Association of adiponectin in patatin-like phospholipase domain-containing 3 (PNPLA3) associated hepatic steatosis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 184-184
Author(s):  
Muhammad Shaalan Beg ◽  
Amit G. Singal ◽  
Colby Ayers ◽  
Sadia Saleem ◽  
Jorge A. Marrero ◽  
...  

184 Background: The I148M polymorphism (rs738409) of the patatin-like phospholipase domain-containing 3 (PNPLA3) gene is strongly associated with hepatic triglyceride content (HTGC) and the development of nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH), which are themselves risk factors for hepatocellular cancer (HCC). Serum adiponectin affects insulin resistance and carcinogenesis and has also been associated with HTGC. Whether these risk factors are additive in predisposing to HTGC is unknown. We evaluated the impact of adiponectin and PNPLA3 genotypes on HTGC in a large community cohort. Methods: The Dallas Heart Study (DHS) is a multi-ethnic population based study of Dallas County residents. HTGC was quantified using H-MR spectroscopy. Univariate and multivariable logistic and linear regression models were generated to test the association between HTGC and log adiponectin stratified by PNPLA3 genotype (CC, CG and GG). Models were adjusted for age, gender, race, hypertension, diabetes, HOMA-IR and BMI. Results: There were 2,259 patients who had complete clinical, biochemical, imaging, and genotyping data and were included in this analysis. Median age was 44 and 47% were male. Race distribution was 48% Black, 32% White, and 18% Hispanic. The prevalences of PNPLA3 genotypes were 61% CC (wild type), 32% GC and 7% GG. The median concentration of adiponectin was 6.6 ug/ml. Adiponectin was an independent predictor HTCG across all genotypes after adjusting for covariates (CC b=-0.34, GC b=-0.42, GG b=-0.38, p<0.005 for each). HTGC decreased across gender and race-stratified quartiles of adiponectin for each PNPLA3 genotype, and the qualitative effect was greatest in the I148M homozygotes (table). Conclusions: Adiponectin is independently associated with hepatic steatosis across all three PNPLA3 genotypes. The combination of at-risk PNPLA3 genotypes and hypoadiponectemia is associated with a high risk of hepatic steatosis. Future studies will need to address downstream HCC risk and whether manipulation of adiponectin level may be of clinical benefit. [Table: see text]

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tiffany M Powell ◽  
Colby R Ayers ◽  
James A de Lemos ◽  
Amit Khera ◽  
Susan G Lakoski ◽  
...  

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.


2013 ◽  
Vol 59 (3) ◽  
pp. 536-546 ◽  
Author(s):  
Lu Q Chen ◽  
James A de Lemos ◽  
Sandeep R Das ◽  
Colby R Ayers ◽  
Anand Rohatgi

BACKGROUND ST2, part of the interleukin-1 receptor family, is released from cardiac myocytes under mechanical strain. Soluble ST2 (sST2) concentrations are associated with adverse cardiac events in high-risk cohorts. We evaluated the association of sST2 with all-cause and cardiovascular mortality in a large, low-risk population–based cohort. METHODS Plasma sST2 was measured in 3294 subjects from the Dallas Heart Study, a probability-based population cohort. We categorized participants into undetectable (reference group) or quartiles of detectable sST2 concentrations. Associations with all-cause and cardiovascular mortality were assessed over a median 8.3 years of follow-up. RESULTS sST2 concentrations were not significantly associated with most traditional risk factors, prevalent subclinical cardiovascular disease, or nonfatal cardiac events. However, a higher proportion of African Americans had detectable concentrations of sST2 than non–African Americans (44% vs 21%, respectively, P &lt; 0.0001). In addition, sST2 concentrations were significantly associated with markers of inflammation. Increased sST2 was associated with increased all-cause mortality (Ptrend ≤ 0.0001) and cardiovascular mortality (Ptrend = 0.0004). In fully adjusted models, those in the highest quartile of detectable sST2 were at increased risk for all-cause death compared to those with undetectable sST2 concentrations (adjusted hazard ratio 2.1, 95% CI 1.4–3.2, P = 0.0009). CONCLUSIONS In a low-risk population, sST2 does not associate with traditional cardiovascular risk factors or nonfatal cardiovascular events but is higher in African Americans and is associated with increased all-cause and cardiovascular mortality. Further investigation is needed regarding the role of sST2 in risk prediction, particularly among African Americans.


