Social mobility by marriage and risk of cardiovascular disease among adults in Southwestern Poland

Background: The social position of a husband or wife can influence the health status of the individual and his/her partner. Also, social position can change over time as a result of education, job, income, marriage and/or divorce.

Aim: To examine the association of mobility by marriage based on educational discrepancy between spouses and risk of cardiovascular disease (CVD) among Polish men and women of 40–50 years of age.

Subjects and methods: The sample included 394 married men and 453 married women of 40–50 years of age. All were residents of Wroc?aw located in southwestern Poland. Risk of CVD was assessed with the Framingham Risk Score (FRS). The sex-specific effect of social mobility on CVD risk (FRS) was tested by multiple regression analyses.

Results: Among Polish married men and women, social mobility by marriage had a significant association with risk of CVD. Downwardly mobile men and women had a higher risk of CVD, while upwardly mobile men and women had a lower risk of CVD compared with individuals from homogamous marriages. The sole exception to this trend was poorly educated men among whom marriage with a better educated wife did not affect CVD risk.

Conclusion: Social mobility by marriage influences CVD risk. The results provide additional insights for studies examining socioeconomic differentials in CVD risk.     

Apolipoprotein B is highly associated with the risk of coronary heart disease as estimated by the Framingham risk score in healthy Korean men

The aim of this study was to examine the association between serum apolipoprotein B (apoB) and the risk of coronary heart disease (CHD) using Framingham risk score (FRS) in healthy Korean men. A total of 13,523 men without medication history of diabetes and hypertension were enrolled in this study. The FRS is based on six coronary risk factors. FRS ≥ 10% was defined as more-than-a-moderate risk group and FRS ≥ 20% as high risk group, respectively. The logistic regression analyses were conducted. When quartile 1 (Q1) set as a reference, in unadjusted analyses, the Q2, Q3, Q4 of apoB level had increased odds ratio (OR) for the risk of CHD in both more-than-a-moderate risk and high risk group, respectively. After adjusting for confounding variables, multivariable-adjusted logistic regression analyses showed a strong relationship between the quartiles of apoB level and more-than-a-moderate risk and high risk group, respectively. These associations were attenuated, but still remained statistically significant. ApoB is found to be independently related to the risk of CHD using FRS in healthy Korean men, and the link between apoB and the risk of CHD is dose-dependent.     

Relationship between chronic kidney disease and risk of coronary heart disease in Korean men

There have been many epidemiological researches of chronic kidney disease (CKD), accompanied by an increase in the incidence of coronary heart disease (CHD). However, as far as we know, little research has been done to examine the extent of the relationship between CKD and CHD as estimated by Framingham risk score (FRS) in Korean men. CKD was defined as either proteinuria or an eGFR of < 60 mL/min per 1.73 m(2). The FRS has been used to predict the 10-yr risk of coronary events and usually divided into three levels of risk < 10% (low), 10%-19% (intermediate) and ≥ 20% (high). We defined FRS ≥ 10% as more-than-a-moderate CHD risk group and FRS ≥ 20% as a high CHD risk group, respectively. After adjusting for covariates, multivariable-adjusted logistic regression analyses showed a strong statistical significant relationship between CKD and high risk of CHD (adjusted OR, 1.95 [95% CI, 1.32-2.87]). Dipstick urinalysis and eGFR can be readily measured in most clinical settings. The measurement of kidney function may represent a relatively inexpensive and efficient way to identify individuals at higher risk for CHD.     

Serum gamma-glutamyltransferase concentration correlates with Framingham risk score in Koreans

Gamma-glutamyltransferase (GGT) is a novel coronary artery disease (CAD) risk factor, but its use as an independent factor for CAD risk prediction remains unclear in Asian population. This study examined the association between serum GGT concentration and Framingham risk score (FRS) in the Korean population. This cross-sectional study was performed on 30,710 Koreans. Besides FRS, body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid and high sensitive C-reactive protein data were used. The study subjects were grouped into quartiles according to the levels of GGT. Analyses relating GGT to FRS ≥ 20% utilized multiple confounders adjusted logistic regression. Positive correlations were established between log-transformed GGT concentration and FRS (r = 0.38; P < 0.001). Increasing the quartile of serum GGT concentration was significantly associated with linear increasing trends in FRS (P-trend < 0.001). Compared to the lowest baseline GGT category, age-gender adjusted odd ratios for FRS ≥ 20% were significantly increased from the lowest to highest GGT quartiles; these results remained significantly after adjustments for multiple confounders. Increased GGT concentration is associated with the increase in FRS. Serum GGT may be helpful to predict the future risk of CAD.     

