Risk in Young Finns’ Study. For 2,442 participants, three weighted genetic risk scores (wGRSs) for HDL-C (38 SNPs), LDL-C (14 SNPs) and triglycerides (24 SNPs) were computed and tested for association with serum lipoprotein levels measured up to 8 times between 1980 and 2011. The categorical analyses revealed no clear divergence of blood lipid trajectories over time between wGRSs categories, with participants in the lower wGRS quartiles tending to have average lipoprotein concentrations 30 to 45% lower than those in the upper-quartile wGRS beginning at age 3 years and continuing through to age 49 years (where the upper-quartile wGRS have 4–7 more risk alleles than the lower wGRS group). Continuous analyses, however, revealed a significant but moderate time-dependent genetic interaction for HDL-C levels, with the association between HDL-C and the continuous HDL-C risk score weakening slightly with age. Conversely, in males, the association between the continuous TG genetic risk score and triglycerides levels tended to be lower in childhood and become more pronounced after the age of 25 years. Although the influence of genetic factors on age-specific lipoprotein values and developmental trajectories is complex, our data show that wGRSs are highly predictive of HDL-C, LDL-C, and triglyceride levels at all ages.
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Affiliation(s)
- Marie-jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- * E-mail:
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
- Murdoch Children Research Institute, Parkville, Australia
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Terho Lehtimäki
- Fimlab Ltd, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Jorma S. A. Viikari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland
| | - Nicholas J. Schork
- Human Biology, The J. Craig Venter Institute, La Jolla, CA, United States of America
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Russell J. Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Song X, Quek RGW, Gandra SR, Cappell KA, Fowler R, Cong Z. Productivity loss and indirect costs associated with cardiovascular events and related clinical procedures. BMC Health Serv Res 2015; 15:245. [PMID: 26104784 PMCID: PMC4478719 DOI: 10.1186/s12913-015-0925-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 06/15/2015] [Indexed: 12/31/2022] Open
Abstract
Background The high acute costs of cardiovascular disease and acute cardiovascular events are well established, particularly in terms of direct medical costs. The costs associated with lost work productivity have been described in a broad sense, but little is known about workplace absenteeism or short term disability costs among high cardiovascular risk patients. The objective of this study was to quantify workplace absenteeism (WA) and short-term disability (STD) hours and costs associated with cardiovascular events and related clinical procedures (CVERP) in United States employees with high cardiovascular risk. Methods Medical, WA and/or STD data from the Truven Health MarketScan® Research Databases were used to select full-time employees aged 18–64 with hyperlipidemia during 2002–2011. Two cohorts (with and without CVERP) were created and screened for medical, drug, WA, and STD eligibility. The CVERP cohort was matched with a non-CVERP cohort using propensity score matching. Work loss hours and indirect costs were calculated for patients with and without CVERP and by CVERP type. Wages were based on the 2013 age-, gender-, and geographic region-adjusted wage rate from the United States Bureau of Labor Statistics. Results A total of 5,808 WA-eligible, 21,006 STD-eligible, and 3,362 combined WA and STD eligible patients with CVERP were well matched to patients without CVERP, creating three cohorts of patients with CVERP and three cohorts of patients without CVERP. Demographics were similar across cohorts (mean age 52.2-53.1 years, male 81.3-86.8 %). During the first month of follow-up, patients with CVERP had more WA/STD-related hours lost compared with patients without CVERP (WA-eligible: 23.4 more hours, STD-eligible: 51.7 more hours, WA and STD-eligible: 56.3 more hours) (p < 0.001). Corresponding costs were $683, $895, and $1,119 higher, respectively (p < 0.001). Differences narrowed with longer follow-up. In the first month and year of follow-up, patients with coronary artery bypass graft experienced the highest WA/STD-related hours lost and costs compared with patients with other CVERP. Conclusions CVERP were associated with substantial work loss and indirect costs. Prevention or reduction of CVERP could result in WA and STD-related cost savings for employers. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-0925-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xue Song
- Truven Health Analytics, Ann Arbor, MI, USA.
| | | | | | | | | | - Ze Cong
- Onyx Pharmaceuticals, Inc., South San Francisco, CA, USA.
