Components Of Cardiometabolic Risk Research Articles

Dietary Inflammatory Index and Cardiometabolic Risk in Ecuadorian School-Age Children

Background Cardiometabolic diseases and metabolic syndrome (MetS) are becoming increasingly prevalent in low- and middle-income countries (LMICs). Cardiometabolic diseases and MetS are closely associated with low-grade systemic inflammation, which may be modified by diet. Previous studies have focused on the association of dietary inflammation with MetS and cardiometabolic risk in adult populations, but few studies have examined this issue in children, especially in LMICs. Methods We conducted a cross-sectional study to explore the association of dietary inflammation with cardiometabolic risk components and MetS in urban Ecuadorian children aged 6-12 years old (n = 276). A semi-quantitative food frequency questionnaire (FFQ) was used to collect data on child dietary intake. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (DII), divided into quartiles. Data were also collected on cardiometabolic risk indicators including blood lipids, blood pressure (BP), blood glucose, body mass index, and waist circumference. Data were analyzed using multivariable linear and logistic regression. Results Child DII scores ranged from −4.87 (most anti-inflammatory) to 4.75 (most pro-inflammatory). We transformed the continuous scores into quartiles (Q): Q1 was the most anti-inflammatory (−4.87 to −3.35), Q2 was anti-inflammatory (−3.34 to −1.45), Q3 was pro-inflammatory (-1.44 to 1.08), and Q4 was the most pro-inflammatory (1.09 to 4.75). In the covariate-adjusted model, DII scores were positively associated with total blood cholesterol (p = 0.027), triglycerides (p = 0.034), and diastolic BP (p = 0.013). In addition, for every one-unit increase in DII score, MetS increased by 1.20 in the covariate-adjusted model (95% CI = 1.01,1.43). Conclusions The findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health in school-age children. This is important because even small increases in child blood pressure, blood cholesterol, and glucose levels over time can damage health and lead to earlier progression to conditions such as hypertension and atherosclerosis.

Frequency of individual nosological units, metabolic syndrome and obesity in patients with adrenal hormonally inactive adenomas and their relationship with anthropometric indicators

Introduction: The diagnosis of adrenal hormonally inactive adenoma is made when a precise endocrine examination rules out the presence of hormonal oversecretion. More and more data indicate an association between hormonally inactive adrenal adenomas and some components of cardiometabolic risk—insulin resistance, obesity, hypertension, hyperglycemia and dyslipidemia. Aim: The main goal of the present study is to determine the frequency of individual nosological units, metabolic syndrome and obesity in patients with adrenal hormonally inactive adenomas and their relationship to anthropometric indicators. Material s and Methods: The subject of the study were 105 patients with hormonally inactive adrenal adenomas, passed through the Clinic of Endocrinology and Metabolic Diseases at St. Marina University Hospital. The results are processed with SPSS v. 20.0, using variance, variation, correlation and comparative analyses, and risk assessment analysis. We take p < 0.05 as the significance level. Results: A proportionally weak relationship between gender and waist circumference has been established. There is a significant difference in the relative share of men and women with HDL level above the norm (p < 0.001). In addition, BMI, arterial hypertension, cholesterol, HDL and fasting blood glucose does not correlate with gender. Triglycerides are found to have a weak correlation with gender. A significant difference was found in the relative proportion of men with serum HDL levels < 1.03 mmol/L with a waist circumference below and above 94 cm (p = 0.001), and there is an inversely proportional moderate dependence between waist circumference in men with inactive adrenal glands adenomas and serum HDL levels (r = -0.369; p < 0.001). It is found that men with hormonal inactive adrenal adenomas, having waist circumference > 94 cm have an 8 times higher risk of decreased serum HDL levels (OR = 8.0) (2.43-26.33); p < 0.001). A positive moderate dependence was found between uric acid serum levels with GGT and FLI. Conclusion: Additional research is needed to conclude whether these patients have an altered metabolic profile and have a statistically increased risk of cardiovascular disease and mortality.

