Examining Association Between Reported High Cholesterol and Risk Factors in Adults With Intellectual and Developmental Disabilities (IDD): A Five-Year Follow-Up

2021 ◽  
Vol 59 (2) ◽  
pp. 112-122
Author(s):  
Sumithra Murthy ◽  
Kelly Hsieh

Abstract Adults with intellectual and developmental disabilities (IDD) are at a greater risk of developing high cholesterol and cardiovascular disease. We examined whether physical inactivity, obesity, and diabetes were predictive of reported high cholesterol and whether there were any mediating effects of diabetes on the relationship between obesity and high cholesterol in 1,618 adults with IDD across five years. Results suggest that obesity and diabetes were significantly associated with high cholesterol after adjusting for age, sex, and residence type with a partial mediator effect of diabetes in the relationship between obesity and high cholesterol across all time points. Further research is needed to explore the causal mechanisms behind the relationships between obesity, diabetes, and high cholesterol.

2010 ◽  
Vol 30 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Jie Dong ◽  
Yuan Chen

ObjectiveWe studied whether improper bag exchange predicts the first peritonitis episode in continuous ambulatory peritoneal dialysis (CAPD) patients.Patients and MethodsOur single-center prospective observational study of 130 incident urban CAPD patients who started peritoneal dialysis (PD) between March 2005 and August 2008 aimed to determine the relationship between bag exchange procedures examined at the 6th month of PD and risk for a first peritonitis episode. All patients were followed until a first peritonitis episode, censoring, or the end of the study.ResultsThese 130 patients experienced 22 first peritonitis episodes during the 14-month follow-up. During bag exchange evaluation, 51.5% of patients washed their hands improperly, 46.2% failed to check expiration date or bag leakage, and 11.5% forgot to wear a face mask and cap. Patients experiencing peritonitis were more likely to forget to wear a face mask and cap. In multivariate Cox regression model, not wearing a face mask and cap [hazard ratio (HR): 7.26; 95% confidence interval (CI): 2.6 to 20.1; p < 0.001] and having anemia (HR: 0.96; 95% CI: 0.94 to 0.99; p = 0.005) were independent risk factors for a first episode of peritonitis.ConclusionsNot wearing a face mask and cap and having anemia were independent risk factors for peritonitis. A further randomized control study needs to verify the correlation between improper bag exchange technique and peritonitis in PD patients.


2012 ◽  
Vol 17 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Kreton Mavromatis ◽  
Konstantinos Aznaouridis ◽  
Ibhar Al Mheid ◽  
Emir Veledar ◽  
Saurabh Dhawan ◽  
...  

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Tracie Barnett ◽  
Melanie Henderson ◽  

Background and Purpose: Sedentary behavior (SB) and physical inactivity are distinct constructs for which separate research and intervention paradigms may be warranted. To this end, we compared individual- and neighborhood-level risk factors of each among youth at risk of obesity. Methods: Data are from QUALITY, a cohort study of the natural history of obesity in Quebec, Canada. Baseline data were obtained in 2005-2008 when children were aged 8-10y (n=512 families). Activity level was measured using accelerometers at age 8-10y and again 2 years later at age 10-12y. At each time point, children were categorized as inactive if they did <60 min/day of moderate to vigorous physical activity (PA) and as excessively sedentary if they recorded <100 counts/min for > 50% of the day. Children were required to have worn the device for at least 4 days and for at least 10 hours/day. Child-level factors included sex, sleep duration, and weekly frequency seeing friends; neighborhood-level factors included density of fast food outlets, convenience stores, and parks; school proximity, street connectivity, land use mix, disorder, social and material deprivation, and parental perceived safety. Separate logistic regression models were estimated for each of inactivity and excessive SB. We tested models using the identical set of baseline risk factors at both time points. Analyses were restricted to 413 children with complete data at age 8-10y, and to 283 children with complete data at age 10-12y. Models controlled for child’s obesity status, father and mother’s obesity status, and parental education. Results: At both time points, girls were 75% to 85% more likely to be inactive than boys, but were equally likely to be excessively sedentary as were boys. Also at both time points, each additional weekly outing with friends reduced the likelihood of being sedentary by 20%, but did not reduce the likelihood of being inactive. Only area-level disorder was associated with being excessively sedentary, and only in 10-12y olds; in contrast, several factors increased the likelihood of being inactive, including area deprivation at age 8-10y (OR: 1.7; 1.0-3.0) and perceived lack of safety at age 10-12y (OR: 2.8: 1.1-6.3). Moreover, the likelihood of being inactive decreased by 24% for each quintile increase in land use mix. Although obesity status in children was strongly associated with outcomes in all models, other determinants were unaffected by its inclusion in the models. Conclusions: Our findings suggest that physical inactivity and sedentary behavior are driven by largely distinct paradigms. Each of these may be impacted through increases in light PA. Although interventions need to target all spheres of influence, reducing physical inactivity may be more effectively mediated by features of the built environment, while leveraging social and peer groups may be more effective to reduce sedentary behaviors.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Tracy E Madsen ◽  
Jane C Khoury ◽  
Kathleen S Alwell ◽  
Opeolu M Adeoye ◽  
Felipe De Los Rios La Rosa ◽  
...  

