Serum ghrelin level is associated with cardiovascular risk score

Abstract Ghrelin, a newly discovered bioactive peptide, was originally reported to induce growth hormone release. Recent studies have shown beneficial hemodynamic effects of ghrelin in the cardiovascular system to support the wide distribution of its receptors in cardiovascular tissues. The aim of the study was to determine whether cardiovascular risk factors influence plasma ghrelin levels. Methods. We evaluated in the Rehabilitation Hospital Cluj-Napoca, Cardiology - Department 88 consecutive subjects, 65 (73.86%) being women, with mean age 61.7±10.33 years. We assessed the presence of cardiovascular risk factors (obesity, arterial hypertension, diabetes mellitus, metabolic syndrome, smoking and lipid fractions). Plasma ghrelin levels were determined with a commercial ELISA kit (pg/ml). Results. After the evaluation of cardiovascular risk factors, we found no statistically significant difference between ghrelin levels in the patients with vs those without cardiovascular risk factors (p>0.05). A negative correlation was found between ghrelin levels and age, r = −0.32 (p <0.05). Using the HeartScore Internet tool we calculated the cardiovascular risk for each patient according to the risk score system (SCORE) for high cardiovascular risk countries. Statistically, the risk of fatal cardiovascular events in the next 10 years was indirectly correlated with the ghrelin levels in each patient - correlation between ghrelin levels and SCORE system r=−0.25, p=0.015. In conclusion, low serum ghrelin concentrations are associated with an increased global cardiovascular risk, calculated based on the European SCORE scale. However, we could not demonstrate a direct relationship between any of the major risk factors and ghrelin.

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The interaction between dietary approaches to stop hypertension and MC4R gene variant in predicting cardiovascular risk factors

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000690 ◽

2020 ◽

pp. 1-9

Author(s):

Habib Yarizadeh ◽

Alireza Bahiraee ◽

Sara Asadi ◽

Niloofar Sadat Maddahi ◽

Leila Setayesh ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Model Assessment ◽

Iranian Women ◽

Cvd Risk ◽

Dash Diet ◽

Melanocortin 4 Receptor Gene ◽

Significant Difference ◽

High Adherence

Abstract. Objective: The genetic variants near the melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and cardiovascular risk factors. However, qualitative and quantitative aspects of diet may modulate the association of this polymorphism with obesity and cardiovascular diseases (CVDs). The aim of this study was to evaluate interactions among MC4R rs17782313, the Dietary Approaches to Stop Hypertension (DASH) diet and risk factors for CVDs. Method: This cross-sectional study was conducted on 266 Iranian women categorized by body mass index (BMI) range of 25–40 kg/m2 as overweight or obese. CVD risk factors included waist circumference (WC), lipid profile, blood pressure, insulin circulation and fasting blood sugar (FBS). Insulin and FBS were used to calculate homeostatic model assessment insulin resistance (HOMA-IR) Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Results: The findings of this study show that high adherence to the DASH diet in the CC groups were associated with decreased SBP and DBP compared to the TT group. In addition, a significant difference between women with high adherence to the DASH diet compared to low adherence was observed for body weight (p < 0.001), fat free mass (FFM) (p = 0.01) and BMI (p = 0.02). Women with the CC genotype had higher insulin (mg/dl) (mean and SD, for TT: 14.6 ± 4.6, TC: 17.3 ± 9.2, CC: 15.3 ± 4.8, p = 0.04) and HOMA-IR (mean for and SD, TT: 3.1 ± 1.07, TC: 3.9 ± 2.4, CC: 3.2 ± 1.1, p = 0.01) than TT group. Inclusion of potential confounding variables (age, physical activity, BMI and daily caloric intake) did not attenuate the difference. Conclusion: Among overweight/obese Iranian women with the CC genotype, incorporating the DASH diet may serve as a dietary prescription to decrease CVD risk. A dietary intervention trial is warranted.

