Risk factors for coronary heart disease among Jerusalem schoolchildren: Preliminary findings

The presence of risk factors for cardiovascular diseases was investigated in 7- and 11-year-old schoolchildren (808 subjects). Data analysis was performed according to sex, age, and country of origin of the father. The following variables were investigated: weight, height, total plasma cholesterol (TCH), high density lipoprotein cholesterol (HDL), plasma triglycerides, and systolic and diastolic blood pressure. Significant differences were found between sex, age, and origin groups for most variables. The prevalence of hypercholesterolemia (>180 mg/dl) varied between 9.6 and 14.1%, in the different sex and age groups, and that of low HDL cholesterol (<40 mg/dl), 6.8–12.1%. Elevated systolic blood pressure (>130 mm Hg) was found in 4.4–6.7% of the 7-year-old children, and in 13.4–18.6% of the 11-year-olds. Elevated diastolic blood pressure (>85 mm Hg) was found predominantly in the 11-year-old children, 6.2–9.1%. These findings demonstrate the necessity to initiate health programs related to prevention of cardiovascular diseases in childhood.     

Dietary patterns and levels of blood pressure and serum lipids in a Japanese population

Background

Associations between dietary patterns and cardiovascular disease risk factors remain unclear. The objective of this study was to evaluate the association between dietary patterns derived from factor analysis and the levels of blood pressure and serum lipids in a Japanese population.

Methods

We conducted a cross-sectional analysis among 6886 (in the analysis on blood pressure) and 7641 (in the analysis on serum lipids) Japanese subjects aged 40-69 years. Dietary patterns were identified from a food frequency questionnaire by factor analysis. Associations between dietary patterns and blood pressure and serum lipids were examined after taking potential confounders into account.

Results

Three dietary patterns were identified: vegetable, meat, and Western. In men, the meat pattern was associated with higher total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol. The Western pattern was associated with higher total and LDL cholesterol. In women, the vegetable pattern was associated with lower systolic and diastolic blood pressure and pulse pressure, and higher HDL cholesterol. The meat pattern was associated with higher total and HDL cholesterol. The Western pattern was associated with higher total, HDL, and LDL cholesterol, and the least intake pattern of Western diet was associated with higher systolic and diastolic blood pressures.

Conclusions

Dietary patterns of a Japanese population were related to cardiovascular disease risk factors, especially in women.Key words: Diet, Factor Analysis, Statistical, Blood Pressure, Cholesterol, Japan     

Association of overall and abdominal obesity with coronary heart disease risk factors: comparison between urban and rural Indian men

The relationship of body mass index (BMI), conicity index (CI) and waist circumference to four coronary heart disease (CHD) risk factors (systolic and diastolic blood pressures, total cholesterol and high-density lipoprotein (HDL) cholesterol levels) was examined in urban (n = 110) and rural (n = 102) men aged > or = 20 years, drawn from the 'Reddy' population of Southern Andhra Pradesh, India. Using ANCOVA we found significant difference (< 0.01) for systolic blood pressure, total cholesterol and HDL cholesterol between the urban and rural samples. The Pearson's correlation coefficients suggest that BMI and waist circumference had significant relationships with most of the risk factors in both the populations. The CI did not significantly influence any of the risk factors in the urban population; however, in the rural population, CI did show a significant positive relationship with both of the blood pressures and with TC. Even after controlling for age, smoking and physical activity (partial correlations), the relations remained constant. In multiple linear regression, BMI showed significant positive association with systolic and diastolic blood pressures (<0.01) and HDL cholesterol (<0.05) in the rural population only. However, the Cl showed a significant association with HDL cholesterol, and waist circumference with total cholesterol and HDL cholesterol in the rural population. The results of the present study revealed that BMI and waist circumference had a greater influence on the CHD risk factors, and that the influence was more conspicuous in the rural sample. Comparing the association of abdominal obesity measures (CI and waist circumference) with CHD risk factors, waist circumference better correlated with most of the risk factors. Hence the present study suggests that BMI and waist circumference are better indicators of CHD risk factors. However, the importance of Cl has to be further studied in South Asian populations.     

