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Vgontzas AN, Karagkouni E, He F, Li Y, Karataraki M, Fernandez-Mendoza J, Bixler EO. Mild-to-moderate obstructive sleep apnea and mortality risk in a general population sample: The modifying effect of age and cardiovascular/cerebrovascular comorbidity. J Sleep Res 2024; 33:e13944. [PMID: 37203593 DOI: 10.1111/jsr.13944] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/04/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023]
Abstract
About 5.4%-45.7% of the general population has mild-to-moderate obstructive sleep apnea (mmOSA), which is highly comorbid with cardiovascular and/or cerebrovascular diseases (CBVD). We examined the association between mmOSA and all-cause mortality and the modifying effect of age and CBVD. A total of 1681 adults 20-88 years old from the Penn State Adult Cohort (PSAC) (41.9% male) were followed up for 20.1 ± 6.2 years for all-cause mortality. Mild and moderate OSA were defined as an apnea/hypopnea index (AHI) 5-14.9 and 15-29.9 events/hour, respectively. CBVD was defined as a report of a physician diagnosis or treatment for heart disease and/or stroke. Cox proportional hazards regression models were used to estimate all-cause mortality adjusted for confounders. All-cause mortality risk was significantly increased in the mmOSA group in young and middle-aged adults (<60 years) (HR = 1.59, 95%CI 1.08-2.04) but not in older adults (≥60 years) (HR = 1.05, 95%CI 0.80-1.39). A synergistic effect between mmOSA and CBVD was stronger in those <60 years (HR = 3.82, 95%CI 2.25-6.48 in <60 years vs 1.86 95%CI 1.14-3.04 in ≥60 years). There was an additive effect between moderate OSA and hypertension in <60 but not in those ≥60 years. Mild OSA was associated with all-cause mortality only in the presence of CBVD. Mortality risk is increased in young and middle-aged adults with moderate OSA, whereas the mortality risk associated with mild OSA is elevated only, regardless of age, in the presence of comorbid CBVD. AHI cut-offs warranting treatment of mmOSA may need to be adjusted based on age and comorbidities.
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Affiliation(s)
- Alexandros N Vgontzas
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Efthalia Karagkouni
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Fan He
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Maria Karataraki
- Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, Greece
| | - Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Edward O Bixler
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
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Fernandez-Mendoza J, Calhoun SL, Bixler EO. Edward O. Bixler, PhD: from the Apollo project and chimpanzees to sleep epidemiology. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae020. [PMID: 38562675 PMCID: PMC10983785 DOI: 10.1093/sleepadvances/zpae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/26/2024] [Indexed: 04/04/2024]
Abstract
What an honor to write about Dr. Edward O. Bixler's contributions to the sleep field. In 1967, Dr. Bixler published a case report on a chimpanzee with implanted brain electrodes while working at an Air Force base in New Mexico. A few years later, in 1971, he published on the sleep effects of flurazepam in individuals with insomnia together with Dr. Anthony Kales, data that he had collected when the Sleep Research & Treatment Center (SRTC) was housed at the University of California Los Angeles. Dr. Bixler, a meticulous scientist, learned from Dr. Kales, a devoted clinician, to study "the whole patient, and all aspects of sleep," a legacy that continued when the SRTC moved to Penn State in Hershey. Indeed, Dr. Bixler's tenure at Penn State from 1971 until 2019 kept the science of the SRTC focused on that premise and helped translate scientific evidence into clinical care. He not only contributed early to the pharmacology of sleep and the effects of hypnotics, but he was also a pioneer in "sleep epidemiology." His "Prevalence of sleep disorders in the Los Angeles metropolitan area" study of 1979 was the first rigorous epidemiological study on sleep disturbances. Starting in 1990, he established the Penn State Adult Cohort to estimate the prevalence and natural history of sleep-disordered breathing and other sleep disorders in adults. Inspired by life-course epidemiology, he established in 2001 the Penn State Child Cohort to estimate the same phenomena in children. This Living Legend paper captures and highlights Dr. Bixler's enduring legacy to sleep science.
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Affiliation(s)
- Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Sleep Research & Treatment Center, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research & Treatment Center, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
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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: 0] [Impact Index Per Article: 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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Vgontzas AN, He F, Fernandez-Mendoza J, Karagkouni E, Pejovic S, Karataraki M, Li Y, Bixler EO. Age-related differences in the association of mild-to-moderate sleep apnea with incident cardiovascular and cerebrovascular diseases. Sleep Med 2024; 113:306-312. [PMID: 38101102 DOI: 10.1016/j.sleep.2023.11.1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Mild-to-moderate obstructive sleep apnea (mmOSA) is highly prevalent in the general population. However, studies on its association with incident cardiovascular and/or cerebrovascular disease (CBVD) are limited. We examined the association between mild-to-moderate OSA and incident cardiovascular and/or cerebrovascular (CBVD) in a general population sample, and whether age modifies this association. METHODS A total of 1173 adults from the Penn State Adult Cohort (20-88 years) without CBVD or severe OSA at baseline were followed-up after 9.2 (±4.1) years. Incident CBVD was defined based on a self-report of a physician diagnosis or treatment for heart disease and/or stroke. Logistic regression examined the association of mild-to-moderate OSA (AHI 5-29.9) with incident CBVD and the combined effect of mmOSA and MetS on incident CBVD after adjusting for multiple confounders. RESULTS Age significantly modified the association between mmOSA with incident CBVD (p-interaction = 0.04). Mild-to-moderate OSA was significantly associated with incident CBVD in adults aged <60 years (OR = 1.74, 95%CI = 1.06-2.88, p = 0.029), but not in adults aged ≥60 years (OR = 0.71, 95%CI = 0.39-1.27, p = 0.247). Even mild OSA (AHI 5-14.9) carried a significant risk for incident CBDV in adults aged <60 years (OR = 1.86, 95%CI = 1.05-3.28, p = 0.032). An additive effect was found between mmOSA and MetS with incident CBVD in those aged <65 years (OR = 3.84, 95%CI = 1.95-7.56, p<0.001). CONCLUSIONS The risk of incident CBVD is increased in young and middle-aged but not older adults with mmOSA, which may affect the way we currently diagnose and treat this highly prevalent sleep-related breathing disorder.
