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Pavlova NT, Moss‐Morris R, Smith C, Carr E, Rayner L, Picariello F. The importance of illness severity and multimorbidity in the association between mental health and body weight in psoriasis: Cross-sectional and longitudinal analysis. SKIN HEALTH AND DISEASE 2022; 2:e117. [PMID: 36479273 PMCID: PMC9720224 DOI: 10.1002/ski2.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND High body weight is common in psoriasis and is associated with depression and anxiety. Past studies are mostly cross-sectional and may underestimate the role of demographic and illness-related factors in the association between mental health and body weight in psoriasis. OBJECTIVES This study explored the association between depression and anxiety with waist circumference and body mass index (BMI) cross-sectionally and at 12 months follow-up, adjusting for demographic and illness-related factors in people with psoriasis. METHOD Routine psoriasis care data were combined with data on depression and anxiety from a large specialist psoriasis centre. The analytical samples consisted of patients with complete data on either waist circumference (N = 326 at time 1; N = 191 at follow-up) or BMI (N = 399 at time 1; N = 233 at follow-up) and corresponding mental health, demographic, and illness-related information. Associations between weight-related outcomes and mental health variables were assessed at time one and at 12 months follow-up, after adjusting for demographic and illness-related factors. RESULTS We found no evidence of associations between mental health and waist circumference or BMI, after adjusting for age, gender and illness-related factors. Higher age, male gender and illness-related factors, specifically multimorbidity and psoriasis severity, were positively associated with waist circumference and BMI at both time points. CONCLUSION This study revealed the important role of factors related to illness severity in body weight in psoriasis. The contribution of depression and anxiety to weight was not observed here likely due to the sample and methodology used. Future work should explore other psychosocial factors such as weight-related attitudes and emotional eating in the context of weight in psoriasis, to help inform the development of successful weight-management treatments.
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Affiliation(s)
- Neli T. Pavlova
- Health Psychology SectionPsychology DepartmentInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Rona Moss‐Morris
- Health Psychology SectionPsychology DepartmentInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Catherine Smith
- Health Psychology SectionPsychology DepartmentInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Guy's and St Thomas' NHS Foundation TrustSt John's Institute of DermatologyLondonUK
| | - Ewan Carr
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Lauren Rayner
- Department of Psychological MedicineInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Federica Picariello
- Health Psychology SectionPsychology DepartmentInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
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Singh P, Rawat A, Saadaoui M, Elhag D, Tomei S, Elanbari M, Akobeng AK, Mustafa A, Abdelgadir I, Udassi S, Hendaus MA, Al Khodor S. Tipping the Balance: Vitamin D Inadequacy in Children Impacts the Major Gut Bacterial Phyla. Biomedicines 2022; 10:biomedicines10020278. [PMID: 35203487 PMCID: PMC8869474 DOI: 10.3390/biomedicines10020278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/12/2022] Open
Abstract
Vitamin D inadequacy appears to be on the rise globally, and it has been linked to an increased risk of osteoporosis, as well as metabolic, cardiovascular, and autoimmune diseases. Vitamin D concentrations are partially determined by genetic factors. Specific single nucleotide polymorphisms (SNPs) in genes involved in vitamin D transport, metabolism, or binding have been found to be associated with its serum concentration, and these SNPs differ among ethnicities. Vitamin D has also been suggested to be a regulator of the gut microbiota and vitamin D deficiency as the possible cause of gut microbial dysbiosis and inflammation. This pilot study aims to fill the gap in our understanding of the prevalence, cause, and implications of vitamin D inadequacy in a pediatric population residing in Qatar. Blood and fecal samples were collected from healthy subjects aged 4–14 years. Blood was used to measure serum metabolite of vitamin D, 25-hydroxycholecalciferol 25(OH)D. To evaluate the composition of the gut microbiota, fecal samples were subjected to 16S rRNA gene sequencing. High levels of vitamin D deficiency/insufficiency were observed in our cohort with 97% of the subjects falling into the inadequate category (with serum 25(OH)D < 75 nmol/L). The CT genotype in rs12512631, an SNP in the GC gene, was associated with low serum levels of vitamin D (ANOVA, p = 0.0356) and was abundant in deficient compared to non-deficient subjects. Overall gut microbial community structure was significantly different between the deficient (D) and non-deficient (ND) groups (Bray Curtis dissimilarity p = 0.049), with deficient subjects also displaying reduced gut microbial diversity. Significant differences were observed among the two major gut phyla, Firmicutes (F) and Bacteroidetes (B), where deficient subjects displayed a higher B/F ratio (p = 0.0097) compared to ND. Vitamin D deficient children also demonstrated gut enterotypes dominated by the genus Prevotella as opposed to Bacteroides. Our findings suggest that pediatric vitamin D inadequacy significantly impacts the gut microbiota. We also highlight the importance of considering host genetics and baseline gut microbiome composition in interpreting the clinical outcomes related to vitamin D deficiency as well as designing better personalized strategies for therapeutic interventions.
