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Liu L, Gracely EJ, Yin X, Eisen HJ. Impact of diabetes mellitus and cardiometabolic syndrome on the risk of Alzheimer’s disease among postmenopausal women. World J Diabetes 2021; 12:69-83. [PMID: 33520109 PMCID: PMC7807256 DOI: 10.4239/wjd.v12.i1.69] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In spite of an increase in the incidence and prevalence of diabetes mellitus (DM) and Alzheimer’s disease (AD) in the aging population worldwide, limited attention has been paid to their potential association.
AIM To investigate the association of DM and cardiometabolic syndrome (CMS, a precursor to DM) with risk of incident AD among postmenopausal women.
METHODS Postmenopausal women aged 50-79 (n = 63117) who participated in the U.S. Women’s Health Initiative Observational Study (WHIOS), recruited in 1993-1998, without baseline AD and followed up through March 1, 2019, were analyzed. AD was classified by participant-reported history of doctor-diagnosis of incident AD in the WHIOS. DM was defined by participant-report or treated because of diabetes or serum glucose concentrations ≥ 126 mg/dL. CMS was defined as having ≥ 3 of five CMS components: large waist circumference, high blood pressure, elevated triglycerides, elevated glucose, and low high-density lipoprotein cholesterol. The associations of DM and CMS with AD were analyzed using Cox’s proportional hazards regression analysis.
RESULTS During a median follow-up of 20 years (range: 3.36 to 23.36 years), of 63117 participants, 8340 developed incident AD. Women with DM had significantly higher incidence of AD [8.5, 95% confidence interval (CI): 8.0-9.0 per 1000 person-years (PY)] than those without DM (7.1, 95%CI: 6.9-7.2 per 1000 PY). Multivariate Cox’s regression analysis indicated that women with DM or CMS had a significantly higher risk of AD than those without DM or CMS. The corresponding hazard ratios [HR (95%CI)] were 1.22 (1.13-1.31, P < 0.001) in subjects with DM, and 1.18 (1.09-1.27, P < 0.001) in subjects with CMS. The HRs diminished with age and became non-significant in the oldest age group.
CONCLUSION During a median follow-up of 20 years, DM and CMS were significantly associated with the risk of AD among postmenopausal women. More specifically, women aged 50-69 with DM or CMS vs those without these conditions had significantly higher relative risks of AD than the relative risks of AD in those aged 70-79 with DM or CMS vs those without DM or CMS.
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Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States
| | - Edward J Gracely
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States
- Department of Family, Community and Preventive Medicine, Drexel University College of Medicine, Philadelphia, PA 19129, United States
| | - Xiaoyan Yin
- Institute for Diabetes, Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Howard J Eisen
- Heart and Vascular Institute, Pennsylvania State University, Hershey, PA 17033, United States
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Martinez EE, Forbes PW, O'Brien SE, de Ferranti SD. Census tract based income level and lipid levels in urban pediatric primary care: a retrospective study. BMC Pediatr 2016; 16:86. [PMID: 27391043 PMCID: PMC4939018 DOI: 10.1186/s12887-016-0622-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/24/2016] [Indexed: 11/10/2022] Open
Abstract
Background Lower socioeconomic status has been associated with adverse lipid levels in adult populations. Childhood dyslipidemia is a risk factor for future cardiovascular disease. However, studies examining relationships between socioeconomic indicators and lipid levels in children are limited. To examine the relationship between income level and lipid levels in childhood. Methods We conducted a retrospective chart review of primary care patients, ages 2 to 18 years, who had lipid levels drawn at two large pediatric practices in Boston, MA between August 01, 2008 and August 31, 2010. Income level was determined using geocoding census tract data. Analysis was performed using t-test, Anova and Spearman correlation coefficients. BMI percentile, age, sex, race/ethnicity, and site were adjusted for on multivariate analyses. Results Reviewing 930 charts of patients with measured lipid levels, 730 had a valid address, no previously diagnosed lipid disorder and met other study eligibility criteria. Mean total cholesterol level did not vary by income level (low 155.5 mg/dl ±26.9, moderate 153.5 mg/dl ±30.4, middle 155.3 mg/dl ±26.6 and high income 155.5 mg/dl ±27.9; p = .87) on multivariate analysis. Income level was not related to LDL, HDL, or triglycerides. Conclusions In this analysis of children cared for in two urban pediatric primary practices, there was no association between income level determined by census tract and lipid levels in childhood. If confirmed in prospective investigations in other geographical locations, income level may not be a key driver of childhood lipid levels.
