Epigenetic age acceleration is associated with cardiometabolic risk factors and clinical cardiovascular disease risk scores in African Americans

Abstract Background Cardiovascular disease (CVD) is the leading cause of mortality among US adults. African Americans have higher burden of CVD morbidity and mortality compared to any other racial group. Identifying biomarkers for clinical risk prediction of CVD offers an opportunity for precision prevention and earlier intervention. Results Using linear mixed models, we investigated the cross-sectional association between four measures of epigenetic age acceleration (intrinsic (IEAA), extrinsic (EEAA), PhenoAge (PhenoAA), and GrimAge (GrimAA)) and ten cardiometabolic markers of hypertension, insulin resistance, and dyslipidemia in 1,100 primarily hypertensive African Americans from sibships in the Genetic Epidemiology Network of Arteriopathy (GENOA). We then assessed the association between epigenetic age acceleration and time to self-reported incident CVD using frailty hazard models and investigated CVD risk prediction improvement compared to models with clinical risk scores (Framingham risk score (FRS) and the atherosclerotic cardiovascular disease (ASCVD) risk equation). After adjusting for sex and chronological age, increased epigenetic age acceleration was associated with higher systolic blood pressure (IEAA), higher pulse pressure (EEAA and GrimAA), higher fasting glucose (PhenoAA and GrimAA), higher fasting insulin (EEAA), lower low density cholesterol (GrimAA), and higher triglycerides (GrimAA). A five-year increase in GrimAA was associated with CVD incidence with a hazard ratio of 1.54 (95% CI 1.22–2.01) and remained significant after adjusting for CVD risk factors. The addition of GrimAA to risk score models improved model fit using likelihood ratio tests (P = 0.013 for FRS and P = 0.008 for ASCVD), but did not improve C statistics (P > 0.05). Net reclassification index (NRI) showed small but significant improvement in reassignment of risk categories with the addition of GrimAA to FRS (NRI: 0.055, 95% CI 0.040–0.071) and the ASCVD equation (NRI: 0.029, 95% CI 0.006–0.064). Conclusions Epigenetic age acceleration measures are associated with traditional CVD risk factors in an African-American cohort with a high prevalence of hypertension. GrimAA was associated with CVD incidence and slightly improved prediction of CVD events over clinical risk scores.

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Epigenetic Age Acceleration in Adolescence Associates With BMI, Inflammation, and Risk Score for Middle Age Cardiovascular Disease

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-02076 ◽

2019 ◽

Vol 104 (7) ◽

pp. 3012-3024 ◽

Cited By ~ 9

Author(s):

Rae-Chi Huang ◽

Karen A Lillycrop ◽

Lawrence J Beilin ◽

Keith M Godfrey ◽

Denise Anderson ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dna Methylation ◽

Middle Age ◽

Accelerated Aging ◽

Model Assessment ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Epigenetic Age ◽

Epigenetic Age Acceleration

Abstract Context “Accelerated aging,” assessed by adult DNA methylation, predicts cardiovascular disease (CVD). Adolescent accelerated aging might predict CVD earlier. We investigated whether epigenetic age acceleration (assessed age, 17 years) was associated with adiposity/CVD risk measured (ages 17, 20, and 22 years) and projected CVD by middle age. Design DNA methylation measured in peripheral blood provided two estimates of epigenetic age acceleration: intrinsic (IEAA; preserved across cell types) and extrinsic (EEAA; dependent on cell admixture and methylation levels within each cell type). Adiposity was assessed by anthropometry, ultrasound, and dual-energy x-ray absorptiometry (ages 17, 20, and 22 years). CVD risk factors [lipids, homeostatic model assessment of insulin resistance (HOMA-IR), blood pressure, inflammatory markers] were assessed at age 17 years. CVD development by age 47 years was calculated by Framingham algorithms. Results are presented as regression coefficients per 5-year epigenetic age acceleration (IEAA/EEAA) for adiposity, CVD risk factors, and CVD development. Results In 995 participants (49.6% female; age, 17.3 ± 0.6 years), EEAA (per 5 years) was associated with increased body mass index (BMI) of 2.4% (95% CI, 1.2% to 3.6%) and 2.4% (0.8% to 3.9%) at 17 and 22 years, respectively. EEAA was associated with increases of 23% (3% to 33%) in high-sensitivity C-reactive protein, 10% (4% to 17%) in interferon-γ–inducible protein of 10 kDa, and 4% (2% to 6%) in soluble TNF receptor 2, adjusted for BMI and HOMA-IR. EEAA (per 5 years) results in a 4% increase in hard endpoints of CVD by 47 years of age and a 3% increase, after adjustment for conventional risk factors. Conclusions Accelerated epigenetic age in adolescence was associated with inflammation, BMI measured 5 years later, and probability of middle age CVD. Irrespective of whether this is cause or effect, assessing epigenetic age might refine disease prediction.

