Adult Cardiometabolic Disease Research Articles

Location Matters: The Role of the Neighborhood Environment for Incident Cardiometabolic Disease in Adults Aging With Physical Disability.

People aging with disability may be limited in their ability to engage in healthy behaviors to maintain cardiometabolic health. We investigated the role of health promoting features in the neighborhood environment for incident cardiometabolic disease in adults aging with physical disability in the United States. Retrospective cohort study. Optum's Clinformatics® Data Mart Database (2007-2018) of administrative health claims. ICD-9-CM codes were used to identify 15467 individuals with a diagnosis of Cerebral Palsy, Spina Bifida, Multiple Sclerosis, or Spinal Cord Injury. Cardiometabolic disease was identified using ICD-9-CM/ICD-10-CM codes over 3 years of follow-up. Measures of the neighborhood environment came from the National Neighborhood Data Archive and linked to individual residential ZIP codes over time. Covariates included age, sex, and comorbid health conditions. Cox regression models estimated hazard ratios (HR) for incident cardiometabolic disease. Using a 1-year lookback period, individuals with pre-existing cardiometabolic disease were excluded from the analysis. Net of individual risk factors, residing in neighborhoods with a greater density of broadband Internet connections (HR = .88, 95% CI: .81, .97), public transit stops (HR = .89, 95% CI: .83, .95), recreational establishments (HR = .89, 95% CI: .83, .96), and parks (HR = .88, 95% CI: .82, .94), was associated with reduced risk of 3-year incident cardiometabolic disease. Findings identify health-promoting resources that may mitigate health disparities in adults aging with disability.

The impact of age-specific childhood body-mass index on adult cardiometabolic traits: a Mendelian randomization study.

To evaluate the causal relationship between childhood body-mass index (BMI) at different ages and adult cardiometabolic traits. We retrieved genetic instrument variables (IVs) for exposures (standardized BMI at newborn, infant, toddler and late childhood), cardiometabolic traits and potential confounders or mediators (adult BMI, SHBG, testosterone and age at menarche) from the corresponding genome-wide association analysis. We performed univariate and multivariable Mendelian randomization (MR) to dissect associations between age-specific childhood BMI and adult cardiometabolic outcomes. Odds ratio was used to present the direction of the causal association. In univariate MR, higher newborn BMI was causally associated with reduced risk for type 2 diabetes in women. Late childhood BMI was associated with increased risk for female diabetes and coronary artery disease (CAD), myocardial infarction (MI), and chronic kidney disease (CKD) in general population. Among these associations, only association between late childhood BMI with MI remained significant after adjusting for adult male BMI and sex hormones, (OR = 1.120, 95% CI 1.023-1.226, p = 0.014). Besides, in multivariable MR, we found evidence for causal association between newborn BMI with reduced risk for CAD (OR = 0.862, 95% CI 0.751-0.989, p = 0.034) and MI (OR = 0.864, 95% CI 0.752-0.991, p = 0.037) in men. No obvious impact of infant or toddler BMI was identified on the above-mentioned diseases. For continuous cardiometabolic traits, in all age epochs except infant, higher BMI was associated with increased level of fasting glucose in women. BMI at birth and late childhood exerts different impact on adult cardiometabolic diseases, while BMI at infant and toddler ages is not causally associated with these outcomes. The effect of childhood BMI may be influenced by sex disparities.

Wakabayashi & Daimon cardiometabolic index as an indicator to assess risk in adults. A systematic review

