Prevalence Of Cardiometabolic Diseases Research Articles

Gambaran Aktivitas Fisik Pada Individu Obesitas Di Wilayah Kerja Puskesmas Sidorejo Kidul Salatiga

Background: Obesity is one of the health problems related to the prevalence of cardiometabolic disease. WHO states that obesity is a complex, serious problem experienced by all age groups, ranging from children, adults to the elderly. Obesity must be treated immediately because it has the potential to become a health problem (1). In obese patients who have a Body Mass Index (BMI)> 30 kg / m2 will increase the risk of Coronary Heart Disease (CHD), both men and women. The American Heart Association (AHA) classifies obesity as a risk factor for coronary heart disease. Someone with central Obesity (upper body obesity) will be easily exposed to the risk of heart disease and other metabolic diseases known as metabolic syndrome compared with ginoid obesity (lower body obesity) is very small will be the risk of metabolic disease and coronary heart disease.
 Objective: The purpose of the study to determine the description of community behavior seen from the point of view of physical activity that became one of the causes of obesity in Salatiga City.
 Method: This research method is descriptive quantitative with observation approach. The population in this study is the people who have checked themselves to the Puskesmas Sidorejo Kidul, each from the scope of work area of Sidorejo Kidul Puskesmas. The inclusion criteria applied were: 1) people living in the working area of pusidmas sidorejo kidul, 2) aged 40 years and over, 3) IMT more than 27,0. Variables studied in this research is the intensity of physical activity and BMI. The instrument used to measure the intensity of physical activity is the Global Physical Activity Questionnaire (GPAQ). The interview was conducted to identify the understanding of the community in the work area of Sidorejo Kidul Public Health Center towards obesity and physical activity.
 Result: After all the data collected the results of the research were carried out by analyzing the data by data reduction, data presentation, drawing conclusions, and verification. Setelah semua data terkumpul hasil penelitian dilakukan dengan cara analisa data dilakukan dengan reduksi data, penyajian data, penarikan kesimpulan, dan verifikasi.
 Conclusion: The physical activity of the elderly in the working area of the Puskesmas Sidorejo in the city of Salatiga, based on the Global Physical Activity Questionnaire (GPAQ) calculation is included in the medium category of 50% with physical activities generally carried out by housewives such as sweeping, mopping, cooking, and wash. As many as 15% of the elderly are in the category of low physical activity and the rest are included in the high category of 35%.

Cardiometabolic disease, depressive symptoms, and sleep disorders in middle-aged adults with functional disabilities: NHANES 2007–2014

Purpose: This study examined whether depressive symptoms and sleep disorders modified the association between functional disabilities and cardiometabolic disease profiles in middle-aged adults (40–64 years).Methods: Participants came from the 2007–2014 NHANES. Information regarding cardiometabolic diseases, demographics, depressive symptoms, and sleep disorders were obtained. Logistic regression analyses were performed with group as the exposure and cardiometabolic diseases as the response.Results: Adults with moderate (n = 550) and severe (n = 556) functional disabilities had a higher prevalence of cardiometabolic diseases, depressive symptoms, and sleep disorders compared to adults without functional disabilities (n = 3765; p < 0.05). After adjusting for demographics, the odds of cardiovascular disease and diabetes were higher in adults with severe functional disabilities (OR: 1.47 and 1.76, p < 0.05), but not in adults with moderate functional disabilities (OR: 1.21 and 1.22, p > 0.05). With further adjustment for depressive symptoms and sleep disorders, the odds of cardiovascular disease (OR: 1.47) and diabetes (OR: 1.76) remained increased (p < 0.05) in adults with severe functional disabilities.Conclusions: By middle-age, adults with functional disabilities have an elevated prevalence of cardiometabolic diseases, depressive symptoms, and sleep disorders compared to adults without functional disabilities. The elevated cardiometabolic disease profiles are present in adults with severe functional disabilities even after adjusting depressive symptoms and sleep disorders.IMPLICATIONS FOR REHABILITATIONIn the elderly population, cardiometabolic diseases, depression, and sleep disorders are prevalent conditions and are often co-morbid.In a nationally representative sample of middle-aged adults, study findings found that those with severe functional disabilities had an elevated cardiometabolic disease prevalence compared to adults without functional disabilities, even after accounting for the higher prevalence of depressive symptoms and sleep disorders.Earlier screening for cardiometabolic diseases, depression, and sleep disorders in adults with functional disabilities, or those who are at risk for developing functional disabilities, are warranted.Interventions pertaining to physical, pharmacological, or care coordination focused on improving cardiometabolic disease profiles among adults with functional disabilities are needed.

