Occurrence Of Multiple Risk Factors Research Articles

Patterns and co-occurrence of risk factors for hepatocellular carcinoma in four Asian American communities: a cross-sectional study.

ObjectivesTo investigate risk factor patterns and the simultaneous occurrence of multiple risk factors in the viral, metabolic and lifestyle domains among Asian Americans, who have had the highest mortality rates from hepatocellular carcinoma (HCC).SettingSacramento County, California, USA.ParticipantsEligible participants were county residents ages 18 and older who had not been screened for chronic hepatitis B virus (HBV) and were born in a CDC-defined endemic area or whose parent was born in that area. Of 1004 enrolled, 917 were foreign-born Chinese (130 women, 94 men), Hmong (133 women, 75 men), Korean (178 women, 90 men) or Vietnamese (136 women, 81 men) with complete risk factor data.Primary and secondary outcome measuresWe tested participants for HBV and chronic hepatitis C virus (HCV); measured haemoglobin A1c and waist circumference; and recorded self-reported history of diabetes, hypertension, alcohol use and smoking status. We identified risk factor patterns using cluster analysis and estimated gender-specific age-standardised prevalence rates.ResultsWe identified four patterns: (1) viral (chronic HBV or HCV); (2) lifestyle (current smoker or alcohol user, no viral); (3) metabolic (≥2 metabolic, no lifestyle or viral); and (4) lower risk (≤1 metabolic, no lifestyle or viral). Vietnamese men (16.3%, 95% CI 7.4% to 25.3%) and Hmong women (15.1%, 95% CI 7.8% to 22.5%) had the highest viral pattern prevalence. Hmong women had the highest metabolic (37.8%, 95% CI 29.8% to 45.9%), and Vietnamese men the highest lifestyle (70.4%, 95% CI 59.1% to 81.7%) pattern prevalence. In multiple domains, Hmong men and women were most likely to have viral+metabolic risk factors (men: 14.4%, 95% CI 6.0% to 22.7%; women: 11.9%, 95% CI 5.6% to 18.3%); Vietnamese men were most likely to have lifestyle+viral (10.7%, 95% CI 2.7% to 18.8%), and lifestyle+metabolic but not viral (46.4%, 95% CI 34.4% to 58.5%) risk factors.ConclusionsEfforts to reduce HCC must comprehensively address multiple risk factors.Trial registration number NCT02596438.

OP.6A.05] CARDIOVASCULAR DISEASE RISK FACTORS IN ADOLESCENT STUDENTS FROM A BRAZILIAN STATE CAPITAL

Objective: To determine the prevalence of cardiovascular disease risk factors in adolescents from public and private schools of a Brazilian state capital. Design and method: Cross-sectional study with a representative sample of adolescents aged 14 to 18 years, enrolled in public and private schools in Goiânia, Goiás state, Brazil. The data collection included a standard questionnaire (gender, age, ethnicity, smoking, alcohol consumption in the last 30 days, socioeconomic status, and family history of cardiovascular disease); the International Physical Activity Questionnaire (IPAQ); and a physical assessment (weight, height, waist circumference, and blood pressure). The prevalence ratio was used as the measure of association, estimated by Poisson regression. Results: The sample was composed of 862 adolescents with a mean age of 15.4 ± 1.1 years and with a predominance of females (52.8%). Alcohol consumption in the last 30 days (72.2%) and physical inactivity (66.8%) were the most prevalent cardiovascular risk factors. The most prevalent variables in female adolescents were socioeconomic class C (53.6%; p = 0.022), alcohol consumption in the last 30 days (75.4%; p = 0.025) and physical inactivity (66.8%, p = 0.000). In male adolescents, the most prevalent variables were abnormal blood pressure (24.3%; p = 0.000), abnormal waist circumference (17.2%; p = 0.011), and overweight (24.6%; p = 0.001). The prevalence of a family history of cardiovascular disease was 39.5%. Most adolescents (60.3%) had three or more risk factors, and only 1.1% did not present any cardiovascular risk factor. Conclusions: The prevalence of cardiovascular disease risk factors, particularly the occurrence of multiple risk factors, was high in the population studied.

Prevalence and risk factors for hepatitis B and C among sexually active undergraduates in southwestern Nigeria

Introduction: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are sources of mortality and morbidity, threatening global public health. Numerous social activities of youths, which are not perceived as risky, put them at risk of contracting these infections. The objective of this study was to assess the prevalence and risk factors for hepatitis B and C among sexually active female undergraduates in southwestern Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out among 306 sexually active female undergraduates of a university in southwestern Nigeria who were selected using multistage sampling method. Research instruments were self-administered, semi-structured pretested questionnaires. Data were analyzed using the SPSS software. Results: The mean age of the respondents was 22.0 ± 2.7 years. Two hundred and fifty one (82.0%) respondents were aware of hepatitis, with 27.6% and 72.4% having good and poor knowledge, respectively, of the risk factors of hepatitis. Nineteen (6.2%) respondents were reactive to hepatitis B, seven (2.3%) were reactive to hepatitis C while two (1.6%) showed coinfection by both viruses. Based on the grouping of the identified risk factors to hepatitis, 190 (62.1%) had a single risk, 77 (25.2%) had double risk while 39 (12.7%) had multiple risk factors for hepatitis infections. Knowledge of risk factors does not have any statistically significant association with the occurrence of risk factors (P < 0.05). The occurrence of multiple risk factors was 7 and 11 times more likely to be a predictor of hepatitis B and C, respectively, compared to having sexual intercourse alone that is a single risk factor. Conclusion: University undergraduates are at a risk of contracting hepatitis infections. High awareness but poor knowledge of hepatitis and a significant seroprevalence rate underscores the need for awareness and more efforts on the part of university health services.