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Affiliation(s)
- Alexandros N Vgontzas
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
| | - Fan He
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Efthalia Karagkouni
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Slobodanka Pejovic
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Maria Karataraki
- Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, Crete, Greece
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Edward O Bixler
- Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, PA, USA
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Nevels TL, Wirth MD, Ginsberg JP, McLain AC, Burch JB. The role of sleep and heart rate variability in metabolic syndrome: evidence from the Midlife in the United States study. Sleep 2023; 46:zsad013. [PMID: 36727300 PMCID: PMC10171632 DOI: 10.1093/sleep/zsad013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/11/2022] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study. METHODS Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses. RESULTS Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV. CONCLUSIONS To the best of the author's knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
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Affiliation(s)
- Torrance L Nevels
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Columbia Veterans Affairs Health Care System, Columbia, SC, USA
- U.S. Military Interservice Physician Assistant Program, MEDCoE, Joint Base San Antonio-Fort Sam Houston, TX, USA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - J P Ginsberg
- Department of Pathology, Microbiology, and Immunology, Saybrook University, Pasadena, CA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James B Burch
- Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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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: 1085] [Impact Index Per Article: 1085.0] [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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The Relationship between Sleep Duration and Metabolic Syndrome Severity Scores in Emerging Adults. Nutrients 2023; 15:nu15041046. [PMID: 36839404 PMCID: PMC9965711 DOI: 10.3390/nu15041046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Research suggests sleep duration can influence metabolic systems including glucose homeostasis, blood pressure, hormone regulation, nervous system activity, and total energy expenditure (TEE), all of which are related to cardiometabolic disease risk, even in young adults. The purpose of this study was to examine the relationship between sleep duration and metabolic syndrome severity scores (MSSS) in a sample of emerging adults (18-24 y/o). METHODS Data were collected between 2012 and 2021 from the College Health and Nutrition Assessment Survey, an ongoing, cross-sectional study conducted at a midsized northeastern university. Anthropometric, biochemical, and clinical measures were obtained following an overnight fast and used to assess the prevalence of metabolic syndrome (MetS). MetS severity scores (MSSS) were calculated using race- and sex-specific formulas. Sleep duration was calculated from the difference in self-reported bedtime and wake time acquired through an online survey. ANCOVA was used to examine the relationship between sleep duration and MetS severity score while adjusting for covariates (age, sex, BMI, physical activity level, smoking status, alcohol consumption, and academic major). RESULTS In the final sample (n = 3816), MetS (≥3 criteria) was present in 3.3% of students, while 15.4% of students presented with ≥2 MetS criteria. Mean MSSS was -0.65 ± 0.56, and the reported sleep duration was 8.2 ± 1.3 h/day. MSSS was higher among low sleepers (<7 h/day) and long sleepers (>9 h/day) compared to the reference sleepers (7-8 h/day) (-0.61 ± 0.02 and -0.63 ± 0.01 vs. -0.7 ± 0.02, respectively, p < 0.01). CONCLUSIONS Our findings suggest short (<7 h/day) and long (>9 h/day) sleep durations raise the risk of MetS in a sample of emerging adults. Further research is needed to elucidate the impact of improving sleep habits on future disease risk.
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Hu Z, Tian Y, Song X, Zeng F, Hu K, Yang A. The effect and relative importance of sleep disorders for all-cause mortality in middle-aged and older asthmatics. BMC Geriatr 2022; 22:855. [DOI: 10.1186/s12877-022-03587-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/04/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Previous studies observed that sleep disorders potentially increased the risk of asthma and asthmatic exacerbation. We aimed to examine whether excessive daytime sleepiness (EDS), probable insomnia, objective short sleep duration (OSSD), and obstructive sleep apnea (OSA) affect all-cause mortality (ACM) in individuals with or without asthma.
Methods
We extracted relevant data from the Sleep Heart Health Study established in 1995–1998 with an 11.4-year follow-up. Multivariate Cox regression analysis with a proportional hazards model was used to estimate the associations between ACM and four sleep disorders among asthmatic patients and individuals without asthma. Dose-response analysis and machine learning (random survival forest and CoxBoost) further evaluated the impact of sleep disorders on ACM in asthmatic patients.
Results
A total of 4538 individuals with 990 deaths were included in our study, including 357 asthmatic patients with 64 deaths. Three multivariate Cox regression analyses suggested that OSSD (adjusted HR = 2.67, 95% CI: 1.23–5.77) but not probable insomnia, EDS or OSA significantly increased the risk of ACM in asthmatic patients. Three dose-response analyses also indicated that the extension of objective sleep duration was associated with a reduction in ACM in asthmatic patients compared to very OSSD patients. Severe EDS potentially augmented the risk of ACM compared with asthmatics without EDS (adjusted HR = 3.08, 95% CI: 1.11–8.56). Machine learning demonstrated that OSSD of four sleep disorders had the largest relative importance for ACM in asthmatics, followed by EDS, OSA and probable insomnia.
Conclusions
This study observed that OSSD and severe EDS were positively associated with an increase in ACM in asthmatic patients. Periodic screening and effective intervention of sleep disorders are necessary for the management of asthma.
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Supples MW, Glober NK, Lardaro TA, Mahler SA, Stopyra JP. Emergency Medical Services Clinicians Have a High Prevalence of Metabolic Syndrome. PREHOSP EMERG CARE 2022; 27:449-454. [PMID: 36260778 DOI: 10.1080/10903127.2022.2138655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Metabolic syndrome is a constellation of risk factors associated with the development of cardiovascular disease and increased all-cause mortality. Data examining the prevalence of metabolic syndrome among emergency medical services (EMS) clinicians are limited.Methods: We conducted a cross-sectional study of EMS clinicians and firefighters from three fire departments with transport-capable EMS divisions. Data were collected from compulsory annual physical exams for 2021 that included age, sex, race, body mass index (BMI), waist circumference, blood pressure, cholesterol levels, and hemoglobin A1c level. These data were used to determine the prevalence of meeting metabolic syndrome criteria. We calculated descriptive statistics of demographics, anthropometrics, and metabolic syndrome criteria for EMS clinicians and firefighters. We used chi-square tests to compare the proportion of EMS clinicians and firefighters meeting criteria for the whole group and among age groups of <40 years old, 40 to 59 years old, and ≥60 years old. We used logistic regression to estimate the odds of meeting criteria in EMS clinicians compared to firefighters, adjusted for age, sex, race, and BMI.Results: We reviewed data for 65 EMS clinicians and 239 firefighters. For the combined cohort, 13.2% (40/304) were female and 95.1% (289/304) were White. The median age for EMS clinicians was 34 years versus 45 years in firefighters (p < 0.0001). Metabolic syndrome criteria were met in 27.3% (83/304) of the entire group. The prevalence of meeting criteria among EMS clinicians and firefighters was 33.9% (22/65) and 25.5% (61/239), respectively (p = 0.18). Of the participants who were younger than age 40, 36.6% (15/41) of EMS clinicians versus 9.1% (7/74) of firefighters met criteria for metabolic syndrome (p < 0.001). EMS clinicians had significantly higher odds of meeting criteria [OR 4.62 (p = 0.001)] compared to firefighters when adjusted for age, sex, race, and BMI.Conclusion: EMS clinicians had a high prevalence of metabolic syndrome at an early age, and had a higher adjusted odds of having metabolic syndrome compared to firefighters.