Associations of METS-IR insulin resistance index with components of cardiometabolic risk in patients with hypertension

Objective — to accurate some possible associations of insulin resistance (IR) index METS‑IR with blood pressure (BP) level, parameters of visceral obesity (VO), values of lipid, carbohydrate and uric exchange in persons with essential hypertension (EH) who were the representatives of nonorganized population of Kharkov’s region.
 Materials and methods. The retrospective study included some data about 165 patients (pts) — 74 (44.8 %) females and 91 (55.1 %) males aged to 20 — 65 years old (an average age is 56.42 ± 1.18 years old) with EH of I — II stages who had been examined and undergone treatment in the clinics of the L. T. Mala National Therapy Institute of NAMS of Ukraine (Kharkiv). Uncomplicated EH in pts included in the study was combined with the components of cardiometabolic risk (CMR) such as excessive body mass (EBM), VO, intolerance to glucose, hyperuricemia, nonalcoholic fatty liver disease and dyslipoproteinemia). The persons with type 2 diabetes mellitus were excluded from the study. Among anthropometric measures derived from the history cases there was body mass index (BMI) and based on it some parameters of VO such as body fat percentage (BFP), total fat mass (TFM) and fat mass index (FMI). The data about pts’ BP as well as data about serum glucose and uric acid (UA) levels had been also taken from the history cases. For analysis of lipid exchange state the characteristics of pts’ lipid profile measured by enzyme method on analyser such as total cholesterol (TC), high‑density lipoprotein cholesterol (HDL‑C), triglycerides (TG), very‑low density lipoprotein cholesterol (VLDL‑C), low‑density lipoprotein cholesterol (LDL‑C), coefficient of atherogenity (CA) and non‑high‑density lipoprotein cholesterol (non‑HDL‑C) as a difference between TC and HDL‑C were derived from the history cases. The values of lipid ratios reflected a functional state of lipid transport systems such as direct cholesterol transport system, reverse cholesterol transport system and system of lipoprotein lipolysis which were closely associated with IR had been calculated additionally.
 Results. It was established that in persons with EH combined with EBM and VO included in the study the secondary lipid abnormalities increased CMR more significantly than glycemia and uricemia and it was confirmed by correlations of METS‑IR index with lipid exchange values and lipid ratios characterized the state of direct cholesterol transport system, reverse cholesterol transport system and system of lipoprotein lipolysis. The pts with EH and VO compared with persons who had EBM are shown to have more significant pathological deviations in the system of lipoprotein lipolysis of TG‑containing VLDL promoted a reduction in HDL synthesis and reverse cholesterol transport disorder and combined with elevation of METS‑IR index.
 As a whole independently on IR there were no significant correlations of METS‑IR index with BP level, serum glucose and parameters of VO such as BMI, BFP, TFM and FMI in pts with EBM and VO included in the study. There was a weak association between METS‑IR index and serum concentration of UA (r = 0.337; p = 0.004 in pts with EBM and r = 0.301; p = 0.004 in pts with VO). But in the case of IR presence in persons with EBM some associations of METS‑IR index with age (r = 0.391; p = 0.029), BFP (r = 0.544; p = 0.002), TFM (r = 0.436; p = 0.014), FMI (r = 0.513; p = 0.003) and serum UA level (r = 0.443; p = 0.013) were found.
 Conclusions. METS‑IR index for CMR evaluation and confirmation of IR presence is concluded to be worth calculated in persons without type 2 diabetes mellitus and BMI > 25 kg/m2 who had hypertriglyceridemia and/or low HDL‑C independently on glycemia level.

Dietary Inflammatory Index and Cardiometabolic Risk in Ecuadorian Women.

Low-grade systemic inflammation is implicated in metabolic syndrome (MetS) and cardiometabolic diseases. Diet is hypothesized to be an important low-grade inflammation modifier. However, few studies have examined the association of dietary inflammation with MetS and cardiometabolic risk in Latin American populations and their findings are inconsistent. Our cross-sectional study examined the association of dietary inflammatory potential with MetS and cardiometabolic risk components in 276 urban Ecuadorian women. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (E-DII), divided into quartiles (Q). E-DII scores ranged from −4.89 (most anti-inflammatory) to 4.45 (most pro-inflammatory). Participants in the most pro-inflammatory (Q4) compared to the least inflammatory E-DII quartile (Q1) had a 4.4 increased adjusted odds for MetS (95% C.I. = 2.0, 9.63; p < 0.001). Every one-unit increase in E-DII was associated with a 1.4 increase in MetS (95% CI = 1.22, 1.52; p < 0.001). In other adjusted models, the most pro-inflammatory E-DII quartile (Q4) was positively associated with total blood cholesterol and triglycerides (p < 0.001), LDL-c (p = 0.007), diastolic blood pressure (p< 0.002), mean arterial pressure (p < 0.006), waist circumference (p < 0.008), and Framingham risk score (p < 0.001). However, the previously identified associations with pulse wave velocity and BMI were no longer evident in the models. These findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health. Promoting healthier diets with a lower inflammatory potential may help to prevent or slow development of cardiometabolic disorders.

