Prevalence of Metabolic Syndrome and Associated CVD Risk Factors among Women of South Asian Ethnic Subgroups

Abstract This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18–60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.

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Abstract P470: Heterogeneity In Prevalence Of Cardiovascular Disease Risk Factors Among Hispanic Ethnic Groups: Evidence From The 2010-2018 National Health Interview Survey

Circulation ◽

10.1161/circ.141.suppl_1.p470 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Sabrina Elias ◽

Ruth-alma N Turkson-ocran ◽

Binu Koirala ◽

Samuel Byiringiro ◽

Hailey Miller ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Ethnic Groups ◽

Physical Inactivity ◽

High Cholesterol ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Current Smoking ◽

Hispanic Adults ◽

Ethnic Subgroups

Introduction: Persons of Hispanic origin are a growing share of the U.S. population but include diverse ethnic groups with unique cultures, lifestyles, exposures, and countries of origin. Hispanics are disproportionately affected by cardiovascular disease (CVD) risk factors in comparison to non-Hispanics. However, few studies have examined the heterogeneity in their burden of CVD risk. Hypothesis: We hypothesized that there would be significant heterogeneity in the prevalence of CVD risk factors among ethnic subgroups of Hispanic adults. Methods: We used a cross-sectional design to examine the prevalence of CVD risk factors, defined per national guidelines, among Hispanic adults in the 2010-2018 National Health Interview Surveys. Generalized linear models using Poisson distribution were fitted to obtain adjusted predicted probabilities and risk of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking by Hispanic ethnic subgroup. Results: We included 185,511 participants with mean(±sd) age 31(0.2) years and 50% male. Most were Mexican (65.1%) whereas, few were Dominican (3.0%). Prevalence of hypertension (28.4%), diabetes (12.9%), high cholesterol (25.0%), and current smoking (6.1%) was highest among Puerto Ricans. Prevalence of overweight/obesity was highest among Mexicans (74.5%) and physical inactivity was highest among Dominicans (62.3%). Compared to Mexicans, Central Americans were less likely to smoke and have hypertension, overweight/obesity, and diabetes (ps<0.05). ( Table ) Conclusion: We observed striking heterogeneity in the prevalence of CVD risk factors across Hispanic ethnic subgroups, especially for diabetes, physical inactivity, and smoking. These results suggest that aggregating data on Hispanics may mask differences in CVD risk and hinder efforts to reduce health disparities in this population. Our findings provide actionable information on CVD risk factors for specific Hispanic ethnic subgroups.

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Reversal Rate of Clustering of Cardiovascular Disease Risk Factors of Metabolic Syndrome in the General Population: The Niigata Preventive Medicine Study

Journal of Obesity ◽

10.1155/2010/623593 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Shinsuke Okada ◽

Akiko Suzuki ◽

Hiroshi Watanabe ◽

Toru Watanabe ◽

Yoshifusa Aizawa

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Risk Factor ◽

Disease Risk ◽

Fasting Blood Glucose ◽

Reversal Rate ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Metabolic Syndrome

The reversal rate from clustering of cardiovascular disease (CVD) risk factors—components of the metabolic syndrome (MetS) is not known.Methods and Results. Among 35,534 subjects who received the annual health examinations at the NiigataHealth Foundation (Niigata, Japan), 4,911 subjects had clustering of 3 or more of the following CVD risk factors: (1) body mass index (BMI) ≥25 Kg/m2, (2) blood pressure ≥130 mm Hg in systolic and/or ≥85 mm Hg in diastolic, (3) triglycerides ≥150 mg/dL, (4) high-density lipoprotein cholesterol ≤40 mg/dL in men, ≤50 mg/dL in women, and (5) fasting blood glucose ≥100 mg/dL. After 5 years 1,929 subjects had a reversal of clustering (39.4%). A reversal occurred more often in males. The subjects with a reversal of clustering had milder level of each risk factor and a smaller number of risk factors, while BMI was associated with the least chance of a reversal.Conclusion. We concluded that a reversal of clustering CVD risk factors is possible in 4/10 subjects over a 5-year period by habitual or medical interventions. Gender and each CVD risk factor affected the reversal rate adversely, and BMI was associated with the least chance of a reversal.

