scholarly journals An Overview on Cardiovascular Risks Definitions by Using Survival Analysis Techniques-Tehran Lipid and Glucose Study: 13-Year Follow-Up Outcomes

2016 ◽  
Vol 9 (4) ◽  
pp. 197
Author(s):  
Nezhat Shakeri ◽  
Farhad Hajsheikholeslami ◽  
Amir abbas Momenan ◽  
Fereidoun Azizi

<p>Risk assessment is an important issue for starting medication for patients. Literature reveals that diabetes, hypertension, dyslipidemia and Body Mass Index (BMI) are among major risk factors for longevity. Since the cut-off points proposed in various sources are generally irrespective of age, sex and race, it has been attempted to validate current definitions for Tehran’s elderly population by using a prospective cohort study. For this purpose, one thousand seven hundred and ninety eight (1,798) individuals above 60 years old were recruited in the primary phase of the Tehran Lipid and Glucose Study (TLGS) during 1998-2001, and were tested for their systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, high density lipoprotein cholesterol (HDL), triglyceride (TG), fasting blood sugar (FBS), 2-h plasma glucose (2HPG) and some other factors at the time of entry to the study. They were followed up for 13 years and their vital statuses were registered (1998-2011).</p><p>According to the standard definition of diabetes, dyslipidemia and hypertension, the participants were divided into ill and healthy groups. By using univariate Cox proportional hazard model, a 95% hazard ratio for various risk factors was estimated. Cut-off points of 126 mg/dL for fasting blood sugar or 200 mg/dL for 2HPG for defining diabetes were identified as appropriate points for predicting longevity for elderly males and females. Systolic blood pressure over 140 mmHg or diastolic blood pressure over 90 mmHg or having medication as a definition of hypertension were identified as a significant risk factor for elderly males only. Dyslipidemia which is defined based on Cholesterol&gt;240 or TG&gt;400 or LDL&gt;160 or HDL&lt;35, was not identified as a longevity predictor for elderly men and women. The results showed that BMI&gt;31 Kg/m<sup>2</sup> at the time of entry to the study significantly reduced the survival time of women. In conclusion, the definitions of diseases like hypertension and dyslipidemia based on cut-off points don’t classify the Tehran’s elderly population accurately. More investigation in this regard is required.</p>

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Shafiqah Mohd Radhi ◽  
Nur Zakiah Mohd Saat ◽  
Nor Farah Mohamad Fauzi ◽  
Siti Aishah Hanawi

Physical activity is an important component of cardiovascular health. The fact that physical activity is also associated with a substantial number of cognitive and academic benefits, therefore schools teachers can be an important role model in promoting a physically-active lifestyle in school children. The aim of this study is to examine the levels of physical activity (PA) and its association with cardiovascular risk factors in a sample of school teachers. Forty-nine (n=49) teachers from primary and secondary schools around Klang Valley urban areas were recruited. The PA level was determined using pedometer, worn for three consecutive days. Anthropometric measurements and blood samples were collected to determine cardiovascular risk factors. Findings showed that the school teachers recorded an overall mean (± SEM) of 7707 ± 490 steps/day, which is below the recommended target of 10 000 steps per day. According to pedometer-determined physical activity indices proposed by Tudor-Locke and Bassett (2004), 20.83% of the sample were classified as ‘sedentary’ (<5000 steps/day), 35.40% were ‘low active’ (5000 – 7499 steps/day) and only 18.70% achieved more than 10 000 steps/day. According to Asian BMI cut-off points, 43% of the teachers were categorized as overweight and obese (>23 kg/m2). The mean values for waist circumference, fasting blood sugar, and cholesterol level, systolic and diastolic blood pressure were 83.96 ± 1.90 cm, 5.41 ± 0.26 mmol/l, 4.64±0.26 mmol/l, 118.90 ± 1.72 mmHg and 72.40±1.58 mmHg respectively. Fisher Exact Test shown that there were significant association between daily step and age category. Daily steps weakly negative correlated with systolic blood pressure (r = -0.024, p > 0.05) as well as blood sugar levels (r = -0.061, p> 0.05), diastolic blood pressure (r = -0.079, p> 0.05), body mass index (r = -0.271, p> 0.05), waist circumference (r = -0.196, p> 0.05), as well as blood cholesterol levels (r = -0.037, p> 0.05). In conclusion, there were weak negative correlations between steps per day and cardiovascular risk factors. Generally, the level of physical activity in the sample of teachers needs to be improved. Interventions aimed at promoting PA among school teachers may be warranted in the future.