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23
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Weeks GR, Fyfe R, Amerena J, George J. Hospital Pharmacist-Led Lipid Clinic for Surgical Patients with Peripheral Vascular Disease at a Regional Australian Hospital. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2015. [DOI: 10.1002/j.2055-2335.2012.tb00124.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - John Amerena
- Geelong Cardiology Research Unit; Deakin University
| | - Johnson George
- Centre for Medicine Use and Safety; Monash University; Parkville Victoria
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24
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Hulmán A, Tabák AG, Nyári TA, Vistisen D, Kivimäki M, Brunner EJ, Witte DR. Effect of secular trends on age-related trajectories of cardiovascular risk factors: the Whitehall II longitudinal study 1985-2009. Int J Epidemiol 2014; 43:866-77. [PMID: 24464190 PMCID: PMC4052135 DOI: 10.1093/ije/dyt279] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort. METHODS Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 308 participants aged from 35 to 80 years over 25 years of follow-up from five clinical examination phases of the Whitehall II study. Changes of body mass index, waist circumference, blood pressure and total and high-density lipoprotein cholesterol distribution characteristics were analysed with quantile regression models in the 57-61 age group. Age-related trajectories of risk factors were assessed by fitting mixed-effects models with adjustment for year of birth to reveal secular trends. RESULTS Average body mass index and waist circumference increased faster with age in women than in men, but the unfavourable secular trend was more marked in men. Distributions showed a fattening of the right tail in each consecutive phase, meaning a stronger increase in higher percentiles. Despite the higher obesity levels in younger birth cohorts, total cholesterol decreased markedly in the 57-61 age group along the entire distribution rather than in higher extremes only. CONCLUSION The past three decades brought strong and heterogeneous changes in cardiovascular risk factor distributions. Secular trends appear to modify age-related trajectories of cardiovascular risk factors, which may be a source of bias in longitudinal analyses.
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Affiliation(s)
- Adam Hulmán
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Adam G Tabák
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, LuxembourgDepartment of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Tibor A Nyári
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Dorte Vistisen
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Mika Kivimäki
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Eric J Brunner
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Daniel R Witte
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
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25
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Royo-Bordonada MÁ, Lobos JM, Brotons C, Villar F, de Pablo C, Armario P, Cortés O, Gil Nuñez A, Lizcano Á, de Santiago A, Sans S. El estado de la prevención cardiovascular en España. Med Clin (Barc) 2014; 142:7-14. [DOI: 10.1016/j.medcli.2012.09.046] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 09/24/2012] [Accepted: 09/27/2012] [Indexed: 11/26/2022]
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26
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Capuano V, Lamaida N, Capuano E, Borrelli MI, Capuano R, Notari E, Iannone AG, Marchese F, Sonderegger M, Capuano E. Trend in prevalence of uncontrolled total serum cholesterol for cardio-cerebro-vascular disease in a mediterranean area, 1988/89-2008/09. World J Cardiol 2013; 5:420-425. [PMID: 24340140 PMCID: PMC3857234 DOI: 10.4330/wjc.v5.i11.420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/17/2013] [Accepted: 10/16/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine trends of uncontrolled total serum cholesterol, treatment and control in a Mediterranean region (Campania).
METHODS: We considered and compared the data collected as part of “Montecorvino Rovella Project” 1988-1989 and cross-sectional data from the two phases of the “VIP Project-Valle dell’Irno Prevenzione”: 1998-1999 (1st phase) and 2008-2009 (2nd phase), in the 35-74-year-old-population.
RESULTS: Data show a reduction of mean cholesterolemia in the last twenty years of 7.3 mg/dL for men and unchanged values for women. In the three surveys the mean values for serum cholesterol are in men: 205.2 ± 47.1 mg/dL (1988/89), 200 ± 38.9 mg/dL (1998/99) and 197.9 ± 40.2 mg/dL (2008/09); in the women: 203.1 ± 42.5 mg/dL (1988/89), 198.9 ± 37.9 mg/dL (1998/99) and 203.3 ± 39.3 mg/dL (2008/09). Prevalence of uncontrolled high cholesterol ≥ 240 mg/dL for men decreased from 20.8% (1988/89) to 14.3% (1998/99) and 13.9% (2008/9), P = 0.002; for women the values decreased from 19.9% (1988/89), to 18.2% (1998/99) and 18.1% (2008/09), P = 0.007. Is statistically increased the number of patients treated and those treated to target.
CONCLUSION: Encouraging increases in awareness, treatment, and control of hypercholesterolemia occurred from 1988 through 2008. Nevertheless, control of hypercholesterolemia remains poor.
