scholarly journals The Genetic Architecture of the Clustering of Cardiometabolic Risk Factors: A Study of 8- to 17-Year-Old Chinese Twins

2020 ◽  
Vol 23 (5) ◽  
pp. 283-291
Author(s):  
Fuling Ji ◽  
Feng Ning ◽  
Haiping Duan ◽  
Liyan Dong ◽  
Feng Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Environmental Factors ◽  
Genetic Architecture ◽  
Childhood And Adolescence ◽  
Cvd Risk ◽  
Latent Factor ◽  
Metabolic Traits ◽  
Pathway Models ◽  
Chinese Twins

AbstractWe explored the genetic architecture of metabolic risk factors of cardiovascular diseases (CVDs) and their clustering in Chinese boys and girls. Seven metabolic traits (body mass index [BMI], waist circumference [WC], systolic blood pressure [SBP], diastolic blood pressure [DBP], total cholesterol [TC], triglyceride [TG], and uric acid [UA]) were measured in a sample of 1016 twins between 8 and 17 years of age, recruited from the Qingdao Twin Registry. Cholesky, independent pathway, and common pathway models were used to identify the latent genetic structure behind the clustering of these metabolic traits. Genetic architecture of these metabolic traits was largely similar in boys and girls. The highest heritability was found for BMI (a2 = 0.63) in boys and TC (a2 = .69) in girls. Three heritable factors, adiposity (BMI and WC), blood pressure (SBP and DBP), and metabolite factors (TC, TG, and UA), which formed one higher-order latent phenotype, were identified. Latent genetic, common environmental, and unique environmental factors indirectly impacted the three factors through one single latent factor. Our results suggest that there is one latent factor influencing several metabolic traits, which are known risk factors of CVDs in young Chinese twins. Latent genetic, common environmental, and unique environmental factors indirectly imposed on them. These results inform strategies for gene pleiotropic discovery and intervening of CVD risk factors during childhood and adolescence.

Abstract 046: Excessive Gain in BMI Between Age 7-16 is Related to Cardiovascular Disease Risk in Adulthood: A Longitudinal Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Julia Steinberger ◽  
Alan R Sinaiko ◽  
David R Jacobs ◽  
Donald R Dengel ◽  
Xia Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Childhood And Adolescence ◽  
Cvd Risk ◽  
Adult Individual

Obesity in childhood has been shown to promote adult obesity and the development of cardiovascular disease (CVD) risk. However, little longitudinal information exists on the rate of progression of adiposity during childhood as a predictor of adult insulin resistance and markers of CVD risk. We hypothesize that excessive adiposity in childhood and adolescence predicts adult individual CV risk factors, insulin resistance and vascular changes. Children (n=383 mean age 7 yrs), were measured periodically for height, weight and blood pressure through adolescence. As adults (n=383, mean age 39 y, 50% female), height, weight, lipids, insulin resistance and carotid intima-media thickness (cIMT) were measured. Body mass index (BMI) categories (normal, overweight, and obese) were created by standard criteria. According to the CDC BMI growth charts, the normal mean change in BMI from age 7-16 at the 50th percentile is 5 kg/m 2 . Linear regression evaluated the influence of excessive weight gain in childhood on the development of adverse CVD risk factors in adulthood stratifying by 50 percentile change in BMI (≤5kg/m 2 vs >5kg/m 2 ) between childhood and adolescence, adjusting for confounding factors. Of 313 normal weight children, 32% stayed normal weight, 68% became overweight and obese in adulthood. Of 45 overweight children 90% stayed overweight or became obese in adulthood. Of 25 obese children 100% became overweight and stayed obese in adulthood. Compared to ≤5kg/m 2 , a BMI gain of >5 kg/m 2 between childhood and adolescence was more common in blacks than in whites and was associated with greater CV risk in adulthood: greater % obesity; higher blood pressure, lipids, insulin resistance (M/lbm=insulin sensitivity) and cIMT (Table). These findings show that: 1) childhood adiposity is a strong predictor of adult overweight and obesity, and 2) excessive BMI gain between childhood and adolescence is a major determinant of obesity and CVD risk in adulthood.

