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Yong J, Song J. CaMKII activity and metabolic imbalance-related neurological diseases: Focus on vascular dysfunction, synaptic plasticity, amyloid beta accumulation, and lipid metabolism. Biomed Pharmacother 2024; 175:116688. [PMID: 38692060 DOI: 10.1016/j.biopha.2024.116688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 05/03/2024] Open
Abstract
Metabolic syndrome (MetS) is characterized by insulin resistance, hyperglycemia, excessive fat accumulation and dyslipidemia, and is known to be accompanied by neuropathological symptoms such as memory loss, anxiety, and depression. As the number of MetS patients is rapidly increasing globally, studies on the mechanisms of metabolic imbalance-related neuropathology are emerging as an important issue. Ca2+/calmodulin-dependent kinase II (CaMKII) is the main Ca2+ sensor and contributes to diverse intracellular signaling in peripheral organs and the central nervous system (CNS). CaMKII exerts diverse functions in cells, related to mechanisms such as RNA splicing, reactive oxygen species (ROS) generation, cytoskeleton, and protein-protein interactions. In the CNS, CaMKII regulates vascular function, neuronal circuits, neurotransmission, synaptic plasticity, amyloid beta toxicity, lipid metabolism, and mitochondrial function. Here, we review recent evidence for the role of CaMKII in neuropathologic issues associated with metabolic disorders.
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Affiliation(s)
- Jeongsik Yong
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun, Jeollanam-do, Republic of Korea.
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2
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Asghari G, Nikparast A, Mahdavi M, Dehghan P, Valizadeh M, Hosseinpanah F, Azizi F, Hadaegh F. Diagnostic performance of different anthropometric indices among Iranian adolescents for intima media thickness in early adulthood: A prospective study and literature review. Front Nutr 2023; 10:1098010. [PMID: 36925962 PMCID: PMC10012864 DOI: 10.3389/fnut.2023.1098010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
Background There is debate regarding which anthropometric indices is the most appropriate predictor of cardiovascular disease (CVD) among adolescents. The purpose of this study was to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in adolescents with high carotid intima-media thickness (cIMT) in early adulthood, as the surrogate marker of CVD in a cohort study. Methods A total of 875 Iranian adolescents (female = 421) aged 10-17 years old were entered the study. The cIMT was measured in early adulthood (20-38 years old) after 18.2 (median) years of follow-up and defined as > 90th percentile for sex and age groups. The gender specific association between a 1-SD increase in each anthropometric measures with high cIMT was examined using multivariate logistic regression analysis adjusted for age, smoking, family history of CVD, systolic blood pressure, total cholesterol, and fasting blood sugar. In the multivariable analysis, the interaction between sex and age groups with anthropometric measures were significant (all p-values < 0.05). Results Among males, all anthropometric measures including BMI, WC, WHR, and WHtR were associated with high cIMT; the corresponding odds ratios were 1.43 (1.05-1.94), 1.63 (1.22-2.19), 1.33 (1.03-1.71), and 1.41 (1.07-1.87), respectively. However, after considering the related adulthood anthropometric measurements, the association remained significant for WC 1.48 (1.04-2.10) and WHR [1.28 (0.99-1.66), P = 0.06]. Moreover, among early adolescent boys aged 10-14 years, all of the anthropometric measures were significantly associated with high cIMT in the multivariate analysis that included the related adulthood anthropometric measures. The area under the curve (AUC) for the anthropometric measurements among males ranged from 0.576 for WHtR up to 0.632 for WC, without any superiority between them. Among females, only in linear regression analysis, a significant association were found between the higher value of WC and WHtR with cIMT measurement in adulthood; however, the risk reached to null after considering adult anthropometric measures. Conclusion General and central obesity measures were significantly associated with high cIMT only among Iranian male adolescents, the relationship that were more prominent among pre-pubertal males.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Nikparast
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pooneh Dehghan
- Department of Imaging, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Explainable machine learning framework for predicting long-term cardiovascular disease risk among adolescents. Sci Rep 2022; 12:21905. [PMID: 36536006 PMCID: PMC9763353 DOI: 10.1038/s41598-022-25933-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Although cardiovascular disease (CVD) is the leading cause of death worldwide, over 80% of it is preventable through early intervention and lifestyle changes. Most cases of CVD are detected in adulthood, but the risk factors leading to CVD begin at a younger age. This research is the first to develop an explainable machine learning (ML)-based framework for long-term CVD risk prediction (low vs. high) among adolescents. This study uses longitudinal data from a nationally representative sample of individuals who participated in the Add Health study. A total of 14,083 participants who completed relevant survey questionnaires and health tests from adolescence to young adulthood were chosen. Four ML classifiers [decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), and deep neural networks (DNN)] and 36 adolescent predictors are used to predict adulthood CVD risk. While all ML models demonstrated good prediction capability, XGBoost achieved the best performance (AUC-ROC: 84.5% and AUC-PR: 96.9% on testing data). Besides, critical predictors of long-term CVD risk and its impact on risk prediction are obtained using an explainable technique for interpreting ML predictions. The results suggest that ML can be employed to detect adulthood CVD very early in life, and such an approach may facilitate primordial prevention and personalized intervention.
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A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents. Pediatr Exerc Sci 2022:1-12. [PMID: 36150705 DOI: 10.1123/pes.2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. METHODS Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. RESULTS Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. CONCLUSION While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.
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Cilhoroz BT, DeBlois JP, Lefferts WK, Keller AP, Pagan Lassalle P, Meyer ML, Stoner L, Heffernan KS. Exploration of cerebral hemodynamic pathways through which large artery function affects neurovascular coupling in young women. Front Cardiovasc Med 2022; 9:914439. [PMID: 36035945 PMCID: PMC9411931 DOI: 10.3389/fcvm.2022.914439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe interactions between large artery function and neurovascular coupling (NVC) are emerging as important contributors to cognitive health. Women are disproportionally affected by Alzheimer's disease and related dementia later in life. Understanding large artery correlates of NVC in young women may help with preservation of cognitive health with advancing age.PurposeTo explore the association between large artery function, NVC and cognitive performance in young women.MethodsVascular measurements were made in 61 women (21 ± 4 yrs) at rest and during a cognitive challenge (Stroop task). Transcranial Doppler was used to measure left middle cerebral artery (MCA) maximum velocity (Vmax), mean velocity (Vmean), and pulsatility index (PI). NVC was determined as MCA blood velocity reactivity to the Stroop task. Large artery function was determined using carotid-femoral pulse wave velocity (cfPWV) as a proxy measure of aortic stiffness and carotid ultrasound-derived measures of compliance and reactivity (diameter change to the Stroop task). Cognitive function was assessed separately using a computerized neurocognitive battery that included appraisal of response speed, executive function, information processing efficiency, memory, attention/concentration, and impulsivity.ResultsMCA Vmax reactivity was positively associated with executive function (β = 0.26, 95% CI 0.01–0.10); MCA Vmean reactivity was negatively associated with response speed (β = −0.33, 95% CI −0.19 to −0.02) and positively with memory score (β = 0.28, 95% CI 0.01–0.19). MCA PI reactivity was negatively associated with attention performance (β = −0.29, 95% CI −14.9 to −1.0). Path analyses identified significant paths (p < 0.05) between carotid compliance and carotid diameter reactivity to select domains of cognitive function through MCA reactivity.ConclusionsNVC was associated with cognitive function in young women. Carotid artery function assessed as carotid compliance and carotid reactivity may contribute to optimal NVC in young women through increased blood flow delivery and reduced blood flow pulsatility.
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Affiliation(s)
- Burak T. Cilhoroz
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Jacob P. DeBlois
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Wesley K. Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Allison P. Keller
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Patricia Pagan Lassalle
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, United States
| | - Michelle L. Meyer
- Department of Epidemiology, Gilling's School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, United States
- Department of Epidemiology, Gilling's School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
- *Correspondence: Kevin S. Heffernan
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Comparative analysis of the association between traditional and lipid-related obesity indicators and isolated systolic hypertension : Association of obesity indicators with ISH. BMC Cardiovasc Disord 2022; 22:119. [PMID: 35313806 PMCID: PMC8939084 DOI: 10.1186/s12872-022-02564-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/15/2022] [Indexed: 11/12/2022] Open
Abstract
Background Obesity is a well-known modified risk factor for isolated systolic hypertension (ISH), but evidence is lacking regarding whether the combination of anthropometric and lipid indicators could strengthen their correlation with ISH. Therefore, we compared the association of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), visceral adiposity index (VAI), lipid accumulation product index (LAP), and cardiometabolic index (CMI) with ISH. Methods A total of 106,248 adults who received routine health screening and did not have diastolic blood pressure ≥ 90 mmHg were recruited in this cross-sectional study. The associations between these indicators and ISH were evaluated using multivariate regression. Results Each standard deviation (SD) increase in traditional obesity indicators (especially WHR and WHtR) had significantly higher multivariate-adjusted odds ratios (ORs) than each SD increase in lipid-related obesity indicators. In addition, multivariate-adjusted ORs for ISH in the third (vs. the first) tertile of traditional obesity indicators were also significantly higher than those of lipid-related indicators. Moreover, traditional obesity indicators exhibited a higher area under the ROC curve for discriminating ISH than lipid-related obesity indicators. Conclusions Traditional obesity indicators were more strongly associated with ISH than lipid-related obesity indicators among Chinese adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02564-2.
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Kim S, Singh H. Sex-specific associations among total bone-specific physical activity score, aortic parameters, and body composition in healthy young adults. J Exerc Sci Fit 2022; 20:27-31. [PMID: 34976077 PMCID: PMC8683586 DOI: 10.1016/j.jesf.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/22/2021] [Accepted: 12/06/2021] [Indexed: 11/12/2022] Open
Abstract
Background/Objective Physical inactivity is one of the major cardiovascular disease risk factors; however, not much is known regarding lifetime bone-specific physical activity and arterial stiffness. The aim of this cross-sectional study was to determine whether total bone-specific physical activity score (tBPAQ) was related to arterial stiffness and body composition in healthy young adults. Methods Healthy young women (n = 56, 20.3 ± 1.3 years) and men (n = 52, 21.0 ± 1.2 years) between 18 and 25 years were recruited for this study. The tBPAQ was used to obtain a comprehensive account of lifetime bone-loading physical activity. We measured the carotid to femoral pulse wave velocity (cfPWV) to evaluate arterial stiffness using the novel oscillometric device (SphygmoCor XCEL). Dual energy X-ray absorptiometry was used to measure bone free lean body mass (BFLBM, kg) and % total body fat. Results Partial correlations analyses showed a significant inverse relationship between tBPAQ and cfPWV (r = - 0.371, p = 0.007) in young women; however, this relationship was not found in young men (p > 0.05). There were significant negative correlations between tBPAQ and % total body fat in both young women (r = - 0.265, p = 0.048) and men (r = - 0.327, p = 0.018). No significant relationships were found between tBPAQ and BFLBM (p > 0.05). Conclusion Our study provides preliminary evidence of sex-specificity of negative relationships of tBPAQ with i) cfPWV (women only) and ii) % total body fat (men and women). Whether bone-loading physical activity can lead to better cardiometabolic outcomes needs to be examined.
