scholarly journals Nutritional Status and Cardiometabolic Risk Factors in Institutionalized Adults with Cerebral Palsy

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 157 ◽  
Author(s):  
Aurora Norte ◽  
Coral Alonso ◽  
José Miguel Martínez-Sanz ◽  
Ana Gutierrez-Hervas ◽  
Isabel Sospedra

Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Adequate nutrition can contribute to the prevention of associated symptoms. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in adults with CP and Gross Motor Function Classification System (GMFCS) levels between IV and V. Materials and Methods: A sample of 41 adults with CP and GMFCS levels from IV to V were studied. The variables used in the study were age, sex, weight, height, mean age, and GMFCS level range. To evaluate nutritional status, body mass index and the Mini Nutritional Assessment (MNA), a nutritional screening tool, were used. To assess cardiometabolic risk, data on obesity, central obesity, blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were collected. Results: More than 80% of the population studied was malnourished or at risk of malnutrition, according to the MNA tool classification ranges, and around 35% of the studied population was within the underweight range. Regarding cardiometabolic risk factors, only one adult with CP was diagnosed with MS. Conclusions: The studied population of adults with CP and GMFCS levels between IV and V is not a population at risk of MS; however, the high prevalence of malnutrition, as well as some of the most prevalent cardiovascular risk factors, should be taken into consideration.

2021 ◽  
Author(s):  
Peter Vanes Ebasone ◽  
Nasheeta Peer ◽  
Anastase Dzudie ◽  
Andre Pascal Kengne

Abstract Background People living with HIV/AIDS (PLHIV) are at increased risk of cardiometabolic diseases attributable to the effects of the virus, antiretroviral therapy (ART) and traditional risk factors found in the general population. Most studies have focused on assessing the effect of ART on cardiometabolic disease in PLHIV with fewer studies assessing the cardiometabolic risk profile prior to any exposure to ART. Therefore, this protocol is for a systematic review and meta-analysis to estimate the global prevalence of selected cardiometabolic risk factors in ART-naïve PLHIV and their association with HIV specific factors. Methods We shall conduct a systematic search of published literature for observational studies on the prevalence of obesity, hypertension, diabetes and dyslipidaemia (high Low-Density Lipoprotein Cholesterol, high Total Cholesterol, high Triglyceride, low High-Density Lipoprotein Cholesterol) in ART-naïve PLHIV and their association with HIV specific characteristics. We will search PubMed-MEDLINE, CINAHL, SCOPUS, Academic Search Premier, Africa-Wide Information and Africa Journals Online databases to identify relevant studies published before March 2021. Two authors will independently screen, select studies, extract data and conduct risk of bias assessments. Disagreements between the two authors will be resolved by consensus or consulting a third reviewer. Data consistently reported across studies will be pooled using random-effects meta-analysis. Heterogeneity will be evaluated using Cochrane’s Q statistic and quantified using I2 statistics. The Preferred Reporting Items for Systematic reviews and Meta-Analysis protocols (PRISMA-P) 2015 guidelines are used for the reporting of this systematic review protocol. Discussion This review will help determine the burden of selected cardiometabolic diseases in ART-naïve HIV-infected populations and the contribution of HIV infection, independent of ART, to cardiometabolic diseases in PLHIV. It will provide new information that can help orientate future research and potentially guide healthcare policy making. This is part of a thesis that will be submitted to the Faculty of Health Sciences, University of Cape Town, for the award of a PhD in Medicine with protocol ethical clearance number (UCT HREC 350/2021). Registration PROSPERO: CRD42021226001


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247600
Author(s):  
Daniel Faurholt-Jepsen ◽  
Henrik Friis ◽  
David L. Mwaniki ◽  
Michael K. Boit ◽  
Lydia U. Kaduka ◽  
...  

