Homocysteine, visceral adiposity-related novel cardiometabolic risk factors, and exaggerated blood pressure response to the exercise treadmill test

Association of blood pressure response during exercise of cardiometabolic risk factors (CMRF) is demonstrated in adults. The objective was to determine predictors of raised exercise blood pressure (BP) response during aerobic exercise in obese adolescents.The maximal treadmill test using the Bruce protocol was performed in 82 normotensive obese adolescents (12–17 y.o., 43 boys). Adolescents were divided into 2 groups: group 1 (n = 68) – children with normal BP response to exercise; group 2 (n = 14) – adolescents who had excessive increase in systolic BP (SBP) during exercise. We used logistic regression analysis to examine the associations between cardiometabolic risk factors (CMRF) and SBP response during exercise with adjustment for baseline SBP, sex, age and duration of exercise test period.We have found exaggerated BP response to exercise in 17.1 % of patients. In adolescents of group 2 baseline SBP was higher than in group 1 (p = 0.01). Glucose level and lipid metabolism disturbances, SDS Z-score, baseline SBP levels only by 24.8 % explained the formation of the hyperreactive SBP response to exercise (χ2 = 13.2; р = 0.068). Only baseline SBP was an independent predictor for exaggerated BP response (p = 0.025) and age was a significant trend towards influence (p = 0.054).Exaggerated BP response to exercise in normotensive obese adolescents is more common for older adolescents who have baseline SBP levels in the range of elevated normal values. Knowing CMRF as well as the degree of excess weight has no effect on excessive BP rise during exercise.

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Assessment of cardiometabolic risk factors in various phenotypes of masked hypertension

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2020-2422 ◽

2020 ◽

Vol 19 (4) ◽

pp. 2422

Author(s):

B. I. Geltser ◽

V. V. Orlova-Ilinskaya ◽

O. O. Vetrova ◽

V. N. Kotelnikov ◽

R. S. Karpov

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Odds Ratio ◽

Cardiometabolic Risk ◽

Blood Pressure Monitoring ◽

Density Lipoprotein ◽

Visceral Adiposity ◽

Cardiometabolic Risk Factors ◽

Visceral Adiposity Index ◽

Masked Hypertension

Aim. To assess the relationship of cardiometabolic risk factors in patients with various phenotypes of masked hypertension (MH).Material and methods. The study included 207 men with a median age of 34,6 years [32,3; 36,3] being systematically stressed. All examined patients had normal clinical blood pressure (BP), and there was no history of its increase. We conducted 24-hour ambulatory blood pressure monitoring (ABPM), carotid duplex scan with determination of the intima- media thickness (IMT). The levels of total cholesterol (TC), low (LDLC) and high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) were determined. Body mass index, visceral adiposity index, lipid accumulation product index and waist-to-height ratio were calculated. We performed clustering of ABPM data, calculated the odds ratio of association between cardiometabolic risk factors and certain MH phenotypes.Results. MH was diagnosed in 142 (68,6%) patients examined, divided into 3 clusters: systolic-diastolic — SDMH (50,7%), isolated systolic — ISMH (27,5%) and isolated diastolic — IDMH (21,8%). Impaired lipid metabolism, visceral adiposity, IMT increase and atherosclerotic plaques were more often recorded in patients with SDMH and IDMH. The levels of TC, LDL-C and IMT were highest in individuals with IDMH. Odds ratio analysis indicated significant associations of SDMH and IDMH phenotypes with indicators of visceral adiposity, IMT, TG, TC, LDL-C and TG/HDL-Cl.Conclusion. Clustering of ABPM data in individuals with MH and comparing related phenotypes with cardiometabolic risk factors complements their clinical and functional characteristics and can be a useful tool for improving customized prevention and therapy programs.

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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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Association between maternal prepregnancy body mass index with offspring cardiometabolic risk factors: analysis of three Brazilian birth cohorts

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174421000179 ◽

2021 ◽

pp. 1-7

Author(s):

Mariane da Silva Dias ◽

Alicia Matijasevich ◽

Ana Maria B. Menezes ◽

Fernando C. Barros ◽

Fernando C. Wehrmeister ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Body Mass Index ◽

