Abstract 273: HDL Particle Concentration Inversely Associates with Incident Metabolic Syndrome in the Multiethnic Dallas Heart Study

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Preethi Mani ◽  
Ian J Neeland ◽  
Darren K McGuire ◽  
Colby Ayers ◽  
Amit Khera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Visceral Fat ◽  
Particle Concentration ◽  
Atherosclerotic Cardiovascular Disease ◽  
Heart Study ◽  
Increased Risk ◽  
Ascvd Risk ◽  
Dallas Heart Study

Objective: Metabolic syndrome (MetS) increases atherosclerotic cardiovascular disease (ASCVD) risk. Low HDL cholesterol (HDL-C) is a diagnostic criterion of MetS and a major ASCVD risk factor. HDL particle concentration (HDL-P) associates with incident ASCVD independent of HDL-C, but its association with incident MetS has not been studied. We hypothesized that HDL-P would be inversely associated with incident metabolic syndrome independent of HDL-C and other recognized risk factors. Methods: HDL-P was measured by NMR and visceral fat by MRI in participants of the Dallas Heart Study, a probability-based population sample of adults age 30-65. Participants with prevalent MetS, DM, CVD, cirrhosis, cancer, HIV, or renal failure were excluded. Incident MetS as defined by NCEP ATPIII criteria was determined in all participants after median follow-up period of 9.4 years. Results: Among a cohort of 1120 participants without DM or MetS at baseline (57% women, 45% Black, mean age 43), 22.8% had incident MetS at follow-up. HDL-P and HDL-C were modestly correlated (r=0.54, p<0.0001). The lowest quartile of HDL-P was associated with younger age, men, Hispanic ethnicity, lower total, HDL, and LDL cholesterol levels and particle sizes, and less reported alcohol intake. Participants in the lowest sex and race stratified quartile of HDL-P had the highest incidence of MetS (Figure). In models adjusted for traditional risk factors, HDL-C, visceral fat, HOMA-IR, and hs-CRP, the lowest quartile of HDL-P was associated with 65% increased risk of incident MetS (Figure). Conclusion: HDL-P is independently associated with incident MetS after adjustment for HDL-C, adiposity, inflammation, and markers of insulin sensitivity. Further studies are warranted to validate these findings and elucidate the mechanisms underpinning this association.

Abstract P177: Discordantly Normal ApoB Relative To Elevated LDL-C In Persons With Metabolic Disorders: A Marker Of Atherogenic Heterogeneity

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Alexander C Razavi ◽  
Lydia A Bazzano ◽  
Jiang He ◽  
Marie Krousel-Wood ◽  
Kirsten S Dorans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Carotid Plaque ◽  
Metabolic Disorders ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ascvd Risk

Introduction: A significant proportion of persons with metabolic syndrome, prediabetes, or type 2 diabetes do not develop atherosclerotic cardiovascular disease (ASCVD). Discordantly normal apolipoprotein B (ApoB) relative to elevated LDL-cholesterol (LDL-C) may help to explain underlying heterogeneity in ASCVD risk among these individuals. Hypothesis: We hypothesized that discordantly normal ApoB (<90 mg/dL) relative to elevated LDL-C ( > 100 mg/dL) would be associated with a lower atherosclerosis burden among individuals with metabolic disorders. Methods: There were 331 Bogalusa Heart Study participants with metabolic syndrome (n=107), prediabetes (n=291), or type 2 diabetes (n=34) and LDL-C > 100 who were free of carotid plaque at baseline (2001-02) and underwent carotid ultrasound at follow-up (2013-16). Carotid plaque was defined as a focal wall thickening >1.5 mm. Modified Poisson regression with robust error variance estimated the long-term absence of plaque for normal ApoB after adjusting for established risk factors. Results: Participants were on average 36.3 years old at baseline, 202 (61.0%) were women, and 93 (29.9%) were African American. Overall, LDL-C explained 42.3% of the variability in ApoB as the lipoprotein markers were only modestly correlated (r=0.65). Participants with ApoB <90 (51.1%) were more likely to remain free of carotid plaque compared to those with ApoB > 90 (74.6% versus 57.4%, p=0.001, Figure ). In multivariable modeling, persons with ApoB <90 were 21% more likely to have long-term absence of plaque (RR=1.21, 95% CI: 1.03-1.43), independent of traditional ASCVD risk factors, including LDL-C. Conclusions: More than half of persons with metabolic disorders and elevated LDL-C had normal ApoB with a lower burden of carotid atherosclerosis over 13 years follow-up. ApoB better represents the atherogenic lipid burden among persons with metabolic disorders compared to LDL-C and may be especially helpful for persons with the pattern of high triglycerides and low HDL-cholesterol.