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Affiliation(s)
- Parul Singh
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha P.O. Box 5825, Qatar
| | - Arun Rawat
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
| | - Marwa Saadaoui
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
| | - Duaa Elhag
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
| | - Sara Tomei
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
| | - Mohammed Elanbari
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
| | - Anthony K. Akobeng
- Division of Gastroenterology, Hepatology, and Nutrition, Sidra Medicine, Doha P.O. Box 26999, Qatar;
| | - Amira Mustafa
- Pediatric Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (A.M.); (S.U.); (M.A.H.)
| | | | - Sharda Udassi
- Pediatric Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (A.M.); (S.U.); (M.A.H.)
| | - Mohammed A. Hendaus
- Pediatric Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (A.M.); (S.U.); (M.A.H.)
| | - Souhaila Al Khodor
- Research Department, Sidra Medicine, Doha P.O. Box 26999, Qatar; (P.S.); (A.R.); (M.S.); (D.E.); (S.T.); (M.E.)
- Correspondence: ; Tel.: +974-4003-7397
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Badawi A, Liu CJ, Rehim AA, Gupta A. Artificial neural network to predict the effect of obesity on the risk of tuberculosis infection. J Public Health Res 2021; 10:1985. [PMID: 33849253 PMCID: PMC7993018 DOI: 10.4081/jphr.2021.1985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/04/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Body weight has been implicated as a risk factor for latent tuberculosis infection (LTBI) and the active disease. DESIGN AND METHODS This study aimed to develop artificial neural network (ANN) models for predicting LTBI from body weight and other host-related disease risk factors. We used datasets from participants of the US-National Health and Nutrition Examination Survey (NHANES; 2012; n=5,156; 514 with LTBI and 4,642 controls) to develop three ANNs employing body mass index (BMI, Network I), BMI and HbA1C (as a proxy for diabetes; Network II) and BMI, HbA1C and education (as a proxy for socioeconomic status; Network III). The models were trained on n=1018 age- and sex-matched subjects equally distributed between the control and LTBI groups. The endpoint was the prediction of LTBI. RESULTS When data was adjusted for age, sex, diabetes and level of education, odds ratio (OR) and 95% confidence intervals (CI) for risk of LTBI with increased BMI was 0.85 (95%CI: 0.77 - 0.96, p=0.01). The three ANNs had a predictive accuracy varied from 75 to 80% with sensitivities ranged from 85% to 94% and specificities of approximately 70%. Areas under the receiver operating characteristic curve (AUC) were between 0.82 and 0.87. Optimal ANN performance was noted using BMI as a risk indicator. CONCLUSION Body weight can be employed in developing artificial intelligence-based tool to predict LTBI. This can be useful in precise decision making in clinical and public health practices aiming to curb the burden of tuberculosis, e.g., in the management and monitoring of the tuberculosis prevention programs and to evaluate the impact of healthy weight on tuberculosis risk and burden.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto.
| | - Christina J Liu
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto.
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Knowlden AP, Higginbotham JC, Grandner MA, Allegrante JP. Modeling Risk Factors for Sleep- and Adiposity-Related Cardiometabolic Disease: Protocol for the Short Sleep Undermines Cardiometabolic Health (SLUMBRx) Observational Study. JMIR Res Protoc 2021; 10:e27139. [PMID: 33687340 PMCID: PMC7988396 DOI: 10.2196/27139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 01/24/2023] Open
Abstract
Background Obesity and short sleep duration are significant public health issues. Current evidence suggests that these conditions are associated with cardiovascular disease, metabolic syndrome, inflammation, and premature mortality. Increased interest in the potential link between obesity and short sleep duration, and its health consequences, has been driven by the apparent parallel increase in the prevalence of both conditions in recent decades, their overlapping association with cardiometabolic outcomes, and the potential causal connection between the two health issues. The SLUMBRx (Short Sleep Undermines Cardiometabolic Health) study seeks to contribute to the development of a comprehensive adiposity-sleep model while laying the groundwork for a future research program that will be designed to prevent and treat adiposity- and sleep-related cardiometabolic disease risk factors. Objective This SLUMBRx study aims to address 4 topics pertinent to the adiposity-sleep hypothesis: the relationship between adiposity and sleep duration; sex-based differences in the relationship between adiposity and sleep duration; the influence of adiposity indices and sleep duration on cardiometabolic outcomes; and the role of socioecological factors as effect modifiers in the relationship between adiposity indices, sleep, and cardiometabolic outcomes. Methods SLUMBRx will employ a large-scale survey (n=1000), recruiting 159 participants (53 normal weight, 53 overweight, and 53 obese) to be assessed in 2 phases. Results SLUMBRx was funded by the National Institutes of Health, Heart, Lung, and Blood Institute through a K01 grant award mechanism (1K01HL145128-01A1) on July 23, 2019. Institutional Review Board (IRB) approval for the research project was sought and obtained on July 10, 2019. Phase 1 of SLUMBRx, the laboratory-based component of the study, will gather objective adiposity indices (air displacement plethysmography and anthropometrics) and cardiometabolic data (blood pressure, pulse wave velocity and pulse wave analysis, and a blood-based biomarker). Phase 2 of SLUMBRx, a 1-week, home-based component of the study, will gather sleep-related data (home sleep testing or sleep apnea, actigraphy, and sleep diaries). During phase 2, detailed demographic and socioecological data will be collected to contextualize hypothesized adiposity and sleep-associated cardiometabolic disease risk factors. Collection and analyses of these data will yield information necessary to customize future observational and intervention research. Conclusions Precise implementation of the SLUMBRx protocol promises to provide objective and empirical data on the interaction between body composition and sleep duration. The hypotheses that will be tested by SLUMBRx are important for understanding the pathogenesis of cardiometabolic disease and for developing future public health interventions to prevent its conception and treat its consequences. International Registered Report Identifier (IRRID) PRR1-10.2196/27139
