Table 1-9. Risk Indicators (Other than Major ASCVD Risk Factors) that Might Be Considered for Risk Refinement

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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Path Analysis on Determinants of Childhood Obesity and Associated Risk Factors of Cardiovascular, Renal, and Hepatic Diseases: The CASPIAN-V Study

Journal of Child Science ◽

10.1055/s-0040-1716917 ◽

2020 ◽

Vol 10 (01) ◽

pp. e148-e158

Author(s):

Vahid Mansouri ◽

Marjan Mansourian ◽

Mostafa Qorbani ◽

Roya Riahi ◽

Rahele Karimi ◽

...

Keyword(s):

Risk Factors ◽

Childhood Obesity ◽

Latent Variables ◽

Mutual Influence ◽

Risk Indicators ◽

Noncommunicable Diseases ◽

Surveillance Program ◽

Predisposing Factor ◽

Blood Samples ◽

Hepatic Diseases

AbstractThe interaction between several lifestyle and obesogenic environmental factors is considered as the main underlying factor for the escalating trend of childhood obesity and its adverse consequences. In this study, we assessed the mutual influence of lifestyle habits and body mass index (BMI) as well as risk factors for cardiometabolic, hepatic, and renal disorders to define the causality power of each item. This nationwide cross-sectional study was conducted as the fifth round of a school-based surveillance program. Overall, 14,800 students living in Iran were studied, and blood samples were obtained from 4,200 of them. Demographic factors, anthropometric and biochemical measures were used to define lifestyle-related latent variables as well as cardiac, renal, and hepatic risk indicators. Total, direct, and indirect effects between factors were analyzed using the standardized regression weights for each pathway. Data from 14,274 students (participation rate of 99%) and 3,843 blood samples were included. All of the latent variables had a significant direct effect on BMI, with the most potent effect of unhealthy nutrition (β ≅ 0.63) in boys and girls. BMI has significant direct effects on risk indicators of cardiovascular, renal, and hepatic diseases with the most powerful effect on cardiovascular risk factors (β ≅ − 0.08). The most important predisposing factor for obesity was unhealthy nutrition, whereas increased activity, adequate sleep, and better hygiene had protective roles. BMI shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases.

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A novel simple risk model to predict the prognosis of patients with paraquat poisoning

Scientific Reports ◽

10.1038/s41598-020-80371-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yanxia Gao ◽

Liwen Liu ◽

Tiegang Li ◽

Ding Yuan ◽

Yibo Wang ◽

...

Keyword(s):

Risk Factors ◽

Latent Class ◽

Risk Model ◽

Risk Groups ◽

Training Sample ◽

Risk Indicators ◽

Hospital Death ◽

Gamma Glutamyl Transferase ◽

Creatine Kinase Mb ◽

Glutamyl Transferase

AbstractTo identify risk factors and develop a simple model to predict early prognosis of acute paraquat (PQ) poisoning patients, we performed a retrospective cohort study of acute PQ poisoning patients (n = 1199). Patients (n = 913) with PQ poisoning from 2011 to 2018 were randomly divided into training (n = 609) and test (n = 304) samples. Another two independent cohorts were used as validation samples for a different time (n = 207) and site (n = 79). Risk factors were identified using a logistic model with Markov Chain Monte Carlo (MCMC) simulation and further evaluated using a latent class analysis. The prediction score was developed based on the training sample and was evaluated using the testing and validation samples. Eight factors, including age, ingestion volume, creatine kinase-MB [CK-MB], platelet [PLT], white blood cell [WBC], neutrophil counts [N], gamma-glutamyl transferase [GGT], and serum creatinine [Cr] were identified as independent risk indicators of in-hospital death events. The risk model had C statistics of 0.895 (95% CI 0.855–0.928), 0.891 (95% CI 0.848–0.932), and 0.829 (95% CI 0.455–1.000), and predictive ranges of 4.6–98.2%, 2.3–94.9%, and 0–12.5% for the test, validation_time, and validation_site samples, respectively. In the training sample, the risk model classified 18.4%, 59.9%, and 21.7% of patients into the high-, average-, and low-risk groups, with corresponding probabilities of 0.985, 0.365, and 0.03 for in-hospital death events. We developed and evaluated a simple risk model to predict the prognosis of patients with acute PQ poisoning. This risk scoring system could be helpful for identifying high-risk patients and reducing mortality due to PQ poisoning.

