Nontraditional Factors Research Articles

Is investor sentiment a relevant factor in determining asset prices?

ABSTRACTThe APT framework allows for a multitude of risk factors to be priced into asset returns, implying that it can be used to model returns using either macroeconomic or microeconomic factors. As such, the APT allows for non-traditional factors, such as investor sentiment, to be included. A macroeconomic APT framework was developed for nine countries using the variables outlined by Chen, Roll, and Ross (1986) and investor sentiment was measured by the FEARS index (Da, Engelberg, & Gao, 2015). Regression testing was used to determine whether FEARS is a statistically significant explanatory variable in the APT model for each country. The results show that investor sentiment is a statistically significant explanatory variable for market returns in five out of the nine countries examined. These results add to the existing APT literature as they show that investor sentiment has a significant explanatory role in explaining asset prices and their associated returns.

Association of betaine with blood pressure in dialysis patients.

Mechanisms underlying elevated blood pressure in dialysis patients are complex as a variety of non-traditional factors are involved. We sought to explore the association of circulating betaine, a compound widely distributed in food, with blood pressure in dialysis patients. We used baseline data of an ongoing cohort study involving patients on hemodialysis. Plasma betaine was measured by high performance liquid chromatography in 327 subjects. Blood pressure level was determined by intradialytic ambulatory blood pressure monitoring. The mean age of the patients was 52.6±11.9years, and 58.4% were male. Average interdialytic ambulatory systolic and diastolic blood pressure were 138.4±22.7mm Hg and 84.4±12.5mm Hg, respectively. Mean plasma betaine level was 37.6μmol/L. Multiple linear regression analysis revealed significant associations of betaine with both systolic blood pressure (β=-3.66, P=.003) and diastolic blood pressure (β=-2.00, P=.004). The associations persisted even after extensive adjustment for cardiovascular covariates. Subgroup analysis revealed that the association between betaine and blood pressure was mainly limited to female patients. Our data suggest that alteration of circulating betaine possibly contributes to blood pressure regulation in these patients.

Abstract WP373: Assessment Of Traditional And Nontraditional Cardiovascular Risk Factors In Older Adults With And Without Metabolic Syndrome.

Background and Purpose: Metabolic Syndrome (MetS) is a constellation of risk factors that increase risks for cardiovascular disease (CVD) and mortality. However, whether additional nontraditional risk factors are associated with MetS in older adults is debatable. Therefore, in the current study we examined nontraditional risks factors and the MetS and its components in older adults at high risk for CVD. Methods: We measured the nontraditional CVD risk factors and MetS and its components in 75 independent living older adults (65-80 years). Fasting glucose, hemoglobin A1c, insulin, and systolic and diastolic blood pressure were measured. Insulin sensitivity was calculated using homeostasis model assessment (HOMA-IR) and body mass index (BMI). We measured nontraditional risk factors, lipids and lipoproteins and inflammatory markers, as well as MetS and its components in each participant. Results: The mean age of our group was 71.9±5.0 years and BMI 26.7±4.9 kg/m 2 . We found 24% of our participants had MetS compared to 76% without MetS. There were no differences in age or blood pressure among those with and without MetS. We found statistically significance differences in traditional MetS components; fasting glucose (105.1±14.1 vs. 93.1±10.0mg/dl, p=0.002); triglycerides (155.1±57.6 vs. 91.9±48.2mg/dl, p=0.0003); HDL-C (41±11.7 vs. 64.9±14.9mg/dl, p=0.001); and BMI (31.4±5.3 vs. 26.7±4.9kg/m 2 , p=0.002). Significant differences existed in HOMA-IR (5.3±3.5 vs. 2.1±2.1%, p=0.001) and Apo A1 (119.9±23.1 vs. 160±27.4mg/dl, p=0.0007) but not for Apo B, Apo CIII, Apo E, C-reactive protein, or IL-6. Conclusions: Our pilot data clearly demonstrates metabolic differences in older adults with and without MetS. Our study confirms that risk factors for CVD are higher in older adults with MetS. However, nontraditional risk factors were not different among our participants. Therefore, the MetS continues to be a valid measure of CVD risks in older adults.