健康体检1084例踝臂指数与心血管危险因素关系的分析

目的了解踝臂指数（ABI）与心血管疾病各相关因素之间的关系。方法对1084例门诊体检人群,检测空腹血糖、血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、体重指数、收缩压、舒张压,并计算不同性别、不同ABI分组条件下各组的患病率。结果男性和女性在不同ABI组中的分布不相同（x^2=52．130,P〈0．05）。按ABI分组,心血管各危险因素中年龄、体重指数、收缩压、舒张压、总胆固醇、三酰甘油及空腹血糖在三组中比较,差异有统计学意义（F值分别为28．268、24．826、192．950、88．213、7．602、14．802、199．216,P〈0．05）。其中年龄、血压及空腹血糖随着ABI的减低而逐渐增加。随着ABI分级的增加,同时并存多个危险因素的例数逐渐增加。结论ABI是预测心血管疾病的重要因子,有利于心血管疾病的发现和监控。     

Menopause-related changes in lipoproteins and some other cardiovascular risk factors

Changes in lipids, lipoproteins and other cardiovascular risk factors associated with the occurrence of menopause have been examined in a cross-sectional study of 435 healthy white women, aged 45-54 years not using sex hormones. Univariate analysis showed that total cholesterol, low density lipoprotein (LDL) cholesterol, apolipoprotein A1, apolipoprotein B, triglycerides, systolic blood pressure and fibrinogen were significantly higher in post menopausal women than in premenopausal women. High density lipoprotein (HDL) cholesterol, diastolic blood pressure and blood glucose did not change with menopausal status. After controlling for the effects of confounding variables (age, body mass index and smoking status), total cholesterol, LDL cholesterol, triglycerides, apolipoprotein B and systolic blood pressure remained significantly increased in postmenopausal women as compared with premenopausal women. Our findings add to epidemiological evidence that menopause adversely affects the lipid and lipoprotein metabolism and thus, may increase the risk of coronary heart disease.     

The relationship between parental history of vascular disease and cardiovascular disease risk factors in children: the Bogalusa Heart Study

The relationship between parental history of vascular disease (heart attack, stroke, diabetes mellitus, and hypertension) and risk factor variables for cardiovascular disease was assessed in 3,312 offspring aged 5-17 years during the 1981-1982 school year in the biracial community of Bogalusa, Louisiana. Risk factors studied included systolic blood pressure, diastolic blood pressure, serum total cholesterol, triglycerides, and individual lipoprotein cholesterol (beta-, low density lipoprotein (LDL) cholesterol; pre-beta, very low density lipoprotein (VLDL) cholesterol; and alpha-, high density lipoprotein (HDL) cholesterol). Risk factors were adjusted for age, race, sex, and height (blood pressure only) prior to testing parental history effects. Univariate comparisons between risk factors in children and vascular disease in parents resulted in statistically significant increases in systolic and diastolic pressures associated with the presence of maternal or paternal hypertension (p less than 0.001). Paternal heart attack was also associated with elevations in diastolic pressure (p less than 0.01) of children. Maternal diabetes mellitus was associated with an increase in serum total cholesterol (p less than 0.05). Paternal diabetes mellitus and maternal heart attack (for female progeny only) were associated with increases in mean triglyceride levels of children. VLDL cholesterol results were similar to those for triglycerides. For HDL cholesterol, paternal diabetes mellitus was associated with a small decrease in mean levels (p less than 0.05). Dramatic increases to the highest decile of risk were found in association with the following parental disease combinations: paternal heart attack-paternal diabetes for serum total cholesterol (p less than 0.0001), maternal heart attack-paternal diabetes (p less than 0.001) and paternal stroke-maternal diabetes (p less than 0.0001) for LDL cholesterol. Multivariate analysis detected no significant effects of single parental vascular disease. However, paternal heart attack in combination with either diabetes mellitus or hypertension was statistically significant in their relationship to the risk factors overall.     

