Dyslipidemia, Obesity, and Ethnicity in Mexican Children

In Mexico, the genetic mechanisms underlying childhood obesity are poorly known. We evaluated the effect of loci, known to be associated with childhood body mass index (BMI) in Europeans, in Mexican children from different ethnic groups. We performed linear and logistic analyses of BMI and obesity, respectively, in Mestizos and Amerindians (Seris, Yaquis and Nahuatl speakers) from Northern (n = 369) and Central Mexico (n = 8545). We used linear models to understand the effect of degree of Amerindian ancestry (AMA) and genetic risk score (GRS) on BMI z-score. Northern Mexican Mestizos showed the highest overweight-obesity prevalence (47.4%), followed by Seri (36.2%) and Central Mexican (31.5%) children. Eleven loci (SEC16B/rs543874, OLFM4/rs12429545/rs9568856, FTO/rs9939609, MC4R/rs6567160, GNPDA2/rs13130484, FAIM2/rs7132908, FAM120AOS/rs944990, LMX1B/rs3829849, ADAM23/rs13387838, HOXB5/rs9299) were associated with BMI and seven (SEC16B/rs543874, OLFM4/rs12429545/rs9568856, FTO/rs9939609, MC4R/rs6567160, GNPDA2 rs13130484, LMX1B/rs3829849) were associated with obesity in Central Mexican children. One SNP was associated with obesity in Northern Mexicans and Yaquis (SEC16B/rs543874). We found higher BMI z-score at higher GRS (β = 0.11, p = 0.2 × 10−16) and at lower AMA (β = −0.05, p = 6.8 × 10−7). The GRS interacts with AMA to increase BMI (β = 0.03, p = 6.08 × 10−3). High genetic BMI susceptibility increase the risk of higher BMI, including in Amerindian children.

This report was derived from a workshop on cardiovascular risk assessment sponsored by the National Heart, Lung, and Blood Institute, which addressed whether risk equations developed in the Framingham Heart Study (FHS) for predicting new-onset coronary heart disease (CHD) apply to diverse population groups. Preparation for the workshop included a reanalysis and comparison of prospective studies in several different populations in which risk factors were related to cardiovascular outcomes. Some studies included fatal and nonfatal CHD end points, whereas others contained only CHD mortality. Extensive collaboration provided as much uniformity as possible with respect to both risk factors and CHD end points. The FHS has led in defining the quantitative impact of risk factors.1 Many potential risk factors were measured and related to cardiovascular outcomes. Several risk factors proved to be strong, largely independent predictors of cardiovascular disease (CVD). These factors—advancing age, cigarette smoking, blood pressure (particularly systolic), cholesterol in total serum and HDL, and diabetes—served as the basis for the development of risk prediction equations.1 If FHS risk estimates are to be widely used, they must apply widely in the US population. To document their transportability, they must be compared with prospective studies in other populations. Although the FHS is the longest running prospective study, there are other major studies. The cardiovascular end points of these other studies have varied. Some include cardiovascular morbidity and mortality; others have only cardiovascular mortality. Among the end points, CHD is the most extensively reported; for this reason, CHD was the primary focus of the workshop. ### Multivariate Relative Risk Comparisons In preparation for the workshop, multivariate regression coefficients for each risk factor were compared in different populations with those of the FHS. Adjusted relative risk estimates make it possible to determine whether each independent risk factor confers a similar or different relative risk among different …

BackgroundThere is an increasing global interest in the role of Japanese diet as a possible explanation for the nation’s healthy diet, which contributes to the world’s highest life-expectancy enjoyed in Japan. However, nationwide studies on current food intake status among general Japanese population have not been established yet. This study examined the association between food intake patterns and cardiovascular risk factors (CVRF) such as waist circumference (WC), body mass index (BMI), blood pressure (SBP, DBP), HbA1c and blood lipid profiles among general Japanese adults.MethodsDe-identified data on the Japan National Health and Nutrition Survey (NHNS) 2012 with a total of 11,365 subjects aged 20–84 years were applied. Food intake patterns were derived by principal component analysis (PCA) based on 98 food groups. Generalized linear regression analysis was used to assess the relation between the food intake patterns and CVRF.ResultsWe identified three food intake patterns: traditional Japanese, Westernized, and meat and fat patterns. Traditional Japanese pattern was significantly related to high WC and BMI in men, and high DBP in women. Westernized pattern was associated with lower SBP, but high total cholesterol and LDL cholesterol in both men and women. Meat and fat pattern was associated with high WC, high BMI, high blood pressure and blood lipid profiles in both men and women (trend P < 0.001).ConclusionThe significant association between cardiovascular disease risks and three food intake patterns derived from the NHNS, showed a similar tendency to other dietary survey methods.