Milk Consumption and Framingham Risk Score: Analysis of the Korea National Health and Nutrition Examination Survey Data (2008-2011)

Purpose

The benefit of milk intake remains controversial. The association between milk consumption and Framingham Risk Score (FRS) in a population consuming relatively low amounts of dairy products is undetermined.

Materials and Methods

A total of 13736 adults (5718 male and 8018 female) aged 20-80 years from the Korea National Health and Nutrition Examination Survey (2008-2011) were divided into groups according to milk consumption (rarely, monthly, weekly, and daily) and compared according to FRS after relevant variable adjustments.

Results

The mean FRS in males and females were 6.53 and 5.74, respectively. Males who consumed milk daily (15.9%) had a significantly lower FRS than males having milk rarely (31.6%) or monthly (17.4%; p=0.007). Females who consumed milk daily (22.3%) also had significantly lower FRS than rarely (29.8%), monthly (13.8%), or weekly (34%; p=0.001) consumers. In particular, males ≥60 years old who consumed milk daily had a significantly lower FRS than males who consumed less milk (p<0.001). The odds ratio in this age group showed a significant and gradual increase in the weekly [OR=2.15; 95% confidence interval (CI) 1.14-4.03], monthly (OR=2.29; 95% CI 1.15-4.54), and rarely (OR=3.79; 95% CI 2.01-7.14) milk consumption groups when compared with the daily milk consumption group.

Conclusion

Milk consumption was associated with a lower FRS in a low milk-consuming population. In particular, daily milk consumption in males over 60 years old may be beneficial for those at risk for cardiovascular disease.     

Impact of Framingham Risk Score,Flow-Mediated Dilation,Pulse Wave Velocity,and Biomarkers for Cardiovascular Events in Stable Angina

Although the age-adjusted Framingham risk score (AFRS), flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and free fatty acid (FFA) can predict future cardiovascular events (CVEs), a comparison of these risk assessments for patients with stable angina has not been reported. We enrolled 203 patients with stable angina who had been scheduled for coronary angiography (CAG). After CAG, 134 patients showed significant coronary artery disease. During 4.2 yr follow-up, 36 patients (18%) showed CVEs, including myocardial infarction, de-novo coronary artery revascularization, in-stent restenosis, stroke, and cardiovascular death. ROC analysis showed that AFRS, FMD, baPWV, and hsCRP could predict CVEs (with AUC values of 0.752, 0.707, 0.659, and 0.702, respectively, all P<0.001 except baPWV P=0.003). A Cox proportional hazard analysis showed that AFRS and FMD were independent predictors of CVEs (HR, 2.945; 95% CI, 1.572-5.522; P=0.001 and HR, 0.914; 95% CI, 0.826-0.989; P=0.008, respectively). However, there was no difference in predictive power between combining AFRS plus FMD and AFRS alone (AUC 0.752 vs. 0.763; z=1.358, P=0.175). In patients with stable angina, AFRS and FMD are independent predictors of CVEs. However, there is no additive value of FMD on the AFRS in predicting CVEs.

Graphical Abstract

相似文献   

Percent body fat is a better predictor of cardiovascular risk factors than body mass index

The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor.     

HIV and coronary artery calcium score: comparison of the Hawaii Aging with HIV Cardiovascular Study and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts

Objectives:

To determine the association of HIV, immunologic, and inflammatory factors on coronary artery calcium (CAC), a marker of subclinical atherosclerosis.

Methods:

Cross-sectional study comparing baseline data of males from Hawaii Aging with HIV – Cardiovascular Study (HAHCS) with the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The cohorts were pooled to determine effects of HIV on CAC and explore immunologic and inflammatory factors that may explain development of CAC in HIV. Multivariable regression models compared CAC prevalence in HAHCS with MESA adjusting for coronary heart disease (CHD) risk profiles.

Results:

We studied 100 men from HAHCS and 2733 men from MESA. Positive CAC was seen in 58% HAHCS participants and 57% MESA participants. Mean CAC was 260.8 in HAHCS and 306.5 in MESA. Using relative risk (RR) regression, HAHCS participants had a greater risk (RR?=?1.20, P?Discussion:

HIV was independently associated with a positive CAC in men with increased likelihood occurring between 45 and 50?years of age. Current HIV viral load, CD4 count, length of HIV, and inflammatory markers were unrelated to either presence or amount of CAC.     

Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks

Current guidelines recommend that coronary artery calcium (CAC) screening should only be used for intermediate risk groups (Framingham risk score [FRS] of 10%–20%). The CAC distributions and coronary artery disease (CAD) prevalence in various FRS strata were determined. The benefit to lower risk populations of CAC score-based screening was also assessed. In total, 1,854 participants (aged 40–79 years) without history of CAD, stroke, or diabetes were enrolled. CAC scores of > 0, ≥ 100, and ≥ 300 were present in 33.8%, 8.2%, and 2.9% of the participants, respectively. The CAC scores rose significantly as the FRS grew more severe (P < 0.01). The total CAD prevalence was 6.1%. The occult CAD prevalence in the FRS ≤ 5%, 6%–10%, 11%–20%, and > 20% strata were 3.4%, 6.7%, 9.0%, and 11.6% (P < 0.001). In multivariate logistic regression analysis adjusting, not only the intermediate and high risk groups but also the low risk (FRS 6%–10%) group had significantly increased odds ratio for occult CAD compared to the very low-risk (FRS ≤ 5%) group (1.89 [95% confidence interval, CI, 1.09–3.29] in FRS 6%–10%; 2.48 [95% CI, 1.47–4.20] in FRS 11%–20%; and 3.10 [95% CI, 1.75–5.47] in FRS > 20%; P < 0.05). In conclusion, the yield of screening for significant CAC and occult CAD is low in the very low risk population but it rises in low and intermediate risk populations.     

内蒙古牧区蒙古族体质指数与高血压及血脂相关

目的 了解内蒙古牧区蒙古族体质指数与高血压、血脂的关系.方法 对18岁以上951人蒙古族人群进行体质指数与高血压及血脂的关系进行调查分析.结果 蒙古族人群的超重与肥胖检出率男性大于女性(P＜0.01),高血压和血脂异常患病率随体质指数的增加而增大.超重与肥胖组人群高血压和血脂异常患病率显著高于正常组(P＜0.01).高血压和血脂异常患病率与体质指数呈正相关.结论 蒙古民族体质指数是高血压和血脂异常患者的危险因素.控制体质量可以有效的预防和减少慢性疾病的发生.     

LDL cholesterol in early pregnancy and offspring cardiovascular disease risk factors

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Short Report: Trend in menarcheal age in Spain: rural and urban comparison during a recent period

Menarcheal age of a sample of rural (n = 342) and urban (n = 469) girls with ages ranging from 9 to 16 years from Madrid province was analysed. Results, obtained through the status quo method and probit analysis (age 12.79 SD 1.04 in Madrid city and 12.90 SD 1.03 in rural sample), were compared with data from previous studies carried out in the same area, as well as those from other regions of the Iberian Peninsula. The aim of these comparisons was to establish the variability of menarche in the recent past, considering physical environment, degree of urbanization and socio-economic development. Decline in menarcheal age was detected and, in general, a tendency towards similar means among Spanish populations in the period studied.     

Hysterectomy prevalence and cardiovascular disease risk factors in American Indian women

OBJECTIVES: We investigated hysterectomy prevalence and associated demographic and reproductive factors among American Indian women. The association between hysterectomy and cardiovascular disease (CVD) risk factors was also examined. METHODS: Data were from 2689 American Indian women who participated in the first examination of the Strong Heart Study from 1989 to 1992. Odds ratios were estimated for factors related to hysterectomy adjusting for other covariates. The association between hysterectomy and CVD risk factors was examined among 1726 eligible women using analysis of covariance. RESULTS: Hysterectomy prevalence ranged from 24% to 34% across differing age groups and the percent with oophorectomy among those with a hysterectomy ranged from 43% to 63%. Geographic area, more prior pregnancy losses, more education, and less speaking of the native language were associated with increased hysterectomy prevalence. After adjustment for age, the women who had a hysterectomy with intact ovaries had higher total cholesterol and low-density lipoprotein cholesterol levels than those with a natural menopause. CONCLUSIONS: American Indian women have comparable hysterectomy prevalence as non-Hispanic white women. Education and native language speaking related to hysterectomy in this population. Hysterectomy alone may relate to unfavorable changes of lipid profile.     

A study on health and the association between overweight/obesity and otorhinolaryngological diseases in 6- to 17-year-old children from Wroclaw,Poland

