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Chuquitarco-Morales A, Rivera-Navarro J, La Parra-Casado D, Fuster M, Franco M. Madrid immigrants' perceptions of urban food environments and their dietary behaviours. Appetite 2024; 199:107390. [PMID: 38703792 DOI: 10.1016/j.appet.2024.107390] [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: 01/24/2024] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
Large cities are home to several groups of immigrants who undergo important changes in their environmental conditions and lifestyles that significantly modify their risk of chronic diseases. Quantitative evidence indicates that both their health and diet worsen over time; much less is known about the qualitative mechanisms that cause these changes. The aim of this article is to understand how immigrants in the city of Madrid perceive the relation between the urban food environment and dietary behaviour. Based on a Social Ecological Framework, we conducted a secondary qualitative analysis derived from data from 41 immigrant residents, collected in eight focus groups (FGs), conducted in two neighbourhoods in the city of Madrid. We identified the following main categories: 1) Transnational identity and dietary behaviour in the neighbourhood; 2) Transitions in dietary behaviour; and 3) Societal/structural factors determining dietary behaviour in the neighbourhood. The participants in the FGs mentioned that they try to maintain traditional dietary customs and perceive that the taste of their typical dishes is better than those of Spanish dishes. Contradictorily, some participants considered their traditional dietary patterns to be less healthy than Mediterranean ones (consuming olive oil, vegetables, fish). Some participants acknowledged having adapted to the latter voluntarily or through dietary negotiations with their children. Immigrant families with two working parents have difficulties cooking homemade food and resort to less healthy options, such as eating fast food or ready-made meals. Due to their low purchasing power, they buy both ethnic products and other products, as well as considering the prices and offers in supermarkets. Our study highlights several structural mechanisms connecting the physical and social urban food environment with dietary behaviours among immigrant residents of a large city.
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Affiliation(s)
| | - Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - Daniel La Parra-Casado
- Department of Sociology 2, Universidad de Alicante, San Vicente del Raspeig, Alicante, Spain.
| | - Melissa Fuster
- Department of Social, Behavioral, and Population Sciences, Tulane University, School of Public Health & Tropical Medicine, New Orleans, LA, United States
| | - Manuel Franco
- Surgery and Medical and Social Sciences Department, Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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2
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Mesa RA, Damas OM, Schneiderman N, Palacio AM, Gallo LC, Talavera GA, Sotres-Alvarez D, Daviglus ML, Pirzada A, Llabre MM, Elfassy T. Association Between High-Sensitivity C-Reactive Protein and Metabolic Syndrome Among Hispanic/Latino Participants of the Hispanic Community Health Study/Study of Latinos. Metab Syndr Relat Disord 2024; 22:327-336. [PMID: 38563777 DOI: 10.1089/met.2023.0298] [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] [Indexed: 04/04/2024] Open
Abstract
Purpose: To determine whether high-sensitivity C-reactive protein (hsCRP) is associated with incident Metabolic Syndrome (MetS) among U.S. Hispanic/Latino adults. Patients and Methods: The Hispanic Community Health Study/Study of Latinos is a longitudinal observational cohort assessing cardiovascular health among diverse U.S. Hispanic/Latino adults. hsCRP was measured at visit 1 (2008-2011) and classified as low, moderate, or high, based on the Centers for Disease Control and Prevention and American Heart Association (CDC/AHA) guidelines. All MetS components [abdominal obesity, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and fasting glucose] were measured at visit 1 and visit 2 (2014-2017). MetS was defined as the presence of three or more components based on the 2005 definition from the modified Third Report of the National Cholesterol Education Program Adult Treatment Panel (modified NCEP ATP III). Participants free of MetS at visit 1 and with complete data on hsCRP and all MetS components were included (n = 6121 participants). We used Poisson regression analysis to determine whether hsCRP was associated with incident MetS after adjusting for demographic, behavioral, and clinical factors. All analyses accounted for the complex survey design of the study. Results: In fully adjusted models, moderate versus low hsCRP was associated with a 33% increased risk of MetS [incidence rate ratio (IRR): 1.33, 95% confidence interval (CI): 1.10-1.61], while high versus low hsCRP was associated with a 89% increased risk of MetS (IRR: 1.89, 95% CI: 1.58-2.25). Conclusions: Greater levels of hsCRP were associated with new onset of MetS in a diverse sample of U.S. Hispanic/Latino adults. Results suggest that hsCRP may be an independent risk factor for MetS.
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Affiliation(s)
- Robert A Mesa
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Oriana M Damas
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Ana M Palacio
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Gregory A Talavera
- Department of Psychology, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Tali Elfassy
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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Marquine MJ, Kamalyan L, Zlatar ZZ, Yassai-Gonzalez D, Perez-Tejada A, Umlauf A, Al-Rousan T, González V, Breton J, Guareña LA, Brody L, Cherner M, Ellis RJ, Zúñiga ML, Mungas DM, Moore RC, Moore DJ, Wojna V, Hall RK, Franklin DR, Heaton RK. Disparities in Metabolic Syndrome and Neurocognitive Function Among Older Hispanics/Latinos with Human Immunodeficiency Virus. AIDS Patient Care STDS 2024; 38:195-205. [PMID: 38662469 DOI: 10.1089/apc.2024.0043] [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] [Indexed: 05/25/2024] Open
Abstract
Neurocognitive impairment and metabolic syndrome (MetS) are prevalent in persons with HIV (PWH). We examined disparities in HIV-associated neurocognitive function between Hispanic and non-Hispanic White older PWH, and the role of MetS in explaining these disparities. Participants included 116 community-dwelling PWH aged 50-75 years enrolled in a cohort study in southern California [58 Hispanic (53% Spanish speaking) and 58 age-comparable non-Hispanic White; overall group: age: M = 57.9, standard deviation (SD) = 5.7; education (years): M = 13, SD = 3.4; 83% male, 58% AIDS, 94% on antiretroviral therapy]. Global neurocognition was derived from T-scores adjusted for demographics (age, education, sex, ethnicity, language) on a battery of 10 cognitive tests. MetS was ascertained via standard criteria that considered central obesity, and fasting elevated triglycerides, low high-density lipoprotein cholesterol and elevated glucose, or medical treatment for these conditions. Covariates examined included sociodemographic, psychiatric, substance use and HIV disease characteristics. Compared with non-Hispanic Whites, Hispanics showed worse global neurocognitive function (Cohen's d = 0.56, p < 0.05) and had higher rates of MetS (38% vs. 56%, p < 0.05). A stepwise regression model including ethnicity and significant covariates showed Hispanic ethnicity was the sole significant predictor of worse global neurocognition (B = -3.82, SE = 1.27, p < 0.01). A model also including MetS showed that both Hispanic ethnicity (B = -3.39, SE = 1.31, p = 0.01) and MetS (B = -2.73, SE = 1.31, p = 0.04) were independently associated with worse neurocognition. In conclusion, findings indicate that increased MetS is associated with worse neurocognitive function in both Hispanic and non-Hispanic White older PWH, but does not explain neurocognitive disparities. MetS remains an important target for intervention efforts to ameliorate neurocognitive dysfunction among diverse older PWH.
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Affiliation(s)
- María J Marquine
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
- Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA
| | - Lily Kamalyan
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, California, USA
| | - Zvinka Z Zlatar
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - David Yassai-Gonzalez
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Alán Perez-Tejada
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
| | - Anya Umlauf
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - Tala Al-Rousan
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA
| | - Verónica González
- Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - Jordana Breton
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
| | - Lesley A Guareña
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Lilla Brody
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Mariana Cherner
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - Ronald J Ellis
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Maria Luisa Zúñiga
- School of Social Work, San Diego State University, San Diego, California, USA
| | - Dan M Mungas
- Department of Neurology, University of California Davis, Davis, California, USA
| | - Raeanne C Moore
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - David J Moore
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - Valerie Wojna
- Neurology Division, Department of Internal Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Rasheeda K Hall
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA
| | - Donald R Franklin
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
| | - Robert K Heaton
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, California, USA
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Sorajja N, Chung J, Alcántara C, Wassertheil-Smoller S, Penedo FJ, Ramos AR, Perreira KM, Daviglus ML, Suglia SF, Gallo LC, Liu PY, Redline S, Isasi CR, Sofer T. A sociodemographic index identifies non-biological sex-related effects on insomnia in the Hispanic Community Health Study/Study of Latinos. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.09.24305555. [PMID: 38645067 PMCID: PMC11030294 DOI: 10.1101/2024.04.09.24305555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Sex differences are related to both biological factors and the gendered environment. To untangle sex-related effects on health and disease it is important to model sex-related differences better. Methods Data came from the baseline visit of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a longitudinal cohort study following 16,415 individuals recruited at baseline from four study sites: Bronx NY, Miami FL, San Diego CA, and Chicago IL. We applied LASSO penalized logistic regression of male versus female sex over sociodemographic, acculturation, and psychological factors jointly. Two "gendered indices", GISE and GIPSE, summarizing the sociodemographic environment (GISE, primary) and psychosocial and sociodemographic environment (GIPSE, secondary) associated with sex, were calculated by summing these variables, weighted by their regression coefficients. We examined the association of these indices with insomnia derived from self-reported symptoms assessed via the Women Health Initiative Insomnia Rating Scale (WHIIRS), a phenotype with strong sex differences, in sex-adjusted and sex-stratified analyses. All analyses were adjusted for age, Hispanic/Latino background, and study center. Results The distribution of GISE and GIPSE differed by sex with higher values in male individuals, even when constructing and validating them on separate, independent, subsets of HCHS/SOL individuals. In an association model with insomnia, male sex was associated with lower likelihood of insomnia (odds ratio (OR)=0.60, 95% CI (0.53, 0.67)). Including GISE in the model, the association was slightly weaker (OR=0.63, 95% CI (0.56, 0.70)), and weaker when including instead GIPSE in the association model (OR=0.78, 95% CI (0.69, 0.88)). Higher values of GISE and of GIPSE, more common in male sex, were associated with lower likelihood of insomnia, in analyses adjusted for sex (per 1 standard deviation of the index, GISE OR= 0.92, 95% CI (0.87, 0.99), GIPSE OR=0.65, 95% CI (0.61, 0.70)). Conclusions New measures such as GISE and GIPSE capture sex-related differences beyond binary sex and have the potential to better model and inform research studies of health. However, such indices do not account for gender identity and may not well capture the environment experienced by intersex and non-binary persons.
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Affiliation(s)
- Natali Sorajja
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Joon Chung
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Alberto R Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, Chula Vista, California, USA
| | - Peter Y Liu
- Division of Genetics, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Tamar Sofer
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- CardioVascular Institute (CVI), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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5
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Liang Z, Zhang Y, Li G. Association between vitamin D levels and risk of periodontitis in patients with metabolic syndrome. J Dent Sci 2024; 19:1012-1020. [PMID: 38618072 PMCID: PMC11010607 DOI: 10.1016/j.jds.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/24/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose The relationship between Vitamin D (VD) and periodontitis in patients with metabolic syndrome (MetS) was unclear. This study was to investigate the relationship between VD and periodontitis in MetS patients. Materials and methods This cross-sectional study collected the data of 2165 MetS patients from the National Health and Nutrition Examination Survey (NHANES). The weighted univariate and multivariable Logistic regression models were applied to identify covariates and evaluate the association between 25-hydroxy vitamin D (25(OH)D) [25(OH)D]2 + 25(OH)D3 and periodontitis in patients. Odds ratio (OR) [95% confidence interval (CI)] was effect size. Subgroup analysis was performed in people with or without diabetes, dyslipidemia, hypertension, cardiovascular disease (CVD) and central obesity groups. Results In the unadjusted model, compared with patients with 25(OH)D2 + 25(OH)D3 < 50 nmol/L, those with 25(OH)D2 + 25(OH)D3 ≥ 50 nmol/L might be associated with decreased risk of periodontitis in MetS patients (OR = 0.70, 95% CI: 0.57-0.85). After adjusting for confounders including age, gender, race, education, poverty income ratio (PIR), smoking, diabetes, VD intake and supplement and number of missing teeth, 25(OH)D2 + 25(OH)D3 ≥ 50 nmol/L was correlated with reduced risk of periodontitis in MetS patients (OR = 0.76, 95% CI: 0.60-0.97). Subgroup analysis revealed that in patients with CVD (OR = 0.60, 95% CI: 0.37-0.98), dyslipidemia (OR = 0.75, 95% CI: 0.57-0.97), and patients with central obesity (OR = 0.73, 95% CI: 0.57-0.95), decreased risk of periodontitis was identified in 25(OH)D2 + 25(OH)D3 ≥ 50 nmol/L. Conclusion VD was associated with the risk of periodontitis in patients with MetS, which suggest the importance of VD supplement in patients with MetS and provide a reference for the management of periodontitis in patients with MetS.
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Affiliation(s)
- Zhaohuang Liang
- Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Yao Zhang
- Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Guoyue Li
- Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
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Tamai R, Dawit L, Lee P, Simmons OL, Ding L, Yuan L. The Association of Metabolic Risk Factors with Advanced Adenomas in Hispanic Patients. Dig Dis Sci 2024; 69:1403-1410. [PMID: 38363522 PMCID: PMC11026227 DOI: 10.1007/s10620-024-08323-x] [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] [Received: 05/15/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Obesity and metabolic syndrome (MetS) have been implicated as rising risk factors for the development of colorectal cancers. A rapid increase in the prevalence of obesity and severe obesity among Hispanic patients in the United States may present substantially increased risk for advanced colorectal neoplasia in this population. Currently, there is very little research in this area. AIMS We sought to identify metabolic risk factors for advanced adenomas (AA) in Hispanic Americans. METHODS We retrospectively reviewed data from the Los Angeles General (LAG) Medical Center of asymptomatic Hispanic patients above 45 years of age who underwent their first colonoscopies following a positive screening FBT. Patient demographics, metabolic characteristics, as well as colon polyp size and histology were recorded. Polyps were classified as adenomas or AA (including both high-risk adenomas and high-risk serrated polyps). Relative risk for AA was assessed by multivariate logistical regression analyses. RESULTS Of the 672 patients in our study, 41.4% were male, 67% had adenomas, and 16% had AA. The mean BMI was 31.2 kg/m2. The mean HDL-C was 49.5 mg/dL (1.28 mmol/L) and the mean triglyceride level was 151 mg/dL. 44.6% had diabetes and 64.1% had hypertension. When comparing patients with AA to patients with no adenoma, male sex, BMI > 34.9 kg/m2, and elevated fasting triglyceride levels were associated with an increased risk of AA. FIB-4 ≥1.45 was also associated with an increased risk of AA in males. There was no significant difference in the risk of AA with diabetes, hypertension, FIB-4 score, LDL-C level, and HDL-C level. CONCLUSIONS Hispanic patients with a positive FBT were observed to have a high incidence of AA. Class II obesity (BMI ≥ 35 kg/m2), elevated triglyceride levels were identified as risk factors among males in our study. Early interventions to address these modifiable risk factors in at-risk populations, such as multi-disciplinary weight management programs for the treatment of obesity and related co-morbidities, could potentially lead to risk reduction and CRC prevention.