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Growth attainment in German children born preterm, and cardiovascular risk factors in adolescence. Analysis of the population representative KiGGS data

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0294 ◽

2017 ◽

Vol 45 (5) ◽

Author(s):

Renate L. Bergmann ◽

Karl E. Bergmann ◽

Rolf Richter ◽

Martin Schlaud ◽

Wolfgang Henrich ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Cardiovascular Risk Factors ◽

Head Circumference ◽

Pubertal Development ◽

Analysis Of Covariance ◽

Risk Indicators ◽

Anthropometric Parameters ◽

Preterm Children

AbstractAim:To compare the growth attainment of preterm children and their cardiovascular risk factors at adolescence with the values measured in term children in Germany.Methods:About 17,641 children aged 0 to <18 years were studied between 2003 and 2006 in the population representative German KiGGS survey (“German Health Interview and Examination Survey for Children and Adolescents”) using questionnaires, physical examinations, standardized anthropometric and blood pressure measurements, and blood sample analyses. Analysis of covariance (ANCOVA) was employed for the analyses of anthropometric parameters.Results:About 11.8% of the 16,737 children with complete and valid data had been born preterm. After adjustment for covariates the estimated z-scores over the total age range were larger in term compared to preterm children for length/height (P<0.001; estimated difference B=0.277, 95% CI 0.191–0.362), head circumference (P<0.001; B=0.238, 95% CI 0.144–0.333), BMI (P=0.001; B=0.160, 95% CI 0.069–0.252), and skinfold thickness (P=0.220; B=0.058, 95% CI −0.035 to 0.151). The onset of pubertal development was slightly (but not significantly) earlier in term compared to preterm children. At 14 to <18 years, anthropometric and biochemical indicators of cardiovascular diseases were not worse in preterm compared to term children.Conclusions:Preterm-born German adolescents remained significantly shorter, lighter, and had a smaller head circumference than term-born adolescents, but the risk indicators for cardiovascular diseases were not higher.

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Seroprevalence and risk factors associated with infection by Neospora caninum of dairy cattle in the state of Alagoas, Brazil

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2012001000011 ◽

2012 ◽

Vol 32 (10) ◽

pp. 1009-1013 ◽

Cited By ~ 9

Author(s):

Maria E. Sousa ◽

J.N. Porto Wagnner ◽

Pedro P.F. Albuquerque ◽

Orestes L. Souza Neto ◽

Eduardo B. Faria ◽

...

Keyword(s):

Risk Factors ◽

Dairy Cattle ◽

Indirect Immunofluorescence ◽

Neospora Caninum ◽

Infection Risk ◽

Control Measures ◽

Risk Indicators ◽

Blood Samples ◽

Factors Associated ◽

Serological Investigation

The objective of this study was to investigate the prevalence of anti-Neospora caninum antibodies in cattle from milk producing farms of the microregion of Batalha, state of Alagoas, Brazil, as well as to identify the risk factors associated with the infection. Blood samples were collected from 1,004 cattle of 17 farms for the serological investigation regarding the presence of anti-N. caninum antibodies by the Indirect Immunofluorescence Reaction Technique (IMRT). From the total amount of samples analyzed, 77/1,004 (7.67%) were positive and 927/1,004 (92.33%) were negative. The logistical regression identified that cattle from farms without consortium breeding have an infection risk 6.33 (p<0.001; C.I. 2.89-13.10) times higher than cattle from farms with that type of breeding. Cattle from farms where the aborted fetuses are not adequately buried have an infection risk 3.04 (p<0.001; C.I. 1.64-5.63) times higher than cattle from farms with adequate destination of these fetuses. Infection by N. caninum occurs in cattle of the investigated region. The factors identified in our study can be used as risk indicators, so that control measures could be implemented to avoid infection by N. caninum in the herds of this region.

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RISK FACTORS ASSOCIATED WITH THE OCCURRENCE OF EARLY COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION AFTER CARDIO-INTERVENTION TREATMENT

Wiadomości Lekarskie ◽

10.36740/wlek202006132 ◽

2020 ◽

Vol 73 (6) ◽

pp. 1245-1251

Author(s):

Iryna A. Holovanova ◽

Grygori A. Oksak ◽

Iryna M. Tkachenko ◽

Maxim V. Khorosh ◽

Mariia M. Tovstiak ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cox Regression ◽