Background: Data from the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) have demonstrated stable or increasing stroke incidence rates in young adults with differences by sex and race, suggesting the need for targeted approaches to stroke prevention in the young. We aimed to describe trends over time in prevalence of stroke risk factors among adults ages 20-54 with stroke by sex and race. Methods: Cases of incident stroke (IS, ICH, SAH) occurring in those 20-54 years old and living in a 5-county area of southern Ohio/northern Kentucky were ascertained during 5 study periods (1993-1994, 1999, 2005, 2010, 2015). All physician-adjudicated inpatient events and a sampling of outpatient events were included, excluding nursing home events. Data on risk factors (hypertension, diabetes, obesity (BMI≥30), and high cholesterol) diagnosed prior to stroke were abstracted from medical records, and prevalence of each risk factor was reported over time in race/sex groups. Trends over time were examined using the Cochran-Armitage test. Results: Over the 5 study periods, 1204 incident strokes were included; 49% were women, 33% were black, and mean age was 46 (SD 7) years. Premorbid hypertension increased over time in Black women (48% in 1993/4 to 76% in 2015, p=0.005) but not in any other race/sex group (all p>0.05). Premorbid high cholesterol increased significantly in all race/sex groups (Figure, all p<0.05) except for White men (p=0.06). There were no significant trends over time in pre-stroke diagnoses of diabetes or obesity in any of the race/sex groups (Figure). Conclusions: Among patients aged 20-54 with incident stroke in a large population-based study, the change in the prevalence of hypertension and high cholesterol differed by sex and race, while obesity and diabetes were stable over time in all race/sex groups. Future research is needed to address risk factor control at a population level and to understand the role of undiagnosed pre-stroke risk factors in the young.


2020 ◽  
Author(s):  
Guang Fu ◽  
Xi-si He ◽  
Hao-li Li ◽  
Hai-chao Zhan ◽  
Jun-fu Lu ◽  
...  

Abstract Background Complication of disseminated intravascular coagulation (DIC) is a determinant of the prognosis in patients with sepsis shock. Procalcitonin (PCT) has been advocated as a marker of bacterial sepsis. The purpose of this study was to evaluate the relationship between serum PCT levels and DIC with sepsis shock Methods A cohort study was designed which included patients that admitted in intensive care unit (ICU) between January 1, 2015 and December 31, 2018 and the follow-up to discharge. 164 septic shock patients were divided into DIC and non-DIC groups according to international society of thrombosis and homeostasis (ISTH). PCT was measured at the admission to ICU, and all the participants received routine biochemical coagulation test subsequently. Results PCT levels were considerably higher in septic shock patients who developed DIC than those who did not (54.6[13.6–200]vs12.6[2.4–53.3]ng/ml), respectively, P < 0.001). Multivariable logistic regression model revealed that PCT level was significantly associated with risk of DIC independent of conventional risk factors. In addition, curve fitting showed a linear relationship between PCT and DIC score. The Receiver Operating characteristic(ROC) curve suggested that the optimal cut-off point for PCT to predicting DIC induced by septic shock was 42.0 ng/ml, and the area under the curve (AUC) was 0.701(95% CI [0.619–0.784], P < 0.001). More importantly, incorporating PCT with other risk factors into the prediction model significantly increased the AUC for prediction of DIC induced by sepsis shock (0.801vs 0.706; P = 0.012). Conclusions Our study suggests that PCT levels on admission is significantly and independently associated with DIC development subsequently with septic shock, combining PCT levels with other risk factors could significantly improve the prediction of DIC induced by sepsis shock.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Sabrina Elias ◽  
Ruth-alma N Turkson-ocran ◽  
Binu Koirala ◽  
Samuel Byiringiro ◽  
Hailey Miller ◽  
...  

