Cardiometabolic Risk Markers Research Articles

PROSPECTIVE ASSOCIATIONS OF PHYSICAL ACTIVITY AND SEDENTARY TIME IN ADOLESCENCE WITH CARDIOMETABOLIC RISK IN YOUNG ADULTHOOD.

Purpose: The relationship between sedentary time, physical activity, and cardiometabolic risk factors during the transition from adolescence to adulthood remain uncertain. We examined the prospective associations of sedentary time and physical activity at age 15 with cardiometabolic risk markers at age 24.Methods: We used data from the Physical Activity among Norwegian Children Studies (PANCS). Sedentary time, moderate-to-vigorous physical activity (MVPA), and vigorous physical activity (VPA) were measured by accelerometry. Outcomes included body mass index (BMI), waist circumference, visceral fat, maximal oxygen uptake (VO2max), systolic blood pressure, LDL-cholesterol, insulin, high-sensitivity CRP, and a clustered risk Z-score. The prospective associations were modelled through regression.Results: A total of 731 boys and girls participated at age 9 (2005-2006) and 15 (2011-2012), and 258 of these participated again at age 24 (2019-2021). Multiple imputation was performed for all eligible individuals (n = 708). Each standard deviation increase (min/day) in sedentary time at age 15 was associated with lower VO2max at age 24 (β: -1.6 ml/kg/min; 95%CI: -2.8, -0.5). Each standard deviation increase (min/d) in MVPA (β: 1.6 ml/kg/min; 95%CI: 0.8, 2.4) and VPA (β: 1.6 ml/kg/min; 95%CI: 0.8, 2.4) at age 15 were associated with higher VO2max at age 24. VPA in adolescence was further inversely associated with visceral fat mass (β: -41 g; 95%CI: -78, -3), insulin level (β: -4.3 pmol/L; 95%CI: -8.2, -0.4), and the clustered risk Z-score (β: -0.09; 95%CI: -0.18, -0.01) in young adulthood. Childhood BMI modified the association of both MVPA and VPA with clustered risk, with the greatest magnitude of association observed in the highest BMI tertile.Conclusions: Physical activity, especially of vigorous intensity, during adolescence appear to beneficially affect cardiometabolic health in young adulthood. These health benefits may be most pronounced among overweight/obese youth.

BMI trajectories from birth to young adulthood associate with distinct cardiometabolic profiles.

Numerous studies have investigated links between body mass index (BMI) trajectories and cardiovascular risk, yet discrepancies in BMI measurement duration and timing of the cardiovascular-related outcome evaluation have led to inconsistent findings. We included participants from the Swedish birth cohort (BAMSE) and applied latent class mixture modeling to identify BMI trajectories using data of multiple BMI measures (≥ 4 times) from birth until 24-year follow-up (n = 3204). Subsequently, we analyzed the associations of BMI trajectories with lipids (n = 1974), blood pressure (n = 2022), HbA1c (n = 941), and blood leukocytes (n = 1973) using linear regression. We also investigated the circulating levels of 92 inflammation-related proteins (n = 1866) across BMI trajectories. Six distinct BMI groups were identified, denoted as increasing-persistent high (n = 74; 2.3%), high-accelerated increasing (n = 209; 6.5%), increasing-accelerated resolving (n = 142; 4.4%), normal-above normal (n = 721; 22.5%), stable normal (n = 1608; 50.2%), and decreasing-persistent low (n = 450; 14.1%) BMI groups. The increasing-persistent high and high-accelerated increasing BMI groups had higher levels of total cholesterol [mean difference (95% confidence intervals): 0.30 (0.04-0.56) and 0.16 (0.02-0.31) mmol/L], triglyceride, low-density lipoprotein, hemoglobin A1C [3.61 (2.17-5.54) and 1.18 (0.40-1.98) mmol/mol], and low-density lipoprotein/high-density lipoprotein ratios, but a lower level of high-density lipoprotein than the stable normal BMI group. These two groups also had higher leukocyte cell counts and higher circulating levels of 28 inflammation-related proteins. No increased cardiometabolic markers were observed in the increasing-accelerated resolving BMI group. Participants with persistently high or accelerated increasing BMI trajectories from birth to young adulthood have elevated levels of cardiometabolic risk markers at young adulthood than those with stable normal BMI. However, a raised BMI in childhood may not be inherently harmful to cardiometabolic health, provided it does not persist into adulthood.

