Association of body mass index and abdominal adiposity with atherogenic lipid profile in Nigerians with type 2 diabetes and/or hypertension

Background:

We explored the relationship between anthropometric indices (obesity and abdominal adiposity) and the presence of an atherogenic lipid profile in Nigerians with major cardiovascular risk factors (type 2 diabetes mellitus-T2DM, hypertension-HBP, and concomitant disease).

Materials and Methods:

Using a prospective design, 278 patients with T2DM, HBP, or concomitant disease, attending out-patient diabetes and hypertension clinics at a tertiary institution in Nigeria were evaluated. All patients were cholesterol-lowering oral medication naοve. Demographic and clinical data and anthropometric measurements were documented. Fasting lipid profiles were measured in all cases. The cut-off points for defining dyslipidaemia were: Elevated total cholesterol (TC) (mg/dL) ≥200, elevated low-density lipoprotein cholestrol (LDL-C) (mg/dL) ≥100, low high-density lipoprotein cholesterol (HDL-C) (mg/dL) <40 for men and <50 for women, and high triglycerides (TG) (mg/dL) ≥150 mg/dL.

Results:

We found a significantly higher mean BMI (kg/m²) in the HBP group (30.5 ± 6.0) compared to T2DM (28.1 ± 5.9) and concomitant HBP and T2DM groups (29.4 ± 5.2) (ANOVA; P = 0.02). The most frequent dyslipidaemia was elevated LDL-C in 92 (96.8%) HBP, 73 (85.9%) T2DM and 79 (80.6%) concomitant disease. The frequency of low HDL-C was highest in T2DM (68.2%) compared to the other 2 groups (P = 0.03).

Conclusions:

Only TG levels were found to relate with any anthropometric index (waist circumference (WC) in this case) in Nigerians with major cardiovascular risk factors in this study. Routine anthropometric indices do not appear to be reliable surrogates for atherogenicity measured by abnormalities in TC, LDL-C and HDL-C.     

Obstructive Sleep Apnea Syndrome is Associated with Metabolic Syndrome among Adolescents and Youth in Beijing: Data from Beijing Child and Adolescent Metabolic Syndrome Study

Background:

Obstructive sleep apnea (OSA) syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome (MS).

Methods:

A total of 558 subjects aged 14–28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test (OGTT), echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire (BQ).

Results:

Among the subjects in obesity, 33.7% of whom were likely to have OSA by BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA (P < 0.001). Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA (P < 0.05). The rates of nonalcoholic fatty liver disease (71.0% vs. 24.2%), MS (38.9% vs. 7.0%), and its components in high-risk group were significantly higher than in low-risk group.

Conclusions:

The prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.     

Assessment of dyslipidemia in pre-dialysis patients in south-west Nigeria

Background:

Majority of chronic kidney disease (CKD) patients are more likely to die of cardiovascular complications before reaching end stage renal disease. The Kidney Disease Outcomes Quality Initiative (K/DOQI) recommends that all CKD patients should be evaluated for dyslipidemia and for treatment to reduce the risk of cardiovascular events.

Patients and Methods:

A cross-sectional case control study to determine the frequency of occurrence of lipid abnormalities in patients with CKD and compare these abnormalities with that of normal controls. A total of 100 patients and 100 controls were recruited for the study. Demographic and clinical data were obtained using structured questionnaire. Weight, height and waist circumference, body mass index (BMI) and blood pressure were also obtained. Subjects had their fasting lipid profile and fasting plasma glucose assayed after overnight fast of 8-14 hours. Low-density lipoprotein (LDL) was obtained using Friedwald formula.

Result:

The study revealed that total cholesterol (TC) was elevated above normal levels in 44% of cases compared with 6% in controls (P < 0.001), with the mean (SD) value of 5.82 ± 3.28 mmol/l for cases compared with 3.9 ± 1.0 mmol/l (P < 0.001) in controls. Low density lipoprotein was elevated in 48% of cases compared with 14% in controls (P < 0.001), with the mean (SD) values of 4.15 ± 2.74 mmol/l and 2.57 ± 0.95 mmol/l for cases and controls, respectively, (P < 0.001). Triglyceride (TG) was elevated above normal level in 26% of cases compared with none in the controls (P < 0.001), with the mean (SD) values of 1.41 ± 1.10 mmol/l and 0.64 ± 0.24 mmol/l for cases and controls, respectively (P < 0.001). All Lipid fractions except HDL also correlated significantly with levels of proteinuria TC (r = 0.345, P = 0.001), TG (r = 0.268, P = 0.011) LDL (r = 0.366, P = 0.001).

