Evidence for distinct genetic effects on obesity and lipid-related CVD risk factors in diabetic compared to nondiabetic American Indians: the Strong Heart Family Study

Background: Obesity is an independent risk factor for diabetes and cardiovascular disease. Telomere length shortens progressively with age, and shorter leukocyte telomere length (LTL) has been associated with a wide range of age-related disorders. However, the association between LTL and obesity has not been well established. Objective: To examine the association of LTL with obesity and related traits in American Indians participating in the Strong Heart Family Study (SHFS, 2001-2003), independent of known risk factors. Methods: A total of 3,162 participants (18-93 years old, 1,938 women) from 94 multigenerational families were included in this analysis. Obesity-related traits included body mass index (BMI), waist circumference, hip circumference, and waist-to-hip ratio. LTL was measured by quantitative PCR. Association of LTL (continuous or in quintiles) with each adiposity index was examined using generalized linear mixed model, adjusting for age, sex, study center, education, lifestyle factors (current smoking, current drinking, physical activity, and total energy intake), hypertension (yes/no) and diabetes (yes/no). The association of LTL with prevalent obesity (BMI ≥30 kg/m2) was examined by multivariate logistic regression using the GLIMMIX procedure in SAS 9.3. Results: Prevalence of obesity was 59.6% (1,883 of 3,162). LTL was negatively correlated with age (r=-0.3, P<0.0001). Obese participants had significantly shorter LTL than non-obese participants (age-adjusted P=0.0004). Multivariate regression analyses demonstrated that, LTL was significantly and inversely associated with all obesity indices (β= -2.68 [95% confidence interval (CI), -3.96 [[Unable to Display Character: ‒]] -1.40] for BMI; -6.28 [95% CI, -9.29 [[Unable to Display Character: ‒]] -3.27] for waist circumference; -3.95 [95% CI, -6.61 [[Unable to Display Character: ‒]] -1.29] for hip circumference; and -0.02 [95% CI, -0.03 [[Unable to Display Character: ‒]] -0.01] for waist-to-hip ratio). Participants with shorter LTL had significantly larger BMI (P trend across quintiles =0.0006), waist circumference (P trend =0.0005), hip circumference (P trend =0.01), and waist-to-hip ratio (P trend =0.002) compared to those with longer LTL. Multivariate-adjusted odds ratio (95% CI) for prevalent obesity was 1.32 (1.05-1.67), 1.29 (0.99-1.67), 1.29 (1.01-1.65) and 1.18 (0.89-1.57), respectively, for the 1st through 4th quintiles of LTL in comparison with the 5th quintile (P for trend =0.02). Excluding participants with diabetes and cardiovascular disease did not change our results. Conclusion: Shorter LTL was significantly associated with obesity and related measures in American Indians, independent of known risk factors. Our results may shed light on the complex pathophysiology of obesity and its related disorders.

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CVD Risk Factors Greater in Girls With Type 1 Diabetes

Pediatric News ◽

10.1016/s0031-398x(11)70187-4 ◽

2011 ◽

Vol 45 (8) ◽

pp. 6

Author(s):

DOUG BRUNK

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Cvd Risk Factors ◽

Cvd Risk

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Geographical profiles of cardiovascular risk and the risk factors in China: data from a nationwide population-based screening project

European Heart Journal ◽

10.1093/ehjci/ehaa946.2826 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C.Q Wu ◽