IntroductionChildhood overweight and obesity have become a global problem in the past three decades. There are very few studies which examine the correlation between body mass index (BMI) and the development of otorhinolaryngological diseases in children. The objective of the study was to determine the association between overweight or obesity in children and the occurrence of otorhinolaryngological diseases.Material and methodsThe survey study was based on a parent-reported multidisciplinary questionnaire on children’s medical status among elementary and junior high school children in the city of Wroclaw, the capital city of Poland’s Lower Silesia region. The children were taking part in the pro-health campaign “Let’s Get the Kids Moving”.ResultsThe study was conducted among 2,913 children. A statistically significant correlation was observed between the assessment of the children’s BMI and the occurrence of adenoid hypertrophy. Adenoid hypertrophy was more common in the overweight and obese children. The children with adenoid hypertrophy had higher BMI than the children without adenoid hypertrophy. There was a statistically significant correlation between BMI and the incidence of adenoidectomy. There was a statistically significant correlation between BMI and the incidence of tonsillectomy.ConclusionsThe development and introduction of preventive programs like “Let’s Get the Kids Moving” in the future will contribute to building a healthier society. The study findings suggest that primal prevention may lead to a decrease in the development of otorhinolaryngological diseases. We also showed that higher body mass correlates with higher prevalence of otorhinolaryngological diseases. Further studies are needed to establish the etiopathology of this association.     

A systematic review and appraisal of methods of developing and validating lifestyle cardiovascular disease risk factors questionnaires

BackgroundWell developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires.Materials/methodsRelevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet.ResultsMethods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis.ConclusionCombination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.     

Heparin-binding EGF-like growth factor in human serum. Association with high blood cholesterol and heart hypertrophy

Heparin-binding epidermal growth factor-like growth factor (HB-EGF) belongs to the EGF family of growth factors which are ligands of the ErbB receptors. Studies in animals suggest the role of HB-EGF in several pathogenic processes such as atherosclerosis and heart hypertrophy. Here, we set up an assay to measure HB-EGF in human serum. Our ELISA determined serum HB-EGF in the range of 0.03–3 nM. It did not cross-react with EGF or with transforming growth factor-α. The mean serum HB-EGF was 0.26 nM (confidence interval: 0.13–0.39) in women and 0.28 nM (confidence interval: 0.09–0.47) in men. In a cohort of 121 healthy volunteers, we identified nine individuals with high serum HB-EGF (above 0.47 nM). These individuals had higher left ventricle mass (determined by Colour Doppler echocardiography) and greater total and low density lipoprotein cholesterol than control. On the basis of our results, we propose that increased serum HB-EGF is associated with heart hypertrophy and elevated blood cholesterol.     

Lipid accumulation product (LAP) is related to androgenicity and cardiovascular risk factors in postmenopausal women

Objectives

To investigate whether lipid accumulation product (LAP) is related to androgen and sex hormone binding globulin (SHBG) levels and to cardiovascular risk factors in postmenopausal women with no evidence of established cardiovascular disease.

Study design

Cross-sectional study.

Main outcome measures

LAP (waist-58 × triglycerides [nmol/L]), LAP ≥ arbitrary cutoff point of 34.5, serum testosterone, SHBG, ultrasensitive C-reactive protein (us-CRP).

Results

Forty-nine women (mean age 55 ± 5 years; median amenorrhea time 5.5 years [3–8]) were studied: 14% had the metabolic syndrome and 24.5% were hypertensive. Compared with LAP < 34.5, LAP ≥ 34.5 (n = 29, 59%) was associated with higher testosterone (p = 0.021) and free androgen index (FAI) (p = 0.003) and lower SHBG levels (p = 0.013). Us-CRP (p = 0.012), total cholesterol (p = 0.041), glucose (p = 0.020) and homeostasis model assessment (HOMA) (p = 0.019) were higher, and high-density lipoprotein cholesterol (HDL-C) (p = 0.001) was lower with LAP ≥ 34.5. LAP was positively correlated with total testosterone (r = 0.349, p = 0.014), FAI (rs = 0.470, p = 0.001), us-CRP (r = 0.315, p = 0.042), systolic (r = 0.318, p = 0.028) and diastolic (r = 0.327, p = 0.023) blood pressure, total cholesterol (r = 0.498, p < 0.001) and glucose (rs = 0.319, p = 0.026). LAP was negatively correlated with SHBG (rs = −0.430, p = 0.003) and HDL-C (r = −0.319, p = 0.026).

Conclusions

LAP index seems to be associated with androgens and SHBG and with cardiovascular risk factors in postmenopausal women. Also, LAP seems to be a suitable method to screen for cardiovascular risk in postmenopause.     

体质指数对超重与肥胖青少年血压的影响

目的探讨体质指数对超重与肥胖青少年高血压的影响。方法测量郴州市6所学校部分12～15岁青少年体重、身高、血压。结果 2566名在校学生血压偏高率为20.7%,其中血压偏高在非超重组、超重组和肥胖组检出率分别为19.15%、34.55%和39.29%,非超重组、超重组和肥胖组儿童血压偏高检出率组间差异有统计学意义（P〈0.05）。结论青少年血压偏高检出率随体质指数增加而明显增高。