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The Metabolic Syndrome: Time for a Critical Appraisal

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2006-12-2-99-116 ◽

2006 ◽

Vol 12 (2) ◽

pp. 99-116 ◽

Cited By ~ 3

Author(s):

R. Kahn ◽

J. Buse ◽

E. Ferrannini ◽

M. Stern

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Critical Appraisal ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Metabolic Syndrome ◽

Criteria For Diagnosis ◽

Treat All ◽

Underlying Pathophysiology ◽

Considerable Doubt

The term «metabolic syndrome» refers to a clustering of specific cardiovascular disease (CVD) risk factors whose underlying pathophysiology is thought to be related to insulin resistance. Since the term is widely used in research and clinical practice, we undertook an extensive review of the literature in relation to the syndrome’s definition, underlying pathogenesis, and association with CVD and to the goals and impact of treatment. While there is no question that certain CVD risk factors are prone to cluster, we found that the metabolic syndrome has been imprecisely defined, there is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a CVD risk marker. Our analysis indicates that too much critically important information is missing to warrant its designation as a «syndrome.» Until much needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the «metabolic syndrome.»

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High prevalence of cardiovascular risk factors and insulin resistance 6 years after hyperglycemia first detected in pregnancy in Cape Town, South Africa

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000740 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000740

Author(s):

Tawanda Chivese ◽

Shane A Norris ◽

Naomi S Levitt

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Cape Town ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Index Pregnancy ◽

High Prevalence ◽

In Pregnancy

ObjectiveTo investigate the prevalence and associated cardiovascular risk factors 6 years after hyperglycemia first detected in pregnancy (HFDP) in Cape Town, South Africa.Research design and methodsData were collected during the index pregnancy from all women diagnosed with HFDP at a major referral hospital in Cape Town. Participants were evaluated 6 years later using a cross-sectional study. At follow-up participants had a 75 g oral glucose tolerance test, fasting lipogram, blood pressure and anthropometric measurements, and a fieldworker administered the questionnaire. We used the Adult Treatment Panel III criteria for the diagnosis of metabolic syndrome and individual risk factors. Insulin resistance was assessed using the homeostatic model of insulin resistance.ResultsAt follow-up 220 women were reviewed. Their mean age at follow-up was 37.2 (SD 6.0) years. The prevalence of cardiovascular disease (CVD) risk factors was 60.9% (95% CI 54.3 to 67.2) for metabolic syndrome, 75% (95% CI 65.9 to 82.3) for insulin resistance, 62.3% (95% CI 55.6 to 68.5) for dysglycemia, 41.4% (95% CI 35.0 to 48.0) for raised blood pressure, and 74.6% (95% CI 683 to 79.9) for dyslipidemia. Women with diabetes in pregnancy compared with those with gestational diabetes during the index pregnancy had a higher prevalence of metabolic syndrome (74.3% vs 54.7%, p=0.010) and dysglycemia (88.6% vs 50.0%, p<0.001) at follow-up. Lower school education attainment, having a subsequent pregnancy, waist circumference at follow-up, and fasting blood glucose at HFDP diagnosis were associated with metabolic syndrome.ConclusionWe found a high prevalence of CVD risk factors in South African women within 6 years of HFDP, which highlights the need to develop and evaluate interventions optimizing the cardiometabolic health of this vulnerable group. The main limitations of our research are the lack of a comparative group of women without HFDP and that we did not assess for CVD risk factors before HFDP.

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Abstract MP007: Epicardial Fat Thickness: Distribution of and Associations With Cardiovascular Risk Factors in the Framingham Heart Study

Circulation ◽

10.1161/circ.125.suppl_10.amp007 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Michael L Chuang ◽

