Abstract P020: Triglyceride-lowering Lipoprotein Lipase Gene Variants And Improvements In Lipids And Lipoprotein Subspecies Defined By Apolipoprotein C-iii: Pounds Lost Trial

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yoriko Heianza ◽  
Tao Zhou ◽  
Hua He ◽  
George Bray ◽  
Frank M Sacks ◽  
...  

Introduction: Triglyceride-lowering variants in the lipoprotein lipase ( LPL ) gene have been associated with a lower risk of coronary heart disease. Lipoproteins are heterogeneous, and lipoprotein subspecies containing apolipoprotein C-III (ApoCIII) have adverse effects on cardiovascular disease (CVD) risk. Hypothesis: We examined associations of triglyceride-lowering LPL gene variants with long-term improvement in lipids and lipoprotein subspecies with ApoCIII in patients with obesity. We also investigated whether the LPL gene variants were significantly related to the improvement of the 10-year CVD risk estimated using the Framingham risk score in the participants of a weight-loss dietary intervention trial. Methods: This study included 382 overweight and obese adults of white European ancestry in a 2-year weight-loss dietary intervention, the POUNDS Lost trial. We evaluated changes in lipids (triglycerides and cholesterol) and lipoproteins (such as very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL)) subfractions defined by the presence or absence of ApoCIII from baseline to 2 years after the intervention. A genetic risk score of LPL (LPL-GRS) was calculated by summing triglyceride-lowering alleles of five independent single nucleotide polymorphisms (SNPs). We calculated the Framingham risk score and estimated changes in the 10-year CVD risk after the intervention. Results: At baseline, higher scores of triglyceride-lowering LPL-GRS were significantly associated with higher levels of HDL cholesterol (p= 0.0065) and lower levels of triglycerides (p= 0.017). Higher LPL-GRS was also associated with more decreases in total triglycerides (p= 0.028) and triglycerides in VLDL with ApoCIII (p=0.018) at 2 years. The LPL-GRS was also predictive of 2-year improvements in other atherogenic lipoprotein subtypes, such as cholesterol in VLDL with ApoCIII (p= 0.037) and cholesterol in LDL with ApoCIII (p= 0.027) after the intervention. Further, the LPL-GRS was significantly associated with a 2-year reduction of the estimated CVD risk, regardless of the initial risk status (p=0.034). Conclusion: The triglyceride-lowering LPL-GRS was significantly predictive of improvements in unfavorable lipid profiles, including lipoprotein subtypes containing ApoCIII after consuming a weight-loss diet in patients with obesity. The reduction of the estimated CVD risk after the dietary intervention was predicted by the LPL-GRS at the pre-intervention.

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.K.H Ho ◽  
C.J O'Boyle ◽  
H Shabana ◽  
K.J Lee

Abstract Introduction Although morbid obesity is strongly associated with cardiovascular disease (CVD) risk, relatively little research has been performed to evaluate the long-term effect of bariatric surgery (BS) on CVD risk reduction. Purpose To evaluate the 2-year effects of laparoscopic gastric bypass (LGBYP) & laparoscopic sleeve gastrectomy (LSG) on blood pressure, lipid profile, diabetic profile and Framingham risk score (FRS). Methods It was a retrospective review of patients undergoing BS between January 2009–2017. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid & diabetic profile were recorded preoperatively & 2-year postoperatively. Results Of 416 patients, 77% (320) were females, 88% (365) were non-smokers & mean (sd) age was 48 (11) years. 69% (286) underwent LGBYP. 27% (114) were diabetic, 78% (324) were hyperlipidaemic and 65% (269) were hypertensive. The mean SBP & DBP decreased progressively while mean high-density-lipoprotein (HDL) & total-cholesterol (TC) increased progressively (table 1). LGBYP has a greater reduction in DBP than LSG (p<0.001, t-test). 10-year CVD risk reduced by 37% at 2-year, with a greater effect in LGBYP than LSG (40% vs 28%, p<0.001, t-test). Conclusion The 10-year risk of CVD reduced by 37% 2-years after bariatric surgery, with a greater risk reduction in LGBYP compared to LSG. Funding Acknowledgement Type of funding source: None


Author(s):  
Marzieh Saei Ghare Naz ◽  
Ali Sheidaei ◽  
Ali Aflatounian ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani

