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Tan X, Li R, Ma H, Yuchi Y, Liao W, Hou X, Zhao Z. Physical activity diminished adverse associations of obesity with lipid metabolism in the population of rural regions of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2167-2179. [PMID: 37086064 DOI: 10.1080/09603123.2023.2203907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
The interactive effects of obesity and physical inactivity on lipid metabolism and prevalent dyslipidemia are scarcely reported in rural regions. 39029 subjects were obtained from the Henan Rural Cohort, and their metabolic equivalents (METs) of physical activity (PA) were computed. Independent associations of the obesity indices and PA with either lipid indices or prevalent dyslipidemia were analyzed by generalized linear models, and additive effects of obesity and PA on prevalent dyslipidemia were further quantified. Each obesity index was positively associated with total cholesterol, triglyceride, low-density lipoprotein or prevalent dyslipidemia but negatively associated with high-density lipoprotein, whereas the opposite association of PA with either each lipid index or prevalent dyslipidemia was observed. Joint association of PA and each obesity index with each lipid index and prevalent dyslipidemia was observed. Furthermore, the association of each obesity index in association with each lipid index was attenuated by increased PA levels.
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Affiliation(s)
- Xiaomeng Tan
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - He Ma
- Health Service and Management Undergraduate, Shangzhen College, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, PR China
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoyu Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zijian Zhao
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, PR China
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Athanasakis K, Bala C, Kokkinos A, Simonyi G, Karoliová KH, Basse A, Bogdanovic M, Kang M, Low K, Gras A. The economic burden of obesity in 4 south-eastern European countries associated with obesity-related co-morbidities. BMC Health Serv Res 2024; 24:354. [PMID: 38504302 PMCID: PMC10953276 DOI: 10.1186/s12913-024-10840-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE To provide an assessment of the cost burden of obesity across a spectrum of obesity-related comorbidities (ORCs) for four countries in South-Eastern Europe (SEE). METHODS A micro-costing analysis from the public payer perspective was conducted to estimate direct healthcare costs associated with ten obesity-related comorbidities (ORCs) in Czech Republic, Greece, Hungary, and Romania. A survey was administered to obtain healthcare resource use and unit cost data. Cost estimates were validated by local steering committees which comprised at least one public sector clinician and a panel of independent industry experts. RESULTS Chronic kidney disease and cardiovascular diseases were the costliest ORCs across all 4 countries, where annual cost burden per ORC exceeded 1,500 USD per patient per year. In general, costs were driven by the tertiary care resources allocated to address treatment-related adverse events, disease complications, and associated inpatient procedures. CONCLUSIONS Our findings confirm that the high prevalence of obesity and its comorbidities result in substantial financial burden to all 4 SEE public payers. By quantifying the burden of obesity from a public healthcare perspective, our study aims to support policy efforts that promote health education and promotion in combating obesity in the region.
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Affiliation(s)
| | - Cornelia Bala
- University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania
| | - Alexander Kokkinos
- Medical School of the National, Kapodistrian University of Athens, Athens, Greece
| | - Gabor Simonyi
- St. Imre University Teaching Hospital, Budapest, Hungary
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Huang H, Leung KSK, Garg T, Mazzoleni A, Miteu GD, Zakariya F, Awuah WA, Yin ETS, Haroon F, Hussain Z, Aji N, Jaiswal V, Tse G. Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID-19 pandemic. Clin Cardiol 2023; 46:831-844. [PMID: 37260143 PMCID: PMC10436799 DOI: 10.1002/clc.24059] [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: 02/10/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
Familial hypercholesterolemia (FH) is a hereditary condition caused by mutations in the lipid pathway. The goal in managing FH is to reduce circulating low-density lipoprotein cholesterol and, therefore, reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Because FH patients were considered high risk groups due to an increased susceptible for contracting COVID-19 infection, we hypothesized whether the effects of the pandemic hindered access to cardiovascular care. In this review, we conducted a literature search in databases Pubmed/Medline and ScienceDirect. We included a comprehensive analysis of findings from articles in English related and summarized the effects of the pandemic on cardiovascular care through direct and indirect effects. During the COVID-19 pandemic, FH patients presented with worse outcomes and prognosis, especially those that have suffered from early ASCVD. This caused avoidance in seeking care due to fear of transmission. The pandemic severely impacted consultations with lipidologists and cardiologists, causing a decline in lipid profile evaluations. Low socioeconomic communities and ethnic minorities were hit the hardest with job displacements and lacked healthcare coverage respectively, leading to treatment nonadherence. Lock-down restrictions promoted sedentary lifestyles and intake of fatty meals, but it is unclear whether these factors attenuated cardiovascular risk in FH. To prevent early atherogenesis in FH patients, universal screening programs, telemedicine, and lifestyle interventions are important recommendations that could improve outcomes in FH patients. However, the need to research in depth on the disproportionate impact within different subgroups should be the forefront of FH research.