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Affiliation(s)
- Michael W Supples
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Nancy K Glober
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Thomas A Lardaro
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Simon A Mahler
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.,Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC.,Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jason P Stopyra
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC
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Hu Z, Tian Y, Song X, Hu K, Yang A. Associations Between Incident Asthma With Comorbidity Profiles, Night Sleep Duration, and Napping Duration Trajectories: A 7-Year Prospective Study. Int J Public Health 2022; 67:1604939. [PMID: 35872705 PMCID: PMC9305997 DOI: 10.3389/ijph.2022.1604939] [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: 03/21/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: We aim to determine whether comorbidity profiles, night sleep duration, and napping duration trajectories were associated with incident asthma in Chinese adults.Methods: A total of 7,655 community-dwelling individuals were included in this study. Latent class/profile analysis(LCA/LPA) identified comorbidity profiles, night sleep duration, and napping duration trajectories. A generalized additive model with binomial regression assessed the associations between incident asthma with sleep trajectories.Results: During a 7-year follow-up period, 205 individuals were newly diagnosed with asthma. LPA identified four trajectories of night sleep duration: dominant short (n = 2,480), dominant healthy-long (n = 1,405), long decreasing (n = 1875), and short increasing (n = 1895). We also found three trajectories of napping duration: short increasing (n = 3,746), stable normal (n = 1,379), and long decreasing (n = 2,530). We found three comorbidity profiles: dominant heart diseases or risks (n = 766), multiple disorders (n = 758), and minimal or least disorders (n = 6,131). Compared with dominant short night sleep duration, three other trajectories were associated with significantly decreasing incident asthma. Minimal or least disorders profile was associated with a significant reduction of new-onset asthma than two other comorbidity profiles in dominant short night sleep duration.Conclusion: Our findings suggested that a dominant short night sleep duration trajectory potentially increases incident asthma in Chinese adults.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital at Zhijiang, Zhijiang, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Yufeng Tian
- Department of Academic Management, China Three Gorges University, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ailan Yang
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital at Zhijiang, Zhijiang, China
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Podlipskyte A, Kazukauskiene N, Varoneckas G, Mickuviene N. Association of Insulin Resistance With Cardiovascular Risk Factors and Sleep Complaints: A 10-Year Follow-Up. Front Public Health 2022; 10:848284. [PMID: 35651853 PMCID: PMC9150369 DOI: 10.3389/fpubh.2022.848284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/21/2022] [Indexed: 11/15/2022] Open
Abstract
The aim of the study was to investigate the association of insulin resistance (IR) with cardiovascular risk factors and sleep complaints among citizens of Palanga over a 10-year follow-up period. This epidemiological longitudinal cohort study was performed with 835 subjects.
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Affiliation(s)
- Aurelija Podlipskyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Nijole Kazukauskiene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Giedrius Varoneckas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Narseta Mickuviene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
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Khotimchenko M, Brunk NE, Hixon MS, Walden DM, Hou H, Chakravarty K, Varshney J. In Silico Development of Combinatorial Therapeutic Approaches Targeting Key Signaling Pathways in Metabolic Syndrome. Pharm Res 2022; 39:2937-2950. [PMID: 35313359 DOI: 10.1007/s11095-022-03231-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/10/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Dysregulations of key signaling pathways in metabolic syndrome are multifactorial, eventually leading to cardiovascular events. Hyperglycemia in conjunction with dyslipidemia induces insulin resistance and provokes release of proinflammatory cytokines resulting in chronic inflammation, accelerated lipid peroxidation with further development of atherosclerotic alterations and diabetes. We have proposed a novel combinatorial approach using FDA approved compounds targeting IL-17a and DPP4 to ameliorate a significant portion of the clustered clinical risks in patients with metabolic syndrome. In our current research we have modeled the outcomes of metabolic syndrome treatment using two distinct drug classes. METHODS Targets were chosen based on the clustered clinical risks in metabolic syndrome: dyslipidemia, insulin resistance, impaired glucose control, and chronic inflammation. Drug development platform, BIOiSIM™, was used to narrow down two different drug classes with distinct modes of action and modalities. Pharmacokinetic and pharmacodynamic profiles of the most promising drugs were modeling showing predicted outcomes of combinatorial therapeutic interventions. RESULTS Preliminary studies demonstrated that the most promising drugs belong to DPP-4 inhibitors and IL-17A inhibitors. Evogliptin was chosen to be a candidate for regulating glucose control with long term collateral benefit of weight loss and improved lipid profiles. Secukinumab, an IL-17A sequestering agent used in treating psoriasis, was selected as a repurposed candidate to address the sequential inflammatory disorders that follow the first metabolic insult. CONCLUSIONS Our analysis suggests this novel combinatorial therapeutic approach inducing DPP4 and Il-17a suppression has a high likelihood of ameliorating a significant portion of the clustered clinical risk in metabolic syndrome.
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Affiliation(s)
- Maksim Khotimchenko
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA
| | - Nicholas E Brunk
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA
| | - Mark S Hixon
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA
| | - Daniel M Walden
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA
| | - Hypatia Hou
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA
| | - Kaushik Chakravarty
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA.
| | - Jyotika Varshney
- VeriSIM Life, 1 Sansome Street, Suite 3500, San Francisco, California, 94104, USA.
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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: 2304] [Impact Index Per Article: 1152.0] [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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14
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Dejenie TA, G/Medhin MT, Admasu FT, Adella GA, Enyew EF, Kifle ZD, Seid MA, Mengstie MA, Abebe EC. Impact of objectively-measured sleep duration on cardiometabolic health: A systematic review of recent evidence. Front Endocrinol (Lausanne) 2022; 13:1064969. [PMID: 36601010 PMCID: PMC9806213 DOI: 10.3389/fendo.2022.1064969] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Cardiometabolic disease is a spectrum of diseases including, cardiovascular diseases, and metabolic syndrome. It is the leading cause of morbidity and mortality worldwide, with premature deaths being preventable. Currently, sleep has emerged as a potential target for cardiometabolic disease prevention. Several epidemiological studies have provided ample evidence that objectively measured short sleep duration increases the risk of cardiometabolic disease. However, the findings are inconsistent, and few studies measure sleep duration on cardiometabolic profiles objectively. Therefore, in this review, we focused on the recently published literature that explored the association between objectively measured sleep duration and cardiometabolic profiles (cardiovascular diseases, type 2 diabetes mellitus, and metabolic syndrome), seeking more insights regarding the applicability and, in turn, the impact of objectively measured sleep duration on cardiometabolic health, which is relatively understudied. We retrieved the information manually from PubMed, Google Scholar, HINARI, and the Cochrane Library from 2015 to 2022 using appropriate search terms, we included 49 articles. In this review, we found a strong relationship between objectively measured sleep duration and the risk of cardiometabolic disease, indicating that objectively measured short sleep durations increase cardiometabolic risks. In general, the association between objectively measured sleep duration and increased cardiometabolic risks (CMR) has been well-documented in higher-income countries. Several studies found that longer sleep duration was associated with a more favorable cardiometabolic profile in early adolescence, independent of other risk factors. On the other hand, objectively measured short sleep duration is associated with adverse cardiometabolic health outcomes such as coronary heart disease, hypertension, type 2 diabetes mellitus, and metabolic syndrome.
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Affiliation(s)
- Tadesse Asmamaw Dejenie
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Markeshaw Tiruneh G/Medhin
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fitalew Tadele Admasu
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive health and nutrition, School of public health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Engidaw Fentahun Enyew
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemene Demelash Kifle
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Department of Physiology, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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15
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Pienaar PR, Roden LC, Boot CRL, van Mechelen W, Twisk JWR, Lambert EV, Rae DE. Association between self-reported sleep duration and cardiometabolic risk in corporate executives. Int Arch Occup Environ Health 2021; 94:1809-1821. [PMID: 34189625 DOI: 10.1007/s00420-021-01739-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This cross-sectional study aimed to compare the association between self-reported sleep duration and cardiometabolic risk among men and women corporate executives and investigate potential lifestyle, work- and stress-related mediators thereof. METHODS Self-reported sleep duration and lifestyle, occupational, psychological and measured anthropometrical, blood pressure (BP) and blood marker variables were obtained from health risk assessment data of 3583 corporate executives. Sex-stratified regression analyses investigated the relationships between occupational and psychological variables with self-reported sleep duration, and sleep duration with individual cardiometabolic risk factors. Mediation analyses investigated the effects of work, psychological and lifestyle factors on the relationships between self-reported sleep duration and cardiometabolic risk factors, as well as a continuous cardiometabolic risk score calculated from the sum of sex-stratified z-standardized scores of negative fasting serum HDL, and positive plasma Glu, serum TG, body mass index (BMI), waist circumference, systolic and diastolic BP. RESULTS Longer work hours and work commute time, depression, anxiety and stress were associated with shorter sleep duration in both men and women (all p < 0.05). Shorter sleep duration was associated with higher BMI, larger waist circumference and greater cardiometabolic risk scores in both men and women (all p < 0.05), higher diastolic BP in men (p < 0.05) and lower HDL cholesterol in women (p < 0.05). Physical activity, working hours and stress significantly mediated the relationships between self-reported sleep duration and BMI, waist circumference, diastolic BP and cardiometabolic risk score in men only. CONCLUSION In these corporate executives, shorter self-reported sleep duration is associated with poorer psychological, occupational and cardiometabolic risk outcomes in both men and women. Given that physical activity, working hours and stress mediate this association among the men, the case for sleep health interventions in workplace health programmes is warranted.
