Risk Factors In Young Adults Research Articles

Prognostic role of remnant cholesterol and traditional cardiovascular risk factors in young adults: results of long-term follow-up of a cohort of 30-year-old norwegians

Abstract Background There are limited data on the prevalence and impact of traditional cardiovascular (CV) risk factors among young adults. In addition, more knowledge on novel CV risk factors is needed to explain the residual risk beyond that of the traditional risk factors. Increasing evidence suggest a causal role of remnant cholesterol (RC) in the development of atherosclerotic cardiovascular disease (CVD) and subsequent clinical events. However, the role of RC in young adults is unresolved. Purpose We aimed to evaluate the prevalence of traditional risk factors and the respective sex-differences in young adults, as well as their association with long-term CV events. Further, we hypothesized that higher RC concentrations are associated with impaired CV prognosis. Methods In year 2000, all 30-year-old inhabitants of our city were invited to a cross-sectional study including assessment of health status, anthropometric measurements, and non-fasting blood samples. RC was calculated as total cholesterol minus (LDL-C + HDL-C). Long-term clinical follow-up was performed through linkage with mandatory national registries, 22 years after inclusion. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, hospitalization for unstable angina and coronary revascularization. Results A total of 5950 individuals were included (56% women). At baseline, men displayed significantly higher systolic and diastolic blood pressure, total cholesterol, LDL-C and triglycerides, as compared with women (Table 1). Also, men had higher levels of RC (Table 1). During a mean follow-up time of 22 years, 108 events (1.8%) occurred. In multivariable Cox regression analysis, non-West-European ancestry (adjusted [a] HR 1.76, 95% confidence interval [CI] 1.03-2.99), diabetes mellitus (aHR 6.39, 95% CI 2.52-16.2), systolic blood pressure (aHR 1.03, 95% CI 1.01-1.04), and LDL-cholesterol (aHR 1.37, 95% CI 1.11-1.68) were associated with an increased risk of CV events during long-term follow-up. Female gender was associated with a reduced risk of CV events (aHR 0.38, 95% CI 0.23-0.64), whereas smoking status did not show any significant association. RC was identified as a significant predictor of CV events (aHR 1.55, 95% CI 1.11-2.18, per 1.0 mmol/L increase). The highest RC quartile (mean RC: 1.1 mmol/L), had the highest event rate (Figure 1, p<0.001 with log-rank test). Conclusion This study uncovers significant sex-differences in modifiable CV risk factors among young adults at the age of 30, which are associated with increased risk for long-term CV events. Interestingly, increasing concentrations of RC at the age of 30 were strongly associated with impaired long-term CV outcome and should be accounted for in early risk prediction.Baseline characteristics.Remnant cholesterol and CVD events.

Primary and residual cardiometabolic risk factors among young adults in a Russian city

BackgroundCardiovascular diseases are a leading cause of mortality and a significant contributor to temporary and permanent disabilities worldwide. This study aimed to investigate the burden of primary and residual cardiometabolic risk factors in a sample of young adults in the Russian city of Kazan.MethodsThis case-control study used the Cardiometabolic Disease Staging (CMDS) classification system, which has been validated in several countries. The study included 191 individuals aged 25–44 years who met the inclusion criteria but did not meet any exclusion criteria. Data collection involved a patient card with questions from the World Health Organization’s STEPS instrument, face-to-face patient interviews, and a physical examination. Anthropometric assessments included height, weight, and waist circumference measurements. Body composition was evaluated using bioelectrical impedance measurements. Patients also underwent in-depth laboratory biochemical analyses.ResultsThe study cohort was comprised of 97 females (50.8%) and 94 males (49.2%). The median age of participants was 35.00 years [IQR: 30.00–39.00]. The study cohort showed an increase in all anthropometric parameters, with abdominal obesity and overweight reaching 100% in the CMDS 3. Apart from atherogenic lipids and raised blood pressure, other risk factors that precipitate residual risk and were not part of CMDS, such as insulin levels, insulin resistance, leptin values, and hyperuricemia, increased as CMDS levels increased.ConclusionsThe prevalence of cardiometabolic risk factors was high in young adults in Kazan. This study highlights the need for the early identification and management of cardiometabolic risk factors in young adults to prevent the development of cardiovascular diseases later in life.

