Prevalence of obesity, hypertension and metabolic abnormalities in patients receiving long term cART: a case control study from South India

Background: Combination antiretroviral therapy (cART) has improved the quality of life and survival of HIV-infected individuals. However, the long term intake of these drugs is associated with multiple metabolic abnormalities eventually leading to increased risk for cardiovascular morbidity and mortality.Methods: Forty five HIV-infected individuals who are on cART having CD4+ cell count of >200 cells/mm3 for at least 2 years were recruited as cases. Age and gender matched, otherwise healthy individuals were taken as controls. Both cases and controls were compared for the prevalence of obesity, abdominal obesity, hypertension, diabetes mellitus and lipid abnormalities.Results: We found higher prevalence of obesity (33.3% vs 26.7%), abdominal obesity (33.3% vs 17.8%), hypertension (33.3% vs 20%), impaired fasting glucose (IFG) (37.7% vs 8.9%), diabetes mellitus (26.7% vs 24.4%), high total cholesterol (33.3% vs 22.2%) and low HDL cholesterol (60% vs 46.7%) among cases compared to controls. The statistically significant difference was noted only for IFG (cases = 17, 37.7%, controls = 4, 8.9%, p value = 0.002). Low HDL cholesterol was the most common metabolic abnormality found in 27 (60%) cases and 21 (46.7%) controls.Conclusions: HIV-infected individuals receiving long term cART have higher prevalence of obesity, hypertension and dysregulations in glucose and lipid metabolism compared to general population and hence, the diagnosis and management of these abnormalities is very important to prevent cardiovascular morbidity and mortality.

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Cognitive Status in COVID-19 Survivors with Metabolic Syndrome

Series of Endocrinology, Diabetes and Metabolism ◽

10.54178/jsedmv3i2001 ◽

2021 ◽

Vol 3 (2) ◽

pp. 33-38

Author(s):

Susmita Halder ◽

Keyword(s):

Metabolic Syndrome ◽

Rating Scale ◽

Hdl Cholesterol ◽

Cognitive Status ◽

Significant Difference ◽

Low Hdl ◽

Long Term Impact ◽

State Examination ◽

Metabolic Syndromes

In the current COVID-19 pandemic, co-morbid metabolic syndromes are identified as important risk factors. The presence of metabolic syndrome not only increases mortality rate and probability of hospitalization but is also predicted to have a long-term impact on cognition. A decline in cognitive functioning and functional abilities can be seen in the COVID-19 survivors and it became accelerated by metabolic syndromes that include hypertension, diabetes mellitus, low HDL cholesterol, abdominal obesity, etc. In the present study, it was aimed to explore the cognitive status in COVID-19 survivors with and without metabolic syndrome. For this purpose, total 36 COVID-19 survivors participated who were divided into two groups, one with existing metabolic syndrome and the other without any significant co-morbidities. Mini-Mental State Examination (MMSE) and Brief Cognitive Rating Scale (BCRS) were administered to assess the cognitive status of the participants. Results suggest a significant difference between the groups in the domains of concentration and memory along with functioning and self-care.

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Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

Journal of Diabetes Research ◽

10.1155/2019/6036359 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Joanna Wojtasik-Bakalarz ◽

Zoltan Ruzsa ◽

Tomasz Rakowski ◽

Andreas Nyerges ◽

Krzysztof Bartuś ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Risk Of Death ◽

Significant Difference ◽

Long Term Follow Up ◽

Artery Disease ◽

The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

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Multimorbidity of Four Cardiometabolic and Chronic Pulmonary Disease Groups: Prevalence and Attributable Fraction in US Adults, 2007–2012

Journal of Comorbidity ◽

10.15256/joc.2017.7.89 ◽

2017 ◽

Vol 7 (1) ◽

pp. 22-32 ◽

Cited By ~ 10

Author(s):

Lisa R. Staimez ◽

Melissa Y. Wei ◽

Min Kim ◽

K. M. Venkat Narayan ◽

Sharon H. Saydah

Keyword(s):

Risk Factors ◽

Pulmonary Disease ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Modifiable Risk Factors ◽