Obesity Is Associated With Family History of ESRD in Incident Dialysis Patients

POS1527 EFFECTS OF APREMILAST ON CHANGES IN CARDIOMETABOLIC PARAMETERS BY DIABETES AND OBESITY STATUS IN PATIENTS WITH PSORIATIC ARTHRITIS

Notes on the origin of extensive endorheic regions in central and northern Mexico, and some implications for paleozoogeography

O verweight and obesity have become increasingly com- mon; worldwide, at least 1.1 billion adults are overweight and 312 million are obese, when overweight and obesity are defined conventionally as having a body mass index (BMI) of Ͼ25 kg/m 2 and Ͼ30 kg/m 2 , respectively. 1,2In the general population, overweight and obesity are associated with increased risk of developing cardiovascular disease, 3,4 and thus it is not surprising that in cohorts of patients with prevalent ischemic heart disease or acute coronary events, well over 50% are overweight or obese. 5,6Despite the association between obesity and cardiovascular risk in the general population, a multitude of studies have described an inverse correlation between BMI and mortality in patients with coronary artery disease (CAD), including post-coronary revascularization patients and those with acute myocardial infarction (MI); the association between elevated BMI and improved survival has been termed the obesity paradox. 7,8 Article p 482In this issue of Circulation, Zeller et al 9 further investigate the obesity paradox in a cohort of 2229 consecutive patients presenting with acute MI in the Côte d'Or region of France.In assessing the impact of obesity on mortality after MI, the group uses both BMI, a traditional index of obesity, as well as waist circumference, an alternate anthropometric index that is more specific for abdominal obesity.Approximately one-half of the subjects in the study were overweight (BMI 25 to 29.9 kg/m 2 ), one-quarter were obese (BMI Ͼ30 kg/m 2 ) and onehalf had increased waist circumference, which was defined as Ͼ102 cm in men and Ͼ88 cm in women.Left ventricular ejection fraction, type of MI, and acute treatment strategy did not generally differ by BMI or waist circumference values.Of note, BMI was inversely correlated with age and plasma N-terminal pro B-type natriuretic peptide, whereas waist circumference was positively correlated with age and did not correlate with N-terminal pro B-type natriuretic peptide.Consistent with prior studies, survival analysis showed that the risk of death decreased with increasing BMI tertile.In a waist-matched analysis of 832 subjects, BMI was a signifi-

Introduction: It is recognized that people with a high body mass index (BMI) will have a high risk of developing diabetes. However, some studies showed that other indices may provide a more accurate insight into the risk of developing diabetes. Our study aimed to compare the predictive abilities of 5 anthropometric measurements [BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-by-height0.5 (WHT.5R), and a body shape index (ABSI)] for diabetes. Hypothesis: WHtR may be most strongly associated with diabetes. High WHtR but normal BMI persons may have higher risk for developing diabetes than persons with high BMI but normal WHtR. Methods: From the UK Whitehall II cohort, we included participants with full records of weight, height, and WC in Phase 3 (1991-1994) for baseline survey, and carried out follow-up survey in Phase 9 (2007-2009) for the non-diabetics of the baseline survey. Our study indices, BMI, WC, WHtR, WHT.5R, and ABSI, were calculated from measured weight, height, or WC. Based on the recognized cut-off value of BMI, WC, and WHtR, we classified the persons into normal group (BMI: &lt;25 kg/m 2 ; WC: &lt;90 cm for men and &lt;80 cm for women; WHtR: &lt;0.5) and abnormal group (≥ corresponding cut-off value). For the indices (WHT.5R and ABSI) without an accepted cut-off value, we selected the 75th cohort-wide centile as the cut point to divide the participants into normal group (WHT.5R &lt;75th cohort-wide centile; ABSI &lt;75th cohort-wide centile) and abnormal group (≥ corresponding cut-off value). Subgroup analyses were based on combination of BMI and WHtR (normal BMI + normal WHtR; high BMI + normal WHtR; normal BMI + high WHtR; high BMI + high WHtR). The outcome is diabetes. We studied predictive value of the indices to diabetes by receiver operator characteristic (ROC) curve analysis at baseline survey, and evaluated the association between the indices and diabetes by Cox regression analysis at follow-up survey. Results: A total of 7979 participants were included at baseline survey [mean age: 50.1 ± 6.0 years; 2468 (30.9%) females], and there were 7488 non-diabetics available for the follow-up survey. At baseline survey, ABSI [areas under the curve (AUC): 0.711, sensitivity: 77.0%, specificity: 55.5%] and WHtR (AUC: 0.709, sensitivity: 67.2%, specificity: 65.6%) had top 2 predictive value of diabetes. At follow-up survey, the abnormal group divided by cut-off value of WHtR had the highest hazard ratio (HR) (2.46; 95% CI: 2.06-2.93), while the abnormal group classified by ABSI cut-off value had the lowest HR (1.77; 95% CI: 1.45-2.15). In subgroup analyses, “normal BMI + high WHtR” group (HR: 2.28; 95% CI: 1.59-3.27) appears to have higher risk for developing diabetes than “high BMI + normal WHtR” group (HR: 1.63; 95% CI: 1.22-2.17). Conclusion: WHtR seems to be an effective indicator for predicting diabetes. Besides BMI, controlling WHtR to the normal range is important for the prevention of diabetes.

