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Cortés-Valencia A, Arvizu M, Monge A, Ortiz-Panozo E, López-Ridaura R, Cantu-Brito C, Chavarro J, Catzin-Kuhlmann A, Fagherazzi G, Yunes E, Lajous M. Sugar- and artificially-sweetened soda consumption and subclinical atherosclerosis among Mexican women. Nutr Metab Cardiovasc Dis 2022; 32:2052-2060. [PMID: 35941038 DOI: 10.1016/j.numecd.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Sugar-sweetened soda consumption is associated with most cardiometabolic risk factors. The role of artificially-sweetened beverages in cardiovascular disease (CVD) is inconclusive, but their consumption correlates with health impairment. Little is known about the contribution of soda consumption in subclinical stages of atherosclerosis. Therefore, we evaluated the relation between sugar- and artificially-sweetened soda consumption and carotid intima-media thickness (IMT) among Mexican women. METHODS AND RESULTS We cross-sectionally evaluated 1093 women enrolled in the Mexican Teachers' Cohort who were free of CVD, diabetes or cancer. Sugar- and artificially-sweetened soda consumption was estimated from a validated 140-item food frequency questionnaire in 2008 and all women underwent a carotid ultrasound assessment three years later. Participants were categorized into tertiles of soda consumption in servings/week. Subclinical atherosclerosis was defined as a mean left and/or right IMT ≥0.8 mm or the presence of plaque on either common carotid artery. In multivariable regression models, women in the highest tertile of sugar-sweetened soda consumption had 2.6% (95%CI: 0.8, 4.5) mean increased IMT, and had 2-fold the risk of carotid atherosclerosis (PR: 2.0, 95%CI: 1.3, 3.2) compared to those in the lowest tertile. In stratified analyses, older and postmenopausal women who consumed sugar-sweetened soda had an increased IMT and atherosclerosis risk. Artificially-sweetened soda consumption was not associated with IMT or carotid atherosclerosis. CONCLUSIONS Sugar-sweetened soda consumption was associated with subclinical atherosclerosis among disease-free Mexican women. Public health strategies to decrease CVD should consider the impact of sugar-sweetened soda consumption, particularly in older women.
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Affiliation(s)
- Adrian Cortés-Valencia
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Ruy López-Ridaura
- National Center for Preventive Programs and Disease Control, Ministry of Health, Mexico
| | - Carlos Cantu-Brito
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Nuevo Leon, Mexico
| | - Jorge Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrés Catzin-Kuhlmann
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Nuevo Leon, Mexico; Department of Medicine, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Guy Fagherazzi
- INSERM (Institut National de la Santé et de la Recherche Médicale), Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France; Paris-South University, UMRS, 1018, Villejuif, France
| | - Elsa Yunes
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Martin Lajous
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Portillo-Romero AJ, Allen-Leigh B, Nyitray AG, Carnalla M, Salmerón J, León-Maldonado L, Yunes E, Rivera L, Magis-Rodríguez C, Vargas G, Giuliano AR, Esquivel-Ocampo EA, Lazcano-Ponce E. Sex Work and High-Risk Anal Human Papillomavirus Infection Among Transgender Women: The Condesa Study. Transgend Health 2022; 6:315-324. [PMID: 34993304 DOI: 10.1089/trgh.2020.0075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The prevalence of high-risk human papillomavirus (hrHPV) infection among transgender women has been reported to be very high and sexually transmitted infection (STI) prevention strategies have focused on transgender women who engage in sex work. The purpose of our study was to describe hrHPV infection prevalence among a group of transgender women and to explore the differences according to sex work history (SW). Methods: The Condesa Study, an HPV vaccine, and screening study, recruited 207 transgender women without previous HPV vaccination, ages 18-60, from two clinics in Mexico City that provide HIV and transgender health care (May 2018-December 2019). At enrollment, they completed a questionnaire on sociodemographic and sexual behavior data. The hrHPV DNA genotyping was done on self-collected anal samples. Factors associated with hrHPV, stratified by presence or absence of SW, were assessed with multiple logistic regression. Results: A total of 43.5% of participants reported a history of SW. Anal hrHPV prevalence was 62.0% among participants with a history of SW and 52.0% among those without. Overall, 1 in 4 (26.6%) participants were living with HIV. Independent risk factors associated with hrHPV among transgender women with a history of SW were younger age, younger age at first anal intercourse (15-17 years), and greater number of sexual partners in the last 3 months. Among transgender women who had not done SW, greater number of sexual partners in the last 3 months and self-reported STIs were associated with hrHPV. Conclusions: Prevalence of anal infection with hrHPV was high among transgender women. Our results support that other sexual behaviors different from participating in SW contribute to the high prevalence of HPV and that there is an urgent need to include all transgender women in prevention programs for HPV and associated cancers, regardless of SW.