Background Limited and conflicting evidence is available regarding the predictive value of adding adverse pregnancy outcomes (APOs) to established cardiovascular disease (CVD) risk factors. Hence, the objective of this study was to determine whether adding APOs to the Framingham risk score improves the prediction of CVD events in women. Methods and Results Out of 5413 women who participated in the Tehran Lipid and Glucose Study, 4013 women met the eligibility criteria included for the present study. The exposure and the outcome variables were collected based on the standard protocol. Cox proportional hazard model was used to evaluate the association of APOs and CVDs. The variant of C‐statistic for survivals and reclassification of subjects into Framingham risk score categories after adding APOs was reported. Out of the 4013 eligible subjects, a total of 1484 (36.98%) women reported 1 APO, while 395 (9.84%) of the cases reported multiple APOs. Univariate proportional hazard Cox models showed the significant relations between CVD events and APOs. The enhanced model had a higher C‐statistic indicating more acceptable discrimination as well as a slight improvement in discrimination (C‐statistic differences: 0.0053). Moreover, we observed a greater risk of experiencing a CVD event in women with a history of multiple APOs compared with cases with only 1 APO (1 APO: hazard ratio [HR] = 1.22; 2 APOs: HR; 1.94; ≥3 APOs: HR = 2.48). Conclusions Beyond the established risk factors, re‐estimated CVDs risk by adding APOs to the Framingham risk score may improve the accurate risk estimation of CVD. Further observational studies are needed to confirm our findings.


2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
I Madujibeya ◽  
L Misook ◽  
T Lennie ◽  
G Mudd-Martin ◽  
M Biddle ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Sedentary lifestyle is one of the modifiable risk factors that account for the high prevalence of cardiovascular diseases (CVD) in the rural areas.1,2 Daily step counting, using wearable devices, is increasingly used to monitor physical activity levels in interventions targeting CVD risk reduction in the rural areas.3,4 However, there is a lack of evidence to support a daily step count threshold that may reduce CVD risk among rural residents. The purpose of this study was to examine the relationship between daily step count cut-points and CVD risk. Methods This secondary analysis included 312 adults living in the rural areas in the southern United States. Daily step counts from pedometers were collected for 14 consecutive days. Established cut-points were used to categorize participants into groups based on mean daily step count as sedentary (≤ 5000 steps/day), less active (5000 -7499 steps/per), and physically active (≥7500 steps/day).5-7 CVD risk was measured with the Framingham risk score. Generalized additive models were used to examine differences among the 3 activity groups in Framingham risk score, controlling for educational level, perceived physical health status, depressive, marital status, and years of residence in a rural county. Results Among the participants (75% female, mean age 50.1 (±13.6) years), 40.7% were sedentary, 35.2% were less active, and 24.0% were physically active. The average Framingham risk score was 11.2% (±9.4%). Framingham risk scores were 1.7% lower in the less active compared to the sedentary group, but the effect was not significant (p <  .11), and 2.6% lower in the physically active compared to the sedentary group (p < .04). The model accounted for 22% of the variation in Framingham risk scores. Conclusion These findings indicate that rural residents who averaged 7500 steps or more per day had lower CVD risk, and the difference is clinically significant.


2021 ◽  
Vol 9 ◽  
Author(s):  
Nayla Cristina do Vale Moreira ◽  
Ibrahimu Mdala ◽  
Akhtar Hussain ◽  
Bishwajit Bhowmik ◽  
Tasnima Siddiquee ◽  
...  

Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population.Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs.Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined.Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age <45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index.Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.