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Affiliation(s)
- Adam P Knowlden
- Department of Health Science, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, United States
| | - John C Higginbotham
- Department of Community Medicine and Population Health, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL, United States
| | - Michael A Grandner
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - John P Allegrante
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, United States.,Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
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5
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Badawi A, Liu CJ. Obesity and Prevalence of Latent Tuberculosis: A Population-Based Survey. Infect Dis (Lond) 2021; 14:1178633721994607. [PMID: 33716508 PMCID: PMC7926054 DOI: 10.1177/1178633721994607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/23/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Diminution in body weight is a known risk factor that increases the burden of active tuberculosis (TB). However, conflicting evidence exists for the effect of body weight on the risk of latent tuberculosis infection (LTBI). The objective of the present study is to examine the prevalence of LTBI at different body weights, evaluate the extent of association between body mass index (BMI) and LTBI and identify factors mediating this relationship in an adult population. METHODS We conducted a cross-sectional study to estimate the relationship between BMI and LTBI in participants from the US-National Health and Nutrition Examination Survey (NHANES; 2012, n = 5156; 514 with LTBI and 4642 controls). RESULTS The association between BMI and levels of cardiometabolic risk markers in both LTBI and control groups had a similar profile. When adjusted for age and sex, BMI was significantly inversely correlated with the prevalence of LTBI (r = -0.147, P < .001). Effect of BMI on the risk of LTBI was evaluated using multivariate logistic regression models adjusted for age, sex, diabetes, and level of education. In this model, increasing BMI was significantly associated with lower risk of LTBI (OR = 0.85; 95%CI: 0.77-0.96, P < .01). CONCLUSION This study further establishes an inverse relationship between BMI and prevalence of LTBI. Decreased BMI can be considered as a risk factor in LTBI, the reservoir for active TB cases.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, ON, Canada
| | - Christina J Liu
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, ON, Canada
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Mohammad S, Aziz R, Al Mahri S, Malik SS, Haji E, Khan AH, Khatlani TS, Bouchama A. Obesity and COVID-19: what makes obese host so vulnerable? IMMUNITY & AGEING 2021; 18:1. [PMID: 33390183 PMCID: PMC7779330 DOI: 10.1186/s12979-020-00212-x] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/03/2020] [Indexed: 12/13/2022]
Abstract
The disease (COVID-19) novel coronavirus pandemic has so far infected millions resulting in the death of over a million people as of Oct 2020. More than 90% of those infected with COVID-19 show mild or no symptoms but the rest of the infected cases show severe symptoms resulting in significant mortality. Age has emerged as a major factor to predict the severity of the disease and mortality rates are significantly higher in elderly patients. Besides, patients with underlying conditions like Type 2 diabetes, cardiovascular diseases, hypertension, and cancer have an increased risk of severe disease and death due to COVID-19 infection. Obesity has emerged as a novel risk factor for hospitalization and death due to COVID-19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to COVID-19. Here we review the published data related to obesity and overweight to assess the possible risk and outcome in Covid-19 patients based on their body weight. Besides, we explore how the obese host provides a unique microenvironment for disease pathogenesis, resulting in increased severity of the disease and poor outcome.
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Affiliation(s)
- Sameer Mohammad
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences-MNGHA, Riyadh, 11426, Saudi Arabia.
| | - Rafia Aziz
- Government Medical College Baramulla, Baramulla, Kashmir, India
| | - Saeed Al Mahri
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences-MNGHA, Riyadh, 11426, Saudi Arabia
| | - Shuja Shafi Malik
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences-MNGHA, Riyadh, 11426, Saudi Arabia
| | - Esraa Haji
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences-MNGHA, Riyadh, 11426, Saudi Arabia
| | - Altaf Husain Khan
- Biostatistics and Bioinformatics Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences-MNGHA, Riyadh, 11426, Saudi Arabia
| | - Tanvir Saleem Khatlani
- Department of Cellular Therapy, Stem Cells Unit, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences--MNGHA, Riyadh, 11426, Saudi Arabia
| | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences-MNGHA, Riyadh, 11426, Saudi Arabia