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Affiliation(s)
- Robert Tamai
- Division of Gastroenterology and Hepatology, Department of Medicine, Keck School of Medicine of USC, HCC 261 1510 San Pablo Street, Health Sciences Campus, Los Angeles, CA, 90089, USA
| | - Lillian Dawit
- Division of Gastroenterology and Hepatology, Department of Medicine, Keck School of Medicine of USC, HCC 261 1510 San Pablo Street, Health Sciences Campus, Los Angeles, CA, 90089, USA
| | - Patrick Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Keck School of Medicine of USC, HCC 261 1510 San Pablo Street, Health Sciences Campus, Los Angeles, CA, 90089, USA
| | - Okeefe L Simmons
- Division of Gastroenterology and Hepatology, Department of Medicine, Keck School of Medicine of USC, HCC 261 1510 San Pablo Street, Health Sciences Campus, Los Angeles, CA, 90089, USA
| | - Li Ding
- Department of Preventative Medicine, University of Southern California, Los Angeles, CA, USA
| | - Liyun Yuan
- Division of Gastroenterology and Hepatology, Department of Medicine, Keck School of Medicine of USC, HCC 261 1510 San Pablo Street, Health Sciences Campus, Los Angeles, CA, 90089, USA.
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7
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Kwak PP, Ibarra C, Hernandez A, Carrasco J, Sears DD, Jeste D, Marquine MJ, Lee EE. Differences in metabolic biomarkers in people with schizophrenia who are of Mexican descent compared to non-Hispanic whites. Psychiatry Res 2024; 334:115788. [PMID: 38401486 PMCID: PMC11249025 DOI: 10.1016/j.psychres.2024.115788] [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] [Received: 06/27/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/26/2024]
Abstract
Metabolic dysfunction is highly prevalent and contributes to premature mortality among people with schizophrenia (PwS), especially in Hispanic/Latino/a/x/e PwS, compared to non-Hispanic White (NHW) PwS. This study evaluated the relative contributions of Mexican descent and schizophrenia diagnosis to metabolic biomarker levels. This cross-sectional study included 115 PwS and 102 non-psychiatric comparison (NC) participants - English-speakers aged 26-66 years, 27% Mexican descent, and 52% women across both groups. Assessments included evaluations of BMI, psychopathology, and fasting metabolic biomarkers. We used ANOVA analyses to compare metabolic outcomes between diagnostic and ethnic subgroups, linear regression models to examine associations between Mexican descent and metabolic outcomes, and Spearman's correlations to examine relationships between metabolic outcomes and illness-related variables in PwS. Mexican PwS had higher hemoglobin A1c levels, insulin resistance, and body mass index than NHW PwS. Mexican descent was associated with higher hemoglobin A1c levels, insulin resistance, body mass index, and leptin levels, controlling for age, sex, depression, education, and smoking. Among Mexican PwS, worse negative symptoms were associated with greater insulin resistance. These findings support the possibility of ethnicity-based differences in metabolic dysregulation, though further investigation is warranted to create targeted health interventions for Hispanic PwS.
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Affiliation(s)
- Paulyn P Kwak
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Sam and Rose Stein Institute for Research on Aging, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Cynthia Ibarra
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Sam and Rose Stein Institute for Research on Aging, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Alexa Hernandez
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Sam and Rose Stein Institute for Research on Aging, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Jessica Carrasco
- Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA
| | - Dorothy D Sears
- Department of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Department of Family Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; College of Health Solutions, Arizona State University, 550N 3rd St, Phoenix, AZ 85004, USA
| | - Dilip Jeste
- Sam and Rose Stein Institute for Research on Aging, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - María J Marquine
- Department of Medicine Geriatrics Division, Duke Center for the Study of Aging and Human Development, Duke University, 201 Trent Dr, Durham, NC 27710, USA; Department of Psychiatry and Behavioral Sciences, Duke Center for the Study of Aging and Human Development, Duke University, 201 Trent Dr, Durham, NC 27710, USA
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Sam and Rose Stein Institute for Research on Aging, 9500 Gilman Dr., La Jolla, CA 92093, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
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8
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Cook SH, Wood EP, Stein JH, McClelland RL. Discrimination, Smoking, and Cardiovascular Disease Risk: A Moderated Mediation Analysis With MESA. J Am Heart Assoc 2024; 13:e032659. [PMID: 38390806 PMCID: PMC10944061 DOI: 10.1161/jaha.123.032659] [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] [Received: 09/15/2023] [Accepted: 01/31/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) and carotid plaque are reliable indicators of cardiovascular disease risk, and research highlights that racial and ethnic minority individuals generally exhibit higher cIMT and carotid plaque than White individuals. At present, the mechanisms driving these disparities among different racial and ethnic and biological sex groups are poorly understood. METHODS AND RESULTS Data came from the baseline examination of MESA (Multi-Ethnic Study of Atherosclerosis). A total of 6814 participants aged 45 to 84 years free of clinical cardiovascular disease completed assessments on health behavior and perceived discrimination. Four sex-stratified moderated mediation models examined associations between discrimination, cigarette smoking, and mean cIMT and plaque. We hypothesized that cigarette use would mediate the association between discrimination and carotid artery disease features, and that these would differ by race and ethnicity. Indirect effects of discrimination on plaque were observed among Hispanic women such that discrimination was associated with cigarette use and, in turn, higher plaque (β=0.04 [95% CI, 0.01-0.08]). Indirect effects of discrimination on mean cIMT were found among Hispanic (β=0.003 [95% CI, 0.0001-0.007]) and White men (β=0.04 [95% CI, 0.01-0.08]) such that discrimination was associated with cigarette use and, in turn, higher cIMT. Finally, a positive indirect effect of discrimination on plaque was observed among Hispanic men (β=0.03 [95% CI, 0.004-0.07]). No other racial and ethnic differences were observed. CONCLUSIONS To understand and address social determinants of cardiovascular disease, researchers must incorporate an intersectional framework that will allow us to understand the complex nature of discrimination and cardiovascular disease risk for individuals of varying intersecting identities and social positions.
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Affiliation(s)
- Stephanie H. Cook
- Department of Social and Behavioral SciencesNew York University School of Global Public HealthNew YorkNYUSA
- Department of BiostatisticsNew York University School of Global Public HealthNew YorkNYUSA
| | - Erica P. Wood
- Department of Social and Behavioral SciencesNew York University School of Global Public HealthNew YorkNYUSA
| | - James H. Stein
- Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWIUSA
| | - Robyn L. McClelland
- Department of BiostatisticsUniversity of Washington School of Public HealthSeattleWAUSA
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Mattei J, Caballero-González A, Maafs-Rodríguez A, Zhang A, O’Neill HJ, Gago C. Lessons learned by adapting and implementing LUCHA: a deep-structure culturally tailored healthy eating randomized pilot intervention for ethnic-diverse Latinos. Front Public Health 2024; 11:1269390. [PMID: 38445250 PMCID: PMC10912621 DOI: 10.3389/fpubh.2023.1269390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/20/2023] [Indexed: 03/07/2024] Open
Abstract
Objectives To report the adaptation and implementation of LUCHA (Latinos United for a Culturally Healthy Alimentation), a pilot intervention to improve dietary quality and behaviors (primary outcomes) of Latinos in Massachusetts, US, and the lessons learned during the process, including disruptions during the COVID-19 pandemic, to help shape future programs. Methods The cultural adaptation process was pre-planned using a framework, grounded in the Theory of Reasoned Action/Planned Behavior, and informed by formative mixed-methods research. A projected 75 self-identifying Latino adults (25-65y) were recruited with community-wide strategies and randomized to receive, in parallel, daily healthy eating text messages for 2 months, reinforced for 2 subsequent months, to either control (i.e., surface-level messages based on USDA MyPlate in Spanish), or intervention (i.e., deep-structure messages). The intervention messages were ethnically tailored to Caribbean or non-Caribbean heritages specifically, grounded in entrenched cultural attitudes, norms, and preferences. Trained research assistants administered questionnaires and clinical measurements at baseline, 2-months, and 4-months, in person (pre-pandemic) or via online video calls (at-pandemic). Clinicaltrials.gov registration #NCT04724382. Results LUCHA faced challenges and opportunities that conveyed lessons for future cultural adaptation and implementation of healthy eating programs. Recommendations are provided to improve digital programs for diverse ethnicities, such as widening language capabilities in texting services, using familiar video call applications, and instructing participants to measure their own clinical metrics at home using guided standardized protocols. Conclusion Tailoring nutrition programs with deep-structure cultural messages is essential when promoting healthy eating in diverse Latino heritages. LUCHA can inform programs for similar ethnic groups.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | | | - Ana Maafs-Rodríguez
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Amelia Zhang
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - H. June O’Neill
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Cristina Gago
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, United States
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Richard SL, Renn BN, Tran DMT, Kim J, Feng D. Metabolic Syndrome, Modifiable Lifestyle Factors, and Sleep-Disordered Breathing: The Hispanic Community Health Study. Ann Behav Med 2024; 58:179-191. [PMID: 38175927 PMCID: PMC10858308 DOI: 10.1093/abm/kaad071] [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] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND US Hispanics/Latinos are disproportionately susceptible to metabolic syndrome (MetS), attributed in part to systemic inequities related to health and lifestyle factors such as low physical activity (PA) levels, diet quality, alcohol use, tobacco use, and sleep disorder. Gender and heritage group differences are vastly understudied and need to be examined in this heterogeneous population. PURPOSE To examine the relationships between select health and lifestyle factors and MetS among Hispanic gender and heritage subgroups (Hypothesis 1) and determine whether gender and heritage moderate those relationships (Hypothesis 2). METHODS Participants included 14,155 Hispanic Americans aged 18-76 (59% female, mean age 45.92 ± 13.97) from seven heritage subgroups. This secondary analysis of cross-sectional data from the observational Hispanic Community Health Study/Study of Latinos (HCHS/SOL) dataset used hierarchical multinomial logistic regression to test Hypothesis 1; the dependent variable, MetS, included three categories delineating absence of MetS and presence of MetS with or without related medication use. Hayes' PROCESS macro tested Hypothesis 2. RESULTS Low PA and sleep-disordered breathing (SDB) each had significant (p < .001) predictive value of MetS group membership, whereas both low and high alcohol use (p < .001) were associated with decreased MetS risk. Cigarette pack-years were not significantly associated with MetS outcomes. Gender moderated the association between MetS and alcohol use (p < .001), cigarette pack-years (p < .001), and SDB (p < .001) such that the effects on MetS were higher in females than males. The association between MetS and diet quality (p < .001) was stronger among males than in females. CONCLUSIONS Gender and heritage differences were prominent among study variables.
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Affiliation(s)
- Shannon L Richard
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Brenna N Renn
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Dieu-My T Tran
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Jinyoung Kim
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Du Feng
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
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11
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Wagner KA, St Laurent CW, Pekow P, Marcus B, Rosal MC, Braun B, Manson JE, Whitcomb BW, Sievert LL, Chasan-Taber L. The Impact of a Lifestyle Intervention on Postpartum Cardiometabolic Risk Factors Among Hispanic Women With Abnormal Glucose Tolerance During Pregnancy: Secondary Analysis of a Randomized Trial. J Phys Act Health 2024; 21:40-50. [PMID: 37890839 DOI: 10.1123/jpah.2023-0145] [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: 04/06/2023] [Revised: 08/28/2023] [Accepted: 09/13/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Women with abnormal glucose tolerance during pregnancy are at risk for cardiovascular disease (CVD), with higher rates among Hispanics. However, studies on the impact of lifestyle interventions on postpartum CVD profiles are sparse. METHODS This is a secondary analysis of a controlled trial among a subsample of Hispanic women with abnormal glucose tolerance participating in Estudió PARTO (Project Aiming to Reduce Type twO diabetes; mean age = 28.2 y, SD: 5.8) who were randomized to a culturally modified Lifestyle intervention (n = 45) or a comparison Health and Wellness intervention (n = 55). Primary endpoints were biomarkers of cardiovascular risk (lipids, C-reactive protein, fetuin-A, and albumin-to-creatinine ratio) and insulin resistance (fasting insulin, glucose, HbA1c, homeostasis model assessment, leptin, tumor necrosis factor-alpha, and adiponectin) measured at baseline (6-wk postpartum) and 6 and 12 months. RESULTS In intent-to-treat analyses, there were no significant differences in changes in biomarkers of CVD risk or insulin resistance over the postpartum year. In prespecified sensitivity analyses, women adherent with the Lifestyle Intervention had more favorable improvements in insulin (intervention effect = -4.87, SE: 1.93, P = .01) and HOMA-IR (intervention effect = -1.15, SE: 0.53, P = .03) compared with the Health and Wellness arm. In pooled analyses, regardless of intervention arm, women with higher postpartum sports/exercise had greater increase in HDL-cholesterol (intervention effect = 6.99, SE: 1.72, P = .0001). CONCLUSIONS In this randomized controlled trial among Hispanic women with abnormal glucose tolerance, we did not observe a significant effect on postpartum biomarkers of CVD risk or insulin resistance. Women adherent to the intervention had more favorable changes in insulin and HOMA-IR.
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Affiliation(s)
- Kathryn A Wagner
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Penelope Pekow
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Bess Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Barry Braun
- Department of Health & Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Joann E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
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ZHAO BEIBO, SOTRES-ALVAREZ DANIELA, EVENSON KELLYR, GREENLEE HEATHER, MOSSAVAR-RAHMANI YASMIN, QI QIBIN, MARQUEZ DAVIDX, VIDOT DENISEC, ELFASSY TALI, ARREDONDO ELVAM, DIAZ KEITHM. Day-of-the-Week and Time-of-the-Day Patterns of Sedentary Behavior in the Hispanic Community Health Study/Study of Latinos. Med Sci Sports Exerc 2023; 55:2203-2213. [PMID: 37494828 PMCID: PMC10662624 DOI: 10.1249/mss.0000000000003266] [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] [Indexed: 07/28/2023]
Abstract
PURPOSE Existing sedentary behavior interventions have largely achieved mixed results. Conventionally, interventions have attempted to reduce sedentary behavior using a full-day approach. An alternative strategy may be to target specific periods during the day and/or week. This study examined the day-of-the-week (Monday to Sunday) and time-of-the-day patterns (3-and 6-h periods) of sedentary behavior among U.S. Hispanics/Latinos adults. METHODS Participants ( n = 12,241) from the Hispanic Community Health Study/Study of Latinos, a multisite community-based prospective cohort study of Hispanic/Latino adults, were studied. Sedentary behavior was assessed for 1 wk using a hip-mounted accelerometer through total sedentary time, sedentary time in bouts ≥60 min, and total number of sedentary breaks. The temporal patterns of sedentary behavior metrics were evaluated using linear mixed effect models accounting for the Hispanic Community Health Study/Study of Latinos complex survey design. RESULTS There were statistically significant variations in temporal patterns across day-of-the-week and time-of-the-day periods for all three metrics ( P < 0.001). Adults were more sedentary on weekends than on weekdays and most sedentary on Sundays. The time-of-the-day patterns had a U-curve pattern wherein adults were most sedentary late at night, became less sedentary throughout the day, reached peak activeness around noon, then gradually became more sedentary into the evening. These patterns were largely robust across seasonality and most sociodemographic characteristics, including age, employment status, work shift schedule, acculturation, and field center. CONCLUSIONS Our findings suggest that early mornings, evenings, and weekends were the more sedentary periods in this cohort of Hispanic/Latino adults, characterized by higher volumes of sedentary time, higher volumes of time in prolonged sedentary bouts, and fewer number of sedentary breaks than other time periods, highlighting important windows of opportunity to reduce sedentary behavior.