2005 ◽  
Vol 40 (11) ◽  
pp. 972-976
Author(s):  
Jeanne E. Frenzel ◽  
Ji M. Koo ◽  
Tze Shien Lo ◽  
Rajeev Kaul ◽  
Amandeep Chadha

Two hundred and three adult males were evaluated for the presence of microalbuminuria. Out of 203 patients, 123 (61%) tested negative for microalbuminuria and 80 (39%) tested positive. Patients were further evaluated for age, body mass index, cigarette smoking, blood pressure, serum lipid levels, renal function, cardiovascular events, and use of antihypertensive and antihyperlipidemic medications. This study shows that age greater than 70 years, creatinine clearance less than 50 mL/min, and systolic blood pressure greater than or equal to 140 mm Hg are all significant risk factors for microalbuminuria.


2020 ◽  
Vol 13 (1) ◽  
pp. 46
Author(s):  
Julianty Pradono ◽  
Delima Delima ◽  
Nunik Kusumawardani ◽  
Frans Dany ◽  
Yudi Kristanto

BACKGROUND: Metabolic syndrome (MetS) is a multiple risk factor for the development of type 2 diabetes mellitus (DM). It is important to understand the contribution of MetS in developing DM in different population characteristics. This study aims to obtain the prevalence of MetS and the magnitude of the contribution of MetS risk factors as a basis for developing targeted DM intervention programs. METHODS: This study used data from the 2018 Riskesdas survey, an Indonesia national health survey, with a total sample of 24,545 individuals aged 15 years and over. This study selected only respondents who had never been diagnosed with diabetes mellitus before the survey was conducted and have complete MetS data according to the National Cholesterol Education Program or Adult Treatment Panel III (NCEP/ATP III) criteria. Data had been analyzed for the Population Attributable Fraction (PAF) statistical test. RESULTS: A total of 29.2 percents of the population with MetS and the prevalence in women (17.2%) was higher than in men (11.9%) Three components of MetS that contribute greatly to DM were fasting blood glucose levels, hypertension and high triglyceride levels. If the men population can maintain two risk factors (fasting blood sugar levels and blood pressure) under normal conditions, the prevalence of DM can be reduced by as much as 15 percent. In women, if three factors (fasting blood sugar levels, blood pressure, and triglyceride levels) can be maintained under normal conditions, the prevalence of DM can be reduced by 29.9 percent. CONCLUSION: Prevention strategy of DM need to include monitoring and controlling of the metabolic syndrome and behavioral risk factors, that can be applied in primary health center as well as in community-based setting of health program.


2021 ◽  
pp. 155982762110063
Author(s):  
Susan M. Friedman ◽  
Carol Hee Barnett ◽  
Robert Franki ◽  
Bruce Pollock ◽  
Beth Garver ◽  
...  