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Badawi A, Di Giuseppe G, Gupta A, Poirier A, Arora P. Bayesian network modelling study to identify factors influencing the risk of cardiovascular disease in Canadian adults with hepatitis C virus infection. BMJ Open 2020; 10:e035867. [PMID: 32371519 PMCID: PMC7228556 DOI: 10.1136/bmjopen-2019-035867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The present study evaluates the extent of association between hepatitis C virus (HCV) infection and cardiovascular disease (CVD) risk and identifies factors mediating this relationship using Bayesian network (BN) analysis. DESIGN AND SETTING A population-based cross-sectional survey in Canada. PARTICIPANTS Adults from the Canadian Health Measures Survey (n=10 115) aged 30 to 74 years. PRIMARY AND SECONDARY OUTCOME MEASURES The 10-year risk of CVD was determined using the Framingham Risk Score in HCV-positive and HCV-negative subjects. Using BN analysis, variables were modelled to calculate the probability of CVD risk in HCV infection. RESULTS When the BN is compiled, and no variable has been instantiated, 73%, 17% and 11% of the subjects had low, moderate and high 10-year CVD risk, respectively. The conditional probability of high CVD risk increased to 13.9%±1.6% (p<2.2×10-16) when the HCV variable is instantiated to 'Present' state and decreased to 8.6%±0.2% when HCV was instantiated to 'Absent' (p<2.2×10-16). HCV cases had 1.6-fold higher prevalence of high-CVD risk compared with non-infected individuals (p=0.038). Analysis of the effect modification of the HCV-CVD relationship (using median Kullback-Leibler divergence; DKL ) showed diabetes as a major effect modifier on the joint probability distribution of HCV infection and CVD risk (DKL =0.27, IQR: 0.26 to 0.27), followed by hypertension (0.24, IQR: 0.23 to 0.25), age (0.21, IQR: 0.10 to 0.38) and injection drug use (0.19, IQR: 0.06 to 0.59). CONCLUSIONS Exploring the relationship between HCV infection and CVD risk using BN modelling analysis revealed that the infection is associated with elevated CVD risk. A number of risk modifiers were identified to play a role in this relationship. Targeting these factors during the course of infection to reduce CVD risk should be studied further.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Giancarlo Di Giuseppe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
| | - Alind Gupta
- Lighthouse Outcomes, Toronto, Ontario, Canada
| | - Abbey Poirier
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Paul Arora
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Twelve Weeks of Combined Resistance and Aerobic Exercise Improves Cardiometabolic Biomarkers and Enhances Red Blood Cell Hemorheological Function in Obese Older Men: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245020. [PMID: 31835508 PMCID: PMC6950327 DOI: 10.3390/ijerph16245020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/06/2019] [Accepted: 12/07/2019] [Indexed: 12/22/2022]
Abstract
The present study examined the effect of a 12-week combined resistance and aerobic exercise training program on cardiometabolic biomarkers and red blood cell (RBC) hemorheological function in 20 obese older men (mean age: 68.8 ± 0.9 years). Subjects were randomly divided into two groups (exercise intervention [EXP; n = 10] and control [CON; n = 10]). The EXP subjects performed resistance and aerobic exercise training program three times per week for 12 weeks, and the CON subjects maintained their regular lifestyle during the intervention period. Body composition was estimated using bioelectrical impedance analysis equipment. Cardiometabolic biomarkers (glucose, insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR), HOMA β-cell function, and leptin) and RBC hemorheological parameters (RBC deformability and aggregation) were analyzed. Percent body fat decreased significantly in the EXP group during the intervention period but increased significantly in the CON group. Insulin increased significantly in the CON group over the 12-week period and both insulin and HOMA-IR were significantly higher in the CON group than in the EXP group at post-test. RBC deformability (RBC EI_3Pa) and aggregation (RBC AI_3Pa) improved significantly only in the EXP group. The present study suggests that combined exercise training can be useful for improving cardiometabolic biomarkers and RBC hemorheological parameters in obese older men and may help prevent metabolic syndrome and cardiovascular diseases.
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Sia D, Miszkurka M, Batal M, Delisle H, Zunzunegui MV. Chronic disease and malnutrition biomarkers among unemployed immigrants and Canadian born adults. ACTA ACUST UNITED AC 2019; 77:41. [PMID: 31548886 PMCID: PMC6751622 DOI: 10.1186/s13690-019-0367-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
Background Immigration status and unemployment may intersect on the health outcomes of men and women. This study aimed to identify intersections between unemployment and immigration in inflammatory, metabolic and nutritional blood markers and assess gender differences. Methods We used Canadian Health Measures Survey data on 2493 participants aged 18 to 65. Outcomes were chronic inflammation (high-sensitivity C-reactive protein (hsCRP) and fibrinogen), nutritional (albumin and hemoglobin), and metabolic blood markers (glycosylated hemoglobin, blood glucose, total and high density lipoprotein (HDL) cholesterol). Multivariate linear regressions were used to assess the associations between each biomarker, unemployment and immigrant status, controlling for age, education, province, smoking, physical inactivity and body mass index and testing for multiplicative interactions between unemployment, immigrant status and gender. Results Unemployment was associated with higher inflammation (hsCRP and fibrinogen) in Canadian born men; Canadian born employed women showed higher hsCRP values compared with corresponding employed men. Unemployed immigrant women presented the highest values of hsCRP while employed immigrant women had the lowest hsCRP. Unemployment was associated with higher glucose; immigrant status was associated with higher glucose and glycosylated hemoglobin. Unemployed immigrants had significantly lower levels of hemoglobin and albumin than employed immigrants, and Canadian-born citizens regardless of their employment status. Some of these associations were attenuated after adjustment by body mass index, physical inactivity and smoking. Conclusion Blood biomarkers unveil intersections among unemployment, immigration and gender. This study provides evidence on biological pathways of unemployment on the likelihood of common chronic diseases, inflammation and potential malnutrition with some increased vulnerabilities in unemployed immigrants, and particularly in unemployed immigrant women.