Commuting physical activity is favourably associated with biological risk factors for cardiovascular disease

Background Little is known about the effects of commuting physical activity on biological cardiovascular risk factors although such knowledge may form an important basis for interventions aimed at reducing cardiovascular disease (CVD) by increasing physical activity. We examined the associations between commuting, leisure time and total physical activity and biological risk factors for CVD. Design A cross-sectional study of men and women, who participated in a health screening programme. Methods The study population comprised persons aged 30–60 years from a population-based random sample, response rate 53% (n = 6,906). Weight, height, waist circumference and blood pressure were measured and blood samples were collected. Physical activity was assessed by a self-administered questionnaire. Results Time spent on commuting, leisure time and total physical activity was positively associated with high-density lipoprotein cholesterol and negatively associated with low-density lipoprotein cholesterol, triglycerides, waist circumference and body mass index. Time spent on total physical activity was negatively associated with total cholesterol and diastolic blood pressure. Among men there was no relationship between time spent on physical activity and systolic blood pressure. Time spent on commuting physical activity and total physical activity was negatively associated with systolic blood pressure among women. Conclusion Commuting physical activity, independent of leisure time physical activity, was associated with a healthier level of most of the cardiovascular risk factors. An increase in commuting physical activity in the population may therefore reduce the incidence of CVD.     

Cardiovascular risk factor profile in subjects with familial predisposition to myocardial infarction in Denmark.

STUDY OBJECTIVES: To identify possible modifiable mediators of familial predisposition to myocardial infarction (MI) by assessing the risk factor profile in individuals without MI in relation to parental occurrence of MI. DESIGN AND METHODS: Cross sectional survey of the general population. The odds of an adverse cardiovascular risk factor profile in subjects reporting parental occurrence of MI versus subjects not reporting parental occurrence were estimated by logistic regression models. SETTING: The Copenhagen Centre for Prospective Population Studies, where subjects investigated in three Danish prospective population studies are integrated. PARTICIPANTS: Subjects were 9306 females and 11,091 males aged 20-75 years with no history of MI. A total of 1370 subjects reported maternal MI and 2583 reported paternal MI. MAIN RESULTS: Increased systolic and diastolic blood pressure, increased cholesterol level, low ratio between high density lipoprotein (HDL) and total cholesterol (TC), and heavy smoking, were more frequent in subjects with parental occurrence of MI than in controls irrespective of sex and age of the subjects. Maternal MI was more predictive for increased cholesterol and decreased HDL/ TC ratio than paternal MI, and the risk of an increased cholesterol level was higher in subjects aged 20-39 years than in older subjects. No differences in body mass index, triglycerides, and physical inactivity were observed. CONCLUSIONS: Subjects free of previous MI who reported a parental occurrence of MI had an adverse cardiovascular risk factor profile regarding systolic and diastolic blood pressure, total cholesterol, the ratio between HDL and total cholesterol, and smoking. Thus, these modifiable risk factors may be mediators of the familial predisposition to MI.     

Serum selenium and precursors of cardiovascular risk factors in adolescents

The aim of this study was to determine, in a population of Italian adolescents, the association of serum selenium levels with precursors of biochemical and anthropometric variables known as being among the major risk factors for cardiovascular diseases in the adult population. The following measurements were taken in a school sample of 627 adolescents (aged 12–13 years): serum selenium, total cholesterol, high density lipoprotein cholesterol, non-HDL cholesterol, height, weight, body mass index, systolic blood pressure and diastolic blood pressure.The serum selenium levels were slightly higher in males (83.1 ± 10.1 g/1) than in females (81.7 ±- 11.0 g/1), but the difference was not statistically significant. Serum selenium was positively correlated with total cholesterol, diastolic blood pressure and HDL cholesterol in both sexes; moreover it was positively correlated with non-HDL cholesterol and negatively correlated with height in males only.Corresponding author.     