To the Editor: I would like to extend the comments of Sattar et al1 on the metabolic syndrome and its relationship to diabetes mellitus. In data presented at the American Academy of Family Physicians Annual Scientific Assembly (1999) and at the 2001 Drugs Affecting Lipid Metabolism symposium, I noted that the incidence of diabetes in patients with combined low HDL cholesterol and elevated triglycerides (TG) was 45% and the incidence of impaired glucose tolerance was 18%. (The data presented were a proposed classification of lipid disorders based on LDL and HDL cholesterol, stratified by TG). This group contained the highest number of patients with impaired glucose tolerance/diabetes of any of the possible LDL, HDL, and TG combinations—ie, high LDL, normal HDL, and low TG versus normal LDL, normal HDL, and …

The potential effects of opium consumption on lipid profile remain unquantified. We considered the association between opium use and dyslipidemia. In this cross-sectional study, we used data obtained from the Rafsanjan cohort study, as a part of the prospective epidemiological research studies in IrAN (PERSIAN) with detailed and validated data on opium consumption and selected other exposures. A total of 9932 adults were included in the study. Logistic regression models were used to assess the relationships of opium consumption with the prevalence of dyslipidemia and lipid disorders. In this population, 73.33% had dyslipidemia and the prevalence rates of high TC, high TG, high LDL and low HDL were 54.24%, 47.45%, 34.43% and 11.91% respectively. After adjustment for all confounders, opium users compared with non-users had lower odds ratios (OR) of high TC and high LDL [0.81 (95% confidence interval, CI 0.71–0.92) and 0.80 (95% CI 0.69–0.93) respectively] and greater OR of low HDL [1.30 (95% CI 1.04–1.62)]. Longer duration of opium consumption resulted in lower ORs of high TC, 0.68 (95% CI 0.55–0.84) and high LDL, 0.82 (95% CI 0.67–0.99), and shorter duration of opium consumption resulted in increased odds of low HDL, 1.30 (95% CI 1.02–1.66). High dose of opium consumption was associated with an OR of dyslipidemia of 0.80 (95% CI 0.65–0.97), high TC of 0.80 (95% CI 0.67–0.95), and high LDL of 0.78 (95% CI 0.64–0.96) and low dose of opium consumption, with an OR of low HDL of 1.30 (95% CI 1.02–1.65). In relation to route of consumption, opium smoking was a risk factor for low HDL with an adjusted odds ratio of 1.31 (1.04–1.63). Opium use was associated with selected changes on serum lipid levels, but opium users had higher frequency of cardiovascular disease history.

The study investigated age, ethnic, and sex disparities in body mass index (BMI) and waist circumference (WC) in South Korea and the United States. We conducted a bi-national large-scale study and analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the National Health and Nutrition Examination Survey in the United States (NHANES). The study found significant differences in BMI and WC between the two countries, as well as within each country based on age, ethnic, and sex groups. In both countries, men had higher BMIs and WCs than women. Among ethnic groups in the United States, non-Hispanic Black individuals had the highest BMIs and WCs, while Mexican American individuals had the highest BMIs and WCs in the South Korean population. The study also found that age was associated with higher BMIs and WCs in both countries, with the highest BMI and WC observed in the 60-69 age group in both South Korea and the United States. Additionally, the study revealed that the prevalence of obesity was higher in the United States than in South Korea, while abdominal obesity was more prevalent in South Korea than in the United States. Overall, the study suggests that there are significant differences in BMI and WC across age, ethnic, and sex groups in both South Korea and the United States, highlighting the importance of considering these factors in efforts to prevent and address obesity and its associated health risks.