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Affiliation(s)
- Paula R Pienaar
- Health Through Physical Activity Lifestyle and Sport Research Centre and Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
- Amsterdam UMC, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Laura C Roden
- Health Through Physical Activity Lifestyle and Sport Research Centre and Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 2DS, UK
| | - Cécile R L Boot
- Amsterdam UMC, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands
| | - Willem van Mechelen
- Health Through Physical Activity Lifestyle and Sport Research Centre and Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Amsterdam UMC, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
- Center of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Estelle V Lambert
- Health Through Physical Activity Lifestyle and Sport Research Centre and Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dale E Rae
- Health Through Physical Activity Lifestyle and Sport Research Centre and Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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16
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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: 2972] [Impact Index Per Article: 990.7] [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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17
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Izumida T, Nakamura Y, Sato Y, Ishikawa S. The Association between Sleeping Pill Use and Metabolic Syndrome in an Apparently Healthy Population in Japan: JMS-II Cohort Study. J Epidemiol 2020; 32:145-150. [PMID: 33162423 PMCID: PMC8824657 DOI: 10.2188/jea.je20200361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Sleeping pills are widely used for sleep disorders and insomnia. This population-based study aimed to evaluate the association between the use of sleeping pills and metabolic syndrome (MetS) and metabolic components in an apparently healthy Japanese cohort. Methods We examined baseline cross-sectional data from the JMS-II Cohort Study. The criteria for MetS and its components were based on The National Cholesterol Education Program Adult Treatment Panel III. Sleep habits including the sleep duration of the subjects and the frequency of sleeping pill use were obtained using The Pittsburgh Sleep Quality Index questionnaire. For different sleep durations, the association between sleeping pill use and MetS was assessed. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using multiple logistic regression models to quantify this association. Results Our study included 6,153 individuals (mean age, 63.8 [standard deviation 11.2] years), and 3,348 (54.4%) among them were women. The association between sleep duration and MetS was an inverted J-shaped curve among sleeping pill users and a J-shaped curve among non-users. After adjustment for various confounders, less than 6 h of sleep among sleeping pill users was associated with increased rates of MetS (<6 h, OR 3.08; 95% CI, 1.29–7.34]). The frequency of sleeping pill use in individuals with short sleep duration showed a positive association with the prevalence of MetS and its components. Conclusions Sleeping pill users with a short sleep duration had a 3-fold higher chance of having MetS than non-users with a short sleep duration.
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Affiliation(s)
- Toshihide Izumida
- Division of Community Medicine, Kanawaza Medical University Himi Municipal Hospital
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University
| | | | - Shizukiyo Ishikawa
- Division of Public Health, Center for Community Medicine, Jichi Medical University
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18
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Ye Y, Zhang L, Wang A, Wang Y, Wang S, Ning G, Mu Y. Association of sleep duration with stroke, myocardial infarction, and tumors in a Chinese population with metabolic syndrome: a retrospective study. Lipids Health Dis 2020; 19:155. [PMID: 32593309 PMCID: PMC7321539 DOI: 10.1186/s12944-020-01328-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 06/16/2020] [Indexed: 01/31/2023] Open
Abstract
Background Previous studies have suggested that abnormal sleep duration is associated with increased risk of metabolic syndrome (MetS). However, evidence on the association of sleep duration with stroke, myocardial infarction (MI) and tumors in populations with MetS is limited. Methods A total of 8968 participants (2754 with MetS at baseline) were recruited in this retrospective study between March 2012 and December 2012. The baseline characteristics and information on sleep duration were collected by self-reported questionnaires. In addition, physical examination and blood test were also performed. The outcome events in this study were new onset of stroke, MI and tumors during subsequent follow-up. Multivariate logistic regressions were adopted to investigate the relationships between sleep duration and outcome events among different sleep duration groups (< 6 h, 6–7 h, 7–8 h [reference], 8–9 h, and > 9 h per day) in participants with MetS. Results The mean self-reported total sleep duration was 7.8 ± 1.2 h. Compared with participants with MetS slept for 7–8 h per day, the adjusted odds ratios (ORs) for those slept for > 9 h in stroke, MI and tumors were 2.014 (95% confidence interval [CI]: 1.184–3.426, P = 0.010), 1.731 (95% CI: 0.896–3.344, P = 0.102) and 2.159 (95% CI: 0.991–4.704, P = 0.053), respectively, whereas the adjusted ORs for those slept for < 6 h in stroke, MI and tumors were 2.249 (95% CI: 0.973–5.195, P = 0.058), 1.213 (95% CI, 0.358–4.104, P = 0.756) and 1.743 (95% CI, 0.396–7.668, P = 0.462), respectively. Conclusions Long sleep duration (> 9 h) significantly increased the risk of stroke but not MI and tumors in individuals with MetS compared with 7–8 h of sleep duration. Short sleep duration (< 6 h) was not associated with the increased risk of stroke, MI and tumors in individuals with MetS.
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Affiliation(s)
- Yingnan Ye
- Department of Endocrinology, Chest Hospital Affiliated to Nankai University, School of Medicine, Nankai University, Tianjin, 300071, China.,Department of Endocrinology, Chinese PLA General Hospital, Medical School of Chinese PLA, No.28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Linxi Zhang
- Department of Endocrinology, Chest Hospital Affiliated to Nankai University, School of Medicine, Nankai University, Tianjin, 300071, China
| | - Anping Wang
- Department of Endocrinology, Chest Hospital Affiliated to Nankai University, School of Medicine, Nankai University, Tianjin, 300071, China
| | - Yuxia Wang
- Department of Endocrinology, Chest Hospital Affiliated to Nankai University, School of Medicine, Nankai University, Tianjin, 300071, China.,Department of Endocrinology, Chinese PLA General Hospital, Medical School of Chinese PLA, No.28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Shiqing Wang
- Department of Endocrinology, Chest Hospital Affiliated to Nankai University, School of Medicine, Nankai University, Tianjin, 300071, China.,Department of Endocrinology, Chinese PLA General Hospital, Medical School of Chinese PLA, No.28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, Chest Hospital Affiliated to Nankai University, School of Medicine, Nankai University, Tianjin, 300071, China. .,Department of Endocrinology, Chinese PLA General Hospital, Medical School of Chinese PLA, No.28, Fuxing Road, Haidian District, Beijing, 100853, China.