ObjectiveTo analyze the Wakabayashi & Daimon (2015) equation, as a predictive indicator of cardiometabolic diseases and its comparison with other indices. DesignA systematic review was carried out between January and March 2023, according to the PRISMA statement. Data sourceScopus, Web of Science, and PubMed databases were reviewed using “cardiometabolic index” (CMI) as the search term. Study selectionThe following inclusion criteria were determined: studies in adults with cardiometabolic diseases using the Wakabayashi & Daimon (2015) CMI formula in different populations; studies that validate or compare the equation or that demonstrate the effects of the intervention. Data extractionOf the 11 selected articles, the characteristics of the population, type of study, indicators for the validation of the CMI, the reported statistics and the conclusions that were recorded in a comparative table were obtained. Results and conclusionsOdds ratio, hazard ratio, sensitivity, and specificity were used to assess associations, risk, effectiveness, and validity of the tests, indicating favorable relationships between the factors analyzed and the results obtained. Validation and probabilistic analysis of the CMI were performed against diverse diseases such as obesity [Man >60y=AUC=0.90 (0.75–1.00) (p=0.01), Se=100, Sp=81.8, YI=0.82 and OR 4.66 and Women >60y=AUC=0.95 (0.88–1.00), p=0.001, Se=90.0, Sp=100, YI=0.90 and OR=36.27]; cardiovascular diseases [AUC=0.617, Se=0.675, Sp=0.509; HR=1.48 (1.33, 1.65), p=<0.001], among others. In conclusion CMI is a new utility index that broadly identifies the presence of risk that leads to cardiometabolic diseases in adults.

Vitamin D levels and lipid profile in children and adolescents: a tight correlation.

Vitamin D is an essential hormone for humans, playing an important role in musculoskeletal and calcium homeostasis. Its deficiency/insufficiency seems to contribute to the development of cardiometabolic diseases in adults: this correlation appears less clear for children and adolescents. The aim of this paper was to review literature data on the relationship between vitamin D and lipid profile alterations in pediatric population. We carried out a comprehensive research in electronic databases, including MEDLINE and PubMed up to December 2022, for cross-sectional or prospective studies that investigated the correlation between serum vitamin D levels and lipid profile in children and adolescents. At the end of the process, 37 articles were included in this review. According to our findings, vitamin D deficiency/insufficiency is strongly associated with lower high-density lipoprotein (HDL) cholesterol levels and higher levels of triglycerides and total cholesterol. Data about low-density lipoproteins (LDL) cholesterol are inconsistent. The potential role of vitamin D supplements for the prevention of cardiometabolic disease currently remains a speculation. An increasing number of studies shows how hypovitaminosis D in the pediatric age may play a role in the pathogenesis of metabolic disorders and lipid profile alterations. Data regarding the potential role of vitamin D supplements for the prevention of cardiometabolic disease are currently controversial. Further studies are needed to evaluate the causality of this association and to assess the underlying pathogenetic mechanisms.

Effects of wholegrain compared to refined grain Intake on cardiometabolic risk markers, gut microbiota and gastrointestinal symptoms in children: A randomized crossover trial

BackgroundWholegrain intake is associated with lower risk of cardiometabolic diseases in adults, potentially via changes in the gut microbiota. Although cardiometabolic prevention should start early, we lack evidence on the effects in children. ObjectivesThis study investigated the effects of wholegrain oats and rye intake on serum low-density lipoprotein (LDL) cholesterol and plasma insulin (coprimary outcomes), other cardiometabolic markers, body composition, gut microbiota composition and metabolites, and gastrointestinal symptoms in children with high body mass index (BMI). MethodsIn a randomized crossover trial, 55 healthy Danish 8- to 13-y-olds received wholegrain oats and rye (“WG”) or refined grain (“RG”) products ad libitum for 8 wk in random order. At 0, 8, and 16 wk, we measured anthropometry, body composition by dual-energy absorptiometry, and blood pressure. Fasting blood and fecal samples were collected for analysis of blood lipids, glucose homeostasis markers, gut microbiota, and short-chain fatty acids. Gut symptoms and stool characteristics were determined by questionnaires. Diet was assessed by 4-d dietary records and compliance by plasma alkylresorcinols (ARs). ResultsFifty-two children (95%) with a BMI z-score of 1.5 ± 0.6 (mean ± standard deviation) completed the study. They consumed 108 ± 38 and 3 ± 2 g/d wholegrain in the WG and RG period, which was verified by a profound difference in ARs (P < 0.001). Compared with RG, WG reduced LDL cholesterol by 0.14 (95% confidence interval: −0.24, −0.04) mmol/L (P = 0.009) and reduced total:high-density lipoprotein cholesterol (P < 0.001) and triacylglycerol (P = 0.048) without altering body composition or other cardiometabolic markers. WG also modulated the abundance of specific bacterial taxa, increased plasma acetate, propionate, and butyrate and fecal butyrate and reduced fatigue with no other effects on gut symptoms. ConclusionHigh intake of wholegrain oats and rye reduced LDL cholesterol and triacylglycerol, modulated bacterial taxa, and increased beneficial metabolites in children. This supports recommendations of exchanging refined grain with wholegrain oats and rye among children.This trial was registered at clinicaltrials.gov as NCT04430465.