The 15-day Jumpstart was developed as an evidence-based, affordable, standardized, replicable, and scalable program, designed to demonstrate quickly to patients that changing what they eat can improve their health. The program was designed using the principles of the self-determination theory of motivation and personality. Patients were instructed to eat an Esselstyn-compliant, whole-food plant-based diet consisting of vegetables, fruits, whole grains, and legumes. Of the 389 participants in the program from September 2018 to February 2020, average weight loss was 5.8 pounds (7.3 for those whose body mass index was >30), average systolic blood pressure drop was 6.8 points (16.8 points for those with systolic blood pressure >140), average drop in cholesterol was 26 points (44 points for those with a cholesterol >200), average drop in low-density lipoprotein was 19 points (33 points for those with a low-density lipoprotein >100), and average drop in fasting blood sugar was 5.1 points (28.4 points for those starting in the diabetic range); P value was <.005 for fasting blood sugar and <.001 for all other comparisons. A 15-day program that helps patients adopt an Esselstyn-style whole-food plant-based diet, through education, individualized medical feedback, social support, and facilitated small group work, rapidly improves health.


Author(s):  
Mariane da Silva Dias ◽  
Alicia Matijasevich ◽  
Ana Maria B. Menezes ◽  
Fernando C. Barros ◽  
Fernando C. Wehrmeister ◽  
...  

Abstract Evidence suggests that maternal prepregnancy body mass index (BMI) is associated with offspring cardiometabolic risk factors. This study was aimed at assessing the association of maternal prepregnancy BMI with offspring cardiometabolic risk factors in adolescence and adulthood. We also evaluated whether offspring BMI was a mediator in this association. The study included mother–offspring pairs from three Pelotas birth cohorts. Offspring cardiometabolic risk factors were collected in the last follow-up of each cohort [mean age (in years) 30.2, 22.6, 10.9]. Blood pressure was measured using an automatic device, cholesterol by using an enzymatic colorimetric method, and glucose from fingertip blood, using a portable glucose meter. In a pooled analysis of the cohorts, multiple linear regression was used to control for confounding. Mediation analysis was conducted using G-computation formula. In the adjusted model, mean systolic blood pressure of offspring from overweight and obese mothers was on average 1.25 (95% CI: 0.45; 2.05) and 2.13 (95% CI: 0.66; 3.59) mmHg higher than that of offspring from normal-weight mothers; for diastolic blood pressure, the means were 0.80 (95% CI: 0.26; 1.34) and 2.60 (95% CI: 1.62; 3.59) mmHg higher, respectively. Non-HDL cholesterol was positively associated with maternal BMI, whereas blood glucose was not associated. Mediation analyses showed that offspring BMI explained completely the association of maternal prepregnancy BMI with offspring systolic and diastolic blood pressure, and non-HDL cholesterol. Our findings suggest that maternal prepregnancy BMI is positively associated with offspring blood pressure, and blood lipids, and this association is explained by offspring BMI.


2021 ◽  
Vol 14 ◽  
pp. 117863882110352
Author(s):  
Yordanos Mengistu ◽  
Gobena Dedefo ◽  
Mesay Arkew ◽  
Gebeyehu Asefa ◽  
Gutema Jebessa ◽  
...  

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.


2019 ◽  
Author(s):  
Zelalem Kofole ◽  
Diresbachew Haile ◽  
Yerukneh Solomon ◽  
Eyayu Girma

Abstract Background: The use of contraceptives has become prevalent among women in Ethiopia. Oral contraceptive use has been suggested to trigger changes in glucose metabolism, energy expenditure, blood pressure, and body weight, among the various populations and ethnic groups. Objective: To elucidate the pattern of fasting blood sugar (FBS), blood pressure and body mass index (BMI) among combined oral contraceptive (COC) pills users, taking into account other confounding factors including socioeconomic conditions and physical activity status. Methods: An institution based cross-sectional study design was employed. A total of 110 healthy women using pills were recruited as cases. Another 110 healthy women not using any hormonal contraceptives were recruited as matched controls. A study was conducted between October 2018 and January 2019. Fasting Capillary blood sample was collected from the study participants for the estimation of the FBS level. Systolic and diastolic blood pressures were measured and means arterial blood pressure was calculated for each participant. Body weight and height were measured to compute body mass index. Data obtained was entered and analyzed using IBM SPSS version 23 software packages. Results: FBS level in users was significantly increased compared to controls (88.55 ± 7.89 vs. 86.00 ± 9.85 in users and controls respectively, P = 0.025). There was a significant difference in mean arterial blood pressure of users compared to controls (88.2 ± 8.48 vs. 86.0 ± 6.74 respectively, P=0.04). The mean weight and body mass index of users were significantly increased (P = 0.03 and P = 0.003, respectively). Changes in mean fasting blood sugar level and mean weight of users were independent (P = 0.27 and P = 0.46) to the duration of use (3-12, 13-24 and ≥ 25 months). On the other hand, changes in mean body mass index and mean arterial blood pressure of users were dependent of the duration of use (P = 0.03 and P = 0.000 respectively). Conclusions: Overall, oral contraceptive pills use appears to cause a 2.9% increase in fasting blood glucose level, a 2.5% increase in mean arterial blood pressure and a 3.9% increase in body mass index among the users.