Sex-Specific Associations Between Leucocyte Measures and Obstructive Sleep Apnea in Han Chinese.

White blood cell (WBC) and its subset counts are standard, inexpensive, direct markers of inflammation. Obstructive sleep apnea (OSA) is implicated in changes in inflammation markers, and sex differences are evident in both OSA and inflammation. It is unknown whether sex modulates the relationship between OSA severity and leukocyte measures. 1222 patients (914 males, 308 females) underwent overnight laboratorial polysomnography and measurement of WBC and its subset (lymphocyte, neutrophil, monocyte) counts. Patients were divided into primary snoring and mild, moderate, and severe OSA groups, and differences in leukocyte parameters were analyzed separately by sex in multivariable analyses. In multiple regression models, higher apnea-hypopnea index (AHI) was independently associated with neutrophil counts only in men, and with higher total WBC, lymphocyte and monocyte counts both in women and men. Further ordinal logistic regression analysis revealed a significant association between AHI and total WBC (OR 1.87, 95% CI 1.09-3.23) and neutrophil (OR 1.77, 95% CI 1.02-3.07) counts in men only. Correlation analysis also revealed more robust relationships between leukocyte measures and cardiometabolic risk markers in men than in women. This study provides novel data suggesting a significant association between neutrophil count and OSA severity only in men but not women. Similarly, the relationship between leukocyte parameters and cardiometabolic risk markers were more pronounced in men than women. Our findings suggest a sex-specific impact of OSA on leukocyte measures and on their relationship with indices of cardiometabolic risk.

Narrative Review of Lifestyle Interventions in Breast Cancer Survivors: Current Evidence and Future Directions.

One in eight females will be diagnosed with breast cancer in their lifetime. While medical advances have increased the likelihood of survival, up to 90% of females will gain weight during and after treatment increasing the risk of breast cancer recurrence and obesity related co-morbidities in survivorship. Behavioral lifestyle interventions focused on diet with or without physical activity can provide breast cancer survivors non-pharmacological options to decrease weight gain and cardiometabolic risk. A PubMed search was conducted to identify all behavioral lifestyle interventions focused on diet or diet combined with physical activity longer than 4 weeks of duration in breast cancer survivors that included body weight as an outcome. This review aims to summarize the effects on body weight, body composition and cardiometabolic risk markers are summarized. Based on the review, there is high heterogeneity in type and duration of the intervention to affect weight and cardiometabolic risk in survivorship. Calorie restriction with and without physical activity appears to promote weight loss among breast cancer survivors. However, the effects on cardiometabolic factors are less clear. Future studies should be powered for both body weight and cardiometabolic effects. Researchers should also consider interventions that are: 1) less complex, 2) recruit a more racially and ethnically diverse sample, 3) integrate resistance training, 4) implement the intervention in closer proximity to diagnosis, 5) target weight management in this population before it occurs and 6) analyze body composition in addition to body weight measurements.

Effect of antenatal use of high energy nutritional supplements on cardio metabolic risk markers in underweight primi gravidas; a randomized controlled trial

BackgroudPregnancy is a state of increased metabolic demand, and poor maternal nutrition can exacerbate these changes, potentially increasing the risk of cardiometabolic disorders.This study is significant as it investigates the effect of high energy nutritional supplements on cardio metabolic risk markers in underweight primigravidas.MethodologyA single blinded randomized controlled trial was conducted from April 2018- August 2019 among the Pakistani tertiary care facilities of Khyber Pakhtunkhwa. A total of thirty six participants were randomized into two groups receiving either high energy nutritional supplement ‘MAAMTA’ or Placebo. They were instructed to take Placebo/Supplement alongside to their regular prenatal care and food from their first antenatal visit till a week postnatally. Anthropometric measurements and blood samples for biochemical parameters insulinlevels, fasting blood glucose & lipid profile were taken at baseline visit, between 16 and 20 weeks gestation and a post natal visit.ResultsThe two-way repeated measures ANOVA showed that there was a highly significant time effect on participant’s Insulin level (F (1.8, 53.6) = 10.64, P < 0 0.000, ηp2 = 0.269). A highly significant time effect on participant’s insulin resistance (F (2, 68) = 8.116,P < 0 0.001, ηp2 = 0.193) was also observed. There was a highly significant time effect on participant’s LDL level as well (F (2, 68) = 11.82, P < 0 0.000, ηp2 = 0.258).ConclusionSupplementation with high energy nutritional supplements may improve insulin levels and insulin sensitivity in underweight primigravidas.Trial registrationhttps://www.ClinicalTrials.govClinicalTrials.gov Identifier: ISRCTN 10088578. Registered on 27 March 2018. https://www.isrctn.com/ISRCTN10088578.