Traditional and psychological factors associated with academic success: investigating best predictors of college retention

We compared factors that colleges have traditionally used to predict students’ academic success (ACT score and high school GPA) to non-traditional factors (perceived stress and grit, defined as having perseverance and passion for long-term goals) to determine best predictors of academic success, measured using college GPA and retention. We obtained data from 165 undergraduate students. Participants completed the Short Grit Scale and Perceived Stress Scale. We obtained participants’ college GPA, high school GPA, and ACT scores. We assessed longitudinally, 1.5 years later, whether participants were retained. ACT score and high school GPA were excellent predictors of college students’ GPA, but poor predictors of retention. Conversely, perceived stress and grit were poor predictors of college students’ GPA, but were statistically significant predictors of retention. Traditional factors, often used for college admissions, are less important than non-traditional, psychological factors, in predicting who will complete college. We discuss potential strategies for improving college retention.

Globalisation and traditional social-ecological systems: Understanding impacts of tourism and labour migration to the transhumance systems in the Himalayas

Globalisation has increased the flow of people, ideas, knowledge, technology and money by varying degrees. Due to constraints such as inaccessibility and fragility, the Himalayan region remained isolated from the outside world until relatively recently. Globalisation has however, now breached such isolation with increased tourism in some areas and increased migration from others. The accelerated rate of tourism and out-migration has the potential to affect different components of traditional socio-ecological system (SES). In the high Himalayan region, the transhumance is a system based on seasonal and recurring movement of livestock. This paper aims to explore the contemporary transhumance systems and impacts of tourism and labour migrations to the SES. The study was conducted in three sites in the northern mountainous areas of Nepal, having either significant tourism activities or labour migration. Primary data were collected by means of livestock census, household survey and focus group discussions. The results show that there were variations in proportions of households involved in transhumance, herd size, herd composition and seasonal mobility across the study sites but transhumance remains a major source of income and an important livelihood strategy for local people in all sites. Tourism and labour migration have reduced the number of households involved in transhumance systems and herd size by changing labour and income dynamics of the households but there are differential outcomes across the study sites. The findings of this study can contribute to strategies and policies for adaptation of SESs experiencing change pressures from non-traditional factors.

Excess psychosocial burden in women with diabetes and premature acute coronary syndrome.

Diabetes is a stronger risk factor for acute coronary syndrome for women than men. We investigate whether behavioural and psychosocial factors contribute to the disparity in acute coronary syndrome risk and outcomes among women with diabetes relative to women without diabetes and men. Among 939 participants in the GENESIS-PRAXY cohort study of premature acute coronary syndrome (age ≤ 55 years), we compared the prevalence of traditional and non-traditional factors by sex and Type 2 diabetes status. In a case-only analysis, we used generalized logit models to investigate the influence of traditional and non-traditional factors on the interaction of sex and diabetes. In 287 women (14.3% with diabetes) and 652 men (10.4% with diabetes), women and men with diabetes showed a heavier burden of traditional cardiac risk factors compared with individuals without diabetes. Women with diabetes were more likely to be the primary earner and have more anxiety relative to women without diabetes, and reported worse perceived health compared with women without diabetes and men with diabetes. The interaction term for sex and diabetes (odds ratio (OR) 1.40, 95% confidence intervals (95% CI) 0.83-2.36) was diminished after additional adjustment for non-traditional factors (OR 1.12, 95% CI 0.54-2.32), but not traditional factors alone (OR 1.41, 95% CI 0.84-2.36). We observed trends toward a more adverse psychosocial profile among women with diabetes and incident acute coronary syndrome compared with women without diabetes and men with diabetes, which may explain the increased risk of acute coronary syndrome in women with diabetes and may also contribute to worse outcomes.

Participant acceptability of exercise in kidney disease (PACE-KD): a feasibility study protocol in renal transplant recipients

IntroductionCardiovascular disease (CVD) is a major cause of mortality in renal transplant recipients (RTRs). General population risk scores for CVD underestimate the risk in patients with chronic kidney disease (CKD)...

