scholarly journals FOR BETTER AND WORSE? THE IMPORTANCE OF CLOSENESS AND AGE FOR SPOUSES’ CARDIOMETABOLIC SIMILARITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S435-S435
Author(s):  
Stephanie J Wilson ◽  
Juan Peng ◽  
Rebecca Andridge ◽  
Lisa M Jaremka ◽  
Christopher P Fagundes ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Fasting Glucose ◽  
Carbohydrate Oxidation ◽  
Cardiometabolic Health ◽  
Older Couples ◽  
Joint Stress ◽  
Age Related ◽  
Disease Risks ◽  
Health Risks And Benefits

Abstract Spouses share age-related disease risks: a person’s diabetes or hypertension raises the partner’s odds for the same condition. To probe the importance of partners’ closeness, marital satisfaction, and age for spouses’ similarity in cardiometabolic health, 43 disease-free couples ages 24-61 provided fasting glucose, fat and carbohydrate oxidation, and blood pressure at two study visits. Couples who felt closer had more similar rates of carbohydrate oxidation compared to those who felt less close. Likewise, happier couples had more similar carbohydrate and fat oxidation. Fasting glucose and blood pressure were more similar within middle-aged couples compared to younger pairs. In follow-up analyses, partners’ health behavior concordance did not explain these effects. In sum, closer, happier, and older couples shared more similar cardiometabolic profiles, perhaps driven by joint stress and emotional spillover. Findings suggest that closer, happier relationships may confer both larger health risks and benefits, and increasing age may raise the stakes.

scholarly journals Carbohydrate Restriction with or without Exercise Training Improves Blood Pressure and Insulin Sensitivity in Overweight Women

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 637
Author(s):  
Shengyan Sun ◽  
Zhaowei Kong ◽  
Qingde Shi ◽  
Haifeng Zhang ◽  
On-Kei Lei ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Insulin Sensitivity ◽  
Exercise Training ◽  
Fasting Glucose ◽  
Training Group ◽  
Moderate Intensity ◽  
Cardiometabolic Health ◽  
Carbohydrate Restriction ◽  
Obese Women ◽  
Low Carbohydrate Diet

Objective: The purpose of this study was to evaluate the effects of a 4-week low-carbohydrate diet (LC) with or without exercise training on cardiometabolic health-related profiles in overweight/obese women. Methods: Fifty overweight/obese Chinese women (age: 22.2 ± 3.3 years, body mass index (BMI): 25.1 ± 3.1 kg·m−2) were randomized to either a LC control group (LC-CON, n = 16), a LC and high-intensity interval training group (LC-HIIT, n = 17), or a LC and moderate-intensity continuous training group (LC-MICT, n = 17). All groups consumed LC for 4 weeks, while the LC-HIIT and LC-MICT groups followed an additional five sessions of HIIT (10 × 6 s cycling sprints and 9 s rest intervals, 2.5 min in total) or MICT (cycling continuously at 50–60% of peak oxygen uptake (VO2peak) for 30 min) weekly. Blood pressure, fasting glucose, insulin sensitivity, and several metabolic or appetite regulating hormones were measured before and after intervention. Results: Significant reductions in body weight (− ~2.5 kg, p < 0.001, η2 = 0.772) and BMI (− ~1 unit, p < 0.001, η2 = 0.782) were found in all groups. Systolic blood pressure was reduced by 5–6 mmHg (p < 0.001, η2 = 0.370); fasting insulin, leptin, and ghrelin levels were also significantly decreased (p < 0.05), while insulin sensitivity was improved. However, there were no significant changes in fasting glucose, glucagon, and gastric inhibitory peptide levels. Furthermore, no group differences were found among the three groups, suggesting that extra training (i.e., LC-HIIT and LC-MICT) failed to trigger additional effects on these cardiometabolic profiles. Conclusions: The short-term carbohydrate restriction diet caused significant weight loss and improved blood pressure and insulin sensitivity in the overweight/obese women, although the combination with exercise training had no additional benefits on the examined cardiometabolic profiles. Moreover, the long-term safety and effectiveness of LC needs further study.

scholarly journals The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health—Follow-Up of a Randomized Controlled Trial