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Cardiovascular disease risk prediction for people with type 2 diabetes in a population-based cohort and in electronic health record data

JAMIA Open ◽

10.1093/jamiaopen/ooaa059 ◽

2020 ◽

Author(s):

Jackie Szymonifka ◽

Sarah Conderino ◽

Christine Cigolle ◽

Jinkyung Ha ◽

Mohammed Kabeto ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Risk Prediction ◽

Incidence Rates ◽

Risk Scores ◽

Cvd Risk ◽

Clinical Risk ◽

Demographic Covariates

Abstract Objective Electronic health records (EHRs) have become a common data source for clinical risk prediction, offering large sample sizes and frequently sampled metrics. There may be notable differences between hospital-based EHR and traditional cohort samples: EHR data often are not population-representative random samples, even for particular diseases, as they tend to be sicker with higher healthcare utilization, while cohort studies often sample healthier subjects who typically are more likely to participate. We investigate heterogeneities between EHR- and cohort-based inferences including incidence rates, risk factor identifications/quantifications, and absolute risks. Materials and methods This is a retrospective cohort study of older patients with type 2 diabetes using EHR from New York University Langone Health ambulatory care (NYULH-EHR, years 2009–2017) and from the Health and Retirement Survey (HRS, 1995–2014) to study subsequent cardiovascular disease (CVD) risks. We used the same eligibility criteria, outcome definitions, and demographic covariates/biomarkers in both datasets. We compared subsequent CVD incidence rates, hazard ratios (HRs) of risk factors, and discrimination/calibration performances of CVD risk scores. Results The estimated subsequent total CVD incidence rate was 37.5 and 90.6 per 1000 person-years since T2DM onset in HRS and NYULH-EHR respectively. HR estimates were comparable between the datasets for most demographic covariates/biomarkers. Common CVD risk scores underestimated observed total CVD risks in NYULH-EHR. Discussion and conclusion EHR-estimated HRs of demographic and major clinical risk factors for CVD were mostly consistent with the estimates from a national cohort, despite high incidences and absolute risks of total CVD outcome in the EHR samples.

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Abstract 08: Heterogeneity in Cardiovascular Disease Risk Factor Prevalence Among Whites, African Americans, African Immigrants and Afro-Caribbeans: Insights From the 2010-2018 National Health Interview Survey

Circulation ◽

10.1161/circ.141.suppl_1.08 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Diana Baptiste ◽

Ruth-Alma N Turkson-Ocran ◽

Oluwabunmi Ogungbe ◽

Binu Koirala ◽

Lucine Francis ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

African Americans ◽

Ethnic Groups ◽

National Health ◽

National Health Interview Survey ◽

African Immigrants ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Interview Survey

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the U.S. Blacks are disproportionately affected by CVD risk factors, compared to whites. However, Blacks are not monolithic and include the following ethnic groups; African Americans (AAs), African Immigrants (AIs), and Afro-Caribbeans (ACs). It is unclear how AIs and ACs compare to their AA counterparts and Whites with respect to CVD risk factors. Objective: To examine trends in CVD risk factors among three Black ethnic groups in comparison to whites between 2010-2018. Methods: A comparative analysis of the National Health Interview Survey was conducted among N=452,997 participants, examining sociodemographic data and trends in self-reported CVD risk factors (hypertension, diabetes, overweight/obesity, and smoking). Generalized linear models with a Poisson distribution were used to obtain the respective predictive probabilities of CVD risk factors. Results: The sample included 82,835 Blacks (89% AAs, 5% AIs and 6% ACs) and 370,362 whites. AIs were the youngest with mean age of 40.8 years and were less likely to be insured (76%) compared to whites (91%) and AAs (83%) ( p =<0.001). ACs (23%) were more likely be college-educated than AAs (17%) but not AIs (36%) or whites (32%), (p=<0.001). AIs had the lowest age- and sex-adjusted prevalence of all four CVD risk factors. There were disparities (among AAs) and advantages (among AIs and ACs) in CVD risk factors. ( Figure) . Overweight/obesity and diabetes prevalence was increasing in AAs and whites ( p -values for trend<0.001). Smoking prevalence was highest in whites and AAs compared to AIs and ACs but the prevalence decreased significantly between 2010-2018 ( p -values for trend<0.001). Conclusion: Our results have shown significant heterogeneity in CVD risk factors among three Black ethnic groups compared to whites. These findings suggest that race alone does not account for health disparities in CVD risk factors. Environmental, psychological, and social factors may play a larger role in CVD risk.