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Affiliation(s)
- Helen Huang
- Royal College of Surgeons in IrelandFaculty of Medicine and Health ScienceDublinIreland
| | - Keith S. K. Leung
- Aston University Medical School, Faculty of Health & Life SciencesAston UniversityBirminghamUK
- Epidemiology Research Unit, Cardiovascular Analytics GroupChina‐UK CollaborationHong KongChina
| | - Tulika Garg
- Government Medical College and Hospital ChandigarhChandigarhIndia
| | - Adele Mazzoleni
- Barts and The London School of Medicine and DentistryLondonUK
| | - Goshen D. Miteu
- School of Biosciences, BiotechnologyUniversity of NottinghamNottinghamUK
- Department of BiochemistryCaleb University LagosLagosNigeria
| | - Farida Zakariya
- Department of Pharmaceutical SciencesAhmadu Bello UniversityZariaNigeria
| | | | | | | | - Zarish Hussain
- Royal College of Surgeons in IrelandMedical University of BahrainBusaiteenBahrain
| | - Narjiss Aji
- Faculty of Medicine and Pharmacy of RabatMohammed V UniversityRabatMorocco
| | - Vikash Jaiswal
- Department of Cardiology ResearchLarkin Community HospitalSouth MiamiFloridaUSA
| | - Gary Tse
- Epidemiology Research Unit, Cardiovascular Analytics GroupChina‐UK CollaborationHong KongChina
- Tianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina
- Kent and Medway Medical SchoolCanterburyUK
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Gasca-Pineda R, Osorio-Hernández M, Mehta R, Escobedo-de-la-Peña J, Narváez-Oriani CA. Economic burden of hypercholesterolemia in high risk of cardiovascular disease population in Mexico. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2023; 93:328-335. [PMID: 37553116 PMCID: PMC10406478 DOI: 10.24875/acm.22000195] [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: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To estimate the direct and indirect economic burden of hypercholesterolemia in patients with high risk of a cardiovascular event, specifically there were defined 5 groups of patients: 1) familial hypercholesterolemia; 2, 3 and 4) patients with hypercholesterolemia and background of diabetes, myocardial infarction or stroke; 5) diabetes, myocardial infarction and hypercholesterolemia (very high-risk patients) from the Mexican public healthcare institutions. METHODS For the estimation of the direct costs the items included correspond to: outpatient care, pharmacological treatment, inpatient hospital care, and surgical procedures. For indirect economic burden, death certificates, before the end of the productive age due to hypercholesterolemia were calculated (premature mortality). RESULTS The direct economic burden for the 5 groups of patients at risk is MXN $39,601,464,154 (USD $1,987,526,432), while the indirect economic burden amounts to MXN $121,646,689 (USD $6,105,229). CONCLUSIONS The economic impact of hypercholesterolemia in patients with high cardiovascular risk is $39,723,110,843 (equivalent to USD $1,993,631,661) and corresponds to the 0.16% of GDP.
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Affiliation(s)
| | | | - Roopa Mehta
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud
| | - Jorge Escobedo-de-la-Peña
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional 1, Instituto Mexicano del Seguro Social
| | - Carlos A. Narváez-Oriani
- Hospital General Tacuba, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Ciudad de México, México
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Tien N, Wu TY, Lin CL, Wu CJ, Hsu CY, Fang YJ, Lim YP. Impact of Inflammatory Bowel Disease (IBD) and IBD Medications on Risk of Hyperlipidemia and in vitro Hepatic Lipogenic-Related Gene Expression: A Population-Based Cohort Study. Front Med (Lausanne) 2022; 9:910623. [PMID: 35770006 PMCID: PMC9234280 DOI: 10.3389/fmed.2022.910623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Patients with inflammatory bowel disease (IBD) present a higher risk of developing cardiovascular diseases (CVDs) due to chronic inflammation, which plays an essential role in atherogenesis. Hyperlipidemia is another risk factor for CVDs; however, the association between IBD, IBD medications, and hyperlipidemia remains controversial. We conducted a nationwide, population-based, retrospective, cohort study to examine the effect of IBD and IBD medications on the risk of developing hyperlipidemia. The effects of IBD medications on the expression of lipogenesis-related hepatic genes were also evaluated. We obtained data from the Longitudinal Health Insurance Database of Taiwan from patients with new-onset IBD and a comparison cohort of patients without IBD. A Cox proportional hazards regression model was used to analyze the difference in the risk of developing hyperlipidemia between the two cohorts. We also examined the influence of IBD medications on the expression of lipogenesis-related hepatic genes. After adjusting for comorbidities and confounding factors, the case group (N = 14,524) had a higher risk for hyperlipidemia than the control group (N = 14,524) [adjusted hazards ratio (aHR), 2.18]. Patients with IBD that did not receive IBD medications exhibited a significantly higher risk of hyperlipidemia (aHR, 2.20). In those treated with IBD medications, the risk of developing hyperlipidemia was significantly lowered than those without such medications (all aHR ≤ 0.45). Gene expression analysis indicated that IBD medications downregulated the expression of lipogenesis-related genes. Screening blood lipids in IBD patients is needed to explore the specific role and impact of IBD medications in the development of CVD.
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Affiliation(s)
- Ni Tien
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Tien-Yuan Wu
- Department of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Jui Wu
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Yi-Jen Fang
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, Department of Environmental Health, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Digestive Disease Center, Show Chwan Memorial Hospital, Changhua, Taiwan
- Yi-Jen Fang
| | - Yun-Ping Lim
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- *Correspondence: Yun-Ping Lim ;
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