Cells ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Stijn Mintjens ◽  
Mireille N. M. van Poppel ◽  
Henk Groen ◽  
Annemieke Hoek ◽  
Ben Willem Mol ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Maternal Obesity ◽  
Controlled Trial ◽  
Cardiometabolic Health ◽  
Control Group ◽  
Z Score ◽  
Infertile Women ◽  
Z Scores

Maternal obesity is associated with adverse metabolic outcomes in her offspring, from the earliest stages of development leading to obesity and poorer cardiometabolic health in her offspring. We investigated whether an effective preconception lifestyle intervention in obese women affected cardiometabolic health of their offspring. We randomly allocated 577 infertile women with obesity to a 6-month lifestyle intervention, or to prompt infertility management. Of the 305 eligible children, despite intensive efforts, 17 in the intervention and 29 in the control group were available for follow-up at age 3–6 years. We compared the child’s Body Mass Index (BMI) Z score, waist and hip circumference, body-fat percentage, blood pressure Z scores, pulse wave velocity and serum lipids, glucose and insulin concentrations. Between the intervention and control groups, the mean (±SD) offspring BMI Z score (0.69 (±1.17) vs. 0.62 (±1.04)) and systolic and diastolic blood pressure Z scores (0.45 (±0.65) vs. 0.54 (±0.57); 0.91 (±0.66) vs. 0.96 (±0.57)) were similar, although elevated compared to the norm population. We also did not detect any differences between the groups in the other outcomes. In this study, we could not detect effects of a preconception lifestyle intervention in obese infertile women on the cardiometabolic health of their offspring. Low follow-up rates, perhaps due to the children’s age or the subject matter, combined with selection bias abating contrast in periconceptional weight between participating mothers, hampered the detection of potential effects. Future studies that account for these factors are needed to confirm whether a preconception lifestyle intervention may improve the cardiometabolic health of children of obese mothers.

Abstract P221: Metabolic Syndrome And Its Factors Associate With Non-calcified Coronary Plaque Burden In Chronic Inflammation: Results From A Prospective Observational Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Meron Teklu ◽  
Wunan Zhou ◽  
Nidhi Patel ◽  
Grigory Manyak ◽  
Amit K Dey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Fasting Glucose ◽  
Coronary Plaque ◽  
Lipid Lowering ◽  
Plaque Burden ◽  
Cardiometabolic Health ◽  
Lipid Lowering Therapy ◽  
Early Atherosclerosis

Introduction: Psoriasis is a common, inflammatory skin disease associated with systemic inflammation and heightened risk of cardiovascular diseases (CVD). Population studies have shown that psoriasis is associated with metabolic syndrome (MetSyn) and its individual components. However, the impact of MetSyn on early atherosclerosis in chronic inflammatory diseases assessed as non-calcified coronary plaque burden (NCB) by coronary computed CT angiography (CCTA) is not known. Hypothesis: We hypothesized that those with MetSyn in psoriasis would have increased NCB compared to non-MetSyn and that MetSyn and its components would associate with NCB in fully adjusted models. Methods: The cohort consisted of 336 psoriasis patients free of cardiovascular disease, of which 326 had adequate data to classify MetSyn based on the International Diabetes Federation criteria (waist circumference, triglycerides, HDL cholesterol, blood pressure and fasting glucose). Of these, 260 had quantitative CCTA data available for analyses (Stata 16). Results: Of the 260 patients, 80 had MetSyn (31%). The MetSyn group had increased cardiometabolic disease and more adverse coronary characteristics including higher non-calcified ( p <.001) and high-risk plaque ( p =.02) (Table) . In fully adjusted models for Framingham risk score, lipid lowering therapy and biologic use, MetSyn (β=0.31; p< .001) and its individual components of waist circumference (β=0.33; p <.001), triglycerides (β=0.17; p =.005), blood pressure (β=0.18; p =.005) and fasting glucose (β=0.17; p =.009) associated with NCB. Conclusions: MetSyn and its components were associated with NCB in psoriasis suggesting that early atherosclerosis is importantly impacted by poor cardiometabolic health. Components of MetSyn should be assessed in psoriasis patients and patients educated about this heightened risk of CVD associated with MetSyn.

scholarly journals Dietary protein and changes in markers of cardiometabolic health across 20 years of follow-up in middle-aged Americans