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Affiliation(s)
| | - Betania Allen-Leigh
- Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alan G Nyitray
- Clinical Cancer Center, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Martha Carnalla
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Jorge Salmerón
- Center for Research in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Leith León-Maldonado
- National Council of Science and Technology (CONACYT)-National Institute of Public Health, Cuernavaca, Mexico
| | - Elsa Yunes
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Leonor Rivera
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Galileo Vargas
- Center for the Prevention and Comprehensive Care of HIV/AIDS in Mexico City, Condesa Clinic, Mexico City, Mexico
| | - Anna R Giuliano
- Center for Infection in Cancer Research, Moffitt Cancer Center, Tampa, Florida, USA
| | - Eiberth A Esquivel-Ocampo
- Coloproctology Unit of General Hospital of Cuernavaca, "Dr. José G. Parres," Cuernavaca, Morelos, México
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Espinosa-Tamez P, Lajous M, Cantú-Brito C, Lopez-Ridaura R, Monge A, Yunes E, Rodríguez BL, Espinosa L, Sifuentes-Osornio J, Catzin-Kuhlmann A. Association of recurrent common infections and subclinical cardiovascular disease in Mexican women. PLoS One 2021; 16:e0246047. [PMID: 33497395 PMCID: PMC7837493 DOI: 10.1371/journal.pone.0246047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute and agent-specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections on cardiovascular disease is limited. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD). METHODS In a cross-sectional study, we assessed the relation of recurrent infections and carotid artery intima-media thickness (IMT) in 1946 disease-free women from the Mexican Teachers' Cohort. Through 2012-2016, participants answered structured questions on respiratory, urinary and vaginal infections during the previous year and their IMT was measured using ultrasound by standardized neurologists. We defined sCVD as mean right and left IMT ≥0.8 mm or the presence of atheromatous plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting for age, sociodemographic, and cardiovascular risk factors. RESULTS Among participants (50±5 years) 13% reported no infections, 20% one infection and 67% three or more episodes. Overall prevalence of sCVD was 12%(n = 240). Adjusted models for logistic regression showed that women with 2 or more infections had 91% higher odds of sCVD (OR 1.91; 95%CI 1.16, 3.13) compared to women without infections (p-trend:0.015). Sub-analyses by type of infection resulted not significant. Linear regression analysis did not show a significant association between mean IMT and recurrent infections. CONCLUSIONS Recurrent infectious events in young adult women are associated with greater sCVD, which supports the hypothesis of low-grade chronic inflammation in the pathophysiology of cardiovascular disease.