Leavin' on My Mind: Influence of Safety Climate on Truck Drivers' Job Attitudes and Intentions to Leave

AbstractMotor carriers are facing a shortage of drivers. Traditional recruiting and retention incentives have become commoditized. This research investigated the effects of perceived safety climate on job attitudes and intentions to leave. The theory of work adjustment provided a model that was tested using responses of 553 truck drivers. Safety climate was strongly and positively associated with overall job attitudes. Overall job attitudes were, in turn, strongly and negatively associated with intentions to leave. This finding suggests that firms facing recruiting and retention challenges could leverage nontraditional occupational factors (such as safety climate) to inform human resource strategies.

Absorption and Excretion of Vitamin K Varies by Age and Triglycerides: A Metabolic Study in Older and Younger Adults Using Deuterium‐Labeled Collard Greens

Vitamin K is an essential fat‐soluble nutrient, with its most established role as a cofactor in coagulation. Emerging roles in soft tissue calcification have been proposed. However, further progress in understanding absorption and metabolism is needed, including knowledge of the factors influencing the physiologic response to vitamin K. Phylloquinone (PK) is the primary form of vitamin K in the diet and circulation. Large intra‐individual variances in circulating PK exist, and little is known about the dietary and non‐dietary factors that influence PK metabolism.The purpose of this study was to compare absorption efficiency and body retention of PK in older and younger adults following dietary vitamin K depletion and repletion.Forty‐two older (55–80 y; n=21) and younger (18–40 y; n=21) adults were maintained on sequential 28‐day vitamin K depletion (~10 ug PK/day) and vitamin K repletion (~500 ug PK/day) diets. At the end of each phase, subjects were fed deuterated collard greens (2H‐PK) and monitored over 72 hours. Liquid chromatography‐mass spectrometry (LC‐MS) was used to measure labeled and unlabeled PK in plasma and triglyceride‐rich lipoprotein (TRL) fractions, and labeled and unlabeled menadione (a PK metabolite) from 24‐hr urine collections.Absorption efficiency of 2H‐PK did not differ between PK depletion and repletion, but was significantly higher in older adults than in younger adults (p=0.02). 2H‐PK in TRL fractions was correlated with the total 2H‐PK in plasma (r=0.95, p<<0.001), corroborating previous data that PK is primarily transported in circulation associated with triglycerides. Age (p=0.015) and plasma triglycerides (p<0.001) were significant linear predictors of 2H‐PK area under the curve (AUC). Both age and plasma triglycerides retained significance in the multivariate model, and together explained 31.6% of the variance in absorbed plasma 2H‐PK during the depletion period, and 29.9% in the repletion period. Analysis of urinary 2H‐menadione showed no differences in body retention of vitamin K by age, sex, or depletion or repletion.In conclusion, age and circulating triglycerides are determinants of vitamin K absorption efficiency and together explained about 30% of the variance observed in absorbed PK. Body retention of vitamin K did not vary by age, sex, or dietary intake. There is a need to elucidate non‐traditional factors, such as genetics, that may influence absorption and metabolism of vitamin K.Support or Funding InformationStudy supported by the USDA ARS under Cooperative Agreement 58‐1950‐7‐707 and the NIH (5R01DK69341‐4).

Predicting Cardiovascular Disease Risk in HIV-Infected Patients: Still Room for Improvement

Accurate cardiovascular disease (CVD) risk prediction is essential to the care of HIV-infected individuals, who have an elevated risk for CVD with contributions from nontraditional HIV-related risk factors. In a U.S. cohort study, investigators assessed how well existing CVD risk prediction tools — the 2013 American College of Cardiology/American Heart Association Pooled Cohorts Equations (PCEs) for prediction of atherosclerotic cardiovascular disease (ASCVD) risk — function in HIV-infected adults, and whether including HIV-specific …

Abstract WP182: Trends in Acute Ischemic Stroke Hospitalizations and Risk Factors Among Young Adults: 12 Years of Nationally Representative Data

