scholarly journals Association between access to social service resources and cardiometabolic risk factors: a machine learning and multilevel modeling analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025281 ◽  
Author(s):  
Seth A Berkowitz ◽  
Sanjay Basu ◽  
Atheendar Venkataramani ◽  
Gally Reznor ◽  
Eric W Fleegler ◽  
...  

ObjectivesInterest in linking patients with unmet social needs to area-level resources, such as food pantries and employment centres in one’s ZIP code, is growing. However, whether the presence of these resources is associated with better health outcomes is unclear. We sought to determine if area-level resources, defined as organisations that assist individuals with meeting health-related social needs, are associated with lower levels of cardiometabolic risk factors.DesignCross-sectional.SettingData were collected in a primary care network in eastern Massachusetts in 2015.Participants and primary and secondary outcome measures123 355 participants were included. The primary outcome was body mass index (BMI). The secondary outcomes were systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol and haemoglobin A1c (HbA1c). All participants were included in BMI analyses. Participants with hypertension were included in SBP analyses. Participants with an indication for cholesterol lowering were included in LDL analyses and participants with diabetes mellitus were included in HbA1c analyses. We used a random forest-based machine-learning algorithm to identify types of resources associated with study outcomes. We then tested the association of ZIP-level selected resource types (three for BMI, two each for SBP and HbA1c analyses and one for LDL analyses) with these outcomes, using multilevel models to account for individual-level, clinic-level and other area-level factors.ResultsResources associated with lower BMI included more food resources (−0.08 kg/m2per additional resource, 95% CI −0.13 to −0.03 kg/m2), employment resources (−0.05 kg/m2, 95% CI −0.11 to −0.002 kg/m2) and nutrition resources (−0.07 kg/m2, 95% CI −0.13 to −0.01 kg/m2). No area resources were associated with differences in SBP, LDL or HbA1c.ConclusionsAccess to specific local resources is associated with better BMI. Efforts to link patients to area resources, and to improve the resources landscape within communities, may help reduce BMI and improve population health.

Author(s):  
Qun Wang ◽  
Sek Ying Chair ◽  
Eliza Mi-Ling Wong ◽  
Ruth E. Taylor-Piliae ◽  
Xi Chen Hui Qiu ◽  
...  

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors. Many people may be unaware of their risk for MetS. A cross-sectional, descriptive study was conducted among hospitalized patients with at least one cardiometabolic risk factor in Mainland China. This study assessed the MetS knowledgelevel(through MetS Knowledge Scale, MSKS) and examined the potential predictors by regression analysis. A total of 204 patients aged 58.5 ± 10.1 years (55% males) participated in this study. The majority of participants had no history of hypertension (54%), dyslipidemia (79%), or diabetes (85%). However, 56% of these participants had at least three cardiometabolic risk factors, indicating the presence of MetS. The average MSKS was very low (mean = 36.7±18.8, possible range = 0–100), indicating the urgent needs of MetS education in current practice. Predictors of better MetS knowledge included higher educational level, history of dyslipidemia, and normal high-density lipoprotein cholesterol (F (8, 195) = 9.39, adjusted R2 = 0.192, p< 0.001). In conclusion, adults with cardiometabolic risk factors are at risk of developing MetS, but with a low level of knowledge. Specific health education on MetS should be provided, particularly for those with limited formal education or inadequate lipid management.


2019 ◽  
Vol 66 (4) ◽  
pp. 366-376
Author(s):  
Akinwumi Ayodeji Akinbodewa ◽  
Ademola Oluseyi Adejumo ◽  
Oluwakemi Abiola Lamidi ◽  
Ogunleye Adeyemi

