Normal-Weight Obesity: A Novel CVD Risk Factor

2008 ◽  
Vol 38 (7) ◽  
pp. 9
Author(s):  
BRUCE JANCIN
Author(s):  
Shaun Scholes ◽  
Linda Ng Fat ◽  
Jennifer S Mindell

Objective. Favourable trends in cardiovascular disease (CVD) risk factors at the population level potentially mask differences within high- and low-risk groups. Data from annual, repeated cross-sectional surveys (Health Survey for England 2003-18) was used to examine trends in the prevalence of key CVD risk factors by body mass index (BMI) category among adults aged 16 years or older (n=115,860). Methods. Six risk factors were investigated: (i) current cigarette smoking; (ii) physical inactivity (<30 minutes of moderate-to-vigorous physical activity per week); (iii) drinking above recommended daily alcohol limits; (iv) hypertension (measured blood pressure ≥140/90mmHg or use of medicine prescribed for high blood pressure); (v) total diabetes (reported diagnosed or elevated glycated haemoglobin); and (vi) raised total cholesterol (≥5mmol/L). Age-standardised risk factor prevalence was computed in each four-year time period (2003-06; 2007-10; 2011-14; 2015-18) in all adults and by BMI category (normal-weight; overweight; obesity). Change in risk factor prevalence on the absolute scale was computed as the difference between the first and last time-periods, expressed in percentage points (PP). Results. Risk factor change varied by BMI category in a number of cases. Current smoking prevalence fell more sharply for normal-weight men (-8.1 PP; 95% CI: -10.3, -5.8) versus men with obesity (-3.8 PP; 95% CI: -6.2, -1.4). Hypertension remained at a stable level among normal-weight men but decreased among men with obesity (-4.1 PP; 95% CI: -7.1, -1.0). Total diabetes remained at a stable level among normal-weight adults, but increased among adults with obesity (men: 3.5 PP; 95% CI: 1.2, 5.7; women: 3.6 PP; 95% CI: 1.8, 5.4). Raised total cholesterol decreased in all BMI groups, but fell more sharply among women with obesity (-21 PP; 95% CI: -25, -17) versus their normal-weight counterparts (-16 PP; 95% CI: -18, -14). Conclusions. Relative to adults with normal weight, greater reductions in hypertension and raised total cholesterol among adults with overweight and obesity reflect at least in part improvements in screening, treatment and control among those at highest cardiovascular risk. Higher levels of risk factor prevalence among adults with overweight and obesity, in parallel with rising diabetes, highlight the importance of national prevention efforts to combat the public health impact of excess adiposity.


2009 ◽  
Vol 31 (6) ◽  
pp. 737-746 ◽  
Author(s):  
Abel Romero-Corral ◽  
Virend K. Somers ◽  
Justo Sierra-Johnson ◽  
Yoel Korenfeld ◽  
Simona Boarin ◽  
...  

Biosensors ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 73
Author(s):  
Brian D. Henderson ◽  
David J. Kinahan ◽  
Jeanne Rio ◽  
Rohit Mishra ◽  
Damien King ◽  
...  

Within microfluidic technologies, the centrifugal microfluidic “Lab-on-a-Disc” (LoaD) platform offers great potential for use at the PoC and in low-resource settings due to its robustness and the ability to port and miniaturize ‘wet bench’ laboratory protocols. We present the combination of ‘event-triggered dissolvable film valves’ with a centrifugo-pneumatic siphon structure to enable control and timing, through changes in disc spin-speed, of the release and incubations of eight samples/reagents/wash buffers. Based on these microfluidic techniques, we integrated and automated a chemiluminescent immunoassay for detection of the CVD risk factor marker C-reactive protein displaying a limit of detection (LOD) of 44.87 ng mL−1 and limit of quantitation (LoQ) of 135.87 ng mL−1.


2021 ◽  
Vol 6 (1) ◽  
pp. e003499
Author(s):  
Ryan G Wagner ◽  
Nigel J Crowther ◽  
Lisa K Micklesfield ◽  
Palwende Romauld Boua ◽  
Engelbert A Nonterah ◽  
...  

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sergi Trias-Llimós ◽  
Lisa Pennells ◽  
Aage Tverdal ◽  
Alexander V. Kudryavtsev ◽  
Sofia Malyutina ◽  
...  