Cardiovascular risk factor prevention in black schoolchildren: two-year results of the "Know Your Body" program

A five-year intervention study of the effectiveness of the "Know Your Body" program in reducing coronary heart disease risk factors among black students in the District of Columbia, who were in grades 4-6 at baseline, was begun in 1983. Nine schools were stratified on socioeconomic status and randomly assigned to control and intervention groups. The "Know Your Body" curriculum focuses on nutrition, fitness, and the prevention of cigarette smoking. At baseline, 1,234 students were eligible for the screening in which the following target risk factors were measured: systolic and diastolic blood pressures, ponderosity index, triceps skinfold thickness, postexercise pulse recovery rate, serum total and high density lipoprotein (HDL) cholesterol, and serum thiocyanate. After two years of intervention, results indicated that the program may have had a favorable impact on the following risk factors: systolic and diastolic pressures, HDL cholesterol, ratio of total to HDL cholesterol, fitness (postexercise pulse recovery rate), and smoking. Significant net changes in the favorable direction also were found for health knowledge and attitude toward smoking. Blood pressure reduction was associated with decreased ponderosity and improved fitness, and increased HDL cholesterol was associated with decreased ponderosity. These results are consistent with other evaluations of the "Know Your Body" program, suggesting that the program may be effective in reducing chronic disease risk in diverse school populations.     

供电职业人群体检指标与心血管疾病危险因素相关性研究

目的 通过描述供电职业人群身体健康状况,探讨体检指标与心血管疾病危险因素的相关性,为供电职业人群健康管理提供理论依据.方法 采用流行病学横断面研究方法对北京市、河北省唐山市、张家口市220 kV及以上电压等级输变电作业场所18～60岁2 782名（男性1 830名,女性952名）供电职业人群身体健康状况和生活方式进行了问卷调查和体格检查.两样本或多样本率的比较采用x2检验.多因素分析采用多变量线性回归.结果 本组供电职业人群超重检出率为38.9％;肥胖检出率为9.7％;收缩压高值检出率为30.1％;高收缩压检出率为17.4％;舒张压高值检出率为34.8％;高舒张压检出率为24.4％;空腹血糖受损率为7.1％;空腹血糖异常率为6.6％;总胆固醇边缘升高率为19.8％;总胆固醇异常率为7.9％;三酰甘油边缘升高率为17.2％;三酰甘油异常率为21.8％;低密度脂蛋白边缘升高率为14.5％;低密度脂蛋白异常率是3.8％;高密度脂蛋白减低率为15.0％;白细胞异常率是2.7％;丙氨酸转氨酶异常率为6.7％;肌酐异常率为4.6％.多因素线性回归结果显示：收缩压、舒张压、体质指数、空腹血糖、总胆固醇、低密度脂蛋白、高密度脂蛋白和丙氨酸转氨酶均与多种心血管疾病的危险因素相关.结论 220 kV及以上电压等级输变电作业场所供电职业人群心血管疾病危险因素边缘增高值和异常率均较高,对该职业人群进行有针对性的健康管理具有重要的公共卫生意义.     

Socioeconomic differences in behavioural and biological risk factors: a comparison of a Japanese and an English cohort of employed men

BACKGROUND: To compare socioeconomic differences in behavioural and biological risk factors in Japanese and English 39-59-year-old employed men. METHODS: We measured systolic and diastolic blood pressure, total and high density lipoprotein (HDL) cholesterol, body mass index (BMI), waist-to-hip ratio and fibrinogen at medical screenings and smoking and alcohol consumption in health questionnaires among Japanese non-manual and manual employees of a steel products company and among English non-manual employees working in Civil Service departments. RESULTS: In England, higher employment grades were advantaged with regard to most risk factors studied. In Japan the picture was different in that higher grades had higher BMI, waist-to-hip-ratio and lower HDL cholesterol. In Japan employment grade differences in these three risk factors are clearly larger among younger men than among older men, while in England age differentials in the grade differences are small. Similar results were obtained for education. CONCLUSIONS: Important differences in the social patterning of risk factors were observed in our cohorts of employed Japanese and English men. The contribution that these risk factors make in explaining social differences in health may vary accordingly. Studies that identify the common and unique determinants of socioeconomic health differences in different populations are needed.     