ADHD Remote Technology study of cardiometabolic risk factors and medication adherence (ART-CARMA): a multi-centre prospective cohort study protocol

BackgroundEmerging evidence points at substantial comorbidity between adult attention deficit hyperactivity disorder (ADHD) and cardiometabolic diseases, but our understanding of the comorbidity and how to manage cardiometabolic disease in adults with ADHD is limited. The ADHD Remote Technology study of cardiometabolic risk factors and medication adherence (ART-CARMA) project uses remote measurement technology to obtain real-world data from daily life to assess the extent to which ADHD medication treatment and physical activity, individually and jointly, may influence cardiometabolic risks in adults with ADHD. Our second main aim is to obtain valuable real-world data on adherence to pharmacological treatment and its predictors and correlates during daily life from adults with ADHD.MethodsART-CARMA is a multi-site prospective cohort study within the EU-funded collaboration ‘TIMESPAN’ (Management of chronic cardiometabolic disease and treatment discontinuity in adult ADHD patients) that will recruit 300 adults from adult ADHD waiting lists. The participants will be monitored remotely over a period of 12 months that starts from pre-treatment initiation. Passive monitoring, which involves the participants wearing a wrist-worn device (EmbracePlus) and downloading the RADAR-base Passive App and the Empatica Care App on their smartphone, provides ongoing data collection on a wide range of variables, such as physical activity, sleep, pulse rate (PR) and pulse rate variability (PRV), systolic peaks, electrodermal activity (EDA), oxygen saturation (SpO2), peripheral temperature, smartphone usage including social connectivity, and the environment (e.g. ambient noise, light levels, relative location). By combining data across these variables measured, processes such as physical activity, sleep, autonomic arousal, and indicators of cardiovascular health can be captured. Active remote monitoring involves the participant completing tasks using a smartphone app (such as completing clinical questionnaires or speech tasks), measuring their blood pressure and weight, or using a PC/laptop (cognitive tasks). The ART system is built on the RADAR-base mobile-health platform.DiscussionThe long-term goal is to use these data to improve the management of cardiometabolic disease in adults with ADHD, and to improve ADHD medication treatment adherence and the personalisation of treatment.

ODP382 Circulating Adipokines and Gamma-Glutamyl Transferase As Markers Associated With Metabolic Syndrome in Mexican Children Aged 6 to 12 Years