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

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

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

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.

scholarly journals Early vascular aging risk assessment in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salasyuk ◽  
S Nedogoda ◽  
I Barykina ◽  
V Lutova ◽  
E Popova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Cvd Risk ◽  
Vascular Age

Abstract Background Metabolic syndrome (MetS) and abdominal obesity are one of the most common CVD risk factors among young and mature patients. However, the currently used CVD risk assessment scales may underestimate the CV risk in people with obesity and MS. Early vascular aging rather than chronological aging can conceptually offer better risk prediction. MetS, as accumulation of classical risk factors, leads to acceleration of early vascular aging. Since an important feature of MetS is its reversibility, an adequate risk assessment and early start of therapy is important in relation to the possibilities of preventing related complications. Purpose To derive a new score for calculation vascular age and predicting EVA in patients with MetS. Methods Prospective open cohort study using routinely collected data from general practice. The derivation cohort consisted of 1000 patients, aged 35–80 years with MetS (IDF,2005 criteria). The validation cohort consisted of 484 patients with MetS and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD (EVA syndrome). Results In univariate analysis, EVA was significantly correlated with the presence of type 2 diabetes and clinical markers of insulin resistance (IR), body mass index (BMI), metabolic syndrome severity score (MetS z-score), uric acid (UA) level, hsCRP, HOMA-IR, total cholesterol (TC), triglycerides (TG), heart rate (HR), central aortic blood pressure (CBP), diastolic blood pressure (DBP). Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of EVA; the odds ratios were 2.75 (95% CI: 2.34, 3.35) and 1.57 (95% CI: 1.16, 2.00), respectively. In addition, the risk of having EVA increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in hsCRP by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 μmol / L increase in the level of UA. The area under the curve for predicting EVA in patients with MetS was 0,949 (95% CI 0,936 to 0,963), 0,630 (95% CI 0,589 to 0,671), 0,697 (95% CI 0,659 to 0,736) and 0,686 (95% CI 0,647 to 0,726), for vascular age, calculated from cfPWV, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860). Conclusion cfPWV at present the most widely studied index of arterial stiffness, fulfills most of the stringent criteria for a clinically useful biomarker of EVA in patients with MetS. Although, parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with MetS and EVA on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care. ROC-curves for predicting EVA in MetS Funding Acknowledgement Type of funding source: None

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

Abstract P199: Higher Circulating Triglycerides are Independently Associated With Greater Short-term Blood Pressure Variability in Middle-aged/older Adults With Obesity

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Rachel E Luehrs ◽  
Graziela Z Kalil ◽  
Seth W Holwerda ◽  
Nealy A Wooldridge ◽  
Jess G Fiedorowicz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Blood Pressure Variability ◽  
Plasma Lipids ◽  
Target Organ Damage ◽  
Density Lipoprotein ◽  
Multiple Linear Regression Model ◽  
Middle Aged ◽  
Short Term ◽  
Cvd Risk

