Cardiometabolic Risk Profile Research Articles

Longitudinal associations of DXA-measured visceral adipose tissue and cardiometabolic risk in middle-to-older aged adults

Background and aimsDXA-measured visceral adipose tissue (VATDXA) is associated with adverse cardiometabolic risk profiles in cross-sectional studies, but longitudinal associations have not been investigated. We examined the longitudinal associations of baseline and change in VATDXA with future cardiometabolic risk in Australian participants of the Busselton Healthy Ageing study. Methods and resultsWe studied 3569 participants (54.7% female, aged 46–70 years) with data on VATDXA (GE Lunar Prodigy) and cardiometabolic risk factors at baseline and 6 years follow-up. The associations were examined using logistic and linear regression models, adjusting for baseline age and lifestyle factors. Mean baseline VATDXA mass was 1653 ± 880 g and 855 ± 580 g, and mean change in VATDXA +99 ± 500 g and +58 ± 312 g in males and females, respectively. Among all participants, 182 males (11.3%) and 197 females (10.1%) developed incident metabolic syndrome (MetS). Baseline VATDXA was associated with incident MetS with an adjusted odds ratio of 2.53 (95% CI: 2.03, 3.15) in males and 2.78 (2.30, 3.36) in females per SD increment. There was a graded positive association between longitudinal change in VATDXA and MetS severity z score in both sexes adjusted for baseline VAT (P < 0.001). All the above associations remained significant after further adjustment for baseline or change in BMI, waist circumference or waist-to-hip ratio in respective models (all P < 0.001). ConclusionsHigher baseline and greater longitudinal increase in VATDXA are independently associated with raised cardiometabolic risk over time, and may serve as useful markers for identifying middle-aged individuals at increased cardiometabolic risk.

Does cardiometabolic risk profile differ among individuals with traumatic and non-traumatic spinal cord injury (SCI): the evidence from the multicenter SCI cohort in Switzerland (SwiSCI)

Study designLongitudinal study.ObjectiveTo explore whether individuals with traumatic spinal cord injury (TSCI) and non-traumatic SCI (NTSCI) experience different trajectories in changes of cardiometabolic disease (CMD) factors during initial rehabilitation stay.SettingMulticenter Swiss Spinal Cord Injury Cohort (SwiSCI) study.MethodsIndividuals without history of cardiovascular diseases were included. CMD factors and Framingham risk score (FRS) were compared between TSCI and NTSCI. Linear mixed models’ analysis was employed to explore the trajectory in CMD factors changes over rehabilitation period and a multivariate linear regression analysis was used at discharge from inpatient rehabilitation to explore factors associated with CMD risk profile in TSCI and NTSCI. We performed age and sex-stratified analyses.ResultsWe analyzed 530 individuals with SCI (64% with TSCI and 36% NTSCI). The median age was 53 years (IQR:39-64) with 67.9% (n = 363) of the study cohort being male. The median rehabilitation duration was 4.4 months (IQR 2.4-6.4). At admission to rehabilitation, FRS (9.61 vs. 5.89) and prevalence of hypertension (33.16% vs. 13.62%), diabetes (13.68% vs. 4.06%), and obesity (79.05% vs. 66.67%) were higher in NTSCI as compared to TSCI, No difference was observed in cardiometabolic syndrome between the groups (around 40% in both groups). Overall, we observed longitudinal increases in total cholesterol, HDL-C and HDL/total cholesterol ratio, and a decrease in fasting glucose over the rehabilitation period. No differences in longitudinal changes in cardiovascular risk factors were observed between TSCI and NTSCI.ConclusionsThere was no deterioration in cardiometabolic risk factors over rehabilitation period, at discharge from initial rehabilitation stay. Both TSCI and NTSCI experienced high burden of cardiometabolic syndrome components with NTSCI experiencing more disadvantageous risk profile. The effectiveness of therapeutic and lifestyle/behavioral strategies to decrease burden of cardiometabolic disease and its components in early phase should be explored in future studies.