Effect of chia seeds or concentrated fish oil on cardiometabolic risk markers in subjects with hypertriglyceridaemia: a parallel clinical trial.

The beneficial effects of n-3 polyunsaturated fatty acids (PUFA) in reducing high blood triglyceride (TG) levels have been well demonstrated. This study aimed to investigate the effect of chia seeds on blood TG and its associated cardiometabolic factors in hypertriglyceridaemic individuals. This three-group randomised controlled trial compared the effects of a low-calorie diet (n = 22), a low-calorie diet with chia seeds (30 g/day, n = 22) or a low-calorie diet with concentrated fish oil (1.8 g/day of n-3 long-chain PUFAs, n = 22) in patients with hypertriglyceridaemia. Anthropometrics, fasting blood lipids, proprotein convertase subtilisin/kexin type 9, insulin, adiponectin, leptin and interleukin-6 levels were measured. After 8 weeks, the mean reduction in weight exhibited by the three groups was not statistically different (2.0, 2.7 and 2.8 kg, respectively, for the control, fish oil and chia seed groups). The plasma TG decreased in both the chia seed and fish oil groups in comparison to the control group (p = 0.001). However, no significant difference was observed between the chia seed and fish oil groups (change from baseline mean: 145.2 and 136.7 mg/dL for the chia seed and fish oil groups, respectively). The consumption of chia seeds was associated with a reduction in diastolic blood pressure (change from baseline mean: 8.4 mmHg) compared to the other two groups. No significant alterations were observed in the other blood biochemical factors between the three groups. In people with moderate hypertriglyceridaemia, a low-calorie diet with 30 g of chia seeds compared to fish oil supplements containing 1.8 g of long-chain PUFAs has a similar effect on reducing plasma TG levels, whereas it has a higher blood pressure-lowering effect.

Early cardiometabolic risk markers of adipose tissue inflammation in apparently healthy individuals: GEMM study

Early cardiometabolic risk markers of adipose tissue inflammation in apparently healthy individuals: GEMM study

Vitamin D supplementation for cardiometabolic risk markers in pregnant women based on the gestational diabetes mellitus or obesity status : a randomized clinical trial.

Women with gestational diabetes mellitus (GDM) or obesity are vulnerable to impaired gestational cardiovascular health (CVH) and cardiovascular disease (CVD) in the future. It is unclear if prenatal vitamin D supplementation improves gestational CVH, especially in women at high risk for developing CVD. Our goal was to find out if vitamin D supplementation could protect against gestational CVH, including the women with GDM or obesity. We randomly assigned women with a serum 25(OH)D concentration < 75 nmol/L to receive 1600 IU/d (intervention group) or 400 IU/d (control group) of vitamin D3 for two months at 24-28 weeks' gestation. The primary outcome was gestational CVH marks (lipids, inflammatory cytokines, endothelial function). There were 1537 participants divided into the intervention (N = 766) and control groups (N = 771). No baseline differences existed among study groups in CVH markers. At the two-month visit, the intervention group's HDL-C levels (2.01 ± 0.39 VS 1.96 ± 0.39 mmol/L) were significantly higher than those of the control group, while the hs-CRP levels were significantly lower (3.28 ± 2.02 VS 3.64 ± 2.42mg/L). Subgroup analysis found that HDL-C, TC, hs-CRP, E-Selectin, and SBP were improved in the intervention group among women with GDM or overweight/obesity, and the improvement was not found in women without GDM or overweight/obesity. Vitamin D supplementation significantly decreased the mean triglyceride-glucose index at the two-month visit in women with GDM. Vitamin D supplementation at mid-gestation might optimize the gestational CVH status for pregnant women, particularly the women with GDM or obesity, which is advantageous for later-life primary prevention of CVD. The Chinese Clinical Trial Registry (ChiCTR2100051914, 10/9/2021, Prospective registered, https://www.chictr.org.cn/showproj.aspx?proj=134700 ).