Differences in cardiovascular risk factors associated with sex and gender identity, but not gender expression, in young, healthy cisgender adults.

Sex differences exist in cardiovascular disease risk factors including elevated blood pressure and arterial stiffness, and decreased endothelial function in males compared to females. Feminine gender expression may be associated with elevated risk of acute coronary syndrome. However, no study has investigated the associations between sex, gender identity, and gender expression and cardiovascular disease risk factors in young adults. One hundred and thirty participants (22 ± 3 years) underwent assessments of hemodynamics, arterial stiffness [pulse wave velocity (PWV)], and brachial artery endothelial function (flow-mediated dilation; %FMD). Participants completed a questionnaire capturing sex category (50 male/80 female), gender identity category (49 men/79 women/2 non-binary), and aspects of gender expression assessed by the Bem Sex Role Inventory-30 (39 androgynous/33 feminine/29 masculine/29 undifferentiated). Sex/gender identity category groups were compared using unpaired t-tests and gender expression groups compared using one-way ANOVAs. Resting systolic and mean arterial pressure (p < 0.01) were elevated in males vs. females. Central PWV was elevated in males [median (interquartile range): 6.4 (1.8) vs. 5.8 (2.2) m/s, p = 0.02]; however, leg and arm PWV were not different between sexes. %FMD was elevated in males vs. females, after accounting for a larger baseline artery diameter in males (8.8 ± 3.3% vs. 7.2 ± 3.1%, p = 0.02); since the majority of participants were cisgender, the same results were found examining gender identity (men vs. women). There were no differences across gender expression groups (p > 0.05). Sex/gender identity category, but not gender expression, influence cardiovascular risk factors (blood pressure, arterial stiffness, endothelial function) in cisgender adults; further research is needed in gender-diverse populations.

Low-Density Lipoprotein Cholesterol, Cardiovascular Risk Factors, and Predicted Risk in Young Adults.

Young adults with elevated LDL-C may experience increased burden of additional cardiovascular disease (CVD) risk factors. It is unclear how much LDL-C levels, a modifiable factor, correlate with non-LDL-C CVD risk factors among young adults or how strongly these CVD risk factors are associated with long-term predicted CVD risk. We quantified clustering of non-LDL-C CVD risk factors by LDL-C among young adults to assess the association between non-LDL-C and LDL-C risk factors with predicted CVD risk in young adults. The current analysis is a cross-sectional study of adults < 40 years with an LDL-C< 190 mg/dL participating in the National Health and Nutrition Examination Survey (NHANES) between January 2015 and March 2020. We measured the prevalence of non-LDL-C risk factors by LDL-C and association between LDL-C and non-LDL-C risk factors with predicted risk of CVD by the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations. Among 2108 young adults, the prevalence of LDL-C ≥ 130 mg/dL was 15.5%. Compared with young adults with LDL-C < 100 mg/dL, those with LDL-C 100-< 130, 130-< 160, and 160-< 190 mg/dL had greater non-LDL-C risk factors. Both LDL-C and non-LDL-C risk factors were independently associated with a 30-year risk of CVD (OR 1.05, 95% CI 1.03-1.07 and OR 1.17, 95% CI 1.12-1.23, respectively). The association of LDL-C and 30-year risk did not vary by non-LDL-C risk factor burden (pinteraction = 0.43). Non-LDL-C risk factors cluster among increasing levels of LDL-C in young adults. Greater guidance on how to manage cardiovascular risk factors in young adults is needed.

Risk factors of acute pancreatitis in young adults: a Nationwide population-based cohort study in South Korea.

This study aimed to identify the risk factors for acute pancreatitis (AP) in young adults in their 20s based on data from the nationwide cohort in South Korea. From the 2009 national health examination database of South Korea, total 471,098 individuals between the ages of 20 and 29 were analyzed. To identify the newly developed AP, the linked claims database was used. The incidence rates of AP were 18.8 and 9.8 per 100,000 person-years in male and female participants, respectively. Alcohol consumption and smoking were associated with the heightened risk of AP. The risk of AP development was increased as daily alcohol consumption increased. Also, ex-smokers and current smokers showed higher AP risk than never smokers. Hypertriglyceridemia and obesity were associated with the increased AP risk as well. Compared to female participants, male participants showed a higher risk of AP in univariate analysis, but showed a lower risk of AP in multivariate analysis. In the young adult population, alcohol consumption, smoking, hypertriglyceridemia, and obesity were associated with an elevated risk of developing AP. It is important to identify and manage the modifiable AP risk factors in young adults to minimize the socioeconomic burden of AP.