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Affiliation(s)
- SoJung Kim
- Department of Health and Exercise Science, School of Nursing & Health Professions, Rowan University, Glassboro, NJ, 08028, USA
| | - Harshvardhan Singh
- Department of Physical Therapy, University of Alabama, 1716 9th Avenue South, Birmingham, AL, 35294, USA
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González-Gil EM, Moreno LA, Nappo A, Santabárbara J, Wolters M, Russo P, De Henauw S, Veidebaum T, Molnar D, Hunsberger M, Fraterman A, Iacoviello L, Tornaritis M, Ahrens W, Bel-Serrat S. Impaired metabolic health over-time and high abdominal fat are prospectively associated with high-sensitivity C-reactive protein in children: The IDEFICS study. Pediatr Obes 2021; 16:e12817. [PMID: 34170079 DOI: 10.1111/ijpo.12817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/10/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Metabolic risk and inflammatory state have an early life onset and are associated with future diseases. OBJECTIVES To assess the association between metabolic syndrome (MetS) and metabolic health with high-sensitive C-reactive protein (hsCRP), cross-sectionally and longitudinally, in children. METHODS 2913 European children (2-10 years) from eight countries from the IDEFICS study were investigated. Data were collected at baseline and 2 years later (follow-up). A MetS z-score was computed with waist circumference (WC), insulin resistance index, blood pressure, high-density lipoprotein cholesterol and triglycerides. Metabolically unhealthy (MU) status was assessed. Multi-level linear and logistic regressions were performed. RESULTS Among the MetS markers, WC was more consistently associated with hsCRP cross-sectional and prospectively. Baseline MetS score was significantly associated with greater risk of high hsCRP at follow-up and with prevalence and incidence of hsCRP. Those children who became MU overtime were significantly (P < .05) associated with future higher levels of hsCRP, independently of weight status at baseline. CONCLUSIONS Transition over time to a MU state was associated with higher levels of hsCRP at follow-up, independent of weight status at baseline. Screening of metabolic factors and routine measurement of WC are needed to prevent inflammatory status and related chronic diseases in children.
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Affiliation(s)
- Esther M González-Gil
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Annunziata Nappo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Javier Santabárbara
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Toomas Veidebaum
- Center of Health and Behavioral Science, National Institute for Health Development, Tallinn, Estonia
| | - Denes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Monica Hunsberger
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Arno Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy.,Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Institute of Statistics, Bremen University, Bremen, Germany
| | - Silvia Bel-Serrat
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Yin J, Li M, Yu L, Hu F, Yu Y, Hu L, Bao H, Cheng X. The relationship between the atherogenic index of plasma and arterial stiffness in essential hypertensive patients from China: a cross-sectional study. BMC Cardiovasc Disord 2021; 21:245. [PMID: 34011265 PMCID: PMC8136204 DOI: 10.1186/s12872-021-02049-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background The atherogenic index of plasma (AIP) always remains in a potential association with arterial stiffness, however, this association has not been fully discovered and needs to be studied in depth in large hypertensive patient populations. The present analysis thus sought to further explore the association that exists between AIP and arterial stiffness in Chinese patients diagnosed with arterial hypertension. Methods This cross-sectional study analyzed 4744 Chinese individuals with essential hypertension. AIP was defined as the base 10 logarithm of the ratio of plasma of triglycerides to high-density lipoprotein cholesterol levels indicated in molar concentrations. Measurement of arterial stiffness was carried out via brachial-ankle pulse wave velocity (baPWV). Results Data were adjusted for potential confounding variables, and multivariate linear regression analysis revealed AIP to be positively correlated with baPWV (β = 1.34, 95% CI: 0.96 to 1.72, P < 0.001). When AIP was instead treated as a categorical variable divided into quartiles, the same relationship was observed (P for trend < 0.001). We additionally found AIP and baPWV had a stronger positive association in individuals with a body mass index (BMI) < 24 kg/m2 (P for interaction < 0.05). Conclusion AIP and arterial stiffness were positively correlated in essential hypertension patients in China, especially in those with a BMI < 24 kg/m2. Clinical trial registration ChiCTR1800017274.
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Affiliation(s)
- Juan Yin
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China.,Department of Gerontology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Minghui Li
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
| | - Lingling Yu
- Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Hu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
| | - Yu Yu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
| | - Longlong Hu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
| | - Huihui Bao
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China
| | - Xiaoshu Cheng
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, 330006, China.
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Pool LR, Aguayo L, Brzezinski M, Perak AM, Davis MM, Greenland P, Hou L, Marino BS, Van Horn L, Wakschlag L, Labarthe D, Lloyd-Jones D, Allen NB. Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review. J Pediatr 2021; 232:118-126.e23. [PMID: 33516680 DOI: 10.1016/j.jpeds.2021.01.053] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). STUDY DESIGN A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. RESULTS There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond "traditional" cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. CONCLUSIONS Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.
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Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Liliana Aguayo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Michal Brzezinski
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Amanda M Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew M Davis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley S Marino
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren Wakschlag
- Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Darwin Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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Forte M, Stanzione R, Cotugno M, Bianchi F, Marchitti S, Rubattu S. Vascular ageing in hypertension: Focus on mitochondria. Mech Ageing Dev 2020; 189:111267. [PMID: 32473170 DOI: 10.1016/j.mad.2020.111267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/25/2022]
Abstract
Hypertension is a common age-related disease, along with vascular and neurodegenerative diseases. Vascular ageing increases during hypertension, but hypertension itself accelerates vascular ageing, thus creating a vicious circle. Vascular stiffening, endothelial dysfunction, impaired contractility and vasorelaxation are the main alterations related to vascular ageing, as a consequence of vascular smooth muscle and endothelial cells senescence. Several molecular mechanisms have been involved into the functional and morphological changes of the aged vessels. Among them, oxidative stress, inflammation, extracellular matrix deregulation and mitochondrial dysfunction are the best characterized. In the present review, we discuss relevant literature about the biology of vascular and cerebrovascular ageing with a particular focus on mitochondria signalling. We underline the therapeutic strategies, able to improve mitochondrial health, which may represent a promising tool to decrease vascular dysfunction associated with ageing and hypertension-related complications.
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Affiliation(s)
- Maurizio Forte
- IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli IS, Italy
| | | | - Maria Cotugno
- IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli IS, Italy
| | - Franca Bianchi
- IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli IS, Italy
| | | | - Speranza Rubattu
- IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli IS, Italy; Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy.
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12
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Imahori Y, Mathiesen EB, Morgan KE, Frost C, Hughes AD, Hopstock LA, Johnsen SH, Emaus N, Leon DA. The association between anthropometric measures of adiposity and the progression of carotid atherosclerosis. BMC Cardiovasc Disord 2020; 20:138. [PMID: 32183704 PMCID: PMC7079386 DOI: 10.1186/s12872-020-01417-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background Few reports are available on the contribution of general and abdominal obesity to the progression of carotid atherosclerosis in late adulthood. This study investigated the impact of four simple anthropometric measures of general and abdominal obesity on the progression of carotid atherosclerosis and the extent to which the association between adiposity and the progression of plaque burden is mediated by cardiometabolic markers. Methods Four thousand three hundred forty-five adults (median age 60) from the population-based Tromsø Study were followed over 7 years from the first carotid ultrasound screening to the next. The progression of carotid atherosclerosis was measured in three ways: incidence of plaques in previously plaque-free participants; change in the number of plaques; and total plaque area (TPA). We used generalised linear models to investigate the association between each adiposity measure – body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) – and each outcome. Models were adjusted for potential confounders (age, sex, smoking, education, physical activity). The pathways through which any associations observed might operate were investigated by further adjusting for cardiometabolic mediators (systolic blood pressure, cholesterol, and HbA1c). Results There was little evidence that adiposity was related to the formation of new plaques during follow-up. However, abdominal adiposity was associated with TPA progression. WHtR showed the largest effect size (mean change in TPA per one standard deviation (SD) increase in WHtR of 0.665 mm2, 95% confidence interval 0.198, 1.133) while BMI showed the smallest. Effect sizes were substantially reduced after the adjustment for potential mediators. Conclusions Abdominal obesity indirectly measured with WC seems more strongly associated with the progression of TPA than general obesity. These associations appear to be largely mediated by known cardiometabolic markers.
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Affiliation(s)
- Yume Imahori
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø and Department of Neurology, University Hospital of North Norway, 9037, Tromsø, Norway
| | - Katy E Morgan
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Chris Frost
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Alun D Hughes
- Department of Population Science & Experimental Medicine, & MRC Unit for Lifelong Health and Ageing, University College London, London, WC1E 6BT, UK
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Stein Harald Johnsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø and Department of Neurology, University Hospital of North Norway, 9037, Tromsø, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - David A Leon
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
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13
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Solanki JD, Mehta HB, Shah CJ. Pulse wave analyzed cardiovascular parameters in young first degree relatives of hypertensives. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:72. [PMID: 30181754 PMCID: PMC6116665 DOI: 10.4103/jrms.jrms_581_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 04/03/2018] [Accepted: 06/14/2018] [Indexed: 11/07/2022]
Abstract
Background: First-degree relatives (FDRs) of hypertensive (HT) are predisposed to hypertension (HTN) which accelerates cardiovascular aging. Same can be studied noninvasively by pulse wave analysis (PWA), encompassing central hemodynamics such as central blood pressure (cBP), cardiac output, and stroke work (SW) and vascular stiffness parameters such as pulse wave velocity (PWV) and augmentation index at HR 75 (AIx@75). We studied PWA-derived cardiovascular parameters in FDRs of HT compared to controls. Materials and Methods: We conducted a case–control study in 119 FDRs of HT and 119 matched controls. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Germany) and cardiovascular parameters were compared. P < 0.05 was considered statistically significant. Results: Groups were comparable with gender, age, height, weight, body mass index, and physical activity. FDRs of HT had significantly higher brachial and cBPs, SW (101.41 ± 25.44 vs. 88.31 ± 20.25, P = 0.001), rate pressure product-119.40 ± 25.34 vs. 108.34 ± 18.17, P < 0.0001), PWV (5.22 ± 0.46, P < 0.0001), and AIx@75 (31.48 ± 9.01 vs. 27.95 ± 9.4, P = 0.002) than control. Dependent study variables correlated with brachial blood pressure more in magnitude and significance level than age or anthropometric variables. PWA results of FDR with maternal inheritance did not differ significantly from those with paternal inheritance. Conclusion: PWA reveals early cardiovascular aging in young FDRs of HTs. It clues to future cardiovascular disease including HTN itself, need for primary prevention, and further study for consolidation of these results.
