scholarly journals Metabolically healthy obesity: predictors of transformation to unhealthy phenotype in St Petersburg population (according to the ESSE-RF study)

2021 ◽  
Vol 27 (3) ◽  
pp. 279-290
Author(s):  
M. A. Boyarinova ◽  
O. P. Rotar ◽  
A. M. Erina ◽  
N. A. Paskar ◽  
A. S. Alieva ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Uric Acid ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Metabolically Healthy Obesity ◽  
Metabolically Healthy ◽  
Over Time

Objective. The purpose of the study was to determine the dynamics of the metabolically healthy obesity (MHO) status according to the Meigs criteria, and to establish the predictors of the transformation of healthy obesity phenotype into an unhealthy (MUHO) one in the population of residents of St Petersburg (Russia) at 6,5-year follow-up. Design and methods. Within the epidemiology study ESSE-RF a random sample of 1600 St Petersburg inhabitants stratified according to gender and age was formed. Examination of participants included anthropometry with measurement of waist circumference and calculation of body mass index (BMI), measurement of blood pressure (BP), fasting blood glucose, insulin (index of insulin resistance was calculated), creatinine, cortisol, lipid spectrum, C-reactive protein, adiponectin, leptin, and uric acid. Meigs MHO criteria (2006) were used in obese subjects (BMI > 30 kg/m²). Obese patients, who were identified as metabolically healthy in 2012–2013, were invited for follow-up in 2018–2019. Results. At the first stage obesity was diagnosed in 430 (26,9 %) participants, according to the BMI, 116 (27,0 %) of them were metabolically healthy according to the Meigs criteria. At follow-up, 44,4% individuals with the MHO phenotype transformed to the MUHO category on average after 6,5 years. Individuals who retained the MHO phenotype over time had significantly lower baseline systolic BP and diastolic BP levels, more favorable lipid levels and lower levels of uric acid, insulin, and index of insulin resistance. Glucose increase by every 0,5 mmol/l and higher was associated with elevated probability of transformation MHO to MUHO phenotype by 10,9 times (adjusted for sex and age). Conclusions. Significantly higher levels of BP, insulin resistance, low density lipoprotein and uric acid at baseline, as well as an increase in glucose levels over time, were associated with the transformation of the metabolically healthy to the unhealthy phenotype in obese individuals at 6,5-year follow-up. In all individuals with the MHO phenotype, there was a significant increase in waist circumference over time, accompanied by an increase in BMI only in those who transformed into the MUHO status.

scholarly journals The Importance of Insulin Resistance Assessing as the Effectiveness Predictor in Rehabilitation and Observation of Patients after Acute Myocardial Infarction

2021 ◽  
Vol 20 (3) ◽  
pp. 59-66
Author(s):  
Tatyana V. Pshenichnikova ◽  
Svetlana E. Ushakova ◽  
Michail V. Alexandrov
Keyword(s):  
Myocardial Infarction ◽  
Insulin Resistance ◽  
Acute Myocardial Infarction ◽  
Waist Circumference ◽  
Central Obesity ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

One of the goals for the management of patients after acute myocardial infarction is to achieve and maintain the optimal level of lowdensitylipoproteins (LDL), which is a factor that determines the prognosis in patients with coronary heart disease. A relevant objectiveis to extract from a number of trophic indicators that indicate disturbance in the adipose tissue distribution and functioning and thatincrease the risk of repeated cardiovascular disasters, the predictors of the low-density lipoprotein targets achieving effectivenessduring rehabilitation and subsequent dispensary follow-up of patients who have suffered a myocardial infarction. Aim. To assess the role of trophological factors, in particular insulin resistance, in achieving LDL cholesterol target values during rehabilitationand follow-up of patients after acute myocardial infarction. Material and methods. The study included 68 men (age from 55 to 65 years) after myocardial infarction underwent rehabilitation atthe Ivanovo State Medical Academy Clinic. The dynamics of the lipidogram parameters over the course of 6 months was evaluated. Todescribe the trophological status of the patients several metabolic and anthropometrical indicators were applied (weight, body massindex, waist circumference, ratio of waist circumference to the hips circumference, index of the central obesity, visceral adiposity index,percentage of fatty tissue, and metabolic index of insulin resistance). A regression model was created to determine significant factorsassociated with achieving low-density lipoprotein cholesterol targets values. Results. The effectiveness of dyslipidemia correction in patients with myocardial infarction was lower in the group of people with signsof insulin resistance. Among the trophic indicators, predictors that have a prognostic value in achieving the target level of low-densitylipoprotein cholesterol are identified: the initial level of low-density lipoprotein cholesterol, the central obesity index, the metabolicinitial index and after 6 months of follow-up. Conclusion. In the course of rehabilitation and subsequent follow-up, it is advisable to distinguish among patients after acute myocardialinfarction, persons with a metabolically unhealthy phenotype and insulin resistance. If an increase in the metabolic central obesityindex is recorded, it is possible to regard the manifestations of insulin resistance as a predictor of the ineffectiveness of achieving thegoals of lipid-lowering therapy and adjust therapeutic and preventive measures.