High burden of the metabolic syndrome and its component disorders in South Africans with psoriasis.

Psoriasis is associated with cardiometabolic diseases (CMDs) in Caucasians, but no data is available from sub-Saharan populations on either CMD prevalence or psoriasis risk factors. Our aim was to investigate the prevalence of CMDs in a predominantly non-Caucasian cohort of South Africans with psoriasis and to determine the principal risk factors associated with psoriasis. This was a cross-sectional case-control study of adult psoriasis patients (n=103) and controls (n=98), comparing sociodemographic, anthropometric, clinical, and biochemical characteristics. The groups were matched for gender, ethnicity, and body mass index (BMI). The prevalence of metabolic syndrome (MetS) (52.4% vs. 33.7%; P=0.007), type 2 diabetes (T2D) (25.2% vs. 4.1%; P<0.0001), and hypertension (70.9% vs. 46.6%; P=0.001) were all higher in the psoriasis group. High-sensitivity CRP was higher in psoriasis patients than controls (4.70 (2.00, 10.9) vs. 2.00 (1.10, 4.80) ng/ml; P<0.0005). Multivariable logistic regression analysis showed that severe psoriasis was independently associated with MetS (odds ratio [95% CIs]: 4.42 [1.72, 11.4]; P=0.002), T2D (11.3 [3.07, 41.3]; P=0.0002), and hypertension (2.48 [0.97, 6.32]; P=0.05), whilst for psoriasis the principal risk factors were smoking (3.87 [1.97, 7.63]; P<0.0001) and hsCRP (1.05 [1.00, 1.10]; P=0.029), with completion of high school (0.23 [0.11, 0.48]; P<0.0001) being protective. In this population, psoriasis is characterized by a high burden of CMDs, particularly in those subjects with severe psoriasis. Inflammation plays a role in the etiology of psoriasis, whilst smoking and poor education further increase disease risk.

HEPATITIS C IN THE BRAZILIAN PUBLIC HEALTH CARE SYSTEM: BURDEN OF DISEASE

Infection by hepatitis C virus is one of the leading causes of chronic hepatitis C and cause severe burden for patients, families and the health care system. The aims of this research were to assess the severity of liver fibrosis, comorbidities and complications of hepatitis C virus; to examine health-related quality of life (HRQoL), productivity loss and resource use and costs in a sample of Brazilian chronic hepatitis C, genotype 1, patients. This was a cross-sectional multicenter study performed in genotype-1 chronic hepatitis C patients to assess disease burden in the Brazilian public health care system between November 2014 and March 2015. Patients were submitted to a liver transient elastography (FibroScan) to assess liver fibrosis and answered an interview composed by a questionnaire specifically developed for the study and three standardized questionnaires: EQ-5D-3L, HCV-PRO and WPAI:HepC. There were 313 subjects enrolled, with predominance of women (50.8%), caucasian/white (55.9%) and employed individuals (39.9%). Mean age was 56 (SD=10.4) years old. Moreover, 42.8% of patients who underwent FibroScan were cirrhotic; the most frequent comorbidity was cardiovascular disease (62.6%) and the most frequent complication was esophageal varices (54.5%). The results also showed that "pain and discomfort" was the most affected HRQoL dimension (55.0% of patients reported some problems) and that the mean HCV-PRO overall score was 69.1 (SD=24.2). Regarding productivity loss, the most affected WPAI:HepC component was daily activity (23.5%) and among employed patients, presenteeism was more frequent than absenteeism (18.5% vs 6.5%). The direct medical costs in this chronic hepatitis C sample was 12,305.72USD per patient in the 2 years study period; drug treatment costs represented 95.9% of this total. This study showed that most patients are cirrhotic, present high prevalence of cardiometabolic diseases and esophageal varices, reduced HRQoL mainly in terms of pain/discomfort, and work productivity impairment, especially presenteeism. Additionally, we demonstrated that hepatitis C virus imposes an economic burden on Brazilian Health Care System and that most of this cost is due to drug treatment.