Abstract Background Clustering of cardiometabolic risk factors is rapidly becoming prevalent among children and adolescents with grave implications for their cardiovascular health. We set out to determine prevalence and pattern of clustering of risk factors and, identify factors (if any) that determine their clustering. Methods A cross-sectional study of children (3–9 years) and adolescents (10–17 years) in a rural, agrarian community. Their blood pressure, body mass index and lipids were measured. Data was analyzed with SPSS 20. Results A total of 114 (M : F, 1 : 1.1) subjects were studied. The mean age of children and adolescents were 5.6 ± 2.1 and 12.9 ± 2.2 years respectively. The most prevalent cardiometabolic risk factors were elevated non-high density lipoprotein-cholesterol (HDL-c; 39.5%), low HDL-c (33.3%), prehypertension (12.3%) and overweight (9.6%). The prevalence of hypertension was higher among females (11.9% vs. 1.8%, p = 0.024) and adolescents (13.2% vs. 1.6%, p = 0.037). Serum levels of non-HDL-c was higher among adolescents than children (50.9% vs. 29.5%, p = 0.013). At least one risk factor was present in 68.4% of the subjects. Clustering of two and three risk factors were present in 18.4% and 6.1%. The presence of prehypertension (χ2 23.93, p &lt; .001), hypertension (χ2 12.19, p = 0.002), high serum non-HDL-c (χ2 6.336, p = 0.011) and high serum total cholesterol (TC; χ2 8.810, p &lt; 0.001) were associated with clustering of cardiometabolic risk factors. Conclusion The burden of cardiometabolic risk factors among children and adolescents is high. Identified determinants of risk factor clustering were prehypertension, hypertension, non-HDL-c and TC.


2011 ◽  
Vol 164 (4) ◽  
pp. 553-558 ◽  
Author(s):  
Sonya V Galcheva ◽  
Violeta M Iotova ◽  
Yoto T Yotov ◽  
Sergio Bernasconi ◽  
Maria E Street

ObjectivesTo analyze the circulating levels of proinflammatory peptides in healthy prepubertal children in relation to abdominal obesity, measured by waist circumference (WC), and to investigate their interactions with cardiometabolic risk factors.Design and methodsA cross-sectional study of 137 healthy prepubertal children with a mean age of 8.0±0.1 years divided into three groups according to their WC as a measure of abdominal obesity: ‘normal-WC’ children (25th–75th percentile, n=48), ‘children at risk’ (75th–90th percentile, n=39), and ‘abdominally obese’ (≥90th percentile, n=50) children. Auxological measurements and blood pressure (BP) were taken. Fasting levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL6), tumor necrosis factor-α (TNF-α), glucose, insulin, and lipid profile were measured. Insulin resistance (IR) was assessed by homeostasis model assessment of IR (HOMA-IR).ResultsAbdominally obese children had significantly higher BP, insulin, HOMA-IR, total cholesterol and triglycerides (TG) compared with their normal-WC counterparts (P<0.05). HsCRP concentrations increased proportionally with the degree of abdominal obesity (r=0.443, P<0.0001), whereas IL6 and TNF-α were not significantly associated with any of the adiposity variables. After controlling for adiposity, hsCRP was significantly correlated with systolic BP (r=0.257, P=0.004), TNF-α levels were related to high-density lipoprotein cholesterol (HDL-C; r=−0.216, P=0.016) and TG (r=0.196, P=0.029), whereas the relationship between IL6 and HDL-C reduced its magnitude to an insignificant level (r=−0.173, P=0.055).ConclusionsHealthy prepubertal children with abdominal obesity have associated inflammatory and cardiometabolic alterations, interacting with each other.


2019 ◽  
Vol 24 ◽  
pp. 1-12
Author(s):  
Patricia Ribeiro Paes Corazza ◽  
Maiara Cristina Tadiotto ◽  
Derick Andrade Michel ◽  
Jorge Mota ◽  
Neiva Leite