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Affiliation(s)
- BEIBO ZHAO
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC
| | | | - KELLY R. EVENSON
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | | | - YASMIN MOSSAVAR-RAHMANI
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - QIBIN QI
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - DAVID X. MARQUEZ
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL
| | - DENISE C. VIDOT
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | - TALI ELFASSY
- Department of Medicine, Miller School of Medicine, University of Miami, Coral Gables, FL
| | | | - KEITH M. DIAZ
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
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13
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Maras AF, Penedo FJ, Ramirez AG, Worch SM, Ortiz MS, Yanez B, Munoz E, Lad T, Hollowell C, Medina HN, Moreno PI. Cardiometabolic comorbidities in Hispanic/Latino cancer survivors: prevalence and impact on health-related quality of life and supportive care needs. Support Care Cancer 2023; 31:711. [PMID: 37982906 DOI: 10.1007/s00520-023-08181-9] [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: 03/28/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The aim of this study was to characterize the prevalence of cardiometabolic comorbidities (i.e., diabetes, peripheral vascular disease, myocardial infarction, congestive heart failure, cerebrovascular disease) among Hispanic/Latino cancer survivors and examine the impact of cardiometabolic comorbidities on health-related quality of life (HRQoL), unmet supportive care needs, patient-provider communication self-efficacy, satisfaction with cancer care, and increases in healthy behaviors. METHODS Hispanics/Latinos diagnosed with breast, prostate, or colorectal cancer (N = 288) were assessed within 15 months of primary treatment completion. RESULTS One-quarter (24.7%) of survivors were diagnosed with diabetes and one-fifth (20.8%) were diagnosed with peripheral vascular disease. Survivors with at least one cardiometabolic comoribidity were older (t(278) = -.3.622, p < .001) and more likely to have a household income of less than $25,000 (X2 = 8.369, p = .004). When adjusting for sociodemographic and medical covariates, survivors with cardiometabolic comorbidities demonstrated worse overall HRQoL (B = -4.792, p = .050), emotional (B = -1.479, p = .018) and physical (B = -2.228, p = .005) wellbeing, a higher odds of unmet psychological (OR = 2.095, p = .027) and sexuality (OR = 2.898, p = .004) needs, and greater patient-provider communication self-efficacy (B = .179, p = .045). There were no differences in healthy behavior changes or satisfaction with cancer care. CONCLUSIONS Cardiometabolic comorbidities may be highly prevalent among Hispanic/Latino cancer survivors and increase the risk of worse HRQoL and unmet supportive care needs. Targeted interventions are needed to optimize health among Hispanic/Latino cancer survivors with cardiometabolic comorbidities.
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Affiliation(s)
- Ashley F Maras
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Miami, FL, USA
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Cancer Control Research Program, University of Miami, Miami, FL, USA
| | - Amelie G Ramirez
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX, USA
- Department of Population Health Sciences, UT Health San Antonio Long School of Medicine, San Antonio, TX, USA
| | - Sarah M Worch
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Manuel S Ortiz
- Department of Psychology, Universidad de La Frontera, Temuco, Chile
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Edgar Munoz
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX, USA
| | - Thomas Lad
- Division of Hematology/Oncology, Cook County Health, Chicago, IL, USA
| | | | - Heidy N Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Patricia I Moreno
- Sylvester Comprehensive Cancer Center, Cancer Control Research Program, University of Miami, Miami, FL, USA.
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
- University of Miami Don Soffer Clinical Research Center, 1120 NW 14Th Street, Miami, FL, 33136, USA.
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Pichardo CM, Chambers EC, Sanchez-Johnsen LAP, Pichardo MS, Gallo L, Talavera GA, Pirzada A, Roy A, Castañeda SF, Durazo-Arvizu RA, Perreira KM, Teng Y, Rodriguez CB, Allison M, Carlson JA, Daviglus ML, Plascak JJ. Association of census-tract level gentrification and income inequality with 6-year incidence of metabolic syndrome in the Hispanic Community Health Study/Study of Latinos, an epidemiologic cohort study. Soc Sci Med 2023; 336:116222. [PMID: 37776783 PMCID: PMC11185427 DOI: 10.1016/j.socscimed.2023.116222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Metabolic syndrome varies by socio-demographic characteristics, with younger (18-29 years) and older (50-69 years) Hispanic/Latino having higher prevalence compared to other groups. While there is substantial research on neighborhood influences on cardiometabolic health, there are mixed findings regarding the effects of gentrification and few studies have included Hispanic/Latinos. The role of neighborhood income inequality on metabolic health remains poorly understood. OBJECTIVES Examined associations of neighborhood gentrification and income inequality with metabolic syndrome (MetSyn) using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). DESIGN, SETTING AND PARTICIPANTS The HCHS/SOL is a community-based cohort of adults of Hispanic/Latinos (aged 18-74). Analyses included 6710 adults who did not meet criteria for MetsS at baseline (2008-2011) and completed the visit 2 examination (2014-2017). Poisson regressions estimated odds ratios (IRR) and 95% confidence intervals (CI) for neighborhood gentrification and change in income inequality with MetSyn incidence. MAIN OUTCOME AND EXPOSURE MEASURES Gentrification was measured with an index that included changes (2000 to 2006-2010) in education, poverty, and income. Change in neighborhood income inequality (2005-2009 to 2012-2016) was measured using the Gini coefficient of income distribution. MetSyn was defined using National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS Among 6647 Hispanic/Latino adults, 23% (N = 1530) had incident MetSyn. In models adjusted for socio-demographic, health insurance status, and neighborhood characteristics, gentrification (IRR, 1.00, 95%CI, 0.96-1.03) and income inequality change (IRR, 1.00, 95%CI, 0.99-1.00) were not associated with MetSyn at visit 2. There was no association between cross-sectional income inequality (2005-2009) and MetSyn at visit 2 (IRR, 0.97, 95%CI, 0.82-1.15). CONCLUSION Neighborhood gentrification and income inequality change were not associated with incidence of MetSyn over 6 years among Hispanic/Latino adults. This study demonstrated that income-based residential changes alone may not be sufficient to explain neighborhood influences on health outcomes among this population.
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Affiliation(s)
- Catherine M Pichardo
- National Cancer Institute, National Institute of Health, 9609 Medical Center Drive, Rockville, MD 20815, USA; University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA.
| | - Earle C Chambers
- Albert Einstein College of Medicine, 1300 Morris Park Ave, The Bronx, NY, 1046, USA
| | - Lisa A P Sanchez-Johnsen
- University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA; Medical College of Wisconsin (MCW), Institute for Health and Equity, Department of Psychiatry and Behavioral Medicine, and MCW Cancer Center, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Margaret S Pichardo
- Hospital of the University of Pennsylvania, Department of Surgery, 3400 Spruce St # 4, Philadelphia, PA, 19104, USA
| | - Linda Gallo
- San Diego State University, Department of Psychology, 5500 Campanile Drive; San Diego, CA, 92182-4611, USA
| | - Gregory A Talavera
- San Diego State University, Department of Psychology, 5500 Campanile Drive; San Diego, CA, 92182-4611, USA
| | - Amber Pirzada
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine West (MC 764) 1819 West Polk Street, Suite 246, Chicago, IL, 60612, USA
| | - Amanda Roy
- University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA
| | - Sheila F Castañeda
- San Diego State University, Department of Psychology, 5500 Campanile Drive; San Diego, CA, 92182-4611, USA
| | - Ramon A Durazo-Arvizu
- Children's Hospital Los Angeles, Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA
| | - Krista M Perreira
- University of North Carolina at Chapel Hill School of Medicine, 321 S Columbia St, Chapel Hill, NC, 27599, USA
| | - Yanping Teng
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 123 W. Franklin Street, Suite 450 CB #8030 Chapel Hill, NC, 27516, USA
| | - Carmen B Rodriguez
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Matthew Allison
- University of California San Diego, School of Health Sciences, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Jordan A Carlson
- Children's Mercy Kansas City Hospital, 2401 Gillham Rd, Kansas City, MO, 64108, USA
| | - Martha L Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine West (MC 764) 1819 West Polk Street, Suite 246, Chicago, IL, 60612, USA
| | - Jesse J Plascak
- Ohio State University Comprehensive Cancer Center, Starling-Loving Hall, 320 W 10th Ave b302, Columbus, OH, 43210, USA
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Malpica D. Metabolic Syndrome, Hyperlipidemias, and Associated Clinical Markers Among Military Airmen. Aerosp Med Hum Perform 2023; 94:604-609. [PMID: 37501307 DOI: 10.3357/amhp.6242.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND: Due to the increased overweight and obesity prevalence in Colombia, the aim of this study is to determine the frequency of metabolic syndrome (MetS) among Colombian Air Force military aviators, crews, remote piloted aircraft operators, and air traffic controllers and relationships with clinical markers.METHODS: Operationally active Columbian Air Force military personnel examined periodically at the Colombian Air Force Aerospace Medical Directorate were chosen for a cross-sectional study performed among 2179 subjects. Medical history, anthropometrics, and laboratory results were analyzed and frequencies, correlations, and odds ratios were calculated.RESULTS: Overall prevalence of MetS was 21.7%; in subjects with BMI ≥25, frequency increased to 36% vs. those with BMI <25. Hypertriglyceridemia was present in 31%, impaired fasting glucose 12.5%, hypertension (≥130/85 mmHg) 14.4%, low HDL-C 35.2%, and increased waist circumference 46.2%. Those with three criteria were 14.6%, four criteria 5.8%, and five criteria 1.2%. Pilots had a significantly lower prevalence of MetS at 17.7% and an adjusted OR of 0.61 (0.49-0.76) than other crew; hyperuricemia was three times more likely (3.2-5.1) and hypercholesterolemia OR was 2.3 (1.9-2.9). Subjects with MetS had a significantly higher fat percentage, waist circumference, low-density lipoprotein, very low-density lipoprotein, non-high-density lipoprotein cholesterol, atherogenic index of plasma (AIP), uric acid, and white blood cell (leukocyte) count, and a lower estimated glomerular filtration rate. There is a linear relationship of the AIP and waist circumference, BMI, uric acid, and white blood cell count.DISCUSSION: MetS prevalence among Colombian Air Force aviators is lower than the general population, higher than other countries, and displays worse lipid profiles that increase cardiovascular and diabetes mellitus risk within the military.Malpica D. Metabolic syndrome, hyperlipidemias, and associated clinical markers among military airmen. Aerosp Med Hum Perform. 2023; 94(8):604-609.
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Mohamud MA, Campbell DJT, Wick J, Leung AA, Fabreau GE, Tonelli M, Ronksley PE. 20-year trends in multimorbidity by race/ethnicity among hospitalized patient populations in the United States. Int J Equity Health 2023; 22:137. [PMID: 37488549 PMCID: PMC10367428 DOI: 10.1186/s12939-023-01950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/03/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The challenges presented by multimorbidity continue to rise in the United States. Little is known about how the relative contribution of individual chronic conditions to multimorbidity has changed over time, and how this varies by race/ethnicity. The objective of this study was to describe trends in multimorbidity by race/ethnicity, as well as to determine the differential contribution of individual chronic conditions to multimorbidity in hospitalized populations over a 20-year period within the United States. METHODS This is a serial cross-sectional study using the Nationwide Inpatient Sample (NIS) from 1993 to 2012. We identified all hospitalized patients aged ≥ 18 years old with available data on race/ethnicity. Multimorbidity was defined as the presence of 3 or more conditions based on the Elixhauser comorbidity index. The relative change in the proportion of hospitalized patients with multimorbidity, overall and by race/ethnicity (Black, White, Hispanic, Asian/Pacific Islander, Native American) were tabulated and presented graphically. Population attributable fractions were estimated from modified Poisson regression models adjusted for sex, age, and insurance type. These fractions were used to describe the relative contribution of individual chronic conditions to multimorbidity over time and across racial/ethnic groups. RESULTS There were 123,613,970 hospitalizations captured within the NIS between 1993 and 2012. The prevalence of multimorbidity increased in all race/ethnic groups over the 20-year period, most notably among White, Black, and Native American populations (+ 29.4%, + 29.7%, and + 32.0%, respectively). In both 1993 and 2012, Black hospitalized patients had a higher prevalence of multimorbidity (25.1% and 54.8%, respectively) compared to all other race/ethnic groups. Native American populations exhibited the largest overall increase in multimorbidity (+ 32.0%). Furthermore, the contribution of metabolic diseases to multimorbidity increased, particularly among Hispanic patients who had the highest population attributable fraction values for diabetes without complications (15.0%), diabetes with complications (5.1%), and obesity (5.8%). CONCLUSIONS From 1993 to 2012, the secular increases in the prevalence of multimorbidity as well as changes in the differential contribution of individual chronic conditions has varied substantially by race/ethnicity. These findings further elucidate the racial/ethnic gaps prevalent in multimorbidity within the United States. PRIOR PRESENTATIONS Preliminary finding of this study were presented at the Society of General Internal Medicine (SGIM) Annual Conference, Washington, DC, April 21, 2017.
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Affiliation(s)
- Mursal A Mohamud
- Cumming School of Medicine, Undergraduate Medical Education, University of Calgary, Calgary, AB, Canada
| | - David J T Campbell
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - James Wick
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Alexander A Leung
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Gabriel E Fabreau
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marcello Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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17
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Richard SL, Renn BN, Kim J, Tran DMT, Feng D. Mental health is related to metabolic syndrome: The Hispanic community health study/ study of Latinos. Psychoneuroendocrinology 2023; 152:106085. [PMID: 36989563 PMCID: PMC10249587 DOI: 10.1016/j.psyneuen.2023.106085] [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] [Received: 10/07/2022] [Revised: 01/28/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Metabolic syndrome (MetS) is associated with common mental health conditions. Using cross-sectional data from the observational Hispanic Community Health Study / Study of Latinos (HCHS/SOL), this study examined the relationship between MetS and depression and anxiety in addition to testing moderating effects of gender and Hispanic heritage subgroups. METHODS Participants included 13,496 Hispanic Americans aged 18-74 (59% women, mean age 46.59 ± 13.65) from seven heritage subgroups. Depression was measured using the Center for Epidemiologic Studies Depression 10-item scale, and anxiety was assessed using the State-Trait Anxiety Inventory 10-item scale. A 3-level categorical variable was developed to assess the combined influence of depression and anxiety. The dependent variable is dichotomous, delineating the presence or absence of MetS as defined by the National Cholesterol Education Program Third Adult Treatment Panel. Logistic regression and Hayes' PROCESS macro assessed these relationships and the moderating effects of gender-heritage subgroups. RESULTS Results suggest depression (p < .001) and anxiety (p < .001) were associated with an increased likelihood of MetS. Puerto Ricans had the highest, and South Americans had the lowest, levels of depression and anxiety. Gender moderated the relationship between mental health and MetS, with women having a significant increase in the probability of MetS with depression (p < .001), anxiety (p < .001), or both (p < .001). CONCLUSION Elevated symptoms of depression and anxiety are associated with the presence of MetS in US Hispanic subgroups. Gender-heritage differences are present among the study variables. Strategies to manage psychological well-being must be employed to optimize cardiometabolic health in US Hispanics.