2008 ◽  
Vol 54 (12) ◽  
pp. 1975-1981 ◽  
Author(s):  
Emmanouil S Brilakis ◽  
Amit Khera ◽  
Bilal Saeed ◽  
Subhash Banerjee ◽  
Darren K McGuire ◽  
...  

Abstract Background: Our aim was to characterize the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with coronary and aortic atherosclerosis in a large population-based study. Methods: Lp-PLA2 mass and activity were measured in 2171 subjects 30–65 years old participating in the Dallas Heart Study. We examined the association of Lp-PLA2 levels with 3 atherosclerosis phenotypes: coronary artery calcium (CAC) measured by electron-beam computed tomography and abdominal aortic plaque (AAP) and aortic wall thickness (AWT) measured by magnetic resonance imaging. Results: CAC and AAP were detected in 21% and 40% of subjects, respectively, and mean AWT (SD) was 1.70 (0.32) mm. In univariable analyses, Lp-PLA2 mass (but not activity) was higher in both men (P = 0.04) and women (P = 0.02) with detectable CAC. Lp-PLA2 mass and activity were higher (P = 0.004 and P = 0.01, respectively) and AWT was greater (P &lt; 0.001 and P = 0.02, respectively) in women with aortic atheroma, but not in men. After adjustment for traditional atherosclerosis risk factors and C-reactive protein concentrations, Lp-PLA2 mass and activity were not associated with AAP or AWT in either sex, but Lp-PLA2 mass remained modestly associated with detectable CAC only in men (odds ratio 1.20 per 1 standard deviation increase, 95% CI 1.01–1.42, P = 0.04). Conclusions: Although Lp-PLA2 mass was independently associated with CAC in men, it was not associated with AAP or AWT in men or with any of the atherosclerosis phenotypes in women. These findings suggest that if Lp-PLA2 independently influences clinical events, it does so by promoting atherosclerotic plaque instability rather than by stimulating atherogenesis.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
David A McNamara ◽  
Ari Bennett ◽  
Jarett D Berry ◽  
Mark S Link

Introduction: Recent studies have shown an association between early repolarization pattern (ERP) ECG morphology and sudden cardiac death. The role of left ventricular mass (LVM) as a potential mediator of ERP has not been well explored. Methods: Participants in the Dallas Heart Study who underwent an ECG and cardiac MRI (CMR) were assessed for ERP, defined as J-point elevation ≥1 mm in any 2 contiguous leads. We compared participants with and without ERP by age, gender, race/ethnicity, established cardiovascular risk factors of diabetes, hypertension and hyperlipidemia, lean body mass and percent body fat, and CMR-derived LVM, LVM/body surface area, and LVH defined by standard criteria, using Student’s T-tests and chi-squared tests where appropriate. Results: Of the 3,015 participants in our study, 276 (9.2%) had ERP. Participants with ERP were younger (43±9 vs 44±10 yrs, p=0.04), more prevalent in blacks than non-blacks (14 vs 5.0%, p<0.00001), and in men than women (18 vs 2.0%, p<0.00001). Baseline cardiovascular risk factors were not significantly different. Participants with ERP demonstrated higher lean body mass (59±10 vs 52±11 kg, p<0.00001) and lower percent body fat (27±8 vs 36±9%, p<0.00001). The presence of ERP was associated with greater LVM, increased LVM/body surface area, and the presence of LVH in the overall population and in analyses stratified by sex (Table 1). Conclusion: In a large, multi-ethnic cohort, ERP is associated with increased total LVM, increased LVM/body surface area, and LVH. These novel associations may provide insight into the biology of ERP. Further studies investigating the relationship of LVM and LVH with ERP are warranted.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alice Y Chang ◽  
Shannon J FitzGerald ◽  
John Cannaday ◽  
Song Zhang ◽  
Amit Patel ◽  
...  

