Differences In Cardiometabolic Risk Factors Research Articles

Disparities in the Cardiometabolic Impact of Adiposity among African American and Hispanic Adolescents.

As adiposity increases in youth, so does the prevalence of cardiometabolic risk factors (CMRFs). The etiology of adiposity-based chronic disease and CMRFs includes ethnoracial disparities that are rarely considered in current treatment approaches. Precision interventions require further characterization of these disparities among high-risk youth. The objective of this study was to characterize differences in CMRF among African American (AA) and Hispanic (H) adolescents with varying levels of adiposity. A cross-sectional analysis of 2284 adolescents aged 12-17 was conducted using 3-year clinical data from Lifedoc Health. CMRF prevalence were compared using χ2, with logistic regression models (LRM) applied to explore the relationships between exposures (age, sex, ethnoracial group, adiposity) and CMRF outcomes. Prevalence of CMRF rose with increasing adiposity, which was the strongest determinant of risk overall. However, individual risk profiles differed between the two groups, with H having higher prevalence of metabolic syndrome (MetS), higher triglycerides and liver enzymes, and low high-density lipoprotein cholesterol (HDL-c). Meanwhile, AA had higher prevalence of elevated blood pressure (BP) in the overweight category, prediabetes in overweight to severe obesity, and type 2 diabetes in obesity. LRM showed 3.0-fold greater chance of impaired glucose metabolism in AA than H, who were 1.7, 5.9, and 8.3 times more likely to have low HDL-c, high liver enzymes, and high triglycerides, respectively. Overweight/obesity prevalence was very high among AA and H adolescents. Excess adiposity was associated with an increased prevalence of CMRF, with individual risk factors differing between groups as adiposity increased. Research within routine clinical settings is required to better characterize these discrepancies and ameliorate their adverse impact on health in the transition to adulthood.

Financial Incentives and Treatment Outcomes in Adolescents With Severe Obesity

Adolescent severe obesity is usually not effectively treated with traditional lifestyle modification therapy. Meal replacement therapy (MRT) shows short-term efficacy for body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) reduction in adolescents, and financial incentives (FIs) may be an appropriate adjunct intervention to enhance long-term efficacy. To evaluate the effect of MRT plus FIs vs MRT alone on BMI, body fat, and cardiometabolic risk factors in adolescents with severe obesity. This was a randomized clinical trial of MRT plus FIs vs MRT alone at a large academic health center in the Midwest conducted from 2018 to 2022. Participants were adolescents (ages 13-17 y) with severe obesity (≥120% of the 95th BMI percentile based on sex and age or ≥35 BMI, whichever was lower) who were unaware of the FI component of the trial until they were randomized to MRT plus FIs or until the end of the trial. Study staff members collecting clinical measures were blinded to treatment condition. Data were analyzed from March 2022 to February 2024. MRT included provision of preportioned, calorie-controlled meals (~1200 kcals/d). In the MRT plus FI group, incentives were provided based on reduction in body weight from baseline. The primary end point was mean BMI percentage change from randomization to 52 weeks. Secondary end points included total body fat and cardiometabolic risk factors: blood pressure, triglyceride to high-density lipoprotein ratio, heart rate variability, and arterial stiffness. Cost-effectiveness was additionally evaluated. Safety was assessed through monthly adverse event monitoring and frequent assessment of unhealthy weight-control behaviors. Among 126 adolescents with severe obesity (73 female [57.9%]; mean [SD] age, 15.3 [1.2] years), 63 participants received MRT plus FIs and 63 participants received only MRT. At 52 weeks, the mean BMI reduction was greater by -5.9 percentage points (95% CI, -9.9 to -1.9 percentage points; P = .004) in the MRT plus FI compared with the MRT group. The MRT plus FI group had a greater reduction in mean total body fat mass by -4.8 kg (95% CI, -9.1 to -0.6 kg; P = .03) and was cost-effective (incremental cost-effectiveness ratio, $39 178 per quality-adjusted life year) compared with MRT alone. There were no significant differences in cardiometabolic risk factors or unhealthy weight-control behaviors between groups. In this study, adding FIs to MRT resulted in greater reductions in BMI and total body fat in adolescents with severe obesity without increased unhealthy weight-control behaviors. FIs were cost-effective and possibly promoted adherence to health behaviors. ClinicalTrials.gov Identifier: NCT03137433.