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Affiliation(s)
| | - Hemant B Mehta
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
| | - Chinmay J Shah
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
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14
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Badhwar S, Chandran DS, Jaryal AK, Narang R, Deepak KK. Regional arterial stiffness in central and peripheral arteries is differentially related to endothelial dysfunction assessed by brachial flow-mediated dilation in metabolic syndrome. Diab Vasc Dis Res 2018; 15:106-113. [PMID: 29283006 DOI: 10.1177/1479164117748840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The interrelationship between endothelial function and arterial stiffness may be different for central and peripheral arteries due to their structural and functional differences. The study aims to assess the interrelationship between central and peripheral vascular function and haemodynamics in metabolic syndrome. Thirty-seven patients [63.0 (57.5-66.0) years, 68.4% males] of metabolic syndrome (National Cholesterol Education Program - Adult Treatment Panel-III criteria) were studied. Carotid-femoral, carotid-radial pulse wave velocity and augmentation index (AIx@75) were assessed using applanation tonometry. Endothelial function was evaluated by brachial flow-mediated dilation using B-mode ultrasonography. Central and peripheral pressures were measured by radial tonometry and sphygmomanometer, respectively. Carotid-radial pulse wave velocity correlated significantly with peripheral diastolic blood pressure ( r = 0.33, p = 0.04) and inversely with flow-mediated dilation ( r = -0.61, p = 0.0001). AIx@75 correlated significantly with carotid-femoral pulse wave velocity ( r = 0.35, p = 0.03) and with aortic pulse pressure ( r = 0.43, p = 0.01). In principal component analysis, an inverse relationship was observed between flow-mediated dilation and carotid-radial pulse wave velocity but not with carotid-femoral pulse wave velocity. Regional arterial stiffness assessed by pulse wave velocity in central-elastic and peripheral-muscular arteries differentially relates to endothelial dysfunction. The central arteries might be predominantly influenced by endothelial dysfunction-induced structural changes, while the peripheral arteries are majorly affected by functional alterations.
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Affiliation(s)
- Smriti Badhwar
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Jaryal
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- 2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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15
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Tomiyama H, Ishizu T, Kohro T, Matsumoto C, Higashi Y, Takase B, Suzuki T, Ueda S, Yamazaki T, Furumoto T, Kario K, Inoue T, Koba S, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Maemura K, Ohya Y, Furukawa T, Ito H, Yamashina A. Longitudinal association among endothelial function, arterial stiffness and subclinical organ damage in hypertension. Int J Cardiol 2017; 253:161-166. [PMID: 29174285 DOI: 10.1016/j.ijcard.2017.11.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/03/2017] [Accepted: 11/07/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the longitudinal mutual association between endothelial dysfunction and arterial stiffness, and also to determine which of the two variables was more closely associated with the progression of subclinical organ damage. METHODS The brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (CIMT), estimated glomerular filtration rate, microalbuminuria and flow-mediated vasodilatation of the brachial artery (FMD) were measured three times at 1.5-year intervals in 674 Japanese patients receiving antihypertensive treatment. RESULTS The change of the baPWV during the study period was larger in the subjects with baseline FMD values in the lowest tertile as compared to those with baseline FMD values in the highest tertile. The change of the CIMT was smaller in the subjects with baseline baPWV values in the lowest tertile than in those with baseline baPWV values in the highest tertile. After the adjustment, the FMD value at the baseline was inversely associated with the baPWV at the end of the study period (beta=-0.07, p=0.01), although, the reverse association was not significant. The baPWV, but not the FMD value, at the baseline was associated with the CIMT (beta=0.06, p=0.04) measured at the end of the study period. CONCLUSIONS In hypertension, endothelial dysfunction was associated with the progression of arterial stiffness, although the reverse association was not confirmed. The increased arterial stiffness rather than endothelial dysfunction may be more closely associated with the progression of atherosclerotic vascular damage, and the endothelial dysfunction-arterial stiffness-atherosclerosis continuum may be important in hypertension.
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Affiliation(s)
| | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takahide Kohro
- Department of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Chisa Matsumoto
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
| | - Bonpei Takase
- Division of Biomedical Engineering, National Defense Medical College Research Institute, Saitama, Japan
| | - Toru Suzuki
- Cardiovascular Medicine, University of Leicester, Leicester, UK
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyu School of Medicine, Okinawa, Japan
| | - Tsutomu Yamazaki
- Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoo Furumoto
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Yasuhiko Takemoto
- Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuzo Hano
- Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yutaka Ishibashi
- Department of General Medicine, Shimane University Faculty of Medicine, Izumo, Japan
| | - Koichi Node
- Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Ohya
- The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
| | - Taiji Furukawa
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Akira Yamashina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
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16
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Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 960:1-17. [PMID: 28585193 DOI: 10.1007/978-3-319-48382-5_1] [Citation(s) in RCA: 608] [Impact Index Per Article: 86.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Increase in prevalence of obesity has become a worldwide major health problem in adults, as well as among children and adolescents. Furthermore, total adiposity and truncal subcutaneous fat accumulation during adolescence are positively and independently associated with atherosclerosis at adult ages. Centrally accumulation of body fat is associated with insulin resistance, whereas distribution of body fat in a peripheral pattern is metabolically less important. Obesity is associated with a large decrease in life expectancy. The effect of extreme obesity on mortality is greater among younger than older adults. In this respect, obesity is also associated with increased risk of several cancer types. However, up to 30% of obese patients are metabolically healthy with insulin sensitivity similar to healthy normal weight individuals, lower visceral fat content, and lower intima media thickness of the carotid artery than the majority of metabolically "unhealthy" obese patients.Abdominal obesity is the most frequently observed component of metabolic syndrome. The metabolic syndrome; clustering of abdominal obesity, dyslipidemia, hyperglycemia and hypertension, is a major public health challenge. The average prevalence of metabolic syndrome is 31%, and is associated with a two-fold increase in the risk of coronary heart disease, cerebrovascular disease, and a 1.5-fold increase in the risk of all-cause mortality.
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Affiliation(s)
- Atilla Engin
- Faculty of Medicine, Department of General Surgery, Gazi University, Besevler, Ankara, Turkey. .,, Mustafa Kemal Mah. 2137. Sok. 8/14, 06520, Cankaya, Ankara, Turkey.
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17
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Meyer J, Elmenhorst J, Giegerich T, Oberhoffer R, Müller J. Controversies in the association of cardiorespiratory fitness and arterial stiffness in children and adolescents. Hypertens Res 2017; 40:675-678. [PMID: 28202944 DOI: 10.1038/hr.2017.19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/02/2017] [Accepted: 01/05/2017] [Indexed: 01/21/2023]
Abstract
The relationship between cardiorespiratory fitness and arterial compliance in children and adolescents remains controversial. The aim of this study was to assess this association with a quantitative approach. A total of 646 healthy children and adolescents (316 females, age 13.9±2.1 years) were cross-sectionally investigated in seven school settings in and around Munich for their cardiorespiratory fitness and demographic, anthropometric and hemodynamic parameters. Surrogates of arterial stiffness, such as pulse wave velocity (PWV), Augmentation Index normalized to a heart rate of 75 (AI@75), and peripheral and central systolic blood pressures were measured in a supine position using the oscillometric Mobil-O-Graph. Cardiopulmonary fitness was measured by 6-min indoor run tests. After correction for age, sex, body weight, body height, heart rate and mean arterial pressure, controversial findings were produced. PWV increased with higher cardiorespiratory fitness (Beta=0.173; P<0.001), which represented an unfavorable relationship, whereas AI@75 declined with higher cardiorespiratory fitness (Beta=-0.106; P=0.025). Therefore, in contrast to PWV, higher cardiorespiratory fitness seems beneficial for AI@75. The third surrogate of arterial stiffness, central systolic blood pressure, showed no association with cardiorespiratory fitness (Beta=0.066; P=0.052). These controversial outcomes remain almost unchanged when the boys and girls were analyzed separately. Different surrogates of arterial stiffness have different relationships with cardiorespiratory fitness in children and adolescents after correcting for multiple confounders. More research is needed in this field to understand the functioning of the juvenile vessels, and measurements and methodological approaches should be reconsidered.
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Affiliation(s)
- Joanna Meyer
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, München, Germany
| | - Julia Elmenhorst
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, München, Germany
| | - Tobias Giegerich
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, München, Germany
| | - Renate Oberhoffer
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, München, Germany
| | - Jan Müller
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technische Universität München, München, Germany
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18
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Oosterhoff M, Joore M, Ferreira I. The effects of school-based lifestyle interventions on body mass index and blood pressure: a multivariate multilevel meta-analysis of randomized controlled trials. Obes Rev 2016; 17:1131-1153. [PMID: 27432468 DOI: 10.1111/obr.12446] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/13/2016] [Accepted: 05/24/2016] [Indexed: 11/30/2022]
Abstract
Primary prevention of childhood obesity and related hypertension is warrant given that both risk factors are intertwined and track into adulthood. This systematic review and meta-analysis assess the impact of school-based lifestyle interventions on children's body mass index (BMI) and blood pressure. We searched databases and prior reviews. Eligibility criteria were the following: randomized controlled trial design, evaluation of a school-based intervention, targeting children aged 4-12 years, reporting on BMI and/or related cardiovascular risk factors, reporting data on at least one follow-up moment. The effects on BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated by means of univariate and multivariate three-level random effects models. A total of 85 RCTs (91 papers) were included in the meta-analyses. In univariate models, the pooled effects were -0.072 (95%CI: -0.106; -0.038) for BMI, -0.183 (95%CI: -0.288; -0.078) for SBP and -0.071 (95%CI: -0.185; 0.044) for DBP. In multivariate analyses, the pooled effects of interventions were -0.054 (95%CI: -0.131; 0.022) for BMI, -0.182 (95%CI: -0.266; -0.098) for SBP and -0.144 (95%CI: -0.230; -0.057) for DBP. Parental involvement accentuated the beneficial effects of interventions. School-based lifestyle prevention interventions result in beneficial changes in children's BMI and blood pressure, and the effects on the latter may be stronger than and accrue independently from those in the former.