Association between age at diagnosis and all-cause mortality in type 2 diabetes: the Renal Insufficiency and Cardiovascular Events (RIACE) Italian Multicenter Study

AimsIt is unclear whether type 2 diabetes diagnosed in young adulthood is associated with increased severity than that occurring later in life beyond longer lifetime exposure to hyperglycemia. This study aimed at assessing the independent association of age at type 2 diabetes diagnosis with all-cause mortality.MethodsThis prospective cohort study enrolled 15,773 Caucasian patients with type 2 diabetes in 19 Italian centers in 2006–2008. Cardiometabolic risk profile and presence of complications and comorbidities were assessed at baseline and participants were stratified by quartiles of age at diabetes diagnosis. All-cause mortality was verified on 31 October 2015.ResultsValid information on vital status was retrieved for 15,656 participants (99.3%). Patients in the lowest quartile had the longest diabetes duration, the worst glycemic control and the highest prevalence of insulin treatment, obesity, atherogenic dyslipidemia, and smoking habits. All complications were inversely associated with age at diabetes diagnosis after adjustment for age and sex, but not after further adjustment for diabetes duration. Percentages of death, Kaplan–Meier estimates, and unadjusted hazard ratios and mortality rates increased from the lowest to the highest quartile. In contrast, when adjusting for age and sex, participants falling in the lowest quartile, showed the highest mortality risk [hazard ratio 1.321 (95% confidence interval 1.196–1.460), P < 0.0001]. However, differences among quartiles disappeared after adjustment for diabetes duration, complications/comorbidities, or other cardiovascular risk factors.ConclusionsType 2 diabetes onset in young adulthood is associated with increased mortality that is mainly driven by longer diabetes duration favoring the development of complications.Trial registration: ClinicalTrials.gov, NCT00715481, retrospectively registered 15 July, 2008.

A 7-Month Multidisciplinary Healthy Lifestyle Intervention Effectively Improved Cardiometabolic Risk Profile of Firefighters.

We investigated the effect of a 7-month healthy lifestyle intervention on cardiometabolic risk factors (CMRF) among male career military firefighters (FFs). Forty-nine FFs participated in a 7-month workplace multiddisciplinary healthy lifestyle intervention designed to reduce CMRF through exercise, diet, and improved sleep. Medical assessments, accelerometry, and surveys at the beginning and end determined program effectiveness. At the end of the intervention period, there was a significant improvement in measures of body composition and blood glucose. The prevalence of hypertension also decreased significantly ( P < 0.01). The 57% of participants who fully adhered to the program had significantly greater improvements across multiple CMRF. Participants increased their physical activity and improved their diet following the intervention. This healthy lifestyle intervention was effective in changing behavior and lowering cardiometabolic risk among FFs.

Cardiovascular Disease Risk in Individuals Following Plant-Based Dietary Patterns Compared to Regular Meat-Eaters.

Plant-based diets (PBDs) have been associated with a lower risk of cardiovascular disease (CVD). The aim was to investigate the predicted 5-year and 10-year risk of developing CVD in individuals following PBDs compared to regular meat-eating diets. This cross-sectional study included n = 240 middle-aged adults habitually consuming dietary patterns for ≥6 months: vegan, lacto-ovo vegetarian (LOV), pesco-vegetarian (PV), semi-vegetarian (SV) or regular meat-eater (RME) (n = 48 per group). Predicted 5-year and 10-year CVD risks were quantified using the Framingham Risk Equation and the Australian Absolute CVD risk calculator, respectively. Multivariable regression analysis was used to adjust for age, sex, smoking status, physical activity, alcohol use and BMI. Over three-quarters of the participants were women, mean age of 53.8 yrs. After adjustments for potential confounders, there was no difference in the predicted risk of CVD between regular-meat diets and PBDs, although crude analyses revealed that vegans had a lower 5-year and 10-year predicted risk of CVD compared to RMEs. SVs, PVs and LOVs had lower CVD risk scores, however, not significantly. Vegans had a favourable cardiometabolic risk profile including significantly lower serum lipid levels, fasting blood glucose and dietary fats and higher dietary fibre intake compared to RMEs. This was the first study to purposefully sample Australians habitually following PBDs. We found that PBDs do not independently influence the predicted risk of CVD, although PBDs tended to have lower risk and vegans had significantly lower cardiometabolic risk factors for CVD.

Improvement in Visceral Adipose Tissue and LDL Cholesterol by High PUFA Intake: 1-Year Results of the NutriAct Trial.

