Abstract P349: Accelerometer-measured Sleep Duration and Markers of Cardiometabolic Health: Findings From a Large Racially Ethnic Diverse Cohort of Older Adult Women

Background: Cross-sectional and prospective studies have demonstrated that self-reported short sleep is a predictor of cardiometabolic conditions including obesity, Type 2 Diabetes, and cardiovascular events. The relationship may be non-linear, with short and long sleep related to markers of cardiometabolic risk. Research on sleep duration and cardiometabolic health is limited by use of single item self-report sleep measures and homogeneous populations. The current study tested the hypothesis that accelerometer-measured sleep duration would be significantly associated with objective markers of cardiometabolic risk in older adult women. Methods: Cross-sectional data were analyzed in 2662 women (mean age: 79.05, 52.8% white, 29.8% black, 17.4% Hispanic), from the Objective Physical Activity and Cardiovascular Health Study, ancillary study to the Women’s Health Initiative. Women wore accelerometers on the hip for 24 hours over 7 days and completed a daily sleep log. To be included in the present analysis women must have validated night wear for at least 3 nights. Sleep data were scored according to a standard protocol using sleep logs and visual inspection of the accelerometer data. Body mass index (BMI) and fasting blood samples were obtained at home visits prior to accelerometer monitoring. Adjusting for age and race/ethnicity, linear regression models estimated the relationship between sleep duration and BMI (kg/m 2 ), HDL cholesterol, triglycerides, and glucose (mg/dL each), and C-reactive protein (CRP; mg/L). A quadratic term for sleep was included in the models to evaluate nonlinearity. Results: The mean nightly sleep duration in the sample was 489.6 mins per night (8.16 hours) with 14.8% of the sample sleeping less than 7 hours per night and 21% sleeping more than 9 hours per night. After adjusting for age and race/ethnicity, sleep duration was significantly related to BMI (regression coefficient [ B ] :- 0.034, p<.01), and the relationship appeared to be non-linear (quadratic, p=.02). The estimated quadratic function indicated a decreasing BMI as sleep duration increased up to 500 minutes/night, and then an increasing BMI as sleep duration continued to increase beyond 500 minutes/night. Additionally, sleep duration was significantly related to CRP ( B: - 0.005, p=.03), triglycerides ( B: 0.002, p=.03) and glucose ( B: - 0.125, p=.05), with both the CRP (quadratic, p =.02) and glucose (quadratic, p =.03) relationships appearing to be u-shaped and the triglyceride relationship linear. Sleep duration was not significantly related to HDL cholesterol. Conclusions: In older women, there is a significant relationship between sleep duration and cardiometabolic risk factors, independent of age and race/ethnicity. These cross-sectional relationships should be further explored in prospective studies to inform sleep guidelines for better cardiovascular health in older adult women.

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Linking Sleep to Hypertension: Greater Risk for Blacks

International Journal of Hypertension ◽

10.1155/2013/436502 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 19

Author(s):

A. Pandey ◽

N. Williams ◽

M. Donat ◽

M. Ceide ◽

P. Brimah ◽

...

Keyword(s):

Sleep Duration ◽

Race And Ethnicity ◽

White Americans ◽

Cross Sectional ◽

Insufficient Sleep ◽

Black And White ◽

Household Interview ◽

Race Ethnicity ◽

Age Range ◽

The Relationship

Background. Evidence suggests that insufficient sleep duration is associated with an increased likelihood for hypertension. Both short (<6 hours) and long (>8 hour) sleep durations as well as hypertension are more prevalent among blacks than among whites. This study examined associations between sleep duration and hypertension, considering differential effects of race and ethnicity among black and white Americans.Methods. Data came from a cross-sectional household interview with 25,352 Americans (age range: 18–85 years).Results. Both white and black short sleepers had a greater likelihood of reporting hypertension than those who reported sleeping 6 to 8 hours. Unadjusted logistic regression analysis exploring the race/ethnicity interactions between insufficient sleep and hypertension indicated that black short (<6 hours) and long (>8 hours) sleepers were more likely to report hypertension than their white counterparts (OR = 1.34 and 1.37, resp.;P<0.01). Significant interactions of insufficient sleep with race/ethnicity were observed even after adjusting to effects of age, sex, income, education, body mass index, alcohol use, smoking, emotional distress, diabetes, coronary heart disease, and stroke.Conclusion. Results suggest that the race/ethnicity interaction is a significant mediator in the relationship between insufficient sleep and likelihood of having a diagnosis of hypertension.