Analysis and projections of disease burden for different risk factors and sexes of ischemic stroke in young adults in China

To estimate the rate of death, and disability-adjusted life years (DALYs) and project the disease burden of ischemic stroke due to relevant risk factors in young adults age 20–49 years by sex in China. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The age-standardized mortality (ASMR), age-standardized DALYs rate (ASDR), and estimated annual percentage changes (EAPC) were calculated to evaluate the temporal trends from 1990 to 2019. We also used the NORDPRED model to predict ASMR for ischemic stroke due to related risk factors in Chinese young adults over the next 10 years. From 1990 to 2019, the general age-standardized mortality [from 2.39 (1.97 to 2.99) in 1990 to 1.8 (1.41 to 2.18) in 2019, EAPC = − 1.23] and DALYs rates (from 171.7 (140.34 to 212.36) in 1990 to 144.4 (114.29 to 177.37) in 2019, EAPC = − 0.86) decreased for ischemic stroke in young adults in China. ASMR and ASDR decreased for all level 1 risk factors (including behavioral, environmental/occupational, and metabolic) from 1990 to 2019, with the slightest decrease for metabolic risks [ASMR from 1.86 (1.39 to 2.41) in 1990 to 1.53 (1.15 to 1.92) in 2019, ASDR from 133.68 (99.96 to 173.89) in 1990 to 123.54 (92.96 to 156.98) in 2019] and the largest decrease for environmental/occupational risks [ASMR from 1.57 (1.26 to 1.98) in 1990 to 1.03 (0.78 to 1.29) in 2019, ASDR from 110.91 (88.44 to 138.34) in 1990 to 80.03 (61.87 to 100.33) in 2019]. In general, high body-mass index, high red meat intake, and ambient particulate matter pollution contributed to the large increase in ASMR and ASDR between 1990 and 2019. Significant reductions in ASMR and ASDR were observed in low vegetables intake, household air pollution from solid fuels, lead exposure, and low fiber intake. In addition, there were sex differences in the ranking of ASMR attributable to risks in ischemic stroke. The disease burden of ischemic stroke attributable to relevant risk factors in young adults in China is greater and has a faster growth trend or a slower decline trend in males than in females (except for secondhand smoke). The apparent increasing trend of ASMR attributable to high fasting plasma glucose, high systolic blood pressure, high body-mass index, and high red meat intake was observed in males but not in females. The projected analysis showed an increasing trend in ASMR between 1990 and 2030 for all specific metabolic risks for males, but a decreasing trend for females. ASMR attributable to ambient particulate matter pollution showed an increasing trend from 1990 to 2030 for both males and females. The burden of ischemic stroke in young adults in China showed a downward trend from 1990 to 2019. Specific risk factors associated with the burden of ischemic stroke varied between the sexes. Corresponding measures need to be developed in China to reduce the disease burden of ischemic stroke among young adults.

Impact of Calorie Intake on Cardiovascular Disease Risk Factors for Young Adults Working from Home During the COVID-19 Pandemic

Abstract: During the COVID-19 pandemic, working from home (WFH) led to increased passivity, potentially affecting body mass index (BMI), waist circumference (WC), and blood pressure (BP) values, which are risk factors for cardiovascular disease (CVD). This study aimed to determine the impact of calorie intake on these risk factors in young adults working from home during the COVID-19 pandemic. This experimental study employed a one-group pre- and post-test design conducted over two months. Respondents' daily physical activities were recorded using Bouchard's questionnaire, and a food record method was used to document all foods consumed over three days. The study followed up with respondents for two months. The results indicated that respondents with good physical activity levels experienced a decrease in BMI: 53.3% of men and 37.5% of women. Adequate calorie intake also contributed to a decrease in BMI, with 53.3% of men and 57.1% of women showing reductions. However, the t-test showed p-values &gt;0.05 for the correlations between calorie intake and BMI, WC, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In conclusion, there was no significant impact of calorie intake on risk factors for CVD, such as obesity and high blood pressure. Nonetheless, it was observed that appropriate calorie intake could potentially prevent the increase of these risk factors. Keywords: calorie intake; cardiovascular disease; COVID-19 pandemic