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19
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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: 4716] [Impact Index Per Article: 1179.0] [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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20
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ElKhouly AM, Youness RA, Gad MZ. MicroRNA-486-5p and microRNA-486-3p: Multifaceted pleiotropic mediators in oncological and non-oncological conditions. Noncoding RNA Res 2020; 5:11-21. [PMID: 31993547 PMCID: PMC6971376 DOI: 10.1016/j.ncrna.2020.01.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/19/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023] Open
Abstract
Despite historically known as "junk" DNA, nowadays non-coding RNA transcripts (ncRNAs) are considered as fundamental players in various physiological and pathological conditions. Nonetheless, any alteration in their expression level has been reported to be directly associated with the incidence and aggressiveness of several diseases. MicroRNAs (miRNAs) are the well-studied members of the ncRNAs family. Several reports have highlighted their crucial roles in the post-transcriptional manipulation of several signaling pathways in different pathological conditions. In this review, our main focus is the multifaceted microRNA-486 (miR-486). miR-486-5p and miR-486-3p have been reported to have central roles in several types oncological and non-oncological conditions such as lung, liver, breast cancers and autism, intervertebral disc degeneration and metabolic syndrome, respectively. Moreover, we spotted the light onto the pleiotropic role of miR-486-5p in acting as competing endogenous RNA with other members of ncRNAs family such as long non-coding RNAs.
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Affiliation(s)
- Aisha M ElKhouly
- Biochemistry Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt
| | - R A Youness
- Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt
| | - M Z Gad
- Biochemistry Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt
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21
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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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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: 5219] [Impact Index Per Article: 1043.8] [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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23
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Chitrala KN, Hernandez DG, Nalls MA, Mode NA, Zonderman AB, Ezike N, Evans MK. Race-specific alterations in DNA methylation among middle-aged African Americans and Whites with metabolic syndrome. Epigenetics 2019; 15:462-482. [PMID: 31739726 DOI: 10.1080/15592294.2019.1695340] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors for all-cause mortality, cardiovascular disease, and cancer. Identifying epigenetic alterations associated with MetS in African Americans (AAs) and Whites may provide insight into genes that influence its differential health outcomes. We examined DNA methylation (DNAm) and performed an epigenome-wide association study (EWAS) of MetS among AAs and Whites with and without MetS. We assessed age, race and poverty status associated DNAm among AAs (n = 225) and White (n = 233) adults using NCEP-ATP III guidelines. Genome-wide DNAm measurement was assessed using Illumina Infinium Methylation EPIC BeadChip. Differentially methylated positions (DMPs) and differentially methylated regions (DMRs) were identified using dmpFinder and bumphunter. EWAS was performed using CpGassoc. We found significant DMPs associated with age, poverty status and MetS in each race. GSTT1(Glutathione S-Transferase Theta 1) was one of the top-hypermethylated genes and MIPEP (Mitochondrial Intermediate Peptidase) was one of the most hypomethylated genes when comparing AAs with and without MetS. PPP1R13L (Protein Phosphatase 1 Regulatory Subunit 13 Like) was the top hypermethylated and SCD (stearoyl-CoA desaturase-1) was one of the most hypomethylated genes for Whites with and without MetS. EWAS results showed that DNAm differences might contribute to MetS risk among Whites and AAs since different genes were identified in AAs and Whites. We replicated previously identified MetS associated genes and found that Thioredoxin-interacting protein (TXN1P) was statistically significantly differentially expressed only in Whites. Our results may be useful in further studies of genes underlying differences in MetS among AAs and Whites.
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Affiliation(s)
- Kumaraswamy Naidu Chitrala
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Dena G Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Michael A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.,Data Tecnica International, Glen Echo, MD, USA
| | - Nicolle A Mode
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Ngozi Ezike
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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Abstract
PURPOSE OF REVIEW This review summarizes key findings linking insomnia, short sleep duration, and cardiovascular health. RECENT FINDINGS Early studies associations between insomnia with short sleep and cardiovascular disease Recent studies have incorporated objective data to assess sleep and identify comorbid sleep disorders (e.g. sleep apnea). Use of objective metrics has facilitated understanding of the impacts of insufficient sleep on autonomic dysregulation, metabolic syndrome, coronary artery disease and overall cardiovascular mortality. Emerging research suggests treatment of insomnia (CBT-I) may be beneficial in terms of reducing cardiovascular disease risk. SUMMARY From short term effects on the autonomic nervous system to lasting effects on metabolic syndrome and coronary artery disease, there is growing evidence to support a physiologic pathway by which insomnia with short sleep contributes to cardiovascular disease. More research is needed to understand the effect of insomnia treatment on cardiovascular risk.
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Affiliation(s)
| | - Jennifer L. Martin
- VA Greater Los Angeles Healthcare System, University of California, Los Angeles, 16111 Plummer St #200, North Hills, CA 91343
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25
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Sleep Apnea and Sleep Habits: Relationships with Metabolic Syndrome. Nutrients 2019; 11:nu11112628. [PMID: 31684029 PMCID: PMC6893600 DOI: 10.3390/nu11112628] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/01/2019] [Accepted: 10/16/2019] [Indexed: 12/19/2022] Open
Abstract
Excess visceral adiposity is a primary cause of metabolic syndrome and often results from excess caloric intake and a lack of physical activity. Beyond these well-known etiologic factors, however, sleep habits and sleep apnea also seem to contribute to abdominal obesity and metabolic syndrome: Evidence suggests that sleep deprivation and behaviors linked to evening chronotype and social jetlag affect eating behaviors like meal preferences and eating times. When circadian rest and activity rhythms are disrupted, hormonal and metabolic regulations also become desynchronized, and this is known to contribute to the development of metabolic syndrome. The metabolic consequences of obstructive sleep apnea syndrome (OSAS) also contribute to incident metabolic syndrome. These observations, along with the first sleep intervention studies, have demonstrated that sleep is a relevant lifestyle factor that needs to be addressed along with diet and physical activity. Personalized lifestyle interventions should be tested in subjects with metabolic syndrome, based on their specific diet and physical activity habits, but also according to their circadian preference. The present review therefore focuses (i) on the role of sleep habits in the development of metabolic syndrome, (ii) on the reciprocal relationship between sleep apnea and metabolic syndrome, and (iii) on the results of sleep intervention studies.
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Smiley A, King D, Bidulescu A. The Association between Sleep Duration and Metabolic Syndrome: The NHANES 2013/2014. Nutrients 2019; 11:E2582. [PMID: 31717770 PMCID: PMC6893635 DOI: 10.3390/nu11112582] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND We aimed to assess the association of sleep with metabolic syndrome in the 2013/2014 National Health and Nutrition Examination Survey (NHANES). METHODS Sample size included 2737 out of 2013 and 2014 NHANES surveys. Cross-sectional study of metabolic syndrome and sleep duration was conducted. Metabolic syndrome was defined according to NCEP ATPIII (National Cholesterol Education Program Adult Treatment Panel III) criteria. Metabolic syndrome severity score was calculated based on actual measurement of each component, adjusted for sex and race. The generalized additive model (GAM) was built to assess the smooth relationship between metabolic syndrome/metabolic syndrome severity score and sleep duration. Adjustment of models were done for age, sex, race, and sitting time. The value of effective degree of freedom (EDF) formed by the GAM model shows the degree of curvature of the relationship. A value of 1 for EDF is translated as the linear shape of relationship. Values larger than one denote a more complex relationship between the response variable and the predicting one. RESULTS There was a U-shaped association between sleep duration and metabolic syndrome in univariable GAM (EDF = 2.43, p = 0.06) and multivariable GAM (EDF = 2.03, p = 0.20). The lowest risk of metabolic syndrome was observed in people sleeping 7 hours/night. There was a significant U-shaped association between sleep duration and metabolic syndrome severity score in multivariable GAM (EDF = 2.94, p = 0.0004). Similarly, the lowest mean metabolic syndrome severity score was observed in people sleeping 7 hours/night. There was an effect modification of sex and sleep duration indicating strong U-shaped relationship of metabolic syndrome severity score and sleep duration in women (EDF = 3.43, p = 0.00002) and semi-linear association in men (EDF = 1.76, p = 0.04). CONCLUSION Short and long sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in women. Short sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in men.