Abstract P018: Calibration of Analytes Over Twenty-Five Years in the Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christina M Parrinello ◽  
Morgan E Grams ◽  
David Couper ◽  
Christie M Ballantyne ◽  
Ron C Hoogeveen ◽  
...  
Keyword(s):  
Uric Acid ◽  
Troponin T ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Lipoprotein Cholesterol ◽  
Gamma Glutamyl Transpeptidase ◽  
Deming Regression ◽  
The Impact ◽  
Over Time

Background: Comparability of laboratory measures over time is important for studies of disease prevalence and progression. While a small amount of bias may seem negligible on an individual level, it can result in substantial misclassification of disease in the population. We conducted a calibration study of important biomarkers across five study visits (25 years) in ARIC. Methods: We re-measured 15 analytes in 200 blood samples to calibrate original measurements at each time point using Bland-Altman plots and Deming regression. We also assessed the impact of calibration on the prevalence of chronic kidney disease (CKD), defined by estimated glomerular filtration rate using creatinine (eGFRcr), and on trends over time. Results: Assays in samples frozen 12-27 years were highly correlated with original values (median r=0.95) after removing outliers (median 4% of values). The range of bias (% difference in means) across visits for each original analyte compared to its reference were: creatinine: 13-49%; uric acid: 3-24%; C-reactive protein: 3-9%; total cholesterol: 1-6%; high density lipoprotein cholesterol: 4-8% (but new methods differed); low density lipoprotein cholesterol: 1-5%; triglycerides: 2-4%; glucose: 1-4%; N-terminal prohormone of brain natriuretic peptide: 2-12%; high sensitivity cardiac troponin T: 1-9%; alanine transaminase (ALT): 21%; aspartate transaminase (AST): 17%; gamma glutamyl transpeptidase: 0.2%; ß2-microglobulin: 1%; beta-trace protein: 13%. Four analytes met calibration criteria: creatinine, uric acid, ALT and AST. The impact on CKD prevalence was substantial and similar to previous statistical calibration (22% uncalibrated, 1.9% previously and 1.3% current laboratory calibration). Trends in eGFRcr over time were better aligned after calibration ( Figure ). Conclusions: Repeat assay of samples shows high correlation with original values. Calibration enables application of absolute cutoffs (required for defining CKD and other conditions) and improves longitudinal analyses.

scholarly journals Determinants of Cardiovascular Disease among Urban Women with Psoriasis: A Case–Control Study

2020 ◽  
Vol 5 (02) ◽  
pp. 102-108 ◽  
Author(s):  
Sudha Bala ◽  
Archana Mavoori ◽  
Harshal Pandve ◽  
Chinmayee Biswal ◽  
Vijay Prasanna ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Case Control Study ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Case Control ◽  
Low Density ◽  
Control Study

Abstract Background and Aim Psoriasis have a direct impact on development of cardiovascular risk factors leading to atherosclerosis and metabolic abnormalities. In order to prevent the complications, early and prompt identification of factors through various parameters help in primary and secondary prevention of cardiovascular diseases (CVDs) among these psoriatic patients. Therefore the aim of this study is to determine the prevalence of various determinants for cardiovascular diseases among cases and controls. Methods A hospital based case control study at a tertiary care hospital included women from the out patient department, aged above 18 years who were known cases of psoriasis. 114 patients were recruited with 1:1 ratio between cases and controls. All patients were evaluated using semi structured interview schedule with socio demographic variables, duration of disease, family history, and usage of drugs. Severity of disease was assessed through the psoriasis area severity index (PASI). Body surface area (BSA), body mass index (BMI), waist circumference and blood pressure measurement were done using standard methods. Lipid profile, high sensitivity C-Reactive protein (HsCRP) and blood sugar through calibrated analyzers having quality control. Carotid intima media thickness (CIMT) was assessed by using carotid Doppler technique to measure atherosclerosis. Results One hundred fourteen patients, means 57 pairs of cases and controls were analyzed in this study. Significant determinants among cases were raised such as waist circumference (p = 0.025), diastolic blood pressure (p = 0.0001), low density lipoprotein (p = 0.002) and fasting blood glucose (p = 0.004) when compared to controls. HsCRP and CIMT were also raised among cases but only CIMT was statistically significant when compared to controls (p = 0.0001). We also found raised determinants among psoriatic arthritis patients compared to psoriasis. Conclusion Psoriasis patients had high waist circumference, diastolic blood pressure, low density lipoprotein, fasting blood glucose, and CIMT when compared to controls. Early identification of these determinants make them amenable for prevention.