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Affiliation(s)
| | | | | | | | - Du Feng
- 4505 S Maryland Pky, Las Vegas, NV 89154, USA
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18
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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: 1209] [Impact Index Per Article: 1209.0] [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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19
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Pichardo CM, Pichardo MS, Gallo LC, Talavera GA, Chambers EC, Sanchez-Johnsen LAP, Pirzada A, Roy AL, Rodriguez C, Castañeda SF, Durazo-Arvizu RA, Perreira KM, Garcia TP, Allison M, Carlson J, Daviglus ML, Plascak JJ. Association of neighborhood segregation with 6-year incidence of metabolic syndrome in the Hispanic community health study/study of Latinos. Ann Epidemiol 2023; 78:1-8. [PMID: 36473628 PMCID: PMC10127516 DOI: 10.1016/j.annepidem.2022.11.003] [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: 08/29/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Examine the association between neighborhood segregation and 6-year incident metabolic syndrome (MetSyn) in the Hispanic Community Health Study/Study of Latinos. METHODS Prospective cohort of adults residing in Miami, Chicago, the Bronx, and San Diego. The analytic sample included 6,710 participants who did not have MetSyn at baseline. The evenness and exposure dimensions of neighborhood segregation, based on the Gini and Isolation indices, respectively, were categorized into quintiles (Q). Racialized economic concentration was measured with the Index of Concentration at the Extremes (continuously and Q). RESULTS Exposure, but not evenness, was associated with higher disease odds (Q1 (lower segregation) vs. Q4, OR = 1.53, 95% CI = 1.082.17; Q5, OR = 2.29, 95% CI = 1.493.52). Economic concentrationprivilege (continuous OR = 0.87, 95% CI = 0.770.98), racial concentrationracialized privilege (Q1 (greater concentration) vs. Q2 OR = 0.75, 95% CI = 0.541.04; Q3 OR = 0.68, 95% CI = 0.441.05; Q4 OR = 0.68, 95% CI = 0.451.01; Q5 OR = 0.64, 95% CI = 0.420.98)(continuous OR = 0.93, 95% CI = 0.821.04), and racialized economic concentrationprivilege (i.e., higher SES non-Hispanic White, continuous OR = 0.86, 95% CI = 0.760.98) were associated with lower disease odds. CONCLUSION Hispanics/Latino adults residing in neighborhoods with high segregation had higher risk of incident MetSyn compared to those residing in neighborhoods with low segregation. Research is needed to identify the mechanisms that link segregation to poor metabolic health.
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Affiliation(s)
- Catherine M Pichardo
- University of Illinois at Chicago, Department of Psychology, Chicago; University of Illinois at Chicago, Institute for Health Research & Policy, Chicago; University of Illinois at Chicago, Institute for Minority Health Research, Chicago; San Diego State University, Department of Psychology, San Diego, CA.
| | - Margaret S Pichardo
- Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia
| | - Linda C Gallo
- San Diego State University, Department of Psychology, San Diego, CA
| | | | | | | | - Amber Pirzada
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago
| | - Amanda L Roy
- University of Illinois at Chicago, Department of Psychology, Chicago
| | | | | | | | - Krista M Perreira
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Tanya P Garcia
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Matthew Allison
- University of California San Diego, School of Health Sciences, La Jolla
| | | | - Martha L Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago
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20
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Carrillo‐Arango HA, Atencio‐Osorio MA, López‐Álban CA, Nava‐González EJ, Correa‐Rodríguez M, Izquierdo M, Ramírez‐Vélez R. Metabolic responses to acute sprint interval exercise training performed after an oral 75-gram glucose load in individuals with overweight/obesity. Physiol Rep 2023; 11:e15555. [PMID: 36695728 PMCID: PMC9875746 DOI: 10.14814/phy2.15555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023] Open
Abstract
There is evidence supporting that acute sprint interval training (SIT) might improve metabolic responses to postprandial glucose, but results are inconclusive. The aim of the present study was to explore the effects of acute SIT on metabolic response and substrate utilization in individuals with overweight/obesity after an oral 75-gram glucose challenge. Thirty-three participants with overweight/ obesity (32.7 ± 8.3 years, 24 male, 9 female) participated in the study and a crossover design was followed. After the 75-gram glucose load, participants were randomly allocated to two groups: no exercise (resting) or SIT protocol. Metabolic data including respiratory quotient (RQ) and substrate utilization rates (fats and carbohydrates) were collected using the COSMED Q-NRG + ® calorimeter. The RQ was significantly lower in the acute SIT group (0.76 [0.01]; p < 0.0001) than in the resting group (0.80 [0.01]; p = 0.036) at the 120-min postprandial time point, and the RQ area under the curve (AUC) was also lower in the SIT group (mean difference of -6.62, 95% CI -12.00 to -1.24; p = 0.0161). The contribution of fat to energy expenditure increased after SIT during the postprandial period whereas the contribution of carbohydrates decreased. The AUC for fat contribution was significantly higher (mean difference 2311.9, 95% confidence interval [CI] 578.8 to 4043.3; p = 0.0098) and the AUC for carbohydrate contribution was significantly lower (mean difference -2283.1, 95% CI -4040.2 to -527.1; p = 0.0117) in the SIT group than in the resting group. In conclusions, acute SIT might have a positive effect on metabolic responses to postprandial glucose and, accordingly, should be recommended for improving metabolism in people with overweight/obesity.
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Affiliation(s)
- Hugo Alejandro Carrillo‐Arango
- Grupo de Investigación en Deporte de Rendimiento (GRINDER), Programa de Educación Física y DeporteUniversidad del ValleCaliColombia
| | - Miguel Alejandro Atencio‐Osorio
- Grupo de Investigación en Deporte de Rendimiento (GRINDER), Programa de Educación Física y DeporteUniversidad del ValleCaliColombia
| | - Carlos Alejandro López‐Álban
- Grupo de Investigación en Deporte de Rendimiento (GRINDER), Programa de Educación Física y DeporteUniversidad del ValleCaliColombia
- Zoe H&F Centro Para la Investigación En Salud y Rendimiento HumanoCaliColombia
| | - Edna J. Nava‐González
- Facultad de Salud Pública y NutriciónUniversidad Autónoma de Nuevo LeónMonterrey, Nuevo LeónMéxico
| | - María Correa‐Rodríguez
- Department of Nursing, Faculty of Health SciencesUniversity of GranadaGranadaSpain
- Biosanitary Research Institute (ibs.GRANADA)GranadaSpain
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA)PamplonaEspaña
- CIBER of Frailty and Healthy Aging (CIBERFES)Instituto de Salud Carlos IIIMadridSpain
| | - Robinson Ramírez‐Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA)PamplonaEspaña
- CIBER of Frailty and Healthy Aging (CIBERFES)Instituto de Salud Carlos IIIMadridSpain
- Facultad de Ciencias de la EducaciónUnidad Central del Valle del Cauca (UCEVA)TúluaColombia
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21
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Correa-Burrows P, Matamoros M, de Toro V, Zepeda D, Arriaza M, Burrows R. A Single-Point Insulin Sensitivity Estimator (SPISE) of 5.4 is a good predictor of both metabolic syndrome and insulin resistance in adolescents with obesity. Front Endocrinol (Lausanne) 2023; 14:1078949. [PMID: 36843603 PMCID: PMC9945119 DOI: 10.3389/fendo.2023.1078949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The Single-Point Insulin Sensitivity Estimator (SPISE) is a biomarker of insulin sensitivity estimated using BMI and triglycerides and high-density lipoprotein cholesterol. We assessed the accuracy of SPISE to screen obesity-related cardiometabolic risk in children and adolescents. METHOD Cross-sectional validation study for a screening test in a sample of n=725 children and adolescents from an obesity clinic. Weight, height, waist circumference, blood arterial pressure, lipid profile, glucose, insulin and Tanner stage were measured. BMI, BMI for-age-and sex (BAZ), and HOMA-IR were estimated. HOMA-IR values ≥2.1 and ≥3.3 were considered IR in Tanner I-II, ≥3.3 for Tanner III-IV and ≥2.6 for Tanner V, respectively. Metabolic Syndrome (MetS) was diagnosed with the Cook phenotype. SPISE was estimated according to the following algorithm: [600* HDL^0.185/(TG^0.2* BMI^1.338)]. The optimal SPISE cut points for IR and MetS prediction were determined by ROC curve analysis. RESULTS In prepubertal obese patients (9.2 ± 2.1y; 18.4% males), the prevalence of IR and MetS was 28.2% y 46.9%, respectively; 58% had severe obesity (BAZ ≥4 SD). In pubertal obese patients (12.6 ± 1.8y; 57% males), the prevalence of IR and MetS was 34.1% and 55.3%, respectively; 34% had severe obesity. In prepubertal children, a SPISE of 6.3 showed the highest sensitivity (73.2%) and specificity (80%) to screen individuals with IR (AUC: 0.80; LR +: 3.3). Likewise, a SPISE of 5.7 got the highest sensitivity (82.6%) and specificity (86.1%) to screen patients with MetS (AUC: 0.87; LR +: 5.4). In pubertal patients, a SPISE of 5.4 showed the highest sensitivity and specificity to screen children and adolescents with both IR (Sn: 76.1%; Sp: 77.5%; AUC: 0.8; LR +: 3.1) and MetS (Sn: 90.4%; Sp: 76.1%; AUC: 0.90; LR +: 3.5). CONCLUSION In children and adolescents with obesity, SPISE has good or very good performance in predicting IR and MetS. SPISE may be considered a relatively simple and low-cost diagnosis tool that can be helpful to identify patients with greater biological risk. In adolescents with obesity, the same cut point allows identification of those at higher risk of both IR and MetS.
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Affiliation(s)
- Paulina Correa-Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Mariela Matamoros
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Valeria de Toro
- Departamento de Gastroenterología y Nutrición Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Diego Zepeda
- Instituto de Investigación Materno Infantil, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Marta Arriaza
- Servicio de Pediatría, Hospital Gustavo Fricke, Viña del Mar, Chile
| | - Raquel Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
- Programa Clínico de Obesidad Infantil (POI), Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
- *Correspondence: Raquel Burrows,
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22
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Cook SH, Wood EP, Martinez V, Alvarez GM, Lazar J. Young men of color lower on adult attachment anxiety have higher carotid-intima media thickness compared to white young men: The exploration of an unexpected finding. Psychoneuroendocrinology 2022; 143:105825. [PMID: 35689986 DOI: 10.1016/j.psyneuen.2022.105825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022]
Abstract
Cardiovascular disease (CVD) remains the number one cause of death among men in the United States. Emerging research demonstrates that socioemotional mechanisms such as adult attachment, or the ways in which individuals are able to form and maintain socioemotional bonds, may impact physical health via alterations in physiological stress functioning. However, there may be key differences in the relation between attachment and physical health by race and sexual orientation. Thus, this study sought to examine the potential moderating effect of race and sexual orientation on the association between adult attachment and carotid-intima media thickness (cIMT), a measure of subclinical cardiovascular disease, among young men. The sample consisted of 72 young men (mean [SD] age = 22.92 [3.23]: 30.6 % identified as White, 30.6 % as Black, and 38.8 % as Other), each of which were surveyed and underwent an ultrasound to measure cIMT. Ordinary Least Squares (OLS) regression was used in order to examine our study hypotheses. We first ran a main effects model to examine adult attachment's (i.e., anxiety and avoidance) association with mean cIMT. We then ran two interaction models with an interaction between race/ethnicity and adult-related attachment and sexual orientation and adult attachment. We found that race significantly moderated the association between attachment-related anxiety and mean cIMT in our study sample. However, we did not find evidence to suggest that race moderated the association between attachment-related avoidance and mean cIMT in our study sample. In comparison to White individuals, Black individuals and those who identified as "Other" race with lower scores on attachment-related anxiety had higher mean cIMT. Additionally, higher scores on attachment-related anxiety were associated with lower mean cIMT among Black and "Other" respondents, but not among White respondents. We did not find evidence to suggest that sexual orientation moderated the association between adult attachment and mean cIMT in our study sample. Our findings suggest that adult attachment anxiety may be protective for young men of color but not for White young men. Future research should utilize longitudinal study designs in order to better understand how adult attachment influences CVD risk among racially/ethnically diverse young men.
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Affiliation(s)
- Stephanie H Cook
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA; Department of Biostatistics, School of Global Public Health, New York University, New York, NY, USA.
| | - Erica P Wood
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Valerie Martinez
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, USA
| | - Gabriella M Alvarez
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jason Lazar
- College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA; College of Molecular and Cell Biology and Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA; School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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23
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Fuster M, Kodali H, Ray K, Elbel B, Handley MA, Huang TTK, Johnson G. Area Characteristics and Consumer Nutrition Environments in Restaurants: an Examination of Hispanic Caribbean Restaurants in New York City. J Racial Ethn Health Disparities 2022; 9:1454-1463. [PMID: 34152587 PMCID: PMC8216094 DOI: 10.1007/s40615-021-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
Hispanics in the USA, particularly those of Caribbean descent, experience high levels of diet-related diseases and dietary risk factors. Restaurants are an increasingly important yet understudied source of food and may present opportunities to positively influence urban food environments. We sought to explore food environments further, by examining the association between neighborhood characteristics and restaurant consumer nutrition environments within New York City's Hispanic Caribbean (HC) restaurant environments. We applied an adapted version of the Nutrition Environment Measurements Survey for Restaurants (NEMS-R) to evaluate a random sample of HC restaurants (n=89). NEMS-HCR scores (continuous and categorized as low, medium, and high based on data distribution) were examined against area sociodemographic characteristics using bivariate and logistic regression analysis. HC restaurants located in Hispanic geographic enclaves had a higher proportion of fried menu items (p<0.01) but presented fewer environmental barriers to healthy eating, compared with those in areas with lower Hispanic concentrations. No significant differences in NEMS-R scores were found by other neighborhood characteristics. Size was the only significant factor predicting high NEMS-HCR scores, where small restaurants were less likely to have scores in the high category (NEMS-HCR score>6), compared with their medium (aOR: 6.6, 95% CI: 1.8-24.6) and large counterparts (aOR: 5.6, 95% CI: 1.5-21.4). This research is the first to examine the association between restaurant location and consumer nutrition environments, providing information to contribute to future interventions and policies seeking to improve urban food environments in communities disproportionately affected by diet-related conditions, as in the case of HC communities in New York City.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY, USA.
| | - Hanish Kodali
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Brian Elbel
- Department of Population Health, Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Terry T-K Huang
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, City University of New York, New York, NY, USA
| | - Glen Johnson
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
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24
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Krishnan A, Sharma H, Yuan D, Trollope AF, Chilton L. The Role of Epicardial Adipose Tissue in the Development of Atrial Fibrillation, Coronary Artery Disease and Chronic Heart Failure in the Context of Obesity and Type 2 Diabetes Mellitus: A Narrative Review. J Cardiovasc Dev Dis 2022; 9:jcdd9070217. [PMID: 35877579 PMCID: PMC9318726 DOI: 10.3390/jcdd9070217] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 12/07/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a significant burden globally and are especially prevalent in obese and/or diabetic populations. Epicardial adipose tissue (EAT) surrounding the heart has been implicated in the development of CVDs as EAT can shift from a protective to a maladaptive phenotype in diseased states. In diabetic and obese patients, an elevated EAT mass both secretes pro-fibrotic/pro-inflammatory adipokines and forms intramyocardial fibrofatty infiltrates. This narrative review considers the proposed pathophysiological roles of EAT in CVDs. Diabetes is associated with a disordered energy utilization in the heart, which promotes intramyocardial fat and structural remodeling. Fibrofatty infiltrates are associated with abnormal cardiomyocyte calcium handling and repolarization, increasing the probability of afterdepolarizations. The inflammatory phenotype also promotes lateralization of connexin (Cx) proteins, undermining unidirectional conduction. These changes are associated with conduction heterogeneity, together creating a substrate for atrial fibrillation (AF). EAT is also strongly implicated in coronary artery disease (CAD); inflammatory adipokines from peri-vascular fat can modulate intra-luminal homeostasis through an “outside-to-inside” mechanism. EAT is also a significant source of sympathetic neurotransmitters, which promote progressive diastolic dysfunction with eventual cardiac failure. Further investigations on the behavior of EAT in diabetic/obese patients with CVD could help elucidate the pathogenesis and uncover potential therapeutic targets.