Effects of cocoa consumption on cardiometabolic risk markers: Protocol for a systematic review and meta-analysis of randomized controlled trials.

Cardiometabolic diseases cover a spectrum of interrelated conditions linked to metabolic dysfunctions and/or cardiovascular disorders, including systemic arterial hypertension, diabetes mellitus, dyslipidemia, and obesity. Cocoa is a rich source of dietary polyphenols and has been associated with cardiovascular health benefits. However, beneficial effects of cocoa consumption and appropriate quantities in decreasing cardiometabolic risk factors have yet to be established. Therefore, we will conduct a systematic review and meta-analysis to examine the effects of cocoa consumption on cardiometabolic risk markers (total cholesterol, HDL, LDL, triglycerides, blood glucose, glycated hemoglobin, waist circumference, abdominal circumference, body mass index, systolic blood pressure and diastolic blood pressure) in adults with or without established cardiovascular risk factors. Our review will include all randomized controlled trials published in English, Portuguese and Spanish with no date of publication restrictions evaluating the effects of cocoa consumption on cardiometabolic risk markers selected from the databases MEDLINE (PubMed), LILACS, Cochrane, EMBASE, Web of Science and SciELO, and gray literature. Eligible studies must involve adults (age ≥18y), and the consumption of cocoa or dark chocolate (≥ 70% cocoa), include a control group and evaluate blood pressure, anthropometric measurements, and lipid or glycemic profiles. We will use risk-of-bias 2 (RoB2) tool to assess the risk of bias and the GRADE system to assess the strength of evidence. Statistical analyses will be performed using RStudio for Windows and R package meta. This meta-analysis will summarize existing evidence on the effects of cocoa consumption on cardiometabolic health in adults. Better understanding the effects of cocoa consumption on anthropometric measurements, blood pressure, and lipid and glycemic profiles can provide valuable insights for health professionals to improve dietary recommendations regarding appropriate quantities. Systematic Review Registration: PROSPERO CRD42023484490.

Electromyography of Sedentary Behavior: Identifying Potential for Cardiometabolic Risk Reduction.

Muscle activation during interruptions to prolonged sedentary time is a hypothesized mechanism underlying observed cardiometabolic benefits. We examined associations of quadriceps and hamstring muscle activity patterns with cardiometabolic risk markers and how these patterns varied between different sitting-interruption countermeasures. Electromyographic (EMG) data (shorts) were gathered for 1 to 2 days from healthy adults in a free-living study (n = 172, age 40.9 ± 12.9, BMI 23.6 ± 1.3) and a laboratory-based study (n = 12, age 47.0 ± 7.7, BMI 30.0 ± 4.7). Patterns examined were average EMG (aEMG ;%EMGMVC); EMG activity duration (% above signal baseline 3 μV); and usual (weighted medians) EMG activity bout amplitude (%EMGMVC) and duration (s). In the free-living study, these were regressed against risk markers (waist; fat percentage; fasting plasma glucose [FPG];total cholesterol; HDL;LDL; triglycerides); in the laboratory study, EMG patterns for the muscle groups were compared between sitting and the active countermeasures. In the free-living study, lower extremity muscles displayed minimal overall activity, with hamstrings and quadriceps using only 2.6% and 2.0% of their capacity (%EMGMVC), respectively, and being active for 30% and 25% of the time. Higher hamstring aEMG and EMG activity duration were beneficially associated with waist, HDL and fat percentage (duration only) and a longer quadriceps usual EMG activity bout duration was beneficially associated with FPG. In the laboratory study, compared with prolonged sitting, active seated or upright active-interruption countermeasures modified these EMG patterns; brief (6 min) walking and simple resistance activities (SRA) were more beneficial than was a bout of standing (30 min) with the SRAs being the only intervention that matched daily aEMG levels. Upright and physically active interruptions to sitting appear to be required to increase the typically low muscle engagement observed in free-living contexts, promoting muscle activity patterns that may help ameliorate cardiometabolic risk.

