Abstract P106: Stable versus Changing BMI Trajectories in Relation to Cardiometabolic Risk Factor Trajectories in Adolescent Girls: The NHLBI Growth and Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jessica G Woo ◽  
Stephen R Daniels ◽  
Elaine M Urbina
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Adolescent Girls ◽  
Cardiometabolic Risk ◽  
Saturated Fat ◽  
Health Study ◽  
Late Adolescent ◽  
Adherence To Diet ◽  
Bmi Trajectories ◽  
Bmi Trajectory

Introduction: Adolescence is a period of increased independence in lifestyle choices, as well as shifts in cardiometabolic risk factors. Understanding how stability or change in BMI status may be superimposed on risk factor changes will enable focused attention on girls whose risk factors are likely to deteriorate during adolescence. Methods: Girls were enrolled at age 10 into the NHLBI Growth and Health Study (NGHS) at 3 centers (n=2379) and assessed annually to age 19. Ideal cardiovascular risk factors (smoking, dietary sodium, dietary saturated fat, BMI, blood pressure (BP), total cholesterol (TC) and glucose), and related risk factors (HDL and LDL cholesterol, and triglycerides (TG)) were assessed. Trajectories of adherence to ideal risk factor definitions were evaluated using group-based modeling, with risk factor trajectories layered over BMI trajectories in change-over-change analysis. Results: Four trajectories of BMI across adolescence were: ideal (51%), deteriorating (14%), improving (11%) and poor (25%). Two to 4 trajectories were identified for other risk factors, with similar trajectory shapes (e.g., ideal, improving, deteriorating and poor). Ideal smoking prevalence only deteriorated, with trajectories differing by timing of smoking uptake (early, middle or late adolescence). Most adolescent girls had poor adherence to diet metrics throughout adolescence, with diet intake trajectories improving somewhat at different ages (early or later adolescence) in a small percent of participants. Stable poor or ideal BMI trajectories were associated primarily with stable risk factor trajectories (poor or ideal, respectively), for LDL, HDL, TG, BP (all p=0.0001). The poor BMI trajectory was also associated with late adolescent deteriorating glucose (p=0.0001) and TC trajectories (p=0.02). Changing BMI trajectories, either improving or deteriorating, can unmask the sensitivity of risk factors to change in BMI status. The improving BMI trajectory was more likely to be in the later-improving saturated fat (p=0.003), improving HDL (p=0.0002) and moderate-improving TG trajectories (p=0.01) and less likely to be in the low-deteriorating BP trajectory (p=0.04) compared to the deteriorating BMI trajectory. Smoking trajectories did not differ by BMI trajectory. Conclusions: Stable poor BMI is associated with poor, but not with deteriorating cardiometabolic risk profiles during adolescence, suggesting these changes must have occurred before age 10. Decreasing ideal TC and glucose appear to be late adolescent responses to persistently poor BMI. However, improving BMI status during adolescence is associated with improving dietary saturated fat intake and blood lipid profiles, while deteriorating BMI is associated with deteriorating BP and lipids. Thus, specific ideal health factors may be differentially sensitive to BMI changes in adolescent girls.

Abstract 26: DASH-Style Eating Pattern in Early Adolescence Reduces Cardiometabolic Risk Clustering

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Lynn L Moore ◽  
M. Loring Bradlee ◽  
Martha R Singer ◽  
Stephen R Daniels
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiometabolic Risk ◽  
Black Girls ◽  
Health Study ◽  
Eating Pattern ◽  
Cardiometabolic Disorders ◽  
The Impact