Reduced Lean Body Mass and Cardiometabolic Diseases in Adult Males with Overweight and Obesity: A Pilot Study.

Little is known about the reduction in lean body mass (LBM) and its health consequences in overweight and in obesity, especially in males. Therefore, we aimed to assess the prevalence of low LBM in treatment-seeking adult males with overweight and obesity and the association with cardiometabolic diseases, i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia. A body composition assessment was conducted by a bio-impedance analyzer (InBody 170) among a total of 110 males, of whom 72 were overweight and obese and were referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon, and 38 were normal-weight participants of similar ages. The participants with overweight and obesity were then categorized as being with or without low LBM. Of the sample of 72 participants, 50 (69.4%) met the criteria for reduced LBM and displayed a significantly higher prevalence of cardiometabolic diseases (i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia) than those with normal LBM (36.0% vs. 9.1%; p = 0.019). Logistic regression analysis showed that low LBM increases the odds of having cardiometabolic diseases by nearly 550% (odds ratio (OR) = 5.46, 95% confidence interval (CI) = 1.31–26.39, p < 0.05) after adjusting for total fat and central adiposity. Treatment-seeking adult males with overweight and obesity displayed a great prevalence of reduced LBM, which seems to be strongly associated with cardiovascular and metabolic diseases.

Anthropometric measures and their association with risk factors for cardio-metabolic diseases in Kenyan adults

Background: The prevalence of cardio-metabolic diseases (CMD) is drastically increasing worldwide. Anthropometric measures of fat accumulation are correlated with CMD and Metabolic Syndrome (MS), but few studies have addressed this association in sub-Saharan African populations.Aim: To investigate the association between anthropometric features, MS and other CMD risk factors in a population from Kenya.Subjects and methods: In this cross-sectional study including 1405 Kenyans, anthropometric measurements including visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) were carried out. Fasting blood glucose and standard oral glucose tolerance test, fasting serum insulin and plasma lipids were analysed. Homeostatic model assessment of insulin resistance was calculated. Systolic and diastolic blood pressures were measured.Results: CMD risk factors and MS were associated with all anthropometric features, except for high-density lipoprotein cholesterol levels (p < 0.05). The strongest association between MS and anthropometrics was seen with SAT (β = 1.45 ± 0.32 in men and 0.88 ± 0.14 in women, both p < 0.05).Conclusions: Anthropometric measures, especially features of central obesity such as VAT and SAT, are relevant indicators of cardio-metabolic health in Kenyan populations. SAT is the strongest predictor of MS. These results highlight the need for further research on the pathological implication of VAT and SAT, in order to understand patterns of fat distribution and cardio-metabolic health among different ethnic groups.