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Affiliation(s)
- Enid E Martinez
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Pediatrics, Boston Medical Center, Boston, MA, USA. .,Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Bader 634, 300 Longwood Avenue, Boston, MA, 02115, USA.
| | - Peter W Forbes
- Clinical Research Program, Boston Children's Hospital, Harvard University, Boston, MA, USA
| | - Sharon E O'Brien
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA.,Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sarah D de Ferranti
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Hur YI, Park H, Kang JH, Lee HA, Song HJ, Lee HJ, Kim OH. Associations between Sugar Intake from Different Food Sources and Adiposity or Cardio-Metabolic Risk in Childhood and Adolescence: The Korean Child-Adolescent Cohort Study. Nutrients 2015; 8:nu8010020. [PMID: 26729156 PMCID: PMC4728634 DOI: 10.3390/nu8010020] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/14/2015] [Accepted: 12/15/2015] [Indexed: 01/19/2023] Open
Abstract
The increasing prevalence of childhood obesity is a serious public health problem associated with co-morbidities in adulthood, as well as childhood. This study was conducted to identify associations between total sugar intake and sugar intake from different foods (fruit, milk, and sugar-sweetened beverages (SSBs)), and adiposity and continuous metabolic syndrome scores (cMetS) among Korean children and adolescents using cohort data. The study subjects were children (n = 770) who participated in the 4th year (2008) of the Korean Child–Adolescent Cohort Study (KoCAS). Dietary intake data were collected via three-day 24-h food records, and sugar intake was calculated for the total sugar content of foods using our database compiled from various sources. Anthropometric measurements, assessments of body composition, and blood sample analysis were performed at baseline and at follow-up four years later. The cMetS was calculated based on waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and mean arterial blood pressure. According to multiple linear regression analysis, there were no significant associations between total sugar intake and adiposity and cMetS. However, higher intake of fruit sugar at baseline was significantly associated with lower body mass index (BMI) z-scores and body fat percentages at baseline (β = −0.10, p = 0.02 and β = −0.78, p < 0.01, respectively). At follow-up, sugar intake from fruit at baseline was still negatively associated with the above outcomes, but only the relationship with BMI z-scores retained statistical significance (β = −0.08, p < 0.05). There was a significant positive relationship between consumption of sugar from SSBs and cMetS at baseline (β = 0.04, p = 0.02), but that relationship was not observed at follow-up (p = 0.83). Differences in consumption sugars from fruit and SSBs might play an important role in the risk of adiposity and metabolic disease in children and adolescents. Our results suggest that strategies for reducing sugar intake need to target particular food groups. Consequently, this information could be of value to obesity- and metabolic disease-prevention strategies.
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Affiliation(s)
- Yang-Im Hur
- Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul 100032, Korea.
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul 07985, Korea.
| | - Jae-Heon Kang
- Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul 100032, Korea.
| | - Hye-Ah Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul 07985, Korea.
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, Gyeonggi-do 14068, Korea.
| | - Hae-Jeung Lee
- Department of Food and Nutrition, Eulji University, Seongnam-si, Gyeonggi-do 13135, Korea.
| | - Ok-Hyun Kim
- Institute for Clinical Nutrition, Inje University, Seoul 100032, Korea.
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Heshmat R, Shafiee G, Kelishadi R, Babaki AES, Motlagh ME, Arefirad T, Ardalan G, Ataie-Jafari A, Asayesh H, Mohammadi R, Qorbani M. Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study. Nutr Res Pract 2015; 9:404-10. [PMID: 26244080 PMCID: PMC4523485 DOI: 10.4162/nrp.2015.9.4.404] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 03/16/2015] [Accepted: 04/19/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND/OBJECTIVES Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.