Cardiometabolic risk (CMR) factor clustering has its roots in childhood and the presence of multiple cardiovascular risk factors in younger populations has been linked with early vascular dysfunction. A DASH-style eating pattern has been shown to reduce blood pressure and other selected cardiometabolic outcomes, primarily in adults, but its role in the development of CMR clustering during adolescence has not been studied. Data from the National Heart, Lung, and Blood Institute’s Growth and Health Study (NGHS) will be used to evaluate the relation between early-to-mid adolescent dietary intake and CMR clustering at the end of adolescence. The NGHS began in 1987-1988 with the enrollment of 2,379 adolescent girls (with approximately equal numbers of blacks and whites), ages 9-10 years. Diet was assessed using 3-day diet records during eight of 10 years of follow up. A total of 1,369 girls had complete data on diet, all potential confounding variables, and follow-up over 10 years for all CMR factors of interest. Risk factor clustering scores were created by summing individual CMR outcomes defined as follows: waist circumference ≥88 cm, systolic and/or diastolic blood pressure ≥90th percentile for age, sex and height, LDL ≥110 mg/dL, HDL <50 mg/dL, serum TG ≥110mg/dl, and HOMA-IR ≥4. Multiple logistic regression analyses were used to estimate the impact of a DASH-style pattern on the relative risk (odds ratio) of CMR clustering at the end of adolescence, defined as having ≥ 2 or ≥ 3 of the above risk factors at 18-20 years of age. The proportion of white and black girls with CMR clustering was very similar. However, the types of risk factors differed by race with blacks being nearly twice as likely to have an increased waist size, elevated BP, or insulin resistance and white girls being much more likely to have abnormal lipid levels, particularly elevated triglyceride levels. By the end of adolescence, only 30.1% of girls had no abnormal CMR factors and 34.9% had a single risk factor; 16.6% of girls had two risk factors and 18.4% had between 3-6 prevalent risk factors. Higher intakes of fruit and non-starchy vegetables, dairy, and grains were independently associated with less CMR clustering. After adjusting for age, race, socio-economic status, height, physical activity, and television watching, girls with a DASH-style eating pattern during early-to-mid adolescence were nearly 50% less likely to have three or more CMR factors (O.R.=0.52; 95% CI: 0.30, 0.89) by late adolescence (at 18-20 years of age). These results suggest a DASH-style eating pattern during adolescence, characterized by higher intakes of fruit, non-starchy vegetables, and dairy, may lower risk for the development of subsequent cardiometabolic disorders.

scholarly journals The impact of obesity on cardiovascular disease risk factor

2018 ◽  
Vol 10 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Arun Kumar
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Sodium Intake ◽  
Action Plan ◽  
Saturated Fat ◽  
The World

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

scholarly journals Cardiometabolic Risk Factors in Patients with Erectile Dysfunction

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Serhat Tanik ◽  
Savas Sarikaya ◽  
Kürşad Zengin ◽  
Sebahattin Albayrak ◽  
Yunus Keser Yilmaz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Erectile Dysfunction ◽  
Cardiometabolic Risk ◽  
Epicardial Adipose Tissue ◽  
Cardiometabolic Risk Factors ◽  
Cardiometabolic Risk Factor ◽  
Healthy Individuals ◽  
Fat Thickness ◽  
Artery Disease

Introduction. There is an increasing interest in the association between erectile dysfunction (ED) and cardiovascular risk factor. Epicardial adipose tissue (EAT) is associated with insulin resistance, increased cardiometabolic risk, and coronary artery disease. Our aim was to investigate relationships between epicardial fat thickness (EFT) as a cardiometabolic risk factor and erectile dysfunction.Method. We selected 30 erectile dysfunction patients without comorbidities and 30 healthy individuals. IIEF-5 score was applied to all patients, and IIEF-5 score below 22 was considered as erectile dysfunction. EFT was measured by echocardiography.Results. Body mass index (BMI) was higher in ED patients than those without ED (28.19 ± 4.45 kg/m2versus23.84±2.36 kg/m2,P = 0.001, resp.). Waist circumstance (WC) was higher in ED patients than those without ED (106.60±5.90versus87.86 ± 14.51,P = 0.001, resp.). EFT was higher in ED patients compared to non-ED patients (0.49 ± 0.09 cm versus0.45 ± 0.03 cm,P = 0.016, resp.). There was positive correlation among BMI, WC, and EFT. There was negative correlation between EFT and IIEF-5 score (r : -0.632,P = 0.001).Conclusion. EAT, BMI, and WC as cardiometabolic risk factors were higher in erectile dysfunction patients.

scholarly journals Changing Epidemiology of Acute Respiratory Infections in Under-Two Children in Dhaka, Bangladesh

2022 ◽  
Vol 9 ◽  
Author(s):  
Karine Vidal ◽  
Shamima Sultana ◽  
Alberto Prieto Patron ◽  
Irene Salvi ◽  
Maya Shevlyakova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Low Income ◽  
Respiratory Infections ◽  
Monsoon Season ◽  
Low Income Countries ◽  
Health Study ◽  
Acute Respiratory Infections ◽  
Respiratory Pathogens ◽  
Prevention Measures