Linking of metabolomic biomarkers with cardiometabolic health in Chinese population

Due to rapid nutrition transitions, the prevalence of cardiometabolic diseases, such as metabolic syndrome, type 2 diabetes, and cardiovascular diseases, has been increasing at an alarming rate in the Chinese population. Moreover, Asians, including Chinese, have been hypothesized to have a higher susceptibility to cardiometabolic diseases than Caucasians. Early prediction and prevention are key to controlling this epidemic trend; to this end, the identification of novel biomarkers is critical to reflect environmental exposure, as well as to reveal endogenous metabolic and pathophysiologic mechanisms. The emerging "omics" technologies, especially metabolomics, offer a unique opportunity to provide novel signatures or fingerprints to understand the effects of genetic and non-genetic factors on cardiometabolic health. During the past two decades, metabolomic approaches have been increasingly used in various epidemiological studies, primarily in Western populations. Although the field is still in its early stages, some studies have tried to identify novel compounds or confirm their metabolites and associations with cardiometabolic diseases in Chinese populations, including amino acids, fatty acids, acylcarnitines and other metabolites. Despite major efforts to discover novel biomarkers for disease prediction or intervention, the limits in current study design, analytical platforms, and data processing approaches are challenges in metabolomic research worldwide. Therefore, future research with more advanced technologies, rigorous study designs, standardized detection and analytic approaches, and integrated data from multiomics approaches are essential to evaluate the feasibility of using metabolomics in clinical settings. Finally, the functional roles and underlying biological mechanisms of metabolomic biomarkers should be elucidated by future mechanistic research.

Geographical variations and influential factors in prevalence of cardiometabolic diseases in South Korea.

Geographical variations and influential factors of disease prevalence are crucial information enabling optimal allocation of limited medical resources and prioritization of appropriate treatments for each regional unit. The purpose of this study was to explore the geographical variations and influential factors of cardiometabolic disease prevalence with respect to 230 administrative districts in South Korea. Global Moran’s I was calculated to determine whether the standardized prevalences of cardiometabolic diseases (hypertension, stroke, and diabetes mellitus) were spatially clustered. The CART algorithm was then applied to generate decision tree models that could extract the diseases’ regional influential factors from among 101 demographic, economic, and public health data variables. Finally, the accuracies of the resulting model–hypertension (67.4%), stroke (62.2%), and diabetes mellitus (56.5%)–were assessed by ten-fold cross-validation. Marriage rate was the main determinant of geographic variation in hypertension and stroke prevalence, which has the possibility that married life could have positive effects in lowering disease risks. Additionally, stress-related variables were extracted as factors positively associated with hypertension and stroke. In the opposite way, the wealth status of a region was found to have an influence on the prevalences of stroke and diabetes mellitus. This study suggested a framework for provision of novel insights into the regional characteristics of diseases and the corresponding influential factors. The results of the study are anticipated to provide valuable information for public health practitioners’ cost-effective disease management and to facilitate primary intervention and mitigation efforts in response to regional disease outbreaks.

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk.

Hypertensive disorders of pregnancy (HDP) complicate 5% to 10% of pregnancies and are increasing with the rising prevalence of cardiometabolic diseases in younger women.1 Normal pregnancy is marked by an initial drop in mean arterial pressure, with an eventual rise in blood pressure (BP) to prepregnancy levels.2 The development of HDP involves a number of factors that result in volume and hemodynamic alterations that fail to adapt to the changes accompanying pregnancy. There are well established associations between HDP and the development of maternal cardiovascular disease (CVD) later in life. Although the associations between preeclampsia and future CVD have long been known, newer evidence suggests that there are also long‐term CVD risks associated with gestational hypertension (GH), although the etiology of GH is thought to be distinct from that of preeclampsia. Whether preeclampsia and GH result as manifestations of already preexisting CVD risk or whether they contribute to the pathogenesis of later CVD development is unclear. A history of HDP has the unique potential to identify women at higher risk of future CVD, for whom targeted risk‐reduction interventions may be particularly helpful. In this review, we discuss the evidence for the long‐ and short‐term risks of maternal CVD associated with HDP, with a focus on preeclampsia and GH. We also outline current recommendations for screening and prevention of CVD in women with a history of HDP and highlight important areas in which additional research is needed.

Identification of Comprehensive Metabotypes Associated with Cardiometabolic Diseases in the Population-Based KORA Study.