Conclusion:

Dyslipidemia is common among patients with CKD. Regular evaluation of all CKD patients for dyslipidemia and treatment need be instituted.     

Prevalence of the Metabolic Syndrome Among Employees in Northeast China

Background:The metabolic syndrome is a clustering of metabolic abnormalities and has been associated with increased risk of type 2 diabetes mellitus and cardiovascular disease.This study aimed to estim...     

Cardiovascular disease risk factors among HIV-infected Nigerians receiving highly active antiretroviral therapy

Background:

Highly active antiretroviral therapy (HAART) has become more accessible to Human immunodeficiency virus infection/Acquired Immunodeficiency Syndrome (HIV/AIDS) patients worldwide. There is growing concern that the metabolic complications associated with HIV and HAART may increase cardiovascular risk and lead to cardiovascular diseases. We, therefore, set out to describe the cardiovascular risk profile of HIV/AIDS patients receiving HAART at a health facility in northern part of Nigeria.

Materials and Methods:

This cross-sectional study was conducted at the Aminu Kano Teaching Hospital, Kano, Nigeria. Consenting patients, who had been receiving HAART, were compared with age and sex matched HAART-naive subjects. Questionnaire interview, electrocardiography, anthropometric and blood pressure measurements were conducted under standard conditions. Blood samples were obtained for the determination of plasma glucose, uric acid and lipid levels.

Results:

Two hundred subjects were studied, 100 were on HAART (group 1) and the other 100 (group 2) were HAART-naive. Subjects’ mean age for all the participants was 32.5 (7.6) years. The prevalence of hypertension was 17% in group 1 and 2% in group 2 (P < 0.001). Similarly, 11% and 21% of group 1 subjects were obese or had metabolic syndrome compared with 2% and 9% of group 2 patients (P < 0.05 for both).

Conclusion:

HAART treatment was associated with significantly higher prevalences of hypertension, obesity and metabolic syndrome.     

A cohort study to evaluate cardiovascular risk of selective and nonselective cyclooxygenase inhibitors (COX-Is) in arthritic patients attending orthopedic department of a tertiary care hospital

Background:

Cyclooxygenase-2 inhibitors (COX-2-Is) have recently been concerned in the occurrence of adverse cardiovascular (CV) events. Rofecoxib and valdecoxib has been withdrawn from the market, but celecoxib, etoricoxib and parecoxib continues to be used. Other nonsteroidal anti-inflammatory drugs (NSAIDs) may also increase the risk of CV events. However, clinical trial databases for COX-2-Is had created lots of controversies regarding cardiovascular safety of selective and nonselective cyclooxygenase inhibitors (COX-Is). This study was, conducted to assess and compare the CV risk of COX-Is in arthritic patients over a period of time.

Materials and Methods:

In this prospective cohort study adult arthritics of either sex those were freshly diagnosed or taking COX-Is for < 3 months; were included. Patients were grouped into nonselective and selective COX-2-I groups with reference to treatment they received. The CV risk factors like blood pressure (BP), blood sugar level (BSL), lipid profile, body mass index (BMI) were assessed and compared; demography of CV risk factors was also studied. Data obtained was analysed using Student''s ‘t’-test of OpenEpi statistical software.

Results:

Study clearly revealed that all NSAIDs exhibit variable CV risk; however, selective COX-2-Is found to exhibit more CV risk. BMI, BP and lipid profile; the potential CV risk factors, showed significant impairment in selective COX-2-Is group; P < 0.01, P < 0.001 and P < 0.05, respectively, compared to baseline and P < 0.05 vs. nonselective COX-Is for BMI.