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Chen Z, Wang X, Ding Z, Fan P, Ma G. Differences in statin usage and target-goal achievement between departments at the same hospital. PLoS One 2012; 7:e50466. [PMID: 23251371 PMCID: PMC3519451 DOI: 10.1371/journal.pone.0050466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 10/23/2012] [Indexed: 11/21/2022] Open
Abstract
Objective To compare use of statins and target-goal achievement in patients with type 2 diabetes mellitus (T2DM), with or without stable coronary artery disease (CAD), between cardiology and endocrinology departments at a tertiary hospital. Methods A total of 966 patients with T2DM were enrolled, including 553 with stable CAD, from the departments of endocrinology and cardiology. Baseline characteristics, prescription of statins, and target-goal achievement of low-density lipoprotein cholesterol (LDL-C) during a 6-month follow-up period were analyzed. Results There was lower ratio of statin use in patients with T2DM, with or without CAD, in the department of endocrinology than in the department of cardiology (all P<0.05). At the 6-month follow-up, compared to patients with T2DM in the endocrinology department, target-goal achievement among patients with T2DM in the department of cardiology was higher (52.90% vs. 41.46%, P<0.01), indicating a significant improvement among patients in the department of cardiology but not for those in the department of endocrinology when compared to baseline. According to the new Chinese guidelines, the goal attainment rate was higher among patients with T2DM combined with CAD in the department of cardiology than in the department of endocrinology (27.62% vs. 19.05%, P<0.05). However, with regard to ATP III 2004, the goal attainment rate was similar for patients with T2DM combined with CAD in both departments during the 6-month follow-up (9.21% vs. 8.84%, P>0.05), with no apparent improvement compared to baseline. Conclusions There was differential and sub-optimal use of statins as well as low target-goal achievement among patients with T2DM, with or without CAD, in the departments of cardiology and endocrinology at the same tertiary hospital, with a lower rate of statin prescription and target-goal achievement of LDL-C in the department of endocrinology.
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Affiliation(s)
- Zhong Chen
- Department of Cardiology, The Affiliated Zhongda Hospital and School of Medicine, Southeast University, Nanjing, PR China.
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Mascitelli L, Goldstein MR. Long-Standing Statin Therapy and the Risk of New-Onset Diabetes in the Elderly. Drugs Aging 2012; 29:9-13. [DOI: 10.2165/11598530-000000000-00000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Mascitelli L, Goldstein MR. Statins, cholesterol depletion and risk of incident diabetes. Int J Cardiol 2011; 152:275-6. [DOI: 10.1016/j.ijcard.2011.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 08/13/2011] [Indexed: 10/17/2022]
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30
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Hardoon SL, Morris RW, Whincup PH, Shipley MJ, Britton AR, Masset G, Stringhini S, Sabia S, Kivimaki M, Singh-Manoux A, Brunner EJ. Rising adiposity curbing decline in the incidence of myocardial infarction: 20-year follow-up of British men and women in the Whitehall II cohort. Eur Heart J 2011; 33:478-85. [PMID: 21653562 PMCID: PMC3272419 DOI: 10.1093/eurheartj/ehr142] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aims To estimate the contribution of risk factor trends to 20-year declines in myocardial infarction (MI) incidence in British men and women. Methods and results From 1985 to 2004, 6379 men and 3074 women in the Whitehall II cohort were followed for incident MI and risk factor trends. Over 20 years, the age–sex-adjusted hazard of MI fell by 74% (95% confidence interval 48–87%), corresponding to an average annual decline of 6.5% (3.2–9.7%). Thirty-four per cent (20–76%) of the decline in MI hazard could be statistically explained by declining non-HDL cholesterol levels, followed by increased HDL cholesterol (17%, 10–32%), reduced systolic blood pressure (13%, 7–24%), and reduced cigarette smoking prevalence (6%, 2–14%). Increased fruit and vegetable consumption made a non-significant contribution of 7% (−1–20%). In combination, these five risk factors explained 56% (34–112%). Rising body mass index (BMI) was counterproductive, reducing the scale of the decline by 11% (5–23%) in isolation. The MI decline and the impact of the risk factors appeared similar for men and women. Conclusion In men and women, over half of the decline in MI risk could be accounted for by favourable risk factor time trends. The adverse role of BMI emphasizes the importance of addressing the rising population BMI.
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Affiliation(s)
- Sarah L Hardoon
- Department of Primary Care and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, UK.
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