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Affiliation(s)
- Priscilla Espinosa-Tamez
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
| | - Martin Lajous
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Carlos Cantú-Brito
- Division of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, Mexico
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - Ruy Lopez-Ridaura
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
| | - Adriana Monge
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - Elsa Yunes
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
| | - Beatriz L. Rodríguez
- Department of Geriatric Medicine, University of Hawaii, Honolulu, HI, United States of America
| | - Luis Espinosa
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - José Sifuentes-Osornio
- Department of Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, Mexico
| | - Andres Catzin-Kuhlmann
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
- Department of Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, Mexico
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4
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Hartasanchez SA, Flores-Torres M, Monge A, Yunes E, Rodriguez B, Cantu-Brito C, Colaci D, Lamadrid-Figueroa H, Lopez-Ridaura R, Lajous M. Pregnancy Loss and Carotid Intima-Media Thickness in Mexican Women. J Am Heart Assoc 2018; 7:e007582. [PMID: 29331960 PMCID: PMC5850165 DOI: 10.1161/jaha.117.007582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/01/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cardiovascular disease in women often develops without conventional risk factors. Prenatal loss is a common pregnancy outcome that may result in physiological changes can increase the potential future risk of cardiovascular disease. Insufficient information exists regarding the impact of pregnancy loss on early markers of cardiovascular disease risk. METHODS AND RESULTS Cross-sectional analysis of 1767 disease-free women from the MTC (Mexican Teachers' Cohort) who had been pregnant was used to evaluate the relationship between pregnancy loss and carotid intima-media thickness (IMT). Participants responded to a questionnaire regarding their reproductive history, risk factors, and medical conditions. We defined pregnancy loss as history of miscarriage and/or stillbirth. Trained neurologists measured IMT using ultrasound. We log-transformed IMT and defined subclinical carotid atherosclerosis (SCA) as IMT ≥0.8 mm and/or plaque. We used multivariable linear and logistic regression models to assess the relation of pregnancy loss, IMT, and SCA. The mean age of participants was 49.8±5.1 years. The prevalence of pregnancy loss was 22%, and we observed SCA in 23% of participants. Comparing participants who reported a pregnancy loss and those who did not, the multivariable-adjusted odds ratio for SCA was 1.52 (95% confidence interval, 1.12-2.06). Women who experienced a stillbirth had 2.32 higher odds (95% confidence interval, 1.03-5.21) of SCA than those who did not. Mean IMT appeared to be higher in women who reported a pregnancy loss relative to those who did not; nevertheless, this was not statistically significant. CONCLUSIONS Pregnancy loss could be linked to cardiovascular disease later in life. The key findings of our study await confirmation and further investigation of the potential underlying mechanisms for this association is required.
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Affiliation(s)
- Sandra A Hartasanchez
- School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Mario Flores-Torres
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Escuela de Medicina, Instituto Tecnológico de Estudios Superiores de Monterrey, Mexico
| | - Elsa Yunes
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Beatriz Rodriguez
- Escuela de Medicina, Instituto Tecnológico de Estudios Superiores de Monterrey, Mexico
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - Carlos Cantu-Brito
- Escuela de Medicina, Instituto Tecnológico de Estudios Superiores de Monterrey, Mexico
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubiran, México City, Mexico
| | - Daniela Colaci
- Department of Maternal and Child's Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Hector Lamadrid-Figueroa
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Ruy Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Martin Lajous
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
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5
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Tamez M, Monge A, López-Ridaura R, Fagherazzi G, Rinaldi S, Ortiz-Panozo E, Yunes E, Romieu I, Lajous M. Soda Intake Is Directly Associated with Serum C-Reactive Protein Concentration in Mexican Women. J Nutr 2018; 148:117-124. [PMID: 29378052 DOI: 10.1093/jn/nxx021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/23/2017] [Indexed: 02/03/2023] Open
Abstract
Background Soda intake is associated with an increased risk of cardiovascular disease. Consumption of diet sodas, often considered healthy alternatives to sodas, could also increase the likelihood of cardiovascular outcomes. Objective This study aims to evaluate the relation between soda and diet soda and biomarkers of cardiovascular risk. Methods We conducted a cross-sectional analysis among 825 Mexican women free of diabetes, cardiovascular disease, and cancer, and for whom serum concentrations of C-reactive protein (CRP), C-peptide, adiponectin, and leptin were available. Mean ± SD age was 45.9 ± 6.6 y, the majority of women were premenopausal (60.4%), and the prevalence of obesity was 35%. We estimated the adjusted percentage differences in biomarkers and 95% CIs by performing multiple linear regression models comparing categories of consumption for soda and diet soda adjusting for age, family history of heart disease, menopause, menopausal hormone therapy, socioeconomic status, region, smoking, physical activity, alcohol intake, and dietary patterns. Results In the entire study sample we observed a 50% higher serum CRP concentration in women in the highest soda intake quartile (median intake: 202.9 mL/d, IQR: 101.4, 304.3 mL/d) compared to those in the lowest (median intake: 11.8 mL/d, IQR: 0.0, 152.1 mL/d). After stratification by menopausal status, results remained significant only for premenopausal women. Premenopausal women in the highest quartile of soda intake had 56% higher CRP concentration relative to women in the lowest quartile. We observed no significant association with the other biomarkers. After further adjustment for body mass index, a potential mediator, results remained significant only for CRP. Diet soda consumption was not associated with any of the biomarkers. Conclusions Consumption of soda was associated with adverse levels in a biomarker of inflammation and cardiovascular risk, serum CRP, in Mexican women. These results add to the accumulating evidence on soda and cardiovascular risk. More research is necessary to understand the potential impact of artificially sweetened sodas.