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.

Gender-related differences in cardiometabolic risk factors and oxidative stress among prepubertal children with obesity.

Gender-related differences in oxidative stress, nitric oxide bioavailability, and cardiometabolic risk factors were examined in a cross-sectional study involving 313 prepubertal children (8-9 years old) from the generation XXI birth-cohort. Anthropometric measurements, cardiometabolic variables, and redox markers were assessed, including plasma and urinary isoprostanes (P-Isop, U-Isop), plasma total antioxidant status (P-TAS), serum myeloperoxidase (MPO), plasma and urinary nitrates and nitrites (P-NOX, U-NOX), and urinary hydrogen peroxide (U-H2O2). Girls showed higher levels of total/non-HDL cholesterol, triglycerides, and insulin resistance (HOMA-IR) compared to boys. Notably, U-H2O2 values were lower in girls. When stratifying by body mass index (BMI) and gender, both girls and boys exhibited higher MPO concentration and U-Isop values. Uric acid concentration was higher in overweight and obese girls than in normal weight girls, while no significant differences were observed among boys across BMI categories. Furthermore, U-NOX values differed only in boys, with higher levels observed in overweight and obese individuals compared to those with normal weight. Multivariate analysis, adjusted for age and BMI z-score, demonstrated inverse associations between U-H2O2 and pulse wave velocity values, as well as between U-NOX and total or non-HDL cholesterol, exclusively in boys. In girls, a positive association between U-Isop and HOMA-IR values was observed. In conclusion, gender differentially impacts oxidative stress, nitric oxide bioavailability, and cardiometabolic risk factors in prepubertal children. Prepubertal girls appear more susceptible to oxidative stress-induced metabolic dysfunction, while in boys, elevated levels of redox and nitric oxide bioavailability markers seem to provide protection against arterial stiffness and lipid homeostasis.

THE IMPACT OF SEX ON METABOLIC AND FUNCTIONAL ABNORMALITIES, INDUCED BY HIGH-FRUCTOSE-DIET IN RATS

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors, which manifestation may be different for men and women. Changes in sex hormone levels in men and women during lifespan contribute to increased cardiometabolic risk. Data of clinical researches suggest that transition from normal glucose tolerance to dysglycemia lead to more adverse differences in cardiometabolic risk factors in women than in men, suggesting an important impact of sex on the development of metabolic abnormalities. A significant increase in risk may be due to the sex differences in manifestation of some components of metabolic syndrome, but accurate reasons of these discrepancies need future investigations. The aim of this study was to determine the differences in impairment of glucose, lipid metabolism and cardiovascular systems function between male and female rats with different levels of estrogen sufficiency. Materials and Methods. MetS was modelled in male and female rats with different levels of estrogens by chronic (for 8 weeks) intake of fructose (high-fructose diet - HFD) with drinking water at a concentration 200 g/L. Estrogens deficiency was reproduced by bilateral ovariectomy. Experimental rats were divided into five groups: control males (n=6), control females (n=6), males with HFD (n=6), sham-operated females with intact ovaries and HFD (n=6), ovariectomized (OVX) females with HFD (n=6). Glucose homeostasis was assessed by basal glycemia, glycemia during the intra-abdominal glucose tolerance test and fructosamine level. Insulin sensitivity was determined using intra-abdominal insulin tolerance test. Body weight gain, visceral fats, level of total cholesterol, triglycerides, levels of estradiol and testosterone in blood serum were determined. At the end of the study, electrocardiograms were recorded in three standard leads from the limbs. Data are presented as mean ± standard error of mean (SEM). Results. It was established that HFD have not been induced metabolic abnormalities in female rats with intact ovaries. HFD, independently of sex, led to the development of insulin resistance and significant increase in fructosamine level in blood serum of rats. Ovariectomized females with HFD had greater intensity of body weight gain, significantly higher levels of relative mass of fats, more pronounced alterations of lipid metabolism with increased total cholesterol and significantly higher levels of triglycerides, than HFD-treated male rats. However, impairment of glucose tolerance, induced by HFD, was more pronounced in male than in OVX female rats. We found the decline testosterone levels and slight increase in estradiol levels in male rats with HFD. OVX females with HFD had a moderate significant increase in testosterone levels and dramatically decrease in estradiol concentration as result of bilateral ovariectomy. HFD, independently from sex, induced the development of sinus tachycardia in experimental animals. Metabolic abnormalities, induced by HFD, in OVX female rats led to more pronounced disturbances of heart depolarization and repolarization processes and development of diastolic dysfunction compare to HFD-treated males. Conclusions. We revealed that sex and estrogens levels have a great impact on the impairment of glucose and lipid metabolism and cardiovascular systems function, induced by high-fructose diet in rats. The obtained data justifies the necessity to take into account sex and estrogens sufficiency in the development of gender-specific prevention and treatment of metabolic syndrome.