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.


Author(s):  
Kelly Hsieh ◽  
Haleigh M. Scott ◽  
Sumithra Murthy

Abstract A better understanding of the factors associated with depression and anxiety in people with intellectual and developmental disabilities (IDD) is needed to provide guidelines for service providers, clinicians, and researchers as well as to improve the diagnostic process. The current study used a longitudinal dataset to explore demographic, health, and psychosocial risk factors of anxiety and depression in adults with IDD. Women were more likely to have depression while older adults, people with autism, and people with hearing impairments, were more likely to have anxiety. Chronic health conditions were associated with both anxiety and depression, while changes in stressful life events were associated with an increased risk of anxiety. Clinical and research contributions are discussed.


Author(s):  
Elena Plans ◽  
Pedro Gullón ◽  
Alba Cebrecos ◽  
Mario Fontán ◽  
Julia Díez ◽  
...  

The aim of this study is to evaluate the relationship between the density of green spaces at different buffer sizes (300, 500, 1000 and 1500 m) and cardiovascular risk factors (obesity, hypertension, high cholesterol, and diabetes) as well as to study if the relationship is different for males and females. We conducted cross-sectional analyses using the baseline measures of the Heart Healthy Hoods study (N = 1625). We obtained data on the outcomes from clinical diagnoses, as well as anthropometric and blood sample measures. Exposure data on green spaces density at different buffer sizes were derived from the land cover distribution map of Madrid. Results showed an association between the density of green spaces within 300 and 500 m buffers with high cholesterol and diabetes, and an association between the density of green spaces within 1500 m buffer with hypertension. However, all of these associations were significant only in women. Study results, along with other evidence, may help policy-makers creating healthier environments that could reduce cardiovascular disease burden and reduce gender health inequities. Further research should investigate the specific mechanisms behind the differences by gender and buffer size of the relationship between green spaces and cardiovascular risk factors.


2019 ◽  
Vol 57 (4) ◽  
pp. 263-273
Author(s):  
Carli Friedman

Abstract There are decades of research indicating ableism is extremely prominent. The aim of this study was to examine the relationships between disability prejudice and institutionalization of people with intellectual and developmental disabilities (IDD). This study had two research questions: (1) How does disability prejudice impact the number of people with IDD who are institutionalized in a state? and (2) How does disability prejudice impact spending on institutions? To do so, we utilized secondary data about state utilization of institutions (fiscal year 2015), and disability prejudice data from 325,000 people. Findings revealed, states with higher disability prejudice institutionalize more people, even when controlling for size. Moreover, states with higher disability prejudice also spend more on institutional funding, regardless of size or wealth.


2020 ◽  
Vol 78 (3) ◽  
pp. 1119-1127
Author(s):  
Kathy Y. Liu ◽  
Harry Costello ◽  
Suzanne Reeves ◽  
Robert Howard ◽  

Background: Agitation in Alzheimer’s disease (AD) has been hypothesized to be an expression of anxiety, but whether anxiety early in the course of dementia could be a risk factor for developing later agitation is unknown. Objective: We used the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database to examine the longitudinal relationship between anxiety and incident agitation in individuals with a diagnosis of AD at baseline or during follow-up. Methods: Longitudinal neuropsychiatric symptom data from AD individuals who were agitation-free at study baseline (N = 272) were analyzed using mixed effects regression models to test the longitudinal relationship between baseline and incident anxiety with incident agitation. Results: Anxiety at baseline was not associated with subsequent agitation, but there was a positive linear relationship between incident anxiety and agitation over the study duration. Baseline apathy and delusions were consistently associated with subsequent agitation and greater disease severity and illness duration also appeared to be risk factors for agitation. Conclusion: Our findings support the concept that anxiety and agitation are likely to be distinct rather than equivalent constructs in mild-moderate AD. Future longitudinal cohort studies are needed to replicate these findings and further characterize potential risk factors for agitation, such as apathy and delusions.


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