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HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors

European Heart Journal ◽

10.1093/ehjci/ehaa946.3310 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Kolossvary ◽

E.K Fishman ◽

G Gerstenblith ◽

D.A Bluemke ◽

R.N Mandler ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Hiv Infection ◽

Cardiovascular Risk Factors ◽

Agatston Score ◽

Funding Source ◽

Significant Difference ◽

Ascvd Risk ◽

Artery Disease

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p>0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p>0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p>0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p<0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p<0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse

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Cardiovascular Risk Factors and Diabetes in Medical Students: Observational Study, Experience in Colombia

International Journal of Medical Students ◽

10.5195/ijms.2018.24 ◽

2018 ◽

Vol 6 (2) ◽

pp. 61-65 ◽

Cited By ~ 1

Author(s):

Diego Mauricio Bados Enriquez ◽

Karoll Vanessa Ladino Oyola ◽

Juan Esteban Yucuma Ruiz

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Medical Students ◽

Cardiovascular Risk Factors ◽

Risk Score ◽

Low Risk ◽

Early Interventions ◽

Moderate Risk

Background: Cardiovascular Disease is a leading cause of preventable death. Cardiovascular risk factors’ identification is the cornerstone for effective and early interventions decreasing the frequency of acute health-threatening events. Since adolescence and youth are very vulnerable stages to develop risky habits, we decided to run this study in the Multidisciplinary Universitary Camp for Research and Service. Methods: A descriptive cross-sectional study was performed in the Multidisciplinary Universitary Camp for Research and Service in which 450 medical students from Colombia were assessed. After a probabilistic random simple sampling (n=50), we applied the World Health Organization test and Finnish Risk Score to calculate Cardiovascular and Diabetes Mellitus risk, respectively. We characterized the population by sociodemographic variables and anthropometric measurements. Results: The study shows that from 18 participating universities (n=50), the mean age of the participants was 21.14 years (SD 7.3) of whom 40% were male and 60% were female. Overall, 92% have a low risk of cardiovascular disease, 6% are at moderate risk and 2% are at high risk. 92% have low risk of diabetes mellitus and 8% are at moderate risk of having diabetes mellitus in the long term. Conclusion: The early identification of and intervention on risk factors could decrease significantly the onset of acute health-threatening cardiovascular pathologies. As medical students, adolescents and young adults are at risk of developing unhealthy habits which increase the incidence of cardiovascular disorders. The use of anthropometric measures and validated risk score scales is an appropriate way to get evidence for starting early interventions.

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Relationship between serum leptin levels, non-cardiovascular risk factors and mortality in hemodialysis patients

Romanian Journal of Internal Medicine ◽

10.2478/rjim-2021-0002 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Ivona Risovic ◽

Vlastimir Vlatkovic ◽

Snjezana Popovicpejicic ◽

Gabrijela Malešević

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Survival Rates ◽

Inverse Correlation ◽

Study Groups ◽

Mineral And Bone Disorder ◽

Serum Leptin ◽

Significant Difference

Abstract Introduction. Hemodialysis (HD) patients have higher mortality rate than the general population. Recent studies indicate a significant role of non-cardiovascular risk factors in for mortality in HD patients. Leptin is protein hormone and may indicate malnutrition in HD patients. Its role in mortality in these patients is being examined. This study aimed to investigate the correlation between serum leptin levels and non-cardiovascular risk factors and relationship between leptin level and mortality in HD patients. Methods The prospective study included 93 patients on maintenance HD and follow-up period was 12 months. We measured leptin level and evaluated non-cardiovascular risk factors: nutritional status, anemia, volemia, parameters of mineral and bone disorder. Results. Out of 93 patients 9 died during study and 1 underwent kidney transplantation. Malnutrition and hypervolemia were two main non-cardiovascular risk factors among deceased subjects. Leptin showed a significant direct correlation with nutritional BMI (r = 0.72, P <0.001), fat tissue index (r = 0.74, P <0.001) and statistically significant inverse correlation with leantissue index (r = -0.349, P <0.05) and inverse correlation with volemic parameters (overhydration / extracellular water ratio (r = -0.38, P <0.001), but no association with anemia and mineral bone parameters was observed. Elevated leptin levels were associated with better survival. However, no statistically significant difference in survival rates was observed between the study groups (Log-Rank P =0.214, Breslow P =0.211, Tarone-Ware P=0.212). Conclusion: Deceased patients had significantly lower leptin values. Leptin was associated with two non-cardiovascular risk factors for mortality: malnutrition and hypervolemia.

