Obesity and metabolic health status are determinants for the clinical expression of hypertrophic cardiomyopathy

2019 ◽  
Vol 27 (17) ◽  
pp. 1849-1857
Author(s):  
Jun-Bean Park ◽  
Da Hye Kim ◽  
Heesun Lee ◽  
In-Chang Hwang ◽  
Yeonyee E Yoon ◽  
...  
Keyword(s):  
Health Status ◽  
Hypertrophic Cardiomyopathy ◽  
Population Based ◽  
Metabolic Health ◽  
Metabolic Abnormalities ◽  
Clinical Expression ◽  
Obesity Status ◽  
Korean National Health Insurance ◽  
Study Participants

Aims We sought to investigate the association of obesity and metabolic health status with the incidence of clinical hypertrophic cardiomyopathy (HCM) diagnosis in the general population. Our goal was to identify modifiable risk factors to attenuate clinical expression of HCM, enabling management evolution from a mostly passive strategy of risk stratification to a proactive strategy of modifying disease expression. Methods Using nationwide population-based data from the Korean National Health Insurance Service, 28,679,891 people who were free of prevalent HCM and who underwent health examinations between 2009 and 2015 were followed until 31 December 2016. The primary outcome was clinical HCM that was defined as incident diagnosis of HCM during the follow-up, after a blanking period of 12 months. Results Over a median follow-up of 5.2 years, 0.027% ( n = 7851) of the study participants were diagnosed as incident HCM. The incidence rate per 1000 person-years was 0.059. A significant association was found between body mass index (BMI) and the incidence of clinical HCM after multivariate adjustment, with a hazard ratio per 1 kg/m2 increase in BMI of 1.063 (95% confidence interval 1.051–1.075). Metabolically unhealthy participants had a greater incidence of HCM than metabolically healthy participants, regardless of obesity status. The effect of BMI was more pronounced in several subgroups, including participants with no hypertension, those aged less than 65 years and men. Conclusion We found that individuals with obesity and/or metabolic abnormalities had a significantly higher incidence of clinical HCM diagnosis than their counterparts. Efforts to manage obesity and metabolic abnormalities may be important in modifying clinical expression of HCM.

scholarly journals Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Hwi Seung Kim ◽  
Jiwoo Lee ◽  
Yun Kyung Cho ◽  
Joong-Yeol Park ◽  
Woo Je Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
National Health ◽  
Population Based ◽  
Metabolic Health ◽  
Metabolically Healthy Obese ◽  
Obesity Status ◽  
Increased Risk ◽  
Metabolically Healthy ◽  
Incident Heart Failure

BackgroundMetabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years.MethodsThe Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI ≥25 kg/m2 according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first.ResultsThe MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20–1.39], 1.37 [1.22–1.53], and 1.63 [1.50–1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status.ConclusionsMetabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF.

scholarly journals The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 216-216
Author(s):  
Ahmed Shakarchi ◽  
Emmanuel Garcia Morales ◽  
Nicholas Reed ◽  
Bonnielin Swenor
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Population Based ◽  
Sensory Impairment ◽  
Loss To Follow Up ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression ◽  
Study Participants ◽  
Adjusted Model

Abstract Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.

scholarly journals Association Between Sense of Coherence and Health Outcomes at 10 and 20 Years Follow-Up: A Population-Based Longitudinal Study in Germany

2021 ◽  
Vol 9 ◽  
Author(s):  
Anna Dziuba ◽  
Janina Krell-Roesch ◽  
Steffen C. E. Schmidt ◽  
Klaus Bös ◽  
Alexander Woll
Keyword(s):  
Longitudinal Study ◽  
Health Status ◽  
Health Outcomes ◽  
Sense Of Coherence ◽  
Population Based ◽  
Community Dwelling ◽  
Significant Group ◽  
Longitudinal Associations ◽  
Health Parameters

Background: The sense of coherence (SOC) is reported to influence health, but health may also have an impact on SOC. The objective of this study was to examine the longitudinal associations between SOC and selected self-reported and physician-assessed health outcomes over a period of 10 and 20 years and to determine the predominant direction of the associations.Methods: We conducted a population-based, longitudinal study, involving 392 participants (188 females and 204 males; mean age 43.01 years) who were followed for a median of 10 and 18 years. Analyses of variance were carried out to examine the longitudinal associations between SOC at baseline and health outcomes (i.e., self-rated health status, SHS; physical health status assessed by a physician, PHS; self-reported satisfaction with life, SWL) at follow-ups. The direction of associations was examined using a cross-lagged model on correlation coefficients.Results: There were significant group effects for SOC at baseline on SHS at 20-year follow-up (F = 4.09, p = 0.018, ηp2 = 0.041), as well as on SWL at 10-year (F = 12.67, p < 0.01, ηp2 = 0.072) and at 20-year follow-up (F = 8.09, p < 0.1, ηp2 = 0.069). SHS (r = 0.238, p < 0.01), PHS (r = −0.140, p < 0.05) and SWL (r = 0.400, p < 0.01) predicted SOC at 10-year follow-up stronger than vice versa. The direction of associations between SOC and health parameters at 20-year follow-up was less consistent.Conclusions: The long-term associations between SOC and self-reported and physician-assessed health may be reciprocal in community-dwelling adults. More research is needed to examine the predictive power of health on SOC and whether interventions targeted at improving health parameters, may impact SOC.

scholarly journals The Importance of Screening for Thyroid Cancer in Patients with Metabolic Syndrome or its Components: A Nationwide Population-Based Cohort Study.