We assessed the effect of a dietary pattern rich in unsaturated fatty acids (UFA), protein and fibers, without emphasizing energy restriction, on visceral adipose tissue (VAT) and cardiometabolic risk profile. Within the 36-months randomized controlled NutriAct trial, we randomly assigned 502 participants (50-80 years) to an intervention or control group (IG, CG). The dietary pattern of the IG includes high intake of mono-/polyunsaturated fatty acids (MUFA/PUFA 15-20% E/10-15% E), predominantly plant protein (15-25% E) and fiber (≥30 g/day). The CG followed usual care with intake of 30% E fat, 55% E carbohydrates and 15% E protein. Here, we analyzed VAT in a subgroup of 300 participants via MRI at baseline and after 12 months, and performed further metabolic phenotyping. A small but comparable BMI reduction was seen in both groups (mean difference IG vs. CG: -0.216 kg/m2 [-0.477; 0.045], partial η2 = 0.009, p = 0.105). VAT significantly decreased in the IG but remained unchanged in the CG (mean difference IG vs. CG: -0.162 L [-0.314; -0.011], partial η2 = 0.015, p = 0.036). Change in VAT was mediated by an increase in PUFA intake (ß = -0.03, p = 0.005) and induced a decline in LDL cholesterol (ß = 0.11, p = 0.038). The NutriAct dietary pattern, particularly due to high PUFA content, effectively reduces VAT and cardiometabolic risk markers, independent of body weight loss.

Cardiometabolic Risk Profiles of Adolescents Living With Perinatally Acquired HIV in South Africa.

We assessed the Pathological Determinants of Atherosclerosis in Youth (PDAY) score and other potential cardiovascular disease risk factors in adolescents previously enrolled in the Children with HIV Early antiRetroviral (CHER) and International Maternal Pediatric Adolescent AIDS Clinical Trials Network P1060 clinical trials. Coronary artery and abdominal aorta (AA) PDAY scores were calculated for 56 participants over 15 years of age using a weighted combination of dyslipidemia, cigarette smoking, hypertension, obesity, and hyperglycemia. A PDAY score ≥1 is associated with early atherosclerosis. Fifty-six participants were enrolled: 46 (82.1%) on a single-tablet regimen of tenofovir disoproxil fumarate, lamivudine and dolutegravir. Median time on antiretroviral therapy was 15.8 [interquartile range (IQR): 15.8-16.5] years and median time on dolutegravir was 14 (IQR: 10.0-19.0) months. Fasting median high-density lipoprotein cholesterol was 20.1 mg/dL (IQR: 16.0-23.7) and median non-high-density lipoprotein cholesterol was 38.3 mg/dL (IQR: 30.8-44.3). The median systolic blood pressure was 115 mm Hg (IQR: 107-121). Median body mass index was 21.3 kg/m 2 (IQR: 19.5-24.7) and median fasted serum glucose was 82.0 mg/dL (IQR: 75.7-87.3). Only 1 (2%) participant smoked cigarettes, but 5 (9%) smoked hookah pipe and 26 (46.4%) smoked cannabis. Thirty-one (55.4%) participants had coronary artery PDAY scores ≥1 and 33 (58.9%) had AA PDAY scores ≥1. Age was associated with an AA PDAY score ≥1 ( P = 0.02) with a 0.06 increase in AA PDAY score for every month of age (95% confidence interval: 0.01-0.12, P = 0.01). Adolescents with perinatally acquired HIV appear at risk for cardiovascular disease. Specific tools for monitoring this risk are needed to institute appropriate preventive interventions.

Abstract P192: Association Between Time-Restricted Eating and All-Cause and Cause-Specific Mortality

Introduction: Time-restricted eating (TRE) has gained popularity as a dietary intervention that limits daily food consumption to a 4- to 12-hour window. Most short-term randomized controlled trials reported that TRE improved cardiometabolic risk profiles. However, whether TRE is associated with long-term hard endpoints remains unknown. Hypothesis: We assessed the hypothesis that TRE is associated with a reduced risk of all-cause and cause-specific mortality. Methods: Participants aged at least 20 years who completed two valid 24-hour dietary recalls and reported usual intake in both recalls were included from the National Health and Nutrition Examination Survey in 2003-2018. Mortality status as of December 2019 was obtained through linkage to the National Death Index. An eating occasion required consuming more than 5 kcal of foods or beverages. Eating duration between the last and first eating occasion was calculated for each day. The average duration of two recall days defined typical eating duration which was then categorized as &lt;8, 8-&lt;10, 10-&lt;12, 12-16 (reference group; mean duration in US adults), and &gt;16 hours. Multivariable Cox proportional hazards models were employed to estimate the association of eating duration with all-cause and cause-specific mortality in the overall sample and among adults with cardiovascular disease or cancer. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were derived. Results: Among 20,078 adults included, the weighted mean (SE) age was 48.5 (0.3) years, 50.0% were men, and 73.3% were non-Hispanic White. During a median follow-up of 8.0 years (IQR, 4.2-11.8), 2797 all-cause deaths occurred, including 840 cardiovascular deaths and 643 cancer deaths. Compared with eating duration of 12-16 hours, eating duration &lt;8 hours was significantly associated with an increased risk of cardiovascular mortality (HR, 1.96 [95% CI, 1.23-3.13]); this association was also observed in adults with cardiovascular disease (HR, 2.06 [95% CI, 1.12-3.81]) and adults with cancer (HR, 2.72 [95% CI, 1.28-5.80]). Other eating durations were not associated with cardiovascular mortality, except for eating duration of 8-&lt;10 hours in people with cardiovascular disease (HR, 1.64 [95% CI, 1.02-2.63]). No significant associations were found between eating duration and all-cause or cancer mortality in the overall sample and diseased subsamples, except that eating duration &gt;16 hours was associated with a lower risk of cancer mortality in people with cancer (HR, 0.46; [95% CI, 0.22-0.95]). Conclusions: In US adults, TRE with eating duration &lt;8 hours was significantly associated with a higher risk of cardiovascular mortality in the general population as well as in people with cardiovascular disease or cancer. These findings do not support long-term use of 16:8 TRE for preventing cardiovascular death.

Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose–response associations from the Prospective Physical Activity, Sitting and Sleep Consortium

Aims/hypothesisThe aim of this study was to examine the dose–response associations of device-measured physical activity types and postures (sitting and standing time) with cardiometabolic health.MethodsWe conducted an individual participant harmonised meta-analysis of 12,095 adults (mean ± SD age 54.5±9.6 years; female participants 54.8%) from six cohorts with thigh-worn accelerometry data from the Prospective Physical Activity, Sitting and Sleep (ProPASS) Consortium. Associations of daily walking, stair climbing, running, standing and sitting time with a composite cardiometabolic health score (based on standardised z scores) and individual cardiometabolic markers (BMI, waist circumference, triglycerides, HDL-cholesterol, HbA1c and total cholesterol) were examined cross-sectionally using generalised linear modelling and cubic splines.ResultsWe observed more favourable composite cardiometabolic health (i.e. z score <0) with approximately 64 min/day walking (z score [95% CI] −0.14 [−0.25, −0.02]) and 5 min/day stair climbing (−0.14 [−0.24, −0.03]). We observed an equivalent magnitude of association at 2.6 h/day standing. Any amount of running was associated with better composite cardiometabolic health. We did not observe an upper limit to the magnitude of the dose–response associations for any activity type or standing. There was an inverse dose–response association between sitting time and composite cardiometabolic health that became markedly less favourable when daily durations exceeded 12.1 h/day. Associations for sitting time were no longer significant after excluding participants with prevalent CVD or medication use. The dose–response pattern was generally consistent between activity and posture types and individual cardiometabolic health markers.Conclusions/interpretationIn this first activity type-specific analysis of device-based physical activity, ~64 min/day of walking and ~5.0 min/day of stair climbing were associated with a favourable cardiometabolic risk profile. The deleterious associations of sitting time were fully attenuated after exclusion of participants with prevalent CVD and medication use. Our findings on cardiometabolic health and durations of different activities of daily living and posture may guide future interventions involving lifestyle modification.Graphical

Adiposity Phenotypes and Associated Cardiometabolic Risk Profile in the Inuit Population of Nunavik.

The Inuit population of Nunavik is faced with a significant rise in the prevalence of obesity [body mass index (BMI) ≥ 30 kg/m2], but the impact on cardiometabolic health is unclear. The aim of this study was to characterize adiposity phenotypes and explore their associations with cardiometabolic risk factors among Nunavimmiut men and women. We used data obtained from 1296 Inuit who participated in the Qanuilirpitaa? 2017 Nunavik Inuit Health survey. Collected information included demographics, anthropometric measurements including visceral fat level (VFL) measured using electrical bioimpedance, biomarkers, hemodynamics, medical history and medication list. Adjusted population-weighted linear regressions were conducted to assess associations between body fat distribution and cardiometabolic risk factors. The accuracy and cut-off points of anthropometric indices to detect cardiometabolic abnormalities was evaluated by area under the receiver operator characteristic curve (AUROC) and a maximum Youden index analysis. Among Nunavimmiut (mean age 38.8 years [95%CI: 38.4 to 39.3]), obesity was observed in 42.8% of women and 25.6% of men. Compared to men, women presented a higher prevalence of abdominal obesity (78.8% vs. 46.4% in men, p < 0.05) and elevated VFL (54.4% vs. 20.1% with an InBody level ≥ 13, p < 0.05). Indices of global fat distribution and abdominal adiposity including VFL provided poor to moderate ability to detect cardiometabolic abnormalities (AUROC between 0.64 and 0.79). This analysis revealed that despite a high prevalence of abdominal obesity, particularly among women, anthropometric measurements of adiposity are inconsistently associated cardio-metabolic risk factors in Inuit adults of Nunavik.