Abstract 15661: Discordant LDL-C Estimates and Incident Atherosclerotic Cardiovascular Disease: The Dallas Heart Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nicholas Macpherson ◽  
Nestor Vasquez ◽  
Amit Khera ◽  
Anand Rohatgi ◽  
Seth S Martin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Lipid Lowering ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lipid Lowering Therapy ◽  
The Metabolic Syndrome ◽  
Heart Study ◽  
Lipid Panel ◽  
Ascvd Risk ◽  
Dallas Heart Study

Introduction: The Friedewald equation (F-LDL-C) and the Martin-Hopkins algorithm (MH-LDL-C) estimate direct LDL-C from a standard lipid panel. Discordant LDL-C estimates by the two methods may carry significant clinical implications. We evaluated the clinical variables associated with discordant LDL-C estimates and the association of discordance with risk of incident atherosclerotic cardiovascular disease (ASCVD) in the Dallas Heart Study (DHS), a multi-ethnic, population based prospective cohort. Methods: We estimated F-LDL-C and MH-LDL-C in 2824 DHS participants (42% male; mean age 43.5 years) with TG ≤ 400 mg/dL, who were not on baseline lipid lowering therapy and were free of prior ASCVD. We divided the cohort into quintiles of LDL-C discordance (MH-LDL-C minus F-LDL-C, in mg/dL) and assessed associations with ASCVD risk factors. We evaluated associations between discordance and incident ASCVD by sequentially adjusted Cox regression models, and we generated restricted cubic spline plots of discordance and hazard for ASCVD. Results: There were 228 ASCVD events over a median of 12.3 years. Clinical characteristics across discordance quintiles are shown in the Table . After adjustment for traditional ASCVD risk factors, there was a linear association between higher LDL-C discordance and increased risk of ASCVD events ( Figure ) with the highest hazard in Quintile 5 (HR 1.5, 95% CI 1.1 - 2.0). Conclusions: Discordant LDL-C estimates were largely associated with male sex, White and Hispanic races, and characteristics of the metabolic syndrome. Individuals in the highest quintile of discordant LDL-C estimates, with MH-LDL-C > F-LDL-C, had greater risk for incident ASCVD.

Abstract 14789: 2013 ACC/AHA Cholesterol Guideline Undertreats HIV-infected Adults With Carotid Atherosclerosis by Ultrasound

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Binh An P Phan ◽  
Bernard Weigel ◽  
Yifei Ma ◽  
Rebecca Scherzer ◽  
Danny Li ◽  
...  
Keyword(s):  
Carotid Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Cardiovascular Disease ◽  
Antiretroviral Medication ◽  
Increased Risk ◽  
History Of ◽  
Ascvd Risk ◽  
Increase In Risk

