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Viswanathan Mohan - One of the best experts on this subject based on the ideXlab platform.
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convergence of prevalence rates of diabetes and cardiometabolic risk factors in middle and low income groups in urban india 10 year follow up of the chennai urban Population Study
Journal of diabetes science and technology, 2011Co-Authors: Mohan Deepa, Ranjit Mohan Anjana, Datta Manjula, K Venkat M Narayan, Viswanathan MohanAbstract:Aim: The aim of this Study was to look for temporal changes in the prevalence of diabetes and cardiometabolic risk factors in two residential colonies in Chennai. Methods: Chennai Urban Population Study (CUPS) was carried out between 1996–1998 in Chennai in two residential colonies representing the middle income group (MIG) and lower income group (LIG), respectively. The MIG had twice the prevalence rate of diabetes as the LIG and higher prevalence rates of hypertension, obesity, and dyslipidemia. They were motivated to increase their physical activity, which led to the building of a park. The LIG was given standard lifestyle advice. Follow-up surveys of both colonies were performed after a period of 10 years. Results: In the MIG, the prevalence of diabetes increased from 12.4 to 15.4% (24% increase), while in the LIG, it increased from 6.5 to 15.3% (135% increase, p < .001). In the LIG, the prevalence rates of central obesity (baseline vs follow-up, male: 30.8 vs 50.9%, p < .001; female: 16.9 vs 49.8%, p < .001), hypertension (8.4 vs 20.1%, p < .001), hypercholesterolemia (14.2 vs. 20.4%, p < .05), and hypertriglyceridemia (8.0 vs 23.5%, p < .001) significantly increased and became similar to that seen in the MIG. Conclusion:
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comparison of carotid intima media thickness arterial stiffness and brachial artery flow mediated dilatation in diabetic and nondiabetic subjects the chennai urban Population Study cups 9
American Journal of Cardiology, 2002Co-Authors: R Ravikumar, R Deepa, C S Shanthirani, Viswanathan MohanAbstract:Abstract This Study compares flow-mediated dilation (FMD) and the augmentation index (AI) in diabetic and nondiabetic subjects and correlates these measurements with carotid intima-media thickness (IMT). Fifty diabetic subjects and 50 age- and sex-matched nondiabetic control subjects were recruited from the Chennai Urban Population Study. IMT of the common carotid artery and FMD of the brachial artery were determined using high-resolution B-mode ultrasonography. AI was measured using the Sphygmocor apparatus. The mean AI of diabetic subjects was significantly higher than the nondiabetic subjects (27.48 ± 7.41% vs 19.10 ± 8.19%, p
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comparison of carotid intima media thickness arterial stiffness and brachial artery flow mediated dilatation in diabetic and nondiabetic subjects the chennai urban Population Study cups 9
American Journal of Cardiology, 2002Co-Authors: R Ravikumar, R Deepa, C S Shanthirani, Viswanathan MohanAbstract:This Study compares flow-mediated dilation (FMD) and the augmentation index (AI) in diabetic and nondiabetic subjects and correlates these measurements with carotid intima-media thickness (IMT). Fifty diabetic subjects and 50 age- and sex-matched nondiabetic control subjects were recruited from the Chennai Urban Population Study. IMT of the common carotid artery and FMD of the brachial artery were determined using high-resolution B-mode ultrasonography. AI was measured using the Sphygmocor apparatus. The mean AI of diabetic subjects was significantly higher than the nondiabetic subjects (27.48 +/- 7.41% vs 19.10 +/- 8.19%, p <0.0001). The FMD values were significantly lower among diabetic subjects compared with the nondiabetic subjects (2.1 +/- 2.95% vs 6.64 +/- 4.38%, p <0.0001). At any given age point, diabetic subjects had significantly higher AI and lower FMD values compared with nondiabetic subjects (p <0.05). In the total Population, AI and FMD showed a correlation with age (p <0.001), fasting plasma glucose (p <0.01), glycosylated hemoglobin (p = 0.001), and IMT (p = 0.001). Among the nondiabetic subjects, FMD and AI showed a strong correlation with IMT. FMD also showed a strong correlation with age and systolic blood pressure, whereas AI showed a correlation with fasting plasma glucose in diabetic subjects. AI and FMD values showed a strong correlation with age. AI values increased and FMD values decreased with an increase in quartiles of IMT both in diabetic and nondiabetic subjects. Multivariate linear regression analyses in the total Study Population showed that age and glycosylated hemoglobin were the risk factors associated with AI and FMD, in addition to diastolic blood pressure with AI. Diabetic patients have decreased FMD and increased arterial stiffness compared with age- and sex-matched nondiabetic subjects. These functional changes correlate well with the structural changes of the arteries measured by IMT.