Risk Indicators ◽

Interventional Treatment ◽

Early Complications ◽

Cox Regression Analysis ◽

Intervention Treatment

The aim of our study was to identify the main risk factors for the occurrence of early complications of acute myocardial infarction after cardio-interventional treatment and to evaluate prognostic risk indicators. Materials and methods: Risk factors of myocardial infarction were determined by copying the case history data and calculating on their basis of the odds ratio and ±95% confidence interval. After it, we made a prediction of the risk of early complications of AMI with cardiovascular intervention by using a Cox regression that took into account the patient’s transportation time by ambulance. Results: Thus, the factors that increase the chances of their occurrence were: summer time of year; recurrent myocardial infarction of another specified localization (I122.8); the relevance of the established STEMI diagnosis; diabetes mellitus; renal pathology; smoking; high rate of BMI. Factors that reduce the chances of their occurrence: men gender – in 35%; the age over of 70 – by 50%; the timely arrival of an emergency medical team – by 55%. The factors that increase the chances of their occurrence were: age over 70 years; subsequent myocardial infarction of unspecified site; diabetes mellitus. Using of a Cox regression analysis, it was proved that the cumulative risk of early complications of AMI with cardio-intervention treatment increased from the 10th minute of ambulance arrival at place, when ECG diagnosis (STEMI), presence of diabetes mellitus, smoking and high BMI. Conclusions: As a result of the conducted research, the risk factors for early complications of AIM with cardio-interventional treatment were identified.

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Towards a Parsimonious Pathway Model of Modifiable and Mediating Risk Factors Leading to Diabetes Risk

10.21203/rs.3.rs-429757/v1 ◽

2021 ◽

Author(s):

Yi-Ching Lynn Ho ◽

Vivian Shu Yi Lee ◽

Moon-Ho Ringo Ho ◽

Gladis Jing Lin ◽

Julian Thumboo

Keyword(s):

Risk Factors ◽

Disease Prevention ◽

Structural Equation ◽

Diabetes Risk ◽

Risk Indicators ◽

Equation Modeling ◽

Pathway Model ◽

Physiological Load ◽

Modifiable Factors ◽

Lifestyle Risk

Abstract Background: The development of diabetes mellitus has been closely linked to multiple risk factors, of which modifiable factors are of particular interest for disease prevention. Yet few studies have assessed the system of pathways though which risk factors lead to diabetes, and how the different groups of risk factors may interact,both as independent or mediating factors. Methods: We aimed to develop a broad pathway model for diabetes risk with modifiable lifestyle risk factors as the start point, hypothesising that Lifestyle Risk (physical inactivity, smoking, poor diet and insufficient sleep) would impact Diabetes Risk (HbA1c) through the mediating factor of Physiological Load (BMI, resting pulse rate, CRP, systolic and diastolic blood pressure). The lifestyle and physiological factors were grouped via principal components analysis and a summary index respectively. Non modifiable risk factors, such as sociodemographics were specified as covariates. We used structural equation modeling to test this model, first using Wave 5 data from the Indonesian Family Life Survey (IFLS), as this was the only wave that collected all indicators of interest. To fit in longitudinal data from an earlier wave (IFLS4), we further tested a smaller model with the two Lifestyle Risk indicators available. Results: Both models showed indirect effects of Lifestyle Risk on Diabetes Risk via Physiological Load, with the cross-sectional model also showing a direct effect. The effect sizes were within the range of other studies that assessed the variables separately. Conclusion: Taken together, the results support the model of an indirect effect of Lifestyle Risk on Diabetes through Physiological Load. Specifying Lifestyle Risk as an observable, composite variable incorporates the cumulative effect of risk behaviour and differentiates this study from previous studies assessing it as a latent construct. We were able to assess causality with retrospective cohort data. Finally, the parsimonious model groups and summarises the multifarious risk factors and illustrates parsimonious and modifiable pathways that could be applied in chronic disease prevention efforts.

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The Effect of Oxymel Syrup on Some Cardiovascular Risk Factors in Overweight and Obese People: A Randomized Controlled Trial Study

Traditional and Integrative Medicine ◽

10.18502/tim.v6i3.7307 ◽

2021 ◽

Author(s):

Marjan Mahdavi Roshan ◽

Arsalan Salari ◽

Sogol Emaminejad ◽

Shirin Parvinroo ◽

Asieh Ashouri ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Controlled Trial ◽

Test Group ◽

The Body ◽

Risk Indicators ◽

Blood Cholesterol ◽

Control Group ◽

Obese People

High blood pressure, diabetes, hyperlipidemia and obesity are risk factors for cardiovascular diseases. With regard to the significant role of a healthy diet in the prevention and even treatment of diseases together with the high cost and side effects of drugs, finding foods effective in the treatment of metabolic disorders has been widely considered. This study aimed to evaluate the effect of oxymel – an Iranian traditional syrup with vinegar base – on cardiovascular risk indicators in obese and overweight people. Candidates were selected based on a set of inclusion criteria and were divided into two groups of control and test. The control group received 250 cc of water, while the test group received 250 cc water containing 30 cc of the oxymel for 30 days. Anthropometric and biochemical indicators were measured at the beginning and end of the study. The results showed that there were no significant changes in the body mass index, waist circumference, hip circumference, waist to hip ratio, HDL, LDL, Triglycerides, systolic and diastolic blood pressure, and blood glucose level. However, weight (P = 0.053) and cholesterol (P = 0.083) decreased relatively significantly in the test group compared to the control group. This study shows that consumption of oxymel has positive cardiovascular effects such as lowering the blood cholesterol level and can contribute to weight loss; however, studies with a larger sample size are recommended.