"Metabotyping" describes the grouping of metabolically similar individuals. We aimed to identify valid metabotypes in a large cohort for targeted dietary intervention, for example, for disease prevention. We grouped 1729 adults aged 32-77 years of the German population-based KORA F4 study (2006-2008) using k-means cluster analysis based on 34 biochemical and anthropometric parameters. We identified three metabolically distinct clusters showing significantly different biochemical parameter concentrations. Cardiometabolic disease status was determined at baseline in the F4 study and at the 7 year follow-up termed FF4 (2013/2014) to compare disease prevalence and incidence between clusters. Cluster 3 showed the most unfavorable marker profile with the highest prevalence of cardiometabolic diseases. Also, disease incidence was higher in cluster 3 compared to clusters 2 and 1, respectively, for hypertension (41.2%/25.3%/18.2%), type 2 diabetes (28.3%/5.1%/2.0%), hyperuricemia/gout (10.8%/2.3%/0.7%), dyslipidemia (19.2%/18.3%/5.6%), all metabolic (54.5%/36.8%/19.7%), and all cardiovascular (6.3%/5.5%/2.3%) diseases together. Cluster analysis based on an extensive set of biochemical and anthropometric parameters allows the identification of comprehensive metabotypes that were distinctly different in cardiometabolic disease occurrence. As a next step, targeted dietary strategies should be developed with the goal of preventing diseases, especially in cluster 3.

Dysmetabolic Iron Overload and Cardiometabolic Diseases. Cause-Effect Relationship or Indirect Association?

The prevalence of cardiometabolic diseases is increasing all over the world. Insulin resistance has been proposed as one major factor of the Metabolic syndrome (MetS) that ultimately leads to type 2 Diabetes Mellitus (T2DM). The relationship between iron status and MetS has been scarcely described. This mini-review presents on one hand the existing knowledge on the effects of excess body iron (iron overload) on insulin resistance and on the other the link between hyperglycemia and alterations in iron metabolism.

Reevaluating nutrition as a risk factor for cardio-metabolic diseases.

Introduction: The consumption of saturated fats is considered a risk factor for cardiovascular diseases.Objective: Review published papers on the role of macro-nutrient intake in cardiovascular risk.Results: Recent reports from the PURE study and several previous meta-analyses, show that the consumption of total saturated and unsaturated fat is not associated with risk of acute myocardial infarction or mortality due to cardiovascular disease. High carbohydrate intake was associated with the highest risk of total and cardiovascular mortality, while total fat consumption or of its different types was associated with a lower risk of mortality. A high consumption of fruits, vegetables and legumes was associated with lower risk of total mortality and non-cardiovascular mortality. The consumption of 100 g of legumes, two or three times a week, ameliorated deficiencies of the nutrients contained in these foods and was associated with a reduction in the risk of developing chronic non-communicable diseases.Conclusion: A healthy diet should be balanced and varied, be composed of a proportion of complex carbohydrates rich in fibber between 50-55% of the daily energy consumed, of saturated and unsaturated fat (25-30%), animal and vegetable protein (including legumes) between 15-25%, vitamins, minerals and water. These nutrients are abundantly present in fruits, vegetables, cereals, legumes, milk and its derivatives, eggs and meats, so public policies should promote the availability and access to these nutrients within primary prevention programs to reduce the growing prevalence of cardio-metabolic diseases.

Health and Cardiometabolic Disease in Transgender Adults in the United States: Behavioral Risk Factor Surveillance System 2015.