Association of Endogenous Testosterone with Physical Fitness Measures during Firefighter Occupational Health Evaluations.

Firefighting is a physically demanding profession associated with unacceptably high on-duty cardiovascular mortality. Low endogenous total testosterone (TT) is an emerging cardiometabolic (CM) risk factor in men, but limited data exists on its interactions with physical fitness (PF). Data from occupational health and fitness assessments of 301 male career firefighters (FFs) were analyzed. TT was categorized as low (<264 ng/dL), borderline (264-399 ng/dL), and reference (400-916 ng/dL). PF tests included cardiorespiratory fitness (submaximal treadmill), body fat percentage (BF%), push-ups, plank, and handgrip strength assessments. In the crude analyses, FFs in the low TT group had worse muscular and cardiorespiratory fitness measures compared to the referent group. However, after adjusting for age and BF%, none of the PF differences remained statistically significant. Similarly, the odds of less-fit FFs (PF performance below median values) having low TT were higher compared to the fitter ones only before adjusting for age and BF%. Therefore, in the final adjusted model, there was no significant association between TT and PF. Our data suggest that age and body fat confound the association between PF and TT. Low TT and poor PF are important components of FFs' CM risk profile, and there is potential benefit to considering TT screening as part of a comprehensive occupational health program that manages performing medical evaluations and provides education and preventative programming.

Sex differences in cardiometabolic risk factors and in response to lifestyle intervention in prepubertal and pubertal subjects with obesity.

Childhood obesity is a growing health problem and requires a tailored treatment. This study explored the sex differences in cardiovascular risk factors in children/adolescents with obesity and in response to a weight loss intervention. Five hundred and thirty-three children/adolescents with obesity and their parents underwent to a 3-months lifestyle intervention program. Tanner criteria were used to assess the pubertal stage. Before and after 3 months, anthropometric measurements, blood pressure (BP), and biochemical measurements were assessed. Four hundred and forty five participants completed the treatment (age 12.4 ± 2.7 years, males 45.8%, prepubertal 29.2%, BMI z score 2.3 ± 0.2). In comparison to boys, prepubertal girls had higher values of BMI z score (2.4 ± 02 vs. 2.3 ± 0.2, p < 0.05), waist circumference z score (2.2 ± 0.3 vs. 2.0 ± 0.3, p < 0.05), HOMA-IR [2.9 (2.1-4.9) vs. 2.3(1.5-3.6), p < 0.01], prevalence of hypertransaminasemia (41.3% vs. 17.7%, p < 0.05) and lower levels of HDL cholesterol (46.2 ± 9.8 vs. 51.2 ± 10.5 mg/dl, p < 0.05). In the pubertal stage, boys had worse cardiometabolic risk profile than girls, including unfavourable measure of systolic BP (z score: 0.6 ± 1.0 vs. 0.3 ± 1.0, p < 0.01), fasting glucose (87.2 ± 6.1 vs. 84.8 ± 7.7 mg/dl, p < 0.01), ALT (26.9 ± 21.5 vs. 20.2 ± 10.6 U/L, p < 0.001) and uric acid (6.1 ± 1.9 vs. 5.0 ± 1.0 mg/dl, p < 0.001). After the lifestyle intervention, changes in BMI z score (p < 0.05) were higher in pubertal boys than pubertal girls. The systolic blood pressure decrease was greater in pubertal boys than in their female counterpart (Δ systolic BP: -7.2 mmHg in boys vs. -3.6 mmHg in girls, p < 0.05; Δ systolic BP z score: -0.6 in boys vs. -0.3 in girls, p < 0.05). LDL cholesterol showed an improvement only in boys, and ALT in the whole group. Our study showed that a short-term lifestyle intervention is more effective in reducing BMI z score and cardiovascular risk factors in pubertal boys than in their female counterparts. Further investigation is needed to deepen this gender difference, especially to develop a tailor-made intervention.