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Affiliation(s)
- Martha Tamez
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, México
- Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Mexico
| | - Ruy López-Ridaura
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, México
| | - Guy Fagherazzi
- INSERM (Institut National de la Santé et de la Recherche Médicale), Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
- Paris-South University, UMRS 1018, Villejuif, France
| | - Sabina Rinaldi
- IARC (International Agency for Research on Cancer), Lyon, France
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, México
| | - Elsa Yunes
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, México
| | - Isabelle Romieu
- IARC (International Agency for Research on Cancer), Lyon, France
| | - Martin Lajous
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, México
- INSERM (Institut National de la Santé et de la Recherche Médicale), Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
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6
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Dossus L, Rinaldi S, Biessy C, Hernandez M, Lajous M, Monge A, Ortiz-Panozo E, Yunes E, Lopez-Ridaura R, Torres-Mejía G, Romieu I. Circulating leptin and adiponectin, and breast density in premenopausal Mexican women: the Mexican Teachers' Cohort. Cancer Causes Control 2017; 28:939-946. [PMID: 28677026 DOI: 10.1007/s10552-017-0917-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/21/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Leptin and adiponectin are produced by the adipose tissue. Mammographic density (MD) is one of the strongest predictors of breast cancer (BC) and is highly influenced by adiposity. How the interplay between MD, obesity, and obesity-related biomarkers influences BC risk, however, is still unknown, especially in premenopausal women, where adiposity seems to be protective for BC. The aim of the present study was to explore the association between circulating leptin, adiponectin, and their ratio, with MD in Mexican premenopausal women who are part of the large Mexican Teachers' Cohort (MTC). METHODS A subsample of 2,084 women from the MTC participated in a clinical evaluation. Of them, 574 premenopausal women were randomly selected, from four MD strata. Serum leptin and adiponectin concentrations were measured by immunoassays. Multivariate regression analyses were performed to compare means of MD by quartiles of adipokines and their ratio. RESULTS High leptin and leptin/adiponectin ratio levels were significantly associated with lower percentage MD and higher absolute and non-absolute dense tissue areas. High adiponectin levels were significantly associated with lower absolute dense and non-dense tissue areas, but not with percentage MD. After adjustment for BMI, only the associations between percentage MD and absolute non-dense tissue area with leptin remained statistically significant. CONCLUSIONS Leptin, adiponectin, and their ratio were associated with MD; however, only the positive association with leptin seemed to be independent from overall obesity.
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Affiliation(s)
- L Dossus
- International Agency for Research on Cancer [IARC], Lyon, France
| | - S Rinaldi
- International Agency for Research on Cancer [IARC], Lyon, France
| | - C Biessy
- International Agency for Research on Cancer [IARC], Lyon, France
| | - M Hernandez
- International Agency for Research on Cancer [IARC], Lyon, France
| | - M Lajous
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico.