Investigating the impact of dietary guidelines transition on cardiometabolic risk profile: a forensic analysis using diet quality metrics

Evaluating dietary guidelines using diet quality (DQ) offers valuable insights into the healthfulness of a population’s diet. We conducted a forensic analysis using DQ metrics to compare the Malaysian Dietary Guidelines (MDG-2020) with its former version (MDG-2010) in relation to cardiometabolic risk (CMR) for an adult Malaysian population. A DQ analysis of cross-sectional data from the Malaysia Lipid Study (MLS) cohort (n = 577, age: 20-65yrs) was performed using the healthy eating index-2015 (HEI-2015) framework in conformation with MDG-2020 (MHEI2020) and MDG-2010 (MHEI2010). Of 13 dietary components, recommended servings for whole grain, refined grain, beans and legumes, total protein, and dairy differed between MDGs. DQ score associations with CMR, dietary patterns and sociodemographic factors were examined. Out of 100, total DQ scores of MLS participants were ‘poor’ for both MHEI2020 (37.1 ± 10.3) and MHEI2010 (39.1 ± 10.4), especially among young adults, males, Malays, and those frequently ‘eating out’ as well as those with greatest adherence to Sugar-Sweetened Beverages pattern and lowest adherence to Food Plant pattern. Both metrics shared similar correlations with CMR markers, with MHEI2020 exhibiting stronger correlations with WC, BF%, TG, insulin, HOMA2-IR, and smallLDL than MHEI2010, primarily attributed to reduced refined grain serving. Notably, participants with the highest adherence to MHEI2020 scores exhibited significantly reduced odds for elevated TG (AOR 0.44, 95% CI 0.21–0.93, p = 0.030), HOMA2-IR (AOR 0.44, 95% CI 0.21–0.88, p = 0.022), and hsCRP (AOR 0.54, 95% CI 0.31–0.96, p = 0.040, compared to those with the lowest adherence. Each 5-unit increase in MHEI2020 scores reduced odds for elevated BMI (− 14%), WC (− 9%), LDL-C (− 32%), TG (− 15%), HOMA2-IR (− 9%) and hsCRP (− 12%). While MHEI2020 scores demonstrated better calibration with CMR indicators, the overall sub-optimally ‘poor’ DQ scores of this population call for health promotion activities to target the public to achieve adequate intake of healthful fruits, non-starchy vegetables and whole grain, and moderate intake of refinedgrain, added sugar and saturated fat.

Caffeine intake and cardiometabolic risk factors in adolescents in the United States.

In adults, caffeine has protective effects against kidney dysfunction and type 2 diabetes mellitus (T2DM) but increases the risk of acute blood pressure (BP) elevation and dyslipidemia. These relationships are unclear in adolescents. This study aimed to determine the association between caffeine intake and markers of childhood cardiometabolic risk, hypothesizing that higher caffeine intake would be associated with elevated BP and dyslipidemia but improved kidney function and insulin sensitivity. Adolescents ages 13-17 who participated in the National Health and Nutritional Examination Survey (NHANES) from 2011 to 2018 and completed 24-h dietary recalls were included. Logistic and linear regression models were used to analyze cross-sectional associations between caffeine and cardiometabolic risk factors. The mean participant age was 15.0 years, with a sex distribution of 49.9% male and 50.1% female. In fully adjusted regression models, higher caffeine intake was not associated with any changes in BP (OR = 0.78, 95%CI [0.52,1.16], p = 0.21), dyslipidemia (OR = 0.91, 95%CI [0.65,1.27], p = 0.57), glomerular hyperfiltration (OR = 1.01, 95%CI [0.60,1.71], p = 0.96), albuminuria (OR = 0.94, 95%CI [0.45,1.98], p = 0.87), or insulin resistance (OR = 1.15, 95%CI [0.85,1.56], p = 0.36). Contrary to its cardiometabolic effects in adults, caffeine intake was not associated with an increased or reduced risk of kidney dysfunction, T2DM, hypertension, or dyslipidemia in adolescents. Although the effects of caffeine intake on cardiometabolic risk have been well defined in adults, data exploring its impact on adolescent cardiovascular and metabolic function is limited. The goal of this study was to understand the relationship between caffeine intake and markers of childhood cardiometabolic risk. Unlike its established effects in adults, caffeine consumption showed no association with markers of cardiometabolic disease, such as kidney dysfunction, type 2 diabetes mellitus, blood pressure, dyslipidemia, or hyperuricemia in adolescents. These findings offer novel insight into the effects of caffeine on cardiometabolic function in adolescents, which may guide clinical recommendations for at-risk patients.