Impact of optimal cholesterol levels on subclinical atherosclerosis in the absence of risk factors in young adults

Background and aimsWe aimed to assess the association of blood lipids with the prevalence, incidence, and progression of subclinical atherosclerosis among young individuals without dyslipidemia and other traditional cardiovascular risk factors (CVRFs). MethodsA total of 1270 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study aged 32–46 years free of cardiovascular disease, diabetes, hypertension, current smoking, and dyslipidemia (total cholesterol [TC] ≥ 240 mg/dL, triglycerides [TG] ≥ 150 mg/dL, low-density lipoprotein cholesterol [LDL-C] ≥ 160 mg/dL, high-density lipoprotein cholesterol [HDL-C] < 40 mg/dL, or taking lipid-lowering medications) were included. A subgroup with optimal lipids within the low-CVRF group was defined with TC < 200 mg/dL, LDL-C < 100 mg/dL, non-HDL-C < 130 mg/dL, and women with HDL-C ≥ 50 mg/dL. Results1-SD higher TC (25.9 mg/dL), LDL-C (24.7 mg/dL), and non-HDL-C (26.6 mg/dL) were associated with a greater risk of presence (hazard ratios: 1.30–1.36), incidence (1.30–1.32), and progression (1.31–1.35) of coronary artery calcium (CAC) and a 42–44% greater odds of composite mean carotid intima-media thickness (CIMT) ≥ 75th percentile [780 μm] (p < 0.05). Repeating the analyses in a subset of participants with a CAC score of zero did not alter the association of TC, LDL-C, and non-HDL-C with CIMT. In the subgroup with optimal lipids, these lipid indices remained associated with an increased risk of presence and incidence of CAC and greater CIMT measures. ConclusionsAmong adults aged 32–46 years, in the absence of traditional CVRFs, elevated cholesterol levels, even within what is considered optimal, are associated with atherosclerosis and arteriopathy.

Low vitamin D levels are linked with increased cardiovascular disease risk in young adults: a sub-study and secondary analyses from the ACTIBATE randomized controlled trial.

Vitamin D deficiency is related to metabolic disturbances. Indeed, a poor vitamin D status has been usually detected in patients with cardiovascular disease (CVD). However, the relationship between vitamin D and CVD risk factors in young adults remains controversial at present. This study aimed to examine the association between circulating 25-hydroxivitamin D (25(OH)D) and CVD risk factors in young adults. The present cross-sectional study included a cohort of 177 young adults aged 18-25years old (65% women). 25(OH)D serum concentrations were assessed using a competitive chemiluminescence immunoassay. Fasting CVD risk factors (i.e., body composition, blood pressure, glucose metabolism, lipid profile, liver, and inflammatory markers) were determined by routine methods. A panel of 63 oxylipins and endocannabinoids (eCBs) was also analyzed by targeted metabolomics. Circulating 25(OH)D concentrations were inversely associated with a wide range of CVD risk factors including anthropometrical (all P ≤ 0.005), body composition (all P ≤ 0.038), glucose metabolism (all P ≤ 0.029), lipid profile (all P < 0.035), liver (all P ≤ 0.011), and pro-inflammatory biomarkers (all P ≤ 0.030). No associations of serum 25(OH)D concentrations were found with pro-inflammatory markers (all P ≥ 0.104), omega-6 and omega-3 oxylipins, nor eCBs concentrations or their analogs (all P ≥ 0.05). The present findings support the idea that 25(OH)D could be a useful predictor of CVD risk in young individuals.

Analysis of Ischemic stroke risk factors in young Adults

Background and objectives: Keeping in mind stroke is the leading cause of disability globally, with increasing incidence of Ischemic stroke in young age reaching approximately more than 5-10 % according to multiple studies worldwide especially in developing countries. Methods: This observational cross-sectional study was conducted at the Neurology Department of the Rizgary Hospital, Erbil, Iraq over 12 months from July 2020 until July 2021. We included consecutive patients whom their age was between 18-45 years with first-ever ischemic stroke fulfilling the definition of The American Stroke Association. All patients underwent thorough history and clinical examination. Each patient underwent routine stroke assessment, including full blood workup and vascular imaging. Results: Out of 70 patients, 41 (58.8%) were males and 29 (41.4%) were females. There is a male predominance over females, which is comparable with other studies. Our present study showed that the most obvious risk factor for stroke in young people was hypertension, which was present in (38.6%) of cases followed by diabetes mellitus (20 %.), obesity (17.1%), smoking (17%), alcohol consumption (11.4%). Regarding stroke subtypes; small vessel disease was the commonest, subtype, it was present in 25.7% of cases. A stroke from a cardiac source is the second most common (24.3%). About (17.1%) of cases were in the large vessel category. The cause of the stroke was undetermined in (14.5 %) percent of cases (cryptogenic). Conclusion: Our study demonstrated that traditional atherosclerotic risk factors such as hypertension, diabetes, dyslipidemia, and smoking are responsible for most cases in young adults.