Higher burden of cardiometabolic and socioeconomic risk factors in women with type 2 diabetes: an analysis of the Glycemic Reduction Approaches in Diabetes (GRADE) baseline cohort

IntroductionType 2 diabetes mellitus (T2DM) is a powerful risk factor for cardiovascular disease (CVD), conferring a greater relative risk in women than men. We sought to examine sex differences in...

Interactions between sex and the age at disease onset on cardiometabolic risk factors in a Ghanaian population with type 2 diabetes mellitus: A cross-sectional study.

The are sex differences in cardiometabolic risk factors in type 2 diabetes mellitus (T2DM) as well as the age at disease onset. However, the impact of these risk factors on the age at onset of T2DM is less known in the Ghanaian population. An understanding of the differential impact of cardiometabolic risk factors on the age at onset on T2DM may lead to sex-specific interventions in preventive and management strategies for T2DM. The study was cross-sectional from January to June 2019 at the Bolgatanga regional hospital. The study involved 163 T2DM patients (Female = 103, Male = 60), aged from 25 to 70 years. The body mass index (BMI) and the waist-to-hip ratio (WHR) were measured following standardized anthropometric techniques. Fasting venous blood samples were collected and analyzed for cardiometabolic risk factors including total cholesterol (TCHOL) and low-density lipoprotein (LDL) cholesterol. While TCHOL was higher in males than females (mean [SD]: F = .78 [1.37], M = 4.27 [1.39]) and LDL higher in females than males (mean [SD]: [F = 4.33 [1.22], M = 3.87 [1.26]), these did not, however, attain conventional statistical significance for TCHOL (t = 1.985, p = 0.05) and LDL (t = 2.001, p = 0.05). There were however, significant interactions between sex and the age at disease onset on TCHOL (t = -2.816, p = 0.006) and LDL (t = -2.874, p = 0.005), which were independent of the BMI, WHR and disease duration. The relationship between the age at disease onset and that of TCHOL and LDL were positive in females but negative in males. Fasting plasma TCHOL and LDL increases with increasing age at onset of T2DM in females but decreases in males. Strategies for the prevention and management of T2DM should be sex-specific. Females with T2DM should be given more attention regarding their fasting plasma cholesterol (total) and LDL cholesterol as they are more likely than men to have increased levels of these lipids with increasing age at disease onset.

Cardiometabolic Risk Factors and Incident Cardiovascular Disease Events in Women vs Men With Type 1 Diabetes