2018 ◽  
Vol 21 (16) ◽  
pp. 2998-3010 ◽  
Author(s):  
Adela Hruby ◽  
Paul F Jacques
Keyword(s):  
Dietary Protein ◽  
Repeated Measures ◽  
Protein Intake ◽  
Cardiometabolic Health ◽  
Age Related ◽  
Heart Study ◽  
Blood Pressures ◽  
Cardiometabolic Markers

AbstractObjectiveDietary protein plays a role in counteracting age-related muscle loss. However, limited long-term data exist on protein intake and markers of cardiometabolic health, which tend to deteriorate with age.DesignProspective cohort study. FFQ-derived protein intake (g/d) and cardiometabolic markers were assessed up to five times across 20 years. Markers included systolic (SBP) and diastolic (DBP) blood pressures, circulating lipids (total, HDL and LDL cholesterol; TAG), estimated glomerular filtration rate (eGFR), fasting glucose (FG), weight and waist circumference (WC). Mixed models accounting for repeated measures were used to estimate adjusted mean annualized changes in outcomes per quartile category of protein.SettingFramingham Heart Study Offspring cohort, USA.SubjectsParticipants (n 3066) with 12 333 unique observations, baseline (mean (sd)) age=54·0 (9·7) years, BMI=27·4 (4·9) kg/m2, 53·5 % female.ResultsIn fully adjusted models, there were favourable associations (mean (se)) of total protein with annualized changes in SBP (lowest v. highest intake: 0·34 (0·06) v. 0·04 (0·06) mmHg, P trend=0·001) and eGFR (−1·03 (0·06) v. −0·87 (0·05) ml/min per 1·73 m2, P trend=0·046), unfavourable associations with changes in FG (0·013 (0·004) v. 0·028 (0·004) mmol/l, P trend=0·004) and no associations with weight, WC, DBP or lipids. Animal protein was favourably associated with SBP and unfavourably with FG and WC; plant protein was favourably associated with FG and WC.ConclusionsThe present study provides evidence that protein intake may influence changes in cardiometabolic health independent of change in weight in healthy adults and that protein’s role in cardiometabolic health may depend on the protein source.

scholarly journals The Role of Growth Hormone and IGF-1 in Retinopathy: A Prospective Study of Retinopathy in Patients with Acromegaly and Impaired Fasting Glucose

2021 ◽  
Author(s):  
Tzu-En Wu ◽  
Harn-Shen Chen
Keyword(s):  
Blood Pressure ◽  
Impaired Fasting Glucose ◽  
Odds Ratio ◽  
Diabetes Management ◽  
Fasting Glucose ◽  
Proliferative Retinopathy ◽  
National Guidelines ◽  
A Prospective Study

Abstract We hypothesized that elevated insulin-like growth factor 1 (IGF-1) could accelerate the progress of non-proliferative retinopathy into proliferative retinopathy. We recruited 91 patients with acromegaly and 123 subjects with impaired fasting glucose (IFG) between 2008 and 2016 to examine the incidence and prevalence of retinopathy. Patients attended follow-ups in our clinics and underwent examinations according to the national guidelines for diabetes management. Both cohorts attended follow-ups until June 2019. Both groups had similar HbA1c, cholesterol, and blood pressure levels. However, patients with acromegaly had higher GH (8.05±16.18 vs. 0.78±1.25 ng/mL) and IGF-1 (547.0±342.1 vs. 146.7±51.4 ng/mL) levels than in subjects with IFG. During the follow-up period, eight patients (8.8%) with acromegaly and 12 patients (9.8%) with IFG developed some degree of retinopathy. Three patients with acromegaly and two with IFG progressed to proliferative retinopathy. Patients with acromegaly had the same incidence of non-proliferative retinopathy (odds ratio [OR]: 0.830; 95% CI: 0.318–2.164) and a non-statistically significantly higher incidence of proliferative retinopathy (OR: 2.461; 95% CI: 0.404–14.988). The data reveals that GH and IGF-1 might play a crucial role in the development of proliferative retinopathy and influence its progression. Therefore, we suggest screening patients with acromegaly should be similar to diabetes patients.