Abstract Obesity and metabolic syndrome are prevalent diseases in children. Circulating leptin, adiponectin, tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and gamma-glutamyl transferase (GGT) are markers associated with cardiometabolic diseases in adults. However, there is a lack of scientific evidence in children. Identifying these markers, which are non-invasive, accessible, and allow early detection and treatment of these diseases at an early age, becomes crucial. We examined the association between circulating adipokines and GGT with the metabolic syndrome in Mexican school-age children. The non-probabilistic sample was 140 school children aged 6 to 12 from Nuevo León, México. Nutritional assessment was performed using BMI Z-score from the World Health Organization; the criteria for metabolic syndrome for children and adolescents were from the International Diabetes Federation. Blood samples were obtained by puncturing the antecubital vein with a 12-hour fast. Serum levels of leptin, adiponectin, TNF-α and IL-6 were measured with the Luminex® xMAP® RIA Kit, and the GGT by kinetic reaction with the Dxc Beckman Coulter equipment. A multivariate statistical analysis was carried out to identify the association with the metabolic syndrome, using Student's T-Test and Simple Linear Regression with the IBM SPSS® software. Results,60 children (43%) presented overweight/obesity; 33 obese children were diagnosed with metabolic syndrome (55%). Significant differences were found in leptin (30.61±18.60 vs. 4.14±3.19 ng/mL; P=0. 00), adiponectin (29.54±23.95 vs. 67.71±41.63µg/mL; P=0. 00) and GGT (21.86±13.49 vs. 15. 00±2.69 U/L; P=0. 00), between the groups of children with and without obesity; no significant differences were found between IL-6 (5.11±4.30 vs. 4.26±5.30 pg/mL; P=0.31) and TNF-α (6.64±3.66 vs. 5.94±4.47 pg/mL; P=0.32). In children with or without metabolic syndrome we found significant differences in leptin (32.42±21.39 vs. 10.26±13.11 ng/mL; P=0. 00) and adiponectin (28. 00±19.98vs. 58.55±41.71µg/mL; P=0. 00), between the groups; no significant differences were found between GGT (18.34±7.77 vs. 17.82±10.18 U/L; P=0.78), IL-6 (5.53±4.90 vs. 4.34±4.88 pg/mL; P=0.22) and TNF-α (6.71±4.15 vs. 6. 09±4.15 pg/mL; P=0.46). In the Simple Linear Regression analysis, leptin explains 27% of the variance and adiponectin 10% of the variance. The frequency of overweight and obese children with metabolic syndrome is like other studies (1). The levels of TNF-α and IL-6 did not show a significant association in children with obesity and metabolic syndrome. Leptin and adiponectin are significantly associated with metabolic syndrome in children. In our study GGT is not associated with metabolic syndrome. However, we highlight the importance to continue studying the association of these metabolic markers in clinical practice in children. Reference: (1)López-Jaramillo et al.,Horm Mol BiolClin Invest.2014;18(1): 1–9. Presentation: No date and time listed

Comparison of the Lipidomic Signature of Fatty Liver in Children and Adults: A Cross-Sectional Study.

ObjectiveNon-alcoholic fatty liver disease (NAFLD) is an increasingly common condition in children characterized by insulin resistance and altered lipid metabolism. Affected patients are at increased risk of cardiovascular disease (CVD) and children with NAFLD are likely to be at risk of premature cardiac events. Evaluation of the plasma lipid profile of children with NAFLD offers the opportunity to investigate these perturbations and understand how closely they mimic the changes seen in adults with cardiometabolic disease.MethodsWe performed untargeted liquid chromatography mass spectrometry (LC-MS) plasma lipidomics on 287 children: 19 lean controls, 146 from an obese cohort, and 122 NAFLD cases who had undergone liver biopsy. Associations between lipid species and liver histology were assessed using regression adjusted for age and sex. Results were then replicated using data from 9,500 adults with metabolic phenotyping.ResultsMore severe paediatric NAFLD was associated with lower levels of long chain, polyunsaturated phosphatidylcholines (PC) and triglycerides (TG). Similar trends in PC and TG chain length and saturation were seen in adults with hepatic steatosis. However, many of the specific lipids associated with NAFLD differed between children and adults. Five lipids replicated in adults (including PC(36:4)) have been directly linked to death and cardiometabolic disease, as well as indirectly via genetic variants.ConclusionThese findings suggest that, whilst similar pathways of lipid metabolism are perturbed in paediatric NAFLD as in cardiometabolic disease in adults, the specific lipid signature in children is different.

Mapping the Cord Blood Transcriptome of Pregnancies Affected by Early Maternal Anemia to Identify Signatures of Fetal Programming.