The lower risk of cardiovascular disease (CVD) among women compared with men in the general population may be diminished among those with diabetes. To evaluate cardiometabolic risk factors and their management in association with CVD events in women vs men with type 1 diabetes enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. This cohort study used data obtained during the combined DCCT (randomized clinical trial, conducted 1983-1993) and EDIC (observational study, conducted 1994 to present) studies through April 30, 2018 (mean [SD] follow-up, 28.8 [5.8] years), at 27 clinical centers in the US and Canada. Data analyses were performed between July 2021 and April 2022. During the DCCT phase, patients were randomized to intensive vs conventional diabetes therapy. Cardiometabolic risk factors and CVD events were assessed via detailed medical history and focused physical examinations. Blood and urine samples were assayed centrally. CVD events were adjudicated by a review committee. Linear mixed models and Cox proportional hazards models evaluated sex differences in cardiometabolic risk factors and CVD risk over follow-up. A total of 1441 participants with type 1 diabetes (mean [SD] age at DCCT baseline, 26.8 [7.1] years; 761 [52.8%] men; 1390 [96.5%] non-Hispanic White) were included. Over the duration of the study, compared with men, women had significantly lower body mass index (BMI, calculated as weight in kilograms divided by height in meters squared; β = -0.43 [SE, 0.16]; P = .006), waist circumference (β = -10.56 cm [SE, 0.52 cm]; P < .001), blood pressure (systolic: β = -5.77 mm Hg [SE, 0.35 mm Hg]; P < .001; diastolic: β = -3.23 mm Hg [SE, 0.26 mm Hg]; P < .001), and triglyceride levels (β = -10.10 mg/dL [SE, 1.98 mg/dL]; P < .001); higher HDL cholesterol levels (β = 9.36 mg/dL [SE, 0.57 mg/dL]; P < .001); and similar LDL cholesterol levels (β = -0.76 mg/dL [SE, 1.22 mg/dL]; P = .53). Women, compared with men, achieved recommended targets more frequently for blood pressure (ie, <130/80 mm Hg: 90.0% vs 77.4%; P < .001) and triglycerides (ie, <150 mg/dL: 97.3% vs 90.5%; P < .001). However, sex-specific HDL cholesterol targets (ie, ≥50 mg/dL for women, ≥40 mg/dL for men) were achieved less often (74.3% vs 86.6%; P < .001) and cardioprotective medications were used less frequently in women than men (ie, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker: 29.6% [95% CI, 25.7%-33.9%] vs 40.0% [95% CI, 36.1%-44.0%]; P = .001; lipid-lowering medication: 25.3% [95% CI, 22.1%-28.7%] vs 39.6% [95% CI, 36.1%-43.2%]; P < .001). Women also had significantly higher pulse rates (mean [SD], 75.2 [6.8] beats per minute vs 71.8 [6.9] beats per minute; P < .001) and hemoglobin A1c levels (mean [SD], 8.3% [1.0%] vs 8.1% [1.0%]; P = .01) and achieved targets for tighter glycemic control less often than men (ie, hemoglobin A1c <7%: 11.2% [95% CI, 9.3%-13.3%] vs 14.0% [95% CI, 12.0%-16.3%]; P = .03). These findings suggest that despite a more favorable cardiometabolic risk factor profile, women with type 1 diabetes did not have a significantly lower CVD event burden than men, suggesting a greater clinical impact of cardiometabolic risk factors in women vs men with diabetes. These findings call for conscientious optimization of the control of CVD risk factors in women with type 1 diabetes.

Age-dependent sex differences in cardiometabolic risk factors

Cardiometabolic diseases (CMDs) are a major cause of mortality worldwide, yet men and women present remarkable differences in disease prognosis, onset and manifestation. Here we characterize how sex differences in cardiometabolic risk factors vary with age by examining 45 phenotypes and 6 lifestyle factors in 146,021 participants of the Dutch population cohort Lifelines. We show that sex differences are present in 71% of the studied phenotypes. For 31% of these phenotypes, the phenotypic difference between sexes is dependent on age. CMD risk factors show various patterns of age-related sex differences, ranging from no difference for phenotypes such as body mass index (BMI) to strong age-modified sex differences for lipid levels. We also identify lifestyle factors that influence phenotypes in a sex- and age-dependent manner. These results highlight the importance of taking age into account when studying sex differences in CMDs.

1236-P: Cardiometabolic Disease Risk in Metabolically Unhealthy vs. Healthy in Normal Weight and Obesity: Results from 2015 and 20KNHNES Data

The concept of metabolically unhealthy vs. healthy obese (MUO vs. MHO) was expanded to non-obese individuals as obesity-related comorbidities exist in a subgroup of metabolically unhealthy vs. healthy normal-weight (MUNW vs. MHNW) . It is unclear if MUNW differs from MHO with respect to cardiometabolic health. Here, we applied a widely accepted definition of metabolic health (JAMA 20285: 2486) and examined differences in cardiometabolic risk factors among 4 subgroups of Korean adults (N=7,594) . Individuals with NW vs. obesity (BMI ≥25 kg/m2) were categorized as either MU or MH if those met one or more of the following criteria: triglyceride ≥150 mg/dl; fasting glucose ≥100 mg/dl; HDL &amp;lt;40 mg/dl in men or &amp;lt;50 mg/dl in women; and SBP ≥130 mmHg or DBP ≥85 mmHg. Despite a gradual increase in BMI and visceral adiposity index from MHNW to MUNW to MHO to MUO, surrogates of insulin resistance (TG/HDL) and arterial stiffness (estimated pulse wave velocity) were higher in MUNW vs. MHO (Table) . HOMA-IR was highest in MUO with no difference between MUNW and MHO (Table) . Individuals with MUNW vs. MHO are at least similar to or more vulnerable to cardiometabolic disease. Our data indicate that cardiometabolic risk is not solely dependent on adiposity, suggesting that early preventive efforts for chronic disease are needed for individuals with normal-weight, yet metabolically unhealthy. Disclosure M.Seo: None. W.Cho: None. J.Rosenberg: None. L.White: None. J.Kim: n/a.

Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study

BackgroundBeyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual cardiometabolic risk factors among obese men and women.MethodsIn this cross-sectional analysis, 432 persons from the ongoing Obesity Weight Reduction Study (n = 356 obese, ØBMI 41 ± 8 kg/m2, and 76 non-obese, ØBMI 25 ± 3 kg/m2), were included. The relations of sex to MetS prevalence and selected cardiometabolic risk factors were assessed using univariate and multivariate adjusted regression models.ResultsIn crude analyses, %fat mass and the fat mass/lean mass ratio were significantly higher in women than in men, regardless of increasing obesity categories, from normal weight to grade-3-obesity. In contrast, markers of abdominal obesity, such as waist circumference and waist-to-hip ratio were higher in men than in women, despite similar BMI. The prevalence of the MetS was higher in obese men than in women (67.6 vs. 45.0%, p < 0.0001), particularly in younger individuals < 40 years (72.5 vs. 36.8%, p < 0.0001), but “metabolically healthy obesity” (BMI ≥ 30, no other NCEP ATPIII MetS component) was more common in women than in men (15.6 vs. 4.1%, p < 0.0001). After adjusting for age, %body fat and height, sex differences were observed for HDL-cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p = 0.002), insulin and HOMA-IR levels (p < 0.001), ALAT (p < 0.001), adiponectin (p < 0.001), and sE-selectin (p = 0.005). In contrast, crude sex differences in other variables, such as leptin levels (68 ± 4 in obese women vs. 33 ± 2 µg/L in men, p < 0.0001), disappeared after accounting for differences in %body fat (least-squares means of leptin: 52 ± 4 vs. 55 ± 6 µg /L, p = 0.740). A logistic regression model adjusting for age and lifestyle factors revealed a lower risk of having MetS for women as compared to men (OR = 0.38[0.22–0.60]). That risk estimate did not materially alter after adding BMI to the model. In contrast, no statistically significant association between sex and MetS prevalence was observed after adding waist circumference and adiponectin to the model (OR = 1.41[0.59–3.36]).ConclusionsDifferent body fat distribution patterns, particularly abdominal adiposity, adiponectin, and related biomarkers, may contribute to sex differences in cardiometabolic risk factors and to the prevalence of the MetS.

Gender differences in cardiometabolic risks among young adults

Aim. To carry out a comparative assessment of cardiometabolic risk factors in men and women aged 18–44 years.Methods. The cross-sectional study included 251 patients divided into 2 groups. Group 1 consisted of 124 men; group 2 had 127 women in it. All participants of the study underwent anamnesis collection, blood pressure measurement, and assessment of anthropometric parameters, physical examination, biochemical and immunological tests.Results. The most significant gender differences were noted in the levels of leptin and adiponectin, fibrinogen and plasminogen activator inhibitor type 1, angiotensin II and interleukin-10 in the blood serum with no differences in cardiometabolic risk factors, including glucose and lipid metabolism.Conclusion. The revealed features of changes in adipokines and cytokines, indicators of hemostasis and vasoconstrictors in men and women expand the current knowledge about the role of some pathophysiological mechanisms in the development of cardiovascular pathology at a young age in the context of cardiometabolic risk concept.

Accelerometer-Measured Physical Activity and Cardiometabolic Risk Factors by Race-Ethnicity: 2003-2006 NHANES.