2021 ◽  
Author(s):  
Jae Hyun Park ◽  
Hyun Seok Cho ◽  
Gilseong Moon ◽  
Jong Ho Yoon
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Cancer ◽  
Large Scale ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Relative Risks ◽  
Increased Risk ◽  
Korean National Health Insurance

Abstract Background The rapidly increasing coincidence of thyroid cancer and metabolic syndrome (MS) in recent decades suggests an association between the two disorders. To investigate this association, we conducted a nationwide study of a large-scale patient cohort. Methods Between 2009 and 2011, data were collected by the Korean National Health Insurance Service for 4,658,473 persons aged 40–70 years without thyroid cancer. During the 6-year follow-up period, participants were monitored for the development of thyroid cancer. The relative risks and incidences of thyroid cancer were calculated using multivariate Cox proportional hazards regression analyses after adjusting for age and body mass index. Results At the end of the study, 47,325 subjects (1.0%) were newly diagnosed with thyroid cancer. The risk of thyroid cancer was significantly elevated in men and women with MS or MS components, except for hyperglycaemia (p = 0.723) or hypertriglyceridemia (p = 0.211) in men. The incidence of thyroid cancer per 10,000 person-years in individuals with MS was significantly higher in men (6.2, p < 0.001) and women (21.3, p < 0.001) compared to those without MS. Additionally, the risk of thyroid cancer increased significantly with an increasing number of MS components even in individuals with only one or two MS components. Conclusions MS and its components were significantly associated with increased risk of developing thyroid cancer. Patients with MS or MS components should be regularly screened for thyroid cancer to enable swift therapeutic response in this at-risk population.

scholarly journals Serum Uromodulin Is Associated With But Does Not Predict Type 2 Diabetes in Elderly KORA F4/FF4 Study Participants

2019 ◽  
Vol 104 (9) ◽  
pp. 3795-3802 ◽  
Author(s):  
Cornelia Then ◽  
Holger Then ◽  
Christa Meisinger ◽  
Margit Heier ◽  
Annette Peters ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Tolerance Test ◽  
Population Based ◽  
Oral Glucose ◽  
Linear Regression Models ◽  
Glucose Tolerance Status ◽  
Study Participants

AbstractAimsSerum uromodulin has recently emerged as promising biomarker for kidney function and was suggested to be associated with type 2 diabetes (T2D) in patients with coronary heart disease. Here, we analyzed the association of serum uromodulin with T2D in the population-based KORA F4/FF4 study.MethodsIn 1119 participants of the KORA F4 study aged 62 to 81 years, serum uromodulin was measured, and the association of serum uromodulin with T2D was assessed using logistic and linear regression models stratified for sex. After a mean follow-up time of 6.5 years, 635 participants where re-evaluated. Glucose tolerance status was determined by oral glucose tolerance test at baseline and at the follow-up examination except in cases of known T2D.ResultsSerum uromodulin was inversely associated with T2D in the crude analysis and after adjustment for age and body mass index in men (P < 0.001) and in women (P < 0.05). After further adjustment for estimated glomerular filtration rate, serum uromodulin was significantly inversely associated with T2D in men (P < 0.001) but not in women. Serum uromodulin was not associated with prediabetes after multivariate adjustment and did not predict T2D in men or in women after the follow-up time of 6.5 ± 0.3 years.ConclusionsIn participants of the KORA F4 study, serum uromodulin is independently associated with T2D in men but is not a predictor of future development of T2D.

scholarly journals Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study

2019 ◽  
Vol 104 (7) ◽  
pp. 2942-2952 ◽  
Author(s):  
Ji-Yeon Lee ◽  
Kyungdo Han ◽  
Eugene Han ◽  
Gyuri Kim ◽  
Hanna Cho ◽  
...  
Keyword(s):  
Cohort Study ◽  
Late Life ◽  
Population Based ◽  
Metabolic Health ◽  
Incident Dementia ◽  
Obesity Status

scholarly journals Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yun Gi Kim ◽  
Yun Young Choi ◽  
Kyung-Do Han ◽  
Kyongjin Min ◽  
Ha Young Choi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Population Based ◽  
Cardiac Events ◽  
Population Based Study ◽  
Increased Risk ◽  
Adverse Cardiac Events ◽  
Korean National Health Insurance ◽  
New Onset

AbstractAtrial fibrillation (AF) is associated with various major adverse cardiac events such as ischemic stroke, heart failure, and increased overall mortality. However, its association with lethal ventricular arrhythmias such as ventricular tachycardia (VT), ventricular flutter (VFL), and ventricular fibrillation (VF) is controversial. We conducted this study to determine whether AF can increase the risk of VT, VFL, and VF. We utilized the Korean National Health Insurance Service database for this nationwide population-based study. This study enrolled people who underwent a nationwide health screen in 2009 for whom clinical follow-up data were available until December 2018. Primary outcome endpoint was the occurrence of VT, VFL, or VF in people who were and were not diagnosed with new-onset AF in 2009. We analyzed a total of 9,751,705 people. In 2009, 12,689 people were diagnosed with new-onset AF (AF group). The incidence (events per 1000 person-years of follow-up) of VT, VFL, and VF was 2.472 and 0.282 in the AF and non-AF groups, respectively. After adjustment for covariates, new-onset AF was associated with 4.6-fold increased risk (p < 0.001) of VT, VFL, and VF over 10 years of follow-up. The risk of VT, VFL, and VF was even higher if identification of AF was based on intensified criteria (≥ 2 outpatient records or ≥ 1 inpatient record; hazard ratio = 5.221; p < 0.001). In conclusion, the incidence of VT, VFL, and VF was significantly increased in people with new-onset AF. The potential risk of suffering lethal ventricular arrhythmia in people with AF should be considered in clinical practice.

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