Postprandial lipemia and CVD; does the magnitude, peak concentration or duration impact intermediary cardiometabolic risk factors differentially? PREDICT I Study.

AbstractPostprandial lipemia is an independent risk factor for CVD, due to effects on lipoprotein remodelling, oxidative stress, inflammation, haemostasis and endothelial dysfunction. However, it is unknown whether the total, peak or duration of the lipemic response determines risk. The PREDICT I study is the largest study to date to measure postprandial lipemic responses and intermediary acutely changing cardiometabolic risk factors at multiple time points using a standardized test meal model.A multi-center postprandial study of 1,000 individuals from the UK (unrelated, identical and non-identical twins) and 100 unrelated individuals from the US, assessed postprandial (hourly 0–6h) metabolic responses to sequential mixed-nutrient dietary challenges (50 g fat, 85 g carbohydrate at 0 h; 22 g fat, 71 g carbohydrate at 4h) in a clinic setting. We investigated the relationship of different postprandial triacylglycerol (TG) measures (4 and 6 h TG iAUC, 4 and 6 h TG concentration, 4 and 6 h TG increase from fasting) with lipoprotein remodelling (XXL-VLDL (including chylomicron remnants and VLDL particles) and XL-VLDL particle concentrations (average diameters > 75, 64 nm respectively), HDL-C) and levels of glycosylated acute phase proteins (GlycA; marker of cardiovascular inflammation), all of which have been implicated as independent predictors of CVD risk.Following adjustment (for use of medication, demographic characteristics, fasting TG, insulin and glucose levels), all six postprandial TG measures (4 and 6 h TG iAUC, 4 and 6 h TG concentration, 4 and 6 h TG increase from fasting) were strongly correlated with markers of atherogenic lipoprotein remodelling and the marker of cardiovascular inflammation (GlycA). The strongest correlation (interim analysis) was observed for the 6 h TG increase from fasting (all P < 0.001, Pearson's coefficient r = 0.94 [95%CI's; 0.93, 0.95] for XXL-VLDL-P; r = 0.95 [95%CI's; 0.95, 0.96] for XL-VLDL-P; r = 0.89 [95%CI's; 0.88, 0.91] for GlycA ; r = -0.61 [95%CI's; -0.66, -0.55] for HDL-C). Inter-individual variability in postprandial lipemic responses was high in the tightly controlled clinic setting (interim analysis, n = 656); IQR (median) was; iAUC (0–6h) 2.39 (2.31) mmol/L.h; Cmax 1.32 (2.06) mmol/L; Tmax 30.0 (300) min; and increase above fasting at 6 h 0.78 (0.62) mmol/L.This is the most detailed postprandial study performed to date and suggests that identifying predictors of the postprandial 6 h TG rise will have the highest CVD relevance. Ongoing exploration in PREDICT I of the determinants of postprandial lipemic responses considering environmental, genetic and microbiome variables will significantly advance our ability to predict an individual's postprandial response and its links to cardiovascular risk.

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Factor analysis for the clustering of cardiometabolic risk factors and sedentary behavior, a cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0242365 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242365

Author(s):

Tsung-Ying Tsai ◽

Pai-Feng Hsu ◽

Chung-Chi Lin ◽

Yuan-Jen Wang ◽

Yaw-Zon Ding ◽

...

Keyword(s):

Risk Factors ◽

Factor Analysis ◽

General Population ◽

Sedentary Behavior ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Validation Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Clustering Pattern

Background Few studies have reported on the clustering pattern of CVD risk factors, including sedentary behavior, systemic inflammation, and cadiometabolic components in the general population. Objective We aimed to explore the clustering pattern of CVD risk factors using exploratory factor analysis to investigate the underlying relationships between various CVD risk factors. Methods A total of 5606 subjects (3157 male, 51.5±11.7 y/o) were enrolled, and 14 cardiovascular risk factors were analyzed in an exploratory group (n = 3926) and a validation group (n = 1676), including sedentary behaviors. Results Five factor clusters were identified to explain 69.4% of the total variance, including adiposity (BMI, TG, HDL, UA, and HsCRP; 21.3%), lipids (total cholesterol and LDL-cholesterol; 14.0%), blood pressure (SBP and DBP; 13.3%), glucose (HbA1C, fasting glucose; 12.9%), and sedentary behavior (MET and sitting time; 8.0%). The inflammation biomarker HsCRP was clustered with only adiposity factors and not with other cardiometabolic risk factors, and the clustering pattern was verified in the validation group. Conclusion This study confirmed the clustering structure of cardiometabolic risk factors in the general population, including sedentary behavior. HsCRP was clustered with adiposity factors, while physical inactivity and sedentary behavior were clustered with each other.