Previous studies suggest that the magnitude of morbidity/mortality reduction may differ between race-ethnic groups despite equated dose of physical activity (PA). The purpose of this study was to compare the potential racial-ethnic differences in cardiometabolic risk factors (CMRF) across quartiles of accelerometer-derived total activity counts/day (TAC/d) among US adults. The final sample (n=4144) included adults who participated in the 2003-2006 National Health and Nutrition Examination Survey (NHANES). CMRF included fasting glucose (FG), fasting insulin (FI), HOMA-IR, resting systolic (SBP) and diastolic blood pressure (DBP), waist circumference (WC), BMI, CRP, HDL-C, LDL-C, and triglycerides. Race-ethnic groups examined included non-Hispanic white (NHW), non-Hispanic black (NHB), and Mexican American (MA). In the highest quartile, NHW had significantly lower values of HOMA-IR, FI, SBP, BMI, WC, and HDL-C when compared to NHB. Compared to MA in the highest quartile, NHW had significantly lower values of HOMA-IR, FI, BMI, and triglycerides. Significant race-ethnic differences were found for several CMRF, especially among those who were in the top quartile of PA (e.g., the most active adults). It is probable that the protective effect of higher volumes of PA on CMRF is moderated by other non-PA factors distinct to NHB and MA.

Oral glucose tolerance response curve predicts disposition index but not other cardiometabolic risk factors in healthy adolescents.

In obese adults the shape of the glucose response curve during an oral glucose tolerance test (OGTT) predicts future type 2 diabetes. Patients with an incessant increase or monophasic curves have increased risk compared to those with biphasic curves. Since type 2 diabetes is associated with increased cardiometabolic risk, we studied whether differences in OGTT response curve are associated with differences in cardiometabolic risk factors in healthy adolescents across a wide body mass index (BMI) range. Sixty-nine (33F/36M), white adolescents (age: 15.2±1.7years; BMI: 21.5±4.7kg/m2; mean±SD) were studied. Risk factors measured included percent body fat, blood pressure, lipids, augmentation index, reactive hyperemia, endothelin 1, plasminogen activator 1, inflammatory markers (interleukin 6, c-reactive protein), insulin secretion, insulin sensitivity (Matusda index), and disposition index (DI). Thirty-two subjects had biphasic responses; 35 subjects had monophasic responses and two females had incessant increases. Sex did not affect the frequency of responses. Glucose area under the curve during OGTT was greater in those with a mono vs. biphasic curves (p=0.01). Disposition index was markedly lower in subjects with a monophasic curve than in those with a biphasic curve (3.6 [2.3-5.0] vs. 5.8 [3.8-7.6], median [25th, 75th%] p=0.003). Triglyceride to high-density lipoprotein cholesterol (HDL) ratio was higher in subjects with a monophasic curve (p=0.046). The decreased disposition index indicates that in healthy adolescents a monophasic response to OGTT is due to decreased insulin secretion relative to the degree of insulin resistance present. This was not associated with differences in most other cardiometabolic risk markers. Clinical Trials.gov, NCT02821104.

Sex differences in cardiometabolic risk factors, pharmacological treatment and risk factor control in type 2 diabetes: findings from the Dutch Diabetes Pearl cohort

IntroductionSex differences in cardiometabolic risk factors and their management in type 2 diabetes (T2D) have not been fully identified. Therefore, we aimed to examine differences in cardiometabolic risk factor levels,...

Evaluating current egg consumption patterns: Associations with diet quality, nutrition and health status in the UK National Diet and Nutrition Survey

AbstractDietary habits are constantly evolving with changes in culture, economics and the food supply. In the UK, red meat intakes have been declining for more than a decade, while egg consumption has increased in tandem with interest in healthy, sustainable diets. To explore current dietary habits of egg consumers and non‐consumers and potential implications for nutrition and health, we analysed dietary records from 647 adults participating in Year 9 (2017) of the UK National Diet and Nutrition Survey (NDNS). Mean consumption of eggs and egg dishes was 29 g/day (3.5 eggs/week). Female egg consumers (n = 224; mean 46 g/day, 5 eggs/week) ate more fruit, vegetables and fish and had significantly higher dietary intakes of protein, monounsaturated fatty acids, n‐3 polyunsaturated fatty acids and most micronutrients, notably vitamin D, most B vitamins, vitamin C, iron, zinc and selenium, compared with non‐consumers (n = 150). They also had higher plasma levels of 25‐hydroxyvitamin D, total carotenoids, selenium and ferritin and were less likely to be anaemic. Female egg consumers had a lower mean body mass index and waist circumference, despite reporting a higher mean energy intake than non‐consumers. Male egg consumers (n = 159; mean 54 g/day, 6 eggs/week) had higher dietary intakes of vitamin D, biotin, iodine and selenium but similar micronutrient status and bodyweight to non‐consumers (n = 114). There were no significant differences in cardiometabolic risk factors for either sex. Egg consumption appears to be associated with signs of higher dietary quality, better nutritional status, and slightly lower body mass index among women participating in the latest NDNS.