Per- and Polyfluoroalkyl Substances Concentrations are Associated with an Unfavorable Cardio-Metabolic Risk Profile: Findings from Two Population-Based Cohort Studies

Per- and polyfluoroalkyl substances (PFAS) are widely used and persistent chemicals, leading to ubiquitous exposure. Although high PFAS levels have been associated with an adverse cardiovascular risk profile, the distribution of levels and relations with cardio-metabolic risk markers in the general population have not been fully characterized. We assessed the association between blood levels of perfluorooctaneic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexanesulfonic acid (PFHxS) and a range of lipoproteins and metabolites as well as clinical lipid measurements. We used data from participants of the Netherlands Epidemiology of Obesity study (NEO) (n = 584) and the Rhineland Study (n = 1962), jointly spanning an age range of 30 to 89 years. PFAS were measured with the Metabolon HD4 platform, and lipoprotein and metabolite profiles were measured using Nightingale’s nuclear magnetic resonance-spectroscopy platform, and mainly comprised lipoprotein markers. Using linear regression analyses, we quantified age-, sex-, and education-adjusted associations of PFOA, PFOS, and PFHxS with clinical lipid measurements and 224 lipoproteins and metabolites. Higher levels of PFAS, particularly PFOS and PFHxS, were associated with higher concentrations of total lipid, cholesterol and phospholipid content in most HDL, IDL, LDL, and VLDL subclasses. The effect sizes were age-dependent for the majority of the associations, with the deleterious effects of PFAS being generally stronger in people below compared to those above median age. Our observation that in the general population even low PFAS concentrations are associated with an unfavorable lipid profile, calls for further critical regulation of PFAS substances.

Influence of the HLA-Cw6 Allele and IFIH1/MDA5 Gene Variants on the Cardiometabolic Risk Profile of Patients with Psoriatic Disease

Background: Cardiovascular comorbidity is a common companion of psoriasis and psoriatic arthritis (PsA). Recently, a significant link has been found between the HLA-Cw6 allele and a better cardiometabolic profile in these patients. We aimed to check this finding in our setting. Methods: A cross-sectional observational study (n: 572 psoriasis patients, 30% with PsA) was conducted. Different study variables were collected in detail, as well as classic cardiometabolic risk factors. The distribution of the HLA-Cw6 allele and the IFIH1/MDA5 gene variants previously linked to disease risk were determined in the study cohort and stratified according to the cardiometabolic comorbidity. Linear and logistic regression models were constructed to analyze these associations. Results: The study cohort included 309 men and 263 women, with a mean age of 46.7 years (SD 14.5) and a mean disease duration of 19.4 years (SD 14.8). We confirmed the known association between HLA-Cw6 and type I psoriasis (familial, severe, and early onset). Psoriasis severity (OR: 2.14), female sex (OR: 1.63), and the IFIH1/MDA5 rs1990760 TT genotype (OR: 1.62) were significantly related to PsA, while HLA-Cw6 was protective (OR: 0.65). HLA-Cw6 carriers showed a lower waist perimeter, lower BMI, and lower risk of both hypertension (OR: 0.52, p &lt; 0.001) and diabetes (OR: 0.36, p &lt; 0.001), but these findings were no longer apparent upon adjusting the regression models. No IFIH1/MDA5 gene variant was associated with any cardiometabolic risk factor. Conclusions: The influence of HLA-Cw6 on the cardiometabolic risk profile of psoriatic patients seems to be explained by other factors (age, sex, duration of the disease or arthritis) and not by this biomarker itself.

Chronic consumption of a bergamot-based beverage does not affect glucose, lipid and inflammatory biomarkers of cardiometabolic risk in healthy subjects: a randomised controlled intervention study.

Background: Pure bergamot juice exerts lipid lowering effects in dyslipidemic subjects. It is unknown whether bergamot-based beverages exert similar effects in healthy subjects. Aim: To assess the effects, if any, of a bergamot-based beverage (BBB, bergamot juice ≤25%) on lipid, metabolic and inflammatory biomarkers. Methods: Forty-five healthy subjects were randomised 1 : 1 to BBB intake (400 mL day-1) (55.5%) or control (44.5%) for 12 weeks. Anthropometric (waist circumference, body mass index (BMI)) and clinical (blood pressure) parameters, blood samples (glucose, glycated haemoglobin, insulinemia, lipid profile, liver and renal function, inflammatory biomarkers) and 24-h urine for the analysis of (poly)phenol metabolites were collected at the baseline and at 12 weeks. Intakes of energy, nutrients and food groups were assessed by a 7-day dietary record. Results: Both groups exhibited a time-related significant decrease in total cholesterol (p = 0.02), fasting plasma glucose (p = 0.016), insulin (p = 0.034), BMI (p < 0.001) and waist circumference (p = 0.04), but with no significant between-arm difference. The urinary profile of metabolites from the BBB-derived (poly)phenols well discriminated the two study groups, documenting good compliance in the intervention arm. Notably, urinary bergamot 3-hydroxy-3-methylglutaryl (HMG) -containing flavanones or derived HMG-containing metabolites were not detectable. BBB was well tolerated and no adverse events were recorded. Conclusion: This first randomized controlled trial of BBB consumption in healthy subjects showed no effects of BBB on the cardiometabolic risk profile. BBB consumption is a safe nutritional adjunct in the context of a well balanced diet.

The prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome in treatment-naïve transgender people assigned female at birth.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. We aimed to investigate the prevalence and phenotypic characteristics of PCOS in testosterone treatment-naïve transgender people assigned female at birth (AFAB), as well as to determine whether cardiometabolic risk factors vary based on the presence of PCOS and its components. Evaluation of 112 testosterone treatment-naïve transgender adults AFAB for PCOS and its individual components, including androgen excess, ovulatory dysfunction and polycystic ovarian morphology (PCOM). In our cohort, 79.5% of transgender individuals AFAB had at least one component of PCOS. The prevalence of PCOS was 38.4% (43/112). Phenotype C was the most common phenotype (17.8%), followed by phenotype B (10.7%). Transgender individuals AFAB with at least one component of PCOS had higher blood pressure (BP) measurements and higher fasting plasma glucose levels compared to those with none. Sixty-one subjects (54%) had hyperandrogenism (HA), with 20 (17.9%) having HA without other components of PCOS. When compared to those without HA, transgender individuals AFAB with HA had higher body mass index (BMI), BP, triglyceride and lower HDL-cholesterol levels. PCOS and androgen excess appear to be prevalent among transgender people AFAB. Transgender individuals AFAB with HA or PCOS may exhibit an unfavorable cardiometabolic risk profile compared to those without any PCOS component. Assessment of androgen excess and the specific components of PCOS at baseline could inform long-term management.

Disentangling the impact of gluteofemoral versus visceral fat accumulation on cardiometabolic health using sex-stratified Mendelian randomization

Background and aimsIndividuals with a higher abdominal adipose tissue accumulation are at higher risk of developing cardiometabolic diseases. For a given body mass index (BMI), women typically present lower abdominal adipose tissue accumulation compared to men. Whether abdominal adiposity is a causal driver of cardiometabolic risk, or a mere marker of ectopic fat deposition is debated. MethodsWe investigated the sex-specific and sex-combined impact of height and BMI-adjusted gluteofemoral adipose tissue (GFATadj) adjusted abdominal subcutaneous adipose tissue (ASATadj) and adjusted visceral adipose tissue (VATadj) on cardiometabolic traits and diseases using Mendelian randomization. ResultsLeveraging genome-wide summary statistics on GFATadj, ASATadj and VATadj from 39,076 UK Biobank participants with full-body magnetic resonance imaging available, we found that GFATadj is associated with a more favourable cardiometabolic risk profile including lower low density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, fasting insulin, liver enzyme levels and blood pressure as well as higher high density lipoprotein (HDL) cholesterol levels. GFATadj also is negatively associated with ischemic stroke, coronary artery disease, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD). ASATadj is not associated with cardiometabolic traits and diseases, whereas VATadj is associated with liver fat accumulation but not with NAFLD or other cardiometabolic traits or diseases. Although the absolute effect sizes of GFATadj on LDL cholesterol were more pronounced in women compared to men, most associations did not differ by sex. ConclusionsThe inability of subcutaneous fat depots to efficiently store energy substrates could be the causal factor underlying the association of visceral lipid deposition with cardiometabolic health.