Background: While HIV infection is associated with increased risk of ASCVD (atherosclerotic cardiovascular disease), it is unknown whether guidelines can identify HIV-infected adults who may benefit from statins. The purpose of our study was to compare the 2013 ACC/AHA and 2004 ATP III recommendations in a HIV population, and to evaluate associations with carotid artery intima-media thickness (CIMT) and plaque. Methods: We used ultrasound to measure CIMT at baseline and 3 years later in 352 HIV-infected adults with no ASCVD and not on statins. Plaque was defined as IMT > 1.5 mm. We compared 2013 ACC/AHA and 2004 ATP III recommendations, and evaluated associations with CIMT and plaque. Results: At baseline, the median age was 43 (IQR 39-49), 85% were male, 74% were on antiretroviral medication, and 50% had plaque. At follow-up, the median IMT progression was 0.052 mm/yr, and 66% had plaque. The 2013 guideline was more likely to recommend statins compared with the 2004 guideline, both overall (26% vs. 14%, p<.001), in those with plaque (32% vs. 17%, p=.0002), and in those without plaque (16% vs. 7%, p=.025). In unadjusted linear regression, the 2004 and 2013 risk score were strongly associated with CIMT (0.01 mm per 10% increase in risk, p<.001) and with CIMT progression (0.01 mm/yr per 10% increase in risk, p<.001). In multivariate analysis, older age, higher LDL-C, pack-years of smoking, and history of opportunistic infection were associated with baseline plaque. Conclusions: While the 2013 ACC/AHA guideline recommended statins to a greater number of HIV-infected adults compared to the 2004 ATP III guideline, both failed to recommend therapy in the majority of HIV-affected adults with carotid plaque. Both the 2004 and 2013 guidelines predicted higher levels of baseline CIMT and faster progression. HIV-specific guidelines that include detection of subclinical atherosclerosis may help to identify HIV-infected adults who are at increased ASCVD risk and may benefit from statins.

scholarly journals Cholesterol efflux capacity and its association with prevalent metabolic syndrome in a multi-ethnic population (Dallas Heart Study)

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257574
Author(s):  
Oludamilola Akinmolayemi ◽  
Suzanne Saldanha ◽  
Parag H. Joshi ◽  
Sneha Deodhar ◽  
Colby R. Ayers ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cholesterol Efflux ◽  
Cholesterol Concentration ◽  
Atherogenic Dyslipidemia ◽  
Study Cohort ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ethnic Population ◽  
Cholesterol Efflux Capacity ◽  
Heart Study ◽  
Dallas Heart Study

Metabolic syndrome (MetS) is characterized by adiposity and atherogenic dyslipidemia consisting of elevated triglyceride and decreased high density lipoprotein cholesterol (HDL-C) levels however, cholesterol concentration alone does not reflect HDL functionality. Cholesterol efflux capacity (CEC) captures a key anti-atherosclerotic function of HDL; studies linking CEC to MetS have yielded inconsistent findings and lacked racial/ethnic diversity. The aim of this study was to evaluate the association between CEC and MetS in a large multi-ethnic population utilizing two different CEC assays interrogating overlapping but distinct reverse cholesterol transport pathways. A cross-sectional study was performed using the Dallas Heart Study cohort and cholesterol efflux was measured with radiolabeled and fluorescent cholesterol assays. The relationship between CEC and MetS was assessed using multivariable regression analyses. A total of 2241 participants were included (mean age was 50 years; 38% men and 53% Blacks). CEC was independently and inversely associated with MetS irrespective of efflux assay (CEC-radiolabeled, adjusted OR 0·71 [95% CI 0·65–0·80]. CEC-fluorescent, adjusted OR 0·85 [95% CI 0·77–0·94]). Both CEC measures were inversely associated with waist circumference and directly associated with HDL-C but not with other MetS components. There was an interaction by sex but not by race such that the inverse associations between CEC and MetS were somewhat attenuated in men (OR 0·86, 95%CI 0·74–1·01). In this large multi-ethnic cohort, impaired CEC is linked to MetS irrespective of efflux assay and race/ethnicity but less so among men. Future studies are needed to assess whether CEC mediates the atherosclerotic cardiovascular disease risk of MetS.

