The prevalence of overweight and obesity is escalating in South Asian countries. South Asians display higher total and abdominal obesity at a lower BMI when compared to Whites. Consequently, ...metabolic dysfunction leading to metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) will account for a majority of the health burden of these countries. In this review, we discuss those factors that contribute to MetS and T2DM in South Asians when compared to whites, focusing on adiposity. Abdominal obesity is the single-most important risk factor for MetS and its predisposition to T2DM. Excessive ectopic fat deposition in the liver (non-alcoholic fatty liver disease) has been linked to insulin resistance in Asian Indians, while the effects of ectopic fat accumulation in pancreas and skeletal muscle need more investigation. South Asians also have lower skeletal muscle mass than Whites, and this may contribute to their higher risk T2DM. Lifestyle factors contributing to MetS and T2DM in South Asians include inadequate physical activity and high intakes of refined carbohydrates and saturated fats. These are reflective of the recent but rapid economic transition and urbanization of the South Asian region. There is need to further the research into genetic determinants of dysmetabolism as well as gene x environment interactions. Collectively, MetS and T2DM have multi-factorial antecedents in South Asians and efforts to combat it through low-cost and socio-culturally appropriate lifestyle interventions need to be supported.
Background
After menopause, women exhibit a higher prevalence of the metabolic syndrome (MetS) and higher risk of cardiovascular disease. However, the timing of changes in MetS severity over the ...menopausal transition and whether these changes differ by racial/ethnic group remain unclear.
Methods and Results
We assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced transition in menopausal status over 10 years (visits 1–4). We used linear mixed models to evaluate changes by menopausal status (premenopause, perimenopause, and postmenopause) in a MetS severity Z‐score and in the individual MetS components. While there were gradual increases in MetS severity over time across menopause stages, black women in particular exhibited more rapid progression in MetS severity during the premenopausal and perimenopausal periods than during the postmenopausal period. In the postmenopausal period (compared with prior periods), white women exhibited unfavorable decreases in high‐density lipoprotein, while black women exhibited favorable alterations in the rate of change for waist circumference, triglycerides, high‐density lipoprotein, and glucose, contributing to the slowed progression of MetS severity. These changes were all observed after adjusting for hormone replacement treatment.
Conclusions
During menopausal transition, women exhibited rapid increases in MetS severity during the premenopausal and perimenopausal periods, with black women having significant reductions in this increase in severity during the postmenopausal period. These data suggest that the higher prevalence of MetS in postmenopausal women may be caused more by changes during the menopausal transition than by postmenopause. These findings may thus have implications regarding the timing of cardiovascular risk relative to menopause.
Influenza is thought to be communicated from person to person by multiple pathways. However, the relative importance of different routes of influenza transmission is unclear. To better understand the ...potential for the airborne spread of influenza, we measured the amount and size of aerosol particles containing influenza virus that were produced by coughing. Subjects were recruited from patients presenting at a student health clinic with influenza-like symptoms. Nasopharyngeal swabs were collected from the volunteers and they were asked to cough three times into a spirometer. After each cough, the cough-generated aerosol was collected using a NIOSH two-stage bioaerosol cyclone sampler or an SKC BioSampler. The amount of influenza viral RNA contained in the samplers was analyzed using quantitative real-time reverse-transcription PCR (qPCR) targeting the matrix gene M1. For half of the subjects, viral plaque assays were performed on the nasopharyngeal swabs and cough aerosol samples to determine if viable virus was present. Fifty-eight subjects were tested, of whom 47 were positive for influenza virus by qPCR. Influenza viral RNA was detected in coughs from 38 of these subjects (81%). Thirty-five percent of the influenza RNA was contained in particles>4 µm in aerodynamic diameter, while 23% was in particles 1 to 4 µm and 42% in particles<1 µm. Viable influenza virus was detected in the cough aerosols from 2 of 21 subjects with influenza. These results show that coughing by influenza patients emits aerosol particles containing influenza virus and that much of the viral RNA is contained within particles in the respirable size range. The results support the idea that the airborne route may be a pathway for influenza transmission, especially in the immediate vicinity of an influenza patient. Further research is needed on the viability of airborne influenza viruses and the risk of transmission.