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Abstract P181: Atherogenic Lipoproteins and Incident Atherosclerotic Cardiovascular Disease in the Framingham Offspring Study

Circulation ◽

10.1161/circ.141.suppl_1.p181 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Hiroaki Ikezaki ◽

Elise Lim ◽

Ching-Ti Liu ◽

L Adrienne Cupples ◽

Bela F Asztalos ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Atherosclerotic Cardiovascular Disease ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Significant Information ◽

Ascvd Risk

Introduction: Elevated plasma low-density lipoprotein cholesterol (LDL-C), small-dense LDL-C (sdLDL-C), LDL-triglyceride (LDL-TG), triglycerides (TG), remnant-lipoprotein cholesterol (RLP-C), triglyceride-rich lipoprotein-C (TRL-C), very low-density lipoprotein cholesterol (VLDL-C), and lipoprotein(a) [Lp(a)] levels have been associated with increased atherosclerotic cardiovascular disease (ASCVD) risk. However, these parameters have not been included in risk factors for ASCVD in the pooled cohort equation (PCE). Hypothesis: We assessed the hypothesis that these atherogenic lipoprotein parameters add significant information for ASCVD risk prediction in the Framingham Offspring Study. Methods: We evaluated 3,147 subjects without ASCVD at baseline (mean age 58 years) from participants of Framingham Offspring Study cycle 6, 677 (21.5%) of whom developed inclusive ASCVD over 16 years. Biomarkers of risk were assessed in frozen plasma samples. Total cholesterol, TG, HDL-C, direct LDL-C, sdLDL-C, LDL-TG, Lp(a), RLP-C, and TRL-C were measured by standardized automated analysis. Calculated LDL-C, large buoyant low-density lipoprotein cholesterol (lbLDL-C), VLDL-C, and non-HDL-C values were calculated. Data were analyzed using Cox proportional regression analysis and net reclassification improvement (NRI) analysis to identify parameters significantly associated with the incidence of ASCVD after controlling for standard ASCVD risk factor and applying the PCE model. Results: All specialized lipoprotein parameters were significant ASCVD risk factors on univariate analysis, but only direct LDL-C, sdLDL-C, and Lp(a) were significant on multivariate analysis with standard risk factors in the model. Together these parameters significantly improved the model c statistic (0.716 vs 0.732, P < 0.05) and net risk reclassification (mean NRI 0.104, P < 0.01) for ASCVD risk. Using the ASCVD risk pooled cohort equation, sdLDL-C, TG, LDL-TG, LDL-C, RLP-C, and TRL-C individually added significant information, but no other parameter added significant information with sdLDL-C (hazard ratio 1.30 for 75th vs 25th percentile, P < 0.0001) in the model. Conclusions: In multivariate analysis, sdLDL-C, direct LDL-C, and Lp(a) contributed significantly to ASCVD risk, but only sdLDL-C added significant risk information to the PCE model, indicating that sdLDL-C may be the most atherogenic lipoprotein particle.

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Prevalence and correlates of multiple behavioural risk factors of non-communicable diseases among university students from 24 countries

Journal of Public Health ◽

10.1093/pubmed/fdaa138 ◽

2020 ◽

Author(s):

Supa Pengpid ◽

Karl Peltzer

Keyword(s):

Risk Factors ◽

University Students ◽

Cross Sectional Study ◽

Communicable Diseases ◽

Risk Indicators ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Targeted Interventions ◽

Behavioural Risk Factors ◽

Male Sex

Abstract Background Globally non-communicable diseases (NCDs) are on the increase. The goal of the study was to estimate the prevalence and correlates of multiple behavioural risk factors of NCDs among university students from 24 countries. Methods In a cross-sectional study, the sample included 18 017 university students from countries in Africa, the Americas and Asia. Results indicate that prevalence of single behavioural NCD risk indicators were 38.2% for physical inactivity, 80.5% for inadequate fruit and vegetables intake, 23.1% for having overweight/obesity, 10.5% for heavy alcohol use and 11.8% for current tobacco use. Students had on average 1.6 (SD = 0.9), and 15.9% had three or more behavioural NCD risk factors. In adjusted linear regression, male sex was positively and stronger beliefs in health benefits were negatively associated with multiple behavioural NCD risk factors. Conclusions A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered. Several behavioural NCD risk factors, such as male sex and low health behaviour benefits beliefs, were found that could be utilized in targeted interventions.

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