Abstract 13328: Impact of Cascade Screening for Familial Hypercholesterolemia on Cardiovascular Events

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hayato Tada ◽  
Atsushi Nohara ◽  
Masakazu Yamagishi ◽  
Masayuki Takamura ◽  
Masa-aki Kawashiri
Keyword(s):  
Risk Factors ◽  
Familial Hypercholesterolemia ◽  
Cardiovascular Events ◽  
Lipid Lowering ◽  
Atherosclerotic Cardiovascular Disease ◽  
Prognostic Impact ◽  
Cascade Screening ◽  
Increased Risk ◽  
Ascvd Risk ◽  
The Impact

Background: Familial hypercholesterolemia (FH) is an autosomal dominant disorder mainly caused by mutations in the low-density lipoprotein (LDL) receptor or associated genes, resulting in elevated serum cholesterol levels and an increased risk of premature atherosclerotic cardiovascular disease (ASCVD). Early diagnosis and timely treatment can substantially lower the risk of ASCVD. In this sense, cascade screening could be one of the most useful options. However, few data exist regarding the impact of cascade screening for FH on the reduction of risk of ASCVD events. We aimed to evaluate the prognostic impact of cascade screening for FH. Methods: We retrospectively investigated the health records of 1,050 patients with clinically diagnosed FH, including probands and their relatives who were cascade-screened, who were referred to our institute. We used Cox models that were adjusted for established ASCVD risk factors to assess the association between cascade screening and major adverse cardiovascular events (MACE). The median period of follow-up was 12.3 years (interquartile range [IQR] = 9.1-17.5 years), and MACE included death from any causes or hospitalization due to ASCVD events. Results: During the observation period, 246 participants experienced MACE. The mean age of patients identified through cascade screening was 18-years younger than that of the probands (38.7 yr vs. 57.0 yr, P < 2.2 х 10 –16 ), with a lower proportion of ASCVD risk factors. Interestingly, patients identified through cascade screening under milder lipid-lowering therapies were at reduced risk for MACE (hazard ratio [HR] = 0.36; 95%CI = 0.22 to 0.60; P = 6.3 х 10 –5 ) when compared with the probands, even after adjusting for those known risk factors. Conclusions: The identification of patients with FH via cascade screening appeared to result in better prognoses.

scholarly journals Objective and Subjective Measures of Socioeconomic Status Are Associated with Metabolic Syndrome Severity Among African American Adults in the Jackson Heart Study (P18-006-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Michelle Cardel ◽  
Yi Guo ◽  
Mario Sims ◽  
Akilah Dulin ◽  
Darci Miller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Socioeconomic Status ◽  
African American ◽  
Waist Circumference ◽  
Social Status ◽  
National Institutes Of Health ◽  
Jackson Heart Study ◽  
Heart Study

Abstract Objectives In this study, data from the Jackson Heart Study (JHS) were used to assess the independent associations between objective socioeconomic status (OSS) and subjective social status (SSS) with metabolic syndrome (MetS) severity and MetS indicators in African American (AA) adults at baseline and eight years later. Methods Participants included 3870 AA participants (63.1% women; mean age 53.8 ± 13.0, age range 35–84 years). OSS was assessed using annual household income and years of school completed. SSS was measured with the MacArthur Scale, using two 10-rung “ladders” with U.S. society and the individual's community as referent groups for their perceived social rank. Associations of OSS and SSS with a sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, and alcohol consumption) at baseline and 8-year follow-up. Results Independent of OSS, demographic, and lifestyle factors, individuals who placed themselves on lower rungs of a visual ladder depicting relative social standing in society had more severe metabolic syndrome at baseline but not 8-years later (P = 0.0123 and P = 0.3248, respectively). The components of MetS driving the relationship between US-level SSS and MetS severity at baseline were waist circumference and triglyceride levels, as waist circumference and triglycerides at baseline were inversely associated with US-level SSS (P = 0.0124 and P = 0.0074, respectively). OSS components, including measures of income and education, were both independently associated with MetS severity at baseline (P < 0.05) but not at 8-year follow-up. Community-level SSS was not associated with MetS severity at baseline or 8-year follow-up. Conclusions These data indicate that both subjective and objective measures of social status are independently associated with cardiometabolic risk factors and the severity of MetS among AA adults and should be considered in adjunct when exploring the role of social determinants of cardiometabolic health. Funding Sources This work was supported by the National Institutes of Health National Heart, Lung, and Blood Institute (R01HL120960 R25HL126146 and K01HL141535) and the National Center For Advancing Translational Sciences of the National Institutes of Health (UL1TR001427).