Elevated short-term (24 hour) blood pressure variability (BPV) is associated with subclinical target organ damage and cardiovascular disease (CVD) among middle-aged/older (MA/O) adults with hypertension and obesity. Circulating total cholesterol (TC), low-density cholesterol (LDL-C) and triglycerides (TGs) increase with human obesity and are independent risk factors for CVD. In addition, BPV is increased in mouse models of hyperlipidemia and is normalized with statins. However, whether higher circulating lipoproteins independently contribute to greater short-term BPV among adults with obesity remains unclear. We hypothesized that higher LDL-C, TGs and lower high-density lipoprotein (HDL-C) would be associated with greater short-term BPV among individuals with obesity. Fasting plasma lipids and 24 hour ambulatory BP monitoring were assessed in fifty-six MA/O adults with obesity defined as body mass index (BMI) ≥ 30 kg/m 2 (56% F; age 54±7 yrs; BMI, 38.2±5.6 kg/m 2 ) and at least one other CVD risk factor. There was a significant relation between 24 hour systolic BPV and TC (r=0.30, P=0.03), TGs (r=0.34, P=0.01) and LDL-C (r=0.25, P=0.059), but not HDL-C (r=-0.07, P=0.61). Interestingly, these findings remained significant after adjusting for age, sex, BMI and 24 hour systolic BP (TC: r=0.34, P=0.01; TGs: r=0.39, P<0.01; LDL-C: r=0.31, P=0.03) but HDL-C remained non-significant (r=-0.16, P=0.27). In contrast, other cardiometabolic risk factors such as fasting glucose, insulin, c-reactive protein concentrations, carotid-femoral pulse wave velocity and HOMA-IR were not associated with 24 hour systolic BPV. In a multiple linear regression model that included age, sex, BMI, 24 hour systolic BP, TGs and LDL-C, only fasting TGs (β=0.02 ± 0.01, P=0.02) were a significant correlate of 24 hour systolic BPV (Model R 2 =0.24, P=0.03). Results were the same if TC was substituted for LDL-C in the model. In conclusion, higher plasma TC, LDL-C and TGs are associated with greater 24 hour BPV among MA/O adults with obesity with only TGs being independently associated with BPV. These data suggest that greater variability in BP among MA/O adults with obesity is mediated in part through circulating TGs suggesting that TGs may be a therapeutic target to modify short-term BPV.

Abstract P052: Circulating Natural Killer Cells and Subclinical Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Nancy S Jenny ◽  
Nels C Olson ◽  
Alicia M Ellis ◽  
Margaret F Doyle ◽  
Sally A Huber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Nk Cells ◽  
Nk Cell ◽  
Agatston Score ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Race Ethnicity

Introduction: Clinically, natural killer (NK) cells are important in inflammatory and autoimmune diseases. As part of innate immunity, NK cells produce chemokines and inflammatory cytokines, potentially linking them to cardiovascular disease (CVD) development and progression as well. However, their role in human CVD is not clear. Hypothesis: NK cells are proatherogenic in humans and are associated with CVD risk factors and subclinical CVD measures. Methods: We examined cross-sectional associations of circulating NK cell levels with CVD risk factors, subclinical CVD measures and coronary artery calcium (CAC) in 891 White, Black, Chinese and Hispanic men and women (mean age 66 y) in the Multi-Ethnic Study of Atherosclerosis (MESA) at Exam 4 (2005-07). NK cell percent, percent of circulating lymphocytes that were CD3 - CD56 + CD16 + , was measured in whole blood by flow cytometry. CAC presence was defined as Agatston score > 0. Results: Mean (standard deviation) NK percent differed by race/ethnicity; 8.2% (4.7) in Whites, 11.3% (7.5) in Chinese (p<0.001 compared to Whites), 7.1 (4.2) in Blacks (p=0.007) and 8.4 (5.2) in Hispanics (p=0.6). NK cell percent was positively associated with age (p<0.001) and systolic blood pressure (P=0.003) in the full group. However, NK cell percent was lower in current smokers than in never smokers (p=0.002). Adjusting for age, sex, race/ethnicity, smoking, body mass index, systolic blood pressure, diabetes and dyslipidemia, NK cell percent was negatively associated with common carotid intima media thickness (IMT; β coefficient -0.01; 95% confidence interval -0.03, -0.003) but was not associated with internal carotid IMT (-0.002; -0.037, 0.033). Likewise, NK cell percent was not associated with the presence of CAC (compared those with no detectable CAC; relative risk 1.02; 95% confidence interval 0.96, 1.08) or continuous Agatston score in those with a positive score (β coefficient 0.16, 95% confidence interval -0.003, 0.32) in the full group (models adjusted as above). Results were similar across race/ethnic groups. Conclusions: Of clinical interest, CD3 - CD56 + CD16 + NK cell percent varied significantly by race/ethnicity in these men and women from MESA. However, NK cell percent was inconsistently associated with CVD risk factors; positively with age and systolic blood pressure, and negatively with smoking. NK cell percent was also negatively associated with common carotid IMT. Larger sample sizes and longitudinal analyses will be required to clarify the potential relationship between NK cells and atherosclerosis in humans.

