Abstract P330: Cardiovascular Adipose Depots Of The Heart And Aorta Are Associated With CVD Risk Factors And Vascular Calcification In Women With SLE

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Kelly J Shields ◽  
Joseph M Ahearn ◽  
Susan Manzi
Keyword(s):  
Risk Factors ◽  
Lupus Erythematosus ◽  
Corticosteroid Treatment ◽  
Healthy Controls ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Perivascular Adipose Tissue ◽  
Glucose Levels ◽  
Related Risk ◽  
Visceral Adipose

Introduction: Women with systemic lupus erythematosus (SLE) are at greater risk of developing cardiovascular disease (CVD), which is not explained by traditional CVD and SLE-related risk factors. Mounting evidence implicates small visceral adipose depots surrounding the heart and vasculature in the pathogenesis of CVD. Previously, we found that women with SLE had a greater volume of aortic perivascular adipose tissue (aPVAT) compared to healthy controls (HC). Here we quantify epicardial (EPI), paracardial (PARA), and total heart (TOT = EPI+PARA) adipose and evaluate their associations with aPVAT, CVD risk factors and coronary artery (CAC) and aortic (AC) calcification. Design: Data included clinically CVD-free SLE women never (SLEc-) or ever (SLEc+) on corticosteroids, and healthy controls (HC) (HEARTS cohort). Electron beam CT scans were used to quantify adipose depots and AC/CAC. Logistic and linear regressions were used and final models were adjusted for waist-to-hip ratio. Results: In this study, age- and race-matched women participated: 15 SLEc-, 15 SLEc+, and 15 HC. More SLE women had hypertension (p=0.04), elevated circulating eSelectin (p=0.04), albumin (p=0.01), and homocysteine (p=0.02) compared to HC. SLEc+ women had decreased circulating C3 (p=0.04) and C4 (p<0.01) compared to SLEc- women. TOT tended to be greater in SLE (mean(std): 108(92)cm3, p=0.07) vs. HC (85.2(30) cm3) and in SLEc+ (122(45) cm3,p=0.06) vs. vs SLEc- (93.5(32) cm3). There were no differences in EPI (p=0.2) or aPVAT (p=0.3), but PARA was greater in SLEc+ (54.2(27) cm3) vs. SLEc-(36.9(19) cm3) (p=0.05). TOT was correlated with aPVAT in SLE (rho,p: 0.47, 0.01) and HC (0.69, <0.01) with PARA volume (SLE(0.43, 0.02) and HC (0.57, 0.03)) driving this association. In HC, EPI and PARA were correlated with insulin (p<0.03) and HOMA-IR (p<0.04) while PARA was correlated with CRP (p=0.04). Glucose levels were correlated with EPI in SLEc+ (0.53, 0.04) and with PARA in SLEc- (-0.55, 0.03). AC was detected in 21/28 SLE women and 11/15 HC while CAC was detected in 13/28 SLE and 4/15 HC. Only aPVAT was associated with increasing AC (OR(95%CI),p): 1.09 (1.0-1.2), 0.04) and CAC (1.11 (1.0-1.2), 0.03) in SLEc+. In adjusted models, only aPVAT(log) remained associated with greater extent of AC in SLE(β(SE),p: 2.90(1.3), 0.04), which was driven by SLEc+ (5.13(1.8), 0.02) women. Conclusion: Adipose depots surrounding the heart and vasculature are greater in clinically CVD-free women with SLE and specifically SLEc+, with significant associations among CVD risk factors and calcification dependent on their location. Corticosteroid treatment may suppress circulating inflammatory markers, but is associated with greater adipose volumes surrounding the heart and increased calcification. Just as AC generally precedes CAC development, aPVAT may be a precursor to extensive PARA and EPI development, with PARA more strongly associated.

The Relationships of High-Sensitivity C-Reactive Protein and Homocysteine Levels With Disease Activity, Damage Accrual, and Cardiovascular Risk in Systemic Lupus Erythematosus

2019 ◽  
Vol 22 (2) ◽  
pp. 169-177 ◽  
Author(s):  
Gabriela Pocovi-Gerardino ◽  
Maria Correa-Rodríguez ◽  
José-Luis Callejas Rubio ◽  
Raquel Ríos Fernández ◽  
María Martín Amada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
High Sensitivity ◽  
Cvd Risk Factors ◽  
Systemic Lupus ◽  
Cvd Risk ◽  
Damage Accrual ◽  
Hs Crp