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Affiliation(s)
- M Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - M Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - I Ferreira
- Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands.,Division of Epidemiology & Biostatistics, School of Public Health, University of Queensland, Brisbane, Australia
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19
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Froylich D, Corcelles R, Daigle CR, Aminian A, Isakov R, Schauer PR, Brethauer SA. Weight loss is higher among patients who undergo body contouring procedures after bariatric surgery. Surg Obes Relat Dis 2016; 12:1731-1736. [DOI: 10.1016/j.soard.2015.09.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 06/30/2015] [Accepted: 09/16/2015] [Indexed: 12/19/2022]
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20
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Melo X, Santa-Clara H, Santos DA, Pimenta NM, Pinto R, Minderico CS, Fernhall B, Sardinha LB. Single and combined effects of body composition phenotypes on carotid intima-media thickness. Pediatr Obes 2016. [PMID: 26199046 DOI: 10.1111/ijpo.12056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Central fatness might be a more sensitive predictor of atherosclerotic changes in children than are total body fat measures. However, it is unclear whether a total body fat measure coupled with an estimate of a more central pattern of fat accumulation predicts increased carotid intima-media-thickness (cIMT) better than either measure alone. OBJECTIVE The objective of the study is to identify the ability of a combination of simple anthropometric screening tools or a combination of objective measures of body composition to predict cIMT. METHODS cIMT was assessed on the common carotid artery in 349 children aged 11-12 years old (183 girls). Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) were dichotomized according to established criteria and indices of total body (TBFI) and abdominal (ABFMI) fat were assessed by dual-energy X-ray absorptiometry and categorized (increased risk ≥85%). Single and combined associations among anthropometric and laboratorial measures with the risk of having increased cIMT (≥85%) and discriminatory performance were tested with logistic regression analysis and Receiver Operator Curve analysis. RESULTS Children with higher total fatness (BMI and TBFI) or higher central pattern of fat accumulation (WC, WHtR and BFMI) were in higher risk for increased cIMT [odds ratio (OR): 2.08-3.24). The risk for increased cIMT was not higher among children who coupled high total and high central fatness (OR: 2.27-3.10). CONCLUSIONS Combination of total and central measures of fat does not improve the prediction of increased cIMT in children. Simple surrogate measures of fatness can be used to predict increased cIMT urging special attention to those children who exhibit increased abdominal fat.
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Affiliation(s)
- X Melo
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - H Santa-Clara
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - D A Santos
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - N M Pimenta
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,Health and Fitness, Sport Sciences School of Rio Maior - Polytechnic Institute of Santarem, Rio Maior, Portugal
| | - R Pinto
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - C S Minderico
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - B Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - L B Sardinha
- Interdisciplinary Centre for the Study of Human Performance - Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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21
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Acree LS, Montgomery PS, Gardner AW. The influence of obesity on arterial compliance in adult men and women. Vasc Med 2016; 12:183-8. [PMID: 17848474 DOI: 10.1177/1358863x07079323] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to determine whether differences in large and small arterial compliance existed among normal weight, overweight, and obese older men and women, and whether large and small arterial compliance were associated with abdominal, hip, and subcutaneous fat distribution. A total of 134 individuals who were 40 years of age and older (age = 62 ± 11 years; mean ± SD) were grouped into normal weight (BMI: 18.5—24.9 kg/m2; n = 33), overweight (BMI: 25.0—29.9 kg/m2; n = 48), or obese (BMI: ≥30.0 kg/m2; n = 53) categories. The hemodynamic and arterial compliance measurements were obtained using the HDI/PulseWave CR-2000 CardioVascular Profiling System (Hypertension Diagnostics, Inc). Body mass index, nine-site sum of skinfolds, and circumference measures around the hip and waist were used for analysis. Large and small arterial compliance was lower (p < 0.001) in the obese group (12.4 ± 4.8 ml/mmHg × 10 vs 4.6 ± 2.5 ml/mmHg × 100, respectively) than the normal weight (16.2 ± 4.9 ml/mmHg × 10 vs 5.5 ± 2.7 ml/mmHg × 100) and overweight (15.2 ± 4.3 ml/mmHg × 10 vs 5.0 ± 2.2 ml/mmHg × 100) groups. This difference remained (p < 0.001) after adjusting for body surface area, sex, hyperlipidemia, and hypertension. Additionally, large arterial compliance correlated (p < 0.05) with sum of skinfolds (r = — 0.209), while small arterial compliance correlated with hip circumference (r = — 0.189). Arterial compliance measures were not related (p > 0.05) to waist circumference or waist-to-hip ratio. In conclusion, obesity was associated with a decrease in large and small arterial compliance independent of conventional risk factors. Additionally, subcutaneous fat and fat around the hips were inversely related to arterial compliance.
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Affiliation(s)
- Luke S Acree
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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Prasad VK, Drenowatz C, Hand GA, Lavie CJ, Sui X, Demello M, Blair SN. Relation of Body's Lean Mass, Fat Mass, and Body Mass Index With Submaximal Systolic Blood Pressure in Young Adult Men. Am J Cardiol 2016; 117:394-8. [PMID: 26718229 DOI: 10.1016/j.amjcard.2015.10.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 01/18/2023]
Abstract
We examined the association of body composition and body mass index (BMI) with submaximal systolic blood pressure (SSBP) among young adult men. The analysis included 211 men with BMI between 20 and 35 kg/m(2). Total lean mass and fat mass were measured using dual x-ray absorptiometry and lean mass percentage was calculated from the total lean mass. Fat mass index (FMI) and BMI were calculated using height and weight (total fat mass and total weight, respectively) measurements. SSBP was measured at each stage of a graded exercise test. Quintiles of lean mass percentage, FMI, and BMI were created with quintile 1 the lowest and quintile 5 the highest lean mass percentage, FMI, and BMI. Compared with men in lean mass percentage quintile 1, those in quintiles 2, 3, and 4 had significantly lower SSBP, whereas there was no significant difference in SSBP between quintile 1 and 5 at 6, 8, and 10 minutes. Compared with men in FMI quintile 5, those in quintiles 2, 3, and 4 had significantly lower SSBP, whereas there was no significant difference in SSBP between quintile 1 and 5. SSBP among men in lean mass percentage quintile 5 and FMI quintile 1 were still less than lean mass percentage quintile 1 and FMI quintile 5, respectively. There were no significant differences in SSBP across BMI quintiles 1 to 4 but a significantly higher SSBP in quintile 5 compared with quintiles 1 to 4. In conclusion, there was a J-curve pattern between SSBP and components of body composition, whereas, a linear relation between SSBP and BMI.
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Affiliation(s)
- Vivek K Prasad
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Clemens Drenowatz
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Gregory A Hand
- School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Madison Demello
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Prasad VK, Drenowatz C, Hand GA, Lavie CJ, Sui X, Demello M, Blair SN. Cardiorespiratory Fitness, Body Fatness, and Submaximal Systolic Blood Pressure Among Young Adult Women. J Womens Health (Larchmt) 2015; 25:897-903. [PMID: 26625192 DOI: 10.1089/jwh.2015.5307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We examined the independent and combined associations of cardiorespiratory fitness (CRF), body fat (BF) percentage (BF%), and body mass index (BMI) with submaximal systolic blood pressure (SSBP) among young adult women. MATERIALS AND METHODS Analyses included a sample of 211 normotensive women with a BMI between 20 and 35 kg/m(2); BF% was calculated using total BF measured from dual X-ray absorptiometry, CRF was assessed using a graded exercise test, and SSBP was measured at each stage. RESULTS There was a significant direct association of SSBP with BF% and BMI, whereas an inverse association between SSBP and CRF when adjusted for the covariates. There was no significant association between SSBP and BF% across the stages 1-3 with a borderline significant association at stage 4 when further adjusted for CRF, whereas no association at any of the stages when adjusted for BMI. A borderline significant association between SSBP and BMI was found at stage 1 and significant association at stages 2-4 when additionally adjusted for CRF, whereas the association disappeared at stages 1-2 when adjusted for BF%. The inverse association between SSBP and CRF was eliminated at stages 3-4 when further adjusted for BF% with borderline significant association at stages 1-2. The associations remained significant at the stages 1-2 but not at stages 3-4 after adjusting for BMI. CONCLUSION CRF, BF%, and BMI seem to have critical roles in determining SSBP with CRF and BF% being more potent at lower intensity exercise, whereas BMI was more strongly associated at higher intensity exercise.