Assessment of PON1 activity and circulating TF levels in relation to BMI, testosterone, HOMA-IR, HDL-C, LDL-C, CHO, SOD activity and TAC in women with PCOS: An observational study

BackgroundPolycystic Ovary Syndrome (PCOS) is the most common female endocrinopathy among premenopausal women associated with hyperandrogenism, obesity, dyslipidemia, insulin resistance and inflammation. Oxidative stress is an important component of cardio-metabolic risk seen in PCOS. Material and methodsA total of 95 women with PCOS and 95 healthy controls were included in this observational study. Serum PON1 activity and stress markers were measured by spectrophotometric methods. Circulating TF level was measured by ELISA. ResultsWe found decreased PON1 activity and increased TF levels in women with PCOS compared to healthy controls. Fasting insulin, HOMA-IR, testosterone, LDL-C, MDA, PC and SOD activity were significantly increased whereas FGIR, QUICKI, HDLC, CAT and TAC were significantly decreased in PCOS women than controls. We observed a positive association of PON1 activity with FGIR, QUICKI, HDL-C and TAC, and its negative association was observed with LH, testosterone, fasting insulin and HOMA-IR in PCOS women. We further observed a positive association of TF with waist, waist to hip ratio, BMI, glucose 1hr, cholesterol, LDL-C, SGPT, uric acid and SOD activity in PCOS women. ConclusionsDecreased PON1 activity and raised circulating TF levels are respective indicators of pro-inflammatory and procoagulant status in PCOS women. The imbalanced oxidant/antioxidant status further supports the evidences that PCOS is an oxidant state. Further, the association of PON1 activity and TF levels with the clinical, laboratory findings and stress marker levels suggest that these factors taken together are involved in aggravating the pro-inflammatory status in PCOS women.

Chronic non­communicable diseases: focus on multimorbid pathological conditions and cardiovascular risk

Objective — to assess the structure of multimorbidity among common chronic non­communicable diseases (NCD) in Kharkiv region.Materials and methods. The screening has been performed among patients (n = 1428) with increased cardiovascular risk (CVR) with multimorbidity; the mean age of patients (58.41 ± 8.12) years; from them 512 (35.85 %) men and 916 (64.15 %) women. The calculation of CVR degree of was carried out according to the latest recommendations (2013, 2018) for the prevention and treatment of cardiovascular diseases (CVD); calculation of the comorbidity index was carried out according to the modern electronic modifications (2012—2017), (M.E. Charlson et al., 1987). To rectify the components of cardiometabolic risk, a retrospective study of the data (n = 191) of patients, that included 82 (42.9 %) women and 109 (57.1 %) men; the mean age (59.17 ± 1.81) years. The laboratory biochemical, clinical­instrumental and statistical methods were used during the study.Results and discussion. At present time, CVD occupies the leading place (68 %) in the structure of mortality in the Kharkiv region, and multimorbidity is an aggravating determining factor. In the study of indicators of multimorbidity of patients with elevated CVR (n = 1428) it has been established that patients with overweight consisted the majority of this category: the mean body mass index was (30.64 ± 0.18) kg/m2. The combined condition and age­related score was (5.98 ± 0.16) points; Charlson index of comorbidity (4.87 ± 0.18) points; ten­year survival rate was (24.94 ± 1.07) %. The increased indices correlated with the worsening of the quality of life (р < 0.001). The retrospective study (n = 191) revealed additional components of cardiometabolic risk: overweight (35.1 %), abdominal obesity (52.6 %), type 2 diabetes (37.7 %), non­alcoholic fatty liver disease (80.6 %), secondary dyslipidemia (90.6 %), hyperuricemia (41.4 %), burdened with hypertension and type 2 diabetes heredity (42.9 %) and (6.8 %), respectively) and smoking (10.5 %). A population­based strategy for the prevention of NCD and their multimorbidity should cover a wide range of populations, including young people (where CVR may be low or moderate) and middle­aged and elderly people (where CVR is high or very high).Conclusions. Multimorbidity, modified and unmodified risk factors significantly affect the prognosis and end points at high and very high СVR, and even more on the specific of disease and the effectiveness of treatment. Given the high frequency of multimorbidity among patients with NCD, the determination of the comorbidity index along with the assessment of CVR allows a more thorough approach to the participation of patients in individual and group complex therapeutic, rehabilitation and preventive measures. For modern medical practice, the problem is not the treatment of a single nosology, but the treatment of a particular patient, taking into account all possible risk factors and multimorbidity. Determining the degree of CVR, taking into account multimorbidity, is a leading step in determining the preventive strategy at the individual, family and population levels.