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Affiliation(s)
- Drissa Sia
- 1Département des sciences infirmières, Campus de Saint-Jérôme, Université du Québec en Outaouais, 5, rue Saint-Joseph, bureau J-3226, Saint Jérôme, Québec J7Z 0B7 Canada
| | - Malgorzata Miszkurka
- 2Département de médecine sociale et préventive, Université de Montréal, Montréal, Québec Canada
| | - Malek Batal
- 3Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, Québec Canada
| | - Hélène Delisle
- 3Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, Québec Canada
| | - Maria Victoria Zunzunegui
- 4Département de médecine sociale et préventive, Université de Montréal, Montréal, Québec Canada.,5École de santé publique, Université de Montréal, Montréal, Québec Canada
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Abstract
Joint pain attributable to osteoarthritis (OA) is complex and influenced by a myriad of factors beyond local joint pathology. Current practice continues to predominantly adopt a biomedical approach to OA despite emerging evidence of the importance of a more holistic approach. This paper will summarise evidence for the presence of multidimensional pain profiles in knee joint pain and the presence of subgroups characterized by systemic features such as psychological distress, high comorbidity load or sensitisation of the nervous system. These factors have the potential to influence patient outcomes making them relevant for clinicians and highlighting the necessity of a broader multifactorial approach to assessment and treatment. This review describes the current state of the evidence for treatments of people with knee OA-related pain, including those receiving strong recommendations from current clinical guidelines, namely exercise, weight loss, self-management advice and pharmacological approaches. Other pain-modulating treatment options are emerging such as sleep and psychological interventions, pain education and multisensory retraining. The evidence and rationale for these newer therapeutic approaches is discussed. Finally, this review will highlight some of the limitations of current international guidelines for the management of OA and make recommendations for future research.
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Affiliation(s)
- K Mills
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - M Hübscher
- Neuroscience Research Australia, Barker Street, Randwick, NSW 2031, Sydney, Australia.
| | - H O'Leary
- Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - N Moloney
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.,Thrive Physiotherapy, Guernsey, Channel Islands, UK
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11
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Badawi A, Di Giuseppe G, Arora P. Cardiovascular disease risk in patients with hepatitis C infection: Results from two general population health surveys in Canada and the United States (2007-2017). PLoS One 2018; 13:e0208839. [PMID: 30540839 PMCID: PMC6291240 DOI: 10.1371/journal.pone.0208839] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/25/2018] [Indexed: 02/06/2023] Open
Abstract
The role of hepatitis C virus (HCV) infection in increasing the risk of cardiovascular disease (CVD) is controversial. The objective of the present study is to estimate the 10-year risk of CVD in HCV- positive subjects and describe their profile of cardiometabolic risk markers compared to HCV-negative subjects. We conducted a cross-sectional study to estimate 10-year CVD risk, calculated using the Framingham Risk Score (FRS), in participants from the Canadian Health Measures Survey (CHMS; 2007–2015, n = 10,115) and the US-National Health and Nutrition Examination Survey (NHANES; 2007–2016, n = 16,668). Subjects included in our analysis were aged 30 to 74 years with no prior history of CVD. FRS estimates, sociodemographic and cardiometabolic risk factors were compared between HCV- positive and -negative subjects in the two surveys. HCV-positive subjects had a distinct sociodemographic profile compared to their HCV-negative counterparts. Cardiometabolic risk factors, inflammatory markers and serum levels of micronutrients were comparable between the two survey populations, both in HCV-positive and -negative subjects. The average FRS in HCV-positive patients was in the range of “intermediate” 10-year CVD risk (i.e., 10–20%) and was significantly higher (P<0.01) than their HCV-negative counterparts who were within the “low” 10-year CVD risk range (i.e., ≤10%). Using a multivariable linear regression model adjusted for ethnicity, number of metabolic syndrome components and BMI, HCV infection was significantly associated with a 2.5–3.5% absolute risk increase of 10-year CVD (P<0.01). The results of the present study suggest a potential association between HCV infection and risk of subclinical and clinical CVD. The expansion of anti-HCV therapy may also contribute to reduced CVD risk and burden in patients with chronic HCV infection and should be explored further in other datasets and population modelling studies.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- * E-mail:
| | | | - Paul Arora
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Division of Enteric Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Toronto, ON, Canada
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Chao YS, Wu CJ, Wu HC, Chen WC. Trend analysis for national surveys: Application to all variables from the Canadian Health Measures Survey cycle 1 to 4. PLoS One 2018; 13:e0200127. [PMID: 30092046 PMCID: PMC6084849 DOI: 10.1371/journal.pone.0200127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 05/16/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Trend analysis summarizes patterns over time in the data to show the direction of change and can be used to investigate uncertainties in different time points and associations with other factors. However, this approach is not widely applied to national surveys and only selected outcomes are investigated. This study demonstrates a research framework to conduct trend analysis for all variables in a national survey, the Canadian Health Measures Survey (CHMS). DATA AND METHODS The CHMS cycle 1 to 4 was implemented between 2007 and 2015. The characteristics of all variables were screened and associated to the weight variables. Missing values were identified and cleaned according to the User Guide. The characteristics of all variables were extracted and used to guide data cleaning. Trend analysis examined the statistical significance of candidate predictors: the cycles, age, sex, education, household income and body mass index (BMI). R (v3.2) and RStudio (v0.98.113) were used to develop the framework. RESULTS There were 26557 variables in 79 data files from four cycles. There were 1055 variables significantly associated with the CHMS cycles and 2154 associated with the BMI after controlling for other predictors. The trend of blood pressure was similar to those published. CONCLUSION Trend analysis for all variables in the CHMS is feasible and is a systematic approach to understand the data. Because of trend analysis, we have detected data errors and identified several environmental biomarkers with extreme rates of change across cycles. The impact of these biomarkers has not been well studied by Statistics Canada or others. This framework can be extended to other surveys, especially the Canadian Community Health Survey.