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Affiliation(s)
- Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Gelayol Ardalan
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asal Ataie-Jafari
- Department of Nutrition, Faculty of Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Rasool Mohammadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Public Health, Alborz University of Medical Sciences, Baghestan Boulevard, 31485/56, Karaj, Iran. ; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Cardiorespiratory fitness predicts clustered cardiometabolic risk in 10-11.9-year-olds. Eur J Pediatr 2013; 172:913-8. [PMID: 23440481 DOI: 10.1007/s00431-013-1973-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/06/2013] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
Abstract
The aim of this study was to investigate levels of clustered cardiometabolic risk and the odds of being 'at risk' according to cardiorespiratory fitness status in children. Data from 88 10-11.9-year-old children (mean age 11.05 ± 0.51 years), who participated in either the REACH Year 6 or the Benefits of Fitness Circuits for Primary School Populations studies were combined. Waist circumference, systolic blood pressure, diastolic blood pressure, glucose, triglycerides, high-density lipoprotein cholesterol, adiponectin and C-reactive protein were assessed and used to estimate clustered cardiometabolic risk. Participants were classified as 'fit' or 'unfit' using recently published definitions (46.6 and 41.9 mL/kg/min for boys and girls, respectively), and continuous clustered risk scores between fitness groups were assessed. Participants were subsequently assigned to a 'normal' or 'high' clustered cardiometabolic risk group based on risk scores, and logistic regression analysis assessed the odds of belonging to the increased cardiometabolic risk group according to fitness. The unfit group exhibited significantly higher clustered cardiometabolic risk scores (p < 0.001) than the fit group. A clear association between fitness group and being at increased cardiometabolic risk (B = 2.509, p = 0.001) was also identified, and participants classed as being unfit were found to have odds of being classified as 'at risk' of 12.30 (95 % CI = 2.64-57.33). Conclusion Assessing cardiorespiratory fitness is a valid method of identifying children most at risk of cardiometabolic pathologies. The ROC thresholds could be used to identify populations of children most at risk and may therefore be used to effectively target a cardiometabolic risk-reducing public health intervention.
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The association between diet and physical activity on insulin resistance in the Women's Interagency HIV Study. J Acquir Immune Defic Syndr 2013; 62:74-80. [PMID: 23075914 DOI: 10.1097/qai.0b013e318275d6a4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the association of diet and physical activity with insulin resistance (IR) in HIV-infected and HIV-uninfected women. METHODS Cross-sectional analyses of summary dietary measures and physical activity intensity scores obtained from women enrolled in the San Francisco (n = 113) and Chicago (n = 65) Women's Interagency HIV Study (WIHS) sites. IR was estimated using the homeostasis model assessment (HOMA-IR). Stepwise regression models assessed the association of diet and physical activity with HOMA-IR after adjustment for demographic, behavioral, and clinical factors. RESULTS Compared with HIV-uninfected women, HIV-infected women were older and more likely to have health insurance. In multivariable analysis including all women, being from San Francisco ( P = 0.005), having a higher mean body mass index (BMI, P < 0.001), and having a higher percent kilocalories from sweets (P = 0.025) were associated with greater HOMA-IR; heavy intensity physical activity (P = 0.006) and annual household income more than $36,000 ( P = 0.02) was associated with a lower HOMA-IR. In analysis limited to HIV-infected women, having a higher body mass index (P < 0.001) and a history of protease inhibitor use (P = 0.002) were significantly associated with higher HOMA-IR; heavy intensity activity (P = 0.06) was marginally associated with lower HOMA-IR and being menopausal (P = 0.05) was marginally associated with higher HOMA-IR. CONCLUSIONS Among urban women with or at risk for HIV-infection, heavy intensity physical activity was associated with lower HOMA-IR, whereas higher percent kilocalories from sweets were associated with higher HOMA-IR. Given the overall health benefits of physical activity and a diet low on sugar, these behaviors should be encouraged whenever possible.