Conclusions:

This study portrays the potential CV risk of selective COX-2-Is; confirms and re-evaluate the results of earlier studies in this regard.     

Prevalence of hypertension among the elderly Malays living in rural Malaysia

Background

We are living in an ageing world. The prevalence of hypertension which is an established risk factor for cardiovascular disease and stroke increases with age. The aim of the study was to determine the prevalence of hypertension among the elderly Malays living in rural parts of north Malaysia.

Method

This cross-sectional study was conducted among the elderly (aged ≥60) Malay residents living in 22 villages in a northwestern state called Kedah in Malaysia from 2007 to 2009. Kedah has one of the highest rates of elderly population in the country. Data was collected by trained research assistants. Besides the baseline demographic information, blood pressure was measured using standardised methods using a manual sphygmomanometer.

Results

The response rate was 97.7%. The prevalence of hypertension among the elderly in these villages was 54.5% (228), 118 (28.2%) were known to be hypertensive and were on medication and an additional 110 (26.3%) respondents were newly diagnosed. Elevated mean systolic (146.17 ± 25.23) and diastolic (89.68 ± 15.60) blood pressure was noted among the known hypertensive. There was an almost fourfold risk (OR 3.64) of having uncontrolled blood pressure among the known hypertensive on treatment. Those with malnutrition were at an almost twofold at risk of being hypertensive (OR 1.73). Binary logistics regression showed occupation (OR 1.65), marital status (OR 2.32) and body mass index (BMI) (OR 1.62) as significant predictor variables.

Conclusion

Screening the elderly for hypertension will benefit this group of people by reducing the morbidity and mortality associated with this condition     

Assessment of Snoring and obstructive sleep apnoea in a Nigerian university: Association with cardiovascular risk factors

Background:

Snoring remains under diagnosed in general population. It however has significant morbidity and mortality risk factors with multiple effects on the cardiovascular system. The Berlin questionnaire is a worldwide validated instrument to identify those at increased risk for obstructive sleep apnoea (OSA).

Materials and Methods:

In all, 206 workers of LAUTECH were invited to participate in the study. The Berlin questionnaire was used for this study. It was a cross-sectional study. Socio-demographic and clinical data were taken with a data form. Statistical Package for the Social Sciences software (SPSS 17.0) was used for statistical analysis. P < 0.05 was taken as statistically significant value.

Results:

The study participants consisted of 96 males (46.6%) and 110 (53.4%) females. The mean age was 45.3 ± 7.9 years. The mean body mass index was 28.5 ± 6.0 kg/m². The frequency of occurrence of snoring was 91 (44.2%) including 50 males (54.9% and 41 females (37.3 %, P <0.05). Using the Berlin score, 63 (30.6%) including 34 females (30.9%) were assessed to be at high risk for OSA. Snorers were more likely to be at higher risk of OSA compared to non snorers: odd risk was 113.8, relative risk was 3.3. Snoring was most likely to be associated with obesity, elevated blood pressure and male gender in this study.

Conclusion:

We concluded that snoring and high risk for sleep apnoea is common among this unselected University population and they are closely related to many conventional cardiovascular risk factors. Appropriate interventional strategies are indicated to reduce the burden of the increased morbidity and mortality associated with sleep apnoea in our population.     

Assessment of some cardiovascular risk factors in predialysis chronic kidney disease patients in Southern Nigeria

Background:

Cardiovascular risk factors are responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD) to end-stage renal disease. Prompt evaluation, modification, and treatment of these factors in predialysis patients will reduce morbidity and mortality. This study assessed some cardiovascular risk factors in predialysis CKD patients in a tertiary hospital in Southern Nigeria.

Patients and Methods:

This was a case–control study that involved 76 consecutive predialysis CKD patients and 38 age-and sex-matched controls without CKD over 1 year period. Both groups were assessed for cardiovascular risk factors, and comparisons were made. A P value of <0.05 was taken as significant.