A high prevalence of obesity exists among national football league (NFL) players as classified by body mass index (BMI). It has not been established whether this elevated BMI is associated with a greater prevalence of cardiovascular (CV) risk factors or coronary artery disease in former NFL players as in non-athletes. This study compared CV risk factors and subclinical coronary atherosclerosis among retired NFL players versus community controls. The design was a case-control study of retired NFL players against matched controls from the population-based Dallas Heart Study (DHS) and a second physically active sample from the Aerobics Center Longitudinal Study (ACLS). CV risk factors were assessed by survey and health screening visit. Coronary atherosclerosis was determined with computed tomography measurements of coronary artery calcium (CAC). 201 NFL players completed measurements of CAC. Compared to DHS men, retired NFL players had a significantly lower prevalence of diabetes, hypertension, a sedentary lifestyle and the metabolic syndrome, yet a higher prevalence of impaired fasting glucose and hyperlipidemia. However, there was no significant difference in the prevalence of positive CAC (46 v 48.3%, p=0.69) or the distribution across subgroups of CAC (0 –10, 10 –100, 100 – 400, 400+, p=0.11) between the retired NFL players and DHS men. These results were not significantly different when controlling for ethnicity or linemen status. When compared to physically active controls (ACLS), retired NFL players had a greater BMI, waist size and prevalence of the metabolic syndrome, but no difference in other CV risk factors or CAC scores. Conclusions: Despite their large body size, former NFL players do not have a greater prevalence of CV risk factors or amount of CAC than community controls when matched by BMI and/or age. Age and hyperlipidemia, not body size, were the most significant predictors of subclinical coronary atherosclerosis among retired NFL players. This research has received full or partial funding support from the American Heart Association, AHA National Center. CV Risk Factors, Retired NFL Players versus Dallas Heart Study Participants


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ehimen C Aneni ◽  
Marcio S Bittencourt ◽  
Miguel Caínzos Achirica ◽  
Michael J Blaha ◽  
Ahmed M Soliman ◽  
...  

Background: Little is known about hepatic steatosis (HS) incidence and its relationship to underlying or new-onset cardiometabolic risk. This study aims to assess the incidence of hepatic steatosis in an asymptomatic population and to determine its relationship to both prevalent and new-onset cardiometabolic risk factors. Methods: We analyzed retrospective data from a voluntary employer-sponsored routine health promotion evaluation at the Preventive Medicine Center of the Hospital Israelita Albert Einstein (São Paulo, Brazil) collected from October 2004 to December 2016.Medical and demographic history, anthropometric measures including blood pressure, body mass index (BMI) and waist circumference, and fasting blood samples were obtained. Participants also had ultrasonography to assess for HS. We included data from 8,448 individuals who had complete cardiometabolic and ultrasound data at baseline and repeated all tests at least 6 months later. Results: The mean age (standard deviation, SD) of participants was 40 (9) years. Over a mean (SD) follow-up of 3.4 (2.3) years, the incidence of HS was 14.7%. As shown in the table, diabetes, poor physical activity, elevated waist circumference and cigarette smoking at baseline were independently associated with hepatic steatosis. There was an additive effect of the increasing cardiometabolic risk factors (see graph) on the risk of developing HS. Participants with new-onset cardiometabolic risk factors also had a higher risk of incident HS after accounting for baseline demographics and cardiometabolic risk factors (see forest plot). This was most pronounced for incident obesity (BMI ≥ 30 Kg/m 2 ). Conclusion: In this relatively young population, the incidence of HS was high and was both independently and collectively associated with baseline cardiometabolic risk. New-onset cardiometabolic risk tracks with incident HS. This study emphasizes the need for assessing and mitigating cardiometabolic risk in the prevention of HS.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kavisha Singh ◽  
Rina Mauricio ◽  
Wanpen Vongpatanasin ◽  
Katy Lonergan ◽  
Monika Sanghavi ◽  
...  