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Kim Y, Conners RT, Hart PD, Kang YS, Kang M. Association of physical activity and body mass index with metabolic syndrome among U.S. adolescents with disabilities. Disabil Health J 2013; 6:253-9. [PMID: 23769485 DOI: 10.1016/j.dhjo.2013.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 11/28/2012] [Accepted: 01/09/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adolescents with disabilities (A-With-D) have shown to be less physically active and more obese compared to adolescents without disabilities (A-Without-D); however, little is known in regards to the impact of physical activity (PA) and body mass index (BMI) on metabolic syndrome (MetS) among A-with-D. OBJECTIVE The purpose of this study was to compare the prevalence of MetS, PA levels and BMI percentile between A-With-D and A-Without-D, and to examine the influence of PA and BMI on MetS among A-With-D. METHODS Data from the National Health and Nutrition Examination Survey 1999-2010 was used in this study. Inclusion criteria for the study consisted of those who indicated, in the survey, that they had received special education or early intervention service (n = 278). PA level was assessed subjectively by asking the amount of leisure time PA. BMI percentile was obtained using BMI growth charts by age and sex. The continuous MetS (cMetS) score was computed using age and sex standardized residual for mean arterial blood pressure, triglyceride, glucose, waist circumference, and high-density lipoprotein cholesterol. RESULTS A-With-D were more likely to be obese and less likely to be engaged in PA compared to A-Without-D. A-With-D were less favorable to MetS with significantly higher cMetS scores than A-Without-D. Lower levels of PA and higher percentile of BMI were significantly associated with higher levels of cMetS scores among A-With-D. CONCLUSION This study provided empirical evidence for the importance of promoting a healthy lifestyle (i.e., increasing the level of PA and decreasing the BMI percentile) among A-With-D in order to reduce the risk of MetS.
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Affiliation(s)
- Youngdeok Kim
- Department of Health and Human Performance, Middle Tennessee State University, 1500 Greenland Dr., P.O. Box 96, Murfreesboro, TN 37132, USA.
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Okosun IS, Seale JP, Boltri JM, Davis-Smith M. Trends and clustering of cardiometabolic risk factors in American adolescents from 1999 to 2008. J Adolesc Health 2012; 50:132-9. [PMID: 22265108 DOI: 10.1016/j.jadohealth.2011.04.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 04/19/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
Abstract
AIM To characterize trends and clustering of cardiometabolic risk factors in 12-17-year-old non-Hispanic white, non-Hispanic black (NHB), Mexican-American (MA), and multiracial American (MRA) adolescents. METHODS Data from the 1999-2000 to 2007-2008 U.S. National Health and Nutrition Examination Surveys were used for this investigation. Clustering of cardiometabolic risk factors was determined using cardiometabolic risk factor clustering score (cMetS) computed by aggregating z scores of mean arterial blood pressure, triglycerides, fasting blood glucose, waist circumference, and high-density lipoprotein cholesterol. RESULTS There were significant increases in waist circumference and high-density lipoprotein cholesterol, and decreases in low density lipoprotein cholesterol, triglycerides, and mean arterial blood pressure in the 10-year period between 1999-2000 and 2007-2008. There were gender and racial/ethnic differences in cMetS, with NHB having a more favorable cMetS for each studied time point. Overall, cMetS decreased by 93% in the 10-year period between 1999-2000 and 2007-2008. cMetS decreased by 98% and 77.3% for male and female adolescents, respectively, in the period between 1999-2000 and 2007-2008. With the exception of Mexican-American and multiracial American female adolescents, all racial/ethnic groups had improved cMetS values on comparing mean cMetS values of 1999-2000 with mean values of 2007-2008. Compared with other racial/ethnic groups, NHB male and female adolescents had the most improved cMetS. CONCLUSION Because clustering of cardiometabolic risk factors is predictive of adult health status, early lifestyle intervention in adolescence may help slow down the progress and delay or prevent the onset of cardiovascular diseases in adulthood.
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Affiliation(s)
- Ike S Okosun
- Institute of Public Health, Georgia State University, Atlanta, Georgia, USA.