There is a growing number of studies that use historical sources to reconstruct recent environmental change. In Mexico there are abundant sources of information that can be used to determine variations in the climate over the historical period. In this paper we draw together information from a variety of primary and secondary historical sources to reconstruct fluctuations in the climate of central Mexico over the last 600 years. The Aztecs are believed to have entered the Basin of Mexico during a period of severe drought. Wet conditions, however, characterized much of the Aztec (AD 1345-1521) and early colonial period prior to a return to drier conditions in the 1640s. Between 1640 and 1915, a series of severe droughts caused widespread devastation throughout central Mexico, particularly during the mid- to late 1700s and late 1800s. Since the early 1900s this region has experienced slightly wetter conditions. The climatic record from the Basin of Mexico is compared with proxy climatic data from two other areas in Mexico: a detailed lake-level curve from Lake Patzcuaro in central Mexico and the few tree-ring records from northern Mexico. Although the palaeoclimatic records from central Mexico are similar, there is greater divergence between the records from central and northern Mexico. In general, fluctuations in the climate over the last 600 years can be explained by changes in the relative strength of the summer 'monsoon', but it is possible that ENSO events can cause considerable differences in prevailing climate conditions in the northern and central parts of the country.

Our aim was to evaluate liver transplant outcomes involving donors with high macrosteatosis grafts in the obese modern liver transplant recipient population. A high-steatosis graft was defined as donor graft macrosteatosis ≥30% on biopsy. Recipient obesity was defined as body mass index (BMI) >35 adjusted for ascites. Raw and adjusted recipient liver transplant survival were evaluated and compared between 4 cohorts: (1) high-steatosis graft in high-BMI recipient; (2) low-steatosis graft in high-BMI recipient; (3) high-steatosis graft in normal-BMI recipient; and (4) low-steatosis graft in normal-BMI recipient. After adjustment for multiple factors, recipient high-BMI remained an independent predictor of posttransplant mortality at 30 days (P < 0.0001) and persisted at 1 year (P = 0.009). A high-steatosis graft was the strongest independent predictor of mortality at 30 days (hazard ratio 2.05, 1.66-2.53; P < 0.0001) and that effect was diminished but persistent at 1 year (1.27, 1.10-1.46; P = 0.001). Recipient high-BMI and a high-steatosis graft are both significant independent and equally powerful predictors of mortality after modern liver transplant. High-steatosis grafts transplanted into obese recipients have the highest mortality. The increase in mortality associated with a high-steatosis graft into a normal-BMI recipient is similar in magnitude to a low-steatosis graft placed into a high-BMI recipient.

The influence of body mass index (BMI) on pregnancy rates and outcomes among infertile Japanese women

Objective To investigate the prevalence of dyslipidemia and associated risk factors in adult She nationality population in Fujian Province. Methods Total of 4 838 adults selected from urban and rural areas of Ningde(Tongcheng Subdistrict in Fuding City, Qianqi Town, Shacheng Town), Fujian Province from April 2009 to September 2009 by multi-stage stratified sampling, completed the survey and physical measurements. The height, weight, blood pressure and serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol(LDL-C), triglycerides were detected and analyzed by chi-square test and multivariate logistic regression analysis among the different groups. Results The overall prevalence of dyslipidemia was 26.6%, the prevalence of dyslipidemia was higher in males than that in females (30.0%(617/2 057) vs 24.0%(667/2 781), χ2=21.91, P<0.05). The prevalence of high total cholesterol(TC), high LDC-C, low HDL-C and hypertriglyceridemia were 10.1%(488/4 838), 12.6%(609/4 838), 5.2%(252/4 838) and 11.4%(551/4 838), respectively. The prevalence of dyslipidemia increased with age (χ2=30.89, P<0.05) and was associated with sex, body mass index, fasting glucose and blood pressure(OR=0.656, 1.146, 1.059, 1.457, respectively , all P<0.05). Conclusion Dyslipidemia is a major public health problem in She population. Steps must be taken to prevent and treat dyslipidemia in She population. Key words: She ethnic minority; Dyslipidemia; Prevalence; Risk factors