scholarly journals Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2056
Author(s):  
Andrea Pasta ◽  
Elena Formisano ◽  
Anna Laura Cremonini ◽  
Elio Maganza ◽  
Erika Parodi ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Ldl Cholesterol ◽  
Plasma Lipid ◽  
Lipid Lowering ◽  
Atherosclerotic Cardiovascular Disease ◽  
Increased Risk ◽  
First Results ◽  
Esc Guidelines ◽  
Ascvd Risk

Background: Dyslipidemias are a heterogeneous group of metabolic disorders mainly characterized by an increased risk of atherosclerotic cardiovascular disease (ASCVD) or other conditions, such as acute pancreatitis in hypertriglyceridemia. The aim of this study was to evaluate the effect of diet treatment and nutraceutical (NUTs) supplementation on the plasma lipid profile in outpatient dyslipidemic subjects, considering the influence of several factors (i.e., gender, age, body mass index, alcohol consumption, and smoking habits). Methods: 487 dyslipidemic patients spanning from 2015 to 2019 were treated with a Mediterranean diet or NUTs in a real-word setting and were retrospectively analyzed. General characteristics and lipid profile at baseline and after the follow-up period were evaluated. Results: Diet alone reduced total cholesterol (−19 mg/dL, −7.7%), LDL cholesterol (−18 mg/dL, −10.1%), and triglycerides (−20 mg/dL, −16.7%). Triglycerides (TG) decreased more in men, while women were associated with higher reduction of LDL cholesterol (LDL-C). Different types of NUTs further ameliorate lipid profiles when associated with diet. Nevertheless, most patients at low ASCVD risk (222 out of 262, 81.6%) did not achieve the 2019 ESC/EAS guidelines recommended LDL-C goals (i.e., LDL-C < 116 mg/dL). Conclusion: Lipid-lowering diet improves lipid profile, and NUTs can boost its efficacy, but taken together they are mainly unsatisfactory with respect to the targets imposed by 2019 EAS/ESC guidelines.

scholarly journals The association between HDL particle concentration and incident metabolic syndrome in the multi-ethnic Dallas Heart Study

2017 ◽  
Vol 11 ◽  
pp. S175-S179 ◽  
Author(s):  
Preethi Mani ◽  
Hao-Yu Ren ◽  
Ian J. Neeland ◽  
Darren K. McGuire ◽  
Colby R. Ayers ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Particle Concentration ◽  
Heart Study ◽  
Dallas Heart Study

scholarly journals The metabolic syndrome and its components in 178 patients treated for craniopharyngioma after 16 years of follow-up

2018 ◽  
Vol 178 (1) ◽  
pp. 11-22 ◽  
Author(s):  
Mark Wijnen ◽  
Daniel S Olsson ◽  
Marry M van den Heuvel-Eibrink ◽  
Casper Hammarstrand ◽  
Joseph A M J L Janssen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
General Population ◽  
Visual Impairment ◽  
Replacement Therapy ◽  
Multivariable Logistic Regression Analysis ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Glucocorticoid Replacement Therapy