This systematic review aimed to synthesize evidence of cross-sectional studies on the associations between physical activity, cardiometabolic risk factors and vitamin D concentrations in children and adolescents. The search was performed in PubMed, SciELO, LILACS, Scopus, MEDLINE and SPORTDiscus. Cardiometabolic risk factors included obesity, insulin resistance, systemic arterial hypertension and unfavorable changes in the lipid profile (low levels of high-density lipoprotein, elevated low-density lipoprotein and triglycerides). Cross-sectional design studies published between 2007 and 2019 were included whether they evaluated the relationship between vitamin D and physical activity and/or vitamin D and cardiometabolic risk factors. Fourteen studies were selected, involving 8340 children and adolescents. The main results found were a significant inverse relationship between vitamin D levels and cardiometabolic risk factors. All studies (n = 8) that tested association between physical activity and 25-hydroxyvitamin D (25 (OH) D) concentrations showed a significant and direct relationship between them. In addition, nine out of eleven studies that tested the association between 25 (OH) D and body mass index reported an inverse and significant relationship between 25 (OH) D and obesity. In conclusion, sufficient concentrations of vitamin D are related to a more favorable cardiometabolic profile, and children and adolescents who are obese or insufficiently active have a higher risk of present hypovitaminosis D.


Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 884
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Sania Al-Hamad ◽  
Javed Yasin ◽  
Elhadi H. Aburawi

(1) Background: This study aimed to examine the distribution of cardiometabolic risk factors (CMRF) in school-aged children with excess body weight (overweight and obese) in Al Ain City, United Arab Emirates and identify the factors associated with increased cardiovascular risk factors between boys and girls. (2) Methods: A cross-sectional survey of children aged 6–17 years was conducted in Al Ain from 1 August 2019 to 31 December 2020. Binary logistic regression analysis was performed to investigate the relationship between excess body weight and CMRF between the groups and reported odds ratios (OR) with 95% confidence intervals (CI). (3) Results: A total of 966 school-aged children (490 boys and 476 girls) participated in the study, and the mean age of the children was 11.8 ± 2.9 years. The proportions of overweight and obesity were 13.5% and 10.2% in boys and 11.1% and 10.3% in girls. Higher glucose of ≥100 mg/dL (26.4%), triglycerides of ≥150 mg/dL and low-density lipoprotein cholesterol: ≥130 mg/dL (23.2%) were more prevalent in children with excess body weight. These children were at least two times more likely to have higher triglycerides levels, high total cholesterol (≥200 mg/dL) in girls (OR:2.06, 95% CI: 1.01–4.21) and low high-density lipoprotein (<35 mg/dL) in boys (OR: 2.20; 95% CI: 1.12–4.31). (4) Conclusions: Excess body weight in school-aged children was associated with increased CMRF, particularly triglycerides.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025397 ◽  
Author(s):  
Maria Adam Nyangasa ◽  
Christoph Buck ◽  
Soerge Kelm ◽  
Mohammed Ali Sheikh ◽  
Kim Laura Brackmann ◽  
...  

ObjectivesTo determine the prevalence of obesity indices (body mass index (BMI), waist circumference (WC), body fat per cent (BF%)) and cardiometabolic risk factors. To investigate the association between obesity indices and cardiometabolic risk factors in a Zanzibari population.DesignsCross-sectional study.SettingsParticipants randomly selected from 80 Shehias (wards) in Unguja, Zanzibar in 2013.ParticipantsA total of 470 participants between 5 and 95 years were examined. Data on socioeconomic status, area of residence, anthropometry and venous blood were collected. Associations between obesity indices and cardiometabolic risk factors were investigated using multilevel logistic regression analyses in two steps: first, each obesity indicator was tested independently; second, all indicators combined in one model were tested for their association with cardiometabolic risk factors.ResultsThe proportion of overweight/obese individuals was 26.4%, high WC (24.9%) and high BF% (31.1%). Cardiometabolic risk factors with highest prevalence of abnormal values included hypertension (24.5%), low high-density lipoprotein cholesterol (HDL-C) (29.4%), high low-density lipoprotein cholesterol (LDL-C) (21.3%) and high glycated haemoglobin (HbA1c) (19.1%). Obesity and hypertension increased with age, and were most prevalent in participants aged 45 years and above. Low HDL-C was most prevalent among participants aged ≥18 to <45 years, while high LDL-C was more prevalent in those above 45 years. High WC and high BF% were associated with high levels of LDL-C (OR=2.52 (95% CI 1.24 to 5.13), OR=1.91 (95% CI 1.02 to 3.58), respectively). Additionally, BMI and WC were associated with high levels of HbA1c (OR=2.08 (95% CI 1.15 to 3.79), OR=3.01 (95% CI 1.51 to 6.03), respectively). In the combined regression model, WC was associated with higher chances for hypertension (OR=2.62 (95% CI 1.14 to 6.06)) and for high levels of HbA1c (OR=2.62 (95% CI 1.12 to 6.15)).ConclusionHigh BMI, WC and BF% were strongly associated with hypertension, with individuals with high WC being twice more likely to have hypertension; this calls for early and effective screening strategies for this study population.