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
| | - A Monge
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - E Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - E Yunes
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - R Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - G Torres-Mejía
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - I Romieu
- International Agency for Research on Cancer [IARC], Lyon, France
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
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Flores-Torres MH, Lynch R, Lopez-Ridaura R, Yunes E, Monge A, Ortiz-Panozo E, Cantu-Brito C, Hauksdóttir A, Valdimarsdóttir U, Lajous M. Exposure to Violence and Carotid Artery Intima-Media Thickness in Mexican Women. J Am Heart Assoc 2017; 6:e006249. [PMID: 28862944 PMCID: PMC5586461 DOI: 10.1161/jaha.117.006249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/07/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Violence against women has become a global public health threat. Data on the potential impact of exposure to violence on cardiovascular disease are scarce. METHODS AND RESULTS We evaluated the association between exposure to violence and subclinical cardiovascular disease in 634 disease-free women from the Mexican Teachers' Cohort who responded to violence-related items from the Life Stressor Checklist and underwent measures of carotid artery intima-media thickness in 2012 and 2013. We defined exposure to violence as having ever been exposed to physical and/or sexual violence. Intima-media thickness was log-transformed, and subclinical carotid atherosclerosis was defined as intima-media thickness ≥0.8 mm or plaque. We used multivariable linear and logistic regression models adjusted for several potential confounders. Mean age was 48.9±4.3 years. Close to 40% of women reported past exposure to violence. The lifetime prevalence of sexual violence was 7.1%, and prevalence of physical violence was 23.5% (7.7% reported both sexual and physical violence). Relative to women with no history of violence, exposure to violence was associated with higher intima-media thickness (adjusted mean percentage difference=2.4%; 95% confidence interval 0.5, 4.3) and subclinical atherosclerosis (adjusted odds ratio=1.60; 95% confidence interval 1.10, 2.32). The association was stronger for exposure to physical violence, especially by mugging or physical assault by a stranger (adjusted mean % difference=4.6%; 95% confidence interval 1.8, 7.5, and odds ratio of subclinical carotid atherosclerosis=2.06; 95% confidence interval 1.22, 3.49). CONCLUSIONS Exposure to violence, and in particular assault by a stranger, was strongly associated with subclinical cardiovascular disease in Mexican middle-aged women.
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Affiliation(s)
- Mario H Flores-Torres
- School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Rebekka Lynch
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ruy Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Elsa Yunes
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Center of Research and Innovation, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Carlos Cantu-Brito
- Department of Neurology and Psychiatry, National Institute of Nutrition and Medical Sciences, Mexico City, Mexico
| | - Arna Hauksdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Unnur Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Martín Lajous
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
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8
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Amadou A, Biessy C, Rinaldi S, Fedirko V, Assi N, Lajous M, Ortiz-Panozo E, Yunes E, Lopez-Ridaura R, Torres-Mejia G, Romieu I. Serum 25-Hydroxyvitamin D3 and Mammography Density among Mexican Women. PLoS One 2016; 11:e0161686. [PMID: 27564705 PMCID: PMC5001725 DOI: 10.1371/journal.pone.0161686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 08/10/2016] [Indexed: 11/18/2022] Open
Abstract
Low circulating levels of vitamin D and high mammographic density (MD) have been associated with higher risk of breast cancer. Although some evidence suggested an inverse association between circulating vitamin D and MD, no studies have investigated this association among Mexican women. We examined whether serum 25-hydroxyvitamin D3 [25(OH)D3] levels were associated with MD in a cross-sectional study nested within the large Mexican Teacher's Cohort. This study included 491 premenopausal women with a mean age of 42.9 years. Serum 25(OH)D3 levels were measured by liquid chromatography/tandem mass spectrometry. Linear regression and non-linear adjusted models were used to estimate the association of MD with serum 25(OH)D3. Median serum 25(OH)D3 level was 27.3 (23.3-32.8) (ng/ml). Forty one (8%) women had 25(OH)D3 levels in the deficient range (< 20 ng/ml). Body mass index (BMI) and total physical activity were significantly correlated with 25(OH)D3 (r = -0.109, P = 0.019 and r = 0.095, P = 0.003, respectively). In the multivariable linear regression, no significant association was observed between 25(OH)D3 levels and MD overall. However, in stratified analyses, higher serum 25(OH)D3 levels (≥27.3 ng/ml) were significantly inversely associated with percent MD among women with BMI below the median (β = -0.52, P = 0.047). Although no significant association was observed between serum 25(OH)D3 and percent MD in the overall population, specific subgroups of women may benefit from higher serum 25(OH)D3 levels.