scholarly journals On the Severity of Carpal Tunnel Syndrome: Metabolic Syndrome or Obesity

2020 ◽  
Vol 8 (A) ◽  
pp. 606-610
Author(s):  
Angelo Vasiliadis ◽  
George Charitoudis ◽  
Theofanis Kantas ◽  
George Giovanidis ◽  
George Biniaris
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Low Density Lipoprotein Cholesterol ◽  
Cholesterol Levels ◽  
Tunnel Syndrome ◽  
The Mean ◽  
The Relationship

AIM: This study aimed to determine the relationship between CTS, metabolic syndrome and obesity and to compare the severity of CTS between patients with or without metabolic syndrome (MS) and patients with or without obesity. METHODS: In this prospective study, patients with clinical and electrophysiological confirmed diagnosis of CTS were included. The waist circumference, blood pressure, fasting blood glucose, fasting triglycerides and high/low density lipoprotein cholesterol levels were recorded. Patients were categorized having metabolic syndrome according to Adult Treatment Panel III definition, while body mass index was used to identify obesity. RESULTS: A total of 65 patients with a mean age of 58.91 ± 12.49 years were included. MS was found in 39 (60%) patients and obesity in 27 (41.5%) patients. The CTS was described as mild, moderate and severe in 8, 12 and 19 hands of those with MS and in 2, 6, and 18 of those without MS respectively (p = 0.207). There were no statistically significant results observed between BMI and the severity of CTS (p > 0.05). The mean waist circumference was 94.75 ± 7.36, 98.78 ± 9.64, 106.42 ± 10.78, 86.41 ± 6.77 for patients with MS+_O–, MS–O+_, MS+_O+_ _and MS–O– _respectively (p < 0.002). CONCLUSION: CTS appears to be more severe in patients with MS than in patients with obesity. Central obesity is one of the well-known risk factors for CTS, but components of MS may have a greater effect on the severity of CTS.

scholarly journals Association of uric acid and glucose disposal rate value in euglycemic Chinese subjects

2020 ◽  
Author(s):  
Tao Yuan ◽  
Shixuan Liu ◽  
Yingyue Dong ◽  
Yong Fu ◽  
Yan Tang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Uric Acid ◽  
Waist Circumference ◽  
Density Lipoprotein ◽  
Stepwise Multiple Regression ◽  
Glucose Disposal ◽  
Oral Glucose ◽  
Visceral Adiposity Index ◽  
Glucose Disposal Rate ◽  
Chinese Subjects

Abstract Background: We aimed to examine the relationship between serum uric acid (SUA) levels and glucose disposal rate value (M value) evaluated by hyperinsulinemic euglycemic clamp technique in euglycemic Chinese subjects.Methods: There were 19 non-diabetic Chinese subjects included in this study. The participants accepted physical examination, laboratory examination and standardized questionnaire. Insulin resistance was evaluated by M value. Some other indices were also calculated by data obtained from 3-hour oral glucose tolerance test (OGTT).
Subjects were divided into two groups based on the median of SUA levels.Results: The level of systolic blood pressure (SBP) (P=0.035), waist circumference (P=0.009), waist-to-hip ratio (P=0.004), Chinese visceral adiposity index (CAVI) (P=0.028), weight (P=0.01), serum creatinine (Cr) (P=0.05) and the percentage of drinking habits (P=0.03) were all significantly increased in high SUA group. The level of M value and high-density lipoprotein cholesterol (HDL-c) were significantly decreased in high SUA group (P=0.041 for M value and P=0.09 for HDL-c). There were no significant differences between those indirect insulin resistance indices and SUA. In addition, the SUA levels were inversely correlated with M value (r=-0.666, P=0.002) and HDL-c (r=-0.619, P=0.005), positively correlated with waist circumference (r=0.615, P=0.005), CVAI (r=0.630, P=0.004), SBP (r=0.521, P=0.022) and Cr (r-0.550, P=0.015) levels. Analysis of stepwise multiple regression showed the independent association between SUA and M value in both male and female euglycemic subjects.Conclusions: There is a significant correlation between SUA levels and glucose disposal rate value in euglycemic Chinese subjects, which suggested that UA played an important role on insulin resistance even in those non-diabetic subjects

