Fetal and infant growth and cardiovascular risk factors in women.

OBJECTIVE--To examine whether cardiovascular risk factors in women are related to fetal and infant growth. DESIGN--Follow up study of women born 1923-30 whose birth weights and weights at one year were recorded. SETTING--Hertfordshire. SUBJECTS--297 women born and still living in East Hertfordshire. MAIN OUTCOME MEASURES--Plasma glucose and insulin concentrations during a standard oral glucose tolerance test; fasting plasma proinsulin and 32-33 split proinsulin concentrations; blood pressure; fasting serum total, low density lipoprotein and high density lipoprotein cholesterol, triglyceride, and apolipoprotein A I and B concentrations; and plasma fibrinogen and factor VII concentrations. RESULTS--Fasting plasma concentrations of glucose, insulin, and 32-33 split proinsulin fell with increasing birth weight (P = 0.04, P = 0.002, and P = 0.0002 respectively, when current body mass index was allowed for). Glucose and insulin concentrations 120 minutes after an oral glucose load showed similar trends (P = 0.03 and P = 0.02). Systolic blood pressure, waist:hip ratio, and serum triglyceride concentrations also fell with increasing birth weight (P = 0.08, P = 0.07, and P = 0.07 respectively), while serum high density lipoprotein cholesterol concentrations rose (P = 0.04). At each birth weight women who currently had a higher body mass index had higher levels of risk factors. CONCLUSION--In women, as in men, reduced fetal growth leads to insulin resistance and the associated disorders: raised blood pressure and high serum triglyceride and low serum high density lipoprotein cholesterol concentrations. The highest values of these coronary risk factors occur in people who were small at birth and became obese. In contrast with men, low rates of infant growth did not predict levels of risk factors in women.     

Effect of sarcopenia on cardiovascular disease risk factors in obese postmenopausal women

Objective: To compare sarcopenic‐obese and obese postmenopausal women for risk factors predisposing to cardiovascular disease (CVD) and determine whether there may be a relationship between muscle mass and metabolic risk in obese postmenopausal women. Research Methods and Procedures: In this cross‐sectional study, 22 healthy obese postmenopausal women (mean age, 66 ± 5 years; mean BMI, 27 ± 3 kg/m²) were divided into two groups matched for age (±2 years) and fat mass (FM) (±2%). Sarcopenia was defined as a muscle mass index of <14.30 kg fat‐free mass (FFM)/m² (which corresponds to 1 standard deviation below the values of a young reference population), and obesity was defined as an FM of >35% (which corresponds to the World Health Organization guidelines). FM, FFM (measured by DXA), daily energy expenditure (accelerometry), dietary intake (3‐day dietary record), and blood biochemical analyses (lipid profile, insulin, glucose, and C‐reactive protein) were obtained. Visceral fat mass (VFM) was calculated by the equation of Bertin, which estimates VFM from DXA measurements. Results: Obese women had more FFM (p = 0.006), abdominal FM (p = 0.047), and VFM (p = 0.041) and a worse lipid profile [p = 0.040 for triglycerides; p = 0.004 for high‐density lipoprotein (HDL); p = 0.026 for total cholesterol/HDL] than sarcopenic‐obese postmenopausal women. Obese women also ingested significantly more animal (p = 0.001) and less vegetal proteins (p = 0.013), although both groups had a similar total protein intake (p = 0.967). Discussion: Sarcopenia seems to be associated with lower risk factors predisposing to CVD in obese postmenopausal women. With the increase in the number of aging people, the health implications of being sarcopenic‐obese merit more attention.     

Alcohol consumption and its relation to cardiovascular risk factors in British women.

OBJECTIVE--To examine the relation between alcohol consumption and risk factors for coronary heart disease in women. DESIGN--Cross sectional study of a stratified random sample of the population grouped into five categories of habitual alcohol consumption. SETTING--People registered with general practitioners at two large health centres in east Bristol, England. SUBJECTS--1048 women aged 25-69 years. MAIN OUTCOME MEASURES--Fasting plasma concentrations of insulin, total cholesterol, total triglycerides, and high density lipoprotein cholesterol, including its subfractions HDL2 and HDL3, and body mass index. RESULTS--Compared with non-drinkers women consuming a moderate amount of alcohol (1-20 g/day) had lower plasma concentrations of triglycerides, by 0.19 mmol/l (95% confidence interval 0.07 to 0.35); cholesterol, by 0.4 mmol/l (0.19 to 0.61); and insulin, by 1.4 mU/l (0.43 to 1.97) and a lower body mass index, by 1.2 kg/m2 (0.43 to 1.97). They also had higher concentrations of high density lipoprotein cholesterol, by 0.09 mmol/l (0.03 to 0.15); HDL2 cholesterol by 0.05 mmol/l (-0.02 to 0.10) and HDL3 cholesterol, by 0.06 mmol/l (0.06 to 0.11). All these were independent of body mass index, smoking habits, and taking oral contraceptives. CONCLUSIONS--Moderate alcohol consumption is associated with lower levels of cardiovascular risk factors in women. Insulin may have a central role.     