scholarly journals Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Yuanyuan Zhang ◽  
Jing Nie ◽  
Yan Zhang ◽  
Jianping Li ◽  
Min Liang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Propensity Scores ◽  
Fasting Glucose ◽  
Pressure Control ◽  
Incident Diabetes ◽  
Chinese Adults ◽  
Normal Fasting Glucose ◽  
Diagnosed Diabetes

Background The association between blood pressure (BP) control and incident diabetes mellitus remains unknown. We aim to investigate the association between degree of time‐averaged on‐treatment systolic blood pressure (SBP) control and incident diabetes mellitus in hypertensive adults. Methods and Results A total of 14 978 adults with hypertension without diabetes mellitus at baseline were included from the CSPPT (China Stroke Primary Prevention Trial). Participants were randomized double‐masked to daily enalapril 10 mg and folic acid 0.8 mg or enalapril 10 mg alone. BP measurements were taken every 3 months after randomization. The primary outcome was incident diabetes mellitus, defined as physician‐diagnosed diabetes mellitus, or use of glucose‐lowering drugs during follow‐up, or fasting glucose ≥126 mg/dL at the exit visit. Over a median of 4.5 years, a significantly higher risk of incident diabetes mellitus was found in participants with time‐averaged on‐treatment SBP 130 to <140 mm Hg (10.3% versus 7.4%; odds ratio [OR], 1.37; 95% CI, 1.15‒1.64), compared with those with SBP 120 to <130 mm Hg. Moreover, the risk of incident diabetes mellitus increased by 24% (OR, 1.24; 95% CI, 1.00‒1.53) and the incidence of regression to normal fasting glucose (<100 mg/dL) decreased by 29% (OR, 0.71; 95% CI, 0.57‒0.89) in participants with intermediate BP control (SBP/diastolic blood pressure, 130 to <140 and/or 80 to <90 mm Hg), compared with those with a tight BP control of <130/<80 mm Hg. Similar results were found when the time‐averaged BP were calculated using the BP measurements during the first 6‐ or 24‐month treatment period, or in the analysis using propensity scores. Conclusions In this non‐diabetic, hypertensive population, SBP control in the range of 120 to <130 mm Hg, compared with the 130 to <140 mm Hg, was associated with a lower risk of incident diabetes mellitus.

scholarly journals The Clustering of Low Diet Quality, Low Physical Fitness, and Unhealthy Sleep Pattern and Its Association with Changes in Cardiometabolic Risk Factors in Children

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 591
Author(s):  
Xianwen Shang ◽  
Yanping Li ◽  
Haiquan Xu ◽  
Qian Zhang ◽  
Ailing Liu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Diet Quality ◽  
Cardiometabolic Risk ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
Sleep Pattern ◽  
Cardiometabolic Health ◽  
Z Scores

The clustering of diet quality, physical activity, and sleep and its association with cardiometabolic risk (CMR) factors remains to be explored. We included 5315 children aged 6–13 years in the analysis. CMR score (CMRS) was computed by summing Z-scores of waist circumference, an average of systolic and diastolic blood pressure, fasting glucose, high-density lipoprotein cholesterol (multiplying by −1), and triglycerides. Low diet quality and low cardiorespiratory fitness (CRF) were more likely to be seen in a pair, but low diet quality was less likely to be clustered with unhealthy sleep patterns. Low diet quality, low CRF, and unhealthy sleep pattern was associated with a 0.63, 0.53, and 0.25 standard deviation (SD) higher increase in CMRS, respectively. Compared to children with no unhealthy factor (−0.79 SD), those with ≥1 unhealthy factor had a higher increase (−0.20 to 0.59 SD) in CMRS. A low diet quality-unhealthy sleep pattern resulted in the highest increase in CMRS, blood pressure, and triglycerides. A low diet quality–low CRF-unhealthy sleep pattern resulted in the highest increase in fatness and fasting glucose. Unhealthy factor cluster patterns are complex; however, their positive associations with changes in CMR factors are consistently significant in children. Some specific patterns are more harmful than others for cardiometabolic health.