Philimon Gona ◽

Noriko Oyama-Manabe ◽

Carol J Salton ◽

Udo Hoffmann ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Risk Factor ◽

Cvd Risk Factors ◽

Odds Ratios ◽

Cvd Risk ◽

Epicardial Fat Thickness ◽

Heart Study ◽

Fat Thickness ◽

Fat Volume

Introduction: High pericardial fat volume (fatVOL) is associated with excess cardiovascular disease (CVD), but analyses for true fat volume can be time-consuming and require specialized software. Linear epicardial fat thickness (fatTHK) can be measured quickly from cardiac magnetic resonance (MRI) images and may serve as a surrogate for fatVOL. We sought to determine the distribution and CVD risk factor correlates of high fatTHK and to compare fatTHK with fatVOL in a community-dwelling adult cohort. Methods: Participants were drawn from the Framingham Heart Study Offspring cohort (N=995, aged 65±9 years, 54% women) and underwent cardiac MRI (SSFP sequence) and multidetector CT during 2002-2005. Clinical and risk factor covariates were obtained at the preceding cycle 7 examination (1998-2001). FatVOL was determined from volumetric MDCT data. FatTHK was measured from the MRI 4-chamber view over the midlevel right ventricular free wall at end-diastole. A healthy referent subsample (N=328), free of major CVD risk factors, was used to determine sex-specific cut points for high fatTHK. Odds ratios for high (>90th percentile) fatVOL and fatTHK versus common CVD risk factors were determined. Results: FatTHK was greater in men than women and increased with age in both sexes. FatTHK correlated with fatVOL at r=0.45 (p less than 0.001) High fatTHK was >=16.0 mm in men and >=13.3 mm in women, with 20.1% prevalence in men and 18.1 % in women. In both sexes, high fatVOL was associated ( Table ) with obesity, metabolic syndrome, dysglycemia, hypertension, prevalent CVD and hypertriglyceridemia. Similar associations, with slightly lower odds ratios, were seen for fatTHK. Conclusions: Greater fatTHK is associated with an excess burden of multiple CVD risk factors. Although correlation between linear fatTHK and true fatVOL was relatively modest, both measures appear to have similar associations with common CVD risk factors. FatTHK may be advantageous in that it can be determined quickly using standard MRI sequences for ventricular function. Table. Odds Ratios for High Pericardial Fat vs. Common CVD Risk Factors fatVOL: Men fatVOL: Women fatTHK: Men fatTHK: Women Obesity, BMI >=30 kg/m2 4.34 (2.78–6.78) 3.13 (2.03–4.82) 2.52 (1.77–3.60) 2.62 (1.84–3.74) Metabolic Syndrome 3.72 (2.38–5.83) 2.60 (1.65–4.08) 2.59 (1.75–3.84) 2.21 (1.53–3.17) Dysglycemia, FPG >=100 mg/dL 2.64 (1.72–4.06) 3.05 (1.98–4.68) 1.75 (1.22–2.50) 1.56 (1.10–2.23) Hypertension, S>=140 or D>=90 mmHg 2.51 (1.66–3.78) 1.96 (1.30–2.97) 2.10 (1.48–2.98) 1.58 (1.13–2.22) Prevalent CVD 1.94 (1.17–3.21) 2.48 (1.41–4.38) 1.73 (1.17–2.55) 1.83 (1.19–2.81) Triglycerides >=150 mg/dL 1.89 (1.25–2.86) 2.21 (1.43–3.42) 1.64 (1.15–2.34) 1.98 (1.38–2.82) Low HDL: M<40, W<50 mg/dL 1.57 (1.03–2.38) 1.44 (0.91–2.28) 1.40 (0.98–1.99) 2.57 (1.80–3.67)

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Are immigrants at risk of heart disease in Australia? A systematic review

Australian Health Review ◽

10.1071/ah090479 ◽

2009 ◽

Vol 33 (3) ◽

pp. 479 ◽

Cited By ~ 12

Author(s):

Jayantha Dassanayake ◽

Shyamali C Dharmage ◽

Lyle Gurrin ◽

Vijaya Sundararajan ◽

Warren R Payne

Keyword(s):

Risk Factors ◽

Systematic Review ◽

South Asian ◽

Physical Inactivity ◽

Middle Eastern ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Higher Alcohol ◽

The United Kingdom ◽

European Immigrants

We systematically reviewed the peer-reviewed literature to establish the prevalence of cardiovascular disease (CVD) among immigrants in Australia and whether being an immigrant is a CVD risk factor. Of 23 studies identified, 12 were included. Higher prevalence of CVD was found among Middle Eastern, South Asian and some European immigrants. Higher prevalence of CVD risk factors was found among Middle Eastern and Southern European immigrants. Higher alcohol consumption was found among immigrants from New Zealand, the United Kingdom and Ireland. Smoking and physical inactivity were highly prevalent among most immigrants.

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Initial Outcomes of CardioClick, a Telehealth Program for Preventive Cardiac Care: Observational Study

JMIR Cardio ◽

10.2196/28246 ◽

2021 ◽

Vol 5 (2) ◽

pp. e28246

Author(s):

Neil M Kalwani ◽

Austin N Johnson ◽

Vijaya Parameswaran ◽

Rajesh Dash ◽

Fatima Rodriguez

Keyword(s):

Risk Factors ◽

South Asian ◽

Patient Engagement ◽

Prevention Program ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Preventive Cardiology ◽

Asian Patients ◽

Cardiology Clinic ◽

Cvd Prevention

Background Telehealth use has increased in specialty clinics, but there is limited evidence on the outcomes of telehealth in primary cardiovascular disease (CVD) prevention. Objective The objective of this study was to evaluate the initial outcomes of CardioClick, a telehealth primary CVD prevention program. Methods In 2017, the Stanford South Asian Translational Heart Initiative (a preventive cardiology clinic focused on high-risk South Asian patients) introduced CardioClick, which is a clinical pathway replacing in-person follow-up visits with video visits. We assessed patient engagement and changes in CVD risk factors in CardioClick patients and in a historical in-person cohort from the same clinic. Results In this study, 118 CardioClick patients and 441 patients who received in-person care were included. CardioClick patients were more likely to complete the clinic’s CVD prevention program (76/118, 64.4% vs 173/441, 39.2%, respectively; P<.001) and they did so in lesser time (mean, 250 days vs 307 days, respectively; P<.001) than the patients in the historical in-person cohort. Patients who completed the CardioClick program achieved reductions in CVD risk factors, including blood pressure, lipid concentrations, and BMI, which matched or exceeded those observed in the historical in-person cohort. Conclusions Telehealth can be used to deliver care effectively in a preventive cardiology clinic setting and may result in increased patient engagement. Further studies on telehealth outcomes are needed to determine the optimal role of virtual care models across diverse preventive medicine clinics.