Cardiometabolic risk profile of young and old adults with diabetes: Pooled, cross-sectional analysis of 42 national health surveys

AimsTo compare levels of cardiometabolic risk factors in young and old adults with diabetes. MethodsPooled analysis of 42 STEPS Surveys (n = 133,717). Diabetes was defined as self-reported diagnosis or fasting plasma glucose ≥ 126 mg/dl. There were two age groups: < 40 and ≥ 40 years. We summarized the mean levels of four cardiometabolic risk factors by country, sex and age group. ResultsIn 11 (men) and seven countries (women), the mean BMI seemed higher in young versus old adults; largest difference was found in men in Qatar (∼6 kg/m2). For waist circumference, such pattern was observed in two (men) and in three (women) countries; largest difference in men in Tuvalu (∼7 cm). Regarding systolic blood pressure, in one country (Myanmar) the mean was higher in young men with ∼8 mmHg difference. Women in the oldest group always had higher mean systolic blood pressure. For total cholesterol, in 13 (men) and five (women) countries the mean was higher in young adults (difference was always <1 mmol/l). ConclusionsLevels of cardiometabolic risk factors in young versus old adults with diabetes were heterogenous across 42 countries and depended on the risk factor. This calls to monitor cardiometabolic risk factors in young adults with diabetes.

30-year cardiovascular disease risk for young adults with serious mental illness

ObjectiveTo estimate 30-year CVD risk and modifiable risk factors in young adults with serious mental illness (SMI) versus those without, and assess variations in CVD risk by race, ethnicity, and sex. MethodIn this cross-sectional study, we estimated and compared the Framingham 30-year CVD risk score and individual modifiable CVD risk factors in young adult (20–39 years) primary care patients with and without SMI at two US healthcare systems (January 2016-Septemeber 2018). Interaction terms assessed whether the SMI-risk association differed across demographic groups. ResultsCovariate-adjusted 30-year CVD risk was significantly higher for those with (n = 4228) versus those without (n = 155,363) SMI (RR 1.28, 95% CI [1.26, 1.30]). Patients with SMI had higher rates of hypertension (OR 2.02 [1.7, 2.39]), diabetes (OR 3.14 [2.59, 3.82]), obesity (OR 1.93 [1.8, 2.07]), and smoking (OR 4.94 [4.6, 5.36]). The increased 30-year CVD risk associated with SMI varied significantly by race and sex: there was an 8% higher risk in Black compared to White patients (RR 1.08, [1.04, 1.12]) and a 9% lower risk in men compared to women (RR 0.91 [0.88, 0.94]). ConclusionsYoung adults with SMI are at increased 30-year risk of CVD, and further disparities exist for Black individuals and women.

The Role of the Low-Density Lipoprotein/High-Density Lipoprotein Cholesterol Ratio as an Atherogenic Risk Factor in Young Adults with Ischemic Stroke: A Case-Control Study.

