Abstract P129: Confirmatory Factor Analysis of Multivariate Lipid Distributions Across Time and Race/Ethnic Groups: United States, 2003-2012

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Ann Von Holle ◽  
Kari North
Keyword(s):  
United States ◽  
Risk Factor ◽  
Ethnic Groups ◽  
Genetic Variants ◽  
Density Lipoprotein ◽  
Cvd Risk ◽  
Latent Factor ◽  
Confirmatory Factor ◽  
And Gender ◽  
Racial Ethnic

Plasma concentrations of low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG) are important risk factors for metabolic and cardiovascular diseases and are widely-used as targets for therapeutic intervention. Consideration of the multivariate distribution of these lipid traits could be informative for studies involving pleiotropic genetic variants, variants associated with more than one lipid outcome, but featuring only univariate lipid outcome models. Confirmatory factor analysis (CFA) is one way to characterize the multivariate distribution of biologically plausible, related indicators such as lipids with a continuous latent factor. Although CFA has been used to characterize metabolic syndrome, a cardiovascular disease (CVD) risk factor involving many correlated indicators, dyslipidemia is a CVD risk factor that remains relatively unexplored in this literature. Thus, the primary aim of this study is to conduct CFA with LDL-C, HDL-C and TG as indicators representing a single continuous latent lipid factor and assess its suitability as an outcome measure in a United States representative sample by racial/ethnic groups stratified by age and gender over five 2-year time periods (2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012) from NHANES. First, we used principal component analyses (PCA) to visually examine clustering by race and gender in biplots. Second, we tested for scale differences in the lipid factor across a) calendar time and b) racial/ethnic groups (Mexican-American, non-Hispanic White, non-Hispanic Black, Other Hispanic and Other race/ethnicity). All analyses were stratified by medication use, gender and three age groups: 12-19 years, 20 to 49 years and 50-80 years, and adjusted for age and body mass index (BMI). We found significant scale differences across racial/ethnic groups. In particular, the center of the distribution differed across racial/ethnic groups for ages 12-19 years (p<0.0001), 20-49 years (p<0.0001) and 50-80 years (p<0.0001), suggesting joint distributions of TG, HDL-C, and LDL-C vary across racial/ethnic groups. In summary, one continuous latent factor representing all three lipids and their concomitant associations provides a means to characterize lipid values simultaneously and can serve as an outcome when studying exposures influencing multiple lipid values, pleiotropic genetic variants being just one example of many. Differences in the lipid latent factor across racial/ethnic groups emphasizes distinct multivariate distributions necessitating stratification. Limited analyses exist using this CFA framework for lipids, and future efforts considering the joint distribution of lipids may improve our understanding of the genetic architecture of dyslipidemia.

scholarly journals Imagining Her Future: Diversity in Mothers’ Socialization Goals for Their Adolescent Daughters

2017 ◽  
Vol 48 (4) ◽  
pp. 593-610 ◽  
Author(s):  
Jennifer Ramirez ◽  
Linda Oshin ◽  
Stephanie Milan
Keyword(s):  
United States ◽  
African American ◽  
Ethnic Groups ◽  
Low Income ◽  
The United States ◽  
Social Traits ◽  
Socialization Goals ◽  
Racial Ethnic ◽  
Q Sort

According to developmental niche theory, members of different cultural and ethnic groups often have distinct ideas about what children need to become well-adapted adults. These beliefs are reflected in parents’ long-term socialization goals for their children. In this study, we test whether specific themes that have been deemed important in literature on diverse families in the United States (e.g., Strong Black Woman [SBW], marianismo, familismo) are evident in mothers’ long-term socialization goals. Participants included 192 mothers of teenage daughters from a low-income city in the United States (58% Latina, 22% African American, and 20% European American [EA]/White). Socialization goals were assessed through a q-sort task on important traits for a woman to possess and content analysis of open-ended responses about what values mothers hoped they would transmit to their daughters as they become adults. Results from ANCOVAs and logistic regression indicate significant racial/ethnic differences on both tasks consistent with hypotheses. On the q-sort task, African American mothers put more importance on women possessing traits such as independence than mothers from other racial/ethnic groups. Similarly, they were more likely to emphasize self-confidence and strength in what they hoped to transmit to their daughters. Contrary to expectation, Latina mothers did not emphasize social traits on the q-sort; however, in open-ended responses, they were more likely to focus on the importance of motherhood, one aspect of marianismo and familismo. Overall, results suggest that these mothers’ long-term socialization goals incorporate culturally relevant values considered important for African American and Latino families.

scholarly journals Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
C. Macchi ◽  
C. Favero ◽  
A. Ceresa ◽  
L. Vigna ◽  
D. M. Conti ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Risk Factor ◽  
Beck Depression Inventory ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Model Assessment ◽  
Cvd Risk ◽  
Assessment Index ◽  
Increased Risk ◽  
Homeostatic Model Assessment

Abstract Background Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk. Results In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9. Conclusions This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.

