Incidence and risk factors for gangrene in patients with systemic sclerosis from the EUSTAR cohort

Abstract Objective In patients with SSc, peripheral vasculopathy can promote critical ischaemia and gangrene. The aim of this study was to investigate the prevalence, incidence and risk factors for gangrene in the EUSTAR cohort. Methods We included patients from the EUSTAR database fulfilling the ACR 1980 or the ACR/EULAR 2013 classification criteria for SSc, with at least one visit recording data on gangrene. Centres were asked for supplementary data on traditional cardiovascular risk factors. We analysed the cross-sectional relationship between gangrene and its potential risk factors by univariable and multivariable logistic regression. Longitudinal data were analysed by Cox proportional hazards regression. Results 1757 patients were analysed (age 55.9 [14.5] years, disease duration 7.9 [10.3] years, male sex 16.7%, 24.6% diffuse cutaneous subset [dcSSc]). At inclusion, 8.9% of patients had current or previous digital gangrene, 16.1% had current digital ulcers (DUs) and 42.7% had ever had DUs (current or previous). Older age, DUs ever and dcSSc were statistically significant risk factors for gangrene in the cross-sectional multivariable model. During a median follow-up of 13.1 months, 16/771 (0.9%) patients developed gangrene. All 16 patients who developed gangrene had previously had DUs and gangrene. Further risk factors for incident gangrene were the dcSSc subset and longer disease duration. Conclusion In unselected SSc patients, gangrene occurs in about 9% of SSc patients. DUs ever and, to a lesser extent, the dcSSc subset are strongly and independently associated with gangrene, while traditional cardiovascular risk factors could not be identified as risk factors.

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Butyrylcholinesterase Activity, Cardiovascular Risk Factors, and Mortality in Middle-Aged and Elderly Men and Women in Jerusalem

Clinical Chemistry ◽

10.1373/clinchem.2005.059857 ◽

2006 ◽

Vol 52 (5) ◽

pp. 845-852 ◽

Cited By ~ 59

Author(s):

Ronit Calderon-Margalit ◽

Bella Adler ◽

Joseph H Abramson ◽

Jaime Gofin ◽

Jeremy D Kark

Keyword(s):

Risk Factors ◽

Enzyme Activity ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Proportional Hazards ◽

Strong Association ◽

Fat Distribution ◽

The Elderly ◽

Cox Proportional Hazards ◽

Cross Sectional

Abstract Background: The association of butyrylcholinesterase (BuChE) with Alzheimer disease and the association of this disease with cardiovascular risk factors raise interest in the association of BuChE activity with cardiovascular risk factors and mortality. Methods: A baseline cross-sectional study was conducted between 1985 and 1987, encompassing residents ≥50 years of age living in a Jewish neighborhood in western Jerusalem. Interviews were followed by examinations and nonfasting blood sampling (available for 1807 participants). Follow-up data to April 1996 on mortality and causes of death were obtained through record linkage with the Israeli Population Registry. Results: BuChE activity was inversely related to age and was positively associated with serum concentrations of albumin (r = 0.35; P <0.001), cholesterol (r = 0.31; P <0.001), and triglycerides (r = 0.30; P <0.001). Enzyme activity was associated with measures of overweight, obesity, and body fat distribution (e.g., body mass index, r = 0.20; P <0.001). In multivariate analysis, the associations of enzyme activity with serum cholesterol, triglycerides, and albumin persisted strongly. After adjustment by Cox proportional hazards regression for other predictors of mortality in this population, individuals in the lowest quintile of BuChE activity had significantly higher mortality than those in the highest quintile [hazard ratios (95% confidence intervals): all-cause mortality, 1.62 (1.15–2.30); cardiovascular deaths, 1.79 (1.05–3.05)]. The association was attenuated by introduction of serum albumin into the models. Conclusions: This is the first study to report on the association between BuChE and mortality. The relatively strong association of BuChE with serum lipid and albumin concentrations requires elucidation. Our results suggest that low BuChE activity may be a nonspecific risk factor for mortality in the elderly.

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Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank

BMC Medicine ◽

10.1186/s12916-021-01980-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jessica Gong ◽

Katie Harris ◽

Sanne A. E. Peters ◽

Mark Woodward

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Sex Difference ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Uk Biobank ◽

The Uk

Abstract Background Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). Methods Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. Results 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62–6.16] for women and 8.42 [8.07–8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77–0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02–1.13] in women and 0.98 [0.93–1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer’s disease). Conclusions Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.

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Plasma adiponectin is related to other cardiovascular risk factors in nondiabetic Korean men with CAD, independent of adiposity and cigarette smoking: Cross-sectional analysis

Clinica Chimica Acta ◽

10.1016/j.cca.2006.01.021 ◽

2006 ◽

Vol 370 (1-2) ◽

pp. 63-71 ◽

Cited By ~ 16

Author(s):

Oh Yoen Kim ◽

Soo Jeong Koh ◽

Yangsoo Jang ◽

Jey Sook Chae ◽

Ji Young Kim ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cigarette Smoking ◽

Cardiovascular Risk Factors ◽

Cross Sectional ◽

Plasma Adiponectin ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Work economic sectors and cardiovascular risk factors: cross-sectional analysis based on the RECORD Study

BMC Public Health ◽

10.1186/1471-2458-14-750 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Antoine Lewin ◽

Frédérique Thomas ◽

Bruno Pannier ◽

Basile Chaix

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Economic Sectors ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Urban index and lifestyle risk factors for cardiovascular diseases in China: A cross-sectional study

Science Progress ◽

10.1177/00368504211003762 ◽

2021 ◽

Vol 104 (1) ◽

pp. 003685042110037

Author(s):

Zhichong Chen ◽

Menghui Liu ◽

Shaozhao Zhang ◽

Zhenyu Xiong ◽

Xiangbin Zhong ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Fruits And Vegetables ◽

Cross Sectional Study ◽

Nutrition Survey ◽

Cross Sectional ◽

Rapid Urbanization ◽

Lifestyle Risk Factors

China is at a stage of rapid urbanization over the past decades, and the association of urbanization with cardiovascular disease has been confirmed by previous studies. However, few studies assessed the association of urbanization with cardiovascular risk factors, especially in Chinese population. We conducted a cross-sectional, populational-based study, using data from China Health and Nutrition Survey (CHNS) in 2009. The logistic regression was used to assess the association of urbanization measured by urban index with cardiovascular risk factors (diabetes mellitus, hypertension, dyslipidemia, obesity, smoking, physical activity and fruits and vegetables consumption), varied with sex. The current study included 18,887 participants enrolled (mean age 39.8 ± 19.8 years; 52.2% female) who live in China. In regression model, the urban index was significantly associated with the variations of cardiovascular risk factors for male, including diabetes (OR 1.34, 95% CI: 1.22–1.48), hypercholesterolemia (OR 1.15, 95% CI: 1.09–1.22), never smoking (OR 0.92, 95% CI: 0.89–0.96), higher fruits and vegetables consumptions (OR 0.93, 95% CI: 0.87–0.99), higher body mass index (BMI) (OR 1.16, 95% CI: 1.10–1.22), and higher physical activity (OR 0.69, 95% CI: 0.66–0.73). Compared with the male, the associations of urban index with cardiovascular risk factors for female were similar, but not for BMI (OR 1.00, 95% CI: 0.96–1.05). The present finding emphasizes the changes of cardiovascular risk factors associated with urbanization in China, and indicated that close attention should be paid to the risk of hypercholesterolemia, diabetes and men’s obesity in the process of urbanization.

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