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Affiliation(s)
- Anirudh Krishnan
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Harman Sharma
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Daniel Yuan
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Alexandra F. Trollope
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| | - Lisa Chilton
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Correspondence:
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Estrada LV, Solano J, Reading Turchioe M, Cortes YI, Caceres BA. Comparative Effectiveness of Behavioral Interventions for Cardiovascular Risk Reduction in Latinos: A Systematic Review. J Cardiovasc Nurs 2022; 37:324-340. [PMID: 37707966 PMCID: PMC8556412 DOI: 10.1097/jcn.0000000000000806] [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: 11/26/2022]
Abstract
BACKGROUND Latinos, the fastest growing ethnic minority group in the United States, are at a high risk for cardiovascular disease (CVD). However, little is known about effective strategies to reduce CVD risk in this population. OBJECTIVE The aim of this study was to systematically review and synthesize evidence from randomized controlled trials that examined the effectiveness of behavioral interventions to reduce CVD risk in Latinos living in the United States. METHODS Four electronic databases were searched for relevant peer-reviewed English- and Spanish-language articles published between January 1, 2000, and December 31, 2019. Four reviewers independently completed article screening, data abstraction, and quality appraisal. At least 2 reviewers completed data abstraction and quality appraisal for each article, and a third reviewer was assigned to settle disagreements. Data on study characteristics and outcomes were abstracted. RESULTS We retrieved 1939 articles. After applying inclusion/exclusion criteria, 17 articles were included. Most interventions were led by community health workers (n = 10); 2 family-based interventions were identified. None of the included studies was nurse led. Behavioral factors were assessed across all included studies, whereas only 4 studies reported on psychosocial outcomes. Improvements were observed in dietary habits and psychosocial outcomes. Findings for physical activity and biological outcomes were mixed. We identified no differences in outcomes based on intervention modalities used or the role of those who led the interventions. CONCLUSION Existing evidence is mixed. Future research should assess the effectiveness of understudied treatment modalities (including nurse-led, mobile health, and family-based interventions) in reducing CVD risk in Latinos.
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Letellier N, Zamora S, Spoon C, Yang JA, Mortamais M, Escobar GC, Sears DD, Jankowska MM, Benmarhnia T. Air pollution and metabolic disorders: Dynamic versus static measures of exposure among Hispanics/Latinos and non-Hispanics. ENVIRONMENTAL RESEARCH 2022; 209:112846. [PMID: 35120894 PMCID: PMC8976727 DOI: 10.1016/j.envres.2022.112846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/14/2022] [Accepted: 01/25/2022] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Exposure to air pollution disproportionately affects racial/ethnic minorities that could contribute to health inequalities including metabolic disorders. However, most existing studies used a static assessment of air pollution exposure (mostly using the residential address) and do not account for activity space when modelling exposure to air pollution. The aim of this study is to understand how exposure to air pollution impacts metabolic disorders biomarkers, how this effect differs according to ethnicity, and for the first time compare these findings with two methods of exposure assessment: dynamic and static measures. METHODS Among the Community of Mine study, a cross-sectional study conducted in San Diego County, insulin resistance, diabetes, hypertension, obesity, dyslipidemia, and metabolic syndrome (MetS) were assessed. Exposure to air pollution (PM2.5, NO2, traffic) was calculated using static measures around the home, and dynamic measures of mobility derived from Global Positioning Systems (GPS) traces using kernel density estimators to account for exposure variability across space and time. Associations of air pollution with metabolic disorders were quantified using generalized estimating equation models to account for the clustered nature of the data. RESULTS Among 552 participants (mean age 58.7 years, 42% Hispanic/Latino), Hispanics/Latinos had a higher exposure to PM2.5 compared to non-Hispanics using static measures. In contrast, Hispanics/Latinos had less exposure to PM2.5 using dynamic measures. For all participants, higher dynamic exposure to PM2.5 and NO2 was associated with increased insulin resistance and cholesterol levels, and increased risk of obesity, dyslipidemia and MetS (RR 1.17, 95% CI: 1.07-1.28; RR 1.21, 95% CI: 1.12-1.30, respectively). The association between dynamic PM2.5 exposure and MetS differed by Hispanic/Latino ethnicity. CONCLUSION These results highlight the importance of considering people's daily mobility in assessing the impact of air pollution on health.
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Affiliation(s)
- Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, 8885 Biological Grade, La Jolla, CA, 92037, USA.
| | - Steven Zamora
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, 8885 Biological Grade, La Jolla, CA, 92037, USA
| | - Chad Spoon
- UC San Diego, Department of Family Medicine, USA
| | - Jiue-An Yang
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | | | - Gabriel Carrasco Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Dorothy D Sears
- UC San Diego, Department of Family Medicine, USA; Arizona State University, College of Health Solutions, USA; UC San Diego, Department of Medicine, USA; UC San Diego, Moores Cancer Center, USA
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, 8885 Biological Grade, La Jolla, CA, 92037, USA
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Marquine MJ, Gallo LC, Tarraf W, Wu B, Moore AA, Vásquez PM, Talavera G, Allison M, Muñoz E, Isasi CR, Perreira KM, Bigornia SJ, Daviglus M, Estrella ML, Zeng D, González HM. The Association of Stress, Metabolic Syndrome, and Systemic Inflammation With Neurocognitive Function in the Hispanic Community Health Study/Study of Latinos and Its Sociocultural Ancillary Study. J Gerontol B Psychol Sci Soc Sci 2022; 77:860-871. [PMID: 34378777 PMCID: PMC9071500 DOI: 10.1093/geronb/gbab150] [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: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Identifying sociocultural correlates of neurocognitive dysfunction among Hispanics/Latinos, and their underlying biological pathways, is crucial for understanding disparities in Alzheimer's disease and related dementias. We examined cross-sectional associations between stress and neurocognition, and the role that metabolic syndrome (MetS) and systemic inflammation might play in these associations. METHOD Participants included 3,045 adults aged 45-75 (56% female, education 0-20+ years, 86% Spanish-speaking, 23% U.S.-born), enrolled in the Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study. Global neurocognition was the primary outcome and operationalized as the average of the z scores of measures of learning and memory, word fluency, and processing speed. Stress measures included self-report assessments of stress appraisal (perceived and acculturative stress) and exposure to chronic and traumatic stressors. MetS was defined via established criteria including waist circumference, high blood pressure, elevated triglycerides, fasting plasma glucose, and high levels of high-density lipoprotein cholesterol. Systemic inflammation was represented by high-sensitivity C-reactive protein (hs-CRP). RESULTS Separate survey multivariable linear regression models adjusting for covariates showed that higher perceived (b = -0.004, SE = 0.002, p < .05) and acculturative stress (b = -0.004, SE = 0.001, p < .0001) were significantly associated with worse global neurocognition, while lifetime exposure to traumatic stressors was associated with better global neurocognition (b = 0.034, SE = 0.009, p < .001). Neither MetS nor hs-CRP were notable pathways in the association between stress and neurocognition; rather, they were both independently associated with worse neurocognition in models including stress measures (ps < .05). DISCUSSION These cross-sectional analyses suggest that stress appraisal, MetS, and systemic inflammation may be targets to reduce neurocognitive dysfunction among Hispanics/Latinos.
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Affiliation(s)
- María J Marquine
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Benson Wu
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Alison A Moore
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Priscilla M Vásquez
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Gregory Talavera
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Matthew Allison
- Department of Family Medicine, University of California San Diego, La Jolla, California, USA
| | - Elizabeth Muñoz
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sherman J Bigornia
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, New Hampshire, USA
| | - Martha Daviglus
- Institute of Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mayra L Estrella
- Institute of Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hector M González
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
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Harmon BE, Shvetsov YB, Lim U, Leak CL, San Diego ERN, Monroe KR, Wilkens LR, Marchand LL. The joint association of cardiometabolic health and weight on mortality in the multiethnic cohort. ETHNICITY & HEALTH 2022; 27:658-671. [PMID: 32508127 PMCID: PMC7719582 DOI: 10.1080/13557858.2020.1771680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
Objective: While cardiometabolic abnormalities are associated with elevated risk of morbidity, they may not occur in all individuals with obesity. Less is known about associations with mortality, especially cancer mortality. This study examined associations between cardiometabolic-weight categories and mortality from cardiovascular disease (CVD), cancer, and all causes.Methods: Cox proportional hazards regressions of time to all-cause, CVD, and cancer mortalities were used to examine associations with cardiometabolic-weight status, in the Multiethnic Cohort (n=157,865). Cardiometabolic-weight status categories were: Metabolically Healthy Normal Weight, Metabolically Healthy Obese, Metabolically Healthy Overweight, Metabolically Unhealthy Normal Weight, Metabolically Unhealthy Obese, and Metabolically Unhealthy Overweight.Results: Higher mortality, especially for all-cause and CVD, was found for all metabolically unhealthy groups no matter the weight classification when compared to the Metabolically Healthy Normal Weight category across sex-ethnic groups. For all-cause mortality, a reduction in mortality was seen for males in the Metabolically Healthy Overweight category (HR: 0.88, 95% CI: 0.84, 0.93), especially for African American, Native Hawaiian, and Latino males. Mortality was elevated in the Metabolically Healthy Obese category for all-cause and CVD mortality in both sexes (HRrange: 1.08-1.93). Few associations were seen with cancer mortality.Conclusions: Past examinations of cardiometabolic-weight status and mortality have been hampered by a lack of diversity. In a racially/ethnically diverse population, metabolically unhealthy groups exhibited a substantially higher risk of death from all causes and CVD than metabolically healthy groups. A reduction in all-cause mortality was seen for some males classified as Metabolically Healthy Overweight; however, being classified as Metabolically Healthy Obese elevated mortality risk for males and females compared to Metabolically Healthy Normal Weight. Future research is needed to examine how sex-ethnic differences in body fat distribution and changes in weight over time influence associations between cardiometabolic-weight status and mortality.
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Affiliation(s)
- Brook E Harmon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Yurii B Shvetsov
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Manoa, HI, USA
| | - Unhee Lim
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Manoa, HI, USA
| | - Cardella L Leak
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Emily Rose N San Diego
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Kristine R Monroe
- Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Lynne R Wilkens
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Manoa, HI, USA
| | - Loic Le Marchand
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Manoa, HI, USA
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Riseberg E, Lopez-Cepero A, Mangano KM, Tucker KL, Mattei J. Specific Dietary Protein Sources Are Associated with Cardiometabolic Risk Factors in the Boston Puerto Rican Health Study. J Acad Nutr Diet 2022; 122:298-308.e3. [PMID: 34144919 PMCID: PMC8671554 DOI: 10.1016/j.jand.2021.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/12/2021] [Accepted: 05/18/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Puerto Rican adults residing in the US mainland experience a high prevalence of metabolic syndrome (MetS). A diet containing healthy protein-rich sources may help control risk factors for MetS. OBJECTIVE This study aimed to evaluate 2-year longitudinal associations between intake of various protein-rich foods and changes in the six MetS components. DESIGN This is a secondary analysis of a longitudinal cohort study using data from the baseline (2004-2007) and 2-year follow-up visits (2006-2011) in the Boston Puerto Rican Health Study. PARTICIPANTS/SETTING Participants were self-identified Puerto Ricans, aged 45 to 75 years, residing in Boston, Massachusetts, or the surrounding area (n = 1,126). MAIN OUTCOME MEASURES MetS components were fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic and diastolic blood pressures, and waist circumference. STATISTICAL ANALYSIS Baseline intake of foods reported in a semiquantitative food frequency questionnaire were expressed as servings/day, and protein-rich foods were categorized as unprocessed white meat, unprocessed red meat, processed meat, milk and yogurt, cheese, fish and seafood, beans, nuts, and eggs. Associations between each continuous protein food group and continuous 2-year change in MetS components were assessed using linear mixed models adjusted for socioeconomic and behavioral factors, and other dietary sources. RESULTS The top contributors to total protein intake were unprocessed red meat (13.3%) and unprocessed poultry (13.0%), and the lowest were eggs (2.92%) and nuts (0.91%). Higher intake of processed meats was associated with an increase in waist circumference over 2 years (β = 1.28; standard error [SE] = 0.63), whereas higher intake of fish and seafood was associated with a decrease in waist circumference (β = -3.47; SE = 1.39). Intake of unprocessed poultry was associated with a decrease in triglycerides (β = -24.5; SE = 9.13). No other significant associations were observed between protein sources and 2-year changes in MetS components. CONCLUSIONS Consuming less processed meat and more fish and seafood and unprocessed poultry was associated with decreases in waist circumference and triglycerides among US mainland Puerto Ricans. Other dietary protein sources were not related to cardiometabolic health.