Oxidized Low-Density Lipoprotein (Ox-LDL) and Triggering Receptor-Expressed Myeloid Cell (TREM-1) Levels Are Associated with Cardiometabolic Risk in Nonobese, Clinically Healthy, and Young Adults.

Oxidative and inflammatory substances play an important role in the genesis of processes related to cardiometabolic risk. High levels of oxidized low-density lipoprotein (Ox-LDL) and of triggering receptor-expressed myeloid cells (TREM-1) are associated with cardiovascular and inflammatory diseases. In this study, we evaluate the association of the plasma concentrations of Ox-LDL and serum levels of circulating TREM-1 (sTREM-1) with the components of cardiometabolic risk (CMR) and other associated risk parameters. Although the individuals in this study were young, nonobese, and did not have signs, symptoms, and diagnosis of diseases, they already presented components of CMR. Ox-LDL lipid fraction correlated positively with CMR-related markers: body mass index (BMI), waist circumference (WC), body fat percentage, total cholesterol, LDL-c, VLDL-c, triglycerides, atherogenic cholesterol, and atherogenic index. Among these parameters, atherogenic cholesterol had a greater predictive effect for Ox-LDL alterations. Individuals with higher serum concentrations of sTREM-1 presented higher values for BMI, WC, triglycerides, VLDL-c, and atherogenic cholesterol. WC showed an effect on the association between the sTREM-1's inflammatory response and the components of CMR. The association of oxidative and inflammatory markers with anthropometric parameters and atherogenic cholesterol in nonobese, clinically healthy, and young individuals suggests the importance of early evaluation of these markers in order to prevent future cardiac events.

Patterns of Cardiometabolic Health as Midlife Women Transition to Menopause: A Prospective Multiethnic Study.

Cardiometabolic conditions increase in midlife, but early customized prevention strategies are not established for such women. To characterize and identify factors longitudinally related to constellations of cardiometabolic risk components in multiracial/ethnic women in midlife. We conducted a prospective, longitudinal, multiethnic cohort study of 3003 midlife women undergoing menopausal transition (MT). Metabolic syndrome (MetS) was defined as having at least three of five components: high fasting triglyceride (hTG) level, low high-density lipoprotein cholesterol (lHDL-C) level, high fasting plasma glucose (hGluc) level, large waist circumference (abdominal obesity; Ob), and hypertension (HTN). We described the patterns of constellations and estimated hazard ratios (HRs) for constellations at (i) incident MetS and (ii) recovery from MetS, using multivariable-adjusted Cox regression. Seven US sites. In all, 1412 non-Hispanic white, 851 black, 272 Japanese, 237 Hispanic, and 231 Chinese women. Race/ethnicity, lifestyle factors, and MT stage. Cardiometabolic constellations, incident MetS, and MetS recovery. Central obesity was the most frequent component. Having no components was the most frequent (31%) baseline constellation. Physical activity (HR = 1.68; 95% CI: 1.06, 2.68) and lower caloric intake (HR = 0.96; 95% CI: 0.93, 0.99 per 100 cal/d) were associated with recovery from MetS. Ob/hTG/lHDL-C (18%), Ob/HTN/lHDL-C (16%), and Ob/HTN/hGluc (14%) were frequent incident constellations. Physically active women had 26% to 62% lower hazards of incident MetS than inactive women. Modifiable lifestyle behaviors were related to recovery from MetS and decreased risk of the most frequent MetS constellations in midlife women.