Chronic Pulmonary Disease ◽

Chronic Pulmonary Diseases ◽

The Usa ◽

Low Hdl ◽

Obesity Hypertension

Background Cardiometabolic and chronic pulmonary diseases may be associated with modifiable risk factors that can be targeted to prevent multimorbidity. Objectives (i) Estimate the prevalence of multimorbidity across four cardiometabolic and chronic pulmonary disease groups; (ii) compare the prevalence of multimorbidity to that of one disease and no disease; and (iii) quantify population attributable fractions (PAFs) for modifiable risk factors of multimorbidity. Design Data from adults aged 18–79 years who participated in the US National Health and Nutrition Examination Survey 2007–2012 were examined. Multimorbidity was defined as ≥2 co-occurring diseases across four common cardiometabolic and chronic pulmonary disease groups. Multivariate-adjusted PAFs for poverty, obesity, smoking, hypertension, and low high-density lipoprotein (HDL) cholesterol were estimated. Results Among 16,676 adults, the age-standardized prevalence of multimorbidity was 9.3%. The occurrence of multimorbidity was greater with age, from 1.5% to 5.9%, 15.0% and 34.8% for adults aged 18–39, 40–54, 55–64 and 65–79 years, respectively. Multimorbidity was greatest among the poorest versus non-poorest adults and among blacks versus other races/ethnicities. Multimorbidity was also greater in adults with obesity, hypertension, and low HDL cholesterol. Risk factors with greatest PAFs were hypertension (38.8%; 95% confidence interval [CI] 29.4–47.4) and obesity (19.3%; 95% CI 10.2–28.2). Conclusions In the USA, 9.3% of adults have multimorbidity across four chronic disease groups, with a disproportionate burden among older, black, and poor adults. Our results suggest that targeting two intermediate modifiable risk factors, hypertension and obesity, might help to reduce the prevalence of multimorbidity in US adults.

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Abstract MP19: Higher Parity is Associated With Components of the Metabolic Syndrome Among U.S. Hispanic/Latina Women: Results From the HCHS/SOL Study

Circulation ◽

10.1161/circ.131.suppl_1.mp19 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Catherine J Vladutiu ◽

Anna Maria Siega-Riz ◽

Alison M Stuebe ◽

Daniela Sotres-Alvarez ◽

Andy Ni ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Abdominal Obesity ◽

Hispanic Women ◽

Hdl Cholesterol ◽

Latina Women ◽

Live Births ◽

The Metabolic Syndrome ◽

Elevated Glucose ◽

Low Hdl

Background: Physiologic adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life. Previous studies have found an association between higher parity and the metabolic syndrome (MetS). However, no studies have examined this association in a Hispanic/Latina population. Hispanic women have a higher prevalence of the MetS and higher birth rates than non-Hispanic women. Hypothesis: We assessed the hypothesis that higher parity is associated with the prevalence of components of the MetS in a cohort of Hispanic/Latina women. Methods: There were 9,482 Hispanic/Latina women of diverse backgrounds, aged 18-74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008-2011. Components of the MetS were defined according to the AHA/NHLBI criteria and included abdominal obesity (waist circumference ≥88cm), elevated triglycerides (≥150 mg/dL), low HDL cholesterol (<50mg/dL), high blood pressure (systolic ≥130mmHg or diastolic ≥85mmHg or on medication), and elevated fasting glucose (≥100mg/dL or on medication). Logistic regression models were used to estimate odds ratios for the association between parity and components of the MetS, adjusting for sociodemographic, behavioral, and reproductive characteristics, and accounting for the complex survey design and sampling weights. Results: At HCHS/SOL baseline, women reported none (19.2%), one (18.9%), two (25.3%), three (19.7%), four (9.3%), and five or more (7.6%) prior live births. Compared to women with only one live birth, women with four live births had the highest odds of abdominal obesity (OR=2.5, 95% CI 1.8, 3.3) and those with five or more live births had the highest odds of low HDL cholesterol (OR=1.5, 95% CI 1.2, 1.9), elevated glucose (OR=1.8, 95% CI 1.3, 2.3), elevated triglycerides (OR=1.4, 95% CI 1.01, 1.8), and high blood pressure (OR=1.5, 95% CI 1.1, 2.0), after adjusting for age, Hispanic background, education, marital status, income, nativity, smoking, physical activity, menopause status, oral contraceptive use, hormone replacement therapy, and field center. Further adjustment for body mass index attenuated these associations for all MetS components, including abdominal obesity (OR=1.5, 95% CI 1.1, 2.2), low HDL cholesterol (OR=1.3, 95% CI 1.03, 1.7), and elevated glucose (OR=1.6, 95% CI 1.2, 2.1), but the associations for triglycerides and blood pressure were no longer statistically significant. Conclusion: Higher parity is associated with the prevalence of selected components of the MetS among U.S. Hispanic/Latina women. High parity among Latinas with a high prevalence of abdominal obesity suggests a context of high risk for metabolic dysregulation. A better characterization of the links between pregnancy, adiposity, and body fat distribution is needed.