Chronic inflammation coupled with cardiovascular disease (CVD) risk factors influences the progression of atherosclerosis in systemic lupus erythematosus (SLE). High-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) are associated with the risk of CVD in the general population, but their associations with CV risk and disease activity in SLE are unclear. In this cross-sectional study ( N = 139 SLE patients, mean age = 45.27 ± 13.18 years), we investigated associations between hs-CRP and Hcy levels and disease activity, damage accrual, and CVD risk in SLE. Disease activity and damage accrual were measured with the SLE Activity Index 2000 (SLEDAI-2K), the Systemic Lupus Erythematosus International Collaborating Clinics Group/American College of Rheumatology damage index (SDI), and anti-double-stranded DNA antibodies (anti-dsDNA). CVD risk factors of obesity, diabetes mellitus, hypertension, blood lipids, and ankle–brachial index were collected. Linear regression analysis and one-way analysis of variance were used to analyze relationships of hs-CRP and Hcy with SLE activity, damage accrual, and CVD risk factors. Results: hs-CRP correlated significantly with SLEDAI-2K ( p = .036), SDI ( p = .00), anti-dsDNA titers ( p = .034), diabetes ( p = .005), and obesity ( p = .027). hs-CRP and Hcy correlated with triglyceride (TG) levels ( p = .032 and p < .001, respectively), TG/high-density lipoprotein cholesterol index ( p = .020 and p = .001, respectively), and atherogenic index of plasma ( p = .006 and p = .016, respectively). hs-CRP levels >3 mg/L correlated with SDI score ( p = .012) and several CVD risk factors. Discussion: Findings suggest SLE patients with elevated hs-CRP and/or Hcy have a higher prevalence of CVD risk factors.

scholarly journals Effects of visceral adipose tissue reduction on CVD risk factors independent of weight loss: The Look AHEAD study

2016 ◽  
Vol 42 (2) ◽  
pp. 86-95 ◽  
Author(s):  
Anawin Sanguankeo ◽  
Mariana Lazo ◽  
Sikarin Upala ◽  
Frederick L. Brancati ◽  
Susanne Bonekamp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Adipose Tissue ◽  
Visceral Adipose Tissue ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Look Ahead ◽  
The Look ◽  
Visceral Adipose ◽  
Tissue Reduction

scholarly journals Differential Response to Exercise in African Americans with High Levels of Inflammation

2017 ◽  
Vol 27 (3) ◽  
pp. 233 ◽  
Author(s):  
Jan Kretzschmar ◽  
Dianne M. Babbitt ◽  
Keith M. Diaz ◽  
Deborah L. Feairheller ◽  
Kathleen M. Sturgeon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
African Americans ◽  
Aerobic Fitness ◽  
Early Stage ◽  
Aerobic Exercise Training ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Glucose Levels ◽  
Reactive Protein

<p><strong>Purpose: </strong>Systemic inflammation, measured by C-reactive protein (CRP), is an important risk factor for cardiovascular disease (CVD) and mortality. We investigated whether aerobic exercise training (AEXT) affects African Americans with high inflammation (HI) the same way it does African Americans with low inflammation (LI) in terms of CVD risk factors. </p><p><strong>Methods: </strong>23 African Americans with CRP levels &lt;3 mg/L (LI) and 14 African Americans with CRP ≥3 mg/L (HI) underwent six months of AEXT. Participants were sedentary, non-diabetic, non-smoking, with clinical blood pressure &lt;160/100 mm Hg, were non-hyperlipidemic, had no signs of cardiovascular, renal, or pulmonary disease, and were not on medication. Measures included CD62E+ endothelial microparticles (EMPs), a measure of early stage endothelial dysfunction, as well as lipid and glucose profile, aerobic fitness, body composition, and blood pressure. </p><p><strong>Results: </strong>The LI group improved aerobic fitness by 10%, body mass index by 3%, and plasma triglycerides by 20%, with no change being observed in HI group for these variables. The HI group improved fasting plasma glucose levels by 10%, with no change occurring in the LI group. Both groups improved CD62E+ EMPs by 38% and 59% for the LI and HI group, respectively. </p><p><strong>Conclusions: </strong>A standard AEXT intervention differentially affected CVD risk factors among African Americans with high and low inflammation. This may indicate that, in African Americans with high inflammation, AEXT alone may not be enough to reap the same benefits as their low-inflammation peers in terms of CVD risk modification. </p><p><em>Ethn Dis. </em>2017;27(3):233-240; doi:10.18865/ed.27.3.233 </p>

scholarly journals Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry

Lupus ◽  
2020 ◽  
Vol 29 (11) ◽  
pp. 1353-1363
Author(s):  
Stéphane Zuily ◽  
Isabelle Clerc-Urmès ◽  
Cédric Bauman ◽  
Danieli Andrade ◽  
Savino Sciascia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Lupus Erythematosus ◽  
Hierarchical Cluster ◽  
Heart Valve Disease ◽  
Antiphospholipid Antibody ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Female Patients ◽  
Clinical Phenotypes