Effects of a Vegetarian Diet on Cardiometabolic Risk Factors, Gut Microbiota, and Plasma Metabolome in Subjects With Ischemic Heart Disease: ARandomized, Crossover Study.

BackgroundA vegetarian diet (VD) may reduce future cardiovascular risk in patients with ischemic heart disease.Methods and ResultsA randomized crossover study was conducted in subjects with ischemic heart disease, assigned to 4‐week intervention periods of isocaloric VD and meat diet (MD) with individually designed diet plans, separated by a 4‐week washout period. The primary outcome was difference in oxidized low‐density lipoprotein cholesterol (LDL‐C) between diets. Secondary outcomes were differences in cardiometabolic risk factors, quality of life, gut microbiota, fecal short‐chain and branched‐chain fatty acids, and plasma metabolome. Of 150 eligible patients, 31 (21%) agreed to participate, and 27 (87%) participants completed the study. Mean oxidized LDL‐C (−2.73 U/L), total cholesterol (−5.03 mg/dL), LDL‐C (−3.87 mg/dL), and body weight (−0.67 kg) were significantly lower with the VD than with the MD. Differences between VD and MD were observed in the relative abundance of several microbe genera within the families Ruminococcaceae, Lachnospiraceae, and Akkermansiaceae. Plasma metabolites, including l‐carnitine, acylcarnitine metabolites, and phospholipids, differed in subjects consuming VD and MD. The effect on oxidized LDL‐C in response to the VD was associated with a baseline gut microbiota composition dominated by several genera of Ruminococcaceae.ConclusionsThe VD in conjunction with optimal medical therapy reduced levels of oxidized LDL‐C, improved cardiometabolic risk factors, and altered the relative abundance of gut microbes and plasma metabolites in patients with ischemic heart disease. Our results suggest that composition of the gut microbiota at baseline may be related to the reduction of oxidized LDL‐C observed with the VD.RegistrationURL: https://www.clini​caltr​ials.gov; Unique identifier: NCT02942628.

Abstract P228: Do Cardiometabolic Risk Profiles Differ Across Race-Ethnicity? An Analysis of the Most Active U.S. Adults in the 2003-2006 NHANES

Introduction: Previous studies have revealed a significant, inverse dose-response relationship between total activity counts/day (TAC/d) and several cardiometabolic risk factors (CMRF). An ongoing line of research is the examination of the contributions of behavioral, environmental, and physiological factors to CMRF differences across race-ethnicity. However, it is unknown if these differences exist among the most physically active adults. Hypothesis: Among the most active U.S. adults, we hypothesize that CMRF measures will differ across race-ethnic groups. Methods: Study sample (n=1,059) included adult (20-79 years of age) participants from the 2003-2006 NHANES who wore an ActiGraph model 7164 accelerometer on the right hip. The top quartile of accelerometer-derived age- and gender-specific TAC/d was used as a cutpoint to define the “most active”. All participants were without T2D (fasting glucose &lt;126 mg/dL, no medication, no self-reported diagnosis) and without CVD (self-report). CMRF included HOMA-IR, fasting insulin and glucose, systolic (SBP) and diastolic blood pressure (DBP), HDL, LDL, triglycerides, BMI, waist circumference (WC) and C-reactive protein (CRP). Multiple linear regression was used to examine CMRF differences between non-Hispanic white (NHW), non-Hispanic black (NHB) and Mexican American (MA) participants. Regression models were adjusted for age, sex, education, smoking, wear time, BMI (except BMI and WC models), objectively-measure MVPA (≥760 counts/min) and race-ethnicity. Results: No significant differences were found in mean TAC/d across race-ethnicity. When compared to NHW, NHB had significantly higher HOMA-IR, fasting insulin, SBP, WC, and BMI. Compared to NHW, MA had significantly higher HOMA-IR, fasting insulin, triglycerides, WC and BMI. When comparing NHB to MA, MA had significantly higher triglycerides and HDL and significantly lower SBP. Conclusions: It has been proposed that the race-ethnic differences in PA participation could be contributing to disparities in elevated CMRF, but even among U.S. adults in the 75th percentile for total activity volume (i.e. TAC/d), race-ethnic differences in CMRF still exist. It is probable that other social, environmental, and genetic factors are responsible for moderating the beneficial effects PA has on CMRF specifically among NHB and MA adults.