ContextLittle is known about the health of transgender adults in the United States, a growing population. There have been no large reports examining differences in health status and cardiometabolic disease in subgroups of transgender adults [female-to-male (FTM), male-to-female (MTF), and gender nonconforming (GNC)] in the United States.ObjectiveCompare the health status and prevalence of cardiometabolic disease among specific subgroups of transgender adults (FTM, MTF, GNC) with those of cisgender adults in the United States.DesignSecondary data analysis based on the 2015 Behavioral Risk Factor Surveillance System survey.SettingThe 22 states in the United States that asked about transgender identity.ParticipantsNoninstitutionalized adults age ≥18 years who reside in the United States, identified through telephone-based methods.Main Outcome MeasuresData were extracted for respondents who answered the transgender identity question. Weighted percentages are given for all measures. Adjusted odds ratios (ORs) are reported for health status and cardiometabolic disease measures.ResultsFTM adults have a higher odds of being uninsured than both cisgender women [OR 3.8; 95% confidence interval (CI), 2.1 to 7.1] and cisgender men (OR 2.5; 95% CI, 1.4 to 4.7). MTF adults have a higher odds of reporting myocardial infarction than cisgender women (OR 2.9; 95% CI, 1.6 to 5.3) but not cisgender men.ConclusionsThere are significant differences in health status measures and cardiometabolic health between subgroups of transgender adults and cisgender adults. There is a need for additional research to understand the societal and medical (e.g., hormone therapy) effects on these outcomes.

&lt;b&gt;Prevalence of major cardiometabolic diseases in the riverine populations from the interior of the State of Amazonas, Brazil

This study aimed to estimate the prevalence of major cardiometabolic diseases according to the sociodemographic characteristics and lifestyle in the riverine communities of the municipalities of Tefé and Santa Isabel do Rio Negro, State of Amazonas, Brazil. Descriptive tests and logistic regression models were used to estimate the effect of age, gender, marital status, education, smoking, alcohol consumption and sedentary lifestyle on the prevalence of cardiometabolic diseases in 552 adults aged from 18 to 78 years. The prevalence of hypertension, diabetes and obesity in Tefé and Santa Isabel do Rio Negro were respectively 28 / 30.7%; 28.2/ 8.9%; and 22.3 / 42%. In Tefé, married men, aged over 35 years, were more susceptible to the cardiometabolic diseases. In Santa Isabel do Rio Negro, smoking men aged over 35 with low education level were more prone to diabetes and hypertension. Such data reinforce the need to monitor the risk indicators as a preventive measure and early detection of some cardiometabolic diseases.

Metabolically healthy obesity and subclinical atherosclerosis in persons with spinal cord injury.

Despite preserved metabolic function, metabolically healthy obesity may increase the risk of subclinical atherosclerosis. Given the high prevalence of cardiometabolic diseases in individuals with spinal cord injury, the aim of this study was to investigate the association of insulin resistance, systemic low-grade inflammation, and markers of subclinical atherosclerosis with metabolically healthy obesity in individuals with spinal cord injury. Insulin resistance index (HOMA-IR), high-sensitivity C-reactive protein, carotid artery intima-media thickness and carotid-femoral pulse wave velocity were measured in individuals with spinal cord injury classified with metabolically healthy obesity (n = 12), metabolically unhealthy obesity (n = 8), or metabolically healthy normal-weight (n = 18). Metabolically healthy obesity was defined as spinal cord injury-specific cut-off of body mass index ≥ 22 kg/m2 with < 3 metabolic abnormalities. There were no differences in HOMA-IR or high-sensitivity C-reactive protein in metabolically healthy obesity compared with metabolically healthy normal-weight (p > 0.05). Pulse wave velocity was higher in metabolically healthy obesity than in metabolically healthy normal-weight (p ≤ 0.05), but lower than in metabolically unhealthy obesity (p ≤ 0.05). Metabolically healthy obesity had similar carotid artery intima-media thickness vs metabolically healthy normal-weight (p > 0.05), but lower carotid artery intima-media thickness compared with metabolically unhealthy obesity (p ≤ 0.05). Despite a somewhat preserved metabolic and inflammatory status, individuals with spinal cord injury with metabolically healthy obesity present with an intermediate subclinical atherosclerotic phenotype, as evidenced by increased aortic stiffness but not carotid thickness.