X Li ◽

J.P Lu ◽

B.W Chen ◽

Y.C Li ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Blood Pressure ◽

Population Based ◽

Staple Food ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Food Factor ◽

Rural And Urban ◽

Activity Factor

Abstract Background In China, an abundance of cardiovascular risk factors has contributed to the increasing prevalence of cardiovascular diseases (CVD), which caused almost 4 million deaths per year. However, comprehensive evidence on the geographical profiles of cardiovascular disease risk in China is lacking, as findings in prior studies have been limited to relatively small sample sizes, had incomplete regional coverage, or focused on a narrow risk factor spectrum. Purpose To compare the population CVD risk among different regions across China, and to describe the geographical distributions of CVD risk factors and their clusters throughout the nation. Methods In a nationwide population-based screening project covering 252 counties of China, standardized measurements were conducted to collect information on 12 major CVD risk factors. Individuals of high CVD risk were identified as those with previous CVD, or with a predicted 10-year risk of CVD greater than 10% according to the WHO risk prediction charts. We applied factor analysis to generate “clusters” that characterized the clustering of these risk factors, then explored their relationship with the local ambient temperature and per capital GDP. Results Among 983476 participants included, 9.2% were of high CVD risk, with a range of 1.6% to 23.6% across counties. Among the seven regions in China, the rate was relatively high in the Northeast (11.8%) and North China (10.4%), while low in the South China (7.2%) and Northwest (7.8%). We identified 6 clusters underlying CVD risk factors, including Obesity factor, Blood pressure factor, Staple food factor, Non-staple food factor, Smoking and alcohol factor, and Metabolic and physical activity factor (Figure). We found high risk regions were facing different leading challenges, like obesity and blood pressure for the North China, while unhealthy non-staple food for the Northeast. The South China, as the region with the lowest CVD risk, still had the highest prevalence of unhealthy staple food. Lower annual average ambient temperature was associated with higher risk in Blood pressure factor, Obesity factor and Non-staple food factor, but lower risk in Staple food factor and Metabolic and physical activity factor (p<0.001 for all), consistently between rural and urban. Higher per capital GDP was associated with lower risk in Non-staple food factor in urban and higher risk in Metabolic and physical activity factor in rural (p<0.05 for both). The correlation between per capital GDP and Smoking and alcohol factor differed significantly between in rural and urban regions (p=0.042). Conclusions The geographical profile of CVD risk in China is complex - population risk levels varied substantially across regions, which were contributed by different risk factors. China needs geographically targeted intervention strategies considering environmental and socio-economic factors to control CVD risk and reduce the burden related to CVD. Geographical disparity of risk clusters Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The National Key Research and Development Program from the Ministry of Science and Technology of China; the CAMS Innovation Fund for Medical Science

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FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2647 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 808.2-808

Author(s):

N. Hammam ◽

G. Salem ◽

D. Fouad ◽

S. Rashad

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Functional Limitations ◽

Functional Limitation ◽

C Reactive Protein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Distribution Width ◽

Reactive Protein ◽

Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

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Cardiovascular risk factors and COVID-19 outcomes in hospitalised patients: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-045482 ◽

2021 ◽

Vol 11 (2) ◽

pp. e045482

Author(s):

Didier Collard ◽

Nick S Nurmohamed ◽

Yannick Kaiser ◽

Laurens F Reeskamp ◽

Tom Dormans ◽

...

Keyword(s):

Risk Factors ◽

Cox Regression ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Icu Admission ◽

Lowering Therapy ◽

Secondary Outcomes ◽

Age And Sex

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.

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Serum alanine aminotransferase activity and risk factors for cardiovascular disease in a Caucasian population: the Tromsø study

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01826-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Svein Ivar Bekkelund

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Alanine Aminotransferase ◽

Maximum Level ◽

Glycated Haemoglobin ◽

Caucasian Population ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional ◽

Serum Alanine Aminotransferase

Abstract Background High and low levels of serum alanine aminotransferase (ALT) are both associated with cardiovascular diseases (CVD) risks especially in elderly, but the mechanisms are less known. This study investigated associations between ALT and CVD risk factors including effects of sex and age in a Caucasian population. Methods Cross-sectional data were analysed sex-stratified in 2555 men (mean age 60.4 years) and 2858 women (mean age 60.0 years) from the population study Tromsø 6. Associations were assessed by variance analysis and multivariable logistic regression of odds to have abnormal ALT. Risk factors included body mass index (BMI), waist-to-hip-ratio, blood pressure, lipids, glucose, glycated haemoglobin and high-sensitive C-reactive protein (CRP). Results Abnormal elevated ALT was detected in 113 men (4.4%) and 188 women (6.6%). Most CVD risk factors associated positively with ALT in both sexes except systolic blood pressure and CRP (women only), while ALT was positively associated with age in men when adjusted for CVD risk factors, P < 0.001. BMI predicted ALT in men (OR 0.94; 95% CI 0.88–1.00, P = 0.047) and women (OR 0.90; 95% CI 0.86–0.95, P < 0.001). A linear inversed association between age and ALT in men and a non-linear inversed U-trend in women with maximum level between 60 and 64 years were found. Conclusion This study confirms a positive relationship between ALT and CVD risk factors, particularly BMI. Age is not a major confounder in the ALT-CVD relationship, but separate sex-analyses is recommended in such studies.

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