Racial and Ethnic Disparities in Preconception Risk Factors and Preconception Care

At-risk drinking, cigarette smoking, obesity, diabetes, and frequent mental distress, as well as their co-occurrence in childbearing aged women, are risk factors for adverse pregnancy outcomes. This study estimated the prevalence of these five risk factors individually and in combination among nonpregnant women aged 18-44 years by demographic and psychosocial characteristics, with a focus on racial and ethnic disparities. Data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) on nonpregnant women aged 18-44 years (n=54,612) were used to estimate the prevalences of five risk factors, pairs of co-occurring risk factors, and multiple risk factors for poor pregnancy outcomes. The majority of women had at least one risk factor, and 18.7% had two or more risk factors. Having two or more risk factors was highest among women who were American Indian and Alaska Native (34.4%), had less than a high school education (28.7%), were unable to work (50.1%), were unmarried (23.3%), and reported sometimes, rarely, or never receiving sufficient social and emotional support (32.8%). The most prevalent pair of co-occurring risk factors was at-risk drinking and smoking (5.7%). The high proportion of women of childbearing age with preconception risk factors highlights the need for preconception care. The common occurrence of multiple risk factors suggests the importance of developing screening tools and interventions that address risk factors that can lead to poor pregnancy outcomes. Increased attention should be given to high-risk subgroups.

Hypofibrinolysis as a Risk Factor for Venous Thrombosis.

Several genetic and acquired risk factors are known to increase the risk of venous thrombosis (VT). The occurrence of multiple risk factors in a single patient may be associated with a thrombotic risk which exceeds the sum of the individual risks, as is for example seen with oral contraceptive use and factor V Leiden. Previously we have shown that reduced fibrinolytic potential a measured by a plasma-based assay increases the risk of VT. Here, we investigated the thrombotic risk in individuals with hypofibrinolysis overall and in combination with the factor V Leiden and prothrombin 20210A mutation, in the Multiple Environmental and Genetic Assessment (MEGA) of risk factors for venous thrombosis study, a large population-based case-control study. In the present analyses, 2420 patients with a first episode of deep vein thrombosis of the leg or a pulmonary embolism and 2943 control subjects (partners and randomly selected individuals) between 18 and 70 years were included. Lysis of a tissue factor-induced clot by exogenous tissue-type plasminogen activator was studied by monitoring changes in turbidity during clot formation and subsequent lysis. Using quartiles of clot lysis time (CLT) based on the values found in the control subjects, we found an increase in risk of VT with each increasing quartile of CLT. The odds ratio (OR) (95% confidence interval (CI)) for individuals in the fourth quartile of CLT compared to individuals in the first quartile was 1.8 (1.5–2.1), after adjustment for age and sex. In younger subjects and women these ORs were slightly elevated (table). In individuals with hypofibrinolysis (i.e., the highest quartile of CLT) and without the factor V Leiden mutation an OR of 1.8 (1.5–2.1) was found compared to those without the mutation and with the lowest CLTs (i.e., in the lowest quartile). Individuals with the factor V Leiden mutation with the lowest CLTs had a risk of VT that was 3.6 (2.4–5.4) times increased, compared to those without the mutation and with the lowest CLTs. The risk of VT increased 6.2–fold (4.2–9.2) for individuals in the fourth quartile of CLT with the factor V Leiden mutation compared to people in the first quartile without the mutation. The same analyses for the prothrombin 20210A mutation gave ORs of 1.8 (1.5–2.1) for hypofibrinolysis only, 3.6 (1.4–9.5) for the mutation only, and 3.2 (1.9–5.3) for the combination. Our study confirms the increased risk of VT in individuals with hypofibrinolysis. This risk is especially pronounced in women and younger individuals. The combination of hypofibrinolysis and the factor V Leiden or prothrombin mutation does not appear to enhance the risk of VT. This study was supported by the Netherlands Heart Foundation (NHF) (Grant no. 2005B060 and 98.113) and the Netherlands Organisation for Scientific research (NWO) (Grant no. 912-03-033/2003).Risk of VT for individuals in the fourth quartile (Q4) of CLToverall<49 years>49 yearswomenmen# cases(Q1/Q4)452/784275/285177/499261/385191/398#controles (Q1/Q4)733/733458/248274/485430/357303/376OR (95% CI)*1.8 (1.5–2.1)2.5 (1.9–3.2)1.7 (1.4–2.2)2.7 (2.1–3.4)1.6 (1.3–2.1)* Q1 is reference