Background Abdominal obesity predict metabolic syndrome parameters at low levels of waist circumference (WC) in Africans. At the same time, the African lipid profile phenotype of low high-density lipoprotein (HDL) cholesterol without concomitant elevated triglyceride levels renders high triglyceride levels detrimental to cardiometabolic health unsuitable for identifying cardiometabolic risk in black African populations. Objectives We aimed to identify simple clinical measures for cardiometabolic risk based on WC and HDL in an adult Kenyan population in order to determine which of the two predictors had the strongest impact. Methods We used linear regression analyses to assess the association between the two exposure variables WC and HDL with cardiometabolic risk factors including ultrasound-derived visceral (VAT) and subcutaneous adipose tissue (SAT) accumulation, fasting and 2-h venous glucose, fasting insulin, fasting lipid profile, and blood pressure in adult Kenyans (n = 1 370), and a sub-population with hyperglycaemia (diabetes and pre-diabetes) (n = 196). The same analyses were performed with an interaction between WC and HDL to address potential effect modification. Ultrasound-based, semi-quantitative hepatic steatosis assessment was used as a high-risk measure of cardiometabolic disease. Results Mean age was 38.2 (SD 10.7) (range 17–68) years, mean body mass index was 22.3 (SD 4.5) (range 13.0–44.8) kg/m2, and 57.8% were women. Cardiometabolic risk was found in the association between both WC and HDL and all outcome variables (p<0.05) except for HDL and SAT, fasting and 2-h venous glucose. Additive cardiometabolic risk (WC and HDL interaction) was found for SAT, low-density lipoprotein cholesterol, and triglycerides. No differences in the association between WC and HDL and the outcome variables were found when comparing the full study population and the hyperglycaemia sub-population. Increase in WC and HDL were both associated with hepatic steatosis (OR 1.09, p<0.001, and OR 0.46, p = 0.031, respectively). Conclusion In adult Kenyans, increasing WC identified more cardiometabolic risk factors compared to HDL.


Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 170 ◽  
Author(s):  
Diana C. Soria-Contreras ◽  
Belem Trejo-Valdivia ◽  
Alejandra Cantoral ◽  
María Luisa Pizano-Zárate ◽  
Andrea A. Baccarelli ◽  
...  

Pregnancy is a contributor to the obesity epidemic in women, probably through postpartum weight retention (PPWR), weight gain (PPWG), or a combination of both (PPWR + WG). The contribution of these patterns of postpartum weight change to long-term maternal health remains understudied. In a secondary analysis of 361 women from the prospective cohort PROGRESS, we evaluated the associations between patterns of weight change one year after delivery and cardiometabolic risk factors at six years postpartum. Using principal component analysis, we grouped cardiometabolic risk factors into: (1) body mass index (BMI), waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA-IR), high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), and glucose; (2) systolic (SBP) and diastolic blood pressure (DBP); and (3) low-density lipoprotein cholesterol and total cholesterol. Using path analysis, we studied direct (patterns of weight change-outcomes) and indirect associations through BMI at six years postpartum. Around 60% of women returned to their pregestational weight (reference) by one year postpartum, 6.6% experienced PPWR, 13.9% PPWG, and 19.9% PPWR + WG. Women with PPWR + WG, vs. the reference, had higher BMI and WC at six years (2.30 kg/m2, 95% CI [1.67, 2.93]; 3.38 cm [1.14, 5.62]). This was also observed in women with PPWR (1.80 kg/m2 [0.80, 2.79]; 3.15 cm [−0.35, 6.65]) and PPWG (1.22 kg/m2 [0.53, 1.92]; 3.32 cm [0.85, 5.78]). PPWR + WG had a direct association with HOMA-IR (0.21 units [0.04, 0.39]). The three patterns of weight change, vs. the reference, had significant indirect associations with HOMA-IR, glucose, TG, HDL-c, SBP, and DBP through BMI at six years. In conclusion, women with PPWR + WG are at high-risk for obesity and insulin resistance. Interventions targeting women during pregnancy and the first year postpartum may have implications for their long-term risk of obesity and cardiovascular disease.