Objectives: Risk factors for acute respiratory infections (ARIs) in community settings are not fully understood, especially in low-income countries. We examined the incidence and risk factors associated with ARIs in under-two children from the Microbiota and Health study.Methods: Children from a peri-urban area of Dhaka (Bangladesh) were followed from birth to 2 years of age by both active surveillance of ARIs and regular scheduled visits. Nasopharyngeal samples were collected during scheduled visits for detection of bacterial facultative respiratory pathogens. Information on socioeconomic, environmental, and household conditions, and mother and child characteristics were collected. A hierarchical modeling approach was used to identify proximate determinants of ARIs.Results: Of 267 infants, 87.3% experienced at least one ARI episode during the first 2 years of life. The peak incidence of ARIs was 330 infections per 100 infant-years and occurred between 2 and 4 months of age. Season was the main risk factor (rainy monsoon season, incidence rate ratio [IRR] 2.43 [1.92–3.07]; cool dry winter, IRR 2.10 [1.65–2.67] compared with hot dry summer) in the first 2 years of life. In addition, during the first 6 months of life, young maternal age (&lt;22 years; IRR 1.34 [1.01–1.77]) and low birth weight (&lt;2,500 g; IRR 1.39 [1.03–1.89]) were associated with higher ARI incidence.Conclusions: Reminiscent of industrialized settings, cool rainy season rather than socioeconomic and hygiene conditions was a major risk factor for ARIs in peri-urban Bangladesh. Understanding the causal links between seasonally variable factors such as temperature, humidity, crowding, diet, and ARIs will inform prevention measures.

scholarly journals Optimal waist:height ratio cut-off point for cardiometabolic risk factors in Turkish adults

2009 ◽  
Vol 13 (4) ◽  
pp. 488-495 ◽  
Author(s):  
Ahmet Selçuk Can ◽  
Emine Akal Yıldız ◽  
Gülhan Samur ◽  
Neslişah Rakıcıoğlu ◽  
Gülden Pekcan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Cardiometabolic Risk ◽  
Roc Curves ◽  
Cross Sectional Study ◽  
Cardiometabolic Risk Factors ◽  
Youden Index ◽  
Cross Sectional ◽  
Men And Women

AbstractObjectiveTo identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.DesignCross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).SettingTurkey, 2003.SubjectsAdults (1121 women and 571 men) aged 18 years and over were examined.ResultsAnalysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.ConclusionsWe show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.

Abstract MP08: Higher Diet Quality is Associated with Lower Odds of Inflammation and Peripheral Artery Disease in the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Josiemer Mattei ◽  
Daniela Sotres-Alvarez ◽  
Marc Gellman ◽  
Sheila F Castaneda ◽  
Frank B Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Arterial Stiffness ◽  
Diet Quality ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Health Study ◽  
Lower Odds ◽  
Artery Disease ◽  
Cardiometabolic Markers

Introduction: C-reactive protein (CRP; a marker of inflammation) and the ankle-brachial index (ABI; a marker of peripheral artery disease (PAD)) are considered emerging risk factors for cardiovascular disease (CVD) in addition to traditional cardiometabolic markers. Results on the association of a healthy diet and these emerging risk factors have been inconsistent, and few studies have been conducted on Hispanics/Latinos, who present high prevalence of cardiometabolic risk factors. Hypothesis: We hypothesized that higher diet quality as measured with the Alternate Healthy Eating Index (AHEI; range 0-110: lowest to highest quality) would be associated with lower odds of having high-risk levels of CRP and of ABI, independently from cardiometabolic risk factors. Methods: Baseline data were analyzed from US-Hispanics/Latinos aged 18-74y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. There were 14,623 participants with complete CRP data, and 7,892 with ABI data (measured only for those aged ≥45y). Food and nutrients components of AHEI were assessed from two 24-hour recalls. High-risk CRP was defined as >3.0 mg/L, and high-risk ABI was defined as <0.90 or >1.40, with further categorization into PAD (<0.90) and arterial stiffness (>1.40). Results: Nearly 35% of Hispanics/Latinos had high-risk CRP levels and 6.3% had high-risk ABI (4.2% had PAD and 2.1% had arterial stiffness). After adjusting for demographic, socioeconomic, and lifestyle factors, as well as cardiometabolic risk factors (diabetes, hypertension, obesity, or dyslipidemia), the odds (95% confidence interval) of having high-risk ABI were 36% (5, 43%) lower for each 10-unit increase in AHEI (p=0.020). The association remained significant for PAD alone, albeit attenuated (p=0.046), but not for arterial stiffness (p=0.210). Each 10-unit increase in AHEI was associated with 21% (10, 31%) lower odds of high-risk CRP(p=0.0003) after similar adjustments. There were no significant interactions between AHEI and sex, background, smoking, or cardiometabolic risk factors for the associations with ABI. The association of AHEI with high-risk CRP was stronger for those with diabetes (0.68 (0.52, 0.89) vs. 0.82 (0.71, 0.94) without diabetes; p-interaction=0.0002) and with obesity (0.70 (0.58, 0.85) vs. 0.86 (0.73, 1.01) without obesity; p-interaction=0.0001). Conclusions: A higher diet quality is associated with lower inflammation and PAD among Hispanics/Latinos, independently from traditional cardiometabolic risk factors. Promoting a healthy overall diet may benefit with further lowering CVD-risk related to emerging factors in a population that already presents high prevalence of cardiometabolic markers.

