Risk of Cardiometabolic Risk Factors in Women With and Without a History of Breast Cancer: The Pathways Heart Study

2022 ◽  
Author(s):  
Marilyn L. Kwan ◽  
Richard K. Cheng ◽  
Carlos Iribarren ◽  
Romain Neugebauer ◽  
Jamal S. Rana ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Endocrine Therapy ◽  
Cumulative Incidence ◽  
Cardiometabolic Risk ◽  
Incidence Rates ◽  
Normal Weight ◽  
Cardiometabolic Risk Factors ◽  
Diabetes Incidence ◽  
Subdistribution Hazard

PURPOSE The incidence of cardiometabolic risk factors in breast cancer (BC) survivors has not been well described. Thus, we compared risk of hypertension, diabetes, and dyslipidemia in women with and without BC. METHODS Women with invasive BC diagnosed from 2005 to 2013 at Kaiser Permanente Northern California (KPNC) were identified and matched 1:5 to noncancer controls on birth year, race, and ethnicity. Cumulative incidence rates of hypertension, diabetes, and dyslipidemia were estimated with competing risk of overall death. Subdistribution hazard ratios (sHRs) were estimated by Fine and Gray regression, adjusted for cardiovascular disease–related risk factors, and stratified by treatment and body mass index (BMI). RESULTS A total of 14,942 BC cases and 74,702 matched controls were identified with mean age 61.2 years and 65% non-Hispanic White. Compared with controls, BC cases had higher cumulative incidence rates of hypertension (10.9% v 8.9%) and diabetes (2.1% v 1.7%) after 2 years, with higher diabetes incidence persisting after 10 years (9.3% v 8.8%). In multivariable models, cases had higher risk of diabetes (sHR, 1.16; 95% CI, 1.07 to 1.26) versus controls. Cases treated with chemotherapy (sHR, 1.23; 95% CI, 1.11 to 1.38), left-sided radiation (sHR, 1.29; 95% CI, 1.13 to 1.48), or endocrine therapy (sHR, 1.23; 95% CI, 1.12 to 1.34) continued to have higher diabetes risk. Hypertension risk was higher for cases receiving left-sided radiation (sHR, 1.11; 95% CI, 1.02 to 1.21) or endocrine therapy (sHR, 1.10; 95% CI, 1.03 to 1.16). Normal-weight (BMI < 24.9 kg/m2) cases had higher risks overall and within treatment subgroups versus controls. CONCLUSION BC survivors at KPNC experienced elevated risks of diabetes and hypertension compared with women without BC depending on treatments received and BMI. Future studies should examine strategies for cardiometabolic risk factor prevention in BC survivors.

Abstract P082: Elevated Circulating Endothelial-Derived Microvesicles Are Associated With Obesity-Related Endothelial Dysfunction

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
L. Madden Brewster ◽  
Tyler D Bammert ◽  
Jamie G Hijmans ◽  
Caitlin A Dow ◽  
Anabel Goulding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endothelial Dysfunction ◽  
Body Fat ◽  
Cardiometabolic Risk ◽  
Disease Risk ◽  
Normal Weight ◽  
Cardiometabolic Risk Factors ◽  
High Risk Populations ◽  
Health And Disease ◽  
Middle Aged Adults

