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

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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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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Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073388 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3388

Author(s):

Nijole Kazukauskiene ◽

Aurelija Podlipskyte ◽

Giedrius Varoneckas ◽

Narseta Mickuviene

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Thyroid Function ◽

Study Groups ◽

Model Assessment ◽

Psychoemotional State ◽

Study Participants

Background: Individuals with insulin resistance (IR) have a high risk of diabetes or metabolic syndrome, and they are more likely to have depression. Furthermore, IR by itself is a major cardiovascular risk factor in healthy persons. Thus, we aimed to investigate IR in association with thyroid function, psychoemotional state, and cardiovascular risk factors among 45–84-year-old citizens of Palanga. Methods: A randomized epidemiological study was performed with 850 subjects. All participants were evaluated for sociodemographic, clinical, and cardiovascular risk factors and biochemical analysis. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). Results: All study participants were stratified into groups without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR > 2.7). The analysis of parameters between the two study groups showed some statistically significant relationships between IR and cardiovascular risk factors. The predictable accuracy was presented using receiver performance characteristic curves for HOMA-IR scores in women and men separately. If the HOMA-IR score is higher than 3.45, individuals are significantly more likely to have type 2 diabetes mellitus (T2DM). Conclusions: An increase of fasting glucose and more frequent incidence of metabolic syndrome, diabetes, and cardiovascular diseases in subjects with IR are associated with the prevalence of cardiovascular risk factors. There was no significant association between thyroid function and HOMA-IR. HOMA-IR cut-offs could predict the presence of T2DM.

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Role of green tea in reduction of cardiovascular risk factors

Nutrition and Dietary Supplements ◽

10.2147/nds.s6025 ◽

2010 ◽

pp. 85

Author(s):

Charalambos Vlachopoulos ◽

Alexopoulos ◽

Stefanadis

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Green Tea

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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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