Diastolic Blood Pressure ◽

Cardiometabolic Risk ◽

Hdl Cholesterol ◽

Cardiometabolic Risk Factors ◽

Birth Cohorts ◽

Prepregnancy Bmi ◽

Prepregnancy Body Mass Index

Abstract Evidence suggests that maternal prepregnancy body mass index (BMI) is associated with offspring cardiometabolic risk factors. This study was aimed at assessing the association of maternal prepregnancy BMI with offspring cardiometabolic risk factors in adolescence and adulthood. We also evaluated whether offspring BMI was a mediator in this association. The study included mother–offspring pairs from three Pelotas birth cohorts. Offspring cardiometabolic risk factors were collected in the last follow-up of each cohort [mean age (in years) 30.2, 22.6, 10.9]. Blood pressure was measured using an automatic device, cholesterol by using an enzymatic colorimetric method, and glucose from fingertip blood, using a portable glucose meter. In a pooled analysis of the cohorts, multiple linear regression was used to control for confounding. Mediation analysis was conducted using G-computation formula. In the adjusted model, mean systolic blood pressure of offspring from overweight and obese mothers was on average 1.25 (95% CI: 0.45; 2.05) and 2.13 (95% CI: 0.66; 3.59) mmHg higher than that of offspring from normal-weight mothers; for diastolic blood pressure, the means were 0.80 (95% CI: 0.26; 1.34) and 2.60 (95% CI: 1.62; 3.59) mmHg higher, respectively. Non-HDL cholesterol was positively associated with maternal BMI, whereas blood glucose was not associated. Mediation analyses showed that offspring BMI explained completely the association of maternal prepregnancy BMI with offspring systolic and diastolic blood pressure, and non-HDL cholesterol. Our findings suggest that maternal prepregnancy BMI is positively associated with offspring blood pressure, and blood lipids, and this association is explained by offspring BMI.

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Abstract P148: Neck Circumference as an Independent Contributor to Cardio Metabolic Risk Factors - ELSA BRASIL

Circulation ◽

10.1161/circ.131.suppl_1.p148 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Cristina P Baena ◽

Paulo A Lotufo ◽

Maria J Fonseca ◽

Isabela J Benseñor

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Blood Pressure ◽

Primary Care ◽

Cardiometabolic Risk ◽

Neck Circumference ◽

Cardiometabolic Risk Factors ◽

Metabolic Risk ◽

Men And Women ◽

Low Hdl

Background: Neck circumference is a proxy for upper body fat and it is a simple anthropometric measure. Therefore it could be a useful tool to identify individuals with cardiometabolic risk factors in the context of primary care. Hypothesis: Neck circumference is independently associated to cardiometabolic risk factors in an apparently healthy population. Methods: This is a cross-sectional analysis of baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of 15105 civil servants aged 35-74 years. We excluded from this analysis those who fulfilled American Diabetes Association criteria for diabetes diagnosis, were taking antihypertensive and/or lipid-lowering drugs. A sex-specific analysis was conducted. Partial correlation (age-adjusted) was used. Risk factors were set as low HDL<50mg/dL for women and <40mg/dL for men, hypertriglyceridemia ≥ 150 mg/dl , hypertension as systolic blood pressure ≥130 mg/dl or diastolic blood pressure ≥85 mm Hg and insulin resistance(HOMA-IR ≥ 75th percentile). Logistic regression models were built to analyze the association between individual and clustered risk factors as dependent variables and 1-SD increase in neck circumference as independent variable. Multiple adjustments were subsequently performed for age, smoking, alcohol, body-mass index, waist and physical activity. Receiver Operating Curves were employed to find the best NC cut-off points for clustered risk factors. Results: We analyzed 3810 men (mean age= 49.0 ±8.3 yrs) and 4916 women (49.2 ±8.0 yrs). Mean NC was 38.9 (±2.6)cm for men and 33.4(±2.6)cm for women. NC positively correlated with systolic and diastolic blood pressure (r=0.21 and r=0.27), HOMA - IR (r=0.44), triglycerides (r=0.31) and negatively correlated with HDL (r= -0.21) in men (p<0.001 for all) with similar results in women. Fully adjusted Odds Ratio (OR) (95% CI) of risk factor per SD increase in neck circumference in men and women were 1.29(1.14;1.46) and 1.42(1.28;1.57) for insulin resistance; 1.24(1.11;1.39) and 1.25(1.11;1.40) for hypertension; 1.33(1.19;1.49) and 1.42(1.29;1.63) for hypertriglyceridemia; 1.07(0.92;1.23) and 1.32 (1.19;1.43) for low HDL. Fully adjusted OR (95% CI) of 2 clustered risk factor per SD increase in neck circumference in men and women were 1.29(1.14;1.48) and 1.37(1.21;1.54 ). Fully adjusted OR (95% CI) of 3 or more clustered risk factors per SD increase in neck circumference in men and women were 1.33 (1.02;1.74) and 1.62 (1.33;1.92). Values of neck circumference of >40 cm for men and >34.1 cm for women were the best cut-off points for 3 or more clustered risk factors. Conclusion: Neck circumference is significantly and independently associated to cardiometabolic risk factors in a well-defined non-treated population. It should be considered as a marker of cardio metabolic risk factors in primary care settings.

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