Dyslipidemia is a major atherogenic risk factor for ischemic stroke. Stroke patients tend to have high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). Therefore, it is noteworthy that there has been an increase in ischemic stroke cases in young and elderly individuals in recent years. This study investigated the TC/HDL-C ratio and the LDL-C/HDL-C ratio, which may be more specific and common lipid parameters in young patients with ischemic stroke. This study aimed to demonstrate the sensitivity and specificity of TC/HDL-C and LDL-C/HDL-C ratios as atherogenic markers for young adult ischemic strokes. This trial was conducted as a retrospective case-control study. A total of 123 patients (patient group) and 86 healthy individuals (control group) aged 18-50 years were randomly selected from four different hospitals. Lipid parameters and TC/HDL-C and LDL-C/HDL-C ratios were compared between these two groups. The mean age was 38.8 ± 7.3 years in patients and 37.7 ± 9 years in controls (p > 005). The HDL-C levels were 39.1 ± 10.8 mg/dL in patients and 48.4 ± 13.8 mg/dL in controls (p < 0.001). LDL-C/HDL-C ratios were 3.23 ± 1.74 and 2.38 ± 0.87, and TC/HDL-C ratios were 5.24 ± 2.31 and 4.10 ± 1.25 in the patient and control groups, respectively (p < 0.001). The LDL-C/HDL-C and TC/HDL-C cutoff values in ROC analyses were 2.61 and 4.40 respectively; the AUCs (95% CI) were determined to be 0.680 (0.608-0.753) and 0.683 (0.610-0.755) (p < 0.001), respectively. An increased risk of stroke was observed in those with a high LDL-C/HDL-C ratio (OR = 1.827; 95% CI = 1.341-2.488; p < 0.001). Our study obtained similar results when we compared the mean TC and LDL-C levels between the two groups. However, considering the TC/HDL-C and LDL-C/HDL-C ratios, it is noteworthy that there was a significant difference between the patient and control groups.

Post COVID-19 symptoms are common, also among young adults in the general population

Post coronavirus disease-19 (post COVID-19) is mainly studied in clinical populations and less is known about post COVID-19 in a young general population. The aim of the study is to investigate the prevalence and symptoms of post COVID-19 and its potential risk factors in young adults. Participants from the Swedish population-based birth cohort BAMSE were included (n = 2022, mean age 26.5 years). Post COVID-19 was assessed through a questionnaire and defined as symptoms after confirmed COVID-19 (registry-based or self-reported positive test) lasting for ≥ 2 months. In total, 681 participants had had confirmed COVID-19. Among them, 112 (16.5%) fulfilled the definition of post COVID-19 (17.8% in females, 14.5% in males, p = 0.26). The most common post COVID-19 symptoms were altered smell and taste (68.8%), dyspnea (33.7%) and fatigue (30.4%). Overall, no major risk factors for post COVID-19 were identified except for being bedbound during COVID-19. However, asthma and rhinitis were associated with the post COVID-19 symptom dyspnea, migraine with altered smell and taste, and lower self-rated health with fatigue. In conclusion, post COVID-19 symptoms are common, also among young adults in the general population. Although not life-threatening, it could have a considerable impact on public health due to the high prevalence and long-term symptoms.

Evaluation of mid-buccal gingival recessions and occlusal interferences.

Dental malocclusions may cause disruption in occlusal harmony, and destructive interferences during mandibular functional movements can be seen. Ideal occlusal contacts during dynamic mandibular movements may be crucial for preventing the occurrence of mid-buccal gingival recession (mbGR). While determining mbGR risk factors in young adults, the effect of occlusal interferences on mbGR has not yet been focused on. Based on this gap, this field needs to be clarified with new studies. The aim of this case-control study was to evaluate the relationships between the presence, extent and severity of mbGRs to dental malocclusions, occlusal interferences in anterior (AG) and lateral guidance (LG) and to determine the potential risk indicators in a young population. A total of 149 dental students were comprised and 70 of them presented mbGR(s) and 79 did not (18-25 years, 4553 teeth). Periodontal status was assessed with full mouth bleeding (FMBS) and plaque score (FMPS), probing depth, clinical attachment level, recession depth and keratinised tissue width (KTW) by a periodontist. Malocclusions and occlusal interferences were evaluated by an orthodontist. Logistic regression analyses provided data on the effect of occlusal interferences and the other indicators towards mbGR. The mean of the number of teeth with mbGR(s) per subject was 4.3. The mean of the overall extent of teeth with mbGR(s) was 14.2%. FMBS, decreased KTW, self-reported bruxism, group function occlusion, increased contact number of all teeth and only premolars/molars in AG or LG and Class III malocclusions were significantly associated with the presence of mbGR. Decreased KTW presenting mbGR in the mandible and non-carious cervical lesion adjunct to mbGR significantly increased the odds of the severity of mbGR. Group function occlusion revealed higher mbGRs in premolar/molars than canine guided occlusion. Increase in the occlusal interferences in premolars/molars during lateral and anterior guidance may have an effect on the presence and severity of mbGR. Further studies should be designed to confirm these findings.