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Affiliation(s)
- Vivek Kumar Prasad
- 1 Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina
| | - Clemens Drenowatz
- 1 Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina
| | - Gregory A Hand
- 2 School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, West Virginia
| | - Carl J Lavie
- 3 Ochner Clinical Sch-UQ School of Medicine , New Orleans, Louisiana
| | - Xuemei Sui
- 1 Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina
| | - Madison Demello
- 1 Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina
| | - Steven N Blair
- 1 Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina.,4 Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina
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Nicol GE, de Las Fuentes L, Riek AE, Bernal-Mizrachi C, Lenze EJ, Miller JP, Schweiger JA, Yingling MD, Huang VJ, Dixon DJ, Hennekens CH, Newcomer JW. Adiposity and Cardiometabolic Risk in Children With and Without Antipsychotic Drug Treatment. J Clin Endocrinol Metab 2015; 100:3418-26. [PMID: 26186300 PMCID: PMC4570158 DOI: 10.1210/jc.2015-2119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT Pediatric obesity is common, particularly in children treated with antipsychotic medications. Antipsychotic exposure can increase cardiometabolic risk by increasing adiposity, and possibly via other adiposity-independent pathways. OBJECTIVE The objectives were to characterize relationships of adiposity with intrahepatic triglyceride (IHTG) content and carotid intima media thickness (CIMT) in children with and without antipsychotic drug treatment, and to explore whether vitamin D alters any effects in these relationships. DESIGN This was a cross-sectional case-control study. SETTING The setting was an academic medical center. PATIENTS OR OTHER PARTICIPANTS Participants were 44 children (ages, 6-19 y): 25 cases treated with antipsychotic and other psychotropic drug therapies and 19 untreated controls, frequency-matched on age, gender, and body mass index. MAIN OUTCOME MEASURES Main outcome measures were dual-energy x-ray absorptiometry percentage body fat (DEXA %fat), IHTG measured by magnetic resonance spectroscopy, and CIMT measured by ultrasonography. Fasting blood glucose, insulin, lipids, C-reactive protein, and liver enzymes were also evaluated. RESULTS There were no significant differences between cases and controls on measures of IHTG, CIMT, or DEXA %fat. In combined crude and adjusted analyses, DEXA %fat predicted IHTG (R(2) = 0.30) but not CIMT. Low levels of vitamin D were associated with larger effects of DEXA %fat on IHTG. CONCLUSION In treated and untreated children alike, adiposity is a significant predictor of liver fat content. This relationship was altered by low vitamin D level. These results suggest a modifiable pathway to hepatic steatosis. Further research is needed to test the hypothesis that children with high adiposity and low vitamin D have particularly increased risks for the development of fatty liver.
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Affiliation(s)
- Ginger E Nicol
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Lisa de Las Fuentes
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Amy E Riek
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Carlos Bernal-Mizrachi
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Eric J Lenze
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - J Phillip Miller
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Julia A Schweiger
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Michael D Yingling
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Vincent J Huang
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - David J Dixon
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - Charles H Hennekens
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
| | - John W Newcomer
- Healthy Mind Laboratory, Department of Psychiatry (G.E.N., E.J.L., J.A.S., M.D.Y., V.J.H., D.J.D.), Department of Internal Medicine, Division of Cardiology, Division of Biostatistics (L.d.l.F.), Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research (A.E.R., C.B.-M.), and Division of Biostatistics (J.P.M.), Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110; and Integrated Medical Science Department, First Sir Richard Doll Professor (C.H.H.), and Department of Clinical Biomedical Science (J.W.N.), Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida 33431
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Shrestha R, Copenhaver M. Long-Term Effects of Childhood Risk Factors on Cardiovascular Health During Adulthood. ACTA ACUST UNITED AC 2015; 7:1-5. [PMID: 26312015 DOI: 10.4137/cmrvh.s29964] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The primary purpose of this article is to provide a broad overview of the research on the long-term effects of childhood risk factors on cardiovascular diseases (CVDs) during adulthood and to outline recommendations for prevention of CVDs based on evidence-based interventions (EBIs). CVDs are the leading cause of death and a major cause of disability in the United States and globally. Risk factors for CVDs are already identifiable in children and youth, and include both modifiable factors (e.g., unhealthy diet, physical inactivity, tobacco smoking), and factors that cannot be changed (e.g., age, heredity, sex). A fundamental issue has been the severity of the long-term effects of childhood risk factors (i.e., behavioral and intermediate risk factors) on subsequent cardiovascular health. It is clear from the empirical evidence that risk factors for CVDs can develop during childhood and adolescence. These risk factors in childhood have been linked to adverse health outcomes, including CVDs, during adulthood. The findings thus far suggest that, in order to be effective and reduce the risk of adulthood CVDs, intervention strategies should begin during childhood. The findings also underscore the importance of adopting a healthy lifestyle as early in life as possible.
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Affiliation(s)
- Roman Shrestha
- Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA ; Center for Health, Intervention, & Prevention (CHIP), University of Connecticut, Storrs, CT, USA
| | - Michael Copenhaver
- Center for Health, Intervention, & Prevention (CHIP), University of Connecticut, Storrs, CT, USA ; Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, Connecticut 06269, USA
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Vascular biology of ageing-Implications in hypertension. J Mol Cell Cardiol 2015; 83:112-21. [PMID: 25896391 PMCID: PMC4534766 DOI: 10.1016/j.yjmcc.2015.04.011] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/30/2015] [Accepted: 04/09/2015] [Indexed: 01/11/2023]
Abstract
Ageing is associated with functional, structural and mechanical changes in arteries that closely resemble the vascular alterations in hypertension. Characteristic features of large and small arteries that occur with ageing and during the development of hypertension include endothelial dysfunction, vascular remodelling, inflammation, calcification and increased stiffness. Arterial changes in young hypertensive patients mimic those in old normotensive individuals. Hypertension accelerates and augments age-related vascular remodelling and dysfunction, and ageing may impact on the severity of vascular damage in hypertension, indicating close interactions between biological ageing and blood pressure elevation. Molecular and cellular mechanisms underlying vascular alterations in ageing and hypertension are common and include aberrant signal transduction, oxidative stress and activation of pro-inflammatory and pro-fibrotic transcription factors. Strategies to suppress age-associated vascular changes could ameliorate vascular damage associated with hypertension. An overview on the vascular biology of ageing and hypertension is presented and novel molecular mechanisms contributing to these processes are discussed. The complex interaction between biological ageing and blood pressure elevation on the vasculature is highlighted. This article is part of a Special Issue entitled: CV Ageing.
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Vigorous physical activity and carotid distensibility in young and mid-aged adults. Hypertens Res 2015; 38:355-60. [PMID: 25693850 DOI: 10.1038/hr.2015.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 12/09/2014] [Accepted: 12/12/2014] [Indexed: 11/09/2022]
Abstract
Although physical activity (PA) improves arterial distensibility, it is unclear which type of activity is most beneficial. We aimed to examine the association of different types of PA with carotid distensibility (CD) and the mechanisms involved. Data included 4503 Australians and Finns aged 26-45 years. Physical activity was measured by pedometers and was self-reported. CD was measured using ultrasound. Other measurements included resting heart rate (RHR), cardiorespiratory fitness (CRF), blood pressure, biomarkers and anthropometry. Steps/day were correlated with RHR (Australian men r = -0.10, women r = - 0.14; Finnish men r = -0.15, women r = -0.11; P<0.01), CRF and biochemical markers, but not with CD. Self-reported vigorous leisure-time activity was more strongly correlated with RHR (Australian men r = -0.23, women r = -0.19; Finnish men r = -0.20, women r = -0.13; P < 0.001) and CRF, and was correlated with CD (Australian men r = 0.07; Finnish men r = 0.07, women r = 0.08; P < 0.05). This relationship of vigorous leisure-time activity with CD was mediated by RHR independently of potential confounders. In summary, vigorous leisure-time PA but not total or less intensive PA was associated with arterial distensibility in young to mid-aged adults. Promotion of vigorous PA is therefore recommended among this population. RHR was a key intermediary factor explaining the relationship between vigorous PA and arterial distensibility.
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Hoekstra T, Barbosa-Leiker C, Wright BR, Twisk JW. Effects of long-term developmental patterns of adiposity on levels of C-reactive protein and fibrinogen among North-American men and women: the Spokane Heart Study. Obes Facts 2014; 7:197-210. [PMID: 24903324 PMCID: PMC5644842 DOI: 10.1159/000362570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 03/04/2014] [Indexed: 01/08/2023] Open
Abstract
This study examined the heterogeneity in BMI development by identifying distinct developmental trajectories. These trajectories were further investigated by relating them to markers of low-grade inflammation later in life. Data from approximately 400 healthy volunteers participating in the Spokane Heart Study were collected in 2-year intervals, and four waves of data were available for the current analyses. Body weight was measured by BMI and low-grade inflammation by high-sensitivity C-reactive protein (CRP) and fibrinogen. Up to date statistical techniques, i.e., latent class growth models, were used to analyse heterogeneity in body weight, and linear regressions were run to analyse possible associations between trajectories of body weight and CRP/fibrinogen levels. Six trajectories were identified (three stable, two increasing, and one decreasing) which differed significantly on CRP/fibrinogen levels, highlighting the importance of weight trajectories. The differences were only partly explained by variations in lifestyle habits.
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Affiliation(s)
- Trynke Hoekstra
- Faculty of Earth and Life Sciences, Department of Health Sciences and the EMGO Institute of Health and Care Research, VU University, WA, USA
- Department of Epidemiology and Biostatistics and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, WA, USA
| | | | - Bruce R. Wright
- Health and Wellness Services, Washington State University Pullman, WA, USA
| | - Jos W.R. Twisk
- Department of Epidemiology and Biostatistics and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, WA, USA
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When to prevent cardiovascular disease? As early as possible: lessons from prospective cohorts beginning in childhood. Curr Opin Cardiol 2014; 28:561-8. [PMID: 23928921 DOI: 10.1097/hco.0b013e32836428f4] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW To detail recent developments linking modifiable youth risk factors with preclinical markers of cardiovascular disease such as carotid artery intima-media thickness, pulse-wave velocity (PVW) and large artery stiffness, brachial artery flow-mediated dilatation, left ventricular geometry, and coronary artery calcification in adulthood. RECENT FINDINGS Population-based data from prospective cohort studies beginning in youth with follow-up into adulthood have shown that the modifiable youth risk factors of elevated blood lipids, blood pressure, and adiposity, smoking (active and passive), metabolic disorders, physical inactivity, low cardiorespiratory fitness, and diet associate with preclinical markers of cardiovascular disease in adulthood. The data suggest that, in some instances, those who amend their trajectory by not maintaining these risk factors into adulthood experience reductions in preclinical markers to levels associated with never having had the risk factor. SUMMARY Though avoidance of risk factors in youth is ideal, there is still a window for intervention where long-lasting cardiovascular effects might be avoided. Health-enhancing changes in the rates of active and passive smoking, adiposity, increased physical activity, accentuated fitness, modified diet, and socioeconomic position in the transition from youth to adulthood might be important in modifying an individual's trajectory from high risk in youth to low risk in adulthood.