Abstract P099: Longitudinal Associations Between Plasma Levels of Perfluoroalkyl Substances and Cardiometabolic Risk Factors

Background: Perfluoroalkyl substances (PFAS) are highly persistent synthetic chemicals with high global demand. Although PFAS may affect different components of cardiometabolic risk through the peroxisome proliferator-activated receptor (a master regulator of lipid and glucose metabolism), evidence remains scarce and inconsistent. Objective: Our aim was to evaluate plasma levels of six PFAS in association with cardiometabolic risk factors in a longitudinal setting among 40-50 year old women and men. Methods: Participants in the Västerbotten Intervention Programme visited their health center twice, 10 years apart: during 1990 to 2003 (baseline) and during 2001 to 2013 (follow-up). Participant underwent a medical examination, and measurements of systolic and diastolic blood pressure, total cholesterol and triglycerides were performed twice 10 years apart. PFAS were measured in 374 participants. The PFAS analysed were perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), perfluorohexanesulfonic acid (PFHxS), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnA). A generalized estimated equations method was used to assess repeated measurements and to provide beta coefficients (β) with their 95% confidence intervals (CI). Results: Overall, we observed little or no evidence of associations between PFAS and cardiometabolic risk factors. Exceptions were statistically significant inverse associations between PFOS and PFHxS with total cholesterol (β~- 0.30 ; mmol/L, comparing 3 rd tertile vs 1 st ) and PFOS, PFOA and PFDA with triglycerides (β from -0.17 to -0.26 mmol/L, comparing 3 rd tertile vs 1 st ), when analysis were restricted to those who did not develop diabetes during the follow-up. Conclusions: Our findings did not support the emerging premise that PFAS might increase cardiovascular risk through disrupting lipid metabolism and/or vascular system.

Cardiometabolic risk factors and health behaviors in family caregivers.

The purpose of this study was to compare components of cardiometabolic risk and health behaviors of 20 family caregivers of allogeneic hematopoietic stem cell transplant patients to those of age, gender, and race/ethnicity-matched controls. A prospective, repeated measures design was used to compare cardiometabolic risk and health behaviors in caregivers and controls at three time-points: pre-transplantation, discharge, and six weeks post-discharge. Measures included components of metabolic syndrome, Reynolds Risk Score, NMR serum lipoprotein particle analyses, and the Health-Promoting Lifestyle Profile II (HPLP-II). Mixed-model repeated measure analyses were used. There were no between or within group differences in LDL cholesterol, HDL cholesterol, and triglycerides. There was a significant interaction effect between time and role in large VLDL concentration (VLDL-P) (F (2, 76) = 4.36, p = .016), with the trajectory of large VLDL-P increasing over time in caregivers while remaining stable in controls. Within caregivers, VLDL particle size (VLDL-Z) was significantly larger at time-point three compared to time-points one (p = .015) and two (p = .048), and VLDL-Z was significantly larger in caregivers than in controls at time point three (p = .012). HPLP-II scores were lower in caregivers than controls at all time-points (p < .01). These findings suggest that caregiving may have a bigger impact on triglycerides than on other lipids, and it is through this pathway that caregivers may be at increased cardiometabolic risk. More sensitive measurement methods, such as NMR lipoprotein particle analyses, may be able to detect early changes in cardiometabolic risk.

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

BackgroundThe oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes.ObjectiveTo investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults.MethodsUniversity students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin.ResultsApproximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; β = 0.17; p = 0.001).ConclusionsThe plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions.