Objective This study aimed to use cluster analysis (CA) to identify different clinical phenotypes among antiphospholipid antibodies (aPL)-positive patients. Methods The Alliance for Clinical Trials and International Networking (APS ACTION) Registry includes persistently positive aPL of any isotype based on the Sydney antiphospholipid syndrome (APS) classification criteria. We performed CA on the baseline characteristics collected retrospectively at the time of the registry entry of the first 500 patients included in the registry. A total of 30 clinical data points were included in the primary CA to cover the broad spectrum of aPL-positive patients. Results A total of 497 patients from international centres were analysed, resulting in three main exclusive clusters: (a) female patients with no other autoimmune diseases but with venous thromboembolism (VTE) and triple-aPL positivity; (b) female patients with systemic lupus erythematosus, VTE, aPL nephropathy, thrombocytopaenia, haemolytic anaemia and a positive lupus anticoagulant test; and (c) older men with arterial thrombosis, heart valve disease, livedo, skin ulcers, neurological manifestations and cardiovascular disease (CVD) risk factors. Conclusions Based on our hierarchical cluster analysis, we identified different clinical phenotypes of aPL-positive patients discriminated by aPL profile, lupus or CVD risk factors. Our results, while supporting the heterogeneity of aPL-positive patients, also provide a foundation to understand disease mechanisms, create new approaches for APS classification and ultimately develop new management approaches.

scholarly journals Longitudinal assessment between lifestyle-related risk factors and a composite cardiovascular disease (CVD) risk index among adolescents in Malaysia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nithiah Thangiah ◽  
Tin Tin Su ◽  
Karuthan Chinna ◽  
Muhammad Yazid Jalaludin ◽  
Mohd Nahar Azmi Mohamed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Physical Fitness ◽  
Healthy Lifestyle ◽  
Risk Index ◽  
Longitudinal Assessment ◽  
Cvd Risk Factors ◽  
Intervention Programme ◽  
Cvd Risk ◽  
Related Risk ◽  
Composite Risk

AbstractThe study aims to create a composite risk index of CVD among adolescents and examine the influence of demographic, socioeconomic and lifestyle-related risk factors on the composite risk index of biological CVD risk factors among adolescents in Malaysia. A Malaysian adolescent cohort of 1320 adolescents were assessed at 13, 15 and 17 years. Seven biological CVD risk factors with moderate correlation were identified, standardized and averaged to form a composite CVD risk index. Generalised estimating equation using longitudinal linear regression was used to examine the effects of changes in adolescent lifestyle-related risk factors on the composite CVD risk index over time. From the ages 13 to 17 years, physical fitness (β = − 0.001, 90% CI = − 0.003, 0.00002) and BMI (β = 0.051, 95% CI = 0.042, 0.060) were significant predictors of attaining high scores of CVD risk. Female (β = 0.118, 95% CI = 0.040, 0.197), Chinese (β = 0.122, 95% CI = 0.006, 0.239), Indians (β = − 0.114, 95% CI = − 0.216, − 0.012) and adolescents from rural schools (β = 0.066, 95% CI = − 0.005, 0.136) were also found to be considerably significant. A more robust and gender-specific intervention programme focusing on healthy lifestyle (including achieving ideal BMI and improving physical fitness) need to be implemented among school-going adolescents.

scholarly journals Geographical profiles of cardiovascular risk and the risk factors in China: data from a nationwide population-based screening project

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.Q Wu ◽  
X Li ◽  
J.P Lu ◽  
B.W Chen ◽  
Y.C Li ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Population Based ◽  
Staple Food ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Food Factor ◽  
Rural And Urban ◽  
Activity Factor