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Tung HH, Tseng LH, Wei J, Lin CH, Wang TJ, Liang SY. Food Pattern and Quality of Life in Metabolic Syndrome Patients who Underwent Coronary Artery Bypass Grafting in Taiwan. Eur J Cardiovasc Nurs 2011; 10:205-12. [DOI: 10.1016/j.ejcnurse.2010.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Revised: 05/21/2010] [Accepted: 05/26/2010] [Indexed: 10/19/2022]
Abstract
Metabolic syndrome is associated with poor operative outcomes of coronary artery bypass grafting surgery (CABG). A healthy food pattern for metabolic syndrome patients is necessary not only in the initial stage to prevent cardiovascular disease but for those who experience cardiovascular problems and undergo heart surgery. Empirical studies that explore food pattern and quality of life metabolic syndrome patients who undergo CABG are lacking. Therefore, the objectives of this study are to explore the food pattern and quality of life of metabolic syndrome patients who undergo CABG and to examine the relationship between these two variables. A descriptive, correlational and cross section design was conducted. Through convenience sampling, 104 patients were recruited. Data were collected through three instruments: a demographic questionnaire; the Chinese Food Frequency Questionnaire-Short Form (Short C-FFQ), used to assess food pattern; and the Taiwanese version of the Medical Outcomes Study Short Form 36-Health Survey (SF-36), used to assess quality of life. Descriptive analysis, one-way analysis of variance (ANOVA) and Pearson correlation were used to analyze the data. The results indicated that patients who ate fruit more frequently tended to have a better quality of life, while the intake of fried food was more frequently associated with a poor quality of life. The use of these data gives the health care provider a better understanding of food pattern and their impact on quality of life in this population. Such an understanding can be used to develop targeted interventions to promote health in this and in other populations.
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Affiliation(s)
- Heng-Hsin Tung
- National Taipei College of Nursing, 365 Ming Te Road PeiTou, Taipei 112, Taiwan, ROC
- Tungs' Taichung MetroHabor Hospital, Taiwan, 365 Ming Te Road PeiTou, Taipei 112, Taiwan, ROC
| | - Li-Hua Tseng
- Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, PeiTou, Taipei 11217, Taiwan, ROC
| | - Jeng Wei
- Heart Center of Chen-Hsin Hospital, 45 Cheng-Hsin St, PeiTou, Taipei 112, Taiwan, ROC
| | - Cheng-Hsin Lin
- Department of Surgery, Chi Mei Medical Center, Taiwan, ROC
| | - Tsae-Jyy Wang
- National Taipei College of Nursing, 365 Ming Te Road PeiTou, Taipei 112, Taiwan, ROC
| | - Shu-Yuan Liang
- National Taipei College of Nursing, 365 Ming Te Road PeiTou, Taipei 112, Taiwan, ROC
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Okosun IS, Lyn R, Davis-Smith M, Eriksen M, Seale P. Validity of a continuous metabolic risk score as an index for modeling metabolic syndrome in adolescents. Ann Epidemiol 2011; 20:843-51. [PMID: 20933191 DOI: 10.1016/j.annepidem.2010.08.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 08/03/2010] [Accepted: 08/07/2010] [Indexed: 01/19/2023]
Abstract
PURPOSE Although continuous values of metabolic syndrome risk scores (cMetS) has been suggested for modeling the association between potential risk factors and metabolic syndrome (MetS) in young people, the construct validity of cMetS has not been sufficiently examined in a representative sample of youngsters. This study examined: (i) sex and race/ethnic-specific optimal cut-off points of cMetS that are associated with MetS and (ii) the construct validity of cMetS in 12- to 19-year old non-Hispanic white (NHW), non-Hispanic black (NHB), and Mexican-American (MA) subjects. METHODS Data (n = 1239) from the 2003 to 2004 and 2005 to 2006 National Health and Nutrition Examination Surveys were used in this study. cMetS was derived by aggregating age- and sex-standardized residuals of arterial blood pressure, triglycerides, glucose, waist circumference, and high-density lipoprotein cholesterol. Receiver operating characteristics analysis was used to determine the validity and performance of cMetS. The overall performance of the receiver operating characteristics test was quantified with area under the curve (AUC). RESULTS A graded relationship between cMetS and increased number of MetS factors was observed, with MetS factors of 3 or greater yielding the greatest cMetS. In male adolescents, the optimal cMetS cut-off points of cMetS that are associated with MetS in NHW, NHB, and MA were 2.01, 2.45, and 2.34, respectively. The corresponding values in female adolescents for NBW, NHB, and MA were 1.93, 2.12, and 2.23, respectively. The construct validity of cMetS for MetS was high (AUC ≥0.885; sensitivity ≥66.7; specificity ≥74.8%). CONCLUSIONS cMetS appears to be a suitable index for investigating the association between potential risk factors and MetS in adolescents. An understanding of the role of genetic and environmental risk factors in MetS in children may be enhanced with the use of cMetS.
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Affiliation(s)
- Ike S Okosun
- Institute of Public Health, Georgia State University, Atlanta, USA.