Abstract P156: Assessing the Effect of the Heart of New Ulm Project: a Population-Based Program to Reduce Cardiovascular Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Abbey C Sidebottom ◽  
Arthur Sillah ◽  
David M Vock ◽  
Michael M Miedema ◽  
Raquel Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Health System ◽  
Matched Control ◽  
Population Based ◽  
Control Population ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Matched Control Population

Background: Despite a highly recognized priority for public health and healthcare to implement population-level strategies to reduce the burden of cardiovascular disease (CVD), limited evidence exists on the most effective strategies. Data collection and evaluation of large scale, community based-prevention programs can be challenging and costly to achieve. The Heart of New Ulm (HONU) Project, begun in 2009, is a population-based initiative with healthcare, community, and workplace interventions addressing multiple levels of the social-ecological model designed to reduce modifiable CVD risk factors in rural New Ulm, MN. The community is served by one health system, enabling the use of electronic health record (EHR) data for surveillance. Objective: To assess trends for CVD risk factors, events, and healthcare utilization for New Ulm residents compared to a matched control population. Methods: We matched New Ulm residents (n = 4,077) with controls (n = 4,077) from a regional community served by the same health system using refined covariate balance techniques to match on baseline demographics, CVD risk factors, and health care utilization. Mixed effects longitudinal models with adjustment for age and gender, and an interaction for time by community, were run. Model based estimates were constructed for the entire cohort at each time period. Results: Over the first 6 years of the HONU Project,blood pressure, LDL, total cholesterol, and triglycerides were managed better in New Ulm than the matched comparison community. The proportion of New Ulm residents with controlled blood pressure increased by 6.2 percentage points while the control group increased by 2 points. 10-year ASCVD risk scores showed less decline for New Ulm residents than controls (16 vs. 18.4). The intervention and control groups did not differ with regard to inpatient stays, CVD events, smoking, or glucose. Conclusions: Compared to a matched control population, we found improved control of CVD risk factors in the New Ulm Population exposed to the HONU Project.

Abstract 44: Cardiometabolic Responses to Weight Change are Different between Obese and Normal Weight Adults Who are Metabolically Healthy: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Zhaohui Cui ◽  
Kimberly P Truesdale ◽  
Patrick T Bradshaw ◽  
Jianwen Cai ◽  
June Stevens
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Weight Maintenance ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Obese Adults ◽  
Metabolically Healthy