A specific molecular signature of extra-vesicles (EVs) was associated with cardiometabolic risk profile and atherosclerotic burden in patients with chronic coronary syndrome: a pilot study

Abstract Background microRNAs (miRs) are pivotal regulators of mRNA and protein expression. They critically contribute to cardiovascular pathophysiology and circulate in the blood using extra-vesicles (EVs) as delivery carrier. The role of EV-associated miRs in atherosclerotic cardiovascular disease, however, is unclear. Purpose The aim of this study was to detect Coronary Artery Disease (CAD)-related miRs carried by EVs in stable patients with Chronic Coronary Syndrome (CCS). In particular we aimed to assess whether a specific miRs signature is associated with the cardiometabolic risk profile and coronary atherosclerotic burden and plaque features, as evaluated by coronary computed tomography angiography (CTA) in these patients. Methods miRs with known effects in the cardiovascular system were analysed by real time-PCR in EVs isolated from CCS patients by density gradient centrifugation (n=21). All patients underwent coronary CTA to assess total, calcified, and noncalcified plaque volume (PV). Obstructive CAD was defined as the presence of stenoses &amp;gt;50% in at least one of the main coronary vessels. Results All CCS patients (n=21) were statin users and had coronary atherosclerosis documented by coronary CTA. Among the 25 miRs tested, 7 were detected within EVs and 4 of them, miR-145-5p, miR-30e5-p, miR-126-5p, miR-375, were significantly related with cardiometabolic profile, showing an alternative association with glucose and insulin, a positive correlation with HDL-Cholesterol and a negative correlation with triglycerides, BMI and waist circumference. No association was observed with Total-Cholesterol and LDL-Cholesterol (Figure1). These miRs were also not associated with the presence of obstructive CAD, but were significantly related with total, calcified, and noncalcified PVs (Figure1). Conclusions In CCS patients, among the 25 miRs studied and out of the 7 EV-associated, only 4 miRs were related with a specific cardiometabolic risk profile, characterized by insulin-resistance, obesity, high triglyceride and low HDL-Cholesterol levels. They were also associated with an increased coronary atherosclerotic burden. These results suggest a potential involvement of specific EV-associated miRs in molecular mechanisms of residual atherosclerotic risk.Figure 1

Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13years follow-up in an unselected population.

Cardiometabolic risk factors are common in women with polycystic ovary syndrome (PCOS) during reproductive years. The aim of this study wasto determine the impact of aging on cardiometabolic risk of the syndrome by examining womenwho had previously been diagnosedto have PCOS or to be healthy in an unselected population in 2009. Forty-one women with PCOS who were diagnosed and phenotyped according to the Rotterdam criteria and 43 age- and body mass index (BMI)-matched healthy women from the same unselected cohort. All participants were evaluated by structured interview, physical examination, anthropometric, hormonal and biochemical measurements. Additionally, body composition analyses and echocardiographic assessments of 30 women with PCOS and 30 control women were conducted at 13 years of follow-up. There was no difference between the patient and the control groups in terms of anthropometric and body composition measures and metabolic parameters. Echocardiographic assessment showed similar systolic functions, strain measurements and epicardial fat measurements between the groups. PCOS patients still had higher levels of total testosterone, free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEAS) levels compared to controls. Epicardial fat thickness showed positive correlations with BMI, total and truncal body fat, homeostatic model assessment for insulin resistance (HOMA-IR) and free androgen index (FAI). Aging women with PCOS in the population have higher androgen levels and similar cardiometabolic risk profile compared to age- and BMI-matched healthy women. Epicardial fat thickness, a marker of cardiometabolic risk, appear to be associated with hyperandrogenism. Further research is needed on larger community-based cohorts where older patients are assessed with a longer follow-up.

Cardiometabolic risk profile of young and old adults with diabetes: Pooled, cross-sectional analysis of 42 national health surveys

AimsTo compare levels of cardiometabolic risk factors in young and old adults with diabetes. MethodsPooled analysis of 42 STEPS Surveys (n = 133,717). Diabetes was defined as self-reported diagnosis or fasting plasma glucose ≥ 126 mg/dl. There were two age groups: < 40 and ≥ 40 years. We summarized the mean levels of four cardiometabolic risk factors by country, sex and age group. ResultsIn 11 (men) and seven countries (women), the mean BMI seemed higher in young versus old adults; largest difference was found in men in Qatar (∼6 kg/m2). For waist circumference, such pattern was observed in two (men) and in three (women) countries; largest difference in men in Tuvalu (∼7 cm). Regarding systolic blood pressure, in one country (Myanmar) the mean was higher in young men with ∼8 mmHg difference. Women in the oldest group always had higher mean systolic blood pressure. For total cholesterol, in 13 (men) and five (women) countries the mean was higher in young adults (difference was always <1 mmol/l). ConclusionsLevels of cardiometabolic risk factors in young versus old adults with diabetes were heterogenous across 42 countries and depended on the risk factor. This calls to monitor cardiometabolic risk factors in young adults with diabetes.