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A Combined Index of Waist Circumference and Muscle Quality is Associated with Accumulation of Cardiovascular Disease Risk Factors in Obese Patients: A Cross-sectional Study

10.21203/rs.3.rs-1029413/v1 ◽

2021 ◽

Author(s):

Kentaro Ikeue ◽

Toru Kusakabe ◽

Kazuya Muranaka ◽

Hajime Yamakage ◽

Takayuki Inoue ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Handgrip Strength ◽

Cross Sectional Study ◽

Risk Scores ◽

Obese Patients ◽

Sectional Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional

Abstract Background: Aging individuals are prone to sarcopenic obesity (SO). SO is associated with higher risks of low physical function, metabolic diseases, cardiovascular disease (CVD), and mortality. Worldwide diagnostic criteria for SO and its cutoff values have not yet been established. In this study, from among obesity- and sarcopenia-evaluated indices, we determined a combined index most associated with the accumulation of CVD risk factors in obese patients.Methods: In this cross-sectional study, we evaluated body composition using a multifrequency bioelectrical impedance analysis device and measured handgrip strength in 188 obese patients (73 men and 115 women). We selected each index most associated with the accumulation of CVD risk factors among obesity- (body mass index, percentage body fat, or waist circumference [WC]) and sarcopenia-evaluated indices (skeletal mass index, handgrip strength, or muscle quantity [MQ]), respectively. We then classified obese patients into four groups (group C, control; group O, obesity alone; group S, sarcopenia alone; and group SO, sarcopenic obesity) using the two selected indices with each median value and compared the CVD risk score, the number of concomitant CVD risk factors, among the four groups.Results: Based on the dichotomous comparison, WC and MQ were selected as the indices most associated with CVD risk factor accumulation. The CVD risk score was significantly higher in groups S and SO as compared with group C (1.94 ± 0.80, 1.95 ± 0.91 vs. 1.41 ± 0.84, all p < 0.05). Odds ratios for CVD risk scores ≥2 were significantly higher in groups S, O, and SO compared with group C (4.78 [95% confidence interval {CI} 1.79-12.81], p = 0.002; 3.28 [95% CI 1.37-7.88], p = 0.008; 3.92 [95% CI 1.74-8.81], p = 0.001; respectively). Furthermore, odds ratios for CVD risk scores = 3 were significantly higher only in group SO compared with group C (4.29 [95% CI 1.49-12.33], p = 0.007).Conclusion: In obese patients, WC and MQ were most associated with the accumulation of CVD risk factors, respectively. Furthermore, classification using the combined index of WC and MQ reflects the accumulation of CVD risk factors in obese patients, regardless sex and age.

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Skin Carotenoid Status Is a Potential Surrogate Marker for Cardiovascular Disease Risk Determination in Middle-Aged and Older Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa041_036 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 132-132

Author(s):

Darel Wee Kiat Toh ◽

Clarinda Sutanto ◽

Wen Wei Loh ◽

Wan Yee Lee ◽

Yuanhang Yao ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Risk Prediction ◽

Disease Risk ◽

Surrogate Marker ◽

Cvd Risk Factors ◽

Middle Aged ◽

Cvd Risk ◽

Metabolic Syndrome Components

Abstract Objectives The study aimed to examine the associations between skin carotenoid status and plasma carotenoids with classical cardiovascular disease (CVD) risk factors among a middle-aged and older Singaporean population. It was hypothesized that skin carotenoid status and plasma carotenoids could be used as an indicator for CVD risk. Methods This cross-sectional study recruited 45 men and 59 women, aged 50 to 75 years, from a community in Singapore (n = 104). Dietary information was obtained using 3-day food records, skin carotenoid status was measured using resonance Raman spectroscopy and plasma carotenoids were analyzed with high-performance liquid chromatography. CVD risk was determined using classical risk factors including blood pressure (BP), serum lipid-lipoprotein concentrations, as well as overall CVD risk predictors such as the number of metabolic syndrome components and a 10-year CVD risk prediction using the Framingham Heart Study risk score calculator. Results Multiple linear regression with covariate adjustments indicated that skin carotenoid status and plasma carotenoids were inversely associated with systolic BP (skin: standardized regression coefficient (β) = −0.341, P < 0.001; plasma: β = −0.258, P < 0.05), diastolic BP (skin: β = −0.378, P < 0.001; plasma: β = −0.309, P < 0.005) as well as both the number of metabolic syndrome components (skin: β = −0.383, P < 0.001; plasma: β = −0.434, P < 0.001) and the 10-year CVD risk prediction (skin: β = −0.347, P < 0.001; plasma: β = −0.334, P < 0.001). The associations between skin carotenoid status with metabolic syndrome and the 10-year CVD risk were null with the inclusion of plasma carotenoids as a covariate which suggested its role as a mediator. Despite the positive linear association between skin carotenoid status and dietary carotenoids intake (Pearson's coefficient: 0.204, P < 0.001), dietary carotenoids were not directly correlated with the CVD risk factors analyzed. Conclusions Skin carotenoid status can function not only as a dietary biomarker, but also, as a potential surrogate marker for CVD risk in middle-aged and older Singaporeans. Funding Sources National University of Singapore Ministry of Education, Singapore Agency for Science, Technology and Research (Singapore).