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Melo X, Santa-Clara H, Pimenta NM, Carrolo M, Martins SS, Minderico CS, Fernhall B, Sardinha LB. Body composition phenotypes and carotid intima-media thickness in 11-13-year-old children. Eur J Pediatr 2014; 173:345-52. [PMID: 24096519 DOI: 10.1007/s00431-013-2164-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 09/16/2013] [Accepted: 09/20/2013] [Indexed: 12/18/2022]
Abstract
UNLABELLED Early detection of impairment in vascular structure is an important clinical pursuit. However, it is unknown which measure of body composition best predicts vascular wall changes. We assess the differences in body composition among intima-media thickness (IMT) tertiles and determined which measures of body composition are associated with IMT in 385 children aged 11-13 years (196 girls). In this cross-sectional study, body mass index (BMI), waist circumference (WC), body fat mass (BFM), and trunk fat mass (TFM) from dual-energy radiographic absorptiometry and IMT through high-resolution ultrasonography were collected. Differences in body composition measures among IMT tertiles [low IMT (LIMT), ≤ 0.46 mm; middle IMT, 0.46-0.53 mm; higher IMT (HIMT), ≥0.53 mm] were assessed with ANOVA/ANCOVA after categorization. Regression analysis was used to assess the relationships between body composition and IMT. The groups were similar for sex, age, and maturity (p > 0.05). As compared with LIMT group, subjects with HIMT had higher mean values of BMI, BFM, TFM, and WC (p < 0.05). Significant differences were found for WC even when controlling for BMI (p < 0.05). Combining all subjects, IMT was significantly correlated to BMI, BFM, TFM, and WC (p < 0.05). In multiple regression, WC was the only predictor of IMT (β = 0.22, p < 0.001). CONCLUSION Differences exist in body composition variables among IMT tertiles. In the overall model, WC was the only obesity-related predictor of increased IMT in 11-13-year-old children.
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Affiliation(s)
- Xavier Melo
- Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Lisbon, Portugal,
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What the Long Term Cohort Studies that Began in Childhood Have Taught Us about the Origins of Coronary Heart Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0373-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Quan HL, Blizzard CL, Sharman JE, Magnussen CG, Dwyer T, Raitakari O, Cheung M, Venn AJ. Resting heart rate and the association of physical fitness with carotid artery stiffness. Am J Hypertens 2014; 27:65-71. [PMID: 24029163 DOI: 10.1093/ajh/hpt161] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Physical fitness is known to influence arterial stiffness. Resting heart rate is reduced by exercise and positively associated with arterial stiffness. This study aimed to investigate the role of resting heart rate in the relationship of physical fitness with arterial stiffness. METHODS Subjects were 2,328 young adults from the Childhood Determinants of Adult Health study. Cardiorespiratory fitness was estimated as physical work capacity at a heart rate of 170 bpm. Muscular strength was estimated by hand-grip (both sides), shoulder (pull and push), and leg strength. Arterial stiffness was measured using carotid ultrasound. RESULTS Arterial stiffness was negatively associated with cardiorespiratory fitness (men P < 0.001; women P = 0.002), and positively associated with muscular strength in women (P = 0.002) but not in men. Resting heart rate was positively associated with arterial stiffness (P < 0.001 both men and women). Adjustment for resting heart rate reduced the inverse association of arterial stiffness with cardiorespiratory fitness by 93.7% (men) and 67.6% (women) but substantially increased the positive association of arterial stiffness with muscular strength among women and revealed a positive association of arterial stiffness with muscular strength among men. These findings were independent of body size, blood pressure, biochemical markers, socioeconomic status, smoking, and alcohol consumption. CONCLUSIONS Our findings attribute a key intermediary role for resting heart rate in the relationship between fitness and arterial stiffness, whereby higher cardiorespiratory fitness may reduce arterial stiffness mainly through resting heart rate, and higher muscular strength might have deleterious effects on arterial stiffness that are partially offset by lower resting heart rate.
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Affiliation(s)
- Huynh L Quan
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
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van de Laar RJ, Stehouwer CD, Prins MH, van Mechelen W, Twisk JW, Ferreira I. Self-reported time spent watching television is associated with arterial stiffness in young adults: the Amsterdam Growth and Health Longitudinal Study. Br J Sports Med 2013; 48:256-64. [DOI: 10.1136/bjsports-2013-092555] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Suboc TM, Dharmashankar K, Wang J, Ying R, Couillard A, Tanner MJ, Widlansky ME. Moderate Obesity and Endothelial Dysfunction in Humans: Influence of Gender and Systemic Inflammation. Physiol Rep 2013; 1. [PMID: 24187612 PMCID: PMC3811111 DOI: 10.1002/phy2.58] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Our objective was to determine whether moderate obesity (Body Mass Index [BMI] ≥ 30 kg/m²) is associated with impaired conduit and microvascular endothelial function, and whether men or women are more susceptible to impairment of endothelial function related to moderate obesity. Forty-one middle aged, nondiabetic moderately obese (BMI 34.7 ± 4.0 kg/m2) and nonobese (BMI 24.3 ± 2.6 kg/m2) subjects of both sexes underwent noninvasive studies of endothelial function (brachial reactivity) and measurements of endothelial-dependent vasodilation of gluteal subcutaneous arterioles to acetylcholine (Ach). Endothelium-dependent vasodilation to Ach was decreased in the moderately obese compared with the nonobese (P < 0.001). Stratified analysis based on sex showed impairment of arteriolar endothelial function in women BMI ≥ 30 kg/m2 (P = 0.02), but not men. There was no difference between in vivo endothelial function flow-mediated dilation (FMD%) by BMI category. Sex-specific analysis showed FMD% was lower in women with BMI ≥ 30 kg/m2 compared to those with BMI < 30 kg/m2 (P = 0.02). No differences were seen in men based on BMI category (P = 0.18). In women, high sensitivity C-reactive protein (hsCRP) correlated with BMI (ρ = 0.68, P = 0.006). Moderate obesity is associated with impaired resistance arteriolar endothelial function. This is more prominent in women than men and is associated with systemic inflammation.
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Affiliation(s)
- Tisha M Suboc
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI
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Association of socioeconomic status, truncal fat and sICAM-1 with carotid intima-media thickness in adolescents: The HELENA study. Atherosclerosis 2013; 228:460-5. [DOI: 10.1016/j.atherosclerosis.2013.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/24/2013] [Accepted: 03/08/2013] [Indexed: 11/22/2022]
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36
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Vasheghani-Farahani A, Majidzadeh-A K, Masoudkabir F, Karbalai S, Koleini M, Aiatollahzade-Esfahani F, Pashang M, Hakki E. Sagittal abdominal diameter to triceps skinfold thickness ratio: a novel anthropometric index to predict premature coronary atherosclerosis. Atherosclerosis 2013; 227:329-33. [PMID: 23466099 DOI: 10.1016/j.atherosclerosis.2013.01.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/20/2012] [Accepted: 01/26/2013] [Indexed: 01/28/2023]
Abstract
OBJECTIVE We aimed to compare the accuracy of a novel index defined by us, as a ratio of Sagittal abdominal diameter (SAD) and triceps skinfold thickness (TSF) with other indices of adiposity for prediction of presence, severity and extension of premature coronary artery disease (CAD). METHODS A cross-sectional study was conducted on 238 younger patients (females <55 years; males <45 years) who underwent coronary angiography. Anthropometric indices including TSF, SAD, waist circumference, and hip circumference were measured before catheterization and body mass index, waist-to-hip ratio, abdominal diameter index, index of central obesity as well as our proposed index, SAD-to-TSF ratio, were calculated accordingly. Evaluation of severity and extension of coronary stenosis was by Gensini score and extent score, respectively. RESULTS After adjustment for age and sex in multivariate regression models, the SAD-to-TSF ratio was the best predictor for the presence (OR = 2.49, 95% CI = 1.44-4.30; p = 0.001) and extension (β = 1.10, p = 0.004) of premature CAD. TSF and the SAD-to-TSF ratio were the only indices that significantly predicted the Gensini score and the correlation remained significant even after adjustment for age and sex (β = -7.28, p < 0.0001 and β = 3.76, p < 0.0001, respectively). CONCLUSION We showed that our proposed index, SAD-to-TSF ratio, has a substantially better accuracy than do the known indices of obesity like body mass index, waist circumference, and waist-to-hip ratio for the prediction of premature CAD. Furthermore, our index was the only index that positively correlated with the severity of premature CAD.
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Affiliation(s)
- Ali Vasheghani-Farahani
- Endocrine and Metabolism Research Center (EMRC), Obesity and Food Group Set, Tehran University of Medical Sciences, Tehran, Iran
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Gerdts E, de Simone G, Lund BP, Okin PM, Wachtell K, Boman K, Nieminen MS, Dahlöf B, Devereux RB. Impact of overweight and obesity on cardiac benefit of antihypertensive treatment. Nutr Metab Cardiovasc Dis 2013; 23:122-129. [PMID: 21775111 DOI: 10.1016/j.numecd.2011.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 02/06/2011] [Accepted: 03/29/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Increased body mass index (BMI) has been associated with increased cardiovascular morbidity and mortality in hypertension. Less is known about the impact of BMI on improvement in left ventricular (LV) structure and function during antihypertensive treatment. METHODS AND RESULTS Annual BMI, echocardiograms and cardiovascular events were recorded in 875 hypertensive patients with LV hypertrophy during 4.8 years randomized treatment in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy. Patients were grouped by baseline BMI into normal (n = 282), overweight (n = 405), obese (n = 150) and severely obese groups (n = 38) (BMI ≤24.9, 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m(2), respectively). At study end, residual LV hypertrophy was present in 54% of obese and 79% of severely obese patients compared to 31% of normal weight patients (both p < 0.01). In regression analyses, adjusting for initial LV mass/height(2.7), higher BMI predicted less LV hypertrophy reduction and more reduction in LV ejection fraction (both p < 0.05), independent of blood pressure reduction, diabetes and in-study weight change. During follow-up, 91 patients suffered cardiovascular death, myocardial infarction or stroke. In Cox regression analysis 1 kg/m(2) higher baseline BMI predicted a 5% higher rate of cardiovascular events and 10% higher cardiovascular mortality over 4.8 years (both p < 0.05). CONCLUSIONS In hypertensive patients in the LIFE study, increased BMI was associated with less reduction of LV hypertrophy and less improvement in LV systolic function which may contribute to the observed higher cardiovascular event rate of treated hypertensive patients.