Effects of combined exercise on cardiovascular risk factors and serum BDNF level in mid-aged women

[Purpose]

The purposes of this study is first to examine a positive effect of long term combined exercise including aerobic and resistance exercise on increasing level of serum BDNF, and investigate how aerobic exercise is related to improving BDNF circulation and resistance exercise improves fat oxidation in mid-aged women.

[Methods]

Initially, 30 mid-aged women, according to their exercise preference, was randomly assigned as a non-exercise group (n=7, control group; CG) and exercise group (n=23). Then, 23 exercise participants were divided by aerobic exercise group (n=15, AEG) and combination of aerobic and resistance exercise group (n=8, CEG). Prior to the experiment, all participants’maximal oxygen uptake (VO₂max), body composition, and blood factors were measured. Changes (Δ delta value) in body composition, fitness level, and serum BDNF level of the different groups were tested through one way ANOVA.

[Results]

For AEG and CG after 24 weeks, VO₂max and high-density lipoprotein cholesterol (HDL-C) were significantly increased. During this period, CEG had significant increase in muscular strength and decrease in triglyceride (TG) total cholesterol (TC)/HDL-C (p=0.013). Continuously, serum BDNF concentration of both AEG and CEG was significantly increased (F=6.328, p=0.001) compared to CG. There, however, was no significant between-group difference.

[Conclusion]

Although there was no difference in serum BDNF level between AEG and CEG, we confirmed that CEG may have a possibility of positive changes in increase of serum BDNF level in mid-aged women.     

Measures of adiposity and cardiovascular disease risk factors

Objective: To determine which of five measures of adiposity maintains the strongest association with cardiovascular disease risk factors. Research Methods and Procedures: A nationally representative sample of 12,608 adult participants of the third National Health and Nutrition Examination Survey were examined. Waist circumference, total body fat, percent body fat, BMI, and skinfold thickness were measured following a standardized protocol. Results: In multivariable adjusted models including waist circumference and BMI as independent variables, waist circumference was a significantly better predictor. The odds ratios (95% confidence intervals) for each standard deviation higher waist circumference and BMI for men were as follows: 1.88 (1.43, 2.48) and 0.99 (0.76, 1.29), respectively, for hypertension; 1.51 (0.87, 2.59) and 1.23 (0.76, 1.99), respectively, for diabetes; and 1.85 (1.48, 2.32) and 1.00 (0.80, 1.24), respectively, for low high‐density lipoprotein‐cholesterol. The analogous odds ratios (95% confidence intervals) for women were as follows: 2.28 (1.74, 3.00) and 0.91 (0.69, 1.19), respectively, for hypertension; 2.72 (1.85, 4.00) and 0.82 (0.55, 1.23), respectively, for diabetes; and 1.90 (1.47, 2.47) and 1.07 (0.83, 1.38), respectively, for low high‐density lipoprotein‐cholesterol. Results were markedly similar for waist circumference in models adjusting for total body fat, percent body fat, and skinfold thickness separately. In contrast, waist circumference was not a significantly better predictor of elevated C‐reactive protein than the other measures of adiposity. Discussion: Waist circumference maintains a stronger association with cardiovascular disease risk factors than other measures of adiposity.     