Background: There is limited recent population-based data of trends in acute ischemic stroke (AIS) hospitalization rates among young adults (YA). Rising prevalence of stroke risk factors may increase stroke rates in YA. We hypothesized that 1) stroke hospitalizations and mortality among YA are increasing over time (2000-2011), 2) besides traditional stroke risk factors, non-traditional factors are associated with stroke in YA, 3) stroke hospitalization among YA is associated with higher mortality, length of stay (LOS), and cost. Methods: In the Nationwide Inpatient Sample database (years 2000-2011), adult hospitalizations for AIS and concurrent diagnoses were identified by ICD-9-CM codes; the analytic cohort constituted all AIS hospitalizations. We performed weighted analysis using chi-square, t-test, and Jonckheere trend test. Multivariable survey regression models evaluated interactions between age group (18-45 vs. >45 years) and traditional and non-traditional risk factors, with outcomes including mortality, LOS, and cost. Models were adjusted for race, sex, Charlson’s Comorbidity Index, primary payer, location and teaching status of hospital, and admission day. Results: Among 5220960 AIS hospitalizations, 231858 (4.4%) were YA. On trend analysis, proportion of YA amongst AIS increased from 3.6% in 2000 to 4.7% in 2011 (p<0.0001) but mortality in YA decreased from 3.7% in 2000 to 2.6% in 2011, compared to 7.1% in 2000 to 4.6% in 2011 (p<0.0001) among older adults. Non-traditional, especially behavioral, risk factors were more common among YA, and LOS and cost were higher (Table). Conclusion: There was a trend for higher proportion of YA among AIS hospitalizations, though there was a decreasing mortality trend over 10 years. Behavioral risk factors were more common among YA, and there was an increased length of stay and cost. AIS in YA may require different preventive approaches compared to AIS among older adults.

Early-onset Preeclampsia in Lupus Pregnancy.

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that occurs during childbearing years and has been associated with preeclampsia. However, little is known about preeclampsia of early onset, which is associated with severe adverse maternal and perinatal outcomes. Using national population-based Swedish registers we identified women with SLE (≥2 visits with corresponding ICD codes) and a sample without SLE who gave birth to singleton infants 2001-12. Risk ratios (RR) and 95% confidence intervals (CI) for early-onset preeclampsia (defined by ICD codes corresponding to preeclampsia registered at <34 weeks) in SLE women were calculated based on adjusted modified Poisson models for first, subsequent, and all pregnancies. Among 742 births to women with SLE and 10 484 births to non-SLE women, there were 32 (4.3%) and 55 (0.5%) diagnoses of early-onset preeclampsia respectively. SLE was associated with an increased risk of early-onset preeclampsia (RR 7.8, 95% CI 4.8, 12.9, all pregnancies). The association remained similar upon restriction to women without pregestational hypertension. Adjustment for antiphospholipid syndrome (APS)-proxy attenuated the association. RRs for early-onset preeclampsia were smaller for subsequent pregnancies (RR 4.7, 95% CI 2.0, 11.2) compared to first and all (see above). Women with SLE are at increased risk of early-onset preeclampsia and this increased risk may be independent of the traditional risk factors such as pregestational hypertension, APS, BMI, or smoking. Women with SLE during pregnancy should be closely monitored for early-onset preeclampsia and future research needs to identify the non-traditional preeclampsia factors that might cause this serious outcome.