ContextAnemia during early pregnancy (EP) is common in developing countries and is associated with adverse health consequences for both mothers and children. Offspring of women with EP anemia often have low birth weight, which increases risk for cardiometabolic diseases, including type 2 diabetes (T2D), later in life.ObjectiveWe aimed to elucidate mechanisms underlying developmental programming of adult cardiometabolic disease, including epigenetic and transcriptional alterations potentially detectable in umbilical cord blood (UCB) at time of birth.MethodsWe leveraged global transcriptome- and accompanying epigenome-wide changes in 48 UCB from newborns of EP anemic Tanzanian mothers and 50 controls to identify differentially expressed genes (DEGs) in UCB exposed to maternal EP anemia. DEGs were assessed for association with neonatal anthropometry and cord insulin levels. These genes were further studied in expression data from human fetal pancreas and adult islets to understand their role in beta-cell development and/or function.ResultsThe expression of 137 genes was altered in UCB of newborns exposed to maternal EP anemia. These putative signatures of fetal programming, which included the birth weight locus LCORL, were potentially mediated by epigenetic changes in 27 genes and associated with neonatal anthropometry. Among the DEGs were P2RX7, PIK3C2B, and NUMBL, which potentially influence beta-cell development. Insulin levels were lower in EP anemia–exposed UCB, supporting the notion of developmental programming of pancreatic beta-cell dysfunction and subsequently increased risk of T2D in offspring of mothers with EP anemia.ConclusionsOur data provide proof-of-concept on distinct transcriptional and epigenetic changes detectable in UCB from newborns exposed to maternal EP anemia.

Maximising use of population data on cardiometabolic diseases

The worldwide burden of adult cardiometabolic diseases such as hypertension, diabetes, obesity, and dyslipidaemia continues its relentless increase. Scaling up the prevention, management, and control of cardiometabolic diseases is cost-effective but requires strong health systems.1 As we have previously argued in this journal,2 building these health systems requires data that is accurate, timely, and transparent. Data from high-quality population-based surveys are particularly essential, as they reflect the spectrum of adults living in communities, including those who are not reached by their health system.

Causative Mechanisms of Childhood and Adolescent Obesity Leading to Adult Cardiometabolic Disease: A Literature Review

The past few decades have shown a worrisome increase in the prevalence of obesity and its related illnesses. This increasing burden has a noteworthy impact on overall worldwide mortality and morbidity, with significant economic implications as well. The same trend is apparent regarding pediatric obesity. This is a particularly concerning aspect when considering the well-established link between cardiovascular disease and obesity, and the fact that childhood obesity frequently leads to adult obesity. Moreover, most obese adults have a history of excess weight starting in childhood. In addition, given the cumulative character of both time and severity of exposure to obesity as a risk factor for associated diseases, the repercussions of obesity prevalence and related morbidity could be exponential in time. The purpose of this review is to outline key aspects regarding the current knowledge on childhood and adolescent obesity as a cardiometabolic risk factor, as well as the most common etiological pathways involved in the development of weight excess and associated cardiovascular and metabolic diseases.

The Association of Cardiometabolic Disease with Psychological Factors in Colombian People during the COVID-19 Pandemic: A Cross-Sectional Study.

During the COVID-19 pandemic, psychological disorders have been documented in the population, and their exacerbation in vulnerable populations such as those with Cardiometabolic Diseases (CD) might challenge health systems. This study determined psychological factors associated with CD in Colombian adults during the COVID-19 pandemic. For this purpose, 284 persons were evaluated, 142 without CD and 142 with CD. Sociodemographic data were collected, and the International Physical Activity Questionnaire (IPAQ), the SF-12v2, the Pittsburgh Sleep Quality Index (PSQI) and the Zung Self-Rating Depression Scale (ZSDS), which were integrated into an online form, were used. Through a simple and multiple logistic regression model, it was shown that CD was associated with low sleeping quality (LSQ) (OR = 3.51) and with depressive symptoms (DS) (OR = 1.98). In addition, in the group with CD, the presence of DS was related to BMI (OR = 2.45), and LSQ was related to living with persons at risk for COVID-19 (OR = 3.64) and BMI (OR = 5.88). In conclusion, this study showed that people with CD have a higher chance of presenting DS and LSQ. Furthermore, living with people at risk for COVID-19 was related to the presence of LSQ.