Background: Obesity reduces the number of years lived free of cardiovascular disease (CVD) and increases the number of years lived with CVD, contributing to increased morbidity and mortality risk across all ages. Experimental and clinical studies indicate that a proatherogenic endothelial phenotype is a major consequence of increased adiposity and a primary mechanism underlying obesity-related CVD. Extracellular microvesicles, particularly endothelial cell-derived microvesicles (EMVs), are seminal functional modulators of vascular health and disease. The purpose of this study was to determine: 1) if circulating EMV levels are elevated with obesity, independent of other cardiometabolic risk factors; and if so, 2) whether circulating EMVs are associated with obesity-related endothelial vasodilator dysfunction. Methods: Thirty sedentary, middle-aged adults (45-63 years) were studied: 15 normal weight (10M/5F; age: 56±1 yr; BMI: 23.2±0.4 kg/m2; body fat: 25.1±2.4 %) and 15 obese (10M/5F; age: 54±1 yr; BMI: 31.5±0.3 kg/m2; body fat: 37.2±1.7 %). All subjects were free of other cardiometabolic risk factors and overt disease. EMV identification (CD31 + /42b - ) and concentration in peripheral blood were determined by flow cytometry. Forearm blood flow (FBF: via plethysmography) was assessed in response to intra-arterial infusions of acetylcholine (4.0, 8.0 and 16.0 μg/100 mL tissue/min) and sodium nitroprusside (1.0, 2.0 and 4.0 μg/100 mL tissue/min). Results: Circulating EMV levels were ~100% higher (P<0.05) in obese (182±14 EMV/μL) compared with normal weight (91±12 EMV/μL) adults. FBF response to acetylcholine was significantly lower (~35%) in the obese (from 4.0±0.2 to 10.3±0.6 mL/100 mL tissue/min vs 4.3±0.3 to 15.4±0.8 mL/100 mL tissue/min) group. Circulating EMVs were significantly and inversely associated with total FBF response to acetylcholine (r=-0.55). Conclusions: Obesity, independent of other cardiometabolic risk factors, is associated with elevated circulating levels of EMVs. Higher circulating EMVs in obese adults may contribute to adiposity-related endothelial dysfunction and vascular disease risk. Indeed, circulating EMVs have been linked to disease risk, severity and outcome in other high-risk populations.

scholarly journals BMI Change, Fitness Change and Cardiometabolic Risk Factors Among 8th Grade Youth

2013 ◽  
Vol 25 (1) ◽  
pp. 52-68 ◽  
Author(s):  
Russell Jago ◽  
Kimberly L. Drews ◽  
Robert G. McMurray ◽  
Tom Baranowski ◽  
Pietro Galassetti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass ◽  
Cardiometabolic Risk ◽  
Normal Weight ◽  
Cardiometabolic Risk Factors ◽  
Additive Effect ◽  
Fitness Effect ◽  
Fitness Effects ◽  
8Th Grade ◽  
Shuttle Run

This paper examined whether a two-year change in fitness, body mass index (BMI) or the additive effect of change in fitness and BMI were associated with change in cardiometabolic risk factors among youth. Cardiometabolic risk factors, BMI group (normal weight, overweight or obese) were obtained from participants at the start of 6th grade and end of 8th grade. Shuttle run laps were assessed and categorized in quintiles at both time points. Regression models were used to examine whether changes in obesity, fitness or the additive effect of change in BMI and fitness were associated with change in risk factors. There was strong evidence (p < .001) that change in BMI was associated with change in cardiometabolic risk factors. There was weaker evidence of a fitness effect, with some evidence that change in fitness was associated with change in total cholesterol, HDL-C, LDL-C and clustered risk score among boys, as well as HDL-C among girls. Male HDL-C was the only model for which there was some evidence of a BMI, fitness and additive BMI*fitness effect. Changing body mass is central to the reduction of youth cardiometabolic risk. Fitness effects were negligible once change in body mass had been taken into account.

scholarly journals Relationship of TSH levels with cardiometabolic risk factors in US youth aged 12-18 years and population-based reference percentiles for thyroid function tests.

2020 ◽  
Author(s):  
Xinlei Chen ◽  
Shuliang Deng ◽  
Cecilia Sena ◽  
Chuhan Zhou ◽  
Vidhu V Thaker
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Abdominal Obesity ◽  
Cardiometabolic Risk ◽  
Normal Weight ◽  
The Body ◽  
Cardiometabolic Risk Factors ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Tsh Levels

Context: Thyroid hormones play an important role in the metabolic homeostasis of the body and have been associated with cardiometabolic risk. Objective: To examine the association of cardiometabolic risk factors (CMRF) with TSH levels in youth at population level in the US. Design & Setting: Cross-sectional study of youth aged 12-18 years without known thyroid abnormalities from National Health and Nutrition Examination Survey 1999-2012. Subclinical hypothyroidism (SH) was defined as TSH levels 4.5-10 mIU/L. Assessed CMRF included abdominal obesity (waist circumference > 90th percentile), hypertriglyceridemia (TG ≥ 130 mg/dL), low HDL cholesterol (HDL-C < 40 mg/dL), elevated blood pressure (SBP and DBP ≥ 90th percentile), hyperglycemia (FBG ≥ 100 mg/dL, or known diabetes), insulin resistance (HOMA-IR > 3.16) and elevated alanine transferase (ALT ≥ 50 U/L for boys and ≥ 44 U/L for girls). Age and sex- specific percentiles for thyroid parameters were calculated for youth with normal weight. Results: In this cohort of youth (51.3% male), 31.2% had overweight/obesity. The prevalence of SH was 2.0 % (95% CI 1.2-3.1). The median TSH levels were higher in youth with overweight/obesity (p<.001). Adjusting for age, sex, race/ethnicity and level of obesity, youth with TSH in the 4th quantile had higher odds of abdominal obesity (OR 2.53 [1.43-4.46], p = .002), higher HOMA-IR (OR 2.82 [1.42-5.57], p=.003) and ≥ 2 CMRF (OR 2.20 [1.23-3.95], p=.009). Conclusions: The prevalence of SH is low in US youth. The higher odds of insulin resistance and CMRF in youth with TSH levels > 75th percentile requires further study.