Author(s):  
Marzena Ratajczak ◽  
Damian Skrypnik ◽  
Piotr Krutki ◽  
Joanna Karolkiewicz

The study aimed to provide evidence on the impact of indoor cycling (IC) in reducing cardiometabolic risk factors. The study compares the effects of a 3 month IC program involving three 55 min sessions per week on women aged 40–60 years, with obesity (OW, n = 18) vs. women with normal body weight (NW, n = 8). At baseline and at the end of the study, anthropometric parameters, oxygen uptake (VO2 peak), and serum parameters: glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), insulin, human anti-oxidized low-density lipoprotein antibody (OLAb), total blood antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS), endothelial nitric oxide synthase (eNOS), C-reactive protein (CRP), lipid accumulation product (LAP), and homeostasis model assessment of insulin resistance index (HOMA IR) were determined. Before the intervention, VO2 peak and HDL-C levels were significantly lower and levels of TG, LAP, insulin, HOMA-IR, and CRP were significantly higher in the OW group compared to those in the NW group. After the intervention, only the OW group saw a decrease in body mass, total cholesterol, OLAb, TBARS, and CRP concentration and an increase in total body skeletal muscle mass and HDL-C concentration. In response to the IC training, measured indicators in the OW group were seen to approach the recommended values, but all between-group differences remained significant. Our results demonstrate that IC shows promise for reducing cardiometabolic risk factors, especially dyslipidemia. After 12 weeks of regular IC, the metabolic function of the OW group adapted in many aspects to be more like that of the NW group.


2019 ◽  
Vol 105 (1) ◽  
pp. 210-218 ◽  
Author(s):  
Yun Liu ◽  
Adrienne S Ettinger ◽  
Martha Téllez-Rojo ◽  
Brisa N Sánchez ◽  
Zhenzhen Zhang ◽  
...  

Abstract Context Several cross-sectional studies have assessed the association of lead exposure with type 2 diabetes and cardiometabolic risk factors in adults; however, studies of such associations in childhood are rare. Objective We assessed the prospective associations of prenatal exposure to lead with type 2 diabetes and cardiometabolic risk factors in children. Design The Early Life Exposure in Mexico to Environmental Toxicants is a birth cohort study of pregnant women and their offspring. Setting Public hospitals in Mexico City. Patients or Other Participants Women were recruited during pregnancy; their offspring were recruited for a follow-up visit at age 10 to 18 years (n = 369). Main Outcome Measures We measured fasting serum markers of type 2 diabetes and cardiometabolic risk factors in children, including fasting glucose, insulin, and lipids. The index of insulin resistance was calculated. Results The geometric mean of maternal blood lead levels (BLLs) during pregnancy was 4.3 µg/dL (95% confidence interval [CI]): 4.0-4.6 µg/dL) in the entire sample. In boys, those with maternal BLLs ≥ 5 µg/dL (compared with those with BLLs &lt; 5 µg/dL) had significantly lower z scores for total cholesterol (β = -0.41, 95% CI: -0.71, -0.12), high-density lipoprotein cholesterol (β = -0.32, 95% CI: -0.59, -0.05), and low-density lipoprotein cholesterol (β = -0.52, 95% CI: -0.81, -0.22), adjusting for covariates. No associations were detected in girls. Conclusions In our study, we found that higher prenatal exposure to lead was associated with lower levels of cholesterol in children following a sex-specific pattern. Further studies with a larger sample size that examine whether sex is a potential modifier are needed to confirm our findings.


Circulation ◽  
2021 ◽  
Vol 143 (12) ◽  
pp. 1202-1214
Author(s):  
Christoph Höchsmann ◽  
James L. Dorling ◽  
Corby K. Martin ◽  
Robert L. Newton ◽  
John W. Apolzan ◽  
...  