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Affiliation(s)
- Yi-Sheng Chao
- Centre de recherche du centre hospitalier de l’Université de Montréal (CRCHUM), Université de Montréal, Montréal, Québec, Canada
| | - Chao-Jung Wu
- Département d'informatique, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Hsing-Chien Wu
- Taipei Hospital, Ministry of Health and Welfare, New Taipei city, Taiwan
| | - Wei-Chih Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Gujral UP, Vittinghoff E, Mongraw-Chaffin M, Vaidya D, Kandula NR, Allison M, Carr J, Liu K, Narayan KMV, Kanaya AM. Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups in the United States: A Cross-sectional Analysis of Two Cohort Studies. Ann Intern Med 2017; 166:628-636. [PMID: 28384781 PMCID: PMC5545925 DOI: 10.7326/m16-1895] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity. OBJECTIVE To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. DESIGN Cross-sectional analysis. SETTING 2 community-based cohorts. PARTICIPANTS 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. MEASUREMENTS Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models. RESULTS Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0% (95% CI, 18.4% to 23.9%) in whites, 32.2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity-body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians. LIMITATION Cross-sectional study design and lack of harmonized dietary data between studies. CONCLUSION Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
- Unjali P Gujral
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Eric Vittinghoff
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Morgana Mongraw-Chaffin
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Dhananjay Vaidya
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Namratha R Kandula
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Matthew Allison
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Jeffrey Carr
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Kiang Liu
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - K M Venkat Narayan
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
| | - Alka M Kanaya
- From Emory University, Atlanta, Georgia; University of California, San Francisco, San Francisco, and University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois; and Vanderbilt University, Nashville, Tennessee
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Fonseca FAH, de Oliveira Izar MC. High-Sensitivity C-Reactive Protein and Cardiovascular Disease Across Countries and Ethnicities. Clinics (Sao Paulo) 2016; 71:235-42. [PMID: 27166776 PMCID: PMC4825196 DOI: 10.6061/clinics/2016(04)11] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/12/2016] [Indexed: 12/22/2022] Open
Abstract
Despite substantial differences in ethnicities, habits, cultures, the prevalence of traditional cardiovascular risk factors and affordable therapies, atherosclerosis remains the major cause of death in developing and developed countries. However, irrespective of these differences, inflammation is currently recognized as the common pathway for the major complications of atherosclerosis, stroke, and ischemic heart disease. A PubMed search was conducted for "high-sensitivity C-reactive protein" (hs-CRP) in combination with the terms race, ethnicity, gender, prevalence, geographic, epidemiology, cardiovascular, obesity, diabetes, hypertension, cholesterol, smoking, ischemic heart disease, stroke, and mortality. This review includes the articles that pertained to the topic and additional articles identified from the reference lists of relevant publications. This review describes the marked differences in cardiovascular mortality across countries and ethnicities, which may be attributed to inequalities in the prevalence of the classic risk factors and the stage of cardiovascular epidemiological transition. However, hs-CRP appears to contribute to the prognostic information regarding cardiovascular risk and mortality even after multiple adjustments. Considering the perception of cardiovascular disease as an inflammatory disease, the more widespread use of hs-CRP appears to represent a valid tool to identify people at risk, independent of their ancestry or geographic region. In conclusion, this review reports that the complications associated with vulnerable atherosclerotic plaques are triggered by the major mechanisms of dyslipidemia and inflammation; whereas both mechanisms are influenced by classic risk factors, hs-CRP contributes additional information regarding cardiovascular events and mortality.
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Chang CJ, Jian DY, Lin MW, Zhao JZ, Ho LT, Juan CC. Evidence in obese children: contribution of hyperlipidemia, obesity-inflammation, and insulin sensitivity. PLoS One 2015; 10:e0125935. [PMID: 26011530 PMCID: PMC4444301 DOI: 10.1371/journal.pone.0125935] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/19/2015] [Indexed: 11/20/2022] Open
Abstract
Background Evidence shows a high incidence of insulin resistance, inflammation and dyslipidemia in adult obesity. The aim of this study was to assess the relevance of inflammatory markers, circulating lipids, and insulin sensitivity in overweight/obese children. Methods We enrolled 45 male children (aged 6 to 13 years, lean control = 16, obese = 19, overweight = 10) in this study. The plasma total cholesterol, HDL cholesterol, triglyceride, glucose and insulin levels, the circulating levels of inflammatory factors, such as TNF-α, IL-6, and MCP-1, and the high-sensitive CRP level were determined using quantitative colorimetric sandwich ELISA kits. Results Compared with the lean control subjects, the obese subjects had obvious insulin resistance, abnormal lipid profiles, and low-grade inflammation. The overweight subjects only exhibited significant insulin resistance and low-grade inflammation. Both TNF-α and leptin levels were higher in the overweight/obese subjects. A concurrent correlation analysis showed that body mass index (BMI) percentile and fasting insulin were positively correlated with insulin resistance, lipid profiles, and inflammatory markers but negatively correlated with adiponectin. A factor analysis identified three domains that explained 74.08% of the total variance among the obese children (factor 1: lipid, 46.05%; factor 2: obesity-inflammation, 15.38%; factor 3: insulin sensitivity domains, 12.65%). Conclusions Our findings suggest that lipid, obesity-inflammation, and insulin sensitivity domains predominantly exist among obese children. These factors might be applied to predict the outcomes of cardiovascular diseases in the future.