Early Life Exposure to Outdoor Air Pollution and Cardiometabolic Risk at Preschool Age

Introduction Children with elevated cardiometabolic (CM) risk could be at greater risk of suffering cardiovascular disease later in life. Outdoor air pollution has been associated with some components of CM risk in children (eg obesity), but there is few literature on outdoor air pollution exposure and overall CM risk in children. Available findings suggest first trimester of pregnancy and first year of life as critical periods for air pollution exposure and CM risk in children. Our aim is to investigate the association between exposure to outdoor nitrogen dioxide (NO2) in different critical periods and CM risk in preschoolers. Methods We used data from a Spanish population-based birth cohort established between 2003 and 2008 in four regions. First trimester of pregnancy NO2 exposure levels were estimated by land-use regression models, extrapolated in time to exact periods of interest. CM risk components (i.e. body mass index [BMI], systolic blood pressure [SBP], low density lipoprotein [LDL]) were measured at 4 years. We tested the association between NO2 and selected CM risk components using linear regression models adjusted for age, sex and cohort. Results We found no association between an IQR increase in NO2 exposure levels in the first trimester of pregnancy (20.6 μg/m^3) and BMI z-score (N=1721; β=-0.02 [CI95% -0.10,0.07]), SBP (N=1296; β=0.00 [CI95% -0.08,0.08]), and LDL (N=849; β=-1.65 [CI95% -4.41,1.10]). Conclusions Results suggest that there is no association between NO2 exposure in the first trimester of pregnancy and selected individual CM risk components. Further analyses will address the association between exposure to NO2 and particulate matter in two critical periods (first pregnancy trimester and first year) and overall CM risk at 4 years, defined as a latent variable in structural equation models fed with CM components. Other exposure windows will also be explored.

A cross-sectional analysis of the association between marijuana and cigarette smoking with metabolic syndrome among adults in the United States

AimTo assess the relationship between marijuana use, cigarette smoking and metabolic syndrome among adults in the United States who reported they use marijuana or cigarettes in comparison to non-marijuana and non-cigarette users. MethodWe conducted multiple logistic regression analyses using data from the 2011–2012 United States National Health and Nutrition Examination Survey to estimate relationships between cardio-metabolic risk factors and increasing years of smoking cigarette or marijuana use. Statistical adjustments were made for both demographic and endogenous factors related to recreational substance use. ResultsEach year increase in marijuana use was significantly associated with increased odds of metabolic syndrome (OR=1.05; 95% CI: 1.01, 1.09), and hypertension (OR=1.04; 95% CI: 1.01, 1.07) adjusting for both demographic and endogenous factors related to recreational substance use. Each year increase in cigarette smoking was significantly associated with increased odds of hypertension (OR=1.03; 95% CI: 1.00, 1.06) and hyperglycemia (OR=1.03; 95% CI: 1.01, 1.05) after adjusting for confounders. ConclusionThe results of this investigation suggest that increased years of marijuana or cigarette use are important factors in metabolic health; and consequently calls for the need to consider the potential negative effects of marijuana or cigarette for metabolic syndrome and its associated cardio-metabolic risk components.

Metabolic Syndrome: Bridging the Gap from Childhood to Adulthood.

Childhood and adolescence are particularly vulnerable periods of life to the effects of cardiometabolic risk and later development of atherosclerosis, hypertension, and diabetes mellitus. Developing countries with limited resources suffer most heavily from the consequences of cardiometabolic risk in children and its future implications to the global health burden. A better understanding of mechanisms leading to cardiometabolic risk in early life may lead to more effective prevention and intervention strategies to reduce metabolic stress in children and later disease. Longitudinal "tracking" studies of cardiometabolic risk in children provide a tremendous global resource to direct prevention strategies for cardiovascular disease. In this review, we will summarize the pathophysiology, existing definitions for cardiometabolic risk components in children. Screening and identifying children and adolescents of high cardiometabolic risk and encouraging them and their families through healthy lifestyle changes should be implemented to as a global public health strategy.

Body Mass Index, Waist Circumference, and the Clustering of Cardiometabolic Risk Factors in Early Childhood.