...this sex- and race-specific score, unlike ATP-III MetS classification, did not exhibit differences in CHD prediction by sex or race and thus may provide similar risk information across ...sub-populations.
Several studies have reported a significant inverse association of light to moderate alcohol consumption with coronary heart disease (CHD). However, studies assessing the relationship between alcohol ...consumption and atherosclerosis have reported inconsistent results. The current study was conducted to determine the relationship between alcohol consumption and aortic calcification.
We addressed the research question using data from the population-based ERA-JUMP Study, comprising of 1006 healthy men aged 40–49 years, without clinical cardiovascular diseases, from four race/ethnicities: 301 Whites, 103 African American, 292 Japanese American, and 310 Japanese in Japan. Aortic calcification was assessed by electron-beam computed tomography and quantified using the Agatston method. Alcohol consumption was categorized into four groups: 0 (non-drinkers), ≤1 (light drinkers), >1 to ≤3 (moderate drinkers) and >3 drinks per day (heavy drinkers) (1 drink = 12.5 g of ethanol). Tobit conditional regression and ordinal logistic regression were used to investigate the association of alcohol consumption with aortic calcification after adjusting for cardiovascular risk factors and potential confounders.
The study participants consisted of 25.6% nondrinkers, 35.3% light drinkers, 23.5% moderate drinkers, and 15.6% heavy drinkers. Heavy drinkers Tobit ratio (95% CI) = 2.34 (1.10, 4.97); odds ratio (95% CI) = 1.67 (1.11, 2.52) had significantly higher expected aortic calcification score compared to nondrinkers, after adjusting for socio-demographic and confounding variables. There was no significant interaction between alcohol consumption and race/ethnicity on aortic calcification.
Our findings suggest that heavy alcohol consumption may be an independent risk factor for atherosclerosis.
•Alcohol consumption has a J-shaped association with CHD.•Studies reported conflicting relationships between alcohol consumption and atherosclerosis.•We cross-sectionally examined the relationship between alcohol consumption and aortic calcification.•The heavy alcohol consumption was positively associated with aortic calcification.•Moderate alcohol consumption may lower CHD risk through mechanisms other than reduced atherosclerotic lesion calcification.
The cross-sectional association of serum vitamin D levels with blood pressure and hypertension status among a representative sample of U.S. adults was examined.
Participants of the National Health ...and Nutrition Examination Survey from 2001 to 2010 were included in these analyses. Harmonizing of the vitamin D levels from 2001 to 2006 with vitamin D measurement from 2007 to 2010 was done using regression equations released by the Centers for Disease Control and Prevention. Use of vitamin D supplements was assessed for all participants. Statistical analyses included examination of linear association of vitamin D levels with blood pressure and non-linear cubic splines with hypertension in overall population, by gender, and by race/ethnicity.
With every 10 nmol/L higher vitamin D, systolic blood pressure decreased by 0.19 mmHg in this population (p<0.01). In fully adjusted stratified analyses, this association was present among females (–0.25 mmHg, p<0.01) and non-Hispanic whites (0.22 mmHg, p<0.01). After race/ethnic and gender stratification, this association was observed among non-Hispanic white females (0.26 mmHg, p=0.01), non-Hispanic black females (0.65 mmHg, p=0.02), and marginally significant among Hispanic males (0.33 mmHg, p=0.07). Non-parametric assessment with cubic splines show that vitamin D has an inverse association with odds of hypertension up to 100 nmol/L with no apparent benefit at higher levels in overall population, and even lower threshold levels of vitamin D in non-Hispanic blacks (50 nmol/L) and Hispanic Americans (70 nmol/L).
Significant race/ethnic and gender differences exist in the association of vitamin D and systolic blood pressure. Odds for hypertension are reduced significantly at higher vitamin D levels, but this benefit plateaus at very high vitamin D levels.