Implementation of antipsychotic selection recommendations at a veterans affairs facility

2013 ◽  
Vol 3 (4) ◽  
pp. 188-192 ◽  
Author(s):  
Jeff Clark ◽  
Jeff Gold ◽  
Sherri Hawk
Keyword(s):  
Blood Pressure ◽  
Second Generation ◽  
Fasting Glucose ◽  
Cost Savings ◽  
Veterans Affairs ◽  
Lipid Profiles ◽  
Second Line ◽  
First Line ◽  
Potential Cost

Introduction: In 2012, the Veterans Affairs (VA) Pharmacy Benefits Management Services created recommendations for antipsychotic selection in schizophrenia and schizoaffective disorders. The recommendations stated that patients must fail two first line agents (haloperidol, loxapine, quetiapine, risperidone or perphenazine) and clozapine (if appropriate) before being allowed to trial second line agents olanzapine, ziprasidone or aripiprazole. The aim of this project was to determine the amount of cost savings that could have been provided had the above recommendations been implemented last year. Use of second generation antipsychotics has been associated with weight gain, diabetes, and worsening lipid profiles. The American Diabetes Association (ADA) has created guidelines regarding cardiometabolic monitoring of second generation antipsychotic agents. A secondary aim of this project was to determine the rate of provider adherence to the ADA recommendations. Methods: A retrospective chart review was performed for patients &gt;18 years of age who were initiated on aripiprazole, ziprasidone, or olanzapine for all indications between July 1, 2011 and July 1, 2012. The costs of the mean doses of these agents were compared to an equivalent mean dose of the first line agent risperidone (4mg) using VA drug acquisition costs. Cardiometabolic monitoring data were collected to include weight, blood pressure, fasting glucose and fasting lipid profiles at baseline and at 12 weeks. Results: Of the 542 patients started on second line agents, only 68 met criteria for their use. A potential cost savings of over $850,000 may have been realized had these criteria been enacted within the one year time period studied. None of the 542 patients had both baseline and follow-up values for weight, blood pressure, fasting glucose and fasting lipid profiles. While roughly 60% of patients had blood pressure and weight values at baseline and 27% had glucose and cholesterol values, less than 14% received follow-up testing with approximately 2% receiving neither baseline nor follow-up testing. Discussion: Significant cost savings can be realized via the use of selection criteria without sacrificing efficacy as most studies do not demonstrate the superiority of one agent and the rates of adverse events between first and second generation agents are more similar than previously thought. This study also highlighted the lack of adequate cardiometabolic monitoring which could lead to cardiovascular disease.

scholarly journals The Role of Growth Hormone and IGF-1 in Retinopathy: A Prospective Study of Retinopathy in Patients with Acromegaly and Impaired Fasting Glucose

2021 ◽  
Author(s):  
Tzu-En Wu ◽  
Harn-Shen Chen
Keyword(s):  
Blood Pressure ◽  
Impaired Fasting Glucose ◽  
Odds Ratio ◽  
Diabetes Management ◽  
Fasting Glucose ◽  
Proliferative Retinopathy ◽  
National Guidelines ◽  
A Prospective Study

Abstract Aims To investigate the effects of the GH-IGF-1 axis on the incidence and progression of retinopathy. Methods We enrolled 91 patients with acromegaly and 123 subjects with impaired fasting glucose (IFG) between 2008 and 2016 to examine the incidence and prevalence of retinopathy. Patients attended follow-ups in our clinics and underwent examinations according to the national guidelines for diabetes management. Both cohorts attended follow-ups until June 2019. Results Both groups had similar HbA1c, cholesterol, and blood pressure levels. However, patients with acromegaly had higher GH (8.05±16.18 vs. 0.78±1.25 ng/mL) and IGF-1 (547.0±342.1 vs. 146.7±51.4 ng/mL) levels than in subjects with IFG. During the follow-up period, eight patients (8.8%) with acromegaly and 12 patients (9.8%) with IFG developed some degree of retinopathy. Three patients with acromegaly and two with IFG progressed to proliferative retinopathy. Patients with acromegaly had the same incidence of non-proliferative retinopathy (odds ratio [OR]: 0.830; 95% CI: 0.318–2.164) and a non-statistically significantly higher incidence of proliferative retinopathy (OR: 2.461; 95% CI: 0.404–14.988). Conclusion The data reveals that GH and IGF-1 might play a crucial role in the development of proliferative retinopathy and influence its progression. Therefore, we suggest screening patients with acromegaly should be similar to diabetes patients.

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