Incidence of cardiovascular risk factors in female patients with systemic lupus erythematosus: a 3-year follow-up cohort

Lupus ◽  
2018 ◽  
Vol 27 (11) ◽  
pp. 1790-1798 ◽  
Author(s):  
C S A Monção ◽  
L N Martins ◽  
M P S Penteado ◽  
R C P Reis ◽  
F M M Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cumulative Incidence ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Systemic Lupus ◽  
Prednisone Dose ◽  
Cad Risk

Objectives To evaluate the incidence and variability of traditional coronary artery disease (CAD) risk factors in a cohort of lupus patients and to investigate if prednisone use predicts an increase in the number of risk factors. Methods A total of 151 women, 37.8 ± 11.1 (mean ± SD) years old at baseline, were reevaluated after a median period of 39 (interquartile range 36.5–42.0) months. The cumulative incidence of traditional risk factors, the incidence rate (with 95% confidence interval) of hypertension, diabetes, dyslipidemia and hypertriglyceridemia, and the frequency of the risk factors’ disappearance were calculated. Metabolic syndrome (MetS) and Framingham risk score (FRS) were computed. Logistic regression was used to investigate if maximum or cumulative prednisone dose used during follow-up predicted an increase in the cardiometabolic risk factors’ number. Results The cumulative incidence of risk factors varied from 39.1% (abdominal obesity) to zero (smoking), and the incidence rate varied from 133.2 (87.8–178.6) per 1000 person-years (dyslipidemia) to 10.4 (1.3–19.5) per 1000 person-years (diabetes). The cumulative incidence for MetS was 18.8%, and 11.7% of 143 patients with low FRS at baseline (T1) were classified in the high-risk category at the end of the study (T2). Dyslipidemia was the most variable risk factor, with 43.5% disappearance at T2. The maximum prednisone dose used during follow-up was borderline ( p = 0.050) for prediction of an increase in the number of cardiometabolic risk factors in an adjusted model for antimalarial use, modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and age. Conclusion The authors described high incidence and variability of CAD risk factors in female lupus patients, with higher prednisone dose being borderline for an increase in the number of cardiometabolic risk factors.

scholarly journals Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative

Cancer ◽  
2018 ◽  
Vol 124 (8) ◽  
pp. 1798-1807 ◽  
Author(s):  
Michael S. Simon ◽  
Jennifer L. Beebe-Dimmer ◽  
Theresa A. Hastert ◽  
JoAnn E. Manson ◽  
Elizabeth M. Cespedes Feliciano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Women’S Health ◽  
Women's Health ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Women's Health Initiative ◽  
Women’S Health Initiative ◽  
Health Initiative ◽  
The Women’S Health Initiative

scholarly journals Sex-specific relationship of cardiometabolic syndrome with lower cortical thickness

Neurology ◽  
2019 ◽  
Vol 93 (11) ◽  
pp. e1045-e1057 ◽  
Author(s):  
Si Eun Kim ◽  
Jin San Lee ◽  
Sookyoung Woo ◽  
Seonwoo Kim ◽  
Hee Jin Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cortical Thickness ◽  
Cardiometabolic Risk ◽  
Brain Aging ◽  
Normal Weight ◽  
Cardiometabolic Risk Factors ◽  
Obese Women ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Age Related