Traditional and emerging cardiometabolic risk profiling among Asian youth with type 2 diabetes: A case-control study

BackgroundYouth-onset type 2 diabetes (YT2D) has been associated with high cardiometabolic risk and accelerated progression of diabetes complications. Data on Asian YT2D are limited. AimWe characterized traditional and emerging cardiometabolic risks profile among Asian YT2D and investigated factors that account for the observed differences. MethodsWe compared the cardiometabolic profile in 25 multiethnic Asian YT2D with a mean age of 18.5 ± 4.60 years and disease duration of 23 ± 6 months, with 15 matched controls. Cardiometabolic risks were compared from clinical histories, physical examination, laboratory and radiological investigations. Multiple linear regression models were sequentially adjusted for demographics and metabolic factors to examine possible mechanisms associated with differences in risk profiles between both groups. ResultsDespite similar BMI, YT2D had a higher waist-hip ratio, visceral adiposity, insulin resistance, hs-CRP level and resting heart rate compared to controls (p < 0.05 for all). While LDL-C were similar, YT2D had a lower HDL-C, higher triglyceride, TC:HDL-C and TG:HDL-C ratios (p < 0.05 for all). Nearly two-thirds of YT2D had metabolic syndrome (MetS), with 40% had microalbuminuria and 48% had glomerular hyperfiltration (≥135 ml/min/1.73m2). Subjects with high resting heart rate had four times higher odds of MetS. Eighty percent of YT2D had a cluster of ≥4 risk factors. Adjustment for BMI, HbA1C and blood pressure substantially attenuated differences in cardiometabolic risk factors between both groups, except glomerular filtration remained higher in the YT2D. ConclusionsDespite a relatively short duration of disease, YT2D exhibited high burden of cardiometabolic risk. Glomerular hyperfiltration is associated with YT2D, independent of BMI, HbA1C and blood pressure, suggestive of a causal pathway between the two.National Medical Research Register: NMRR-12-1042-13254.

Cardiometabolic risk factors correlated with the incidence of dysglycaemia in a Brazilian normoglycaemic sample: the Baependi Heart Study cohort

BackgroundDysglycaemia is defined by elevated glucose levels in the blood, commonly characterized by impaired fasting glucose, impaired glucose tolerance, elevated glycated haemoglobin, or diabetes mellitus (DM) diagnosis. The abnormal levels of glucose may occur many years before DM, a condition known as prediabetes, which is correlated with comorbidities such as cardiovascular diseases. Therefore, the aim of this study was to investigate the incidence of prediabetic dysglycaemia and its relationship with cardiometabolic risk factors at a 5-year follow-up, based on an initially normoglycaemic sample in the Baependi Heart Study cohort.MethodsThe data used comes from the Baependi Heart Study cohort, which consists of two periods: cycle 1 (2005–2006) and cycle 2 (2010–2013). For this study, we excluded those who had fasting blood glucose ≥ 100 mg/dL or were taking anti-diabetic medications at baseline, and those that had diabetes diagnosed in cycle 2. Mixed-effects logistic regression models were used to assess the association between cardiometabolic risk factors and the incidence of dysglycaemia, including a familiar random effect such as a cluster.ResultsThe incidence of prediabetic dysglycaemia was 12.8%, and it did not differ between men and women (14.4% and 11.6%, respectively). Two models were analysed to investigate the relationship between cardiometabolic risk factors and the occurrence of prediabetic dysglycaemia. The model that better explained the occurrence of dysglycaemia over the 5 years, after correction, included the waist circumference (WC) (measures and Δ), systolic blood pressure (SBP), HDL-c levels, and age. Although sex was not associated with the incidence of dysglycaemia, women and men showed differences in cardiometabolic risk factors related to glucose impairment: men who developed dysglycaemia showed, in parallel, higher LDL-c levels, TC/HDL-c ratio and DBP measurements; while these parameters remained similar between women who developed dysglycaemia and dysglycaemia-free women, after 5 years.ConclusionsIn an initially normoglycaemic sample of a highly mixed population living in a traditional Brazilian lifestyle, important cardiometabolic risk factors were associated with the occurrence of prediabetic dysglycaemia, and this relationship appeared to be more important in men. These results provide important insights about cardiovascular risk in prediabetic individuals.