Abstract Background In China, an abundance of cardiovascular risk factors has contributed to the increasing prevalence of cardiovascular diseases (CVD), which caused almost 4 million deaths per year. However, comprehensive evidence on the geographical profiles of cardiovascular disease risk in China is lacking, as findings in prior studies have been limited to relatively small sample sizes, had incomplete regional coverage, or focused on a narrow risk factor spectrum. Purpose To compare the population CVD risk among different regions across China, and to describe the geographical distributions of CVD risk factors and their clusters throughout the nation. Methods In a nationwide population-based screening project covering 252 counties of China, standardized measurements were conducted to collect information on 12 major CVD risk factors. Individuals of high CVD risk were identified as those with previous CVD, or with a predicted 10-year risk of CVD greater than 10% according to the WHO risk prediction charts. We applied factor analysis to generate “clusters” that characterized the clustering of these risk factors, then explored their relationship with the local ambient temperature and per capital GDP. Results Among 983476 participants included, 9.2% were of high CVD risk, with a range of 1.6% to 23.6% across counties. Among the seven regions in China, the rate was relatively high in the Northeast (11.8%) and North China (10.4%), while low in the South China (7.2%) and Northwest (7.8%). We identified 6 clusters underlying CVD risk factors, including Obesity factor, Blood pressure factor, Staple food factor, Non-staple food factor, Smoking and alcohol factor, and Metabolic and physical activity factor (Figure). We found high risk regions were facing different leading challenges, like obesity and blood pressure for the North China, while unhealthy non-staple food for the Northeast. The South China, as the region with the lowest CVD risk, still had the highest prevalence of unhealthy staple food. Lower annual average ambient temperature was associated with higher risk in Blood pressure factor, Obesity factor and Non-staple food factor, but lower risk in Staple food factor and Metabolic and physical activity factor (p&lt;0.001 for all), consistently between rural and urban. Higher per capital GDP was associated with lower risk in Non-staple food factor in urban and higher risk in Metabolic and physical activity factor in rural (p&lt;0.05 for both). The correlation between per capital GDP and Smoking and alcohol factor differed significantly between in rural and urban regions (p=0.042). Conclusions The geographical profile of CVD risk in China is complex - population risk levels varied substantially across regions, which were contributed by different risk factors. China needs geographically targeted intervention strategies considering environmental and socio-economic factors to control CVD risk and reduce the burden related to CVD. Geographical disparity of risk clusters Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The National Key Research and Development Program from the Ministry of Science and Technology of China; the CAMS Innovation Fund for Medical Science

scholarly journals FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.2-808
Author(s):  
N. Hammam ◽  
G. Salem ◽  
D. Fouad ◽  
S. Rashad
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Functional Limitations ◽  
Functional Limitation ◽  
C Reactive Protein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Distribution Width ◽  
Reactive Protein ◽  
Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

scholarly journals Cardiovascular risk factors and COVID-19 outcomes in hospitalised patients: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045482
Author(s):  
Didier Collard ◽  
Nick S Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Icu Admission ◽  
Lowering Therapy ◽  
Secondary Outcomes ◽  
Age And Sex

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.

scholarly journals Serum alanine aminotransferase activity and risk factors for cardiovascular disease in a Caucasian population: the Tromsø study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Svein Ivar Bekkelund
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Alanine Aminotransferase ◽  
Maximum Level ◽  
Glycated Haemoglobin ◽  
Caucasian Population ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Serum Alanine Aminotransferase

Abstract Background High and low levels of serum alanine aminotransferase (ALT) are both associated with cardiovascular diseases (CVD) risks especially in elderly, but the mechanisms are less known. This study investigated associations between ALT and CVD risk factors including effects of sex and age in a Caucasian population. Methods Cross-sectional data were analysed sex-stratified in 2555 men (mean age 60.4 years) and 2858 women (mean age 60.0 years) from the population study Tromsø 6. Associations were assessed by variance analysis and multivariable logistic regression of odds to have abnormal ALT. Risk factors included body mass index (BMI), waist-to-hip-ratio, blood pressure, lipids, glucose, glycated haemoglobin and high-sensitive C-reactive protein (CRP). Results Abnormal elevated ALT was detected in 113 men (4.4%) and 188 women (6.6%). Most CVD risk factors associated positively with ALT in both sexes except systolic blood pressure and CRP (women only), while ALT was positively associated with age in men when adjusted for CVD risk factors, P < 0.001. BMI predicted ALT in men (OR 0.94; 95% CI 0.88–1.00, P = 0.047) and women (OR 0.90; 95% CI 0.86–0.95, P < 0.001). A linear inversed association between age and ALT in men and a non-linear inversed U-trend in women with maximum level between 60 and 64 years were found. Conclusion This study confirms a positive relationship between ALT and CVD risk factors, particularly BMI. Age is not a major confounder in the ALT-CVD relationship, but separate sex-analyses is recommended in such studies.

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