Effects of Interrupting Prolonged Sitting with Light-Intensity Physical Activity on Inflammatory and Cardiometabolic Risk Markers in Young Adults with Overweight and Obesity: Secondary Outcome Analyses of the SED-ACT Randomized Controlled Crossover Trial.

Sedentary behavior (SB) is an essential risk factor for obesity, cardiovascular disease, and type 2 diabetes. Though certain levels of physical activity (PA) may attenuate the detrimental effects of SB, the inflammatory and cardiometabolic responses involved are still not fully understood. The focus of this secondary outcome analysis was to describe how light-intensity PA snacks (LIPASs, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affect inflammatory and cardiometabolic risk markers. Seventeen young adults with overweight and obesity participated in this study (eight females, 23.4 ± 3.3 years, body mass index (BMI) 29.7 ± 3.8 kg/m2, glycated hemoglobin A1C (HbA1c) 5.4 ± 0.3%, body fat 31.8 ± 8.2%). Participants were randomly assigned to the following conditions which were tested during an 8 h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND, 2.5 h total standing time), continuous standing (STAND), and continuous walking (1.6 km/h; WALK). Each condition also included a standardized non-relativized breakfast and lunch. Venous blood samples were obtained in a fasted state at baseline (T0), 1 h after lunch (T1) and 8 h after baseline (T2). Inflammatory and cardiometabolic risk markers included interleukin-6 (IL-6), c-reactive protein (CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), visceral fat area (VFA), triglyceride-glucose (TyG) index, two lipid ratio measures, TG/HDL-C and TC/HDL-C, albumin, amylase (pancreatic), total protein, uric acid, and urea. We found significant changes in a broad range of certain inflammatory and cardiometabolic risk markers during the intervention phase for IL-6 (p = 0.014), TG (p = 0.012), TC (p = 0.017), HDL-C (p = 0.020), LDL-C (p = 0.021), albumin (p = 0.003), total protein (p = 0.021), and uric acid (p = 0.040) in favor of light-intensity walking compared with uninterrupted prolonged sitting, alternate sitting and standing, and continuous standing. We found no significant changes in CRP (p = 0.529), creatinine (p = 0.199), TyG (p = 0.331), and the lipid ratios TG/HDL-C (p = 0.793) and TC/HDL-C (p = 0.221) in response to the PA snack. During a simulated 8 h work environment replacement and interruption of prolonged sitting with light-intensity walking, significant positive effects on certain inflammatory and cardiometabolic risk markers were found in young adults with overweight and obesity.

Effect of metabolic status on response to SIV infection and antiretroviral therapy in nonhuman primates.

Current antiretroviral therapy (ART) regimens efficiently limit HIV replication, thereby improving the life expectancy of people living with HIV; however, they also cause metabolic side effects. The ongoing obesity epidemic has resulted in more people with metabolic comorbidities at the time of HIV infection, yet the effect of preexisting metabolic dysregulation on infection sequelae and response to ART is unclear. Here, to investigate the impact of preexisting obesity and insulin resistance on acute infection and subsequent long-term ART, we infected a cohort of lean and obese adult male macaques with SIV and administered ART. The responses of lean and obese macaques to SIV and ART were similar with respect to plasma and cell-associated viral loads, ART drug levels in plasma and tissues, SIV-specific immune responses, adipose tissue and islet morphology, and colon inflammation, with baseline differences between lean and obese groups largely maintained. Both groups exhibited a striking depletion of CD4+ T cells from adipose tissue that did not recover with ART. However, differential responses to SIV and ART were observed for body weight, omental adipocyte size, and the adiponectin/leptin ratio, a marker of cardiometabolic risk. Thus, obesity and insulin resistance had limited effects on multiple responses to acute SIV infection and ART, while several factors that underlie long-term metabolic comorbidities were influenced by prior obesity and insulin resistance. These studies provide the foundation for future investigations into the efficacy of adjunct therapies such as metformin and glucagon-like peptide-1 receptor agonists in the prevention of metabolic comorbidities in people living with HIV.

Pre-Prediabetes: Insulin Resistance is Associated with Cardiometabolic Risk in Non-obese Patients (STOP DIABETES).