2021 ◽  
Vol 15 (5) ◽  
pp. 1522-1525
Author(s):  
S. Inayat ◽  
H. F. Khattak ◽  
M. G. Muhammad ◽  
K. Robeen ◽  
A. Inayat ◽  
...  

Objective: The main objective of this study is to determine the efficacy of metformin therapy on clinical and hormonal indices of patients with polycystic ovary syndrome. Study Design: Randomized control trial Place and Duration: Study was conducted at Obstetrics & Gynaecology department of Northwest General Hospital and Research Center, Peshawar and Mian Rashid Hussain Shaheed Memorial Hospital, Pabbi for duration of nine months from March 2020 to November 2020. Methods: Total 100 patients of polycystic ovary syndrome were presented in this study. Patients were aged between 18 to 45years. Patients detailed demographics including age, body mass index and socio-economicstatus were recorded after taking informed written consent. Patients were divided into 2-groups, group I had 50 patients and received metformin (500 mg) three times a day and group II had 50 patients and received pioglitazone (30 mg) three times a day for 3months.Clinical (body weight, blood pressure (BP), and body mass index) and indices fasting blood sugar (FBS), serum triglyceride (TG), cholesterol, low-density lipoprotein, high-density lipoprotein, insulin, testosterone, and dehydroepiandrosterone (DHEA) were measured before and after therapy. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients in group I was 29.18 ± 2.25 years with mean BMI 26.14 ± 8.86 kg/m2 and in group II mean age was 29.8 ± 2.52 years with mean BMI 27.64 ± 7.68 kg/m2.Significantly decrease in blood pressure (systolic 105.41±8.57, diastolic 67.19±8.9), hair loss 20 (40%),oligomenorrhea 23 (46%), body weight 74.45±9.72, waist circumference and dehydroepiandrosterone (DHEA) 2.35±0.67 and as compared to group II. Only triglycerides gave results of reduction in group II 115.39±64.11. Among both groups serum insulin, acne, menstrual disturbance and fasting blood sugar were controlled after treatment. Conclusion: We concluded in this study that use of metformin in patients with polycystic ovary syndrome resulted in to decrease clinical body weight, blood pressure (BP), body mass index and hormonal indices with reduction of serum insulin, acne, menstrual disturbance and fasting blood sugar but pioglitazone was an alternative effective and reliable method in PCOS patients. Keywords: Polycystic ovary syndrome, Insulin resistance, Metformin, Pioglitazone


2019 ◽  
Vol 59 (2) ◽  
pp. 79-86
Author(s):  
Roslina Dewi ◽  
Rafita Ramayati ◽  
Nelly Rosdiana ◽  
Oke Rina Ramayani ◽  
Rosmayanti Siregar ◽  
...  