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Affiliation(s)
- Abbas Smiley
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, New York, NY 10595, USA
| | - David King
- Henry M Jackson Foundation for the advancement of Military Medicine, Bethesda, MD 20817, USA;
| | - Aurelian Bidulescu
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN 47404, USA;
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Piovezan RD, Hirotsu C, Moizinho R, de Sá Souza H, D'Almeida V, Tufik S, Poyares D. Associations between sleep conditions and body composition states: results of the EPISONO study. J Cachexia Sarcopenia Muscle 2019; 10:962-973. [PMID: 31125517 PMCID: PMC6818458 DOI: 10.1002/jcsm.12445] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/27/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Evidence suggests anthropometric indicators of obesity are associated with changes in sleep quality and quantity, and the presence of obstructive sleep apnoea (OSA). Investigations including diverse and objective evaluations of sleep and body composition are scarce. We aimed to evaluate the associations between indicators of sleep impairment and body composition states in a sample from a population-based study. METHODS Participants of the first follow-up of the EPISONO (São Paulo, Brazil) >50 years were cross-sectionally evaluated. Sleep was assessed through questionnaires, actigraphy, and polysomnography. Body composition was evaluated by bioelectrical impedance analysis. Appendicular skeletal muscle mass adjusted for body mass index defined sarcopenia (men <0.789 and women <0.512). Total body fat defined obesity (men >30% and women >40%). The overlap between both conditions defined sarcopenic obesity (SO). Final results were obtained by multinomial logistic regression analysis. RESULTS Three hundred fifty-nine adults [mean (standard deviation) age, 61 (8.8) years; 212 (59.1%) female] were enrolled. Obesity was detected in 22.6% of the sample, sarcopenia in 5.6%, and SO in 16.2%. After controlling for covariates, OSA was associated with SO [odds ratio = 3.14, 95% confidence interval (CI) = 1.49-6.61]. Additionally, nocturnal hypoxaemia was associated with both obesity (adjusted odds ratio = 2.59, 95% CI = 1.49-4.49) and SO (odds ratio = 2.92, 95% CI = 1.39-6.13). Other indicators of poor sleep/sleep disorders were not associated with body composition states. CONCLUSIONS Sarcopenic obesity but not obesity alone was associated with OSA. Both obesity and SO but not sarcopenia were associated with nocturnal hypoxaemia. The findings suggest a complex pathophysiologic relationship between adverse body composition states and OSA. Upcoming research on risk factors and therapeutic interventions for OSA should target synchronically the lean and adipose body tissues.
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Affiliation(s)
- Ronaldo D Piovezan
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Camila Hirotsu
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Renato Moizinho
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Helton de Sá Souza
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Vania D'Almeida
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Dalva Poyares
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Bailey O, Combs D, Sans-Fuentes M, Havens CM, Grandner MA, Poongkunran C, Patel S, Berryhill S, Provencio N, Quan SF, Parthasarathy S. Delayed Sleep Time in African Americans and Depression in a Community-Based Population. J Clin Sleep Med 2019; 15:857-864. [PMID: 31138383 DOI: 10.5664/jcsm.7836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/08/2019] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES Studies have shown racial differences in circadian rhythm in African Americans when compared to non-Hispanic whites, and an association between circadian dyssynchrony and depression. We hypothesized that the prevalence of delayed sleep time is greater in African Americans when compared to whites and that delayed sleep time is associated with depression. METHODS We analyzed data from the Sleep Heart Health Study (SHHS), a large community-based sample. Delayed sleep time was defined as self-reported weeknight bedtime after midnight. Depression was defined based on participant's response to the question, "In the past 4 weeks have you felt downhearted and blue?" or reported antidepressant use. We performed multivariate linear and logistic regression, adjusting for age, sex, race, body mass index, smoking, apnea-hypopnea index, alcohol use, and caffeine consumption. RESULTS Adjusted weekday bedtime was 15 ± 7 minutes later in African Americans compared to whites (P < .001). Similarly, weekend bedtime was 18 ± 7 minutes later in African Americans compared to whites (P = .025). The prevalence of delayed sleep time was greater in African Americans (33.3%) compared to whites (18.7%; P < .001). After adjusting for confounders, when compared to whites, a greater proportion of African Americans had delayed sleep time (adjusted odds ratio [aOR] 2.03; 95% confidence interval [95% CI] 1.5, 2.4; P < .0001). Depression was independently associated with delayed sleep time after adjustment (aOR 1.4; 95% CI 1.1, 1.7; P = .007). CONCLUSIONS African Americans are more likely to have a delayed sleep time compared to whites, and delayed sleep time was independently associated with depression.
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Affiliation(s)
- Omavi Bailey
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Daniel Combs
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona.,Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Maria Sans-Fuentes
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Cody M Havens
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Department of Integrative Life Sciences, Virginia Commonwealth University, Richmond, Virginia.,Virginia Institute of Psychiatric, Behavioral, and Statistical Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Michael A Grandner
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Department of Psychiatry, University of Arizona, Tucson
| | - Chithra Poongkunran
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Sarah Patel
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Sarah Berryhill
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Natalie Provencio
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Asthma and Airways Disorders Research Center, University of Arizona, Tucson, Arizona
| | - Sairam Parthasarathy
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona.,Asthma and Airways Disorders Research Center, University of Arizona, Tucson, Arizona
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29
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Bakr Zaki M, Abulsoud AI, Elsisi AM, Doghish AS, Mansour OAE, Amin AI, Elrebehy MA, Mohamed MY, Goda MA. Potential role of circulating microRNAs (486-5p, 497, 509-5p and 605) in metabolic syndrome Egyptian male patients. Diabetes Metab Syndr Obes 2019; 12:601-611. [PMID: 31190928 PMCID: PMC6511614 DOI: 10.2147/dmso.s187422] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/27/2019] [Indexed: 12/22/2022] Open
Abstract
Objective: This study aims to evaluate the expression pattern of circulating microRNAs (miR)-486-5p, miR-497, miR-509-5p, and miR-605 in the serum of metabolic syndrome (MetS) Egyptian male patients. Methods: In this study, the circulating miR-486-5p, miR-497, miR509-5p, and miR-605 were amplified and quantitatively detected by quantitative real-time polymerase chain reaction in sera of 55 MetS male patients in comparison to 20 male controls. The level of fasting plasma glucose and triacylglycerol (TAG) were measured using calorimetric assay. Blood pressure was measured using mercuric sphygmomanometer. Anthropometric measurements were done to each individual. Furthermore, MetS patients were defined according to the criteria proposed by the American Heart Association and divided into three groups according to MetS index. Results: The study was performed on three groups and a control group defined as follows: group 1: 15 MetS patients who fulfilled all diagnostic criteria of MetS; group 2: 20 MetS patients with normal blood pressure; group 3: 20 MetS patients with normal TAG levels.The levels of miRs are expressed as [median (IQR)]. miR-486-5-p and miR-497 expression were elevated in group 1 [31.9(49), p˂0.0001; 73.1(42.5), p˂0.0001], group 2 [36.4(15.7), p˂0.0001; 68.3(54.8), p˂0.0001], and group (3) [10.8(18.9), p=0.0014; 27.5(39.7), p=0.0012]. MiR-509-5p was elevated in groups 1 and 2 [501(468), p=0.0001], [309(436), p=0.0006], respectively, while normally expressed in group 3 [0.93(0.077), p=0.0001]. miR-605 was elevated in groups 1 and 3 [25.4(20.0), p=0.0018], [54.8(65.8), p˂0.0001], while normally expressed in group 2 [0.84(0.67), p˂0.0001]. Conclusion: miRs (486-5p, 497, 509-5p, and 605) serum levels were higher in MetS patients than in healthy control subjects; therefore, these serum miRs can serve as early biomarkers and can be used to follow-up the prognosis of MetS.