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Phillips AC, Carroll D, Thomas GN, Gale CR, Deary I, Batty GD. The influence of multiple indices of socioeconomic disadvantage across the adult life course on the metabolic syndrome: the Vietnam Experience Study. Metabolism 2010; 59:1164-71. [PMID: 20045139 DOI: 10.1016/j.metabol.2009.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 11/05/2009] [Accepted: 11/06/2009] [Indexed: 10/20/2022]
Abstract
Few studies have explored the relationship between individual and combined multiple indicators of socioeconomic status across the life course and the metabolic syndrome, or attempted to understand the mechanisms underlying any associations. The present study examined the associations between 4 indicators of socioeconomic status, individually and in combination, and metabolic syndrome risk in a study of male US veterans and examined the influence of health behaviors, intelligence, and psychologic distress on these associations. Participants (N = 4253) were drawn from the Vietnam Experience Study. From military service files, telephone interviews, and a medical examination, occupational, sociodemographic, health behavior, intelligence, psychologic, and health data were collected. The 4 indices of socioeconomic status were as follows: education achieved, early adulthood income, household income in midlife, and occupational prestige in midlife. Metabolic syndrome was diagnosed from the following: body mass index, fasting blood glucose or a diagnosis of diabetes, blood pressure-a diagnosis of hypertension or taking antihypertensives, high-density lipoprotein cholesterol, and triglyceride levels. In models that adjusted for age, men in the lower 2 groups on the combined measure of socioeconomic status experienced a higher risk of metabolic syndrome. This association was accounted for mainly by education achieved, household income in midlife, and occupational prestige in midlife. Intelligence appeared to explain much of this association. Combined socioeconomic status measures across the life course were related to metabolic syndrome but in a threshold rather than dose-response manner. Intelligence appeared to mediate this relationship.
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Affiliation(s)
- Anna C Phillips
- School of Sport and Exercise Sciences, University of Birmingham, UK.
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Okosun IS, Boltri JM, Lyn R, Davis-Smith M. Continuous Metabolic Syndrome Risk Score, Body Mass Index Percentile, and Leisure Time Physical Activity in American Children. J Clin Hypertens (Greenwich) 2010; 12:636-44. [PMID: 20695944 DOI: 10.1111/j.1751-7176.2010.00338.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ike S Okosun
- Institute of Public Health, College of Health and Human Sciences, Georgia State University, Atlanta, GA, USA.
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Liu L, Núñez AE. Cardiometabolic syndrome and its association with education, smoking, diet, physical activity, and social support: findings from the Pennsylvania 2007 BRFSS Survey. J Clin Hypertens (Greenwich) 2010; 12:556-64. [PMID: 20629821 PMCID: PMC8673169 DOI: 10.1111/j.1751-7176.2010.00317.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Revised: 02/28/2010] [Accepted: 03/08/2010] [Indexed: 12/28/2022]
Abstract
The authors aimed to examine the prevalence of cardiometabolic syndrome (CMS) and its association with education, smoking, diet, physical activity, and social support among white, black, and Hispanic adults using data from the 2007 Pennsylvania Behavior Risk Factor Surveillance System (BRFSS) survey, the largest population-based survey in the state. The authors examined associations between CMS and associated factors cross-sectionally using univariate and multivariate methods. The study included a representative sample of 12,629 noninstitutionalized Pennsylvanians aged > or =18. Components of CMS included obesity, hypercholesterolemia, angina (as a surrogate for decreased high-density lipoprotein), prehypertension or hypertension, and prediabetes or diabetes. CMS was identified as the presence of > or =3 CMS components. The results show that the prevalence of CMS was 20.48% in blacks, followed by Hispanics (19.14%) and whites (12.26%), (P<.01). Multivariate logistic regression analyses indicated that physical inactivity, lower educational levels, smoking, daily consumption of vegetables and/or fruits <3 servings, and lack of social support were significantly associated with the odds of having CMS. In conclusion, black and Hispanic adults have a significantly higher prevalence of CMS than whites. The significant association between CMS and risk factors provides new insights in the direction of health promotion to prevent and control CMS in those who are at high risk.
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Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
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Premetabolic syndrome and clustering of cardiometabolic risk factors in White, Black and Mexican American adults. Diabetes Metab Syndr 2009. [DOI: 10.1016/j.dsx.2009.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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