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Gender Differences in the Association between Sleep Duration and Cardiometabolic Risk: A Cross-sectional Study

10.21203/rs.3.rs-66808/v1 ◽

2020 ◽

Author(s):

Rei Matsuo ◽

Shigemasa Tani ◽

Naoya Matsumoto ◽

Yasuo Okumura

Keyword(s):

Metabolic Syndrome ◽

Gender Differences ◽

Risk Factor ◽

Waist Circumference ◽

Sleep Duration ◽

Cardiometabolic Risk ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Relationship

Abstract Background: Inappropriate sleep duration (shorter/longer than optimal sleep duration) has come to be identified as a potential cardiometabolic risk factor, and thereby, as a risk factor for atherosclerotic cardiovascular disease (ASCVD). Few data exist regarding the gender differences in the relationship between sleep duration and cardiometabolic risk.Methods: This cross-sectional study was conducted in a study population of 9262 apparently healthy (5004 male, 4258 female) subjects at the Health Planning Center of Nihon University Hospital between September, 2015, and October 2016.Results: In the male subjects, as compared to a sleep duration of 6 to 7 hours, a sleep duration of ³8 hours was associated with an odds ratio (OR) for abdominal obesity (defined according to the Japanese criteria for metabolic syndrome as a waist circumference of ³85 cm) of 1.31 (95% confidence interval [CI], 1.004-1.71) and for a non-high-density lipoprotein cholesterol level of ³150 mg/dL (defined as “Borderline hyper” by the Japan Atherosclerosis Society Guidelines for Prevention of ASCVD 2017) of 1.33 (1.05-1.68), and a sleep duration of <5 hours was associated with an OR (95% CI) for a fasting blood glucose of ³100 mg/dL (defined as “high” by a specialized lifestyle checkup program for the detection of symptoms of metabolic syndrome in Japan) of 1.74 (1.25-2.42). On the other hand, in the female subjects, as compared to a sleep duration of 6 to 7 hours, a sleep duration of <5 hours was associated with an OR (95% CI) for abdominal obesity (waist circumference ³90 cm) of 1.98 (1.11-3.55) and for a hemoglobin A1c (HbA1c) level of ³5.6 % of 1.52 (1.10-2.10), whereas a sleep duration of ³8 hours was not associated with worsening of any of the examined cardiometabolic risk factors. Conclusions: There may be gender differences in the relationship between sleep duration and cardiometabolic risk. To further reduce the risk of ASCVD, it may be of particular importance to emphasize adequate sleep duration.Clinical Trial Registration: UMIN (http://www.umin.ac.jp/) Study ID:　 UMIN000037643 retrospectively registered on 9 August 2019

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Habitual Nightly Fasting Duration, Eating Timing, and Eating Frequency are Associated with Cardiometabolic Risk in Women

Nutrients ◽

10.3390/nu12103043 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3043

Author(s):

Nour Makarem ◽

Dorothy D. Sears ◽

Marie-Pierre St-Onge ◽

Faris M. Zuraikat ◽

Linda C. Gallo ◽

...

Keyword(s):

Cardiovascular Health ◽

Cardiometabolic Risk ◽

Heart Association ◽

Cardiometabolic Health ◽

Linear Regression Models ◽

Cross Sectional ◽

Eating Frequency ◽

Nighttime Eating ◽

Fasting Duration ◽

Prospective Analyses

Nightly fasting duration (NFD) and eating timing and frequency may influence cardiometabolic health via their impact on circadian rhythms, which are entrained by food intake, but observational studies are limited. This 1-year prospective study of 116 US women (33 ± 12y, 45% Hispanic) investigated associations of habitual NFD and eating timing and frequency with cardiovascular health (CVH; American Heart Association Life’s Simple 7 score) and cardiometabolic risk factors. NFD, eating timing and frequency, and nighttime eating levels were evaluated from 1-week electronic food records completed at baseline and 1 y. In multivariable-adjusted linear regression models, longer NFD was associated with poorer CVH (β = −0.22, p = 0.016 and β = −0.22, p = 0.050) and higher diastolic blood pressure (DBP) (β = 1.08, p < 0.01 and β = 1.74, p < 0.01) in cross-sectional and prospective analyses, respectively. Later timing of the first eating occasion at baseline was associated with poorer CVH (β = −0.20, p = 0.013) and higher DBP (β = 1.18, p < 0.01) and fasting glucose (β = 1.43, p = 0.045) at 1 y. After adjustment for baseline outcomes, longer NFD and later eating times were also associated with higher waist circumference (β = 0.35, p = 0.021 and β = 0.27, p < 0.01, respectively). Eating frequency was inversely related to DBP in cross-sectional (β = −1.94, p = 0.033) and prospective analyses (β = −3.37, p < 0.01). In cross-sectional analyses of baseline data and prospective analyses, a higher percentage of daily calories consumed at the largest evening meal was associated with higher DBP (β = 1.69, p = 0.046 and β = 2.32, p = 0.029, respectively). Findings suggest that frequent and earlier eating may lower cardiometabolic risk, while longer NFD may have adverse effects. Results warrant confirmation in larger multi-ethnic cohort studies with longer follow-up periods.