Background The prevalence of hypertension in children and adolescents has increased with the rising obesity epidemic. Recent studies have found that prevalence of hypertension was higher in obese children or adolescents than in the normal weight ones. Anthropometric measurements such as body mass index (BMI), waist circumference, and skinfold thickness have been used as criteria to determine obesity in children and adolescents. Increased waist circumference has been most closely related to increased blood pressure. Objective To compare waist circumference, BMI, and skinfold thickness as potential risk factors for hypertension in adolescents. Methods This cross-sectional study was conducted in May 2014 in three senior high schools in Medan, North Sumatera, and included 253 students with normal urinalysis test. All subjects underwent blood pressure, waist circumference, tricep- and subscapular-skinfold thickness (TST and SST), body weight, and body height measurements. The study population was categorized into underweight, normoweight, overweight, and obese, according to four different criteria: waist circumference, BMI, TST, and SST; all variables were analyzed for possible correlations with systolic and diastolic blood pressure. Results There were significant positive correlations between systolic blood pressure and waist circumference (OR 7.933; 95%CI 2.20 to 28.65; P=0.011) as well as BMI (OR 4.137; 95%CI 1.16 to 14.75; P=0.041). There were also significant correlations between diastolic blood pressure and waist circumference (OR 3.17; 95%CI 1.83 to 5.51; P=0.002), BMI (P=0.0001; OR=3.69), TST (OR 4.73; 95%CI 2.31 to 9.69; P=0.0001), and SST (OR 3.74; 95%CI 2.35 to 5.94; P=0.0001). Multivariate analysis showed that waist circumference was a predictive factor for systolic blood pressure (OR 9.667), but not for diastolic blood pressure. Conclusion Waist circumference is the strongest, significant, predictive factor for elevated systolic blood pressure; meanwhile BMI, SST, and TST could be predictive factors for elevated diastolic blood pressure. 


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Na Yeong Lee ◽  
Kyungdo Han ◽  
Yoonji Lee ◽  
Seulki Kim ◽  
Seonhwa Lee ◽  
...  

Background. Little information is available on the association between parents’ metabolic syndrome (MetS) and adolescent offspring’s obesity in Korea. The aim of our study is to determine the association between parent’s metabolic syndrome and offspring’s obesity. Methods. The study data were obtained from the Korean National Health and Nutrition Examination Survey conducted during 2009–2016. In the present study, 3140 adolescents aged 12 to 18 years, their paternal pairs (PP, fathers = 2244), and maternal pairs (MP, mothers = 3022) were analyzed. Of these 3140 adolescents, 2637 had normal weight {age- and sex-specific body mass index (BMI) under the 85th percentile}, whereas 467 were overweight (age- and sex-specific BMI over the 85th percentile). Results. Offspring’s overweight and central obesity were associated with all components of the PP’s metabolic risk factors, including central obesity ( p < 0.001 ), systolic ( p < 0.001 ) and diastolic blood pressure ( p < 0.001 ), glucose intolerance ( p < 0.001 ), and triglyceride ( p < 0.002 ) and high-density lipoprotein levels ( p = 0.049 ). In addition, offspring’s overweight and central obesity were also associated with the metabolic risk factors of MP, including central obesity ( p < 0.001 ), systolic ( p < 0.001 ) and diastolic blood pressure ( p < 0.001 ), glucose intolerance ( p < 0.001 ), and triglyceride levels ( p < 0.001 ). In multivariate logistic regression analysis, offspring’s overweight was significantly and positively associated with parental central obesity (PP, adjusted odds ratio (OR) = 1.593; 95% confidence interval (CI): 1.192–2.128; MP, adjusted OR = 2.221, 95% CI: 1.755–2.812) and parental metabolic syndrome (PP, adjusted OR = 2.032; 95% CI: 1.451–2.846; MP, adjusted OR = 2.972, 95% CI: 2.239–3.964). As the number of parental metabolic risk factors increased, offspring’s risk for overweight and central obesity increased ( p for trends < 0.001). Conclusion. Parental metabolic syndrome was associated with obesity in 12- to 18-year-old offspring in Korea.


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