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ApoB48-Lipoproteins Are Associated with Cardiometabolic Risk in Adolescents with and without Polycystic Ovary Syndrome

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa061 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Donna F Vine ◽

Lawrence J Beilin ◽

Sally Burrows ◽

Rae-Chi Huang ◽

Martha Hickey ◽

...

Keyword(s):

Risk Factors ◽

Polycystic Ovary Syndrome ◽

Adolescent Girls ◽

Cardiometabolic Risk ◽

Polycystic Ovary ◽

Cardiometabolic Risk Factors ◽

Cvd Risk ◽

Ovary Syndrome ◽

Apo B ◽

Fasting Plasma

Abstract Context Adolescents with polycystic ovary syndrome (PCOS) have increased incidence of cardiometabolic risk factors including dyslipidemia. Atherogenic apolipoprotein (apo) B-lipoprotein remnants are associated with increased cardiovascular disease (CVD) risk. Objective The aim of this study was to determine the concentrations of fasting plasma apoB-lipoprotein remnants, apoB48 and apoB100, and their association with cardiometabolic risk factors and androgen indices in adolescent girls with and without PCOS. Design, setting and participants Participants (n = 184) aged 17 years were recruited in the Menstruation in Teenagers Study from the Western Australian Pregnancy Cohort (Raine) Study. The main outcome measures Fasting plasma apo-B48 and -B100 lipoprotein remnant concentrations in adolescent girls with and without PCOS. Results Fasting plasma apoB48-lipoprotein remnants but not apoB100-lipoprotein remnants were elevated in adolescent girls with increased cardiometabolic risk compared with those with lower cardiometabolic risk (13.91 ± 5.06 vs 12.09 ± 4.47 µg/mL, P < .01). ApoB48-lipoprotein remnants were positively correlated with fasting plasma triglycerides (b = .43, P < .0001). The prevalence of increased cardiometabolic risk factors was 2-fold higher in those diagnosed with PCOS (35.3%) than in those without PCOS (16.3%).Conclusion: Adolescents with PCOS have a 2-fold higher incidence of cardiometabolic risk factors than those without PCOS. Fasting apoB48-lipoprotein remnants are elevated in adolescent girls with a high prevalence of cardiometabolic risk factors.

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Abstract 012: Psoriasis is Associated With Atherogenic Lipoprotein Particle Concentration and Size Independent of Cardiometabolic Risk Factors

Circulation ◽

10.1161/circ.125.suppl_10.a012 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Ron C Li ◽

Parasuram Krishnamoorthy ◽

YiDing Yu ◽

Jules Antigua ◽

Anna Raper ◽

...

Keyword(s):

Risk Factors ◽

Particle Concentration ◽

Cardiometabolic Risk ◽

Traditional Risk Factor ◽

Cardiometabolic Risk Factors ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Atherogenic Lipoprotein ◽

Lipoprotein Particle ◽

Increased Risk

Introduction: Psoriasis is a chronic inflammatory skin disease associated with increased risk of cardiovascular disease (CVD). We have previously shown that psoriasis is associated with atherogenic lipoprotein particle concentration and size. However, it is unknown whether this association is independent of traditional CVD risk factors or insulin resistance (IR). Methods: We prospectively enrolled a consecutive sample of patients with psoriasis (n=122) and compared cardiometabolic risk factors with an asymptomatic sample without psoriasis from our practice (n=129). Fasting lipids, insulin, glucose were measured by standard assays, and lipoprotein concentration and size were measured by nuclear magnetic resonance (NMR) (LipoScience, North Carolina). HOMA-IR, an estimation of IR, was calculated by standard methods. Multivariable linear regression for adjusted models was performed using STATA12 software. Results: LDL-C and HDL-C were lower in psoriasis compared to controls [106.9 mg/dL (90-132.5) vs 128 (110.2-145.6), p<0.01 and 43 mg/dL (36-58) vs 50 (42-62), p<0.01] with no difference in triglycerides. However, NMR showed an atherogenic profile in psoriasis similar to that observed in diabetes, with significant increase in LDL [1210.5 (1002-1498) vs 1115 (935-1291), p=0.03] particle concentration with a concomitant decrease in LDL size [20.6 (20.3-21.1) vs 21.3 (20.6-21.1), p<0.001] even after adjusting for obesity, tobacco use, hypertension, lipids, and HOMA-IR (p=0.001). An increase in VLDL particle concentration was also seen before [61.9 (38.3-95.3) vs 53.4 (30.4-84.5), p=0.05] and after adjusting for cardiometabolic risk factors (p=0.018). Conclusions: Despite normal lipids, we demonstrate a more atherogenic lipoprotein profile by NMR in psoriasis compared to healthy controls after adjustment for CVD risk factors and IR. These findings suggest that traditional risk factor analysis and lipid testing may not ideally capture the increased CVD risk observed in psoriasis.