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Affiliation(s)
- Mohamed Bakr Zaki
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, El-Nahda, Cairo Governorate11777, Egypt
- Correspondence: Mohamed Bakr ZakiBiochemistry Department, Faculty of Pharmacy, Heliopolis University, Cairo-Belbeis Desert Rd, El-Nahda, Cairo Governorate11777, EgyptTel +20 109 363 5239Email
| | - Ahmed Ibrahim Abulsoud
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, El-Nahda, Cairo Governorate11777, Egypt
- Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, 13465, Egypt
| | - Ahmed Mohamed Elsisi
- Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, 13465, Egypt
- Biochemistry Department, Faculty of Pharmacy, Nahda University, Beni-Suef, Egypt
| | - Ahmed Soliman Doghish
- Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, 13465, Egypt
- Biochemistry Department, Faculty of Pharmacy, Badr University in Cairo, Badr City, Cairo, Egypt
| | | | - Ashraf Ismail Amin
- Department of Chemical and Clinical Pathology, National Institute of Diabetes and Endocrinology, Kasr El Ainy, Cairo, Egypt
| | - Mahmoud Ahmed Elrebehy
- Biochemistry Department, Faculty of Pharmacy, Badr University in Cairo, Badr City, Cairo, Egypt
| | - Mohamed Yousef Mohamed
- Clinical Pharmacy Department, Faculty of Pharmacy (boys), Al-Azhar University, Nasr City, Cairo13465, Egypt
| | - Mohamed Ahmed Goda
- Clinical Pharmacy Department, Faculty of Pharmacy (boys), Al-Azhar University, Nasr City, Cairo13465, Egypt
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Huang RJ, Lee SD, Lai CH, Chang SW, Chung AH, Chen CW, Huang IN, Ting H. Objectively Measured Disrupted Sleep Is Independently and Directly Associated With Low Exercise Capacity in Males: A Structural Equation Model. J Clin Sleep Med 2018; 14:1995-2004. [PMID: 30518440 DOI: 10.5664/jcsm.7522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 08/10/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES We investigated the interaction between objective sleep disturbance and obesity, sedentary lifestyle, and lung dysfunction and whether it is negatively associated with cardiorespiratory fitness. METHODS In this community cohort study of 521 men (age 46.6 ± 7.5 years), measures of anthropometry, pulmonary function, overnight sleep polysomnography, and cardiopulmonary exercise testing were processed stepwise using structural equation modeling (SEM). RESULTS A univariate correlation analysis was used to group the corresponding variables (in parentheses) into the following eligible latent variables for lower exercise capacity: obesity (body mass index, waist-to-hip ratio), irregular exercise, impaired lung function (predicted values of forced expiratory volume in the first second, forced vital capacity, maximal ventilatory volume, and lung diffusion capacity for carbon monoxide), disrupted sleep (total sleep time, percentage of slow-wave sleep, sleep efficiency), and sleep-disordered breathing (apnea-hypopnea index, lowest oxygen saturation, percentage of total period of oxygen saturation < 90%). Advanced SEM analyses produced a well-fitted final confirmatory model that obesity (direct strength βd = .366, P < .001), irregular exercise (βd = .274, P < .001), and impaired lung function (βd = .152, P < .001), with their mutual interactions, as well as disrupted sleep (βd = .135, P = .001) were independently and directly associated with low exercise capacity. By contrast, sleep-disordered breathing (βd = 0, P = .215) was related to low exercise capacity indirectly through obesity into the mutual interaction cycle of obesity, irregular exercise, and impaired lung function. Sleep-disordered breathing was robustly and mutually correlated with obesity (mutual relationship index = .534, P < .001). CONCLUSIONS Objectively measured disrupted sleep is directly and independently associated with low exercise capacity; however, sleep-disordered breathing is indirectly mediated by obesity and mutual interactions among obesity, lung dysfunction, and sedentary lifestyle and is linked to low exercise capacity. Our findings indicate that individuals with limited exercise capacity without definite causes should undertake a sleep study, particularly in those describing symptoms of sleep-disordered breathing or insomnia.
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Affiliation(s)
- Ren-Jing Huang
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Shin-Da Lee
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan.,Department of Occupational Therapy, Asia University, Taichung, Taiwan.,School of Rehabilitation Medicine, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ching-Hsiang Lai
- Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan
| | - Shen-Wen Chang
- Sleep Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ai-Hui Chung
- Sleep Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiung-Wei Chen
- Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - I-Ning Huang
- Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hua Ting
- Sleep Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Rivera-Almaraz A, Manrique-Espinoza B, Ávila-Funes JA, Chatterji S, Naidoo N, Kowal P, Salinas-Rodríguez A. Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty. BMC Geriatr 2018; 18:236. [PMID: 30286727 PMCID: PMC6172837 DOI: 10.1186/s12877-018-0928-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/24/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions. METHODS Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument. All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models. RESULTS Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (β = 5.05; p < 0.01 and β = 5.10; p < 0.01, respectively) and decreased WHOQOL score (β = - 1.81; p < 0.01 and β = - 2.99; p < 0.01, respectively). Vascular-metabolic was associated with mortality (HR = 1.47; p = 0.04), disability (β = 3.27; p < 0.01) and quality of life (β = - 1.30; p = 0.02). Frailty was associated with mortality (pre-frail: HR = 1.48; p = 0.02 and frail: HR = 1.68; p = 0.03), disability (pre-frail: β = 5.02; p < 0.01; frail: β = 13.29; p < 0.01) and quality of life (pre-frail: β = - 2.23; p < 0.01; frail: β = - 4.38; p < 0.01). Interaction terms of frailty and multimorbidity were not statistically significant. CONCLUSIONS Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided.