Obesity has its origins in early childhood; however, there is limited evidence of the association between anthropometric indicators and cardiometabolic risk factors in young children. Our aim was to evaluate the associations between body mass index (BMI) and waist circumference (WC) in relation to cardiometabolic risk factors and to explore the clustering of these factors. A cross-sectional study was conducted in children aged 1-5 years through TARGet Kids! (n = 2917). Logistic regression was used to evaluate associations between BMI and WC z-scores and individual traditional and possible non-traditional cardiometabolic risk factors. The underlying clustering of these measures was evaluated using principal components analysis (PCA). Child obesity (BMI z-score >2) was associated with high (>90th percentile) leptin [odds ratio (OR) 8.15, 95% confidence interval (CI) 4.56, 14.58] and insulin (OR = 1.76; 95% CI 1.05, 2.94). WC z-score >1 was associated with high insulin (OR 1.59, 95% CI 1.11, 2.28), leptin (OR 5.48, 95% CI 3.48, 8.63) and 25-hydroxyvitamin D < 75 nmol/L (OR 1.39, 95% CI 1.08, 1.79). BMI and WC were not associated with other traditional cardiometabolic risk factors, including non-High Density Lipoprotein (HDL) cholesterol, and glucose. Among children 3-5 years (n = 1035) the PCA of traditional risk factors identified three components: adiposity/blood pressure, metabolic, and lipids. The inclusion of non-traditional risk factors identified four additional components but contributed minimally to the total variation explained. Anthropometric indicators are associated with selected cardiometabolic risk factors in early childhood, although the clustering of risk factors suggests that adiposity is only one distinct component of cardiometabolic risk. The measurement of other risk factors beyond BMI and WC may be important in defining cardiometabolic risk in early childhood.

Strength Capacity and Cardiometabolic Risk Clustering in Adolescents

The purpose of this study was to determine the gender-specific independent association between muscular strength and cardiometabolic risk clustering in a large cohort (n = 1421) of children. Principal component analysis was used to determine the pattern of risk clustering and to derive a continuous aggregate score (MetScore) from various cardiometabolic risk components: percent body fat (%BF), fasting glucose, blood pressure, plasma triglycerides levels, and HDL-cholesterol. Gender-stratified risk and MetScore were assessed by using general linear models and logistic regression for differences between strength tertiles, as well as independent associations with age, BMI, estimated cardiorespiratory fitness (CRF), physical activity, and muscular strength (normalized for body mass). In both boys (n = 670) and girls (n = 751), there were significant differences in cardiometabolic profiles across strength tertiles, such that stronger adolescents had lower overall risk. Age, BMI, cardiorespiratory fitness, physical activity participation, and strength were all individually correlated with multiple risk components, as well as the overall MetScore. However, in the adjusted model, only BMI (β = 0.30), physical inactivity (β = 0.30), and normalized strength capacity (β = -1.5) emerged as significant (P < .05) predictors of MetScore. %BF was the strongest loading coefficient within the principal component analysis-derived MetScore outcome. Normalized strength is independently associated with lower cardiometabolic risk in boys and girls. Moreover, %BF was associated with all cardiometabolic risk factors and carried the strongest loading coefficient. These findings bolster the importance of early strength acquisition and healthy body composition in childhood.

Bariatric surgery reverses metabolic risk in patients treated in outpatient level

BackgroundThe conventional treatment of obesity presents unsatisfactory results on weight loss and its long-term sustainability, therefore bariatric surgery has been suggested as an effective therapy, determining sustainable long-term weight loss, reversal of components of cardiometabolic risk and improved quality and life expectancy.AimTo investigate the clinical component of the cardiometabolic risk in patients undergoing bariatric surgery assisted on outpatient basis.MethodsThe sample consisted of 47 patients with ages between 18 and 60 years, 72% females. Diabetes mellitus, hypertension, and dyslipidemia were prospectively evaluated by using the Assessment of Obesity-Related Co-morbidities scale.ResultsOccurred improvement in these co-morbidities within 12 months after surgery. Co-morbidities resolved were greater than those improved.ConclusionThe study revealed that the Assessment of Obesity-Related Co-morbidities is a system that can be effectively used to quantify the degree of reduction of the severity of the cardiometabolic risk in response to bariatric surgery.