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Affiliation(s)
- Amina Amadou
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Nada Assi
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Martin Lajous
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States of America
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Elsa Yunes
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Ruy Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Gabriela Torres-Mejia
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
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Monge A, Harris WS, Ortiz-Panozo E, Yunes E, Cantu-Brito C, Catzin-Kuhlmann A, López-Ridaura R, Lajous M. Whole Blood ω-3 Fatty Acids Are Inversely Associated with Carotid Intima-Media Thickness in Indigenous Mexican Women. J Nutr 2016; 146:1365-72. [PMID: 27281801 DOI: 10.3945/jn.115.227264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/25/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs) may reduce the risk of atherosclerosis. The association between n-3 PUFAs and cardiovascular disease may vary across different populations, and there is limited information on Hispanic individuals with mixed Amerindian and European origin. OBJECTIVE We evaluated the cross-sectional relations between whole blood n-3 PUFAs and carotid intima-media thickness (IMT) in Mexican women living in Mexico and assessed whether this relation was different in women who spoke an indigenous language compared with women who did not. METHODS In 2012-2013, we assessed the association between blood n-3 PUFAs and IMT in 1306 women free of disease in Chiapas and Yucatan, Mexico. We categorized blood n-3 PUFAs (% of total FAs) in quartiles and adjusted linear regression models by age, indigenous language, site, socioeconomic status, education, smoking, menopause, diabetes, hypertension, hypercholesterolemia, body mass index, physical activity, and diet. We stratified analyses by indigenous/nonindigenous language speakers (n = 315 of 991). RESULTS Whole blood n-3 PUFAs (means ± SDs) were 3.58% ± 0.78% of total FAs. We did not observe a significant association between n-3 PUFAs and IMT in the overall study population. However, the adjusted mean difference of IMT was -6.5% (95% CI: -10.7%, -2.3%; P-trend < 0.0001) for indigenous women in the highest quartile compared with the lowest quartile of blood n-3 PUFAs. In nonindigenous women, we did not observe an association (-0.6%; 95% CI: -3.0%, 1.8%, comparing extreme quartiles; P-trend = 1.00). CONCLUSIONS Overall, circulating n-3 PUFAs were not associated with IMT. However, we observed a strong statistically significant inverse association with IMT in indigenous Mexican women. Future studies should evaluate genetic markers that may reflect differences in n-3 PUFA metabolism across populations.
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Affiliation(s)
- Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - William S Harris
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD; OmegaQuant Analytics, LLC, Sioux Falls, SD
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Elsa Yunes
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Carlos Cantu-Brito
- National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; and
| | | | - Ruy López-Ridaura
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Martín Lajous
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
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10
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Romieu I, Amadou A, Rinaldi S, Fedirko V, Biessy C, Lajous M, Yunes E, Lopez‐Ridaura R, Torres Mejia G, Ortiz‐Panozo E. Serum 25−Hydroxyvitamin D3 ((25(OH)D3) and Mammography Density Among Mexican Women. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.906.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Isabelle Romieu
- Nutrition and Metabolism SectionInternational Agency for Research on CancerLyonFrance
| | - Amina Amadou
- Nutrition and Metabolism SectionInternational Agency for Research on CancerLyonFrance
| | - Sabina Rinaldi
- Nutrition and Metabolism SectionInternational Agency for Research on CancerLyonFrance
| | - Veronika Fedirko
- Department of Epidemiology Emory UniversityAtlantaGAUnited States
| | - Carine Biessy
- Nutrition and Metabolism SectionInternational Agency for Research on CancerLyonFrance
| | - Martin Lajous
- Center for Research on Population Health National Institute of Public HealthMexico CityMexico
| | - Elsa Yunes
- Center for Research on Population Health National Institute of Public HealthMexico CityMexico
| | - Ruy Lopez‐Ridaura
- Center for Research on Population Health National Institute of Public HealthMexico CityMexico
| | - Gabriela Torres Mejia
- Center for Research on Population Health National Institute of Public HealthMexico CityMexico
| | - Eduardo Ortiz‐Panozo
- Center for Research on Population Health National Institute of Public HealthMexico CityMexico
