Associations between hypo-HDL cholesterolemia and cardiometabolic risk factors in middle-aged men and women: Independence of habitual alcohol drinking, smoking and regular exercise

Background: Neck circumference is a proxy for upper body fat and it is a simple anthropometric measure. Therefore it could be a useful tool to identify individuals with cardiometabolic risk factors in the context of primary care. Hypothesis: Neck circumference is independently associated to cardiometabolic risk factors in an apparently healthy population. Methods: This is a cross-sectional analysis of baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of 15105 civil servants aged 35-74 years. We excluded from this analysis those who fulfilled American Diabetes Association criteria for diabetes diagnosis, were taking antihypertensive and/or lipid-lowering drugs. A sex-specific analysis was conducted. Partial correlation (age-adjusted) was used. Risk factors were set as low HDL<50mg/dL for women and <40mg/dL for men, hypertriglyceridemia ≥ 150 mg/dl , hypertension as systolic blood pressure ≥130 mg/dl or diastolic blood pressure ≥85 mm Hg and insulin resistance(HOMA-IR ≥ 75th percentile). Logistic regression models were built to analyze the association between individual and clustered risk factors as dependent variables and 1-SD increase in neck circumference as independent variable. Multiple adjustments were subsequently performed for age, smoking, alcohol, body-mass index, waist and physical activity. Receiver Operating Curves were employed to find the best NC cut-off points for clustered risk factors. Results: We analyzed 3810 men (mean age= 49.0 ±8.3 yrs) and 4916 women (49.2 ±8.0 yrs). Mean NC was 38.9 (±2.6)cm for men and 33.4(±2.6)cm for women. NC positively correlated with systolic and diastolic blood pressure (r=0.21 and r=0.27), HOMA - IR (r=0.44), triglycerides (r=0.31) and negatively correlated with HDL (r= -0.21) in men (p<0.001 for all) with similar results in women. Fully adjusted Odds Ratio (OR) (95% CI) of risk factor per SD increase in neck circumference in men and women were 1.29(1.14;1.46) and 1.42(1.28;1.57) for insulin resistance; 1.24(1.11;1.39) and 1.25(1.11;1.40) for hypertension; 1.33(1.19;1.49) and 1.42(1.29;1.63) for hypertriglyceridemia; 1.07(0.92;1.23) and 1.32 (1.19;1.43) for low HDL. Fully adjusted OR (95% CI) of 2 clustered risk factor per SD increase in neck circumference in men and women were 1.29(1.14;1.48) and 1.37(1.21;1.54 ). Fully adjusted OR (95% CI) of 3 or more clustered risk factors per SD increase in neck circumference in men and women were 1.33 (1.02;1.74) and 1.62 (1.33;1.92). Values of neck circumference of >40 cm for men and >34.1 cm for women were the best cut-off points for 3 or more clustered risk factors. Conclusion: Neck circumference is significantly and independently associated to cardiometabolic risk factors in a well-defined non-treated population. It should be considered as a marker of cardio metabolic risk factors in primary care settings.

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Optimal waist:height ratio cut-off point for cardiometabolic risk factors in Turkish adults

Public Health Nutrition ◽

10.1017/s1368980009991637 ◽

2009 ◽

Vol 13 (4) ◽

pp. 488-495 ◽

Cited By ~ 10

Author(s):

Ahmet Selçuk Can ◽

Emine Akal Yıldız ◽

Gülhan Samur ◽

Neslişah Rakıcıoğlu ◽

Gülden Pekcan ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Risk Factor ◽

Cardiometabolic Risk ◽

Roc Curves ◽

Cross Sectional Study ◽

Cardiometabolic Risk Factors ◽

Youden Index ◽

Cross Sectional ◽

Men And Women

AbstractObjectiveTo identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.DesignCross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).SettingTurkey, 2003.SubjectsAdults (1121 women and 571 men) aged 18 years and over were examined.ResultsAnalysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.ConclusionsWe show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.

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654 Cardiometabolic risk factors of early atherosclerosis development in apparently healthy young men and women

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2011.07.543 ◽

2011 ◽

Vol 27 (5) ◽

pp. S301

Author(s):

E. Larose ◽

E. De Larochellière ◽

J. Côté ◽

M. Ross ◽

V. Dion-Roy ◽

...