Background: Intensive lifestyle interventions (ILIs) are the first-line approach to effectively treat obesity and manage associated cardiometabolic risk factors. Because few people have access to ILIs in academic health centers, primary care must implement similar approaches for a meaningful effect on obesity and cardiometabolic disease prevalence. To date, however, effective lifestyle-based obesity treatment in primary care is limited. We examined the effectiveness of a pragmatic ILI for weight loss delivered in primary care among a racially diverse, low-income population with obesity for improving cardiometabolic risk factors over 24 months. Methods: The PROPEL trial (Promoting Successful Weight Loss in Primary Care in Louisiana) randomly allocated 18 clinics equally to usual care or an ILI and subsequently enrolled 803 (351 usual care, 452 ILI) adults (67% Black, 84% female) with obesity from participating clinics. The usual care group continued to receive their normal primary care. The ILI group received a 24-month high-intensity lifestyle-based obesity treatment program, embedded in the clinic setting and delivered by health coaches in weekly sessions initially and monthly sessions in months 7 through 24. Results: As recently demonstrated, participants receiving the PROPEL ILI lost significantly more weight over 24 months than those receiving usual care (mean difference, −4.51% [95% CI, −5.93 to −3.10]; P <0.01). Fasting glucose decreased more in the ILI group compared with the usual care group at 12 months (mean difference, −7.1 mg/dL [95% CI, −12.0 to −2.1]; P <0.01) but not 24 months (mean difference, −0.8 mg/dL [95% CI, −6.2 to 4.6]; P =0.76). Increases in high-density lipoprotein cholesterol were greater in the ILI than in the usual care group at both time points (mean difference at 24 months, 4.6 mg/dL [95% CI, 2.9–6.3]; P <0.01). Total:high-density lipoprotein cholesterol ratio and metabolic syndrome severity ( z score) decreased more in the ILI group than in the usual care group at both time points, with significant mean differences of the change of −0.31 (95% CI, −0.47 to −0.14; P <0.01) and −0.21 (95% CI, −0.36 to −0.06; P =0.01) at 24 months, respectively. Changes in total cholesterol, low-density lipoprotein cholesterol, triglycerides, and blood pressure did not differ significantly between groups at any time point. Conclusions: A pragmatic ILI consistent with national guidelines and delivered by trained health coaches in primary care produced clinically relevant improvements in cardiometabolic health in an underserved population over 24 months. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02561221.


Author(s):  
Małgorzata Rumińska ◽  
Ewelina Witkowska-Sędek ◽  
Anna Stelmaszczyk-Emmel ◽  
Anna Majcher ◽  
Anna Kucharska ◽  
...  

IntroductionOsteoprotegerin has been shown to play a role in vascular calcification, atherosclerosis and the pathogenesis of cardiovascular diseases. We aimed to evaluate whether excess fat mass affects serum osteoprotegerin concentrations and to evaluate its associations with chosen cardiometabolic risk factors in overweight and obese children.Material and methodsWe enrolled 105 children ranging from 7.0 to 17.8 years of age. Among them 70 individuals were overweight and obese, and 35 were healthy with normal physical parameters. In all patients, anthropometric measurements and laboratory tests were performed. Atherogenic and insulin resistance indices were calculated.ResultsWe did not find any differences in serum osteoprotegerin concentrations between overweight and obese children and their lean peers. In all studied patients, together with elevated quartiles of osteoprotegerin concentration, insulin resistance status decreased, and low-density lipoprotein cholesterol concentration increased. In the group of overweight and obese children osteoprotegerin was associated with low-density lipoprotein cholesterol, total cholesterol, and non high-density lipoprotein cholesterol. In the multiple linear regression analysis osteoprotegerin correlated only with low-density lipoprotein cholesterol (β = 0.140, p = 0.005).ConclusionsInsulin resistance and lipid profile seem to influence circulating osteoprotegerin levels, but most likely needs more time to change its concentration in overweight and obese patients. The association of osteoprotegerin with low-density lipoprotein cholesterol may suggest its link with atherogenesis.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Katsuyasu Kouda ◽  
Yuki Fujita ◽  
Kumiko Ohara ◽  
Takahiro Tachiki ◽  
Junko Tamaki ◽  
...  

Abstract Background Body mass-independent parameters might be more appropriate for assessing cardiometabolic abnormalities than weight-dependent indices in Asians who have relatively high visceral adiposity but low body fat. Dual-energy X-ray absorptiometry (DXA)-measured trunk-to-peripheral fat ratio is one such body mass-independent index. However, there are no reports on relationships between DXA-measured regional fat ratio and cardiometabolic risk factors targeting elderly Asian men. Methods We analyzed cross-sectional data of 597 elderly men who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study, a community-based single-center prospective cohort study conducted in Japan. Whole-body fat and regional fat were measured with a DXA scanner. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat. Results Both TAR and TLR in the group of men who used ≥ 1 medication for hypertension, dyslipidemia, or diabetes (“user group”; N = 347) were significantly larger than those who did not use such medication (“non-user group”; N = 250) (P < 0.05). After adjusting for potential confounding factors including whole-body fat, both TAR and TLR were significantly associated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting serum insulin, and the insulin resistance index in the non-user group and non-overweight men in the non-user group (N = 199). Conclusion The trunk-to-peripheral fat ratio was associated with cardiometabolic risk factors independently of whole-body fat mass. Parameters of the fat ratio may be useful for assessing cardiometabolic risk factors, particularly in underweight to normal-weight populations.