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11
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Rinaldi S, Biessy C, de la Luz Hernandez M, Lajous M, Ortiz-Panozo E, Yunes E, Lopez-Ridaura R, Torres-Mejia G, Romieu I. Endogenous hormones, inflammation, and body size in premenopausal Mexican women: results from the Mexican Teachers' Cohort (MTC, ESMaestras). Cancer Causes Control 2015; 26:475-86. [PMID: 25665532 DOI: 10.1007/s10552-015-0527-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE Obesity is a major risk factor for several cancers, including female cancers. Endogenous hormones and inflammatory factors may mediate the association between anthropometric measures and cancer risk, although these associations have been studied mainly in Caucasians. The aim of the current study was to explore the association of circulating hormones, adipokines, and inflammatory factors with obesity and overweight in premenopausal Mexican women. METHODS We conducted a cross-sectional analysis of 504 premenopausal women from the large Mexican Teachers' Cohort (MTC, ESMaestras) study to determine the association of insulin-like growth factor I (IGF-I), its major circulating binding protein (IGFBP-3), leptin, adiponectin, C-peptide, and C-reactive protein with comprehensive measures of body size. Biomarkers were measured by immunoassays. Multivariate regression analyses were performed to compare geometric mean biomarker concentrations with measured markers of body size and adiposity. RESULTS Mean IGF-I and IGFBP-3 concentrations significantly increased with increasing height and leg length. Concentrations of IGF-I, adiponectin, and the IGF-I/IGFBP-3 ratio strongly decreased with increasing BMI, weight, waist and hip circumferences, waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), while CRP, leptin, C-peptide concentrations, and the leptin/adiponectin ratio strongly increased. Adiponectin and the leptin/adiponectin ratio remained significantly related to measures of central adiposity (waist circumference, WHpR, and WHtR) after adjustment by body mass index. CONCLUSIONS The results of our study suggest a strong relation between biomarkers and body size in this study population and suggest that different fat depots may have different metabolic properties.
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Affiliation(s)
- Sabina Rinaldi
- International Agency for Research on Cancer (IARC), Lyon, France
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12
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Salmerón J, Lazcano-Ponce E, Lorincz A, Hernández M, Hernández P, Leyva A, Uribe M, Manzanares H, Antunez A, Carmona E, Ronnett BM, Sherman ME, Bishai D, Ferris D, Flores Y, Yunes E, Shah KV. Comparison of HPV-based assays with Papanicolaou smears for cervical cancer screening in Morelos State, Mexico. Cancer Causes Control 2003; 14:505-12. [PMID: 12948281 DOI: 10.1023/a:1024806707399] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare the performance of human papillomavirus (HPV) assays with conventional Pap cytology for cervical cancer (CC) screening in Mexico. METHODS Pap smears, self-collected vaginal specimens (SS) for HPV testing, and clinician-collected cervical specimens (CS) for HPV testing were obtained from 7868 women, aged 15-85 years old, attending CC screening at the Mexican Institute of Social Security (IMSS) between May and October, 1999. SS and CS specimens were screened for oncogenic HPV DNA by Hybrid Capture 2. Women who received cytological interpretations of atypical squamous cells of undetermined significance (ASCUS), and/or a positive HPV test were referred for colposcopy and histologic studies. The relative estimates for sensitivity, specificity and predictive values of each test were calculated using histological diagnoses of cervical intraepithelial neoplasia (CIN) grades 2 or 3, or CC histological diagnosis. RESULTS Oncogenic HPV detection rate was 11.6% for SS, and 9.3% for CS. Pap smear abnormalities were observed in 2.4% of the women. Of 1147 women who had at least one abnormal test result, 88.5% underwent colposcopy, and 101 biopsy-confirmed CIN2/3 or cancer cases were identified. The relative sensitivity estimates for the Pap test, SS and CS were 59.4% (95% CI: 49.2-68.9), 71.3% (95% CI: 61.3-79.6), and 93.1% (95% CI: 85.8-96.9), respectively, while the specificities were 98.3% (95% CI: 98.0-98.6), 89.2% (95% CI: 88.5-89.9), and 91.8% (95% CI: 91.2-92.4), respectively. The positive predictive values of Pap, SS and CS were 36.1, 9.1 and 14.9, the colposcopy referrals needed to detect a case of CIN2/3 or cancer were 2.8, 11.0 and 6.7, respectively. DISCUSSION Both HPV assays detected more cases of CIN2/3 or CC than Pap cytology alone. However, the HPV assays increased the number of colposcopy referrals. Our study suggests that HPV testing could be an effective way to improve the performance of CC screening.