Background. We examined the association between insufficient rest/sleep and cardiovascular disease or diabetes mellitus separately among non-Hispanic whites, non-Hispanic blacks, Hispanic Americans, ...and other races in a contemporary sample of US adults. Methods. Multiethnic, nationally representative, cross-sectional survey (2008 BRFSS) participants who were >20 years of age (n=369, 217; 50% women). Self-reported insufficient rest/sleep in the previous month was categorized into: zero, 1–13, 14–29, and all 30 days. Outcomes were: (1) any CVD, (2) coronary artery disease (CHD), (3) stroke, and (4) diabetes mellitus. Results. Insufficient rest/sleep was found to be positively associated with (1) any CVD, (2) CHD, and (3) stroke among all race-ethnicities. In contrast, insufficient rest/sleep was positively associated with diabetes mellitus in all race-ethnicities except non-Hispanic blacks. The odds ratio of diabetes association with insufficient rest/sleep for all 30 days was 1.37 (1.26–1.48) among non-Hispanic whites, 1.11 (0.90–1.36) among non-Hispanic blacks, 1.88 (1.46–2.42) among Hispanic Americans, and 1.48 (1.10–2.00) among other race/ethnicities. Conclusion. In a multiethnic sample of US adults, perceived insufficient rest/sleep was associated with CVD, among all race-ethnicities. However, the association between insufficient rest/sleep and diabetes mellitus was present among all race-ethnicities except non-Hispanic blacks.
Data presented in this article are supplementary data to our primary article ‘Association of Alcohol Consumption and Aortic Calcification in Healthy Men Aged 40–49 Years for the ERA JUMP Study’ 1. In ...this article, we have presented supplementary tables showing the independent association of alcohol consumption with coronary artery calcification using Tobit conditional regression and ordinal logistic regression.
Abstract Background Although Westernized lifestyle was associated with increased coronary heart disease (CHD) morbidity and mortality in first and second generation Japanese Americans; CHD mortality ...was reported to be lower in them than whites. Risk profile of CHD for third and fourth generation Japanese Americans is not known. We compared progression of CIMT between third or fourth generation Japanese Americans and whites. Methods Population-based samples of 473 men (Japanese Americans=227 and whites=246) aged 40-49 years at baseline and free of clinical cardiovascular disease were examined for CIMT at baseline (2002-06) and follow-up (2007-13). CIMT was read centrally at the University of Pittsburgh. Analysis of covariance was used to compare annualized progression of CIMT between Japanese Americans and whites, adjusting for cardiovascular risk factors and baseline CIMT. Results Progression of CIMT was significantly greater in Japanese Americans than whites both before and after adjusting for covariates (mean in μm/year 95% confidence interval): 14.4 (12.3, 16.4) vs 9.8 (7.8, 11.7), P <0.05 and 15.1 (13.1, 17.1) vs 9.1 (7.2, 11.0), P <0.05, respectively. Age, total cholesterol/high-density lipoprotein-cholesterol, and diabetes in Japanese Americans and age, hypertension, and lipid medication in whites were significantly associated with progression of CIMT. Conclusions The significantly greater progression of CIMT in Japanese Americans than whites might suggest a higher burden of CHD in Japanese Americans than whites in the future. The current study identifies Japanese Americans as an important target group for prevention of CHD. Future research assessing carotid plaque in addition to CIMT is warranted.
Pre-eclampsia (PE) affects approximately 3% of all pregnancies worldwide, with onset of symptoms in the late second or third trimester, commonly after 32(nd) week. It is common in nulliparous women. ...To avoid complications it is necessary to diagnose it in advance, but the available tools are unable to clinch the diagnosis of preeclampsia effectively in majority.
To find out an association of lipid profile and uric acid with PE in nullipara pregnant women in third trimester.
One hundred nulliparous pregnant women in their third trimester of 18-35 years were divided into; 50 pre-eclamptics of study group and 50 non pre-eclamptic in control group; further subdivided according to age, 18-26 and 27-35 yrs. Diagnosis was confirmed as per the standard criteria. Lipid profile and uric acid levels were estimated by Vitros 250 dry chemistry analyser. Data was analysed statistically by student t-test at p<0.01 level of significance.
TC, LDL-c and VLDL-c levels in the study group as a whole and in the patients between 18-26 years were significant; HDL-c levels in the patients between 27-35 years were significant while TG and uric acid levels in all the three study groups were significant.
Total cholesterol, LDL-c, VLDL-c, triglycerides (TGs) and uric acid levels were raised in preeclampsia and statistically significant; while HDL-c levels were raised in these patients but statistically non-significant, it can be concluded that there exists an association in lipid profile and uric acid with PE therefore dyslipidemia and raised uric acid levels are the features of PE in nullipara pregnant women in their third trimester.
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