Adverse childhood experiences and adult cardiometabolic risk factors and disease outcomes: Cross-sectional, population-based study of adults in rural Uganda

BackgroundCardiovascular diseases (CVD) pose a major threat to public health in sub-Saharan African communities, where the burden of these classes of illnesses is expected to double by 2030. Growing research suggests that past developmental experiences and early life conditions may also elevate CVD risk throughout the life course. Greater childhood stress and adversity are consistently associated with a range of adult CVDs and associated risk factors, yet little research exists on the long-term effects of early life stress on adult physical health outcomes, especially CVD risk, in sub-Saharan African contexts. This study aims to evaluate the associations between adverse childhood experiences and adult cardiometabolic risk factors and health outcomes in a population-based study of adults living in Mbarara, a rural region of southwestern Uganda.MethodsData come from an ongoing, whole-population social network cohort study of adults living in the eight villages of Nyakabare Parish, Mbarara. A modified version of the Adverse Childhood Experiences-International Questionnaire (ACEs) assessed past exposure to physical, emotional, and sexual adversity. Participants also took part in a health fair where medical histories on cardiometabolic risk factors and cardiovascular diseases were gathered. Multiple logistic regression models estimated the associations between ACEs and cardiometabolic risk factors and health outcomes.ResultsData were available on 545 adults. The average number of ACEs was 4.9 out of a possible 16. The cumulative number of ACEs were associated with having a history of heart attack and/or heart failure (adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 0.999-1.234, P = 0.051), but the estimated association was not statistically significant. ACEs did not have statistically significant associations with any others measures of adult cardiometabolic risk and CVD.ConclusionsAdverse childhood experiences are not associated with a range of adult cardiometabolic risk factors and health outcomes in this sample of rural Ugandan adults. Further research in this sample is necessary to identify the pathways that may motivate these null relationship and possibly protect against adverse cardiometabolic and cardiovascular health outcomes.

The role of genetics in fetal programming of adult cardiometabolic disease.

Disturbances affecting early development have broad repercussions on the individual's health during infancy and adulthood. Multiple observational studies throughout the years have shown that alterations of fetal growth are associated with increased cardiometabolic disease risks. However, the genetic component of this association only started to be investigated in the last 40 years, when single genes with distinct effects were investigated. Birth weight (BW), commonly reported as the outcome of developmental growth, has been estimated to be 20% to 60% heritable. Through Genome-Wide Association (GWA) meta-analyses, 190 different loci have been identified being associated with BW, and while many of these loci designate genes involved in glucose and lipid metabolism, with clear ties to fetal development, the role of others is not yet understood. In addition, due to its influence over the intrauterine environment, the maternal genotype also plays an important part in the determination of offspring BW, with the same loci having independent effects of different magnitude or even direction. There is still much to uncover regarding the genetic determinants of BW and the interactions between maternal, offspring, and even paternal genotype. To fully understand these, diverse and novel cohorts from multiple ancestries collecting extensive neonatal phenotype will be needed. This review compiles, chronologically, the main findings in the investigation of the genetics of BW.

Abstract P201: Early Life Exposure To Environmental Tobacco Smoke And Cardiometabolic Diseases In Middle Age: A 4-decade Follow-up Study Of The Collaborative Perinatal Project