To examine if insulin resistance is associated with markers of glycemic, cardiometabolic and atherosclerotic risk in non-obese, non-prediabetic individuals compared to insulin sensitive subjects matched for BMI, gender, and age. Of 1860 patients from STOP DIABETES study, 624 had normal fasting plasma glucose, body mass index < 30, and HbA1c < 5.7%. All received oral glucose tolerance test (OGTT). Insulin sensitivity was quantitated using Matsuda index: <25th percentile = Insulin Resistant (IR) (n=151) and ≥ 25th percentile = Insulin Sensitive (IS) (n=473). Measures of dysglycemia and cardiometabolic risk were compared between insulin resistant subjects (n=151) and subset of insulin sensitive individuals who were matched for BMI, gender, age (n=151). Carotid intima media thickness (CIMT) and carotid plaque were measured in 65 IR and 76 IS individuals. Compared to matched insulin sensitive patients, insulin resistant non-obese subjects demonstrated increased indicators of glycemic and cardiometabolic risk including: increased 60-minute plasma glucose and percentage of patients with 60-minute plasma glucose > 155mg/dL; increased 120-minute plasma glucose; unrecognized impaired glucose tolerance (IGT) and type 2 diabetes (T2D), decreased disposition index; increased systolic and diastolic blood pressure; elevated plasma triglycerides; reduced HDL cholesterol; increased triglyceride/HDL ratio and hs-CRP. The presence, size, and number of carotid plaques was greater in the insulin resistant group. Approximately 1 in 4 non-obese patients in this population with normal fasting glucose and HbA1c were insulin resistant. In these non-obese subjects, insulin resistance was associated with multiple indicators of dysglycemia and cardiometabolic risk.

Epicardial fat thickness in rheumatoid arthritis: Insights from echocardiographic analysis and autoimmune correlations.

Rheumatoid arthritis (RA) is a chronic inflammatory disease that primarily affects the joints. RA is associated with high cardiovascular mortality and morbidity. One of the new markers of cardiometabolic risk is epicardial fat thickness, the study of EFT in patients with RA and its association with echocardiographic parameters may provide valuable insight into the potential cardiac involvement and overall cardiovascular risk in these patients. The present study is a cross-sectional study with a comparison group conducted in 2024. The study population included 66 RA patients and 66 healthy participants. Echocardiographic parameters, laboratory data including lipid profile and inflammatory markers, were obtained from the medical record. Comparison of echocardiographic parameters between RA and healthy participants showed that E parameter and EFT were statistically significant in RA patients. (EFT was 5.22 ± 2.6 in RA patients which in comparison with healthy participant (5.22 ± 2.06) was statistically significant (p-value: <.001)). Also, EFT was correlated with RF, Anti-CCP, ESR, and systolic blood pressure. To the best of our knowledge, ours is the first EFT study on RA patients in Iran, which shows a higher EFT in RA patients. High EFT is correlated with more cardiovascular events and is an early sign and independent predictor of atherosclerosis in RA patients, which greatly underlines the importance of cardiovascular assessment in RA patients.

Cardiometabolic Risk Markers in Children With Obesity and Variants in MC4R Pathway-related Genes.

Variants in melanocortin 4 receptor (MC4R) pathway-related genes have been associated with obesity. The association of these variants with cardiometabolic parameters are not fully known. We compared the severity of obesity and cardiometabolic risk markers in children with MC4R pathway-related clinically reported genetic variants relative to children without these variants. A retrospective chart review was performed in children with obesity who underwent multigene panel testing for monogenic obesity. Data on a total of 104 children were examined, with 93 (89%) identified as White. Thirty-nine (37.5%) patients had clinically reported variants in the MC4R pathway, and the remaining 65 patients did not have reported MC4R pathway-related variants. Among the MC4R-related variants, PCSK1 risk alleles were most common, reported in 15 children (14%). The maximum body mass index percent of the 95th percentile was not different between groups (P = .116). Low-density lipoprotein cholesterol (LDL-C) was not different between groups (P = .132). However, subgroup analysis demonstrated higher LDL cholesterol in children with the PCSK1 c.661A>G risk allele relative to those with MC4R-related variant of uncertain significance (P = .047), negative genetic testing (P = .012), and those with non-MC4R related variants (P = .048). The blood pressure, fasting glucose, hemoglobin A1C, total cholesterol, alanine transaminase, and high-density lipoprotein cholesterol were not different between groups. Variants in the MC4R pathway-related genes were not associated with severity of obesity and cardiometabolic risk markers except for the c.661A>G PCSK1 risk allele, which was associated with higher LDL-C levels.