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Affiliation(s)
- Emily Riseberg
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Andrea Lopez-Cepero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kelsey M Mangano
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Kazemi M, Kim JY, Wan C, Xiong JD, Parry SA, Azziz R, Lujan ME. Comprehensive evaluation of disparities in cardiometabolic and reproductive risk between Hispanic and White women with polycystic ovary syndrome in the United States: a systematic review and meta-analysis. Am J Obstet Gynecol 2022; 226:187-204.e15. [PMID: 34384776 DOI: 10.1016/j.ajog.2021.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to comprehensively compare cardiometabolic and reproductive health risk between Hispanic and White women with polycystic ovary syndrome in the United States in response to the call by the international guideline for polycystic ovary syndrome to delineate health disparities. DATA SOURCES Databases of MEDLINE, Web of Science, and Scopus were initially searched through October 25, 2020, and confirmed on February 1, 2021. STUDY ELIGIBILITY CRITERIA Observational studies comparing glucoregulatory, lipid profile, anthropometric, blood pressure, androgen, ovarian morphology, oligoanovulation, and infertility status between Hispanic and White women with polycystic ovary syndrome were included. The primary outcome was metabolic syndrome risk. Furthermore, major cardiovascular events (stroke, coronary heart disease, and heart failure) and mortality rate (cardiovascular death and total mortality) data were evaluated. Studies on adolescents (<2 years after menarche), pregnant, or menopausal-aged women (>50 years) were excluded. METHODS Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Risk of bias was assessed by the Newcastle-Ottawa Scale. RESULTS A total of 11 studies (n=2267; 589 Hispanic and 1678 White women) were eligible. All studies, including both White and Hispanic women, had high-quality assessment (Newcastle-Ottawa Scale score of ≥8). Hispanic women exhibited comparable metabolic syndrome prevalence (7% [95% confidence interval, -1 to 14]; P=.06; I2=0%); however, Hispanic women exhibited higher modified Ferriman-Gallwey score (0.60 [95% confidence interval, -0.01 to 1.21]; P=.05; I2=0%), fasting insulin (5.48 μIU/mL [95% confidence interval, 3.11-7.85]; P≤.01; I2=40.0%), and homeostatic model assessment of insulin resistance (1.20 [95% confidence interval, 0.50-1.89]; P≤.01; I2=43.0%) than White women. The 2 groups had comparable glucose, lipid profile, waist circumference, blood pressure, and androgen status (all P≥.08). Findings about group differences in certain reproductive outcomes (ie, ovarian dysmorphology and infertility) were contradictory and described only narratively as inclusion in the meta-analyses was not possible. No study reported on cardiovascular events or mortality. CONCLUSION Hispanic women with polycystic ovary syndrome exhibited greater impairments in glucoregulatory status than White women. Disparities in reproductive risks could not be concluded. The degree to which glucoregulatory aberrations translate into patient-pressing diseases (diabetes mellitus and infertility) remains a major roadblock given the paucity of available evidence. Our observations have supported the consideration of these disparities in the diagnostic, monitoring, and management practices for polycystic ovary syndrome and reinforced the need to elucidate mechanisms that account for the observed disparities to foster equity in polycystic ovary syndrome care.
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Affiliation(s)
- Maryam Kazemi
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Joy Y Kim
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Cynthia Wan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Julia D Xiong
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL; Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York, Albany, NY
| | - Marla E Lujan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY.
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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: 2443] [Impact Index Per Article: 1221.5] [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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Allencherril RP, Markides KS, Al Snih S. Liver Disease Among Mexican Americans Aged 67 Years and Older. J Prim Care Community Health 2022; 13:21501319221116231. [PMID: 35929017 PMCID: PMC9358553 DOI: 10.1177/21501319221116231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The Center for Disease Control and Prevention (CDC) reports that liver disease is a significant cause of morbidity and mortality in the US, afflicting 4.5 million people in 2018, or approximately 1.7% of the American adult population. Objective: To determine the prevalence and risk factors associated with liver disease among older Mexican Americans over 18 years of follow-up. Methods: Non-institutionalized Mexican Americans aged ≥67 years (N = 1938) from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13) were studied. Measures included socio-demographic variables, self-reported liver disease, language of interview, medical conditions, hand-grip strength, physical and cognitive function, depressive symptoms, and body mass index. Generalized estimating equation models were used to estimate the odds ratio and 95% confidence interval (CI) of liver disease over time. Results: The mean age at baseline was 74.9 ± 6.0 years and 58.4% were female. The prevalence of liver disease ranged from 2.4% to 8.4%. Over time, the odds ratio of reporting liver disease was 1.17 (CI = 1.12-1.22). Older age, Spanish interview, arthritis, diabetes, heart failure, cancer, and high scores on the Mini-Mental-State-Examination were factors associated with greater odds of reporting liver disease over time. Married participants reported lower odds of liver disease over time. Conclusions: The prevalence of liver disease in this population was high, ranging from 2.4% to 8.4%. Diabetes, heart failure, arthritis, and cancer were risk factors for liver disease. Screening for liver function among patients with these morbidities may help prevent liver disease in this population with high rates of diabetes and obesity.
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Affiliation(s)
| | | | - Soham Al Snih
- The University of Texas Medical Branch, Galveston, TX, USA
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Pacheco LS, Bradley RD, Denenberg JO, Anderson CAM, Allison MA. Effects of Different Allotments of Avocados on the Nutritional Status of Families: A Cluster Randomized Controlled Trial. Nutrients 2021; 13:nu13114021. [PMID: 34836276 PMCID: PMC8623192 DOI: 10.3390/nu13114021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/25/2021] [Accepted: 11/09/2021] [Indexed: 11/24/2022] Open
Abstract
Avocados are a nutrient-dense plant-food, but limited trial-derived evidence exists about the effects of avocado intake on family nutritional status. We investigated the impact of two levels of avocado allotment, plus a standard nutrition education intervention on the nutritional status of Hispanic/Latino families. Seventy-two families consisting of at least three members of ≥5 years of age and residing in the same home, free of severe chronic disease, not on specific diets, and self-identified of Hispanic heritage, were randomized to one of two levels of avocado allotment (low = 3/week/family or high = 14/week/family) for 6 months plus 12 bi-weekly nutrition education sessions. The primary outcomes included change in a family’s total energy and macro- and micronutrient intakes. Primary analysis was intention-to-treat with unpaired, two-sided t-tests to assess mean changes between groups at 6 months. At 6 months, the high avocado allotment group had a significant reduction in energy intake, carbohydrate, animal and vegetable protein, saturated and polyunsaturated fat, calcium, magnesium, sodium, potassium, iron, and vitamin D intakes (all p < 0.05). A high allotment of avocados significantly reduced self-reported energy intake by 29% kcal/family/day, compared to a 3% kcal/family/day reduction in families who received a low allotment. Culturally-appropriate plant-food interventions may alter the nutritional status of at-risk families.
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Affiliation(s)
- Lorena S. Pacheco
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (R.D.B.); (J.O.D.); (C.A.M.A.)
- School of Public Health, San Diego State University, Hardy Tower Room 119, 5500 Campanile Drive, San Diego, CA 92182, USA
- Correspondence: ; Tel.: +1-617-981-4381
| | - Ryan D. Bradley
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (R.D.B.); (J.O.D.); (C.A.M.A.)
| | - Julie O. Denenberg
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (R.D.B.); (J.O.D.); (C.A.M.A.)
| | - Cheryl A. M. Anderson
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (R.D.B.); (J.O.D.); (C.A.M.A.)
| | - Matthew A. Allison
- Department of Family Medicine in the School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA;
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Camacho-Rivera M, Gonzalez CJ, Morency JA, Blake KD, Calixte R. Heterogeneity in Trust of Cancer Information among Hispanic Adults in the United States: An Analysis of the Health Information National Trends Survey. Cancer Epidemiol Biomarkers Prev 2021; 29:1348-1356. [PMID: 32611616 DOI: 10.1158/1055-9965.epi-19-1375] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/19/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hispanics are differentially burdened by inequities in cancer outcomes. Increasing knowledge about cancer and cancer services among Hispanics may aid in reducing inequities, but little is known about what information sources are considered most effective or most trusted by this diverse population. The goal of this study was to examine heterogeneity in trust of cancer information from various media sources among U.S. Hispanic adults. METHODS Using data from the Health Information National Trends Survey (HINTS) 4, Cycles 2 and 4 and HINTS 5, Cycle 2, we examined nine trust questions, divided into four domains of health communication sources [doctor, government health/charitable organizations, media (including Internet), and family/friends and religious organizations]. Independent variables examined were gender, Hispanic ethnic categories (Mexican American, Cuban/Puerto Rican, and other Hispanics), age, education, income, language, and nativity. We used multivariable logistic regression with survey weights to identify independent predictors of cancer information source use and trust. RESULTS Of the 1,512 respondents, trust in sources ranged from 27% for radio to 91% for doctors. In multivariable models, Cubans/Puerto Ricans were twice as likely to trust cancer information from print media compared with Mexican Americans. Hispanics 75 years and older were nearly three times as likely to trust cancer information from religious organizations compared with those ages 18 to 34. Hispanic women were 59% more likely to trust cancer information from the Internet compared with men. CONCLUSIONS Subgroup variability in source use and trust may be masked by broad racial and ethnic categories. IMPACT Among Hispanics, there is significant variation by ethnicity and other sociodemographics in trust of sources of cancer information across multiple constructs, with notable implications for disseminating cancer information.
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Affiliation(s)
- Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, School of Public Health, Brooklyn, New York.
| | | | - Jason Amilcar Morency
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, New York
| | - Kelly D Blake
- Health Communication and Informatics Research Branch, National Cancer Institute, Bethesda, Maryland
| | - Rose Calixte
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, New York
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Cabrera LY, Kelly P, Vega IE. Knowledge and Attitudes of two Latino Groups about Alzheimer Disease: a Qualitative Study. J Cross Cult Gerontol 2021; 36:265-284. [PMID: 34196838 PMCID: PMC8421275 DOI: 10.1007/s10823-021-09432-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
Clustering Latinos under a single group in Alzheimer Disease (AD) research, neglects, among other things cultural and environmental differences. To address this, we examine knowledge and attitudes about AD among two Latino groups. We held 5 focus groups and 2 interviews all in Spanish with Mexicans and Puerto Ricans between 40 and 60 years old living in the Grand Rapids area in Michigan. Using content analysis of the discussions, we identified themes related to knowledge, attitudes and concerns about AD and caregiving. A total of 20 Mexicans and 9 Puerto Ricans participated. Improving knowledge and awareness, barriers and home-based family care were important themes in both Latino groups. Puerto Rican groups raised more concerns about the disease, whereas lack of knowledge was a key theme among Mexican participants. The exploratory study is a first step in promoting research that is attentive to the commonalities and differences of Latino groups and in continuing efforts to enhance health literacy among these groups.
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Affiliation(s)
- Laura Y Cabrera
- Department of Engineering Science and Mechanics, Center for Neural Engineering, College of Engineering, Pennsylvania State University, W-316 Millennium Science Complex, University Park, PA, 16802, USA.
- Rock Ethics Institute and Huck Institute of Life Sciences, Pennsylvania State University, University Park, PA, USA.
| | - P Kelly
- College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - I E Vega
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Fernandez ML. Lifestyle Factors and Genetic Variants Associated to Health Disparities in the Hispanic Population. Nutrients 2021; 13:2189. [PMID: 34202120 PMCID: PMC8308310 DOI: 10.3390/nu13072189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
Non-communicable diseases including type 2 diabetes mellitus, coronary heart disease, hepatic steatosis, and cancer are more prevalent in minority groups including Hispanics when compared to Non-Hispanic Whites, leading to the well-recognized terminology of health disparities. Although lifestyle factors including inadequate dietary habits, decreased physical activity, and more prominently, an unhealthy body weight, may be partly responsible for this disproportion in chronic diseases, genetic variations also make a substantial contribution to this problem. In this review, the well-recognized obesity problem in Hispanics that has been associated with chronic disease is examined as well as the influence of diet on promoting an inflammatory environment leading to increased cardiometabolic risk, insulin resistance, fatty liver disease, and cancer. In addition, some of the more studied genetic variations in Hispanics and their association with chronic disease is reviewed.
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Affiliation(s)
- Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
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Kaur SS, Tarraf W, Wu B, Gonzalez KA, Daviglus M, Shah N, Sotres-Alvarez D, Gallo LC, Wohlgemuth W, Redline S, Gonzalez HM, Ramos AR. Modifying pathways by age and sex for the association between combined sleep disordered breathing and long sleep duration with neurocognitive decline in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Alzheimers Dement 2021; 17:1950-1965. [PMID: 34032354 DOI: 10.1002/alz.12361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/09/2021] [Accepted: 04/07/2021] [Indexed: 12/10/2022]
Abstract
INTRODUCTION We aimed to determine whether obesity or metabolic syndrome (MetS) modify associations between sleep-disordered breathing (SDB), self-reported sleep duration (SD), and phenotypes of combined SDB/SD with 7-year neurocognitive decline (ND) in a community based-cohort of U.S. Hispanic/Latinos (N = 5500) in different age and sex groups. METHODS The exposures were baseline SDB (respiratory event index ≥ 15), sleepiness (Epworth Sleepiness Scale ≥ 10), SD (< 6 hours, 6-9 hours, ≥ 9 hours). The outcome was 7-year ND. RESULTS Mean age was 56.0 years, 54.8% were females. Obesity modified the association between SDB/SD and ND in memory (F = 21.49, P < 0.001) and global cognition (F = 9.14, P < 0.001) in the oldest age group. Women without MetS with combined long sleep/SDB exhibited most pronounced decline in global cognition (F = 3.07, P = 0.010). DISCUSSION The association between combined SDB/long sleep and declines in memory and global cognition was most pronounced in obese older adults. Among women, MetS status modified the association between long sleep/SDB and decline in global cognition.
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Affiliation(s)
- Sonya S Kaur
- University of Miami Miller School of Medicine, Miami, Florida, USA.,Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Benson Wu
- University of California San Diego, San Diego, California, USA
| | | | | | - Neomi Shah
- Mount Sinai Icahn School of Medicine, New York, New York, USA
| | | | - Linda C Gallo
- San Diego State University, San Diego, California, USA
| | | | - Susan Redline
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alberto R Ramos
- University of Miami Miller School of Medicine, Miami, Florida, USA.,Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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Asemota J, Oladunjoye O, Babalola A, Nwosu U, Liu PHS, Oladunjoye AO, Castro-Webb N, Miksad RA. Comparison of Hepatocellular Carcinoma in Hispanic and Non-Hispanic Patients. Cureus 2021; 13:e14884. [PMID: 34104609 PMCID: PMC8180179 DOI: 10.7759/cureus.14884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the fastest growing cancer in the United States. Studies have shown that compared to Blacks and non-Hispanic Whites, Hispanics have a higher HCC incidence and mortality rate. Most studies investigating HCC in Hispanics have been conducted utilizing data largely from the Western and Southern United States. These findings may, however, not be highly representative of Hispanics in the Northeast, given the nonhomogenous distribution and diversity of Hispanics across the United States. METHODS Some 148 HCC patients diagnosed between 1996 and 2012 were identified from a tertiary center in the northeastern United States. Hispanic patients were randomly matched to non-Hispanic White patients by year of diagnosis. Patient characteristics, HCC risk factors, treatment, and outcome were recorded. A Kaplan-Meier (KM) plot with log-rank tests was used for survival analysis. RESULTS Compared to non-Hispanic White patients (n=89), Hispanic HCC patients (n=59) were more likely to have chronic hepatitis C infection (69.5% vs. 38.2%, p < 0.01), alcoholic liver disease (37.3% vs. 21.4%, p = 0.04) and were less likely to have chronic hepatitis B infection (6.8% vs. 24.7%, p = 0.01), and private insurance (37.3% vs. 57.3%, p = 0.02). Hispanics were more likely to be diagnosed with an earlier stage disease (Barcelona Clinic Liver Cancer, BCLC stages A and B) compared to non-Hispanic patients (71.7% vs. 36.8%, p < 0.01) and were more likely to receive locoregional treatment. Although Hispanics trended towards improved overall survival, this finding did not hold when stratified by the BCLC stage. CONCLUSION Risk factors for HCC in the northeastern Hispanic population are like those found among Hispanics in other US regions. Other research suggests Hispanics are at increased risk for hepatic injury and HCC. However, HCC in this northeastern Hispanic population appears to be less aggressive (earlier stage and trend towards better overall survival) than non-Hispanics. Further research may be needed to identify potential differences by ethnic group for HCC risk factors, presentation, and outcomes.