Ventricular-arterial coupling and cardiovascular risk among young adults: The African-PREDICT study.

Ventricular-arterial coupling (VAC) has independent diagnostic and prognostic value for cardiovascular (CV) risk stratification, but studies on its association with anthropometric and CV factors are sparse in young individuals without overt CV disease. We aim to provide descriptive data regarding VAC and its associations with CV risk factors in young adults without overt CV disease. For 631 (mean age, 24 ± 3 yr; 51% female) individuals, VAC was determined by carotid-femoral pulse wave velocity (PWV)/global longitudinal strain (GLS). Multivariable logistic and linear regression models were performed to explore the association between PWV/GLS and CV risk factors. A P-value < 0.05 was considered statistically significant. The mean PWV/GLS was 0.33 ± 0.07 m/s%. Higher ratios of PWV/GLS associated with older age, male sex, and a higher prevalence of CV risk factors (i.e., higher blood pressure, prevalent hypertension, higher waist circumference, active smoking, higher plasma triglycerides, lower high-density lipoprotein cholesterol, and an adverse urine albumin/creatinine ratio). Furthermore, higher PWV/GLS was associated with echocardiographic measures such as lower ejection fraction and higher left ventricle mass index. In expanded logistic regression models, higher ratios of PWV/GLS were significantly associated with the prevalence of active smoking [odds ratio (OR), 1.88; confidence interval (CI) 1.36-2.58, P < 0.001] and hypertension (OR 1.98; CI 1.40-2.80, P < 0.001). We demonstrated that worse VAC reflected by higher values of PWV/GLS are significantly associated with CV risk factors in young adults. The results suggest that PWV/GLS might serve as a tool to improve the profiling of cardiovascular risk in young adults.NEW & NOTEWORTHY Assessing VAC is especially useful in heart failure and valvular heart disease, but less is known about VAC in the pathophysiology of CV disease risk in younger individuals. In young individuals without overt CV disease, we showed descriptive data regarding VAC, determined by PWV/GLS ratio, and explored the associations of VAC with clinical CV disease risk factors. Worse VAC, reflected by higher values of PWV/GLS, associated with high blood pressure and smoking in young adults.

Comorbidities associated with COVID-19 mortality in adults in Lima, Peru: a retrospective cohort study.

Motivation for the study. During the COVID-19 pandemic, the mortality rate from this disease was higher in adults and the elderly. Therefore, it is important to identify the factors that were associated with mortality from COVID-19 in adults, by age group. Main findings. Chronic neurological disease, kidney disease, liver disease, and cancer increased the risk of dying from COVID-19 in the three age groups we analyzed, which were made up of hospitalized patients from Lima and Callao. The risk of mortality associated with comorbidities was higher in patients aged 18 to 29. Implications. This study helps to identify the groups of patients with the highest risk of death from COVID-19, according to age group and type of comorbidity. . To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao. In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years). We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly. Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.

Molecular Biomarkers for Cardiometabolic Disease: Risk Assessment in Young Individuals.

Cardiometabolic diseases, including cardiovascular disease and diabetes, are major causes of morbidity and mortality worldwide. Despite progress in prevention and treatment, recent trends show a stalling in the reduction of cardiovascular disease morbidity and mortality, paralleled by increasing rates of cardiometabolic disease risk factors in young adults, underscoring the importance of risk assessments in this population. This review highlights the evidence for molecular biomarkers for early risk assessment in young individuals. We examine the utility of traditional biomarkers in young individuals and discuss novel, nontraditional biomarkers specific to pathways contributing to early cardiometabolic disease risk. Additionally, we explore emerging omic technologies and analytical approaches that could enhance risk assessment for cardiometabolic disease.

Childhood atopic dermatitis is associated with cardiovascular risk factors in young adulthood-A population-based cohort study.