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Obese and Type 2 Diabetic Youth Have Increased Forward and Backward Wave Reflections

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.120.315317 ◽

2020 ◽

Author(s):

Andrew H. Tran ◽

Thomas R. Kimball ◽

Philip R. Khoury ◽

Lawrence M. Dolan ◽

Elaine M. Urbina

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Linear Models ◽

Left Ventricular ◽

Wave Reflections ◽

Significant Difference ◽

Backward Wave

Objective: Pulse wave analysis estimates arterial wave reflections relating to left ventricular dysfunction and cardiovascular event risk in adults. Forward and backward waves (Pf and Pb) may improve risk stratification for cardiovascular events. Data in youth are lacking. We hypothesized that a significant difference in wave reflections would be identified in young subjects with adverse cardiovascular risk factors. Approach and Results: Vital signs and labs were obtained in 551 patients aged 10 to 24 years who were lean (L=199), obese (O=173), or had type 2 diabetes (T=179). Wave separation was performed. Differences in cardiovascular risk factors and wave reflections were assessed using ANOVA. General linear models were constructed to elucidate independent predictors of wave reflections. O and T subjects had an adverse cardiovascular risk profile versus L. O and T subjects had higher Pf and Pb versus L ( P ≤0.05). When adjusted for adiposity and other cardiovascular risk factors, reflection magnitude increased from L to O to T with higher T versus L values ( P ≤0.05) and near-significant O versus L values ( P =0.06). Adiposity and blood pressure were major determinants of wave reflections. Pb influenced log left ventricular mass index, log E/e′, and log composite carotid intima-media thickness. Conclusions: Adolescents and young adults with obesity and type 2 diabetes have altered forward and backward wave reflections versus lean controls related to adiposity, BP, and insulin levels. These parameters may help risk stratify patients with adverse cardiovascular risk factors.

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Are the Variants of the Circle of Willis Determined by Genetic or Environmental Factors? Results of a Twin Study and Review of the Literature

Twin Research and Human Genetics ◽

10.1017/thg.2018.50 ◽

2018 ◽

Vol 21 (5) ◽

pp. 384-393 ◽

Cited By ~ 4

Author(s):

Bianka Forgo ◽

Adam Domonkos Tarnoki ◽

David Laszlo Tarnoki ◽

Daniel Tamas Kovacs ◽

Laszlo Szalontai ◽

...

Keyword(s):

Risk Factors ◽

Blood Flow ◽

Cardiovascular Risk ◽

Environmental Factors ◽

Cardiovascular Risk Factors ◽

Transcranial Doppler Sonography ◽

Circle Of Willis ◽

Significant Difference ◽

Altered Blood ◽

Mz Twins

Background: Anatomic variants of the circle of Willis (CW) are commonly observed in healthy subjects. Genetic and environmental factors influencing these variants remain unclear. Our aim was to assess the genetic and environmental background affecting variant CW phenotypes. Methods: A total of 122 adult healthy twins from the Hungarian Twin Registry (39 monozygotic (MZ) and 22 dizygotic (DZ) pairs, average age 49.7 ± 13.4 years) underwent Time-of-Flight magnetic resonance angiography and transcranial Doppler sonography. We investigated the anterior and posterior CW according to morphological categories. Prevalence and concordance rates of CW variants were calculated. MZ twins discordant for CW variants were analyzed for cardiovascular risk factors and altered blood flow. Results: Complete CW (45.0%) and bilaterally absent posterior communicating artery (PCoA) (22.5%) were the most prevalent variants in the anterior and posterior CW, respectively. There was no significant difference regarding the prevalence of variants across zygosity except for bilaterally hypoplastic PCoA (p = .02). DZ concordance was higher compared to MZ twins regarding morphological categories of the CW. Cardiovascular risk factors were not significantly associated with variant CW in MZ twins discordant to CW morphology. Flow parameters did not differ significantly among MZ twins discordant to CW variants. Conclusion: CW variants may not be determined by substantial genetic effects and are not influenced by altered blood flow in healthy individuals. Further investigations are needed to identify potential environmental factors affecting these variants.

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959Coronary artery disease risk according to genetic risk score deciles, Age and cardiovascular risk factors

European Heart Journal ◽

10.1093/eurheartj/ehx502.959 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

A. Pereira ◽

M. Neto ◽

R. Rodrigues ◽

J. Monteiro ◽

A.C. Sousa ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Risk Score ◽

Genetic Risk ◽

Disease Risk ◽

Genetic Risk Score ◽

Artery Disease

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P5642A clinical risk score for estimating sudden cardiac death risk in the general population

European Heart Journal ◽

10.1093/eurheartj/ehz746.0585 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Aro ◽