Cardiovascular risk in systemic lupus erythematosus

Abstract Background Patients with systemic lupus erythematosus (SLE) have a higher frequency of traditional cardiovascular risk factors (CVR). This, combined with the presence of non-traditional cardiovascular risk factors, increases the probability of cardiac events by five times. Objective To determine the prevalence of CVR factors in a population of patients with SLE. Material and methods A descriptive, cross-sectional, observational study in 51 patients with the diagnosis of SLE. Results A lupus dyslipoproteinaemia pattern was reported, of which 52.9% had hypo-alpha-lipoproteinaemia, 49% hypercholesterolaemia, 35.3% hypertriglyceridaemia, and 19.6% with an elevated c-LDL. The comorbidities found were, 31.4% with obesity, 27.5% with high blood pressure, and 6% suffered from diabetes mellitus. Predominant non-traditional CVR factors were associated with disease activity, with 90.1% taking glucocorticoids, 70.6% had low levels of complement C3, 41.2% had low levels of complement C4, 66.7% had a CRP > 2 mg/l, 56.9% had a SLEDAI-2K score greater than 4 points, 29.4% had more than 10 years of disease duration, and 25.5% had lupus nephritis. As regards the presence of antibodies associated with CVR, 58.8, 9.8, 74.8 and 3.9% had anti-Smith antibodies, lupus anticoagulant, anti-beta2glycoprotein I, and positive anticardiolipin, respectively. Conclusions Patients with SLE have a pro-inflammatory and atherogenic state, increasing the risk of developing cardiovascular diseases, and therefore a higher incidence of traditional risk factors, such as the presence of factors that promote chronic inflammation.

Metabolic characterization of overweight and obese adults

ABSTRACTObjectives: Traditional evaluations of metabolic health may overlook underlying dysfunction in individuals who show no signs of insulin resistance or dyslipidemia. The purpose of this study was to characterize metabolic health in overweight and obese adults using traditional and non-traditional cardiometabolic variables. A secondary purpose was to evaluate differences between overweight/obese and male/female cohorts, respectively.Methods: Forty-nine overweight and obese adults (Mean ± SD; Age = 35.0 ± 8.9 yrs; Body mass index = 33.6 ± 5.2 kg·m−2; Percent body fat [%fat] = 36.7 ± 7.9%) were characterized. Body composition (fat mass [FM], lean mass [LM], %fat) was calculated using a 4-compartment model; visceral adipose tissue (VAT) was quantified using B-mode ultrasound. Resting metabolic rate (RMR) and respiratory exchange ratio (RER) were evaluated using indirect calorimetry. Fasted blood and saliva samples were analyzed for total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TRG), glucose (GLUC), insulin, leptin, estradiol, and cortisol.Results: The prevalence of individuals with two or more cardiometabolic risk factors increased from 13%, using traditional risk factors (GLUC, TRG, HDL), to 80% when non-traditional metabolic factors (VAT, LM, RMR, RER, TC, LDL, HOMA-IR) were considered. Between overweight/obese, there were no significant differences in %fat (p = 0.152), VAT (p = 0.959), RER (p = 0.493), lipids/GLUC (p > 0.05), insulin (p = 0.143), leptin (p = 0.053), or cortisol (p = 0.063); obese had higher FM, LM, RMR, and estradiol (p < 0.01). Males had greater LM, RMR, and TRG (p < 0.01); females had greater %fat, and leptin (p < 0.001). There were no significant sex differences in RER, estradiol, insulin, or cortisol (p > 0.05).Conclusions: Evaluating metabolic health beyond BMI and traditional cardiometabolic risk factors can give significant insights into metabolic status. Due to high variability in metabolic health in overweight and obese adults and inherent sex differences, implementation of body composition and visceral fat measures in the clinical setting can improve early identification and approaches to disease prevention.

Cognitive Impairment and Dementia in Older Adults With Chronic Kidney Disease: A Review.

Individuals with chronic kidney disease (CKD), especially older adults, are at more risk of experiencing cognitive impairment, possibly leading to mild cognitive impairment and/or dementia. Studies report associations between CKD and cognitive impairment; although unclear, there seems to be a graded association between stage of CKD and affected cognitive domains, with executive function being affected earlier in the process than episodic memory and global ability. In CKD, dysexecutive mild cognitive impairment and vascular dementia are also more prominent than other subtypes. Explanations are directed toward traditional and nontraditional vascular factors, which may also explain or mediate the association between CKD and type of cognitive impairment. Future research is urged to focus on the longitudinal association between specific domains of cognitive function, including executive function and memory and CKD; to develop screening tools fit for every CKD stage in elderly individuals, and lastly, to use imaging methods that may help clarify the underlying mechanisms connecting the kidney and the brain.