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Affiliation(s)
- Jorge Salmerón
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Morelos, México.
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13
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Berumen J, Ordoñez RM, Lazcano E, Salmeron J, Galvan SC, Estrada RA, Yunes E, Garcia-Carranca A, Gonzalez-Lira G, Madrigal-de la Campa A. Asian-American variants of human papillomavirus 16 and risk for cervical cancer: a case-control study. J Natl Cancer Inst 2001; 93:1325-30. [PMID: 11535707 DOI: 10.1093/jnci/93.17.1325] [Citation(s) in RCA: 211] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Human papillomavirus 16 (HPV16) has a number of variants, each with a different geographic distribution and some that are associated more often with invasive neoplasias. We investigated whether the high incidence of cervical cancer in Mexico (50 cases per 100 000 women) may be associated with a high prevalence of oncogenic HPV16 variants. METHODS Cervical samples were collected from 181 case patients with cervical cancer and from 181 age-matched control subjects, all from Mexico City. HPV16 was detected with an E6/E7 gene-specific polymerase chain reaction, and variant HPV classes and subclasses were identified by sequencing regions of the E6 and L1/MY genes. Clinical data and data on tumor characteristics were also collected. All statistical tests were two-sided. RESULTS HPV16 was detected in cervical scrapes from 50.8% (92 of 181) of case patients and from 11% (20 of 181) of control subjects. All HPV16-positive samples, except one, contained European (E) or Asian-American (AA) variants. AA and E variants were found statistically significantly more often in case patients (AA = 23.2% [42 of 181]; E = 27.1% [49 of 181]) than in control subjects (AA = 1.1% [two of 181]; E = 10% [18 of 181]) (P<.001 for case versus control subjects for either E or AA variants, chi2 test). However, the frequency of AA variants was 21 times higher in cancer patients than in control subjects, whereas that ratio for E variants was only 2.7 (P =.006, chi2 test). The odds ratio (OR) for cervical cancer associated with AA variants (OR = 27.0; 95% confidence interval [CI] = 6.4 to 113.7) was higher than that associated with E variants (OR = 3.4; 95% CI = 1.9 to 6.0). AA-positive case patients (46.2 +/- 12.5 years [mean +/- standard deviation]) were 7.7 years younger than E-positive case patients (53.9 +/- 12.2 years) (P =.004, Student's t test). AA variants were associated with squamous cell carcinomas and adenocarcinomas, but E variants were associated with only squamous cell carcinomas (P =.014, Fisher's exact test). CONCLUSIONS The high frequency of HPV16 AA variants, which appear to be more oncogenic than E variants, might contribute to the high incidence of cervical cancer in Mexico.
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Affiliation(s)
- J Berumen
- Laboratorio Multidisciplinario de Investigación, Escuela Militar de Graduados de Sanidad y Escuela Médico Militar, Universidad del Ejército y Fuerza Aérea, México D.F.
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