AbstractSurprisingly few attempts have been made to quantify the simultaneous contribution of well-established risk factors to CVD mortality differences between countries. We aimed to develop and critically appraise an approach to doing so, applying it to the substantial CVD mortality gap between Russia and Norway using survey data in three cities and mortality risks from the Emerging Risk Factor Collaboration. We estimated the absolute and relative differences in CVD mortality at ages 40–69 years between countries attributable to the risk factors, under the counterfactual that the age- and sex-specific risk factor profile in Russia was as in Norway, and vice-versa. Under the counterfactual that Russia had the Norwegian risk factor profile, the absolute age-standardized CVD mortality gap would decline by 33.3% (95% CI 25.1–40.1) among men and 22.1% (10.4–31.3) among women. In relative terms, the mortality rate ratio (Russia/Norway) would decline from 9–10 to 7–8. Under the counterfactual that Norway had the Russian risk factor profile, the mortality gap reduced less. Well-established CVD risk factors account for a third of the male and around a quarter of the female CVD mortality gap between Russia and Norway. However, these estimates are based on widely held epidemiological assumptions that deserve further scrutiny.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Kamel A Gharaibeh ◽  
Vanessa Xanthakis ◽  
Jung Hye Sung ◽  
Tandaw S Samdarshi ◽  
Herman A Taylor ◽  
...  

Background . Metabolic derangements such as diabetes (DM) and metabolic syndrome (MetS) are common in African Americans (AA) and contribute to the higher cardiovascular disease (CVD) mortality in this group. A greater prevalence of subclinical disease (ScD) among those with DM and MetS in the AA community may be an explanatory factor. Objective . We assessed the CVD risk factor profile and distribution of ScD among AA with DM and MetS in the Jackson Heart Study (JHS). Methods . We evaluated 4,365 AA participants [mean age (SD) of 53.8 (12.3) years, 64.5% women] free of overt CVD who attended JHS Exam 1 (between 2000- 2004), when ScD assessment was routinely performed(with the exception of CT for coronary calcium that occurred in Exam2). SCD measures included 1) peripheral artery disease (PAD, defined as ankle-brachial index<0.9), 2) high coronary artery calcium (CAC, defined as score>100), 3) left ventricular (LV) hypertrophy (LVH defined as left ventricular mass index>51 g/m 2.7 , 4) low LV ejection fraction (low EF, defined as an EF<50%), and 5) microalbuminuria (MA, defined as an albumin-to-creatinine ratio>25 μg/mg in men and >35 μg/mg in women). We compared the distribution of standard CVD risk factors and ScD prevalence in 1) those without DM or MetS (referent), 2) those with MetS but no DM and 3) those with DM. Results . In our study sample, 1,089 (24.9%) had MetS with no DM and 752 (17.2%) had DM. Compared to the referent group, groups with metabolic derangement tended to be older, female, hypertensive, obese, and had lower HDL, higher fasting glucose, and higher triglycerides levels. Table 1 compares the distribution of ScD for the three groups, and demonstrates the greater odds of. CAC, LVH and microalbuminuria in participants with MetS or DM. Conclusion . In our large community-based sample of AAs, we observed a significantly high prevalence of ScD overall, especially so in participants with MetS and DM. These findings likely contribute to the high CVD rates in AA with MetS and DM. -->


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jo-Ann Eastwood ◽  
Debra K Moser ◽  
Nabil Alshurafa ◽  
Lynn V Doering ◽  
Karol Watson ◽  
...  

Fifty thousand Black women, disproportionately affected by cardiovascular disease (CVD), die annually; 49% of Black women ≥ 20 years have CVD. Implementing proactive risk reduction is essential. The purpose of this community - based pilot was to test the feasibility of a program combining self-care education with wireless individualized feedback via a unique smartphone designed to appeal specifically to young Black women (YBW). Methods: Using church-based recruitment, 49 YBW (aged 25-45 years, 60% single) were randomized to treatment (TX) and control groups by church site. The TX group participated in 4 interactive self-care classes on CVD risk reduction. Each participant set individualized goals. Risk factor profiles (waist circumference (WC), BP, lipid panel by Cholestech [Alere]), medical and reproductive history and a battery of psychosocial instruments were assessed prior to classes and 6 months later. Participants were given smartphones with embedded accelerometers and WANDA-CVD, an application that delivered prompts and messages specifically for this pilot. For activity monitoring, phones were worn on the hip during waking hours. Participants obtained and transmitted BP measurements wirelessly via the phone. Changes over time were measured with paired t-tests and linear regression controlling for age and weight. Effect sizes were calculated using Cohen’s D. Results: In risk factor profiles, significant differences favoring the TX group occurred in DBP, WC, and TC/HDL ratio; similar changes in triglycerides yielded a medium-large effect size (Table). TX participants had greater drops in stress, anxiety, and better adherence to heart healthy habits. Conclusion: These interim pilot data validate the feasibility of a combined education/wireless monitoring-feedback program in YBW. Further testing in a large randomized trial is warranted to determine long-term effects on behavior change and cardiac risk profiles in this high risk population.


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