Author(s):  
Martiningsih Martiningsih ◽  
Abdul Haris

Penyakit kardiovaskular (PKV) adalah penyakit yang disebabkan oleh gangguan fungsi jantung dan pembuluh darah. PKV dapat dicegah terutama pada kelompok berisiko, diantaranya dengan penilaian risiko menggunakan Framingham Risk Score (FRS). Tujuan penelitian ini adalah untuk menganalisis risiko PKV dan korelasinya dengan Ankle Brachial Index (ABI) dan obesitas pada peserta Prolanis di Kota Bima. Pengambilan data menggunakan instrumen Framingham Risk Score, pengukuran tekanan darah, indeks massa tubuh, lingkar lengan, dan lingkar perut. Jenis penelitian ini adalah penelitian deskriptif analitik dengan rancangan cross-sectional. Pemilihan sampel ditentukan secara consecutive sampling pada semua responden yang aktif mengikuti kegiatan Prolanis dan memenuhi kriteria inklusi di lima Puskesmas di Kota Bima tahun 2018. Analisis data dengan uji parametrik Spearman. Hasil penelitian menunjukkan kelompok risiko tinggi 33 orang (40,7%), risiko sedang 28 orang (34,6%), dan risiko rendah 20 orang (24,7%). Tidak terdapat korelasi antara risiko PKV dengan ABI dan obesitas. Temuan lain dalam penelitian ini mengindikasikan adanya korelasi antara risiko PKV dengan subvariabel obesitas sentral walaupun tidak ditemukan adanya signifikansi (p> 0,05). Pada penelitian selanjutnya, disarankan jumlah sampel yang lebih banyak di komunitas dengan proporsi laki-laki dan perempuan yang berimbang. Kata Kunci: ABI, Framingham, kardiovaskuler, obesitas Abstract Risk of Cardiovascular Disease at Chronic Disease Management Program Participants in The Community Health Centers of Bima Town: The Correlation with Ankle Brachial Index and Obesity. Cardiovascular disease (CVD) is a disease caused by impaired heart and blood vessel function, which can be prevented, especially in risk groups that can be risk assessed using the Framingham Risk Score (FRS). The purpose of this study was to analyze the risk of CVD and the correlation with ABI and obesity in Prolanis participants at Bima City. Data collection was done by using the instrument FRS and measuring systolic blood pressure, body mass index, arm circumference, and waist circumference. This study was a descriptive-analytic study with a cross-sectional design. The sample selection was determined by consecutive sampling for all respondents who actively participated in Prolanis activities and fulfilled the inclusion criteria in five community health center at Bima City in 2018. Data analyzed with Spearmen parametric test. The results of research showed high risk group was 33 peoples (40.7%), moderate risk was 28 peoples (34.6%), and low risk was 20 peoples (24.7%). There was no correlation between risk of CVD  with ABI and obesity. Other findings in this study indicate a correlation between CVD risk and subvariable central obesity, although no significance was found (p> 0.05). In further research, it is recommended that a larger number of samples in the general community with a balanced proportion of men and women. Keywords:  ABI, cardiovaskuler, Framingham, obesity


2020 ◽  
Vol 148 (7-8) ◽  
pp. 423-429
Author(s):  
Aleksandra Klisic ◽  
Nebojsa Kavaric ◽  
Ana Ninic

Introduction/Objective. Given the contradictory results regarding the association of liver function biomarkers [e.g., alanine-aminotransferase (ALT), gamma-glutamyl transferase (GGT) and total bilirubin)] and the risk of cardiovascular disease (CVD), we aimed to explore the relationship between these biomarkers and Framingham risk score (FRS), an established tool used in the prediction of 10-year CVD risk in the cohort of women. Methods. A total of 278 women participated in this cross-sectional study. Anthropometric, biochemical parameters, and blood pressure were obtained. Results. There was a significant increase in ALT and GGT activity, as well as a decrease in total bilirubin level in the high-risk FRS group compared to moderate-, and low-risk FRS (p for trend = 0.025, p < 0.001, p < 0.001, respectively). Multivariate logistic regression analysis showed that body mass index, triglycerides, creatinine, and high sensitivity C-reactive protein levels were the independent predictors of FRS in women [odds ratio (OR) = 1.234, p = 0.001; OR = 2.856, p = 0.001; OR = 1.090, p = 0.002, and OR = 1.295, p = 0.045, respectively]. In contrast, total bilirubin, ALT and GGT lost their independent predictions for high CVD risk. Conclusion. Liver function biomarkers (i.e. ALT, GGT, and total bilirubin) are not independently associated with FRS. It seems that some other cardiometabolic disturbances might modulate this relationship.