scholarly journals Transition from metabolically healthy to unhealth status associated with risk of carotid artery plaque in Chinese adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tao Tan ◽  
Yiquan Zhou ◽  
Yanping Wan ◽  
Zhuping Fan ◽  
Renying Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Carotid Artery ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Total Cholesterol ◽  
Chinese Adults ◽  
Carotid Artery Plaque ◽  
Metabolically Healthy

Abstract Objective We aimed to evaluate the association between the shift of metabolic status and future risk of carotid artery plaque (CAP) in community-based Chinese adults. Methods The current study included 9836 Chinese adults (4085 males and 5751 females, mean age 35.8 years) with metabolically healthy status at baseline (2013). Metabolically healthy status was defined as no self-reported history of metabolic diseases and cancer, and normal blood pressure, fasting blood glucose, glycated hemoglobin A1c level, and lipid profiles. Metabolically unhealthy status was defined if any of the following metabolic abnormalities were confirmed twice during follow up: high blood pressure, impaired glucose regulation, high triglycerides, high total cholesterol, high low-density lipoprotein cholesterols, or low high-density lipoprotein cholesterols. The transition was confirmed if participants’ metabolic status shifted from baseline healthy to unhealthy status during follow up (2014–2018). Results We have identified 133 incident cases of CAP during follow up. Compared to those who remained metabolically healthy, the transition to high blood pressure, high total cholesterol, and high low-density lipoprotein cholesterols, were associated with high risk of developing carotid artery plaque (Hazards ratios (HRs) ranged from 1.69 to 2.34; p < 0.05 for all). The transition to impaired glucose regulation, high total triglycerides, and low high-density lipoprotein cholesterols, were associated with high risk of carotid artery plaque only in participants with metabolically healthy overweight at baseline (HR ranged from 1.95 to 4.62; p < 0.05 for all). Conclusion The transition from baseline metabolically healthy status to unhealth status was associated with high risk of incident CAP.

scholarly journals Elevation of serum E-selectin in Thai hyperlipidemia adults

2021 ◽  
Vol 9 (12) ◽  
pp. 3520
Author(s):  
Apinya Michuea ◽  
Somsak Fongsupa ◽  
Thaval Rerksngarm ◽  
Sudawadee Kongkhum
Keyword(s):  
Uric Acid ◽  
Blood Glucose ◽  
Endothelial Dysfunction ◽  
Total Cholesterol ◽  
Blood Lipids ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Specific Marker

Background: Hyperlipidemia is an important risk factor of cardiovascular diseases (CVD), whose pathogenesis involves vascular endothelial dysfunction. Therefore, a specific marker of endothelial dysfunction, serum E-selectin, was assessed in Thai hyperlipidemia adults.Methods: Subjects who had no history of hypertension, diabetes and other serious illness were recruited and classified as normolipidemia (n=100) and hyperlipidemia (n=100), by using the levels of blood lipids (hyperlipidemia: total cholesterol >200 mg/dl, low density lipoprotein cholesterol (LDL-C) >130 mg/dl, and triglyceride >150 mg/dl). Clinical data were collected, and laboratory analysis was done. Serum levels of uric acid, fasting blood glucose (FBS), blood urea nitrogen (BUN), and creatinine were measured by the dry chemistry automate analyzer. Serum E-selectin was measured by using the enzyme-linked immunosorbent assay.Results: The hyperlipidemia subjects had significantly higher serum E-selectin levels than the normolipidemia subjects (18.98±11.58.56 versus 8.85±4.02 ng/ml). E-selectin was significantly correlated with blood lipids; total cholesterol, triglyceride, LDL-C, and HDL-C (r=0.477, 0.441, 0.453, and -0.191, respectively). Moreover, significant correlations of E-selectin with uric acid and fasting blood glucose were also found (r=0.155 and 0.166, respectively).Conclusions: Serum E-selectin levels increased in hyperlipidemia and correlated with uric acid and fasting blood glucose, reflecting the association between hyperlipidemia and pathogenesis of CVD, Therefore, it emphasizes the importance of hyperlipidemia management. 