Exploring Inconsistent Counts of Racial/Ethnic Minorities in a 2010 Census Ethnographic Evaluation

2017 ◽  
Vol 135 (1) ◽  
pp. 32-49 ◽  
Author(s):  
Rodney L. Terry ◽  
Laurie Schwede ◽  
Ryan King ◽  
Mandi Martinez ◽  
Jennifer Hunter Childs
Keyword(s):  
United States ◽  
Ethnic Groups ◽  
Ethnic Minorities ◽  
Race And Ethnicity ◽  
Cultural Awareness ◽  
Data Sources ◽  
Cultural Issues ◽  
Factors Affecting ◽  
Racial Ethnic ◽  
Differential Counts

Previous research has shown differential counts by race and ethnicity across several recent United States decennial censuses. This article presents findings from a 2010 Census ethnographic evaluation with a record check, conducted to identify factors affecting enumeration among racial/ethnic groups. In eight sites targeted to major racial/ethnic groups, ethnographers observed live census interviews and assessed where persons should have been counted. In the record check, housing unit rosters were matched with four data sources to identify inconsistencies in where to count persons. Ethnographic themes that contributed to record check inconsistencies include respondent access difficulty, language issues, and cultural issues. Ways to improve enumeration include improving access to hard-to-reach respondents and increasing the cultural awareness of enumerators.

scholarly journals Dementia Care in Diverse Older Adults in the U.S. Deep South and the Rest of the United States

2021 ◽  
pp. 1-13
Author(s):  
Maria Pisu ◽  
Roy C. Martin ◽  
Liang Shan ◽  
Giovanna Pilonieta ◽  
Richard E. Kennedy ◽  
...  
Keyword(s):  
United States ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Drug Use ◽  
Ethnic Groups ◽  
The United States ◽  
Deep South ◽  
Racial Ethnic ◽  
The U.S

Background: Use of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer’s disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it. Objective: To examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS. Methods: We obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013–2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS. Results: Across racial/ethnic groups, 33%–43% in DS and 43%–50% in non-DS used specialists; 47%–55% in DS and 41%–48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor “Availability of Medical Resources” were associated with specialist use; Alzheimer’s disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes. Conclusion: We did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.

scholarly journals Non-HDL Cholesterol Versus LDL Cholesterol as a CVD Risk Factor in Diabetic Subjects

2014 ◽  
Vol 31 (4) ◽  
pp. 199-203
Author(s):  
M Saiedullah ◽  
S Begum ◽  
S Hayat ◽  
SM Kamahuddin ◽  
MR Rahman ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Upward Trend ◽  
Cvd Risk ◽  
Cross Sectional

Objective: Serum low density lipoprotein (LDL) cholesterol is considered as the primary target of lipid lowering therapy and non-high density lipoprotein (HDL) cholesterol is the recommended second target. Recent studies claimed that non-HDL cholesterol is a better predictor of cardiovascular diseases (CVD) than LDL cholesterol. In this study we aimed to compare non-HDL cholesterol and LDL cholesterol as a CVD risk factor in confirmed diabetic subjects. Materials and methods: In this cross-sectional observational study, 1042 confirmed diabetic subjects selected randomly were included. HbA1cResults: In the total subjects, 767 (74%) subjects had LDL cholesterol > 100 mg/dL and 822 (79%) subjects had non- HDL cholesterol > 130 mg/dL. HbA1c values were different (p<0.02) in five groups and showed upward trend (p<0.01). All the lipid parameters studied were significantly different in five groups (p<0.0001) and TC, TG and non-HDL cholesterol showed upward trend (p<0.0001), but HDL cholesterol and LDL cholesterol showed downward trend (p<0.0001). Odds ratio (OR) of likelihood of risk individuals regarding non-HDL cholesterol compared to LDL cholesterol were 0.50 (p<0.001), 1.32 (p>0.05), 2.96 (p<0.001), 6.49 (p<0.001) and 9.37 (p<0.001) for TG concentrations of up to 150 mg/dL, 151-200 mg/dL, 201-250 mg/dL, 251-300 mg/dL and 301-400 mg/dL respectively with relative risk of 0.60, 1.24, 2.43, 4.83, 5.10. Conclusion: LDL cholesterol is a better tool for the detection of high-risk individuals than non-HDL cholesterol at TG concentration up to 150 mg/dL, whereas non-HDL cholesterol is better than LDL cholesterol at TG concentration above 200 mg/dL as a CVD risk factor. DOI: http://dx.doi.org/10.3329/jbcps.v31i4.21004 J Bangladesh Coll Phys Surg 2013; 31: 199-203

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