Objective Patients with craniopharyngioma are at an increased risk for cardio- and cerebrovascular mortality. The metabolic syndrome (MetS) is an important cardiometabolic risk factor, but barely studied in patients with craniopharyngioma. We aimed to investigate the prevalence of and risk factors for the MetS and its components in patients with craniopharyngioma. Design Cross-sectional study with retrospective data. Methods We studied the prevalence of and risk factors for the MetS and its components in 110 Dutch (median age 47 years, range 18–92) and 68 Swedish (median age 50 years, range 20–81) patients with craniopharyngioma with ≥3 years of follow-up (90 females (51%); 83 patients with childhood-onset craniopharyngioma (47%); median follow-up after craniopharyngioma diagnosis 16 years (range 3–62)). In Dutch patients aged 30–70 years and Swedish patients aged 45–69 years, we examined the prevalence of the MetS and its components relative to the general population. Results Sixty-nine (46%) of 149 patients with complete data demonstrated the MetS. Prevalence of the MetS was significantly higher in patients with craniopharyngioma compared with the general population (40% vs 26% (P < 0.05) for Dutch patients; 52% vs 15% (P < 0.05) for Swedish patients). Multivariable logistic regression analysis identified visual impairment as a borderline significant predictor of the MetS (OR 2.54, 95% CI 0.95–6.81; P = 0.06) after adjustment for glucocorticoid replacement therapy and follow-up duration. Age, female sex, tumor location, radiological hypothalamic damage, 90Yttrium brachytherapy, glucocorticoid replacement therapy and follow-up duration significantly predicted components of the MetS. Conclusions Patients with craniopharyngioma are at an increased risk for the MetS, especially patients with visual impairment.

scholarly journals Development of Metabolic Syndrome Decreases Bone Mineral Density T-Score of Calcaneus in Foot in a Large Taiwanese Population Follow-Up Study

2021 ◽  
Vol 11 (5) ◽  
pp. 439
Author(s):  
Hsuan Chiu ◽  
Mei-Yueh Lee ◽  
Pei-Yu Wu ◽  
Jiun-Chi Huang ◽  
Szu-Chia Chen
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Metabolic Syndrome ◽  
Bone Mineral ◽  
Large Population ◽  
Atherosclerotic Cardiovascular Disease ◽  
Mineral Density ◽  
Taiwanese Population ◽  
T Score

Studies have suggested that there may be common pathogenic pathways linking osteoporosis and metabolic syndrome (MetS) due to the multiple risk factors for atherosclerotic cardiovascular disease caused by MetS. However, results on the association between MetS and bone health are inconsistent and sometimes contradictory. In this study, we aimed to investigate the associations between the effects of MetS risk factors and bone mineral density (BMD) T-score in a longitudinal study of 27,033 participants from the Taiwan Biobank with a follow-up period of 4 years. BMD of the calcaneus was measured in the non-dominant foot using ultrasound in the Taiwanese population. The overall prevalence rates of MetS were 16.7% (baseline) and 21.2% (follow-up). The participants were stratified into four groups according to the status of MetS (no/yes at baseline and follow-up). We investigated associations between MetS and its five components (baseline, follow-up) with BMD ΔT-score and found that the (no, yes) MetS group, (no, yes) abdominal obesity group, (no, yes) hypertriglyceridemia group, and (no, yes) low high-density lipoprotein (HDL) cholesterol group had the lowest ΔT-score. Furthermore, in the (no, yes) MetS group, high Δwaist circumference (p = 0.009), high Δtriglycerides (p = 0.004), low ΔHDL cholesterol (p = 0.034), and low Δsystolic blood pressure (p = 0.020) were significantly associated with low ΔT-score, but Δfasting glucose was not. In conclusion, in this large population-based cohort study, our data provide evidence that the development of MetS is strongly associated with increased rates of BMD loss in the Taiwanese population. This suggests that the prevention of MetS should be taken into consideration in the prevention of osteoporosis in the Taiwanese population.

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