Relation of body fatness and its distribution to cardiovascular risk factors in young blacks and whites. The role of insulin

Persons whose body fat is distributed predominantly in the abdomen compared with the hips are at increased risk of several chronic diseases. This study examined the cross-sectional relation of percent body fat, computed from skinfold thickness, and fat distribution, measured by the waist-to-hip girth ratio, to physiologic cardiovascular risk factors in a biracial sample (blacks and whites) of young adults aged 18-30 years. The subjects were persons who were examined at baseline (1984-1986) in the Coronary Artery Risk Development in Young Adults Study in four US metropolitan areas. The two hypotheses tested were that 1) after adjusting for percent body fat, waist-to-hip girth ratio is associated with several physiologic risk factors, and 2) fasting concentrations of serum insulin partly explain such association. Percent body fat was significantly associated with all measured blood lipids, lipoproteins, apolipoproteins, uric acid, and blood pressure. Waist-to-hip girth ratio was significantly, although more weakly, associated in multivariate models with blood concentrations of triglycerides, high density lipoprotein (HDL) cholesterol, HDL2 cholesterol, apolipoproteins A-I and B, low density lipoprotein cholesterol (in women only), uric acid, and systolic blood pressure, but was not associated in either sex with total cholesterol, HDL3 cholesterol, or diastolic blood pressure. Fasting serum insulin concentrations were significantly associated with percent body fat (Pearson r = 0.45-0.53), waist-to-hip girth ratio (Pearson r = 0.18-0.27), and most of the physiologic risk factors. Inclusion of fasting insulin in multivariate models reduced, but rarely eliminated, associations between waist-to-hip girth ratio and the physiologic risk factors. These findings suggest that obese young adults, especially those with abdominal fat preponderance, carry a physiologic profile that places them at higher risk of cardiovascular disease, and that fasting insulin concentrations are only partly explanatory.     

Physical activity and cardiovascular risk: a cross-sectional study of middle-aged premenopausal women

The relationship between self-reported physical activity and cardiovascular risk factors was evaluated in a population-based sample. The sample included 541 premenopausal women recruited for a study of the natural history of risk factor change associated with change in sex hormone status. Physical activity was assessed using the Paffenbarger Activity Questionnaire. Women were classified according to quartile of weekly energy expenditure into groups of 0-500, 501-999, 1,000-1,999, and 2,000 kcal or greater. Results showed that the more active the women, the lower their blood pressure and heart rate. More active women had lower cholesterol and triglycerides, and higher high-density lipoprotein (HDL) cholesterol. Tricep and suprailiac skinfolds, fasting insulin, and insulin/glucose levels were also lower among the more active women. When the analysis was repeated controlling for the effect of education and body mass index, the statistical test for linear trend remained significant except for the trend for heart rate, total cholesterol, and triglycerides. Women reporting activity of 1,000 kcal/week had higher high-density lipoprotein cholesterol and lower diastolic blood pressure, body mass index, skinfolds, fasting insulin, and fasting insulin/glucose ratios compared with women reporting lower levels of activity. Only those women who reported 2,000 kcal/week had significantly lower total cholesterol, triglycerides, and low-density lipoprotein cholesterol, and higher HDL2 cholesterol; women reporting less activity did not differ with regard to these lipids and lipoproteins. The study suggests that physical activity is associated with improved cardiovascular risk profiles among middle-aged women and that the beneficial effects of activity are seen at different levels for specific risk factors.     