Low- versus High-Glycemic Index Mediterranean-Style Eating Patterns Improved Some Domains of Health-Related Quality of Life but Not Sleep in Adults at Risk for Type 2 Diabetes: The MEDGICarb Randomized Controlled Trial

BackgroundA healthy eating pattern such as the Mediterranean-style healthy eating pattern (MED-HEP) is associated with favorable effects on both cardiometabolic risk markers and self-reported health outcomes. Limited evidence exists regarding the influence of the glycemic index (GI) of carbohydrate foods consumed within a healthy eating pattern on self-reported health status and sleep. ObjectivesTo investigate the effects of a low- compared with high-GI MED-HEP on changes in health-related quality of life (HRQoL) and sleep. MethodsThe MEDGICarb-intervention trial is a 12-wk randomized, controlled, parallel multi-center trial in adults with ≥2 features of the metabolic syndrome. Participants consumed an eu-energetic diet profiled as a MED-HEP with either low GI (experimental) or high GI (control). HRQoL and sleep were measured with Medical Outcomes Study 36-item short-form health survey version 2, Pittsburgh sleep quality index, and Epworth Sleepiness Scale at baseline and postintervention. ResultsOne hundred and sixty adults with ≥2 features of the metabolic syndrome completed the intervention [53% females, age 56 ± 10 y, body mass index (kg/m2) 31.0 ± 3.1]. Low- compared with high-GI MED-HEP resulted in differential changes between the groups in the HRQoL domains role physical [5.6 ± 2.2 arbitrary units (AU) compared with –2.5 ± 2.5 AU) and vitality (6.9 ± 1.7 AU compared with 0.0 ± 1.8 AU] (P < 0.05), which were driven mostly by improvements in the low-GI group. There were no significant differences between the MED-HEPs for changes in aggregated physical or mental components or for the other individual domains of HRQoL (physical functioning, bodily pain, general health, social functioning, role emotional, and mental health) or for sleep quality or daytime sleepiness. ConclusionsLow compared to high GI in the context of a MED-HEP resulted in modest improvements in some, but not all, health domains of HRQoL. No major differences were seen between the groups for measures of sleep.This trial was registered at clinicaltrials.gov as NCT03410719.

Unveiling the link: Neonicotinoids and elevated cardiometabolic risks in Chinese rural residents–from a prospective cohort study combing mendelian randomization study

PurposeThis study aimed to evaluate the relationships of separate and mixed exposure of neonicotinoids on cardiometabolic risk at baseline and follow-up and its change over 3 years, and further explore whether inflammatory markers levels and platelet traits (PLT) mediate these relationships. MethodsIn this prospective cohort study from the Henan Rural Cohort Study, 2315 participants were involved at baseline, and 1841 participants completed cardiometabolic risk predictors determinations during the 3-year follow-up. Each neonicotinoid pesticide was normalized to imidacloprid (IMIeq) using the relative potency factor approach. Quantile-based g-computation (Qgcomp) regression was used to evaluate the effect of the mixtures of neonicotinoids mediation analysis was employed to explore whether inflammatory markers levels and platelet traits mediated these relationships. A two-sample mendelian randomization (MR) study was further used to causal association. ResultsQgcomp regression revealed a statistically positive relationship between neonicotinoids mixture exposure and cardiometabolic risk score at baseline and follow-up over 3 years. Both neutrophils/monocytes and PLT were mediators in the relationship between IMIeq and cardiometabolic risk score at baseline and follow-up over 3 years. The causal risk effect of pesticide exposure were 2.50 (0.05, 4.95) and 5.24 (1.28, 9.19) for cardiometabolic risk indicators including insulin resistance and triglyceride, respectively. Nevertheless, there was no correlation discovered between pesticide exposure and other markers of cardiometabolic risk. ConclusionNeonicotinoid insecticides exposure was connected to an increased cardiometabolic risk, especially in individuals with T2DM. Furthermore, inflammatory markers and PLT seem to be two vital mediators of these associations. Additionally, genetic evidence on pesticide exposure and cardiometabolic risk still needs to be validated by multiregional and multiethnic GWAS studies.

Physical activity, physical fitness and cardiometabolic health among Finnish military workers

IntroductionThe Western lifestyle challenges national defence. Inactivity, obesity, high BP and elevated lipid and glucose levels as well as tobacco use all increase cardiometabolic risk. The present study was thus...