Results:

The mean ages of the CKD versus control group were 48.00 ± 15.28 versus 45.34 ± 15.35 years. The male:female ratio was 1.7:1 for both groups. The common etiologies of CKD in this study were hypertension 30 (39.5%), diabetes mellitus 23 (30.3%), and chronic glomerulonephritis 19 (25%). There were 38 (50%) in CKD stage 3, 31 (40.8%) in CKD stage 4, and 7 (9.2%) in CKD stage 5. The common cardiovascular risk factors found in the CKD versus control were hypertension (96.1% vs. 42.1%), anemia (96.1% vs. 23.7%), left ventricular hypertrophy (77.6% vs. 23.7%), dyslipidemia (67.1% vs. 39.5%), hypocalcemia (60.1% vs. 18.5%), hyperphosphatemia (63.2% vs. 0%), and hyperuricemia (57.9% vs. 15.8%). These risk factors were significantly higher in CKD group. Hyperphosphatemia and hypoalbuminemia significantly increased across CKD stages 3–5. Anemia was significantly more common in males whereas dyslipidemia was more common in female CKD patients.

Conclusion:

Cardiovascular risk factors were highly prevalent in predialysis CKD subjects even in early stages. Hypoalbuminemia and hyperphosphatemia significantly increased across the CKD stages 3–5 whereas anemia and dyslipidemia showed significant gender differences. Cardiovascular risk factors should be treated early in predialysis CKD patients.     

Prevalence of obesity and its associated risk factors among Chinese adults in a Malaysian suburban village

INTRODUCTION

Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village.

METHODS

This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires.

RESULTS

Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253–0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215–0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225–6.011; p < 0.05).

CONCLUSION

The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population.     

Knowledge of heart disease risk factors among workers in a Nigerian University: A call for concern

Introduction:

Cardiovascular disease is the commonest cause of mortality worldwide. Many risk factors predate the development of cardiovascular diseases. Adequate knowledge of risk factors for cardiovascular diseases is the first step towards effective preventive strategies to combat the cardiovascular diseases burden in any population. This study aims to determine the knowledge of workers in a Nigerian University on risk factors for cardiovascular diseases.

Materials and Methods:

A cross-sectional survey of 206 academic and non-academic staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria using the Heart Disease Fact Questionnaire (HDFQ). Demographic data were taken. The lipid profile and random blood sugar were taken. Statistical analysis was done using SPSS 17.0.

Results:

The mean age of the study participants was 45.3 ± 7.9 years. There were 96 males (46.6%). The mean HDFQ score was 48.6%. Only 41 (19.9%) of participants were assessed to have good knowledge of heart disease risk factors. Majority, 101 (49.0%) had poor knowledge while 64 (31.2%) had fair knowledge of heart disease risk factors. There was no significant difference between prevalence of CV risk factors between those with good or fair or low level of knowledge. Most participants did not have a good level of knowledge about risk factors, prevention, treatment and association with diabetes as it relates to heart diseases.

Conclusion:

Knowledge of heart disease risk factors is low among University workers in Nigeria. Effective education on heart disease risk factors and appropriate preventive strategies are indeed important to reduce cardiovascular disease burden in Nigerian University communities.     

Hypertensive disorders in pregnancy among pregnant women in a Nigerian Teaching Hospital

Background:

Hypertensive disorders in pregnancy (HDP) represent a group of conditions associated with high blood pressure during pregnancy. It is an important cause of feto-maternal morbidity and mortality, particularly in developing countries. The aims of the study were to find the prevalence of hypertensive disorders and its associated risk factors among women attending the antenatal clinic of Usmanu Danfodiyo University Teaching Hospital,(UDUTH) Sokoto.

Materials and Methods:

A longitudinal study of 216 consecutively recruited women that were less than 20 weeks pregnant at booking was carried out. Blood pressure was measured for each woman at booking and at subsequent visits. Urinalysis was done at booking and whenever blood pressure was elevated. Patients were followed-up to delivery and 6 weeks postpartum. Data entry and analysis was done using Statistical Analysis System (SAS) statistical package.

Results:

The prevalence of HDP in the study was 17% while preeclampsia was 6%. Previous history of preeclampsia (P < 0.001; Relative risk (RR) 4.2; conficence interval (CI) 2.144-6.812), multiple gestation (P < 0.03; RR 3.8; CI 1.037-6.235), gestational diabetes (P < 0.02; RR 4.8; CI 1.910-6.751) and obesity (P < 0.002; RR 2.7; CI 1.373-5.511) were the significant risk factors in the development of HDP among the study population.