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Modeling the cardiometabolic benefits of sleep in older women: exploring the 24-hour day

SLEEP ◽

10.1093/sleep/zsz205 ◽

2019 ◽

Vol 43 (1) ◽

Author(s):

Kelsie M Full ◽

Linda C Gallo ◽

Atul Malhotra ◽

John Bellettiere ◽

Jacqueline Kerr ◽

...

Keyword(s):

Physical Activity ◽

Waist Circumference ◽

Sleep Duration ◽

Cardiometabolic Risk ◽

Vigorous Physical Activity ◽

Cardiometabolic Health ◽

Cross Sectional ◽

Reactive Protein ◽

Intensity Physical Activity ◽

Cardiometabolic Markers

Abstract Study Objectives Activities throughout the day, including sleep, sedentary behavior (SB), light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA) are independently associated with cardiometabolic health. Few studies have examined interrelationships between sleep and 24-hour activity and associations with cardiometabolic risk. The objective of this study is to understand how replacing time in SB, LIPA, or MVPA with sleep impacts cardiometabolic risk. Methods Women’s Health Initiative OPACH Study participants (N = 3329; mean age = 78.5 ± 6) wore ActiGraph GT3X+ accelerometers 24 hours/7 days. Adjusted linear regression estimated the relationship between sleep duration and cardiometabolic markers. Separately for shorter (<8 hours) and longer (≥8 hours) sleepers, isotemporal substitution models estimated the cross-sectional associations with cardiometabolic markers with reallocating time in daytime activities to or from sleep. Results Longer sleep duration was associated with higher insulin, HOMA-IR, glucose, total cholesterol, and triglycerides (all p < 0.05). The associations between sleep duration and C-reactive protein, waist circumference, and body mass index (BMI) were U-shaped (both p < 0.05). For shorter sleepers, reallocating 33 minutes of MVPA to sleep was associated with higher values of insulin, HOMA-IR, glucose, triglycerides, waist circumference, and BMI (0.7%–11.5%). Replacing 91 minutes of SB time with sleep was associated with lower waist circumference and BMI (−1.3%, −1.8%). For long sleepers, shifting 91 minutes of sleep to SB was associated with higher waist circumference and BMI (1.3%, 1.4%). Conclusions This is one of the first isotemporal analyses to include objectively measured sleep duration. Results illuminate possible cardiometabolic risks and benefits of reallocating time to or from sleep.

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Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0399 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Ana P. Sehn ◽

Anelise R. Gaya ◽

Caroline Brand ◽

Arieli F. Dias ◽

Roya Kelishadi ◽

...

Keyword(s):

Body Mass Index ◽

Risk Factor ◽

Sleep Duration ◽

Body Mass ◽

Cardiometabolic Risk ◽

High Systolic Blood Pressure ◽

Television Time ◽

The Relationship ◽

Moderating Role

AbstractObjectivesThe combination of sleep duration, television (TV) time and body mass index (BMI) may be related to the alteration of cardiometabolic risk. However, there are few studies that use these variables grouped, and showing the moderating role of age. This study aimed to verify if the combination of sleep duration, TV time and BMI is associated with cardiometabolic risk and the moderating role of age in this relationship in youth.MethodsCross-sectional study conducted with 1411 adolescents (611 male), aged 10–17 years. Sleep duration, TV time and BMI were assessed and grouped into eight categories. Cardiometabolic risk was assessed by a continuous metabolic risk score, including the following variables: low HDL-cholesterol, elevated triglycerides, dysglycemia, high systolic blood pressure, high waist circumference and low cardiorespiratory fitness. Generalized linear models were used to test moderation of age in the relationship between the eight categories of sleep duration/television time/BMI with cardiometabolic risk.ResultsCardiometabolic risk factor showed association with all overweight or obesity independent of sleep time and TV time. Age moderated the relationship between sleep duration/television time/BMI with cardiometabolic risk. This association was stronger in younger adolescents (11 and 13 years), indicating that individuals with inadequate sleep, prolonged TV time and overweight/obesity present higher cardiometabolic risk values when compared to 15-year-old adolescents.ConclusionOverweight/obesity, independently of sleep duration and TV time, is the main risk factor for cardiometabolic disorders in adolescence. When moderated by age, younger adolescents that presented the combination of risk factors had higher cardiometabolic risk.

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Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain

Cardiovascular Diabetology ◽

10.1186/s12933-020-01195-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Mercedes Sotos-Prieto ◽

Rosario Ortolá ◽

Miguel Ruiz-Canela ◽

Esther Garcia-Esquinas ◽

David Martínez-Gómez ◽

...