ObjectiveTo investigate whether cardiometabolic factors were associated with age-related differences in cortical thickness in relation to sex.MethodsIn this cross-sectional study, we enrolled 1,322 cognitively normal elderly (≥65 years old) individuals (774 [58.5%] men, 548 [41.5%] women). We measured cortical thickness using a surface-based analysis. We analyzed the associations of cardiometabolic risk factors with cortical thickness using multivariate linear regression models after adjusting for possible confounders and interactions with age.ResultAmong women, hypertension (β = −1.119 to −0.024, p < 0.05) and diabetes mellitus (β = −0.920, p = 0.03) were independently associated with lower mean cortical thickness. In addition, there was an interaction effect between obesity (body mass index [BMI] ≥27.5 kg/m2) and age on cortical thickness in women (β = −0.324 to −0.010, p < 0.05), suggesting that age-related differences in cortical thickness were more prominent in obese women compared to women with normal weight. Moreover, low education level (<6 years) was correlated with lower mean cortical thickness (β = −0.053 to −0.046, p < 0.05). Conversely, among men, only being underweight (BMI ≤18.5 kg/m2, β = −2.656 to −0.073, p < 0.05) was associated with lower cortical thickness.ConclusionsOur findings suggest that cortical thickness is more vulnerable to cardiometabolic risk factors in women than in men. Therefore, sex-specific prevention strategies may be needed to protect against accelerated brain aging.

scholarly journals Nomograms for Estimating Cause-Specific Death Rates of Patients With Inflammatory Breast Cancer: A Competing-Risks Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110163
Author(s):  
Fengshuo Xu ◽  
Jin Yang ◽  
Didi Han ◽  
Qiao Huang ◽  
Chengzhuo Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Competing Risks ◽  
Inflammatory Breast Cancer ◽  
Cumulative Incidence ◽  
Histological Grade ◽  
Estrogen Receptor Status ◽  
Incidence Rates ◽  
Subdistribution Hazard ◽  
Receptor Status ◽  
Calibration Curves

Purpose: Inflammatory breast cancer (IBC) is a rare, aggressive and special subtype of primary breast cancer. We aimed to establish competing-risks nomograms to predict the IBC-specific death (BCSD) and other-cause-specific death (OCSD) of IBC patients. Methods: We extracted data on primary IBC patients from the SEER (Surveillance, Epidemiology, and End Results) database by applying specific inclusion and exclusion criteria. Cumulative incidence function (CIF) was used to calculate the cumulative incidence rates and Gray’s test was used to evaluate the difference between groups. Fine-Gray proportional subdistribution hazard method was applied to identify the independent predictors. We then established nomograms to predict the 1-, 3-, and 5-year cumulative incidence rates of BCSD and OCSD based on the results. The calibration curves and concordance index (C-index) were adopted to validate the nomograms. Results: We enrolled 1699 eligible IBC patients eventually. In general, the 1-, 3-, and 5-years cumulative incidence rates of BCSD were 15.3%, 41.0%, and 50.7%, respectively, while those of OCSD were 3.0%, 5.1%, and 7.4%. The following 9 variables were independent predictive factors for BCSD: race, lymph node ratio (LNR), AJCC M stage, histological grade, ER (estrogen receptor) status, PR (progesterone receptor) status, HER-2 (human epidermal growth factor-like receptor 2) status, surgery status, and radiotherapy status. Meanwhile, age, ER, PR and chemotherapy status could predict OCSD independently. These factors were integrated for the construction of the competing-risks nomograms. The results of calibration curves and C-indexes indicated the nomograms had good performance. Conclusions: Based on the SEER database, we established the first competing-risks nomograms to predict BCSD and OCSD of IBC patients. The good performance indicated that they could be incorporated in clinical practice to provide references for clinicians to make individualized treatment strategies.

Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review

2020 ◽  
pp. 1-12
Author(s):  
Bruna Clemente Cota ◽  
Lara Gomes Suhett ◽  
Nathália Nogueira Leite ◽  
Patrícia Feliciano Pereira ◽  
Sarah Aparecida Vieira Ribeiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Physical Fitness ◽  
Cardiometabolic Risk ◽  
Eating Habits ◽  
Health Behaviours ◽  
Normal Weight ◽  
Cardiometabolic Risk Factors ◽  
High Waist Circumference ◽  
Normal Weight Obesity ◽  
Meta Analyses

Abstract Objective: To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. Design: The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. Setting: School, university and population. Participants: Adolescents between 10 and 19 years old. Results: A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. Conclusions: The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).

Sign in / Sign up

Export Citation Format

Share Document