Conclusion:

The prevalence of HDP in the study group is high. Therefore, paying attention to the risk factors will ensure early detection and prevention of the progression of the disease and its sequelae.     

Relationship of blood pressure with some cardiovascular disease risk factors in a rural population of Plateau State,North Central Nigeria

Background:

Hypertension is associated with certain cardiovascular disease (CVD) risk factors which vary from one place to the other depending on community sophistication. We decided to obtain the situation as it affects this rural Nigerian community to be in an evidence-based position to initiate individual and group prevention strategies.

Design:

Cross-sectional population survey.

Materials and Methods:

We surveyed for CVD risk factors among subjects 15 years and above in this rural community using a questionnaire requesting personal, medical and anthropometric information. One in three of them were randomly assigned to laboratory investigations.

Results:

Of the 840 subjects studied, 25% were males. The population mean age was 45.5 (18.2) standard deviation (SD), with 1.8% smokers and 4.1% using alcohol. Systolic blood pressure (SBP) correlated with age, body mass index (BMI), total cholesterol (TC) and uric acid (UA); while diastolic blood pressure (DBP) correlated with age, BMI, TC, UA and atherogenic index (AI). SBP and DBP improved with exercise but not salt intake. The local seasonings used in cooking had no impact on blood pressure.

Conclusion:

To reduce cardiovascular morbidity in this and probably other rural sub-Saharan African communities, BMI, TC, UA and salt intake in diet should be targeted for reduction. Physical activity should be encouraged. Interestingly, these fall into the sphere of healthy lifestyle which should be encouraged and re-inforced.     

Primary non-alcoholic fatty liver disease in hypertensive patients

Background

Non-alcoholic fatty liver disease (NAFLD) is considered the most common liver disease affecting 15–25% of the general population.

Aims

The aim of this study was to investigate the prevalence of NAFLD and the relationship between insulin sensitivity and NAFLD in grade III high and very high cardiovascular additional risk essential hypertensive patients according to the circadian blood pressure (BP) rhythm.

Method

This four-year prospective study was conducted at the Department of Internal Medicine at Cluj-Napoca’s Diagnosis and Treatment Centre in Romania. The study included grade III essential hypertensive patients. Hypertensive patients were divided into four groups according to the diurnal index (DI) from ABPM monitoring: dipper (D), non-dipper (ND), reverse-dipper (RD), and extreme-dipper (ED). All hypertensive patients underwent 24 ABPM, blood tests and abdominal ultrasonography for the diagnosis of fatty liver disease.

Results

Thirty-five hypertensive patients were included in the study, with 31.42% ND, 11.43% RD, 8.57% ED and 48.57% D. The prevalence of NAFLD was significantly higher in ND, RD and ED when compared to D. When compared to the dipper group of hypertensive patients a statistically significantly higher level of plasma insulin was observed: in non-dipper [86.3±17.9pmol/l vs. 62.2±203pmol/l, p<0.05], in reverse dipper [88.3±18.6pmol/l vs. 62.2±20.3pmol/l] and in extreme-dippers [86.7±16.88pmol/l vs. 62.2±20.3 pmol/l, p<0.05].

Conclusion

The altered dipping status (ND, RD, ED) of hypertension associated with a higher insulin resistance could be the pathogenetic link between the NAFLD and altered blood pressure status. Altered BP status could be a marker of NAFLD in hypertensive patients.     

Sonographic assessment of the carotid intima-media thickness on B-mode ultrasonography in a Nigerian population

Background:

Hypertension is a common health problem and a major risk factor of cardiovascular disease. The most important mechanism by which hypertension acts as a cardiovascular risk factor is the induction of arteriosclerosis. The early phase of atherosclerosis before its clinical manifestation can be studied using B-mode ultrasonography.

Aims and Objectives:

This study evaluated the intima-media thickness of the common carotid artery (CCA), carotid intima-media thickness (CIMT) of subjects with essential hypertension as a way of detecting these early changes of atherosclerosis.