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prevalence of coronary artery disease and its relationship to lipids in a selected Population in south india the chennai urban Population Study cups no 5
Journal of the American College of Cardiology, 2001Co-Authors: Viswanathan Mohan, R Deepa, Subramaniam Shanthi Rani, G PremalathaAbstract:Abstract OBJECTIVES The aim of this Study was to assess the prevalence and risk factors for coronary artery disease (CAD) in a native urban South Indian Population. BACKGROUND High prevalence rates of premature CAD have been reported in migrant Asian Indians. There are very few studies on CAD in native Indians living in the Indian subcontinent. METHODS The Chennai Urban Population Study (CUPS) is an epidemiological Study involving two residential areas in Chennai in South India. Of the total of 1,399 eligible subjects (age ≥20 years), 1,262 (90.2%) participated in the Study. All the Study subjects underwent a glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes. Twelve-lead electrocardiogram (ECG) was performed in 1,175 individuals (84%). Coronary artery disease was diagnosed based on previous medical history or Minnesota coding of ECGs. RESULTS The overall prevalence rate of CAD is 11.0% (age standardized, 9.0%). The prevalence rates of CAD were 9.1%, 14.9% and 21.4% in those with NGT, IGT and diabetes, respectively. Prevalence of CAD increased with an increase in total cholesterol (trend chi-square: 26.2, p CONCLUSIONS The prevalence of CAD is rising rapidly in urban India. Lifestyle changes and aggressive control of risk factors are urgently needed to reverse this trend.
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intra urban differences in the prevalence of the metabolic syndrome in southern india the chennai urban Population Study cups no 4
Diabetic Medicine, 2001Co-Authors: Viswanathan Mohan, R Deepa, G Premalatha, S Shanthirani, N G Sastry, R SarojaAbstract:SUMMARY Aims To assess the influence of socioeconomic status on the prevalence of the metabolic syndrome in an urban south Indian Population in Chennai. Methods The Chennai Urban Population Study is an epidemiological Study involving two residential colonies in Chennai (formerly Madras) in south India representing the middle and lower income groups. All individuals ≥ 20 years of age living in the colonies were invited to participate in the Study. Of the total 1399 eligible subjects, 1262 individuals (479 belonging the middle income group colony and 783 from the low income group colony) participated in the Study. The overall response rate was 90.2%. The main outcome measures were the prevalence rates of the various components of the metabolic syndrome. Results There were significant differences in the socioeconomic status and lifestyle of the inhabitants of the two areas. The mean monthly income of the Tirumangalam (middle income) group (Rs8075 ± 3859) was significantly higher than the T. Nagar (low income) group (Rs1399 ± 916). The dietary profile of the middle income group showed higher intake of calories, fat and sugar compared to low income group (P < 0.001). The age-standardized prevalence rates of the various components of the metabolic syndrome were significantly higher in the middle compared to the low income group – diabetes (12.4 vs. 6.5%), impaired glucose tolerance (7.5 vs. 2.9%), hypertension (14.9 vs. 8.4%), obesity (males 38 vs. 13.4%, females 33.1 vs. 24.2%), hypercholesterolaemia (24.2 vs. 14.2%) and hyperinsulinaemia (16.7 vs. 6.6%) P < 0.001). Although the prevalence of coronary artery disease and hypertriglyceridaemia were higher in the middle income group, the differences did not reach statistical significance. The relative odds ratio for diabetes and impaired glucose tolerance increased significantly with increase in income while hypercholesterolaemia, hypertriglyceridaemia, hypertension and coronary artery disease showed no significant changes. Logistic regression analysis revealed that geographical area (higher social class) had a strong association with the components of the metabolic syndrome even after inclusion of other risk factors like age and body mass index in the model. Conclusions Significant differences exist in the prevalence of various components of the metabolic syndrome even within an urban environment and this appears to be influenced by socioeconomic status.
R Deepa - One of the best experts on this subject based on the ideXlab platform.