Dietary minerals and modification of cardiovascular risk factors

High serum cholesterol, hypertension and obesity are major risk factors for cardiovascular diseases, and together with insulin resistance form a deadly disorder referred to as the metabolic syndrome. All the aspects of this syndrome are strongly related to dietary and lifestyle factors; therefore, it would be reasonable to look for dietary approaches to their modification. Mineral nutrients, such as calcium, potassium and magnesium, lower blood pressure, and especially calcium has beneficial effects also on serum lipids. Recent evidence suggests that increased intake of calcium may help in weight control as well. This review summarizes previous literature on the effects and use of dietary minerals on serum lipids, blood pressure and obesity, with specific focus on the effects of calcium. Calcium and magnesium as divalent cations can form insoluble soaps with fatty acids in the intestine and thus prevent the absorption of part of the dietary fat. Decreased absorption of saturated fat leads to reduction in serum cholesterol level via decreased production of VLDL and increased intake of LDL in the liver. Dietary calcium may also bind bile acids, which increases the conversion of cholesterol to bile acids in the liver. Furthermore, calcium appears to enhance the cholesterol-lowering effect of plant sterols. Thus, dietary combination of the mineral nutrients and plant sterols provides a promising novel approach to the modification of cardiovascular risk factors.     

Socioeconomic disparities in risk factors for cardiovascular disease.

Despite a general decline in mortality rates in recent decades, these rates are substantially higher among lower socioeconomic groups. To determine target groups for preventive health promotion programs, the prevalence of risk factors for cardiovascular disease by socioeconomic group in Canadian adults aged 20 to 69 years was examined through comparison of estimates from the 1978-79 Canada Health Survey, the 1981 Canada Fitness Survey and the labour force smoking surveys of 1975 and 1983. Level of education was used as a measure of socioeconomic status. The risk factors considered were cigarette smoking, overweight, obesity, elevated diastolic blood pressure, physical inactivity, excessive alcohol consumption, elevated serum cholesterol level, diabetes mellitus and the conjoint use of oral contraceptives and cigarettes. The prevalence of the risk factors tended to be higher among men and women with a low level of education. The results were consistent with those of recent Canadian studies showing that both men and women in lower socioeconomic groups are more likely to die from cardiovascular disease.     

Physiological and ethnogenetic risk factors for cardiovascular thrombosis

An analysis of publications on the polymorphism of enzymes, receptors, and other systems of lipid and lipoprotein metabolism critical for the formation of vascular lipoprotein plaques and thrombi revealed the importance of certain genetic factors for the development of cardiovascular disorders. However, because of the polygenic nature of these disorders, the assessment of the corresponding hereditary risk factors requires multivariablecorrelation analysis. Population studies show that the polymorphism of individual genes manifests itself in the difference in incidence rates between ethnic groups.     

Birth weight correlates differently with cardiovascular risk factors in youth

Objective: Childhood obesity has become prevalent, resulting in a greater risk of hypertension, diabetes, and dyslipidemia. However, the relationship between these comorbid conditions and birth weight remains uncertain. We conducted this study to evaluate the relationship between birth weight and cardiovascular risk factors in children and adolescents. Research Methods and Procedures: In a nationwide survey conducted between 1992 and 2000, all schoolchildren 6 to 18 years old with glucosuria, proteinuria, or microscopic hematuria in repeated urine samples were included and received a physical examination and blood test. Those with gestational age <37 weeks were excluded. We enrolled 81,538 children (51,111 girls and 30,427 boys) and obtained their birth weights from the Taiwan Birth Registry. Obesity and hypertension were defined by age‐ and sex‐specific cut‐offs. Diabetes was diagnosed if the fasting glucose was >7 mM. Results: The risk of obesity was higher for those with birth weights ≥4000 grams [odds ratio (OR), 1.65] and 3543 to 3999 grams (OR, 1.28) and lower for those with birth weights 2601 to 2999 grams (OR, 0.90), using 3000 to 3542 grams as the reference group. An increased risk of diabetes was associated with both higher and lower birth weights, indicating a U‐shaped relationship (OR, <2600 grams, 1.607; 2601 to 2999 grams, 1.119; 3543 to 3999 grams, 1.112; ≥4000 grams, 1.661). In the 10‐ to 12‐year‐old age group, the risk of hypertension was higher in those with birth weights <2600 grams (OR, 1.20). Discussion: Low birth weight was associated with childhood diabetes. High birth weight was correlated with childhood obesity and diabetes. Our data indicate different relationships between birth weight and the development of obesity, hypertension, and diabetes in childhood.     