A Holkeri ◽

A Eranti ◽

T Kerola ◽

M J Junttila ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Risk Score ◽

Clinical Risk Score ◽

Clinical Risk ◽

All Cause Mortality ◽

Male Sex

Abstract Background Sudden cardiac death (SCD) remains a major cause of premature mortality worldwide, so there has been an ongoing pursuit for tools for SCD risk stratification. Coronary artery disease is the major cause for SCD in adults, but the level of risk associated with multiple cardiovascular risk factors is not well established. Purpose To create a clinical risk score for estimating SCD risk in the general population. Methods Using data from a Finnish general population cohort of 7200 adults (mean age 51y, 46% male) with a mean follow-up of 24±11 years, we assessed the incremental SCD risk associated with the presence of several cardiovascular risk factors. SCD events were adjudicated based on death certificates according to the established criteria (autopsy was performed on 48% of SCD cases). Hazard ratios (HR) for SCD and all-cause mortality were calculated using the Cox proportional hazards model. Of the multiple parameters analysed, male sex, increasing age, diabetes, hypertension, smoking and previously diagnosed cardiac disease were independently associated with SCD in a multivariable model. Based on the magnitude of risk, a SCD risk score was created (2 points: age >70y; 1 point: male sex, age 60–70y, diabetes, hypertension, smoking, cardiac disease). Results 75.2% of the study subjects had 0–2 risk points, 12.8% 3 risk points, and 12.0% >3 risk points. During the follow-up, 400 SCDs occurred. Increasing risk score was associated with a progressively greater risk for SCD (Figure). Compared with subjects without risk factors, those with a risk score of 3 had a HR of 21.2 (95% CI 12.7–35.4, p<0.001) and those with a risk score of >3 had a HR of 52.6 (95% CI 31.3–88.3, p<0.001) for SCD. Clinical risk score predicted significantly also all-cause mortality (HR 31.5 with risk score >3 [95% CI 27.6–35.9, p<0.001]). Risk of SCD according to the risk score Conclusions Accumulation of multiple cardiovascular risk factors is associated with a markedly elevated risk for SCD in the general population. This highlights the need for SCD prevention efforts with lifestyle interventions and medical therapy in the high-risk subjects. Studies on focused SCD risk stratification may be warranted in the subjects at highest risk.

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Essential Thrombocythemia: Analysis of Risk Factors for Thrombotic Events in a Series of 306 Patients.

Blood ◽

10.1182/blood.v106.11.4937.4937 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4937-4937

Author(s):

Franca Radaelli ◽

Stefania Bramanti ◽

Mariangela Colombi ◽

Alessandra Iurlo ◽

Alberto Zanella

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Essential Thrombocythemia ◽

Thrombotic Event ◽

Previous History ◽

Significant Difference ◽

Platelet Number ◽

History Of

Abstract Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by peripheral thrombocytosis and abnormal proliferation of megakariocytes in the bone marrow. Even thought thrombosis is frequently associated to ET, the risk factors of this clinical complication are still controversial. The aim of this retrospective, single institution study was to investigate clinical and laboratory characteristics associated with the occurrence of thrombotic events, with the purpose of identifying subgroups of patients who could benefit from antiaggregant and/or cytostatic treatment. 306 consecutive ET patients (109 men and 197 females, median age 58 yr) diagnosed between January 1979 and December 2002 were included in the study. At the time of analysis, 196 patients were still alive with a median follow up of 96 months. The following variables were investigated for the association with thrombotic complications: age, platelet count, previous history of thrombotic events, time from diagnosis, treatment with antiaggregant/cytostatic drugs, and cardiovascular risk factors such as arterial hypertension, obesity, hypercolesterolemia, diabetes, cigarette smoking. At the time of last follow up, 46 patients (15%) experienced at least one thrombotic event. The occurrence of thrombotic events was observed in 26/64 (40.6%) patients with previous history of thrombosis and in 20/242 (8.3%) patients with no previous history of thrombosis (p<0.0001 Fisher’s exact test, odd ratio 7.6). A significant difference between the two groups of patients was also confirmed when Kaplan Meier estimates of thrombosis-free survival were compared by log-rank test (p<0.0001). By logistic regression, platelet number at diagnosis did not associate with occurrence of thrombosis in the whole patient population. When patients without previous history of thrombosis were stratified according to the number of cardiovascular risk factors (none vs one vs more than one), a significant correlation with occurrence of thrombotic events was observed (Mantel-Haenszel Chi-square 5.47, p<0.05). This study confirms that history of thrombosis is strongly related with risk of further thrombotic events in patients with ET, whereas platelet number at diagnosis does not seem to represent a prognostic factor. In patients with no previous history of thrombosis, the presence of other cardiovascular risk factors has to be taken into account when establishing the therapeutic approach.

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