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Affiliation(s)
- Joseph Asemota
- Internal Medicine, Howard University Hospital, Washington DC, USA
- Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
- Clinical Anatomy, St. George's University School of Medicine, True Blue, GRD
| | - Olubunmi Oladunjoye
- Internal Medicine, Tower Health-Reading Hospital, West Reading, USA
- Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Atinuke Babalola
- Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Ugonna Nwosu
- Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Po-Hong S Liu
- Internal Medicine, UT Southwestern Medical Center, Dallas, USA
- Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | | | - Nelsy Castro-Webb
- Epidemiology and Public Health, Boston University School of Medicine, Boston, USA
- Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Rebecca A Miksad
- Medicine, Boston University School of Medicine, Boston, USA
- Oncology, Flatiron Health, New York, USA
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Poteat T, Gallo LC, Harkness A, Isasi CR, Matthews P, Schneiderman N, Thyagarajan B, Daviglus ML, Sotres-Alvarez D, Perreira KM. Influence of Stress, Gender, and Minority Status on Cardiovascular Disease Risk in the Hispanic/Latino Community: Protocol for a Longitudinal Observational Cohort Study. JMIR Res Protoc 2021; 10:e28997. [PMID: 33955843 PMCID: PMC8138714 DOI: 10.2196/28997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Hispanic/Latino sexual and gender minorities (SGM) are the fastest growing ethnic group of SGM in the United States. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Hispanics/Latinos. SGM inequities in CVD risk have been identified as early as young adulthood, and minority stress has been identified as a potential mediator. Yet, the small number of ethnic or racial minority participants in SGM studies have precluded the examination of the intersections of sexual orientation, gender identity, and race and ethnicity. OBJECTIVE Minority stress models conceptualize relationships between stressors in minority groups and health outcomes. In this study, we will (1) examine the influence of sexual orientation and gender identity on CVD risk among all Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants at visit 3 (2021-2024; N~9300); (2) model pathways from sexual orientation and gender identity to CVD risk through stigma, discrimination, and stress in a 1:2 matched subcohort of SGM and non-SGM participants at visit 3 (n~1680); and (3) examine the influence of resilience factors on sexual orientation or gender identity and CVD risk relationships among subcohort participants at visit 3 (n~1680). METHODS This study will leverage existing data from the parent HCHS/SOL study (collected since 2008) while collecting new data on sexual orientation, gender identity, stigma, discrimination, stress, coping, social support, and CVD risk. Data analysis will follow the SGM minority stress model, which states that excess stigma against SGM populations leads to minority stress that increases CVD risk. In this model, coping and social support serve as resilience factors that can mitigate the impact of minority stress on CVD risk. Cross-sectional and longitudinal regression models as well as structural equation models will be used to test these relationships. RESULTS This study was funded by the National Heart, Lung, and Blood Institute in March 2020. Recruitment is scheduled to begin in the first quarter of 2021 and continue through 2024. CONCLUSIONS Understanding the influence of stigma-induced stress on CVD risk among Hispanic/Latino SGM has significant implications for the development of culturally specific CVD risk reduction strategies. Study findings will be used to build on identified Hispanic/Latino cultural strengths to inform adaptation and testing of family and community acceptance interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/28997.
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Affiliation(s)
- Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Audrey Harkness
- Department of Public Health Sciences, University of Miami, Miami, FL, United States
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, United States
| | - Phoenix Matthews
- Department of Population Health Nursing Science, University of Illinois Chicago, Chicago, IL, United States
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Miami, FL, United States
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL, United States
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
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40
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Hu J, Amirehsani KA, McCoy TP, Coley SL, Wallace DC. Cardiovascular disease risk in Hispanic American women. Women Health 2021; 61:395-407. [PMID: 33941048 DOI: 10.1080/03630242.2021.1917476] [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] [Indexed: 10/21/2022]
Abstract
Hispanic American women have an increased risk for the development of cardiovascular disease (CVD). This study examined CVD risk in a sample of immigrant Hispanic women using Framingham point scores and the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator for 10-year CVD risk and prevalence of metabolic syndrome. A cross-sectional study using baseline data from a diabetes self-management intervention study in a sample of 118 Hispanic American women was conducted. Data were c ollected with interviewer-administered surveys, and HbA1C and lipid profiles were obtained through capillary finger stick blood at clinics and churches in rural counties in central North Carolina. A majority (58%) of the women had type 2 diabetes and 61% had metabolic syndrome. Using the Framingham point scores for 10-year CVD risk, 2.5% were determined to have intermediate risk, compared to 7.6% at intermediate risk and 2.5% at high risk using the ASCVD 10-year risk estimator. High rates of CVD risk factors were found among this sample of Hispanic women. Early recognition of risk, mitigation of modifiable risk factors, and effective self-care programs are needed for Hispanic women. Hispanic American women may benefit from community-based CVD educational programs that have been culturally and linguistically tailored.
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Affiliation(s)
- Jie Hu
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Karen A Amirehsani
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
| | - Thomas P McCoy
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
| | - Sheryl L Coley
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
| | - Debra C Wallace
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
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Sánchez-Solís CN, Hernández-Fragoso H, Aburto-Luna V, Olivier CB, Diaz A, Brambila E, Treviño S. Kidney Adaptations Prevent Loss of Trace Elements in Wistar Rats with Early Metabolic Syndrome. Biol Trace Elem Res 2021; 199:1941-1953. [PMID: 32789645 DOI: 10.1007/s12011-020-02317-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/29/2020] [Indexed: 12/22/2022]
Abstract
Metabolic syndrome (MetS) represents a cluster of related metabolic abnormalities, including central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance. These metabolic derangements present significant risk factors for chronic kidney disease that carries to loss of essential micronutrients, which accelerates comorbidity apparition. The work aimed was to evaluate the trace element homeostasis regarding morphological adaptations and renal function in MetS early-onset. Fifty male Wistar rats were divided into two groups: (a) control group and (b) hypercaloric diet group that developed MetS early-onset after 3 months. Classical zoometric parameters do not show changes; however, biochemical modifications were observed such as hyperglycemia, protein glycation, insulin resistance, dyslipidemia, hyperinsulinemia, and hypoadiponectinemia. MetS early-onset group observed renal structural modifications, but no functional changes. The structural modifications observed were minimal glomerular injury, glomerular basement membrane thickening, as well as mesangial and tubular cells that showed growth and proliferation. In serum and kidney (cortex and medulla), the concentrations of Zn, Fe, Cr, Mg, Mn, Cu, Co, and Ni were no differences between the experimental groups, but excretory fractions of these were lower in the hypercaloric diet group. In conclusion, MetS early-onset coexist renal structural modification and a hyperreabsorptive activity of essential trace elements that avoid its loss; thus, the excretory fraction of oligo-elements could be used a biomarker of early renal injury caused by metabolic diseases in the clinical practice.
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Affiliation(s)
- Cristhian Neftaly Sánchez-Solís
- Laboratorio de Investigaciones Químico Clínicas, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Hugo Hernández-Fragoso
- Laboratorio de Investigaciones Químico Clínicas, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Violeta Aburto-Luna
- Laboratorio de Investigaciones Químico Clínicas, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Christophe Barbier Olivier
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México, Mexico
| | - Alfonso Diaz
- Departamento de Farmacia, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Eduardo Brambila
- Laboratorio de Investigaciones Químico Clínicas, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Samuel Treviño
- Laboratorio de Investigaciones Químico Clínicas, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
- Laboratorio de Investigaciones Químico Clínicas, Departamento de Química Clínica, Facultad de Ciencias Químicas, Universidad Autónoma de Puebla, 14 Sur. FCQ1, Ciudad Universitaria, C.P.72560, Puebla, Mexico.
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Tarraf W, Kaplan R, Daviglus M, Gallo LC, Schneiderman N, Penedo FJ, Perreira KM, Lamar M, Chai A, Vásquez PM, González HM. Cardiovascular Risk and Cognitive Function in Middle-Aged and Older Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Alzheimers Dis 2021; 73:103-116. [PMID: 31771064 DOI: 10.3233/jad-190830] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cardiovascular disease is linked to cognitive decline and disorders (e.g., dementia). The evidence is based largely on older non-Latino White cohorts. OBJECTIVE Examine the association between global vascular risk and cognitive function among Hispanics/Latinos in the United States. METHODS We used data from a large sample of stroke- and cardiovascular disease-free, middle-aged and older Hispanics/Latinos with diverse backgrounds (n=7,650) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We compared associations between two measures of cardiovascular risk (CVR), the Framingham Cardiovascular Risk Score (FCRS) and the multiethnic Global Vascular Risk Score (GVRS), and cognitive performance using measures of global and domain specific cognitive function, and tested for modification by sex and age. RESULTS Higher FCRS and GVRS were associated with lower global cognition and higher probability of low mental status, after covariates adjustment. Both CVR indices were associated with lower performances in learning and memory, verbal fluency, and psychomotor speed. Higher GVRS presented stronger associations with lower cognitive function compared to the FCRS. Women and younger age (45-64 years) exhibited more pronounced associations between higher CVR and worse cognition, particularly so with the GVRS. DISCUSSION CVR is also a risk for compromised cognitive function and evident in middle-age among Hispanics/Latinos. The multiethnic GVRS, tailored to specific risks based on racial/ethnic background, is feasible to use in primary care settings and can provide important insight on cognitive risk. Even modest shifts in population toward cardiovascular health in the high-risk Hispanic/Latino population can have important positive impacts on healthy cognitive aging.
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Affiliation(s)
- Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | | | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Frank J Penedo
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Krista M Perreira
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA.,Department of Psychiatry & Behavioral Sciences and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Albert Chai
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| | - Priscilla M Vásquez
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
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Burden of Future Liver Abnormalities in Patients With Intrahepatic Cholestasis of Pregnancy. Am J Gastroenterol 2021; 116:568-575. [PMID: 33657042 PMCID: PMC8451947 DOI: 10.14309/ajg.0000000000001132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION There are limited data on the incidence, predictors, and time to future liver abnormalities in patients with intrahepatic cholestasis of pregnancy (ICP). METHODS Single-center retrospective study of pregnant women with and without ICP who delivered from 2005 to 2009 evaluating incidence and time to future liver abnormalities. Women returning for care with liver function tests at a minimum of 6 months postpartum were included. Liver disease diagnoses and liver functions test abnormalities were compared. Time to development of alanine aminotransferase (ALT) >25 U/L, alkaline phosphatase (ALP) >140 U/L, and diagnosis of liver disease (through imaging or clinical evaluation) were compared between women with and without ICP using Kaplan-Meier methods and Cox regression models. RESULTS A total of 255 women with ICP and 131 age-matched control subjects with delivery during the same period were identified. Subjects in both groups were similar in follow-up time, age at pregnancy, prepregnancy body mass index, and ethnicity (≥75% were Hispanic in both groups). On univariate analyses, ICP was associated with increased incidence of ALT >25 U/L P < 0.01 ALP >140 U/L (P < 0.01) and liver disease (P = 0.03). Adjusting for metabolic factors, ICP diagnosis was associated with risk of future liver abnormalities: postpartum ALT >25 U/L (hazard ratio [HR] 1.9, P < 0.01), ALP >140 U/L (HR 3.4, P < 0.01), and liver disease (HR 1.5, P = 0.05). DISCUSSION In our cohort of urban women, ICP diagnosis predicted risk of future liver disease and abnormal liver tests. Women with pregnancies complicated by ICP may benefit from surveillance for postpartum liver abnormalities.
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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: 3063] [Impact Index Per Article: 1021.0] [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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Andrisse S, Garcia-Reyes Y, Pyle L, Kelsey MM, Nadeau KJ, Cree-Green M. Racial and Ethnic Differences in Metabolic Disease in Adolescents With Obesity and Polycystic Ovary Syndrome. J Endocr Soc 2021; 5:bvab008. [PMID: 33644620 PMCID: PMC7896356 DOI: 10.1210/jendso/bvab008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Indexed: 01/23/2023] Open
Abstract
Context Polycystic ovary syndrome (PCOS) is common and associated with metabolic syndrome. In the general population, metabolic disease varies by race and ethnicity. Objective This work aimed to examine in depth the interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth. Methods A secondary analysis was conducted of data from girls (age 12-21 years) with overweight or obesity (> 90 body mass index [BMI] percentile) and PCOS. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test (OGTT), and magnetic resonance imaging for hepatic fat. Groups were categorized by race or ethnicity. Results Participants included 39 non-Hispanic White (NHW, age 15.7 ± 0.2 years; BMI 97.7 ± 0.2 percentile), 50 Hispanic (HW, 15.2 ± 0.3 years; 97.9 ± 0.3 percentile), and 12 non-Hispanic Black (NHB, 16.0 ± 0.6 years; 98.6 ± 0.4 percentile) adolescents. Hepatic markers of insulin resistance were worse in NHW, including lower sex hormone-binding globulin and higher triglycerides over high-density lipoprotein cholesterol (TGs/HDL-C) ratio (P = .002 overall, HW vs NHB [P = .009] vs NHW [P = 0.020]), although homeostasis model assessment of estimated insulin resistance was worst in NHB (P = .010 overall, NHW vs NHB P = .014). Fasting and 2-hour OGTT glucose were not different between groups, although glycated hemoglobin A1c (HbA1c) was lowest in NHW (overall P < .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3 P < .001 vs 5.7 ± 0.4%, P < .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%, P = .032); low HDL-C < 40 mg/dL (HW 82%, NHW 61%, NHB 50%, P < .001) and prediabetes HbA1c 5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%, P < .001) were different between the groups. Conclusion Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.