Subjects and Methods:

The study was performed on 200 subjects with newly diagnosed hypertension and 100 apparently normal controls that were consecutively recruited by a cardiologist. An ultrasound examination of both CCA were done to obtain the CIMT. Data were analyzed using the SPSS data analysis software.

Results:

The CIMT of males were greater in the hypertensive group compared to the controls (0.10 ± 0.02 cm vs. 0.077 ± 0.02 cm [P < 0.0001] and 0.10 ± 0.02 cm vs. 0.078 ± 0.02 cm [P < 0.0001] for the right and left sides, respectively). The female group showed a similar pattern of results (0.09 ± 0.02 cm vs. 0.072 ± 0.02 cm [P < 0.0001] and 0.1 ± 0.02 cm vs. 0.076 ± 0.02 cm [P < 0.0001] for the right and left sides respectively).

Conclusion:

A statistically significant increase in CIMT was noted in both male and female hypertensives in comparison to a normal population.     

Prevalence and predictors of obstructive sleep apnea syndrome in a sample of patients with type 2 Diabetes Mellitus in Nigeria

Introduction:

Obstructive sleep apnea (OSA) and Diabetes Mellitus (DM) are growing health challenges worldwide. However, the relation of OSA with type 2 diabetes is not well understood in developing countries. This study described the prevalence and predictors of OSA in type 2 DM patients using a screening questionnaire.

Materials and Methods:

Patients aged 40years and above with type 2 diabetes mellitus were recruited into the study consecutively from the outpatient clinics of a university hospital. They were all administered the Berlin questionnaire and the Epworth sleepiness scale (ESS) to assess the risk of OSA and the tendency to doze off, respectively. Anthropometric details like height, weight and body mass index (BMI) were measured and short-term glycaemic control was determined using fasting blood glucose.

Results:

A total of 117 patients with type 2 diabetes mellitus were recruited into the study. The mean (SD) age, height and BMI was 63 years (11), 160 cm (9) and 27.5 kg/ m² (5.7), respectively. Twenty-seven percent of the respondents had a high risk for OSA and 22% had excessive daytime sleepiness denoted by ESS score above 10. In addition, the regression model showed that for every 1 cm increase in neck circumference, there is a 56% independent increase in the likelihood of high risk of OSA after adjusting for age, sex, BMI, waist, hip circumferences and blood glucose.

Conclusion:

Our study shows a substantial proportion of patients with type 2 diabetes may have OSA, the key predictor being neck circumference after controlling for obesity.     

Intestinal Microbiota Metabolism and Atherosclerosis

Objective:

This review aimed to summarize the relationship between intestinal microbiota metabolism and cardiovascular disease (CVD) and to propose a novel CVD therapeutic target.

Data Sources:

This study was based on data obtained from PubMed and EMBASE up to June 30, 2015. Articles were selected using the following search terms: “Intestinal microbiota”, “trimethylamine N-oxide (TMAO)”, “trimethylamine (TMA)”, “cardiovascular”, and “atherosclerosis”.

Study Selection:

Studies were eligible if they present information on intestinal microbiota metabolism and atherosclerosis. Studies on TMA-containing nutrients were also included.

Results:

A new CVD risk factor, TMAO, was recently identified. It has been observed that several TMA-containing compounds may be catabolized by specific intestinal microbiota, resulting in TMA release. TMA is subsequently converted to TMAO in the liver. Several preliminary studies have linked TMAO to CVD, particularly atherosclerosis; however, the details of this relationship remain unclear.

Conclusions:

Intestinal microbiota metabolism is associated with atherosclerosis and may represent a promising therapeutic target with respect to CVD management.     

Knowledge and attitudes towards obesity among primary school children in Dar es Salaam,Tanzania

Background:

Childhood obesity has increased over the past two decades. Child obesity is likely to persist through adulthood and increases the risk of non-communicable diseases (NCDs) later in life. This study assessed knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania.

Materials and Methods:

A cross-sectional study was conducted in randomly selected primary schools in Dar es Salaam. A structured questionnaire was used to assess the knowledge and attitudes. Anthropometric and blood pressure measurements were taken using standard procedures.