Introduction: The proximal aorta has been shown to enlarge with aging in humans, but the long-term impact of hormonal and hemodynamic changes associated with pregnancy on aortic size and function are unknown. We examined if number of live births was independently associated with aortic dimensions and stiffness in a healthy multi-ethnic population-based cohort, the Dallas Heart Study (DHS). We hypothesized that multiparity (>/=4 live births) is independently associated with aortic dilation and aortic stiffness after adjustment for CV risk factors. Methods: Women with available thoracic aortic MRI measurements (n=1468, mean 44.5 years old) from DHS were stratified based on self-reported number of live births (0,1,2,3,>/=4). Sequential multivariable logistic regression models were used to assess independent associations of the number of live births with ascending aortic cross-sectional area/height, aortic pulse wave velocity (PWV) and aortic compliance. Models were adjusted for major CV risk factors. Results: Women with >/=4 live births were older, more likely to be Black, and had higher blood pressure, triglycerides and body mass index. Compared with nulliparous women, women with >/=4 had larger ascending aortic areas indexed to height [5.19 vs 4.74 cm2/m; p<0.0001; Table 1]. After adjustment for risk factors, multiparity remained a significant predictor of aortic size. Compared to nulliparous women, women with >/=4 live births also had higher aortic PWV (5.54 vs 4.54 m/s; p<0.0001) and lower aortic compliance (21.9 vs 27.2 mL/mmHg; p 0.0002), but these relationships were no longer significant after multivariable adjustment (Table 1). Analyzing live births as a continuous variable did not change these results. Conclusions: Multiparity was associated with thoracic aortic enlargement, independent of age and relevant risk factors. Parity is an emerging sex-specific risk factor in cardiovascular disease that may have an impact on aortic remodeling in women.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K G Skaarup ◽  
M C H L Lassen ◽  
S R B S Biering-Soerensen ◽  
P G J Joergensen ◽  
M A Appleyard ◽  
...  

Abstract Background Global longitudinal strain (GLS) of the left ventricle (LV) has proved to be a strong predictor of cardiovascular morbidity and mortality. GLS declines throughout adult-life as the LV remodels and adapts. Information on the impact of cardiac risk factors such as male sex, obesity, smoking status, hypertension, hypercholesterolemia, and diabetes on GLS through time has not yet been investigated. Purpose The aim of the present study was to investigate the impact of age, sex, body mass index (BMI), smoking status (current and previous vs never), mean arterial blood pressure (MAP), total plasma cholesterol (TPC), and HbA1c on GLS in the general population over a 10-year period. Method A total of 689 citizens recruited from the general population participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5) a prospective longitudinal study. At CCHS4 the mean age was 51 years and 45% were male. The average decline in GLS during the follow-up period was −0.65%. All participants underwent two echocardiographic examinations median 10.4 [IQR: 10.2, 10.9] years apart along with thorough health examinations. All analyses were adjusted for baseline GLS value (CCHS4 value). Results In regression models, increasing age, male sex, increasing BMI, MAP, hypertension, increasing HbA1c, and diabetes proved to be significantly associated with increased decline in GLS. Relationship between significant continuous cardiovascular risk factors and ΔGLS are displayed in restricted spline curves (Figure 1). In a multivariable regression model including all the investigated cardiovascular risk factors, estimated glomerular filtration rate, plasma pro B-type natriuretic peptide, heart rate, and previous ischemic heart disease, age (standardized β-coef. = −0.10, P=0.005), male sex (standardized β-coef. = −0.16, P<0.001), and MAP (standardized β-coef. = −0.07, P=0.009) remained independent predictors of an accelerated decline in GLS during a 10-year period. Restricted cubic spline curves Conclusion In the general population increasing age, male sex, and increasing MAP are all independently associated with an accelerated decline in GLS over a 10-year period.


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