Telomere length and cardiovascular risk factors in a middle-aged population free of overt cardiovascular disease

Evidence assembled over the last decade shows that average telomere length (TL) acts as a biomarker for biological aging and cardiovascular disease (CVD) in particular. Although essential for a more profound understanding of the underlying mechanisms, little reference information is available on TL. We therefore sought to provide baseline TL information and assess the association of prevalent CVD risk factors with TL in subjects free of overt CVD within a small age range. We measured mean telomere restriction fragment length of peripheral blood leukocytes in a large, representative Asklepios study cohort of 2509 community-dwelling, Caucasian female and male volunteers aged approximately 35-55 years and free of overt CVD. We found a manifest age-dependent telomere attrition, at a significantly faster rate in men as compared to women. No significant associations were established with classical CVD risk factors such as cholesterol status and blood pressure, yet shorter TL was associated with increased levels of several inflammation and oxidative stress markers. Importantly, shorter telomere length was associated with an increasingly unhealthy lifestyle, particularly in men. All findings were age and gender adjusted where appropriate. With these cross-sectional results we show that TL of peripheral blood leukocytes primarily reflects the burden of increased oxidative stress and inflammation, whether or not determined by an increasingly unhealthy lifestyle, while the association with classical CVD risk factors is limited. This further clarifies the added value of TL as a biomarker for biological aging and might improve our understanding of how TL is associated with CVD.     

Fetal growth and cardiovascular risk factors in Jamaican schoolchildren.

OBJECTIVE--To determine relation between schoolchildren''s blood pressure, glycated haemoglobin level, and cholesterol concentration and their anthropometry, socioeconomic status, and birth measurements. DESIGN--Retrospective cohort study. SETTING--27 schools closest to University Hospital of the West Indies, Kingston, Jamaica. SUBJECTS--2337 children aged 6-16 years who were born at university hospital were recruited, and their birth records were recovered: 1610 had suitable records, 659 had records including birth length, and 610 of these were prepubertal. MAIN OUTCOME MEASURES--Blood pressure, glycated haemoglobin level, serum cholesterol concentration, anthropometry at birth, current anthropometry, and socioeconomic status. RESULTS--Multiple regression analysis showed that children''s systolic blood pressure was inversely related to their birth weight (P < 0.0001) and directly related to their current weight. Glycated haemoglobin level was higher in children with thicker triceps skinfolds (P < 0.001) and who had been shorter at birth (P = 0.003). Serum cholesterol concentration was inversely related to current height (P = 0.001) and to length at birth (P = 0.09) and was directly related to triceps skinfold thickness and higher socioeconomic status (P < 0.001). CONCLUSIONS--Blood pressure in childhood was inversely related to birth weight and directly to current weight. Glycaemic control and serum cholesterol were related to short length at birth, height deficit in childhood, and childhood obesity.     

Obesity and cardiovascular risk factors among men and women aged 40 years and older in a rural area of Japan

Obesity is one of the most common health problems, and is recognized worldwide as an "escalating epidemic." For the establishment of an obesity-prevention strategy in Japan, it is important to assess the association between obesity and cardiovascular risk factors. Therefore, we conducted anthropometric measures of obesity and investigated the association of obesity with cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia among community-dwelling men (N=85) and women (N=173) aged 40 years and older. Height, weight, and waist circumference (WC) were measured, and body mass index (BMI) was calculated. Subjects with a BMI> or =25 kg/m(2) were considered obese (BMI obesity), while men with a WC> or =85 cm and women with a WC> or =90 cm were classified as obese (WC obesity). In the present study, we defined 'obesity' as a BMI> or =25 kg/m(2) or a WC> or =85 cm for men, and a BMI> or =25 kg/m(2) or a WC> or =90 cm for women. The results of an age- and sex-adjusted logistic regression analysis indicated that BMI obesity was associated with dyslipidemia (p=0.04), WC obesity was associated with dyslipidemia (p=0.07), and 'obesity' was associated with diabetes (p=0.06) and dyslipidemia (p=0.01). These results emphasize the importance of preventing obesity in Japan. Therefore, healthcare professionals should measure BMI and WC in order to enhance their assessment of cardiovascular risk.     

Relation of cardiovascular risk factors to atherosclerosis in type III hyperlipoproteinemia

The familial lipoprotein disorder type III hyperlipoproteinemia (HPL) carries a marked increase in the risk of accelerated and premature atherosclerosis, but there is considerable variation among affected individuals in susceptibility to cardiovascular disease (CVD). We studied the influence of independent risk factors for atherosclerosis in 67 patients with clinically overt type III HPL and homozygosity for apolipoprotein (apo) E2. Among the different risk factors (lipid and lipoprotein levels, age, sex, body mass index, smoking status, hypertension, and diabetes mellitus) there was only a statistically significant difference in age between 25 patients with atherosclerosis and 42 patients without atherosclerosis. Serum lipoprotein (a), [Lp, (a)], levels were 30.6% higher in the atherosclerosis group, but this was not statistically significant. We conclude that (in contrast to familial hypercholesterolemia) elevated Lp (a) concentrations may not be regarded as a component of the clinical syndrome of type III HPL.     