Results:

A total of 446 children were included in the analysis. The mean age of the participants was 11.1 ± 2.0 years. The mean body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 16.6 ± 4.0 kg/m², 103.9 ± 10.3 mmHg and 65.6 ± 8.2 mmHg, respectively. Prevalence of obesity (defined as BMI >95^th percentile for age and sex) was 5.2%. Half of the children (51.1%) had heard about obesity from teachers at school (20%), radio (19.4%) and books/newspaper (17.3%). Less than half (45.4%) had knowledge about the risk factors for childhood obesity and correctly defined obesity (44.6%). However, a good number of the children (72.1%) were aware that they can be affected by obesity. Majority of them had negative attitude towards obesity and various factors leading to or resulting from childhood obesity.

Conclusions:

Knowledge about childhood obesity among primary school children is moderate and have negative attitude towards obesity. Integrating educational programs early in primary schools may be an effective strategy to impact knowledge about obesity and other non-communicable diseases early in childhood.     

Effects of Continuous Positive Airway Pressure on Cognitive Deficits in Middle-aged Patients with Obstructive Sleep Apnea Syndrome: A Meta-analysis of Randomized Controlled Trials

Background:

Current views on continuous positive airway pressure (CPAP) treatment to improve the cognitive deficits of patients with obstructive sleep apnea syndrome (OSAS) are controversial, so we performed a meta-analysis.

Methods:

A comprehensive literature search was undertaken in PubMed, CINAHL, Medline, PsycInfo, EMBASE, Cochrane Library, CNKI, WanFang, VIP, and CBMdisc for studies published from June 1971 to July 2014. The outcome measures included neuropsychological tests of the 7 cognitive domains detailed below.

Results:

After screening the titles and abstracts and thoroughly reading the full text, we obtained 13 studies with little risk of bias that incorporated 1744 middle-aged obese participants with mild to severe OSAS. The studies were published from 1994 to 2012. Treatment durations varied from 1 to 24 weeks. The effect sizes of attention, vigilance, processing speed, working memory, memory, verbal fluency, and visuoconstructive skills domains were −0.10 (P = 0.24), −0.12 (P = 0.04), −0.08 (P = 0.16), 0.00 (P = 0.95), −0.04 (P = 0.30), −0.06 (P = 0.34), and −0.01 (P = 0.92), respectively.

Conclusions:

Cognition partially improved in patients with OSAS after CPAP treatment. The only domain with significant improvement was vigilance. Rigorous randomized controlled trials need to be performed to obtain clear results.     

Effect of interval training program on white blood cell count in the management of hypertension: A randomized controlled study

Objective:

Elevated white blood cell (WBC) count is considered to be prospectively and positively associated with cardiovascular diseases, particularly hypertension. Also, the positive role of exercise in the management of hypertension has been well and long established. However the relationship between WBC count and hypertensive management particularly in the nonpharmacological technique is ambiguous and unclear. Therefore the purpose of the present study was to determine the effect of interval training program on WBC count and cardiovascular parameters in male hypertensive patients.

Materials and Methods:

A total of 245 male patients with mild to moderate (systolic blood pressure (SBP) between 140 mmHg and 179 mmHg and diastolic blood pressure (DBP) between 90 mmHg and 109 mmHg) essential hypertension were age matched and grouped into experimental and control groups. The experimental (n=140; 58.90±7.35 years) group involved in an 8-week interval training (60-79% HR max reserve) program of between 45 minutes to 60 minutes, while the age-matched controls hypertensive (n=105; 58.27±6.24 years) group remain sedentary during this period. Cardiovascular parameters (SBP, DBP, and VO₂ max) and WBC count were assessed. Student''s t and Pearson correlation tests were used in data analysis.

Results:

Findings of the study revealed a significant effect of the interval training program on VO2max, SBP, and DBP and WBC count at P<0.05 and VO2max is negatively related to the WBC count (r=–0.339) at P<0.01.

Conclusions:

It was concluded that the interval training program is an effective adjunct nonpharmacological management of hypertension and the therapeutic effect of exercise programs may be mediated through suppression of inflammatory (WBC count) reaction.