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Affiliation(s)
- Stanley Andrisse
- Howard University College of Medicine, Physiology and Biophysics, Baltimore, Maryland, USA.,Johns Hopkins Medicine, Pediatric Endocrinology, Baltimore, Maryland, USA
| | - Yesenia Garcia-Reyes
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Megan M Kelsey
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Center for Women's Health Research, Aurora, Colorado, USA
| | - Kristen J Nadeau
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Center for Women's Health Research, Aurora, Colorado, USA
| | - Melanie Cree-Green
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Center for Women's Health Research, Aurora, Colorado, USA
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St‐Onge M, Aggarwal B, Allison MA, Berger JS, Castañeda SF, Catov J, Hochman JS, Hubel CA, Jelic S, Kass DA, Makarem N, Michos ED, Mosca L, Ouyang P, Park C, Post WS, Powers RW, Reynolds HR, Sears DD, Shah SJ, Sharma K, Spruill T, Talavera GA, Vaidya D. Go Red for Women Strategically Focused Research Network: Summary of Findings and Network Outcomes. J Am Heart Assoc 2021; 10:e019519. [PMID: 33619972 PMCID: PMC8174263 DOI: 10.1161/jaha.120.019519] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/17/2020] [Indexed: 02/01/2023]
Abstract
The Go Red for Women movement was initiated by the American Heart Association (AHA) in the early 2000s to raise awareness concerning cardiovascular disease (CVD) risk in women. In 2016, the AHA funded 5 research centers across the United States to advance our knowledge of the risks and presentation of CVD that are specific to women. This report highlights the findings of the centers, showing how insufficient sleep, sedentariness, and pregnancy-related complications may increase CVD risk in women, as well as presentation and factors associated with myocardial infarction with nonobstructive coronary arteries and heart failure with preserved ejection fraction in women. These projects were augmented by collaborative ancillary studies assessing the relationships between various lifestyle behaviors, including nightly fasting duration, mindfulness, and behavioral and anthropometric risk factors and CVD risk, as well as metabolomic profiling of heart failure with preserved ejection fraction in women. The Go Red for Women Strategically Focused Research Network enhanced the evidence base related to heart disease in women, promoting awareness of the female-specific factors that influence CVD.
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Affiliation(s)
- Marie‐Pierre St‐Onge
- Sleep Center of ExcellenceDepartment of MedicineColumbia University Irving Medical CenterNew YorkNY
| | - Brooke Aggarwal
- Sleep Center of ExcellenceDepartment of MedicineColumbia University Irving Medical CenterNew YorkNY
| | - Matthew A. Allison
- Division of Preventive MedicineDepartment of Family Medicine and Public HealthSchool of MedicineUniversity of California San DiegoLa JollaCA
| | - Jeffrey S. Berger
- Sarah Ross Soter Center for Women's Cardiovascular ResearchNYU Grossman School of MedicineNew YorkNY
| | | | - Janet Catov
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of PittsburghPA
- Magee‐Womens Research InstituteUniversity of PittsburghPA
| | - Judith S. Hochman
- Sarah Ross Soter Center for Women's Cardiovascular ResearchNYU Grossman School of MedicineNew YorkNY
| | - Carl A. Hubel
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of PittsburghPA
- Magee‐Womens Research InstituteUniversity of PittsburghPA
| | - Sanja Jelic
- Sleep Center of ExcellenceDepartment of MedicineColumbia University Irving Medical CenterNew YorkNY
| | - David A. Kass
- Division of CardiologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Nour Makarem
- Sleep Center of ExcellenceDepartment of MedicineColumbia University Irving Medical CenterNew YorkNY
| | - Erin D. Michos
- Division of CardiologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Lori Mosca
- Division of CardiologyDepartment of MedicineColumbia University Irving Medical CenterNew YorkNY
| | - Pamela Ouyang
- Division of CardiologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Chorong Park
- Sarah Ross Soter Center for Women's Cardiovascular ResearchNYU Grossman School of MedicineNew YorkNY
| | - Wendy S. Post
- Division of CardiologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Robert W. Powers
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of PittsburghPA
- Magee‐Womens Research InstituteUniversity of PittsburghPA
| | - Harmony R. Reynolds
- Sarah Ross Soter Center for Women's Cardiovascular ResearchNYU Grossman School of MedicineNew YorkNY
| | - Dorothy D. Sears
- Division of Preventive MedicineDepartment of Family Medicine and Public HealthSchool of MedicineUniversity of California San DiegoLa JollaCA
- College of Health SolutionsArizona State UniversityPhoenixAZ
- Department of Medicine and Moores Cancer CenterUniversity of California San DiegoLa JollaCA
| | | | - Kavita Sharma
- Division of CardiologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Tanya Spruill
- Sarah Ross Soter Center for Women's Cardiovascular ResearchNYU Grossman School of MedicineNew YorkNY
| | | | - Dhananjay Vaidya
- General Internal MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMD
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Mindt MR, Marquine MJ, Aghvinian M, Paredes AM, Kamalyan L, Suárez P, Heaton A, Scott TM, Gooding A, Diaz-Santos M, Umlauf A, Taylor MJ, Fortuny LAI, Heaton RK, Cherner M. The Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project: Overview and considerations for life span research and evidence-based practice. Clin Neuropsychol 2021; 35:466-480. [PMID: 32727283 PMCID: PMC8725610 DOI: 10.1080/13854046.2020.1794046] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/26/2020] [Accepted: 06/05/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This paper summarizes the findings of the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project and offers a roadmap for future research. METHODS The NP-NUMBRS project represents the largest and most comprehensive co-normed neuropsychological battery to date for native Spanish-speaking healthy adults from the U.S. (California/Arizona)-Mexico borderland region (N = 254; ages 19-60 years). These norms provide demographic adjustments for tests across numerous domains (i.e., verbal fluency, processing speed, attention/working memory, executive function, episodic memory [learning and delayed recall], visuospatial, and fine motor skills). CONCLUSIONS This project: 1) shows that the NP-NUMBRS norms consistently outperformed previously published norms for English-speaking non-Hispanic (White and African-American) adults in identifying impairment; 2) explores the role of Spanish-English bilingualism in test performance; and 3) provides support for the diagnostic validity of these norms in detecting HIV-associated neurocognitive impairment. Study limitations include the limited assessment of sociocultural variables and generalizability (e.g., other Latina/o populations, age limit [19 - 60 years]). Future research is needed to: 1) investigate these norms with U.S.-dwelling Spanish-speakers of non-Mexican heritage and other clinical subpopulations; 2) expand coverage of cognitive domains (e.g. language, visuospatial); 3) develop large normative datasets for children and older Latina/o populations; 4) examine how sociocultural factors impact performance (e.g., bilingualism, acculturation); 5) investigate these norms' diagnostic and ecological validity; and 6) develop norms for neurocognitive change across time. It is hoped that the NP-NUMBRS norms will aid researchers and clinicians working with U.S.-dwelling Spanish-speakers from the U.S.-Mexico borderland to conduct research and evidence-based neuropsychological evaluations in a more culturally responsive and ethical manner.
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Affiliation(s)
- Monica Rivera Mindt
- Department of Psychology & Latin American Latino Studies Institute, Fordham University, New York City, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - María J. Marquine
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Maral Aghvinian
- Department of Psychology & Latin American Latino Studies Institute, Fordham University, New York City, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | - Lily Kamalyan
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Paola Suárez
- Hispanic Neuropsychiatric Center of Excellence - Cultural Neuropsychology Program, Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Anne Heaton
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Travis M. Scott
- Department of Psychology & Latin American Latino Studies Institute, Fordham University, New York City, NY, USA
- VA Palo Alto Health Care System, Sierra Pacific MIRECC, Palo Alto, CA, USA
| | - Amanda Gooding
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Mirella Diaz-Santos
- Hispanic Neuropsychiatric Center of Excellence - Cultural Neuropsychology Program, Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Michael J. Taylor
- Department of Psychiatry, University of California, San Diego, CA, USA
| | | | - Robert K. Heaton
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, CA, USA
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Ge H, Yang Z, Li X, Liu D, Li Y, Pan Y, Luo D, Wu X. The prevalence and associated factors of metabolic syndrome in Chinese aging population. Sci Rep 2020; 10:20034. [PMID: 33208868 PMCID: PMC7675973 DOI: 10.1038/s41598-020-77184-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/05/2020] [Indexed: 12/14/2022] Open
Abstract
Metabolic syndrome (MetS) is hitting high notes in the aging society in China. However, the prevalence and associated factors in Chinese aging population lack clarity to some extent. In the present study, we projected to inquire into the prevalence of MetS and its associated factors by analyzing datasets downloaded from the China Health and Retirement Longitudinal Study (CHARLS). Data comprising age, gender, socioeconomic status, lifestyle and health behaviors as well as blood biomarkers were subjected to descriptive statistics followed by univariate logistic regression and multivariate logistic regression. The overall prevalence of MetS was 33.38% (95% CI 32.42–34.34%). With age augments, prevalence increased during 40–70 years, while declined in participants aged 70 years above. Females had 2.94 times of risks (95% CI 2.55–3.39, P < 0.001). Marital status and alcohol consumption contributed nothing to the suffering of MetS. Participants with GDP per capita > 10,000 RMB and a non-agricultural hukou sustained higher risks than other participants (P < 0.05). Participants under education of middle school suffered 1.16 times of risks than other level of education (95% CI 1.01–1.34, P < 0.05). Smokers, participants with high low-density lipoprotein (LDL) or hyperuricemia or high glycosylated hemoglobin HbA1c sustained increased risks (P < 0.05). In Chinese aging population, with the augment of age, the prevalence ascended in men, while descended in women and was interfered by socioeconomic status, lifestyle and health behaviors as well as blood biomarkers, but not marital status and alcohol consumption.
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Affiliation(s)
- Huisheng Ge
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Zihui Yang
- Tsinghua Changgeng Hospital, Tsinghua University, Beijing, 102218, China
| | - Xiaoyu Li
- Laboratory of Innovation, Basic Medical Experimental Teaching Center, Chongqing Medical University, Chongqing, 400016, China
| | - Dandan Liu
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yan Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yue Pan
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Dan Luo
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| | - Xixi Wu
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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Cortés YI, Marginean V, Berry D. Physiologic and psychosocial changes of the menopause transition in US Latinas: a narrative review. Climacteric 2020; 24:214-228. [PMID: 33174466 DOI: 10.1080/13697137.2020.1834529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Latinos comprise the fastest-growing minority group in the USA, with Hispanic women (Latinas) constituting 17% of women aged 45-54 years. The menopause transition (MT) is associated with many physiological, behavioral, and psychosocial changes that can affect disease risk in women. While several epidemiologic investigations have enhanced our understanding of the MT, to date, menopause research has mostly focused on non-Latina White women. As a consequence, there is a dearth of information on strategies for managing menopause-related issues in Latinas and important factors to consider to provide culturally appropriate care and promote lifestyles that may reduce adverse health outcomes. This narrative review summarizes existing evidence of the MT in Latinas, with a focus on hormonal alterations, menopausal symptoms, mental health, cognition, and cardiometabolic health. The clinical and research implications of the current literature will also be discussed.
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Affiliation(s)
- Y I Cortés
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - V Marginean
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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50
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Pomenti S, Gandle C, Abu Sbeih H, Phipps M, Livanos A, Guo A, Yeh J, Burney H, Liu H, Dakhoul L, Kettler C, Gawrieh S, deLemos A, Scanga A, Chalasani N, Miller E, Wattacheril J. Hepatocellular Carcinoma in Hispanic Patients: Trends and Outcomes in a Large United States Cohort. Hepatol Commun 2020; 4:1708-1716. [PMID: 33163839 PMCID: PMC7603535 DOI: 10.1002/hep4.1575] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 12/23/2022] Open
Abstract
Hepatocellular carcinoma (HCC) has a strong racial and ethnic association, with Hispanic patients having a higher incidence and mortality. However, there are limited data regarding clinical features and outcomes. This study includes Hispanic and non‐Hispanic White patients with HCC diagnosed between January 2000 and June 2014 from five United States academic medical centers. The chi‐square test for categorical variables and analysis of variance for continuous variables were used for statistical analysis, with two‐tailed P < 0.05 considered statistically significant. Of 5,327 patients, 4,217 met inclusion criteria, of whom 12.3% were Hispanic patients. Compared to their non‐Hispanic White counterparts, Hispanic patients were older at age of diagnosis (mean ± SD, 64.2 ± 10.9 vs. 61.9 ± 10.5 years; P < 0.0001), with higher body mass index (29.6 ± 6.5 vs. 28.8 ± 5.9 kg/m2; P = 0.01), and were more likely to have diabetes and hypertension. Hispanic patients had significantly more nonalcoholic fatty liver disease and alcohol‐related liver disease (both P < 0.0001). Hispanic patients presented with larger tumors, more advanced stage disease, and increased rates of macrovascular invasion and extrahepatic spread. HCCs in Hispanic patients were less likely to be within Milan criteria (26% vs. 38%; P < 0.0001) and were less likely to be treated with resection (9% vs. 13%; P = 0.03) or transplantation (8% vs. 19%; P < 0.0001). Hispanic patients had a median overall survival of 1.4 years (95% confidence interval [CI], 1.22‐1.56), which was similar to that of non‐Hispanic White patients (1.3 years; 95% CI, 1.26‐1.41; P = 0.07). Conclusion: Hispanic patients with HCC were more likely to have metabolic risk factors for chronic liver disease, including obesity. Despite diagnosis at more advanced stages with less curative intervention than non‐Hispanic White patients, median overall survival was similar between groups.
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Affiliation(s)
- Sydney Pomenti
- Department of Medicine Columbia University Irving Medical Center New York NY USA
| | - Cassandra Gandle
- Department of Medicine Baylor College of Medicine Houston TX USA
| | - Hamzah Abu Sbeih
- Department of Gastroenterology Hepatology, and Nutrition MD Anderson Cancer Center Houston TX USA
| | - Meaghan Phipps
- Department of Medicine Division of Digestive and Liver Diseases Center for Liver Disease and Transplantation Columbia University Irving Medical Center- New York Presbyterian Hospital New York NY USA
| | - Alexandra Livanos
- Department of Medicine Columbia University Irving Medical Center New York NY USA
| | - Averill Guo
- Department of Medicine Columbia University Irving Medical Center New York NY USA
| | - Jonathan Yeh
- Department of Medicine Division of Digestive and Liver Diseases Center for Liver Disease and Transplantation Columbia University Irving Medical Center- New York Presbyterian Hospital New York NY USA
| | - Heather Burney
- Department of Biostatistics Indiana University School of Medicine Indianapolis IN USA
| | - Hao Liu
- Department of Biostatistics Indiana University School of Medicine Indianapolis IN USA
| | - Lara Dakhoul
- Department of Medicine Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA
| | - Carla Kettler
- Department of Biostatistics Indiana University School of Medicine Indianapolis IN USA
| | - Samer Gawrieh
- Department of Medicine Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA
| | - Andrew deLemos
- Department of Medicine Division of Hepatology Atrium Health Charlotte NC USA
| | - Andrew Scanga
- Gastroenterology, Hepatology and Nutrition Vanderbilt University Medical Center Nashville TN USA
| | - Naga Chalasani
- Department of Medicine Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA
| | - Ethan Miller
- Department of Gastroenterology Hepatology, and Nutrition MD Anderson Cancer Center Houston TX USA
| | - Julia Wattacheril
- Department of Medicine Division of Digestive and Liver Diseases Center for Liver Disease and Transplantation Columbia University Irving Medical Center- New York Presbyterian Hospital New York NY USA
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