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Diabeteses dyslipidaemia és atherosclerosis

Orvosi Hetilap ◽

10.1556/650.2016.30441 ◽

2016 ◽

Vol 157 (19) ◽

pp. 746-752 ◽

Cited By ~ 5

Author(s):

László Márk ◽

Győző Dani

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

High Risk ◽

Statin Therapy ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Small Dense Ldl ◽

Target Values ◽

Postprandial Triglyceride ◽

Low Hdl

The incidence and the public health importance of diabetes mellitus are growing continuously. Despite the improvement observed in the latest years, the leading cause of morbidity and mortality of diabetics are cardiovascular diseases. The diagnosis of diabetes mellitus constitutes such a high risk as the known presence of vascular disease. Diabetic dyslipidaemia is characterised by high fasting and postprandial triglyceride levels, low HDL level, and slightly elevated LDL-cholesterol with domination of atherogenic small dense LDL. These are not independent components of the atherogenic dyslipidaemia, but are closely linked to each other. Beside the known harmful effects of low HDL and small dense LDL, recent findings confirmed the atherogenicity of the triglyceride-rich lipoproteins and their remnants. It has been shown that the key of this process is the overproduction and delayed clearance of triglyceride-rich lipoproteins in the liver. In this metabolism the lipoprotein lipase has a determining role; its function is accelerated by ApoA5 and attenuated by ApoC3. The null mutations of the ApoC3 results in a reduced risk of myocardial infarction, the loss-of-function mutation of ApoA5 was associated with a 60% elevation of triglyceride level and 2.2-times increased risk of myocardial infarction. In case of diabetes mellitus, insulin resistance, obesity, metabolic syndrome and chronic kidney disease the non-HDL-cholesterol is a better marker of the risk than the LDL-cholesterol. Its value can be calculated by subtraction of HDL-cholesterol from total cholesterol. Target values of non-HDL-cholesterol can be obtained by adding 0.8 mmol/L to the LDL-cholesterol targets (this means 3.3 mmol/L in high, and 2.6 mmol/L in very high risk patients). The drugs of first choice in the treatment of diabetic dyslipidaemia are statins. Nevertheless, it is known that even if statin therapy is optimal (treated to target), a considerable residual (lipid) risk remains. For its reduction treatment of low HDL-cholesterol and high triglyceride levels is obvious by the administration of fibrates. In addition to statin therapy, fenofibrate can be recommended. Orv. Hetil., 2016, 157(19), 746–752.

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Increase in Pulse Pressure Relates to Diabetes Mellitus and Low HDL Cholesterol, but Not to Hyperlipidemia in Hypertensive Patients Aged 50 Years or Older.

Hypertension Research ◽

10.1291/hypres.25.335 ◽

2002 ◽

Vol 25 (3) ◽

pp. 335-341 ◽

Cited By ~ 15

Author(s):

Takako MIYAGI ◽

Hiromi MURATANI ◽

Yorio KIMURA ◽

Koshiro FUKIYAMA ◽

Yuhei KAWANO ◽

...

Keyword(s):

Diabetes Mellitus ◽

Pulse Pressure ◽

Hdl Cholesterol ◽

Hypertensive Patients ◽

Low Hdl

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Prevalence of Abdominal Obesity and Metabolic Syndrome in Children and Adolescents: A Community Based Cross-Sectional Study

Iranian Journal of Public Health ◽

10.18502/ijph.v49i2.3106 ◽

2020 ◽

Author(s):

Nastaran AHMADI ◽

Seyed Mahmood SADR ◽

Mohammad Reza MOHAMMADI ◽

Masoud MIRZAEI ◽

Amir Hooshang MEHRPARVAR ◽

...

Keyword(s):

Metabolic Syndrome ◽

Children And Adolescents ◽

Abdominal Obesity ◽

Adult Population ◽

International Diabetes Federation ◽

Hdl Cholesterol ◽

National Study ◽

Cross Sectional ◽

Common Component ◽

Low Hdl

Background: Although the prevalence of abdominal obesity and metabolic syndrome has been widely studied in the adult population, little is known about it in children and adolescents especially in developing countries. This study aimed to determine the prevalence of abdominal obesity and metabolic syndrome among children and adolescents in Yazd Greater Area, Iran; over the period of 2016-2017. Methods: This study was part of a larger national study with a cross-sectional design. Using multistage cluster random sampling method, 1035 children, and adolescents of both sexes aged 6-18 yr were randomly selected from rural and urban districts in Yazd Greater Area, Iran. Components of metabolic syndrome, and anthropometry measured in the standard situation. Results: The prevalence of abdominal obesity in children 6-10 yr old was 13.2% in boys versus 24.7% in girls. The overall prevalence of metabolic syndrome according to International Diabetes Federation (IDF) criteria in adolescents aged 10-18 yr old was 7.6% (9.4% in boys). The most prevalent metabolic syndrome components were low HDL-cholesterol (56.2%) and abdominal obesity (27.8%). Conclusion: Comparatively, the prevalence of metabolic syndrome in Yazd is high. Low HDL-cholesterol levels and abdominal obesity were the most common component, and family history of heart disease, BMI, and male gender were the main determinants of metabolic syndrome in adolescents.

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