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Affiliation(s)
- Chi-Jen Chang
- Division of Pediatric Surgery, Department of Surgery, Shin-Kong Wu Ho-Su Hospital, Taipei, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Deng-Yuan Jian
- Institutes of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Nephrology, Wen-Lin Hemodialysis Unit, Taipei, Taiwan
| | - Ming-Wei Lin
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jun-Zhi Zhao
- Division of Pediatric Surgery, Department of Surgery, Shin-Kong Wu Ho-Su Hospital, Taipei, Taiwan
| | - Low-Tone Ho
- Institutes of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chi-Chang Juan
- Institutes of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- * E-mail:
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Sadeghi O, Maghsoudi Z, Nasiri M, Khorvash F, Ghiasvand R, Askari G. Association Between Abdominal Obesity Indicators and Serum Levels of Homocysteine in Migraine Patients: A Cross-Sectional Study. ACTA ACUST UNITED AC 2014. [DOI: 10.17795/jjhr-26653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Badawi A, Sayegh S, Sadoun E, Al-Thani M, Arora P, Haddad PS. Relationship between insulin resistance and plasma vitamin D in adults. Diabetes Metab Syndr Obes 2014; 7:297-303. [PMID: 25045275 PMCID: PMC4094570 DOI: 10.2147/dmso.s60569] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A recent relationship between vitamin D deficiency and the risk of type 2 diabetes mellitus (T2DM) and insulin resistance has been established through several studies. Research suggests a correlation between serum vitamin D and glycemic status measures. The aim of this study was to investigate the relationship between the plasma vitamin D levels (25[OH]D) and the factors linked to insulin resistance in a representative sample of Canadians ranging in age from 16-79 years. Data were used from the Canadian Health Measures Survey where direct measures of health and wellness were reported from 1,928 subjects. These data were gathered from March 2007-February 2009 at 15 sites selected through a multistage sampling strategy. An inverse relationship between insulin resistance and plasma vitamin D level in both men and women was observed. This study provides additional evidence for the role of vitamin D in T2DM. If causally associated, the supplementation of vitamin D may help in preventing insulin resistance and subsequent T2DM.
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Affiliation(s)
- Alaa Badawi
- Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
- Correspondence: Alaa Badawi, Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, 180 Queen Street West, Toronto, ON M5V 3L7, Canada, Email
| | - Suzan Sayegh
- Department of Public Health, Supreme Council of Health, Doha, Qatar
| | - Eman Sadoun
- Clinical Research Division, Supreme Council of Health, Doha, Qatar
| | - Mohamed Al-Thani
- Department of Public Health, Supreme Council of Health, Doha, Qatar
| | - Paul Arora
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - Pierre S Haddad
- Department of Pharmacology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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Bariatric orthopaedics: total knee arthroplasty in super-obese patients (BMI > 50 kg/m2). Survivorship and complications. Clin Orthop Relat Res 2013; 471:3523-30. [PMID: 23839328 PMCID: PMC3792257 DOI: 10.1007/s11999-013-3154-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 06/27/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Some studies have suggested that patients who are super obese (BMI > 50 kg/m(2)) may have poorer outcomes and more frequent complications when undergoing TKA compared with those who have lower BMI, however, the literature on this is scant. QUESTIONS/PURPOSES The purpose of this study was to compare a group of super-obese patients undergoing TKA with a matched group of patients with BMI less than 30 kg/m(2) in terms of (1) implant survivorship, (2) complications, (3) functional parameters, and (4) intraoperative variables (including operative time and estimated blood loss). METHODS One-hundred one knees in 95 patients (21 men, 74 women) who had a minimum BMI of 50 kg/m(2) and who had undergone a primary TKA at one of the four high-volume institutions were compared with a group of patients who had a BMI less than 30 kg/m(2) who were matched by age, gender, preoperative clinical scores, and mean followup. End points evaluated by chart review included implant survivorship, medical and surgical complications, functional parameters (The Knee Society outcome scores and ROM), and intraoperative variables at a mean followup of 62 months (range, 36-85 months). RESULTS With the numbers available, there were no differences in aseptic implant survivorship (94% versus 98%, p = 0.28), however, medical and surgical complication rates (14% versus 5%, OR: 3.1, 95% CI=1.07-8.9; p = 0.037) were significantly higher in the super-obese patients compared with the nonobese matching group, respectively. Super-obese patients also achieved lower mean Knee Society functional scores (82 versus 90 points, p = 0.004) and smaller gains in flexion arc ROM (14° versus 21°, p = 0.009); they also lost more blood during surgery and experienced longer surgical anesthesia times compared with the matched group, respectively. CONCLUSIONS With the numbers available, we could not identify what might have been modest differences in implant survivorship, however, complications were more frequent and functional outcomes were significantly lower in super-obese patients. Other studies similarly have found inferior outcomes in this challenging group of patients. Our data may be considered pilot data for future prospective studies with longer followup.