Prevalence of coronary heart disease risk factors in an urban black population: the Minnesota Heart Survey, 1985

A cross-sectional study of a sample of Minnesota black urban residents was conducted in 1985 to develop cardiovascular risk profiles. Participants were evaluated during a home interview (N = 1,254, 78% participation) and a survey center visit (N = 1,052, 65% participation). Black men had significantly higher mean systolic and diastolic blood pressure than Black women (129.7/80.9 vs 124.8/77.3, respectively). Age-specific values for systolic and diastolic blood pressure were greater in men than women for all age categories. Men were more likely to have uncontrolled hypertension or to be unaware of their hypertension than women in all age categories. Women had significantly higher mean total and high-density lipoprotein cholesterol values than men (202.1 and 56.1 mg/dl vs 193.2 and 48.7 mg/dl, respectively). Age-specific values for total and high-density lipoprotein cholesterol values were greater in women than men for all age categories except the 35-44 age group. Men were significantly more likely to be current cigarette smokers (43.3% vs 33.2%) and to have higher cigarette consumption per day (17 vs 14) than women. The major risk factors for cardiovascular disease (with the exception of smoking) were lower in the Minnesota study in 1985 than in the National Health and Nutrition Examination Survey in 1976-1980. These lower levels may also be a component in the decline of cardiovascular disease mortality rates among Blacks.     

Different worlds, different tasks for health promotion: comparisons of health risk profiles in Chinese and Finnish rural people.

The aim of this study was to compare cardiovascular risk factors of working-aged people in Chinese and Finnish rural villages. The surveys were carried out in 1989 in Tianjin, China, and in Kuopio, Finland. Altogether, 897 Chinese inhabitants and 795 Finnish subjects participated in the surveys. Health behaviours were recorded, and height, weight, blood pressure, heart rate and serum lipids were measured. Generally Finns had a significantly higher mean body-mass index, systolic and diastolic blood pressures, and serum total cholesterol, low-density lipoprotein cholesterol, and total cholesterol/high-density lipoprotein ratio than the Chinese. However, no difference was seen between Chinese and Finnish women in diastolic blood pressure and serum triglycerides. Lower high-density lipoprotein cholesterol levels were observed in Finnish men than in Chinese men, whereas a higher mean level was shown in Finnish women than in Chinese women. There were significantly higher mean heart rates and prevalence of smoking in Chinese than in Finnish populations. More people who were overweight, obese and hypertensive were found in the Finnish than in the Chinese populations. Most of the Finns had two or more cardiovascular risk factors compared with the Chinese, the majority of whom were in the group with less than two risk factors. In conclusion, the risk profiles are clearly somewhat different in these two countries. A major task for the Chinese health policy and health care system is to decrease smoking and to prevent obesity and hypertension. In Finland, the biggest task seems to be the reduction of weight and lipid abnormalities, and the prevention of hypertension.     

Cardiovascular risk factors among black schoolchildren: comparisons among four Know Your Body studies

Baseline cardiovascular risk factor variables were obtained from 1,041 black District of Columbia children in Grades 4-6 as part of a Know Your Body evaluation project. Screening included height, weight, triceps skinfold measurements, systolic and diastolic blood pressures, step-test for fitness, serum cholesterol, high-density lipoprotein cholesterol and thiocyanate. Results were compared with those in three other Know Your Body studies, Bronx, New York, Westchester, New York, and Los Angeles, and indicated that District of Columbia black children are more likely to have high cholesterol levels and to fail the fitness test than black children in the other studies. In the District of Columbia, obese children had significantly higher total serum cholesterol, systolic, diastolic, and high-density lipoprotein levels, and were less fit than other District of Columbia children; almost three-fourths of all of the children had one or more risk factors. Socioeconomic status was negatively correlated with diastolic blood pressure, skinfold thickness, and cholesterol levels and was positively correlated with high-density lipoprotein cholesterol. Rates of obesity and diastolic blood pressure were consistent with Bronx and Westchester comparisons suggesting that socioeconomic status interacts with ethnicity to determine risk factor levels. The existence of children with multiple risk factors in all of the Know Your Body studies supports the need for early intervention.     