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Lack of Excess Cardiovascular Risks among First Degree Relatives of Persons with Diabetes Mellitus: Is Lifestyle the Cause?

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/44775.14566 ◽

2021 ◽

Author(s):

Taiwo H Raimi ◽

Bolade Folasade Dele-Ojo ◽

Samuel A Dada ◽

Joseph O Fadare

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Risk Factors ◽

Metabolic Syndrome ◽

State University ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Family History Of Diabetes ◽

The People ◽

Significant Difference

Introduction: The prevalence of Diabetes Mellitus (DM) is rising worldwide with a projected increase of more than 50% in next three decades. Family History of Diabetes (FHD) is a recognised risk factor for DM, but development of DM in relatives of people with the disease, who carry susceptible genes, is dependent on interaction with other factors such as nutrition, physical activity and environment. Aim: To determine the prevalence of metabolic syndrome and impact of lifestyle on the CVD risk factors among adult Nigerian with FHD. Materials and Methods: This was a cross-sectional study among staff and students of Ekiti State University and Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Eighty-six participants with FHD were age and sex-matched with 86 participants who had no FHD. Relevant demographic and lifestyle information were obtained, and clinical measurements of Body Mass Index (BMI), waist and hip circumferences and blood pressures were obtained by standard protocols. Fasting plasma glucose and lipid panel were determined. Metabolic syndrome was defined according to the International Diabetes Federation criteria (IDF). The clinical, laboratory and other variables of the people with FHD and those without FHD were compared with Pearson’s Chi-Square and Student’s t-test. Results: The age, clinical, anthropometric and laboratory parameters were similar between the two groups. Participants with FHD consume more poultry (17.6% vs 3.5%) and less red meat (27.1% vs 37.2%) than those without FHD (p=0.036), but the level of physical activity and consumption of fruits/vegetables, and smoking did not differ between the two groups. Metabolic syndrome was equally prevalent between the people with or without FHD (p=0.846). There was no significant difference (p>0.05), in the prevalence of CVD risk factors, such as hypertension, hyperglycaemia, dyslipidaemia, and obesity between the two groups. Conclusion: The prevalence of metabolic syndrome was similar among people with or without FHD. Healthy lifestyle may explain the lack of excess CVD risk factors among people with FHD.

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Sex Differences in Associations of Depressive Symptoms with Cardiovascular Risk Factors and Metabolic Syndrome among African Americans

Cardiovascular Psychiatry and Neurology ◽

10.1155/2013/979185 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 12

Author(s):

Denise C. Cooper ◽

Ranak B. Trivedi ◽

Karin M. Nelson ◽

Gayle E. Reiber ◽

Alan B. Zonderman ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Sex Differences ◽

African American ◽

Depressive Symptoms ◽

African Americans ◽

African American Women ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Unit Increase

Young to middle-aged women usually have notably lower rates of cardiovascular disease (CVD) than their male counterparts, but African American women lack this advantage. Their elevated CVD may be influenced by sex differences in associations between depressed mood and CVD risk factors. This cross-sectional study examined whether relations between scores on the Center for Epidemiologic Studies-Depression (CES-D) scale and a spectrum of CVD risk factors varied by sex among African Americans (n=1076; ages 30–64) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Sex-stratified multiple regressions and logistic regressions were conducted. Among women, CES-D scores correlated positively with systolic blood pressure and waist-to-hip ratio (P's<.05), but inversely with high-density lipoprotein cholesterol (HDL-C) (P<.01). Women had twice the odds for metabolic syndrome if CES-D scores ≥16 and had a ≥14% increase in odds of hypertension, abdominal obesity, and low HDL-C with each 5-unit increase in CES-D scores. Among men, CES-D scores correlated positively with high-sensitivity C-reactive protein (P<.05), and odds of hypertension increased by 21% with each 5-unit increase in CES-D scores. Depressive symptoms may promote premature CVD risk in African Americans, at least in part, via CVD risk factors and prevalent metabolic syndrome, particularly in African American women.

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