Introduction of "Sugar Tax" in South Africa: Placebo or panacea to curb the onset of cardio-metabolic diseases?

During 2016 an announcement was made that South Africans will be obliged to pay a 20% “sugar tax’’ that will soon be implemented in order to help curb the rising prevalence of cardio-metabolic diseases. This announcement was met with mixed responses, with strong support from some quarters while others questioned whether it would indeed lead to improved health and well-being of South Africans. As sugar-sweetened beverages (SSBs) constitute a significant portion of added sugars in modern-day diets, it is firmly in the cross-hairs of the new taxation. This perspective article reflects on the proposed sugar tax by exploring the nature of SSB consumption patterns, evaluating epidemiological evidence associating SSB intake to cardio-metabolic diseases risk and by considering examples where a similar tax had previously been introduced. Here data reveal that there is robust evidence supporting a detrimental link between high SSB consumption patterns and the onset of cardiometabolic diseases. It is therefore our strong opinion that the sugar tax option should be pursued in parallel with well-designed, long-term studies to evaluate whether it decreases SSB intake and lowers the prevalence of cardio-metabolic diseases within the South African context.

Insulin Resistance and Hypertension in Obese Youth With Sleep-Disordered Breathing Treated With Positive Airway Pressure: A Prospective Multicenter Study.

There is evidence that cardiometabolic disease associated with obesity and sleep-disordered breathing (SDB) in adults is present in youth. SDB is often treated with positive airway pressure (PAP) in youth with obesity. Our aims were to determine: (1) the prevalence of cardiometabolic disease and (2) whether PAP improves markers of cardiometabolic disease, in youth with obesity and newly diagnosed moderate-severe SDB. A prospective multicenter cohort study was conducted in youth (8 to 16 years old) with obesity, prescribed PAP therapy for newly diagnosed moderate-severe SDB. Assessments occurred at baseline and at 6 and 12 months. Outcomes included markers of insulin resistance (change in homeostasis model assessment of insulin resistance (HOMA-IR) at 6 months = primary outcome), hypertension (24-hour ambulatory/blood pressure) and inflammation (high-sensitivity C-reactive protein: hs-CRP). Twenty-seven participants were enrolled. Of those with baseline testing available, 10/25 (40%) had HOMA-IR above the 97th percentile, 10/23 (44%) were hypertensive, 16/23 (70%) had loss of nocturnal blood pressure dip and hs-CRP was elevated in 16/27 (64%). There were no significant changes over time in markers of metabolic dysfunction or blood pressure, nor between PAP-adherent and non-adherent subgroups. In youth with obesity and SDB, metabolic dysfunction and hypertension were highly prevalent. There were no statistically significant improvements in cardiometabolic markers 1 year after the prescription of PAP therapy, although clinically relevant improvements were seen in insulin resistance and systolic blood pressure load, important predictors of future risk of cardiovascular disease. Larger, longer-term studies are needed to determine whether PAP improves cardiometabolic outcomes in obese youth. A commentary on this article appears in this issue on page 1025.

The relationship between duration of psoriasis, vascular inflammation, and cardiovascular events

Psoriasis is associated with risk of cardiovascular (CV) disease (CVD) and a major adverse CV event (MACE). Whether psoriasis duration affects risk of vascular inflammation and MACEs has not been well characterized. We utilized two resources to understand the effect of psoriasis duration on vascular disease and CV events: (1) a human imaging study and (2) a population-based study of CVD events. First, patients with psoriasis (N=190) underwent fludeoxyglucose F 18 positron emission tomography/computed tomography (duration effect reported as a β-coefficient). Second, MACE risk was examined by using nationwide registries (adjusted hazard ratios in patients with psoriasis (n=87,161) versus the general population (n=4,234,793). In the human imaging study, patients were young, of low CV risk by traditional risk scores, and had a high prevalence of cardiometabolic diseases. Vascular inflammation by fludeoxyglucose F 18 positron emission tomography/computed tomography was significantly associated with disease duration (β=0.171, P=.002). In the population-based study, psoriasis duration had strong relationship with MACE risk (1.0% per additional year of psoriasis duration [hazard ratio, 1.010; 95% confidence interval, 1.007-1.013]). These studies utilized observational data. We found detrimental effects of psoriasis duration on vascular inflammation and MACE, suggesting that cumulative duration of exposure to low-grade chronic inflammation may accelerate vascular disease development and MACEs. Providers should consider inquiring about duration of disease to counsel for heightened CVD risk in psoriasis.