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Affiliation(s)
- E Gerdts
- Institute of Medicine, University of Bergen, N-5021, Bergen, Norway.
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De Ciuceis C, Rossini C, Porteri E, La Boria E, Corbellini C, Mittempergher F, Di Betta E, Petroboni B, Sarkar A, Agabiti-Rosei C, Casella C, Nascimbeni R, Rezzani R, Rodella LF, Bonomini F, Agabiti-Rosei E, Rizzoni D. Circulating endothelial progenitor cells, microvascular density and fibrosis in obesity before and after bariatric surgery. Blood Press 2013; 22:165-72. [PMID: 23286244 DOI: 10.3109/08037051.2012.749584] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
It is not known whether, in obesity, the capillary density or the number of circulating endothelial progenitor cells (EPCs) are reduced, or whether fibrosis of small vessels is also present. In addition, possible effects of weight reduction on these parameters have never been evaluated. Therefore, we investigated EPCs and capillary density in 25 patients with severe obesity, all submitted to bariatric surgery, and in 18 normotensive lean subjects and 12 hypertensive lean patients as controls. All patients underwent a biopsy of subcutaneous fat during bariatric surgery. In five patients, a second biopsy was obtained after consistent weight loss, about 1 year later, during a surgical intervention for abdominoplasty. EPCs and capillary density were reduced in obesity, and EPCs were significantly increased after weight reduction. Vascular collagen content was clearly increased in obese patients. No significant difference in vascular collagen was observed between normotensive obese patients and hypertensive obese patients. After pronounced weight reduction, collagen content was nearly normalized. No difference in stress-strain relation was observed among groups or before and after weight loss. In conclusion, our data suggest that microvascular rarefaction occurs in obesity. EPCs were significantly reduced in obese patients. Pronounced weight loss induced by bariatric surgery seems to induce a significant improvement of EPC number, but not of capillary rarefaction. A pronounced fibrosis of subcutaneous small resistance arteries is present in obese patients, regardless of the presence of increased blood pressure values. Consistent weight loss induced by bariatric surgery may induce an almost complete regression of microvascular fibrosis.
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Affiliation(s)
- Carolina De Ciuceis
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Italy
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van de Laar RJJ, Stehouwer CDA, van Bussel BCT, Prins MH, Twisk JWR, Ferreira I. Adherence to a Mediterranean dietary pattern in early life is associated with lower arterial stiffness in adulthood: the Amsterdam Growth and Health Longitudinal Study. J Intern Med 2013; 273:79-93. [PMID: 22809371 DOI: 10.1111/j.1365-2796.2012.02577.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To investigate whether adherence to a Mediterranean dietary pattern during adolescence and early adulthood affects arterial stiffness in adulthood, and the extent to which any such association may be attributed to a beneficial impact of this diet on cardiovascular disease risk factors such as blood pressure, central fatness and dyslipidaemia. SETTING The Amsterdam Growth and Health Longitudinal Study. DESIGN AND SUBJECTS We compared longitudinal levels of adherence to a Mediterranean dietary pattern (aMED score with range 0-9) during adolescence and adulthood (two to eight repeated measures obtained between the ages of 13 and 36) between individuals with different levels of arterial stiffness in adulthood. The study population included 373 (196 women) apparently healthy adults in whom properties of the carotid, brachial and femoral arteries were assessed using ultrasonography at 36 years of age. RESULTS After adjustments for potential confounders, individuals with stiffer carotid arteries (defined on the basis of the most adverse tertile of, for instance, the distensibility coefficient) had lower aMED scores (-0.32, 95% CI -0.60; -0.06) and were less likely to have adhered to this dietary pattern (aMED score ≥5, odds ratio 0.69, 95% CI 0.50; -0.94) during the preceding 24 years compared with those with less stiff arteries. Differences in aMED scores were already present in adolescence and were only in part explained by the favourable associations between the Mediterranean dietary pattern and other cardiovascular disease risk factors (up to 26%), particularly mean blood pressure (up to 19%). CONCLUSIONS Promoting the Mediterranean diet in adolescence and early adulthood may constitute an important means of preventing arterial stiffness in adulthood.
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Affiliation(s)
- R J J van de Laar
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
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40
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Aortic stiffness in obese children and adolescents: Comparison of two distance measures of carotid–femoral pulse wave velocity. Artery Res 2013. [DOI: 10.1016/j.artres.2013.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sun M, Huang X, Yan Y, Chen J, Wang Z, Xie M, Li J. Rac1 is a possible link between obesity and oxidative stress in Chinese overweight adolescents. Obesity (Silver Spring) 2012; 20:2233-40. [PMID: 22421922 DOI: 10.1038/oby.2012.63] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Enhanced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity in the monocytes occurred in metabolic syndrome, hypertension, diabetes and obese patients in adults. However, whether NADPH oxidase is involved in the oxidative stress of overweight adolescents without comorbidities is still unclear. This study aimed to identify whether and how NADPH oxidase plays a crucial role in overweight adolescents. The study was performed in 93 overweight adolescents and 31 normal weight controls. Moreover, 87 overweight adolescents were enrolled in weight-loss program. Demographics characteristics, anthropometrics, composition and clinical characteristics were analyzed. Oxidative stress indexes including the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in plasma and the expression of NADPH oxidase in the monocytes were examined. Overweight adolescents showed a higher oxidative stress state, as indicated by decreased SOD activity and elevated MDA level (P < 0.01). Furthermore, increased NADPH oxidase activity in the monocytes was accompanied by Rac1 upregulation. A significant positive bivariate correlation was found between Rac1 expression and MDA (r = 0.289). There also was a significant positive bivariate correlation between Rac1 expression and obesity-related indexes including BMI (r = 0.227) and percentage of trunk fat (r = 0.233). Data from weight-loss program reinforced the results. Partial correlation analysis indicated that obesity-induced oxidative stress and Rac1 expression is a consequence of aberrant glucose-lipid metabolism in overweight adolescents. In conclusion, we provided novel data showing that NADPH oxidase in the monocytes was highly activated by enhancing Rac1 expression in Chinese overweight adolescents and Rac1 may act as a link between obesity and oxidative stress in overweight adolescents.
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Affiliation(s)
- Mingxiao Sun
- Department of Endocrinology, The Key Laboratory of Geriatrics, Beijing Hospital & Beijing Institute of Geriatrics, Ministry of Health, Beijing, China
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Cintra W, Modolin M, Faintuch J, Gemperli R, Ferreira MC. C-reactive protein decrease after postbariatric abdominoplasty. Inflammation 2012; 35:316-20. [PMID: 21455591 DOI: 10.1007/s10753-011-9321-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In a prospective study, indices of glucose homeostasis, lipid profile, and systemic inflammation were monitored after an aesthetic abdominoplasty, aiming to scrutinize the possible metabolic benefits for abdominal fat removal. Premenopausal females with substantial weight loss (N=40) undergoing circumferential abdominoplasty (index group, n=20) or augmentation mammoplasty with mastopexy (controls, n=20) were recruited. All of them originally underwent Roux-en-Y gastric bypass. Variables included BMI, white blood cell count, C-reactive protein, hemoglobin, total cholesterol and fractions, triglycerides, glucose, and HbA1c. Follow-up reached 20.3 ± 13.6 months for index cases and 29.5 ± 17.4 months for controls. The metabolic and inflammatory indices improved after the bariatric surgery. Subsequent monitoring indicated a stable body weight and biochemical profile in both groups. The exceptions were HDL cholesterol and C-reactive protein, which respectively increased and diminished after the abdominoplasty, consistent with an inflammatory and metabolic advantage for this operation. This is the first long-term study in a weight-stable population to point out such a pattern after abdominoplasty.
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Affiliation(s)
- Wilson Cintra
- Plastic Surgery Service, Hospital das Clinicas, Sao Paulo, Sao Paulo, 05403-900, Brazil
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Ozari HO, Oktenli C, Celik S, Tangi F, Ipcioglu O, Terekeci HM, Top C, Uzun M, Sanisoglu YS, Nalbant S. Are increased carotid artery pulsatility and resistance indexes early signs of vascular abnormalities in young obese males? JOURNAL OF CLINICAL ULTRASOUND : JCU 2012; 40:335-340. [PMID: 22532370 DOI: 10.1002/jcu.21927] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/19/2012] [Indexed: 05/31/2023]
Abstract
PURPOSE To provide insight into the factors by which obesity in itself may directly lead to early arterial damage, we aimed to determine early sonographic markers of obesity-related vascular dysfunction in young obese males. METHODS Thirty-five young obese males and 23 age-matched healthy male volunteers were recruited into the study. Common carotid artery pulsatility index and resistance index were calculated from blood flow velocities curves obtained by pulsed Doppler ultrasonography. RESULTS The mean pulsatility index, resistance index, body mass index, waist circumference, systolic and diastolic blood pressure, homeostasis model assessment for insulin resistance, plasma fasting glucose, insulin, C-peptide, triglycerides, low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were statistically higher in obese subjects than in healthy controls. CONCLUSIONS Our results suggest that depressed vessel compliance and increased vascular resistance are features of young, obese, normotensive subjects independently of and in addition to cardiovascular risk factors. As changes in arterial wall properties may be incipient in young obese subjects, future studies will be required to demonstrate whether early intervention such as diet and exercise in this population can improve vascular functions.
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Affiliation(s)
- H Onur Ozari
- Division of Internal Medicine, GATA Haydarpasa Training Hospital, Tibbiye Caddesi TR-34668 Uskudar-Istanbul, Turkey
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Wijnstok NJ, Hoekstra T, van Mechelen W, Kemper HCG, Twisk JWR. Cohort profile: the Amsterdam Growth and Health Longitudinal Study. Int J Epidemiol 2012; 42:422-9. [PMID: 22434862 DOI: 10.1093/ije/dys028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Amsterdam Growth and Health Longitudinal Study (AGHLS) is a unique, multidisciplinary cohort study that was initially set up to examine growth and health among teenagers. Throughout the years, the AGHLS has aimed to answer research questions dealing with the relationships between the (natural) development of anthropometry, lifestyle and health from adolescence into adulthood. The AGHLS specifically focuses on anthropometrics, physical activity and fitness, cardiovascular disease risk, lifestyle, musculoskeletal health, psychological health and well-being. Besides this, many methodological issues related to the analysis of longitudinal data were also explored within the framework of the AGHLS. In 1976, students from two secondary schools from the greater Amsterdam area were included in the study. Between 1976 and 2006, 10 rounds of measurement were performed covering an age range between 13 and 43 years. The huge database collected so far has been primarily used to answer relevant research questions regarding the longitudinal relationship between lifestyle and health. Further information about the study can be obtained from the principal investigator Jos Twisk (jwr.twisk@vumc.nl), and up-to-date information on AGHLS can be found by visiting the website www.aggo.nl.