scholarly journals Low-Density Lipoprotein Cholesterol Target Attainment in Patients With Established Cardiovascular Disease: Analysis of Routine Care Data

10.2196/16400 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e16400
Author(s):  
T Katrien J Groenhof ◽  
Daniel Kofink ◽  
Michiel L Bots ◽  
Hendrik M Nathoe ◽  
Imo E Hoefer ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Routine Care ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Target Attainment ◽  
History Of ◽  
Over Time

Background Direct feedback on quality of care is one of the key features of a learning health care system (LHS), enabling health care professionals to improve upon the routine clinical care of their patients during practice. Objective This study aimed to evaluate the potential of routine care data extracted from electronic health records (EHRs) in order to obtain reliable information on low-density lipoprotein cholesterol (LDL-c) management in cardiovascular disease (CVD) patients referred to a tertiary care center. Methods We extracted all LDL-c measurements from the EHRs of patients with a history of CVD referred to the University Medical Center Utrecht. We assessed LDL-c target attainment at the time of referral and per year. In patients with multiple measurements, we analyzed LDL-c trajectories, truncated at 6 follow-up measurements. Lastly, we performed a logistic regression analysis to investigate factors associated with improvement of LDL-c at the next measurement. Results Between February 2003 and December 2017, 250,749 LDL-c measurements were taken from 95,795 patients, of whom 23,932 had a history of CVD. At the time of referral, 51% of patients had not reached their LDL-c target. A large proportion of patients (55%) had no follow-up LDL-c measurements. Most of the patients with repeated measurements showed no change in LDL-c levels over time: the transition probability to remain in the same category was up to 0.84. Sequence clustering analysis showed more women (odds ratio 1.18, 95% CI 1.07-1.10) in the cluster with both most measurements off target and the most LDL-c measurements furthest from the target. Timing of drug prescription was difficult to determine from our data, limiting the interpretation of results regarding medication management. Conclusions Routine care data can be used to provide feedback on quality of care, such as LDL-c target attainment. These routine care data show high off-target prevalence and little change in LDL-c over time. Registrations of diagnosis; follow-up trajectory, including primary and secondary care; and medication use need to be improved in order to enhance usability of the EHR system for adequate feedback.

Serum uric acid is associated with metabolic risk factors for cardiovascular disease in the Uygur population

2009 ◽  
Vol 34 (6) ◽  
pp. 1032-1039 ◽  
Author(s):  
Nan F. Li ◽  
Hong M. Wang ◽  
Jin Yang ◽  
Ling Zhou ◽  
Xiao G. Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Resistance Index ◽  
Lipoprotein Cholesterol ◽  
Model Assessment

The prevalence of hyperuricemia is low in Uygurs, who have a high prevalence of cardiovascular risk factors such as hypertension, overweight–obesity, dyslipidemia, hyperglycemia, and insulin resistance (IR). This study sought to investigate the relationships between serum uric acid (UA) and these risk factors in this population. A cross-sectional study was conducted in Uygurs (859 males, 1268 females) aged 20 to 70 years. Demographic data, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and fasting and postprandial blood were obtained, and biological measurements were determined. The mean of BMI, SBP, DBP, total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides, fasting blood glucose, fasting insulin, and homeostasis model assessment insulin resistance index (HOMA-IR), and the prevalence of hypertension, IR, hyperglycemia, overweight–obesity, hypercholesteremia, hyper-LDL-c, and hypertriglyceridemia increased with UA but the prevalence of hypo-HDL-c decreased (p < 0.05). Logistic regression analysis showed that the odds ratios for IR, overweight–obesity, hypercholesteremia, hyper-LDL-c, and hypertriglyceridemia against the lowest UA group increased but decreased for hypo-HDL-c (p < 0.05). The UA in the hypo-HDL-c group was lower than that of the controls; the prevalence of hypo-HDL-c in hyperuricemia subjects was lower than in those with normal UA (p < 0.05). But the opposite results were observed between overweight–obesity, hyperglycemia, IR, hypercholesteremia, hypertriglyceridemia, and hyper-LDL-c and correspondence controls, respectively (p < 0.05). In Uygur, elevated UA is associated with overweight–obesity, hypercholesteremia, hyper-LDL-c, hypertriglyceridemia, hyperglycemia, and IR. The HDL-c level significantly increases with UA, whereas the prevalence of hypo-HDL-c decreases. Further studies are needed to clarify why UA is positively correlated to HDL-c.

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