2021 ◽  
pp. 1-24
Author(s):  
Pâmela Ferreira Todendi ◽  
Rafaela Salla ◽  
Nitin Shivappa ◽  
James R. Hebert ◽  
Julianna Ritter ◽  
...  

Abstract Dietary factors play a role in modulating chronic inflammation and in the development of cardiovascular disease. We aimed to investigate the association between the dietary inflammatory index (DII) and cardiometabolic risk factors among adolescents.A total of 31,684 Brazilian adolescents (12–17 years), from the Study of Cardiovascular Risks in Adolescents (ERICA) were included. Dietary intake was assessed using a 24-hour dietary recall. The E-DII (energy-adjusted)score was calculated based on data for 25available nutrients. The anthropometric profile, blood pressure, lipid profile, glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and glycated hemoglobin were measured. Poisson regression models were used to examine the associations between sex-specific quartiles of the E-DII and cardiometabolic risk factors. In the energy-adjusted models, when comparing a high pro-inflammatory diet (quartile 4) withananti-inflammatory diet (quartile 1), there was a positive association with high HOMA-IR among boys(prevalence ratios (PR)Q4=1.37, 95%CI: 1.04–1.79); and with high fasting glucose (PRQ4 = 1.96, 95%CI: 1.02–3.78), high triglycerides (PRQ4 = 1.92, 95%CI: 1.06–3.46),low HDL-c (PRQ4 = 1.16, 95%CI: 1.02–1.32) and high LDL-c (PRQ4 = 1.93, 95%CI: 1.12–3.33) among girls. Additionally, a moderately pro-inflammatory diet was positively associated with high HOMA-IR (PRQ2 = 1.14, 95%CI: 1.02–1.29) among girls, and high total cholesterol (PRQ3 = 1.56, 95%CI: 1.20–2.01) among boys.In conclusion, this study provides new evidence on the association between inflammatory diets with cardiometabolic risk factors among adolescents.


2018 ◽  
Vol 24 (2) ◽  
pp. 102-106
Author(s):  
Jaqueline de Oliveira Santana ◽  
Juliana Vaz de Melo Mambrini ◽  
Sérgio Viana Peixoto

ABSTRACT Introduction: Cardiorespiratory fitness (CF) is associated with mortality and the development of cardiovascular disease, in addition to being related to work capacity. Objectives: This study aimed to verify the demographic, cardiometabolic and behavioral factors associated with CF in a representative sample of professors from a public university in Minas Gerais, Brazil. Methods: This is a cross-sectional study which evaluated, in addition to the CF, age, sex, glycemia, triglycerides, LDL and HDL cholesterol, C-reactive protein, body mass index (BMI), waist circumference, and physical activity (PA). The association between CF and cardiometabolic risk factors was estimated by logistic regression to obtain the odds ratios and respective confidence intervals (95%). Results: After adjustment, it was observed that professors with lower levels of CF were older, female, had higher BMI and a greater chance of being physically inactive. Conclusion: In general, the results show that the probability of low CF increases with the increase in BMI, in addition to the strong association with PA practice, which is a major focus of intervention measures aimed at improving workers health and their work capacity. Level of Evidence III; Case control study.


Sign in / Sign up

Export Citation Format

Share Document