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Affiliation(s)
- Nienke J Wijnstok
- Department of Internal Medicine and the Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands
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Terzis ID, Papamichail C, Psaltopoulou T, Georgiopoulos GA, Lipsou N, Chatzidou S, Kontoyiannis D, Kollias G, Iacovidou N, Zakopoulos N, Alevizaki M, Stamatelopoulos KS. Long-Term BMI changes since adolescence and markers of early and advanced subclinical atherosclerosis. Obesity (Silver Spring) 2012; 20:414-20. [PMID: 21617635 DOI: 10.1038/oby.2011.137] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although long-term weight gain has been associated with cardiovascular risk and intima-media thickening (IMT), no sufficient data exist on possible associations of such weight changes with more advanced stages of subclinical atherosclerosis. Moreover, the value of self-reported weight changes, a more practical approach to assess long-term history in adiposity status, is still a matter of debate. In this longitudinal study, long-term changes in BMI and overweight status were assessed in 106 healthy young adults (age 40.5 ± 1.1 years, 60 males). These were a subgroup of adolescent school students who had originally been examined in 1983 initially aiming to assess cardiovascular risk factor prevalence. Markers of early (carotid IMT) and advanced (presence of plaques in the carotid and femoral arteries and ankle-brachial index, ABI) subclinical atherosclerosis were measured in all individuals. By multivariate analysis, among other risk factors, IMT and the presence of plaques were independently determined by BMI change, while a low ABI was also determined by changes in overweight status. An adverse long term adiposity profile change (≥ +4 kg/m(2) and/or change into overweight/obese status from normal weight since adolescence) incrementally determined a low ABI over current risk factors. Self-reported and actual BMI changes were correlated (r = 0.587) but their means significantly differed, while the former significantly correlated with IMT only (P = 0.032). In conclusion, an adverse long term adiposity status change was more prominently associated with advanced subclinical atherosclerosis and particularly low ABI. These results also suggest that the utility of self-reported weight changes may be limited in primary prevention practice.
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Affiliation(s)
- Ioannis D Terzis
- Vascular Laboratory, Department of Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Athens, Greece
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Ferreira I, van de Laar RJ, Prins MH, Twisk JW, Stehouwer CD. Carotid stiffness in young adults: a life-course analysis of its early determinants: the Amsterdam Growth and Health Longitudinal Study. Hypertension 2011; 59:54-61. [PMID: 22068867 DOI: 10.1161/hypertensionaha.110.156109] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cardiovascular risk factors affecting arterial stiffness in adulthood may develop at different critical periods earlier in life. We examined whether the trajectories, from adolescence to young adulthood, of blood pressure, body fatness and fat distribution, blood lipids, cardiorespiratory fitness, and heart rate determined levels of arterial stiffness in young adults. We investigated 373 apparently healthy adults in whom cardiovascular risk factors were repeatedly examined between the ages of 13 and 36 years and carotid stiffness estimates were obtained at the age of 36 years. Differences in the mean levels and the trajectories of risk factors throughout the 24-year longitudinal period between subjects with different levels of carotid stiffness at age 36 years were analyzed with generalized estimating equations. Compared with individuals with less stiff carotid arteries, those with stiffer carotid arteries at the age of 36 years were characterized from ages 13 to 36 years by greater levels of and steeper increases in blood pressure and central fatness, independently of each other and other risk factors. These increases were already present in adolescence, preceded the development of poorer levels of blood lipids, cardiorespiratory fitness, and heart rate, which were evident during adulthood only, and explained to a great extent the deleterious association between these risk factors and carotid stiffness at the age of 36 years. Multiple and intertwined mechanisms involved in the pathogenesis of arterial stiffness have their origins in early life. Blood pressure and central fatness have a pivotal role herein and should be specifically targeted to prevent arterial stiffening and its cardiovascular sequelae.
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Affiliation(s)
- Isabel Ferreira
- Department of Internal Medicine, School for Cardiovascular Diseases, Maastricht University Medical Centre, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
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Continuing smoking between adolescence and young adulthood is associated with higher arterial stiffness in young adults. J Hypertens 2011; 29:2201-9. [DOI: 10.1097/hjh.0b013e32834b0ecf] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Elkiran O, Yilmaz E, Koc M, Kamanli A, Ustundag B, Ilhan N. The association between intima media thickness, central obesity and diastolic blood pressure in obese and overweight children: a cross-sectional school-based study. Int J Cardiol 2011; 165:528-32. [PMID: 22014414 DOI: 10.1016/j.ijcard.2011.09.080] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 07/31/2011] [Accepted: 09/17/2011] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To examine relationship between carotid intima-media thickness (IMT) and central obesity, cardiovasculary risk factors, and chronic inflammation markers in overweight and obese schoolchildren in Eastern Turkey. METHODS A cross-sectional school-based survey on 2765 schoolchildren was performed. We collected the clinical data (age, sex, percentage of body fat, and measured systolic blood pressure [BP] and diastolic BP, triglycerides, high- and low-density lipoprotein cholesterol, glucose, insulin, homocysteine and high-sensitivity C-reactive protein) in 67 obese and 24 overweight children. The control group was composed of nonobese children of similar age and sex. RESULTS Mean systolic and diastolic BP values in the cases of overweight and obese groups were higher than those in the control group cases (p=0.001). Obese and overweight children demonstrated a significantly thicker intima media as compared with the control group (p=0.001). Carotid IMT was significantly correlated to the body mass index (r=0.396, p=0.001), fat mass percentage (r=0.257, p=0.036), waist circumference (r=0.390, p=0.001), diastolic BP (r=0.266, p=0.030), glucose (r=0.250, p=0.042), and high-sensitivity C-reactive protein levels (r=0.269, p=0.001) in the obese group. In multiple linear regression analysis, carotid IMT correlated significantly to waist circumference (p=0.045), and diastolic BP (p=0.031) in obese group. CONCLUSIONS Obesity is related to cardiovascular risk factors leading to early atherosclerosis in schoolchildren. There is a relationship between atherosclerosis, and central obesity, diastolic BP, and chronic inflammation. Waist circumference measurement is more sensitive than other anthropometric measurements in predicting obesity and associated complications.
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Affiliation(s)
- Ozlem Elkiran
- Division of Pediatric Cardiology, Department of Pediatrics, Inonu University Faculty of Medicine, Malatya, Turkey.
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Rizzoni D, De Ciuceis C, Porteri E, Semeraro F, Rosei EA. Structural alterations in small resistance arteries in obesity. Basic Clin Pharmacol Toxicol 2011; 110:56-62. [PMID: 21883940 DOI: 10.1111/j.1742-7843.2011.00786.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In cardiovascular and metabolic diseases, small resistance arteries may show the presence of structural alterations. In particular, in essential hypertension, an increased media-to-lumen ratio of subcutaneous small arteries with no change in the total amount of vascular wall tissue (eutrophic remodelling) has already been described several years ago. Similar alterations have been demonstrated also in patients with diabetes mellitus and obesity; in this case, however, a more evident contribution of vascular smooth muscle cell growth (hypertrophic remodelling) is present. This review addresses the effects of obesity on small resistance artery structure. Similar to diabetic patients, obese patients show an increased media-to-lumen ratio of subcutaneous small arteries, which appears associated with hypertrophic remodelling, as demonstrated by an increase in media cross-sectional area. Endothelial dysfunction evaluated as vasodilator response to acetylcholine has also been observed. Several studies have shown that increased media-to-lumen ratio of subcutaneous small resistance arteries possesses a prognostic significance in relation to cardiovascular outcome. Appropriate antihypertensive treatment may improve microvascular alterations both in essential hypertension and in type 2 diabetes mellitus. In obesity, a pronounced weight loss may improve microvascular structure. However, further studies are needed to elucidate the effects of other pharmacological and non-pharmacological interventions in obesity.
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Affiliation(s)
- Damiano Rizzoni
- Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
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Schouten F, Twisk JW, de Boer MR, Stehouwer CD, Serné EH, Smulders YM, Ferreira I. Increases in central fat mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening in healthy adults: the Amsterdam Growth and Health Longitudinal Study. Am J Clin Nutr 2011; 94:40-8. [PMID: 21562083 DOI: 10.3945/ajcn.111.013532] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Central fatness is associated with higher arterial stiffness, a mechanism that may explain adiposity-related increases in cardiovascular disease risk. In contrast, peripheral fat and lean masses may counteract such adverse effects, but evidence of this contention, as derived from longitudinal studies at the general population level, is lacking. OBJECTIVE The objective was to investigate the associations between changes in central (ie, trunk) fat mass, peripheral (ie, limbs) fat mass, and lean masses with changes in arterial stiffness. DESIGN A longitudinal study in 277 (145 women) healthy adults was conducted. Body composition (dual-energy X-ray absorptiometry) and arterial stiffness estimates (ultrasound imaging) were measured repeatedly at the ages of 36 and 42 y. RESULTS Changes (per 10 kg) in trunk fat mass were positively associated and changes in peripheral fat mass were inversely associated with carotid Young's elastic modulus (in 10(3) ⋅ kPa) [β = 0.14 (95% CI: 0.02, 0.25) and -0.16 (-0.30, -0.01), respectively] and carotid-femoral pulse wave velocity (in m/s) [β = 1.54 (0.02, 3.07) and -1.46 (-3.48, 0.56), respectively]. Individuals in whom trunk fat increased and peripheral fat decreased over the 6-y follow-up (33% of the study population) had the steepest increases in these stiffness estimates. Notably, these changes were accompanied by minor increases in body weight, which remained within the limits of the normal range throughout. CONCLUSIONS Increases in trunk mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening. These findings emphasize the importance of assessing regional changes in body composition, because it may enable identification of individuals with an unrecognized increased cardiovascular disease risk.
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Affiliation(s)
- Fleur Schouten
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University, Amsterdam, Netherlands, VU University Medical Center, Amsterdam, Netherlands
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