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Assessment of Cardiovascular Disease Risk in South Asian Populations

International Journal of Vascular Medicine ◽

10.1155/2013/786801 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 8

Author(s):

S. Monira Hussain ◽

Brian Oldenburg ◽

Yuanyuan Wang ◽

Sophia Zoungas ◽

Andrew M. Tonkin

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

South Asian ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Risk Scores ◽

Cvd Risk Factors ◽

Qualitative Synthesis ◽

Cvd Risk ◽

Asian Populations

Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of individual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both “classical” and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk.

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Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Advances in Nutrition ◽

10.1093/advances/nmz007 ◽

2019 ◽

Vol 10 (4) ◽

pp. 634-646 ◽

Cited By ~ 12

Author(s):

Ehsan Ghaedi ◽

Mohammad Mohammadi ◽

Hamed Mohammadi ◽

Nahid Ramezani-Jolfaie ◽

Janmohamad Malekzadeh ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Lipid Profile ◽

Meta Analysis ◽

Controlled Trials ◽

Cvd Risk Factors ◽

Paleolithic Diet ◽

Cvd Risk ◽

Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

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Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031044 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1044

Author(s):

Magdalena Mijas ◽

Karolina Koziara ◽

Andrzej Galbarczyk ◽

Grazyna Jasienska

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Gay Men ◽

Disease Risk ◽

Older Age ◽

Analysis Of Covariance ◽

Control Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Wide Range

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.

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Effect of DASH Diet Versus Healthy Dietary Advice on the Estimated Atherosclerotic Cardiovascular Disease Risk

Journal of Primary Care & Community Health ◽

10.1177/2150132720980952 ◽

2021 ◽

Vol 12 ◽

pp. 215013272098095

Author(s):

Marwa S. Said ◽

Inas T. El Sayed ◽

Eman E. Ibrahim ◽

Ghada M. Khafagy

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dietary Advice ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Post Intervention ◽

Dash Diet ◽

Significant Difference ◽

Diet Versus

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.

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Is night-time light intensity associated with cardiovascular disease risk factors among adults in early-stage urbanisation in South India? A cross-sectional study of the Andhra Pradesh Children and Parents Study

BMJ Open ◽

10.1136/bmjopen-2019-036213 ◽

2020 ◽

Vol 10 (11) ◽

pp. e036213

Author(s):

Tina Bonde Sorensen ◽

Robin Wilson ◽

John Gregson ◽

Bhavani Shankar ◽

Alan D Dangour ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Andhra Pradesh ◽

South India ◽

Early Stage ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Night Time ◽

Cross Sectional ◽

Children And Parents

ObjectivesTo explore associations of night-time light intensity (NTLI), a novel proxy for continuous urbanisation levels, with mean systolic blood pressure (SBP), body mass index (BMI), fasting serum low-density lipoprotein (LDL) and fasting plasma glucose (FPG), among adults in early-stage urbanisation in Telangana, South India.DesignCross-sectional analysis of the third wave of the Andhra Pradesh Children and Parents Study cohort.Setting28 villages representing a continuum of urbanisation levels, ranging from rural settlement to medium-sized town in Telangana, South India.ParticipantsData were available from 6944 participants, 6236 of whom were eligible after excluding pregnant women, participants younger than 18 years of age and participants missing data for age. Participants were excluded if they did not provide fasting blood samples, had implausible or missing outcome values, were medicated for hypertension or diabetes or had triglyceride levels invalidating derived LDL. The analysis included 5924 participants for BMI, 5752 participants for SBP, 5287 participants for LDL and 5328 participants for FPG.ResultsIncreasing NTLI was positively associated with mean BMI, SBP and LDL but not FPG. Adjusted mean differences across the range of village-level NTLI were 1.0 kg/m2 (95% CI 0.01 to 1.9) for BMI; 4.2 mm Hg (95% CI 1.0 to 7.4) for SBP; 0.3 mmol/L (95% CI −0.01 to 0.7) for LDL; and −0.01 mmol/L (95% CI −0.4 to 0.4) for FPG. Associations of NTLI with BMI and SBP were stronger in older age groups.ConclusionThe association of NTLI with cardiovascular disease (CVD) risk factors identify NTLI as a potentially important tool for exploring urbanisation-related health. Consistent associations of moderate increases in urbanisation levels with important CVD risk factors warrant prevention strategies to curb expected large public health impacts from continued and rapid urbanisation in India.

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