Introduction: The 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults recommended weight loss for obese adults in order to reduce their cardiovascular disease (CVD) risk. However, not all obese adults develop CVD and approximately 17% of obese Americans in the 1999-2004 NHANES were metabolically healthy. The absence of abnormal CVD risk factors in this subgroup of obese adults indicates that some individuals are resistant to excess adiposity and positive energy balance, and raises the question of whether all obese adults should be recommended for weight loss treatment. We know of no study that has examined whether metabolically healthy obese (MHO) adults respond to weight changes the same way as metabolically healthy normal weight adults (MHNW). Also, no study has compared the effects of weight loss, weight maintenance and weight gain on CVD risk factors in MHO adults. Hypothesis: We hypothesized that the effects of weight change would be different in MHNW and MHO adults, with MHO adults having less stable risk factors, and that weight loss has a protective effect on CVD risk factors in the MHO compared to weight maintenance and weight gain. Methods: Data were from 2,710 MHO and MHNW participants in the Atherosclerosis Risk in Communities (ARIC) study. Four examinations yielded 4,541 observations over sequential 3-year intervals. Metabolically healthy was defined as absence of all components of metabolic syndrome, excluding waist circumference, at the beginning of a 3-year interval. Mixed effect models were applied to individually compare changes in five CVD risk factors (systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and glucose) in MHO and MHNW adults within 3 weight change categories (<3% weight loss, weight maintenance (±3%) and >3% weight gain). Results: Weight loss was associated with small or no changes in the five CVD risk factors in both MHO and MHNW adults. Weight maintenance was associated with larger increases in MHO compared to MHNW adults in triglycerides (mean ± standard error: 10.0±1.7 vs. 6.5±1.0 mg/dL) and glucose (1.7±0.4 vs. 0.9±0.2 mg/dL). Weight gain was associated with larger increases in systolic (8.6±0.6 vs. 6.2±0.4 mmHg) and diastolic (3.9±0.4 vs. 2.5±0.3 mmHg) blood pressure, triglycerides (22.0±1.8 vs. 16.0±1.1 mg/dL) and glucose (4.9±0.4 vs. 1.9±0.3 mg/dL) among the MHO compared to the MHNW. MHO weight losers experienced more favorable changes in the five CVD risk factors compared to MHO weight maintainers (p<0.04) or gainers (p<0.0001). Conclusions: We showed that compared to MHNW, MHO adults experienced similar changes in CVD risk factors with weight loss and larger increases with weight maintenance and gain. Our study supports the 2013 Guideline that primary health care providers should recommend weight loss treatment for MHO patients.

scholarly journals Impact of Low-Fat and Full-Fat Dairy Intake on Cardiovascular Disease Risk Factors: A Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 563-563
Author(s):  
Kelsey Schmidt ◽  
Gail Cromer ◽  
Maggie Burhans ◽  
Jessica Kuzma ◽  
Derek Hagman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Density Lipoprotein ◽  
Cvd Risk Factors ◽  
Low Fat ◽  
Cvd Risk ◽  
Intervention Effect ◽  
Dairy Foods ◽  
Dairy Fat ◽  
The Metabolic Syndrome

Abstract Objectives Dairy fat has been hypothesized to promote cardiovascular disease (CVD) due to its high saturated fat content, contributing to recommendations to consume low-fat dairy foods. However, emerging evidence indicates that dairy fat does not negatively impact CVD risk, particularly when consumed in foods with a complex matrix. Though, few trials have directly compared the effect of low-fat versus full-fat dairy foods. Therefore, we aimed to test the effects of diets rich in low-fat or full-fat dairy on CVD risk factors, compared to a limited dairy diet. We hypothesized that diets rich in dairy would not impact CVD risk factors. Methods Seventy-two participants with the metabolic syndrome completed a 4-week wash-in period; limiting their dairy intake to ≤ 3 servings of skim milk per week. Participants were then randomized to either continue the limited dairy diet or switch to a diet containing 3.3 servings per day of either low-fat or full-fat milk, yogurt, and cheese for 12-weeks. The plasma lipid profile and blood pressure were assessed before and after the intervention period. Results In the per protocol analysis (n = 66), there was no intervention effect on fasting plasma total-, low-density lipoprotein-, and high-density lipoprotein-cholesterol, triglycerides, free fatty acids, or cholesterol content in 38 isolated lipoprotein fractions (p &gt; 0.1 for all variables). There was also no intervention effect on diastolic blood pressure. There was a significant difference among the diet interventions for systolic blood pressure (P = 0.045), with a trend for a decrease in the low-fat dairy diet compared to the limited dairy diet in post hoc testing after adjustment for multiple testing. Conclusions In individuals with the metabolic syndrome, consuming 3.3 servings of dairy per day, regardless of fat content, did not affect blood lipids and modestly improved blood pressure compared to a diet virtually free of dairy. This provides further evidence that dairy fat, when consumed as part of complex whole foods, does not significantly impact CVD risk factors. Funding Sources This work was supported by the National Dairy Council, Dairy Farmers of Canada, the Dutch Dairy Association, Dairy Australia, and the French Dairy Interbranch Organization.

Sign in / Sign up

Export Citation Format

Share Document