Concurrent Physical Activity Modifies the Association between n3 Long-Chain Fatty Acids and Cardiometabolic Risk in Midlife Adults

Greater consumption of n3 (ω3) polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can reduce risk for cardiovascular disease events, yet their effects on metabolic risk factors and diabetes remain unclear. This cross-sectional study used a community volunteer sample to test whether the associations between n3 fatty acids and cardiometabolic risk vary as a function of physical activity. Participants were 344 generally healthy adults, 30–54 y of age, not taking fish oil supplements or confounding medications. Serum phospholipid EPA and DHA were used together (EPA+DHA) as a biomarker of n3 fatty acid exposure. Cardiometabolic risk was calculated as a continuous measure based on standardized distributions of blood pressure, waist circumference, HDL cholesterol, triglycerides, glucose, and a simple count of risk factors. Insulin resistance was estimated from the homeostatic model assessment. Physical activity was found to predict cardiometabolic risk (P ≤ 0.02) and insulin resistance (P ≤ 0.02) and to moderate the association between EPA+DHA and both cardiometabolic risk (P-interaction ≤ 0.02) and insulin resistance (P-interaction ≤ 0.02). Specifically, higher EPA+DHA was associated with lower cardiometabolic risk and insulin resistance in persons engaged in regular physical activity but not in relatively inactive individuals. These findings were noted in several components of cardiometabolic risk, in men and women separately, and in models adjusted for overall diet quality. In midlife adults, habitual physical activity may be necessary to unmask the salutary effects of n3 fatty acids on cardiometabolic risk and insulin resistance.

Salivary pH as a marker of plasma adiponectin concentrations in Women

BackgroundPlasma adiponectin is a significant correlate of the pro-inflammatory cardiometabolic risk profile associated with obesity and type 2 diabetes. Salivary pH is influenced by several cardiometabolic risk components such as inflammation, oxidation and numerous oral and systemic health modulators, including the menopausal status. This study aimed to assess the association between plasma adiponectin concentrations and salivary pH in women according to the menopausal status.MethodUnstimulated saliva collection was performed in 151 Caucasian women of French-Canadian origin (53 premenopausal women (PMW) and 98 menopausal women (MW)). Student's t test, ANOVA and linear regression models were used to assess the association between plasma adiponectin concentrations and salivary pH.ResultsPlasma adiponectin levels increased as a function of salivary pH in the whole sample and among MW (r = 0.29 and r = 0.36, p < 0.001). The proportion of the variance of plasma adiponectin levels explained by the salivary pH (R2) was 10.8% (p < 0.001). Plasma adiponectin levels progressively increased across salivary pH quartiles (p = 0.005).ConclusionsThese results suggest that salivary pH is a significant correlate of plasma adiponectin levels in women. With the increasing prevalence of type 2 diabetes and obesity, new technologies should be developed to more easily monitor health status, disease onset and progression. Salivary pH, a simple, inexpensive and non-invasive measure, could be a very promising avenue.

Effects of daily quercetin-rich supplementation on cardiometabolic risks in male smokers

Limited information from human studies indicates that dietary quercetin supplementation influences blood lipid profiles, glycemic response, and inflammatory status, collectively termed cardiometabolic risks. We tested the hypothesis that quercetin-rich supplementation, derived from onion peel extract, improves cardiometabolic risk components in healthy male smokers in a randomized, double blinded, placebo-controlled parallel design. Randomly assigned subjects were instructed to take either the placebo (n = 43) or 100 mg quercetin capsules each day (n = 49) for 10 weeks. Anthropometric parameters and blood pressure were measured, and blood lipids, glucose, interleukin-6, and soluble vascular cell adhesion molecule-1 (sVCAM-1) were determined at baseline and after 10 weeks of quercetin supplementation. Quercetin-rich supplementation significantly reduced serum concentrations of total cholesterol (P < 0.05) and LDL-cholesterol (P < 0.01), whereas these effects were not shown in the placebo group. Furthermore, significant increases were observed in serum concentrations of HDL-cholesterol both in the placebo (P < 0.005) and quercetin-rich supplementation group (P < 0.001); however, changes in HDL-cholesterol were significantly greater in subjects receiving quercetin-rich supplementation than the placebo. Both systolic (P < 0.05) and diastolic blood pressure (P < 0.01) decreased significantly in the quercetin-rich supplementation group. Glucose concentrations decreased significantly after 10 weeks of quercetin-rich supplementation (P < 0.05). In contrast, no effects of quercetin-rich supplementation were observed for the inflammatory markers-IL-6 and sVCAM-1. Daily quercetin-rich supplementation from onion peel extract improved blood lipid profiles, glucose, and blood pressure, suggesting a beneficial role for quercetin as a preventive measure against cardiovascular risk.