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Factor analysis for the clustering of cardiometabolic risk factors and sedentary behavior: a VGH-HEALTHCARE substudy

European Heart Journal ◽

10.1093/ehjci/ehaa946.2869 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T.Y Tsai ◽

S.S Lim ◽

S.C Chan ◽

Y.L Yang ◽

P.F Hsu ◽

...

Keyword(s):

Risk Factors ◽

Factor Analysis ◽

Sedentary Behavior ◽

Physical Inactivity ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Validation Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Clustering Pattern

Abstract Background Few studies have reported the clustering pattern of new CVD risk factors including sedentary behavior, systemic inflammation and cadiometabolic components in the general population. Purpose We aimed to explore the clustering pattern of CVD risk factors using exploratory factor analysis to investigate the underlying relationships between various CVD risk factors Methods A total of 5606 subjects (3157 male, 51.5±11.7y/o) were enrolled and 14 cardiovascular risk factors including sedentary behaviors and physical inactivity were analyzed in exploratory group (n=3926). The established model was validated with the validation group (n=1676). Results Five factor clusters had been identified to explained 69.4% of total variance, including adiposity (BMI, TG, HDL, UA, and HsCRP 21.3%), lipid, (Total cholesterol, and LDL-cholesterol 14.0%), blood pressure (SBP & DBP 13.3%), glucose (HbA1C, fasting glucose 12.9%) and sedentary behavior (MET per week and sitting time per day 8.0%), respectively. HsCRP was clustered with adiposity factors, not other cardiometabolic risk factors. This clustering pattern was verified in the validation group. Conclusion Our current study confirmed the clustering structure of cardiometabolic risk factors including sedentary behavior in general population. hsCRP was clustered with adiposity factors while physical inactivity and sedentary behavior were clustered with each other. Funding Acknowledgement Type of funding source: None

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Increased monocyte to HDL cholesterol ratio in vitamin B12 deficiency: is it related to cardiometabolic risk?

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000668 ◽

2020 ◽

pp. 1-8

Author(s):

Sanem Kayhan ◽

Nazli Gulsoy Kirnap ◽

Mercan Tastemur

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Uric Acid ◽

Vitamin B12 ◽

Cardiometabolic Risk ◽

Vitamin B12 Deficiency ◽

Left Ventricular ◽

Cardiometabolic Risk Factors ◽

B12 Deficiency ◽

Deficiency Group

Abstract. Vitamin B12 deficiency may have indirect cardiovascular effects in addition to hematological and neuropsychiatric symptoms. It was shown that the monocyte count-to-high density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel cardiovascular marker. In this study, the aim was to evaluate whether MHR was high in patients with vitamin B12 deficiency and its relationship with cardiometabolic risk factors. The study included 128 patients diagnosed with vitamin B12 deficiency and 93 healthy controls. Patients with vitamin B12 deficiency had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), MHR, C-reactive protein (CRP) and uric acid levels compared with the controls (median 139 vs 115 mmHg, p < 0.001; 80 vs 70 mmHg, p < 0.001; 14.2 vs 9.5, p < 0.001; 10.2 vs 4 mg/dl p < 0.001; 6.68 vs 4.8 mg/dl, p < 0.001 respectively). The prevalence of left ventricular hypertrophy was higher in vitamin B12 deficiency group (43.8%) than the control group (8.6%) (p < 0.001). In vitamin B12 deficiency group, a positive correlation was detected between MHR and SBP, CRP and uric acid (p < 0.001 r:0.34, p < 0.001 r:0.30, p < 0.001 r:0.5, respectively) and a significant negative correlation was detected between MHR and T-CHOL, LDL, HDL and B12 (p < 0.001 r: −0.39, p < 0.001 r: −0.34, p < 0.001 r: −0.57, p < 0.04 r: −0.17, respectively). MHR was high in vitamin B12 deficiency group, and correlated with the cardiometabolic risk factors in this group, which were SBP, CRP, uric acid and HDL. In conclusion, MRH, which can be easily calculated in clinical practice, can be a useful marker to assess cardiovascular risk in patients with vitamin B12 deficiency.

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