Keyword(s):

Risk Factors ◽

Cardiometabolic Risk ◽

Young Men ◽

Cardiometabolic Risk Factors ◽

Men And Women ◽

Atherosclerosis Development ◽

Early Atherosclerosis ◽

Apparently Healthy

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Different Associations of Trunk and Lower-Body Fat Mass Distribution with Cardiometabolic Risk Factors between Healthy Middle-Aged Men and Women

International Journal of Endocrinology ◽

10.1155/2018/1289485 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Bin Wu ◽

Jingshan Huang ◽

Keisuke Fukuo ◽

Kazuhisa Suzuki ◽

Gen Yoshino ◽

...

Keyword(s):

Risk Factors ◽

Gender Differences ◽

Fat Mass ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Oxidative Stress Marker ◽

Sensitivity Index ◽

Lower Body ◽

Middle Aged ◽

Cardiometabolic Profile

The aim of this study was to assess whether the gender-specific pattern of fat mass (FM) distribution is related to gender differences in cardiometabolic risk factors. 207 healthy middle-aged Japanese were included in the study. We measured FM in the total body, trunk, and lower-body with dual-energy X-ray absorptiometry (DXA). The percentage of trunk FM (TFM) and lower-body FM (LFM) is noted as %TFM and %LFM, respectively. Other measurements included glucose and insulin during oral glucose tolerance test (OGTT), leptin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP), and systemic oxidative stress marker. Arterial properties were indicated by cardio-ankle vascular index (CAVI) and intima-media thickness (IMT) of the common carotid artery. The results showed that %TFM is higher whereas %LFM is lower in men than in women and men have a more atherogenic cardiometabolic profile. In both genders, %TFM (%LFM) is related to an unfavorable (favorable) cardiometabolic profile. In particular, the relation between %LFM and OGTT-derived insulin sensitivity index is stronger in women than in men. These findings suggested that in relatively healthy adults, android and gynoid pattern of FM distribution contributes to gender differences in cardiometabolic risk factors.

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Association of Basal Metabolic Rate and Nutrients Oxidation with Cardiometabolic Risk Factors and Insulin Sensitivity in Sedentary Middle-Aged Adults

Nutrients ◽

10.3390/nu12041186 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1186

Author(s):

Francisco J. Amaro-Gahete ◽

Lucas Jurado-Fasoli ◽

Jonatan R. Ruiz ◽

Manuel J. Castillo

Keyword(s):

Risk Factors ◽

Insulin Sensitivity ◽

Lean Mass ◽

Basal Metabolic Rate ◽

Plasma Insulin ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Middle Aged ◽

Middle Aged Adults

This cross-sectional study aimed to examine the association of basal metabolic rate (BMR) and basal fat and carbohydrate oxidation (BFox and BCHox, respectively) with cardiometabolic risk factors and insulin sensitivity in sedentary middle-aged adults. A total of 71 healthy sedentary adults (37 women) aged 40–65 years participated in the current study. Data were collected during the baseline assessments of the FIT-AGEING randomized controlled trial. BMR was measured via indirect calorimetry, and BFox and BCHox estimated by stoichiometric equations. Blood pressure, glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides plasma levels were selected as cardiometabolic risk factors and assessed following standard procedures. We observed positive associations of BMR with plasma insulin and the homeostatic model assessment of insulin resistance index (HOMA; all p < 0.05) which were attenuated or disappeared after controlling by sex, age, and/or lean mass. There were positive associations between BFox and the quantitative insulin sensitivity check index (QUICKI; p < 0.015), while negative associations were noted between BFox and plasma insulin and HOMA (p < 0.015). There was a significant negative association between BCHox with QUICKI (p < 0.01), whereas significant positive relationships were obtained when BCHox was associated with plasma insulin and HOMA (p < 0.01). These associations persisted in almost all cases when controlling by sex, age and/or lean mass. No further relationships were found when BMR, BFox, and BCHox were associated with other cardiometabolic risk factors. In conclusion, our study findings support that greater BFox and lower BCHox are related to improved insulin sensitivity, whereas BMR seems to be not associated with neither cardiometabolic risk nor insulin sensitivity in sedentary middle-aged adults. Further intervention studies are necessary to well-understand the physiological mechanism implied in this relationship.

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