Kennedy Space Center Cardiovascular Disease Risk Reduction Program evaluation

This program evaluation examined the Kennedy Space Center (KSC) Cardiovascular Disease (CVD) Risk Reduction Program which aims to identify CVD risk factors and reduce these risk factors through health education phone counseling. High risk participants (those having two or more elevated lipid values) are identified from monthly voluntary CVD screenings and counseled. Phone counseling consists of reviewing lab values with the participant, discussing dietary fat intake frequency using an intake questionnaire, and promoting the increase in exercise frequency. The participants are followed-up at two-months and five-months for relevant metrics including blood pressure, weight, body mass index (BMI), total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, dietary fat intake, and exercise frequency. Data for three years of the KSC CVD Program included 366 participants, average age of 49 years, 75% male, and 25% female. For those with complete two and five month follow-up data, significant baseline to two-month follow-up comparisons included decreases in systolic blood pressure (p = 0.03); diastolic blood pressure (p = 0.002); total cholesterol, LDL cholesterol and dietary fat intake (all three at p < 0.0001) as well as a significant increase in exercise frequency (p = 0.04). Significant baseline to five-month follow-up comparisons included decreases in triglycerides (p = 0.05); and total cholesterol, LDL cholesterol and dietary intake (all three at p < 0.0001). These program evaluation results indicate that providing brief phone health education counseling and information at the worksite to high risk CVD participants may impact CVD risk factors.     

The roles of insulin, obesity, and fat distribution in the elevation of cardiovascular risk factors in impaired glucose tolerance. The San Luis Valley Diabetes Study.

The objective of this study was to determine whether a less favorable risk factor pattern for cardiovascular disease among persons with impaired glucose tolerance could be explained by fasting insulin, obesity, and/or a central distribution of body fat. Between 1984 and 1988, cardiovascular risk factors were examined cross-sectionally in Hispanic and non-Hispanic white participants in the San Luis Valley Diabetes Study who had either impaired (n = 173) or normal (n = 1,107) glucose tolerance. Sex-specific analysis of covariance models were constructed to adjust risk factor levels for age, age and insulin, and age, insulin, body mass index, and centrality index. Both males and females with impaired glucose tolerance had higher age-adjusted mean diastolic blood pressures, heart rates, uric acid levels, and triglyceride levels and lower levels of high density lipoprotein (HDL) cholesterol and HDL3 cholesterol than normal subjects; differences were significant for all risk factors except HDL cholesterol and HDL3 cholesterol in males. Differences in diastolic blood pressure in males, and differences in heart rate and triglyceride in both sexes, remained significant after adjustment for all covariates. However, differences in uric acid in males and differences in diastolic blood pressure and HDL3 cholesterol in females were attenuated to borderline significance levels. Differences in uric acid and HDL cholesterol in females were diminished to nonsignificant levels, especially after adjustment for obesity-related measures. With few exceptions, fasting insulin did not appear to play a major role in accounting for differences in these risk factors. With adjustment, ethnic differences (Hispanic vs. non-Hispanic white) were smaller and were statistically significant less often than differences observed between impaired and normal glucose tolerant groups. The authors concluded that hyperinsulinemia, obesity, and a central body fat distribution accounted for some, but usually not all, of the less favorable cardiovascular risk factor pattern found in subjects with impaired glucose tolerance.     

Relation of body weight change to changes in atherogenic traits; a study of middle-aged Japanese obese male office workers

We examined the effect of body weight change on the modification of atherogenic risk factors in 296 middle-aged obese male office workers without medication for hypertension, dyslipidemia, hyperuricemia or diabetes mellitus. During a 1-year education program, 39.2% of the participants could reduce their weight, and the percentage of those who lost 2 kg or more was only 17.7%. Concomitant with the decrease of weight, however, the levels of systolic and diastolic blood pressures, total cholesterol, triglyceride, uric acid and hemoglobin A1c and the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol decreased significantly, whereas the HDL cholesterol level increased significantly. In a multivariate regression analysis, in addition to the initial risk-factor level, weight change was an important factor determining the changes in atherogenic risk factors. Changes in alcohol consumption were significantly associated with the changes in systolic blood pressure and HDL cholesterol levels. Changes in cigarettes smoking also showed significant associations with the changes in triglyceride level and the ratio of total cholesterol to HDL cholesterol. These results suggest that although the education program for controlling weight may have limited success, weight reduction exhibits beneficial changes in the atherogenic risk-factor profile in middle-aged obese men.