2021 ◽  
Vol 4 (1) ◽  
pp. 71-83
Author(s):  
GA Amusa ◽  
G Osaigbovo ◽  
L Imoh ◽  
B Awokola

HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We sought to evaluate the prevalence of CVD risk factors in HIV positive (HIV+) adults and assessment of these risks using the Framingham risk score (FRS). A cross-sectional study of adult clients of the HIV clinic at Jos University Teaching Hospital. One hundred and fifty HIV+ selected randomly with 50 (age and sex matched) HIV negative (HIV-) participants were enrolled. Relevant history, physical examination and biochemical investigations and 12-lead electrocardiography were performed. Data was analyzed using Epi-info 7.2 statistical software and P value < 0.05 was considered significant. The prevalent major CVD risk factors were dyslipidaemia (30.0% versus 6.0%), hypertension (34.0% versus 10.0%) and diabetes mellitus (10.0% versus 2.0%) among the HIV+ and HIV- participants respectively. The FRS of the HIV+, 3 (IQR 3-28) were statistically significantly higher than that of the HIV- participants, 2 (IQR 1-13); P=0.001. Furthermore, 32% of the HIV+ had moderate-high FRS compared to 2% of HIV- participants. CD4 count ≤ 200 cells/ml, use of anti-retroviral (ART), ART use ≥ 2 years and use of protease inhibitors (PI) emerged as predictors of moderate-high FRS among the HIV+ participants. In conclusion, a high prevalence of CVD risk factors exists among HIV+ population in our local environment. These risk factors can be identified early by baseline/periodic cardiovascular work-up which should include use of CVD risk tools. Early diagnosis and treatment will significantly reduce morbidity and mortality in these patients.


2021 ◽  
Vol 8 (1) ◽  
pp. e000448
Author(s):  
Jagan Sivakumaran ◽  
Paula Harvey ◽  
Ahmed Omar ◽  
Oshrat Tayer-Shifman ◽  
Murray B Urowitz ◽  
...  

BackgroundSLE is an independent risk factor for cardiovascular disease (CVD). This study aimed to determine which among QRISK2, QRISK3, Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS) and SLE Cardiovascular Risk Equation (SLECRE) best predicts CVD.MethodsThis is a single-centre analysis on 1887 patients with SLE followed prospectively according to a standard protocol. Tools’ scores were evaluated against CVD development at/within 10 years for patients with CVD and without CVD. For patients with CVD, the index date for risk score calculation was chosen as close to 10 years prior to CVD event. For patients without CVD, risk scores were calculated as close to 10 years prior to the most recent clinic appointment. Proportions of low-risk (<10%), intermediate-risk (10%–20%) and high-risk (>20%) patients for developing CVD according to each tool were determined, allowing sensitivity, specificity, positive/negative predictive value and concordance (c) statistics analysis.ResultsAmong 1887 patients, 232 CVD events occurred. QRISK2 and FRS, and QRISK3 and mFRS, performed similarly. SLECRE classified the highest number of patients as intermediate and high risk. Sensitivities and specificities were 19% and 93% for QRISK2, 22% and 93% for FRS, 46% and 83% for mFRS, 47% and 78% for QRISK3, and 61% and 64% for SLECRE. Tools were similar in negative predictive value, ranging from 89% (QRISK2) to 92% (SLECRE). FRS and mFRS had the greatest c-statistics (0.73), while QRISK3 and SLECRE had the lowest (0. 67).ConclusionmFRS was superior to FRS and was not outperformed by the QRISK tools. SLECRE had the highest sensitivity but the lowest specificity. mFRS is an SLE-adjusted practical tool with a simple, intuitive scoring system reasonably appropriate for ambulatory settings, with more research needed to develop more accurate CVD risk prediction tools in this population.


2021 ◽  
Author(s):  
MJ Iglesias ◽  
LD Kruse ◽  
L Sanchez-Rivera ◽  
L Enge ◽  
P Dusart ◽  
...  

ABSTRACTEndothelial cell (EC) dysfunction is a well-established response to cardiovascular disease (CVD) risk factors, such as smoking and obesity. Risk factor exposure can modify EC signalling and behaviour, leading to arterial and venous disease development. Biomarker panels to assess EC dysfunction are lacking, but could be useful for risk stratification and to monitor treatment response. Here, we used affinity proteomics to identify EC-derived proteins circulating in plasma that were associated with CVD risk factor exposure. 216 proteins, known to be expressed in ECs across vascular beds, were measured in plasma samples (n=1005) from the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot. We identified 38 EC-derived proteins that were associated with body mass index, total cholesterol, low density lipoprotein, smoking, hypertension or diabetes. Sex-specific analysis revealed female- and male-only associations were most frequently observed with BMI, or total cholesterol, respectively. We showed a relationship between individual CVD risk, calculated with the Framingham risk score, and the corresponding biomarker profiles; presenting the concept of measuring EC-derived proteins in plasma to infer vascular status.


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