Introduction: Environmental tobacco smoke (ETS) is a major source of indoor air pollution and has been associated with cardiovascular diseases (CVD) risks. There is little research on the associations of ETS exposure in early life with CVD risks in later life. Hypothesis: We hypothesized that ETS exposures in the uterus, childhood, and teenage increase midlife CVD risks. Methods: For 1,623 offspring born in 1959-1966 at two sites from the Collaborative Perinatal Project, we defined intrauterine ETS exposure in each trimester if the mother smoked (1-19 or ≥20 cigs/day). ETS exposure in each year from birth to 18 years was quantified by total daily-average hours of parents smoking weighted by daily packs from a questionnaire at the adult follow-up (mean age: 39 years). Ever diagnoses of diabetes (cumulative incidence: 3.0%), heart diseases (1.5%), hypertension (17.3%), and high cholesterol (25.3%) until adult follow-up were reported. Cardiometabolic diseases (CMD, cumulative incidence: 35.4%) were defined as any diagnosis. We estimated odds ratio (OR) for CMD by ETS exposures in each trimester adjusting for prenatal factors (maternal SES, pre-pregnancy BMI, parity, newborn sex); additionally adjusted for maternal smoking in pregnancy, birth weight, and gestational age for ETS exposure from birth to 18 years. We also stratified the analyses by adult smoking status. Results: Exposure to ≥20 cigs/day in the 1 st (OR: 1.52, 95% CI: 1.02-2.26) and 2 nd (OR: 1.50, 95% CI: 1.01-2.24) trimester was significantly associated with hypertension compared to none exposure, and the associations were stronger in adult offspring who were smokers. Among the 70% of participants who reported childhood ETS exposure, the average exposure was 8.5 smoker-hours/day and 10.5 smoker-hour*packs/day (HP/Day), with a declining trend from birth to 18 years. ETS exposure (per SD increment) in early life from birth to 18 years, separately or cumulatively (OR=1.24, 95% CI: 1.07-1.43), was associated with higher odds of adult hypertension. ETS exposure in teenage (11-18 years, OR=1.26, 95% CI: 1.05-1.50), but not in childhood (birth to 10 years, OR=1.18, 95% CI: 0.96-1.45), was associated with higher odds of a combination of adult heart disease and diabetes, which was more striking in adult non-smokers than smokers. Odds of adult CMD increased by 13% (95% CI: 1%-28%) for each SD (about 10 HP/Day) increment in ETS in the whole childhood and by 16% (95% CI: 3%-30%) in teenage. The results for smoker-hours/day were similar to those for smoker-hour*packs/day. Conclusions: Intrauterine exposure to maternal smoking and ETS exposures (time and total amount) from birth to 18 years increase the risk of adult hypertension. ETS exposure in early life may also increase the risk of adult cardiometabolic diseases. Teenage may be a sensitive window for elevated risk of adult heart diseases and diabetes associated with ETS exposure.

Increased mitochondrial oxygen consumption in adult survivors of preterm birth.

Background:Premature birth affects roughly 10% of live births and is associated with long-term increased risk for multiple comorbidities. Though many comorbidities are associated with increased oxidative stress, the potential late impact of extreme premature birth on mitochondrial function has not previously been assessed. We hypothesized that mitochondrial function would be impaired in adult survivors of premature birth.Methods:Mitochondrial function in peripheral blood mononuclear cells from young adults born moderately to extremely preterm was measured using a Seahorse XF Analyzer at baseline and in response to acute oxidative stress, and compared to age-matched term-born adults. Adult pulmonary function was also obtained.Results:Young adults born preterm (average gestational age 29 weeks) had increased mitochondrial oxygen consumption at baseline, particularly with respect to basal and non-ATP linked respiration. Maximal and spare capacity were also higher, even in response to acute oxidative stress. Lung function was lower in adults born preterm, and the degree of airflow obstruction correlated only modestly with mitochondrial function.Conclusion:In conclusion, adults born preterm have higher basal and non-ATP linked mitochondrial respiration. Similar mitochondrial profiles have previously been documented in diabetics, and may support the increased risk for cardiometabolic disease in adults born preterm.

Suboptimal Birthweight and Adult Cardiometabolic Disease: The HPA-Axis Link

The entire world is undergoing a hard-hitting scenario and trying to combat the COVID-19 by recent technological advancements, which involves machine learning chiefly. The forecasting demand has become a prerequisite as it helps the government officials and other organizations to make well-versed verdicts and impose pertinent measures to benefit the living conditions of the individuals around the globe. Consequently, the current paper focuses on four significant machine learning methods (Facebook Prophet, Auto Regression, Vector Auto Regression, and Holt-Winters), which help forecast the total confirmed and daily confirmed cases. Moreover, the paper reveals the ideal method for the future forecast based on the attained results and efficacy rate. The results of the study reveal the best methods for the considered countries based on the calculation of Error percentage. Out of the four Machine Learning models, AR and FB models stood out as the best methods when compared to the other two.