Screening for Risk Factors of Cardiometabolic Disease Among Female University Students in Riyadh, Saudi Arabia

Background:Prevalence of cardiometabolic diseases (CMD), especially among the youth, is a growing public health concern in both developed and developing countries.Objective:To examine cardiovascular and metabolic disease risk factors among a cohort of female university students in Riyadh, Saudi Arabia.Method:Two hundred and twenty-three (223) female students aged 17-25 years participated in the study. Both physical and physiological parameters were assessed using standard procedures and equipment. The study also evaluated the extent to which body mass index (BMI) could predict CMD risk factors among the participants. Alpha level was set at α =0.05.Results:The results showed that 22.4%, 8.5% and 11.2% of the women were overweight, obese, and underweight, respectively. Hemodynamic results indicated that of those overweight and obese, 9.4%and 21.1% were pre-hypertensive, respectively, while only 3 (1.3%) were hypertensive. Blood glucose results showed that 30 (13.5%) participants were pre-diabetic. Also, the BMI for overweight (26.9±1.54 kg/m2)and obese (33.5±3.17 kg/m2) categories indicated participants at the risk of CMD. Further analysis showed a statistically significant correlation between BMI and the following dependent measures: systolic (r = 0.352, p = 0.001) and diastolic (r = 0.136, p = 0.043) BP, waist circumference (r = 0.791, p = 0.001), and fasting blood glucose (r = 0.157, p = 0.019). BMI and age yielded a non-significant association (r = 0.023, p = 0.728). Results of adjusted regression coefficients indicated that BMI accounted for 65.6% of the variance in the women’s physiological variables.Conclusion:It was concluded that although many of the women screened had healthy CMD risk profiles, a few presented with excessively high levels which require follow-up clinical investigation and intervention. The need to undertake large scale surveillance of CMD risk factors among this relatively less studied population is recommended as it will promote early detection of risk profiles and health enhancing behaviours among the youth.

Residential proximity to abandoned uranium mines and serum inflammatory potential in chronically exposed Navajo communities.

Members of the Navajo Nation, who possess a high prevalence of cardiometabolic disease, reside near hundreds of local abandoned uranium mines (AUM), which contribute uranium, arsenic and other metals to the soil, water and air. We recently reported that hypertension is associated with mine waste exposures in this population. Inflammation is a major player in the development of numerous vascular ailments. Our previous work establishing that specific transcriptional responses of cultured endothelial cells treated with human serum can reveal relative circulating inflammatory potential in a manner responsive to pollutant exposures, providing a model to assess responses associated with exposure to these waste materials in this population. To investigate a potential link between exposures to AUM and serum inflammatory potential in affected communities, primary human coronary artery endothelial cells were treated for 4 h with serum provided by Navajo study participants (n=145). Endothelial transcriptional responses of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and chemokine ligand 2 (CCL2) were measured. These transcriptional responses were then linked to AUM exposure metrics, including surface area-weighted AUM proximity and estimated oral intake of metals. AUM proximity strongly predicted endothelial transcriptional responses to serum including CCL2, VCAM-1 and ICAM-1 (P<0.0001 for each), whereas annual water intakes of arsenic and uranium did not, even after controlling for all major effect modifiers. Inflammatory potential associated with proximity to AUMs, but not oral intake of specific metals, additionally suggests a role for inhalation exposure as a contributor to cardiovascular disease.