Riesgo cardiovascular en lupus eritematoso sistémico

BackgroundPatients with systemic lupus erythematosus (SLE) have a higher frequency of traditional cardiovascular risk factors (CVR). This, combined with the presence of non-traditional cardiovascular risk factors, increases the probability of cardiac events by five times. ObjectiveTo determine the prevalence of CVR factors in a population of patients with SLE. Material and methodsA descriptive, cross-sectional, observational study in 51 patients with the diagnosis of SLE. ResultsA lupus dyslipoproteinaemia pattern was reported, of which 52.9% had hypo-alpha-lipoproteinaemia, 49% hypercholesterolaemia, 35.3% hypertriglyceridaemia, and 19.6% with an elevated c-LDL. The comorbidities found were, 31.4% with obesity, 27.5% with high blood pressure, and 6% suffered from diabetes mellitus. Predominant non-traditional CVR factors were associated with disease activity, with 90.1% taking glucocorticoids, 70.6% had low levels of complement C3, 41.2% had low levels of complement C4, 66.7% had a CRP>2mg/l, 56.9% had a SLEDAI-2K score greater than 4 points, 29.4% had more than 10 years of disease duration, and 25.5% had lupus nephritis. As regards the presence of antibodies associated with CVR, 58.8, 9.8, 74.8 and 3.9% had anti-Smith antibodies, lupus anticoagulant, anti-beta2glycoprotein I, and positive anticardiolipin, respectively. ConclusionsPatients with SLE have a pro-inflammatory and atherogenic state, increasing the risk of developing cardiovascular diseases, and therefore a higher incidence of traditional risk factors, such as the presence of factors that promote chronic inflammation.

Global security challenges and their impact on the Security Strategy of Kosova

Security is a fundamental prerequisite for the existence and development of humans and their society. Its scientific research and understanding is focused both on the State as a single entity, and on the international politics, as a System of States. At the current level of social development, security policy is implemented through various security systems, which analyze the possibilities and degrees of organization to perform security function in contemporary society. It is part of the Comprehensive State Policy as a whole, and implemented through a host of National Security Goals. This means that, in order to formulate and develop a security concept, any state, must take under consideration both internal and external factors, both traditional and non-traditional factors. Contemporary concept of the security policy is seen as a combination of objectives, interests, and actions in economy on one hand, and of the Strategy of the Armed Forces, on the other hand, including international cooperation and coordination. Kosova has fallen behind in this field, because it still misses some documents of crucial importance, i.e. “Comprehensive Security Strategy”, a Comprehensive document defining the National Critical Infrastructure. These two documents are supposed to define the basic national interests of Kosova, as crucial elements of the National Being, and define institutions and actions for their preservation and development. To make the situation even more difficult, Kosova is still missing a clear definition of its security environment, whereas the entire security policy is based on the capability of KFOR, EULEX and other international presence, to provide their support. The presence of parallel structures, and even criminal groups, sponsored, or instigated, by the official Government of Serbia, have a serious impact on the situation. Those structures and groups are a constant challenge against legal institutions of Kosova, in their efforts to execute the sovereignty throughout its territory.

A Multi-Center International Study Assessing the Impact of Differences in Baseline Characteristics and Perioperative Care Following Radical Cystectomy.