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García-Bailo B, Da Costa LA, Arora P, Karmali M, El-Sohemy A, Badawi A. Plasma vitamin D and biomarkers of cardiometabolic disease risk in adult Canadians, 2007-2009. Prev Chronic Dis 2013; 10:E91. [PMID: 23742939 PMCID: PMC3682811 DOI: 10.5888/pcd10.120230] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction Vitamin D may modulate cardiometabolic disease risk, although the relationship has not been investigated in the general Canadian population. Understanding this relationship may inform public health strategies to curb the incidence of cardiometabolic disease in Canada and elsewhere. The objectives of this study were to examine the association between vitamin D and traditional and novel biomarkers of cardiometabolic disease and to describe the extent of the month-to-month fluctuations of vitamin D in the Canadian population. Methods We examined the association between plasma 25-hydroxyvitamin D and a range of cardiometabolic risk biomarkers in participants (n = 1,928; age range, 16–79 years) from the Canadian Health Measures Survey. We conducted linear regressions analyses (adjusted for sex, waist circumference, physical activity, hormone use, and season) to assess the relationship between 25-hydroxyvitamin D and biomarkers of dysglycemia, dyslipidemia, and inflammation in the study population. We repeated analyses stratified by sex, and we evaluated monthly fluctuations in 25-hydroxyvitamin D in men and women. Results We observed wide month-to-month variations in 25-hydroxyvitamin D; fluctuations were more pronounced in men. Plasma 25-hydroxyvitamin D was inversely associated with insulin, insulin resistance, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and the ratio of total to high-density lipoprotein cholesterol but not with fasting glucose, apolipoprotein A1, apolipoprotein B, C-reactive protein, fibrinogen, or homocysteine. This pattern varied between men and women. Conclusion Vitamin D may modulate various metabolic processes and may influence cardiometabolic disease risk in Canadians. These findings may have public health implications when recommending vitamin D for the prevention of cardiometabolic disease and related conditions.
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Affiliation(s)
- Bibiana García-Bailo
- Department of Nutritional Sciences, University of Toronto, and Office of Biotechnology and Population Health, Public Health Agency of Canada, Toronto, Canada
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Badawi A, Arora P, Sadoun E, Al-Thani AA, Thani MHA. Prevalence of vitamin d insufficiency in qatar: a systematic review. J Public Health Res 2012; 1:229-35. [PMID: 25170469 PMCID: PMC4140375 DOI: 10.4081/jphr.2012.e36] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 11/19/2012] [Indexed: 12/27/2022] Open
Abstract
Qatar has a high burden of chronic diseases including obesity, cardiovascular disease and type 2 diabetes mellitus. Low serum vitamin D levels have been implicated in the development and progression of a range of these chronic conditions. The prevalence of vitamin D insufficiency or deficiency in the general population of Qatar has still not been investigated. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of vitamin D insufficiency or deficiency in the Qatari population. A search strategy was developed for online databases (PubMed, Ovid MEDLINE, Embase and Embase Classic) between 1980 to the last week of August 2012, and bibliographies of the included studies were further searched for additional reports. Search terms used were QATAR and VITAMIN D. Studies reporting the serum levels of vitamin D in several Qatari sub-populations were identified. Weighted-average vitamin D serum levels and prevalence of low vitamin D status (<75 nmol/L) were calculated. Subgroup analysis was carried out by age. The quality of each study was evaluated according to four criteria: national representativeness, representation of males and females, the sample size, and the sampling protocol. A total of 16 relevant publications were identified, and 8 of these (reporting from 7 unique studies) met our inclusion and exclusion criteria with a total number of 1,699 Qatari subjects. The pooled sample size weighted-average vitamin D concentration (±SD) was 45.3±14.3 nmol/L (95% CI: 44.6-46.0; range 29.2-66.9 nmol/L). The weighted-average prevalence of low vitamin D status was 90.4% (95% CI: 90.1-91.0; range 83%-91%). Age was inversely correlated with vitamin D levels and directly with its insufficiency/deficiency prevalence. There have only been a few studies on the prevalence of low vitamin D in Qatar a very high prevalence of vitamin D insufficiency/deficiency in Qatar that increases with age has been suggested. The present report underlines the need to develop a nationally representative study to further evaluate vitamin D status in Qatar. Given the growing evidence of the role of vitamin D in chronic disease, this study could help develop public health strategies for disease prevention in Qatar.
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Affiliation(s)
- Alaa Badawi
- Public Health Division, Supreme Council of Health , Doha, Qatar ; Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada , Toronto, Ontario, Canada
| | - Paul Arora
- Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada , Toronto, Ontario, Canada ; Dalla Lana School of Public Health, University of Toronto , Ontario, Canada
| | - Eman Sadoun
- Clinical Research Division, Supreme Council of Health , Doha, Qatar
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