Abstract P152: Cardiometabolic Risk Factors in Adolescent Blood Donors

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
James Keeton ◽  
Stephen J Eason ◽  
Merlyn Sayers ◽  
Colby Ayers ◽  
Maria O Gore
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Total Cholesterol ◽  
Blood Donors ◽  
Cardiometabolic Risk ◽  
Blood Donation ◽  
Cardiometabolic Risk Factors ◽  
Cardiometabolic Risk Factor ◽  
Targeted Interventions ◽  
Increased Risk

Objective: Cardiometabolic risk factors have been extensively studied in adults, but to a lesser extent in adolescents. We assessed potential cardiometabolic risk factors in a large cohort of adolescent blood donors. Methods: Glycated hemoglobin (HbA 1c ), blood pressure (BP), and total cholesterol were measured in 10,756 blood donors aged 16-19 years at school blood drives conducted by Carter BloodCare, a large North Texas blood center. Borderline values were defined as HbA 1c 5.7-6.4%, BP (systolic/diastolic) 120-139/80-89 mm Hg, and total cholesterol 170-199 mg/dL. Elevated values were defined as HbA 1c ≥6.5%, BP ≥140/90, and total cholesterol ≥200 mg/dL. Subjects were classified into one of three subcohorts: (A) no borderline or elevated values (“healthy” subcohort); (B) one borderline value; (C) either two borderline values or one elevated value. The subcohorts were further stratified as shown in the Table. Results: Of the 10,756 blood donors, 35.2% had one borderline cardiometabolic risk factor, and 17.9% had either two borderline or one elevated risk factor. There were more girls than boys in the “healthy” subcohort (p<0.0001). Girls had a higher prevalence of borderline or elevated total cholesterol (p<0.0001), whereas boys had higher prevalence of borderline or elevated BP (p<0.0001). Other differences between subcohorts are summarized in the Table. Conclusion: More than half of adolescents in this study had at least one cardiometabolic risk factor that was either borderline or elevated. Blood donation programs can serve as highly efficient and cost-effective gateways for cardiometabolic risk screening in adolescents, with potential for the development of targeted interventions aimed at promoting healthy behaviors early in life, specifically among those at increased risk.

Abstract 52: Plasma Metabolomic Signatures of the American Heart Association Diet Score: Findings From the Boston Puerto Rican Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Danielle E Haslam ◽  
Jun Li ◽  
Liming Liang ◽  
Clary Clish ◽  
Alice H Lichtenstein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Puerto Rican ◽  
American Heart Association ◽  
Cardiometabolic Risk ◽  
American Heart ◽  
Metabolic Response ◽  
Heart Association ◽  
Dietary Guidelines ◽  
Health Study ◽  
Diet Score

Introduction: Puerto Rican adults living on the US mainland tend to have poor quality diets and adverse cardiometabolic risk. Plasma metabolomic signatures reflect dietary intakes and variability in metabolic response to diet. Hypothesis: A plasma metabolomic signature reflecting adherence to the American Heart Association (AHA) dietary guidelines will be associated with cardiometabolic risk. Methods: We used LC/MS to measure plasma metabolites (>700) among Boston Puerto Rican Health Study participants, aged 45-75 years, without (n=252) and with (n=254) type 2 diabetes (T2D). We calculated a modified version of a previously validated AHA diet score (AHA-DS), which included variety and amounts of fruits/vegetables, whole grains, fish, saturated fat, trans fat, sodium, and added sugars. We used elastic net regression to identify a metabolomic signature that associated with higher adherence to the AHA-DS among those without T2D (training set) and replicated the associations among those with T2D (testing set). A metabolomic score was calculated as the weighted sum of the diet associated metabolites. We used general linear models to determine the cross-sectional associations between the AHA-DS, metabolomic score, and cardiometabolic risk factors. Results: A diet-associated metabolomic signature with 58 metabolites, primarily lipids and amino acids, was identified. This metabolomic score correlated moderately with the AHA-DS among those with and without T2D (r=0.42-0.46, P <5.7x10 -12 ). In all participants (n=506), the metabolomic score, but not the AHA-DS, was significantly associated with higher HDL-C and LDL-C concentrations, and lower waist circumference ( P <0.004; Table 1). No associations were observed for triglyceride concentrations, glycemia measures, or blood pressure. Conclusions: In individuals of Puerto Rican descent, we identified a metabolomic signature that reflected adherence and metabolic response to the AHA dietary guidelines and that associated with cardiometabolic risk factors.

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