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Affiliation(s)
- Ana Rivera-Almaraz
- National Institute of Public Health, Avenida Universidad #655, Colonia Santa María Ahuacatitlán, ZC, 62100 Cuernavaca, Morelos Mexico
| | - Betty Manrique-Espinoza
- National Institute of Public Health, Avenida Universidad #655, Colonia Santa María Ahuacatitlán, ZC, 62100 Cuernavaca, Morelos Mexico
| | - José Alberto Ávila-Funes
- Department of Geriatrics, Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Nirmala Naidoo
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Paul Kowal
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
- University of Newcastle Research Centre on Gender, Health and Ageing, Newcastle, Australia
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Aarón Salinas-Rodríguez
- National Institute of Public Health, Avenida Universidad #655, Colonia Santa María Ahuacatitlán, ZC, 62100 Cuernavaca, Morelos Mexico
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Yang Q, Durmer JL, Wheaton AG, Jackson SL, Zhang Z. Sleep duration and excess heart age among US adults. Sleep Health 2018; 4:448-455. [PMID: 30241660 PMCID: PMC10913064 DOI: 10.1016/j.sleh.2018.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/15/2018] [Accepted: 07/02/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Insufficient sleep negatively impacts the cardiovascular system. No study has examined the association between sleep duration and heart age (person's predicted vascular age based on cardiovascular disease [CVD] risk profile). This study examines association between sleep duration and excess heart age (EHA; difference between heart age and chronological age) among US adults. DESIGN AND PARTICIPANTS Cross-sectional 2007-2014 National Health and Nutrition Examination Survey data for respondents aged 30-74 years without CVD or stroke (n = 12,775). MEASUREMENTS Self-reported sleep duration was classified into 5 categories (≤5, 6, 7, 8, and ≥9 hours). We used sex-specific Framingham heart age algorithm to calculate heart age and multivariable linear regression to examine association between sleep duration and EHA. RESULTS A total of 13.4% (95% confidence interval 12.5-14.3), 24.2% (23.1-25.2), 31.0% (29.8-32.3), 25.9% (25.0-26.9), and 5.5% (5.0-6.1) reported sleeping ≤5, 6, 7, 8, and ≥9 hours, respectively. We observed a nonlinear relationship between sleep duration and EHA using 7 hours as reference: EHA (adjusted for sociodemographics, body mass index, physical activity, Healthy Eating Index-2010, sleep disorder, and depression status) was 5.1 (4.8-5.8), 4.5 (3.9-5.1), 3.7 (3.3-4.0), 4.5 (4.1-5.0), and 4.1 (3.3-4.9) years for sleep durations of ≤5, 6, 7, 8 and ≥9 hours, respectively (P = .015 for quadratic trend). EHA was significantly higher among participants with lower education, lower income, and obesity. CONCLUSION Mean adjusted EHA was lowest among adults who reported sleeping 7 hours per night and increased as adults reported sleeping fewer or more hours. Discussing sleep duration in the context of EHA may be helpful for patients and clinicians.
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Affiliation(s)
- Quanhe Yang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Julia L Durmer
- College of Arts & Sciences, Emory University, Atlanta, GA, USA
| | - Anne G Wheaton
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Holanda NCPD, de Castro Moreno CR, Marqueze EC. Metabolic syndrome components: Is there a difference according to exposure to night work? Chronobiol Int 2018; 35:801-810. [DOI: 10.1080/07420528.2018.1450267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Narriane Chaves Pereira de Holanda
- Epidemiology, Public Health Graduate Program - Catholic University of Santos, Santos, Brazil
- Department of Internal Medicine School of Medicine, Federal University of Paraiba, João Pessoa, PB, Brazil
| | - Claudia Roberta de Castro Moreno
- School of Public Health, University of São Paulo, São Paulo, SP, Brazil
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Elaine Cristina Marqueze
- Epidemiology, Public Health Graduate Program - Catholic University of Santos, Santos, Brazil
- School of Public Health, University of São Paulo, São Paulo, SP, Brazil
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and risk factors of type 2 diabetes in insomnia sufferers: a study on 1311 individuals referred for sleep examinations. Sleep Med 2018; 46:37-45. [PMID: 29773209 DOI: 10.1016/j.sleep.2018.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/26/2018] [Accepted: 02/28/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Several studies have investigated the particular relationship between insomnia and type 2 diabetes. However, few studies have investigated the prevalence and risk factors for type 2 diabetes in insomnia sufferers. The aim of this study was to examine the prevalence and risk factors of type 2 diabetes in a large sample of insomnia sufferers. METHODS Data from 1311 insomnia sufferers recruited from the research database of the Erasme Hospital sleep laboratory were analyzed. Only individuals with a diagnosis of type 2 diabetes according to the diagnostic criteria of the American Diabetes Association at admission were included in the diabetes group. Logistic regression analyses were conducted to examine clinical and demographic risk factors of type 2 diabetes in insomnia sufferers. RESULTS The prevalence of type 2 diabetes in insomnia sufferers is 21.13%. Multivariate logistic regression analysis revealed that significant risk factors of type 2 diabetes in insomnia sufferers were as follows: being male, Z-drugs use, high blood pressure, hypertriglyceridemia, alcohol consumption of ≥4 units/day, BMI ≥25 & <30 kg/m2, BMI ≥30 kg/m2, age ≥50 years, C-reactive protein ≥4.5 mg/L, a sleep duration of <6.5 h, apnea-hypopnea index ≥15/hour, periodic limb movements index ≥26/hour, and severe complaints of early morning awakening. CONCLUSION Type 2 diabetes is a common pathology in insomnia sufferers. In this subpopulation, most of the risk factors for type 2 diabetes are reversible, which justifies better prevention and management of this pathology in order to avoid its negative consequences.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwénolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Paul Linkowski
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
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Georgousopoulou EN, D'Cunha NM, Mellor DD, Tyrovolas S, Naumovski N, Foscolou A, Bountziouka V, Gotsis E, Metallinos G, Tyrovola D, Piscopo S, Valacchi G, Tsakountakis N, Zeimbekis A, Tur JA, Matalas AL, Polychronopoulos E, Lionis C, Sidossis L, Panagiotakos DB, MEDIS Study Group. The Association Between Sleeping Time and Metabolic Syndrome Features, Among Older Adults Living in Mediterranean Region: The MEDIS Study. Metab Syndr Relat Disord 2018. [DOI: 10.1089/met.2017.0113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ekavi N. Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition & Dietetics, Faculty of Health, University of Canberra, Canberra, Australia
| | - Nathan M. D'Cunha
- Department of Nutrition & Dietetics, Faculty of Health, University of Canberra, Canberra, Australia
| | - Duane D. Mellor
- School of Life Science, Coventry University, Coventry, United Kingdom
| | - Stefanos Tyrovolas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Nenad Naumovski
- Department of Nutrition & Dietetics, Faculty of Health, University of Canberra, Canberra, Australia
| | - Alexandra Foscolou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Vassiliki Bountziouka
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Efthimios Gotsis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - George Metallinos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitra Tyrovola
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Suzanne Piscopo
- Nutrition, Family and Consumer Studies Office, University of Malta, Msida, Republic of Malta
| | - Giuseppe Valacchi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
- Animal Science Department, Plants for Human Health Institute, NC State University, Kannapolis, North Carolina
| | - Nikos Tsakountakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Akis Zeimbekis
- Health Center of Kalloni, General Hospital of Mitilini, Mitilini, Greece
| | - Josep-Antoni Tur
- Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears & CIBERobn, Palma de Mallorca, Spain
| | - Antonia-Leda Matalas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Evangelos Polychronopoulos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Labros Sidossis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition & Dietetics, Faculty of Health, University of Canberra, Canberra, Australia
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey
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