Individual and contextual exposures and cardio-metabolic diseases in adults of Argentina. A contribution for epidemiological surveillance

The aim of this study was to assess the association of individual and contextual exposures with cardio-metabolic diseases (CMD) occurrence in adults of Córdoba province (Argentina) for epidemiological surveillance purposes. Methods: A population-based study of 493 subjects (30-60 years-old) was performed in Córdoba Province, Argentina, in 2017. Bio-socio-economic individual characteristics (gender, age, BMI, tobacco habit, socio-economic status and occupational exposure); adherence level to characteristics dietary patterns (DP) (Argentine Pro-inflammatory-APP-, Fast food -FSP-, Simile-Mediterranean -SMP- and Prudent-PP-), and contextual exposure (farm machinery warehouse -FMW- and agricultural pesticide applications-NAP- within 100m from home) were assessed. Self-reported hypertension (HT), diabetes (DBT), and obesity (measured BMI) were the CMD considered. For the analysis, all CMD were considered together and independently (HT, DBT and obesity). Two steps were performed: 1) Multiple Correspondence Analyses (MCA) for exploring exposure profiles; 2) Logistic regression models were fitted to estimate the association between individual and contextual exposures and CMD (in the full sample and stratified by two socio-environmental and economically differentiated areas, north and south). Results: MCA identified two different profiles regarding sociodemographic and environmental indicators -coincident with areas studied- (71.39% of explained variation on first and second factors). 42% of all the individuals had at least one CMD (19% HT, 7.3% DBT and 32.52% obesity); age and a high socioeconomic status were directly and inversely associated to all CMD, together and independently. Also, BMI was associated with HT and DBT; SMP (overall) and PP (in North area) were inversely associated with all CMD together and specifically with obesity; the environmental exposure FMW was significantly associated with DBT, while NAP was associated with all CMD and particularly with HT, in the North area. Conclusions: In Córdoba province, epidemiological surveillance programs are required to reduce CMD epidemic; both individual and community - environmental factors needs to be addressed.

Lifecourse body mass index trajectories and cardio-metabolic disease risk in Guatemalan adults.

Little is known about body size over the life-course and non-communicable disease risk in low- and middle-income country populations. Our study explored the role of body mass index (BMI) trajectories from infancy through mid-adulthood on cardio-metabolic disease (CMD) risk factors in a prospective cohort of Guatemalan adults. Study participants were born in Guatemala from 1962-77 and have been followed prospectively since participating in a nutrition supplementation trial as children. Sex-specific BMI latent class trajectories were derived using latent class growth modeling from up to 22 possible BMI values from age 1 month to 42 years measured between 1969 and 2004. CMD risk factors were assessed in 2015-17 (at age 37-54 years) using anthropometry, blood glucose and lipids, and blood pressure. We used logistic regression to assess the role of BMI trajectory on CMD risk factors in 510 women and 346 men (N = 856). We identified two BMI latent classes for women (low [n = 287, 56.3%] and high [n = 223, 43.7%]) and three classes for men (low [n = 141, 40.8%], medium [n = 160, 46.2%], and high [n = 45, 13.0%]). Given the small percentage of men in the high BMI latent class, we collapsed the medium and high BMI latent classes for men (n = 205, 59.1%). Among the most prevalent CMD risk factors at ages 37-54 years were abdominal obesity defined by waist-height ratio (99.6% of women and 87.3% of men), obesity defined by percent body fat (96.6% of women and 75.9% of men), low HDL-c (87.5% of women and 74.5% of men), and elevated triglycerides (78.3% of women and 73.6% of men). Except for obesity defined by BMI, we found no associations between BMI latent class and CMD risk factors in women. Among men, BMI latent class was not associated with CMD risk factors after controlling for current BMI. For the CMD risk factors we analyzed, the role of early life BMI on adult CMD appeared to be mediated by adult BMI among men-highlighting the need to establish and maintain healthy body weight over the life course.

Suboptimal Birthweight and Adult Cardiometabolic Disease: The HPA-Axis Link

Suboptimal birthweight (<10th percentile, >90th percentile) has a well-established relationship with several adult cardiometabolic risk factors, including obesity, dyslipidaemia and elevated blood pressure (BP) [1]. Over the past three decades, several animal studies have investigated this relationship. Together, these studies have shown that in sub-optimally grown offspring, adaptive changes occur in key organ systems to maximize chances of ex-utero survival [2].