Keyword(s):

Metabolic Syndrome ◽

Cardiovascular Mortality ◽

Cardiovascular Health ◽

Total Mortality ◽

Hdl Cholesterol ◽

Cardiometabolic Health ◽

The Metabolic Syndrome ◽

Mediterranean Countries ◽

Low Hdl ◽

The Mediterranean

Abstract Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence). Results Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions The Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.

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Relation between uric acid and metabolic syndrome in subjects with cardiometabolic risk

Einstein (São Paulo) ◽

10.1590/s1679-45082015ao3194 ◽

2015 ◽

Vol 13 (2) ◽

pp. 202-208 ◽

Cited By ~ 14

Author(s):

Hellen Abreu da Silva ◽

Júlia Cristina Cardoso Carraro ◽

Josefina Bressan ◽

Helen Hermana Miranda Hermsdorff

Keyword(s):

Metabolic Syndrome ◽

Uric Acid ◽

Serum Uric Acid ◽

Abdominal Obesity ◽

Health Program ◽

Cardiovascular Health ◽

Cardiometabolic Risk ◽

Cross Sectional Study ◽

Cross Sectional ◽

Potential Biomarker

Objective To identify possible relations between serum uric acid levels and metabolic syndrome and its components in a population with cardiometabolic risk. Methods This cross-sectional study included 80 subjects (46 women), with mean age of 48±16 years, seen at the Cardiovascular Health Program. Results The prevalence of hyperuricemia and metabolic syndrome was 6.3% and 47.1%, respectively. Uric acid level was significantly higher in individuals with metabolic syndrome (5.1±1.6mg/dL), as compared to those with no syndrome or with pre-syndrome (3.9±1.2 and 4.1±1.3mg/dL, respectively; p<0.05). The uric acid levels were significantly higher in men presenting abdominal obesity, and among women with abdominal obesity, lower HDL-c levels and higher blood pressure (p<0.05). Conclusion Uric acid concentrations were positively related to the occurrence of metabolic syndrome and its components, and there were differences between genders. Our results indicate serum uric acid as a potential biomarker for patients with cardiometabolic risk.

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CARDIORESPIRATORY FITNESS AND CARDIOMETABOLIC RISK FACTORS AMONG UNIVERSITY PROFESSORS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220182402171631 ◽

2018 ◽

Vol 24 (2) ◽

pp. 102-106

Author(s):

Jaqueline de Oliveira Santana ◽

Juliana Vaz de Melo Mambrini ◽

Sérgio Viana Peixoto

Keyword(s):

Risk Factors ◽

Cardiorespiratory Fitness ◽

Cardiometabolic Risk ◽

Strong Association ◽

Protein Body ◽

Hdl Cholesterol ◽

Work Capacity ◽

Cardiometabolic Risk Factors ◽

Level Of Evidence ◽

Cross Sectional

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.

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The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study

BMC Endocrine Disorders ◽

10.1186/s12902-021-00863-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rui Huang ◽

Li Yan ◽

Yuhua Lei

Keyword(s):

Glycemic Control ◽

Interaction Analysis ◽

Glycosylated Hemoglobin ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Cerebrovascular Diseases ◽

Diabetic Patients ◽

Cross Sectional ◽

Race Ethnicity ◽

The Relationship

Abstract Aim The incidence rate of diabetes is increasing year by year, seriously threatening human health. As a predictor of glycemic control, glycated hemoglobin is reported to be related to various complications and prognoses of diabetes. Besides, HDL-C dyslipidemia is a component of metabolic syndrome and may be related to various cardiovascular and cerebrovascular diseases. The principal objective of this project was to investigate the relationship between HDL-C and glycosylated hemoglobin in adult diabetic patients. Methods A total of 3171 adult diabetic patients aged 20 years and above were included in the present study from the National Health and Nutrition Examination Survey (NHANES). HDL-C and glycosylated hemoglobin were regarded as independent and dependent variables, respectively. EmpowerStats software and R (version 3.4.3) were used to examine the association between HDL-C and glycosylated hemoglobin. Results HDL-C was inversely associated with glycohemoglobin after adjusting for other covariates (β = − 0.004, 95% CI:− 0.008 to − 0.000, p = 0.044). Race/ethnicity and age were considered the most prominent interactive factors that affect the relationship between HDL and glycosylated hemoglobin by the interaction analysis. A U-shaped association was detected between HDL-C and glycosylated hemoglobin for people of other race/ethnicity or aged 60 and above, which had an inflection point of HDL-C at 60 mg/dL. In contrast, we observed an inverted U-shaped distribution between HDL-C and glycosylated hemoglobin in people under 40 with point of inflection located at 60 mg/dL as well. Conclusions HDL-C in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control. However, a U-shaped relationship was also observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better.

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