Background: To identify potential avenues for quality improvement, we compared the variations in clinical practice and their association with perioperative morbidity and mortality following radical cystectomy (RC) for bladder cancer in the United States (US) and Japan.Methods: We reviewed our retrospectively collected database of 2240 patients who underwent RC for bladder cancer at the University of Michigan (n = 1427) and in 21 Japanese institutions (n = 813) between 1997 and 2014. We performed a systematic comparison of clinical and perioperative factors and assessed predictors of perioperative morbidity and mortality. Death within 90 days of surgery was the primary outcome.Results: There were apparent differences between the two study populations. Notably, US patients had a significantly greater BMI and higher ASA score. In Japanese institutions, median postoperative hospital stay was significantly higher (40 days vs. 7 days, p < 0.001) and 90-day readmission rates were significantly lower (0.6% vs. 26.8% , p < 0.001). There was a total of 1372/2240 (61.2%) patients with complications within 90 days and 66/2240 (2.9%) patient deaths. Significant predictors of 90-day mortality were older age (OR 1.04, CI 1.01–1.07), higher body mass index (OR 1.07, CI 1.02–1.12), node-positive disease (OR 3.14, CI 1.78–5.47), increased blood loss (OR 1.02, CI 1.01–1.03), and major (Clavien-grade 3 or greater) complication (OR 3.29, CI 1.88–5.71).Conclusion: Despite major differences in baseline characteristics and care of cystectomy patients between the two study populations, peri-operative mortality rates proved to be comparable. This data supports an exploration of non-traditional factors that may influence mortality after cystectomy.

Genetic susceptibility to cerebrovascular disease.

Cerebrovascular disease (CeVD) remains a major cause of death and a leading cause of disability worldwide. CeVD is a complex and multifactorial disease caused by the interaction of vascular risk factors, environment, and genetic factors. In the present article, we discussed genetic susceptibility to CeVD, with particular emphasis on genetic studies of the associations between lipid traits and CeVD. Several animal and clinical studies clearly defined genetic predisposition to atherosclerosis and CeVD, and particularly to ischemic stroke. Recent evidence has shown that traditional vascular risk factors explain only a small proportion of variance in atherosclerosis, suggesting that additional nontraditional factors and novel genetic determinants impact CeVD. With the help of genome-wide technology, novel genetic variants have been implicated in CeVD and lipid metabolism such as those in protein convertase subtilisin/kexin type 9 (PCSK9) gene in stroke and familial hypercholesterolemia. These studies are important as they contribute to our understanding of the genetic mechanisms underlying CeVD and to developing more effective CeVD prevention strategies. CeVD is a complex and multifactorial disease and genetics likely plays an important role in its pathogenesis. The gene-gene and gene-environment interactions of genes involved in biology of vascular disease, including the lipid metabolism are important factors for individual susceptibility to CeVD. Accounting for individual variation in genes, environment and lifestyle will bring us closer to precision medicine, which is an emerging and recently introduced new approach for disease treatment and prevention in clinical practice.

Complex Assessment of Risk Factors for the Development of Cardiovascular Calcification in Hemodialysis Patients

The aim of the present study was the integrated assessment of the role of non-traditional factors (inflammation, malnutrition, calcium-phosphorus disorder and imbalance in the concentration of inducers and inhibitors of calcification) in forming cardiovascular calcification (CVC) and the structural-functional rearrangement of LV myocardium in patients with chronic kidney disease (CKD) receiving hemodialysis (HD). Materials and Methods: The present study included 84 HD patients with CKD 5D stage. We evaluated 3 components of the Dialysis Malnutrition Score (DMS), according to which body mass index (BMI), the level of serum albumin, and the percent saturation of transferrin with iron were determined. We also analyzed CRP, fibrinogen, and beta-2 microglobulin, and calculated the number of points (from zero to 2) according to the Glasgow Prognostic Score (GPS), which allowed us to combine indicators of inflammation and make a common prognostic assessment. The serum levels of protein alpha-Klotho и FGF-23 were determined by enzyme immunoassay. Echocardiographic measurements were performed using B-mode, M-mode and Doppler-mode. Different patterns of LV geometry were identified according to Ganau et al. (1992). The severity of calcification was estimated by a semi-quantitative scale for assessing the degree of calcification of heart structures according to the National recommendations for CKD-MBD (2010). Results: The increased risk for development of CVC, LVH, and diastolic dysfunction was associated with markers of malnutrition, anemia, and inflammation in HD patients. Reduced serum alpha-Klotho level, hypoalbuminemia and a high level of FGF-23 had a prognostic value in CVC formation. (Int J Biomed. 2016;6(1):22-26.).