Studies have indicated that atopic dermatitis (AD) is associated with an increased risk of cardiovascular disease (CVD). However, data are conflicting. Furthermore, the longitudinal effect of childhood AD on cardiovascular risk factors in young adulthood is less investigated. To assess associations between AD in childhood and CVD risk factors in young adulthood. The study encompasses longitudinal data from a population-based birth cohort. Participants with data up to age 24 years were included (n = 2270). The primary outcomes were body mass index (BMI), waist circumference (WC), body fat per cent (BF%) and blood pressure (BP) at 24 years. The secondary outcome was blood lipids. Severe AD was defined as AD in combination with sleep disturbance due to itching. In total, 18.6% (n = 420) had AD at 24 years. Males with AD had higher BMI (βAdj. 0.81, 95% CI 0.15-1.47), BF% (βAdj. 1.19, 95% CI 0.09-2.29), systolic BP (βAdj. 1.92, 95% CI 0.02-3.82), total cholesterol (βAdj. 0.14, 95% CI 0.00-0.28) and LDL cholesterol (βAdj. 0.15, 95% CI 0.02-0.27) compared with males without AD. No associations were seen in females. Current AD with prepubertal onset was associated with increased BMI in both males (βAdj. 0.89, 95% CI 0.11-1.67) and females (βAdj. 0.72, 95% CI 0.11-1.33). At 24 years, 23.1% (n = 97) of all with AD, had severe disease, which was significantly associated with overweight in both sexes, with BMI (βAdj. 1.83, 95% CI 0.72-2.94), WC (βAdj. 4.03, 95% CI 1.54-6.52) and BF% (βAdj. 2.49, 95% CI 0.60-4.39) in females and with BF% (βAdj. 2.96, 95% CI 0.23-5.69) in males, compared with peers with mild to moderate AD. AD in males appears to be associated with CVD risk factors in young adulthood. The duration and severity of AD seem to be of importance in both sexes.

Cardiometabolic risk factors in young adults diagnosed with acute myocardial infarction

Abstract Funding Acknowledgements Type of funding sources: None. Background/introduction Morbidity and mortality associated with atherosclerotic cardiovascular diseases are prevalent in young patients. Meanwhile, traditional cardiovascular risk calculators underestimate disease risk in young adults. Purpose To characterize cardiometabolic risk factors and lipid levels in young adults with acute myocardial infarction. Setting: A multicenter, population-based analysis of patients diagnosed at our hospitals in Arizona, as well as our clinic health system spanning Minnesota and Wisconsin. Methods This is a retrospective cohort study including patients 18 to 50 years old diagnosed with acute myocardial infarction from October 1, 2015, to December 31, 2018. Parameters obtained included: Age, sex, ethnicity, body mass index, tobacco use, comorbid medical conditions, fasting blood glucose, hemoglobin A1c, lipid levels, and prescribed lipid-lowering therapy. Results Among 553 young patients diagnosed with acute myocardial infarction, the mean age at the time was 44.4 years, with men accounting for 69.1% of cases. The mean body mass index was 32.2 kg/m2. Hypertension, diabetes mellitus, and tobacco use were present in 64.7%, 25.9%, and 36.2% of patients. Insulin resistance, elevated triglycerides, and low HDL-C were present in 29.8%, 51.0%, and 62.8% of patients, respectively. Approximately 61.3% of patients within this cohort met World Health Organization criteria for diagnosis of metabolic syndrome. Mean LDL-C was 116 mg/dL and mean triglycerides were 190 mg/dL. Statin therapy was prescribed to 92 (16.6%) of patients prior to diagnosis of acute myocardial infarction, whereas 359 (67.3%) of patients met ACC/AHA criteria for lipid-lowering therapy. Within this subgroup receiving statin therapy, the mean serum LDL-C was 101 mg/dl, 26.1% had levels below 70 mg/dL, and 56.5% had LDL-C levels below 100 mg/dL. Thirty-four patients (6.1%) with LDL-C levels greater than 190 mg/dL, and 29 (85.3%) were not on lipid-lowering therapy. Conclusions and Relevance Multiple treatable risk factors were present in most young adults with acute myocardial infarction, including many with LDL-C levels below 100 mg/dL. Being overweight or obese was the most prevalent risk factor, while elevated non-HDL cholesterol was the most common lipid panel abnormality. In addition to known cardiometabolic risk factors, these findings build upon a growing body of evidence implicating triglyceride-rich lipoproteins in non-HDL and remnant cholesterol as an independent risk factor of ASCVD, which were common in this cohort of young patients presenting with myocardial infarction. In this cohort, lipid-lowering therapy was underutilized in young patients with known cardiometabolic risk factors, elevated estimated 10-year ASCVD risk, and individuals with phenotypic Familial Hypercholesterolemia.