Prospective breast cancer risk factors prediction in Saudi women

Women's health is affected by breast cancer worldwide and Saudi Arabia (SA) is no exception. Malignancy has enormous consequences for social, psychological and public health. The aim of this study was to examine the risk factors for Saudi women from breast cancer using logistic regression models. In 135 patient cases for different stages of breast cancer was used to study case management, 270 healthy women from King Abd Alla Medical City, Mecca, SA were taken to predict the probability of women developing breast cancer, logistic regression was analyzed taking factors such as age, marital status, family history, parity, age at first full-term pregnancy, menopausal status, body mass index (BMI) and breast feeding. The logistic regression model showed that there are important risk factors (age, marital status, family history, parity, age at first full-term pregnancy, menopausal status, body mass index, and breast feeding) in development of breast cancer. Fewer cases were observed in unmarried women, age ≤30, BMI ≤20. In contrast, more cases were found with women age 41–50 married, BMI > 30, a smaller number of children, not breast feeding, age of first pregnancy ≥30, menopausal status age at 46–50. Based on our data there is role of risk factors in developing breast cancer, less BMI, the increase number of children, breast feeding, which are playing as protective factor for breast cancer.     

Anthropometric risk factors for colorectal polyps in African-American women

Objective: Colorectal adenomas are thought to be precursor lesions to colorectal cancer, a leading cause of cancer incidence and mortality in African‐American women. Studies suggest that obesity is associated with risk of adenomas in white women, but little is known about the relation in African‐American women. We prospectively examined the association between selected anthropometric factors and colorectal polyps in African‐American women. Methods and Procedures: Data were obtained from the Black Women's Health Study (BWHS), a prospective cohort study of African‐American women. From 1997 to 2003, we followed 33,403 women aged ≥30 years with no prior diagnosis of cancer or polyps. Cox regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for risk of polyps, with adjustment for potential confounders. Results: After 211,797 person‐years of follow‐up, 1,189 cases of colorectal polyps were reported. The IRR comparing women with a current BMI ≥35 to <25 kg/m² was 1.35 (95% CI = 1.12–1.62), after adjustment for covariates including waist‐to‐hip ratio (WHR). Women who gained ≥30 kg since age 18 were 1.76 times as likely as those who gained <5 kg to report polyps (95% CI = 1.33–2.33). The IRR comparing the highest (≥0.87) to lowest (<0.71) quintiles of WHR was 1.26 (95% CI = 1.04–1.54), after adjustment for covariates including BMI. BMI at age 18, adult height, and waist circumference (BMI‐adjusted) were not materially associated with risk. Results were similar among women with a recent endoscopy. Discussion: Weight gain and obesity in adulthood may increase the risk of colorectal polyps in African‐American women.     

Adiponectin and visceral fat associate with cardiovascular risk factors

Objective: To examine the combined effect of CT‐measured visceral fat area (VFA) and adiponectin level against the clustering of metabolic risk factors. Design and Methods: The subjects were 6,996 Japanese. The subjects were divided according to the combinations of VFA and adiponectin level quartiles and the odds ratio for multiple risk factors of metabolic syndrome were calculated (adjusted for age and lifestyle factors using logistic regression analyses). Group with the lowest VFA and the highest adiponectin level was used as a reference. The correlation between adiponectin level and each metabolic risk factor was evaluated. Results: The strongest correlation was observed between adiponectin level and high‐density lipoprotein cholesterol levels (r = 0.369 and 0.439 for men and women). Both VFA and adiponectin level were independently associated with the clustering of metabolic risk factors (interaction P = 0.58 and 0.11 for men and women). The odds ratio for the clustering of metabolic risk factors in the group with the highest VFA and the lowest adiponectin level, compared with the group with the lowest VFA and the highest adiponectin level, was 12.7 (9.7‐16.6) for men and 13.5 (6.0‐30.2) for women. Conclusion: The ability to detect metabolic syndrome could be improved by examining adiponectin level in conjunction with VFA.