2019 ◽  
Vol 32 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Teresa Maria Bianchini de Quadros ◽  
Alex Pinheiro Gordia ◽  
Alynne Christian Ribeiro Andaki ◽  
Edmar Lacerda Mendes ◽  
Jorge Mota ◽  
...  

Abstract Background Anthropometric indicators are associated with cardiometabolic risk factors (CMRF), but there is no consensus as to which indicator is the most suitable to screen for clustered CMRF. This study aimed to evaluate the utility of five anthropometric indicators to screen for clustered CMRF in children and adolescents. Methods A cross-sectional study was conducted in 1139 schoolchildren aged 6–17 years from Northeastern Brazil. Body weight, height, waist circumference (WC) and subscapular (SSF) and triceps skinfold thickness (TSF) were measured. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. The following CMRF were evaluated: elevated total cholesterol, low high-density lipoprotein-cholesterol (HDL-C), elevated low-density lipoprotein-cholesterol (LDL-C), high triglyceride concentration, hyperglycemia and high blood pressure. The participants were categorized into no CMRF, 1 CMRF, 2 CMRF and ≥3 CMRF. Receiver operating characteristic (ROC) curves were constructed to assess the accuracy of the anthropometric indicators in predicting CMRF for age group and sex. Results Poor associations were observed between the anthropometric indicators and 1 CMRF (accuracy of 0.49–0.64). The indicators showed moderate associations with 2 CMRF (accuracy of 0.57–0.75) and ≥3 CMRF (accuracy of 0.59–0.79). In general, TSF exhibited the worst performance in predicting CMRF, followed by WHtR. The highest accuracies were observed for BMI, WC and SSF, with no significant difference between these indicators. Conclusions The routine use of BMI, WC and SSF as epidemiological screening tools for clustered CMRF in childhood and adolescence should be encouraged.


Author(s):  
Fernanda Thomazini ◽  
Beatriz Silva de Carvalho ◽  
Priscila Xavier de Araujo ◽  
Maria do Carmo Franco

Abstract Objectives The prevalence of hyperuricemia, a common disorder, has been increasing. Moreover, the association between obesity, serum uric acid levels, and cardiometabolic markers in children is unclear. Therefore, this study aimed to analyze the inter-relationships between these factors in a sample of children aged 6–12 years. Methods We evaluated 764 children and stratified them according to their body mass index (BMI). Blood pressure and uric acid, creatinine, lipid, and glycemic profiles were evaluated, and the estimated glomerular filtration rate (eGFR) and the homeostatic model assessment for insulin resistance (HOMA-IR) index were calculated. Results There was a significant linear trend of increasing systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), total cholesterol, low-density lipoprotein cholesterol (LDLc), uric acid, insulin levels, and HOMA-IR index values corresponding with overweight and obese groups; however, high-density lipoprotein cholesterol (HDLc) levels decreased with increasing obesity. The mean creatinine level and eGFR were similar across all BMI groups. Uric acid levels were significantly correlated with BMI (r=0.527), waist circumference (r=0.580), SBP (r=0.497), DBP (r=0.362), TG (r=0.534), total cholesterol (r=0.416), LDLc (r=0.286), HDLc (r=−0.248), insulin (r=0.613), and HOMA-IR index (r=0.607). Multiple regression analyses showed that BMI (B=0.071; SE=0.012; p<0.001), TG (B=0.004; SE=0.001; p<0.001), LDLc (B=0.003; SE=0.001; p=0.006), and insulin (B=0.066; SE=0.007; p<0.001) (R2=0.460) were significant predictors of increased uric acid levels and explained 46% of the variability in uric acid in these children. Conclusions Our findings suggest that overweight or obese children are more likely to have higher uric acid levels. Moreover, several cardiometabolic risk factors were strongly associated with high uric acid levels.


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