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comparison of carotid intima media thickness arterial stiffness and brachial artery flow mediated dilatation in diabetic and nondiabetic subjects the chennai urban Population Study cups 9
American Journal of Cardiology, 2002Co-Authors: R Ravikumar, R Deepa, C S Shanthirani, Viswanathan MohanAbstract:Abstract This Study compares flow-mediated dilation (FMD) and the augmentation index (AI) in diabetic and nondiabetic subjects and correlates these measurements with carotid intima-media thickness (IMT). Fifty diabetic subjects and 50 age- and sex-matched nondiabetic control subjects were recruited from the Chennai Urban Population Study. IMT of the common carotid artery and FMD of the brachial artery were determined using high-resolution B-mode ultrasonography. AI was measured using the Sphygmocor apparatus. The mean AI of diabetic subjects was significantly higher than the nondiabetic subjects (27.48 ± 7.41% vs 19.10 ± 8.19%, p
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comparison of carotid intima media thickness arterial stiffness and brachial artery flow mediated dilatation in diabetic and nondiabetic subjects the chennai urban Population Study cups 9
American Journal of Cardiology, 2002Co-Authors: R Ravikumar, R Deepa, C S Shanthirani, Viswanathan MohanAbstract:This Study compares flow-mediated dilation (FMD) and the augmentation index (AI) in diabetic and nondiabetic subjects and correlates these measurements with carotid intima-media thickness (IMT). Fifty diabetic subjects and 50 age- and sex-matched nondiabetic control subjects were recruited from the Chennai Urban Population Study. IMT of the common carotid artery and FMD of the brachial artery were determined using high-resolution B-mode ultrasonography. AI was measured using the Sphygmocor apparatus. The mean AI of diabetic subjects was significantly higher than the nondiabetic subjects (27.48 +/- 7.41% vs 19.10 +/- 8.19%, p <0.0001). The FMD values were significantly lower among diabetic subjects compared with the nondiabetic subjects (2.1 +/- 2.95% vs 6.64 +/- 4.38%, p <0.0001). At any given age point, diabetic subjects had significantly higher AI and lower FMD values compared with nondiabetic subjects (p <0.05). In the total Population, AI and FMD showed a correlation with age (p <0.001), fasting plasma glucose (p <0.01), glycosylated hemoglobin (p = 0.001), and IMT (p = 0.001). Among the nondiabetic subjects, FMD and AI showed a strong correlation with IMT. FMD also showed a strong correlation with age and systolic blood pressure, whereas AI showed a correlation with fasting plasma glucose in diabetic subjects. AI and FMD values showed a strong correlation with age. AI values increased and FMD values decreased with an increase in quartiles of IMT both in diabetic and nondiabetic subjects. Multivariate linear regression analyses in the total Study Population showed that age and glycosylated hemoglobin were the risk factors associated with AI and FMD, in addition to diastolic blood pressure with AI. Diabetic patients have decreased FMD and increased arterial stiffness compared with age- and sex-matched nondiabetic subjects. These functional changes correlate well with the structural changes of the arteries measured by IMT.
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prevalence of coronary artery disease and its relationship to lipids in a selected Population in south india the chennai urban Population Study cups no 5
Journal of the American College of Cardiology, 2001Co-Authors: Viswanathan Mohan, R Deepa, Subramaniam Shanthi Rani, G PremalathaAbstract:Abstract OBJECTIVES The aim of this Study was to assess the prevalence and risk factors for coronary artery disease (CAD) in a native urban South Indian Population. BACKGROUND High prevalence rates of premature CAD have been reported in migrant Asian Indians. There are very few studies on CAD in native Indians living in the Indian subcontinent. METHODS The Chennai Urban Population Study (CUPS) is an epidemiological Study involving two residential areas in Chennai in South India. Of the total of 1,399 eligible subjects (age ≥20 years), 1,262 (90.2%) participated in the Study. All the Study subjects underwent a glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes. Twelve-lead electrocardiogram (ECG) was performed in 1,175 individuals (84%). Coronary artery disease was diagnosed based on previous medical history or Minnesota coding of ECGs. RESULTS The overall prevalence rate of CAD is 11.0% (age standardized, 9.0%). The prevalence rates of CAD were 9.1%, 14.9% and 21.4% in those with NGT, IGT and diabetes, respectively. Prevalence of CAD increased with an increase in total cholesterol (trend chi-square: 26.2, p CONCLUSIONS The prevalence of CAD is rising rapidly in urban India. Lifestyle changes and aggressive control of risk factors are urgently needed to reverse this trend.
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intra urban differences in the prevalence of the metabolic syndrome in southern india the chennai urban Population Study cups no 4
Diabetic Medicine, 2001Co-Authors: Viswanathan Mohan, R Deepa, G Premalatha, S Shanthirani, N G Sastry, R SarojaAbstract:SUMMARY Aims To assess the influence of socioeconomic status on the prevalence of the metabolic syndrome in an urban south Indian Population in Chennai. Methods The Chennai Urban Population Study is an epidemiological Study involving two residential colonies in Chennai (formerly Madras) in south India representing the middle and lower income groups. All individuals ≥ 20 years of age living in the colonies were invited to participate in the Study. Of the total 1399 eligible subjects, 1262 individuals (479 belonging the middle income group colony and 783 from the low income group colony) participated in the Study. The overall response rate was 90.2%. The main outcome measures were the prevalence rates of the various components of the metabolic syndrome. Results There were significant differences in the socioeconomic status and lifestyle of the inhabitants of the two areas. The mean monthly income of the Tirumangalam (middle income) group (Rs8075 ± 3859) was significantly higher than the T. Nagar (low income) group (Rs1399 ± 916). The dietary profile of the middle income group showed higher intake of calories, fat and sugar compared to low income group (P < 0.001). The age-standardized prevalence rates of the various components of the metabolic syndrome were significantly higher in the middle compared to the low income group – diabetes (12.4 vs. 6.5%), impaired glucose tolerance (7.5 vs. 2.9%), hypertension (14.9 vs. 8.4%), obesity (males 38 vs. 13.4%, females 33.1 vs. 24.2%), hypercholesterolaemia (24.2 vs. 14.2%) and hyperinsulinaemia (16.7 vs. 6.6%) P < 0.001). Although the prevalence of coronary artery disease and hypertriglyceridaemia were higher in the middle income group, the differences did not reach statistical significance. The relative odds ratio for diabetes and impaired glucose tolerance increased significantly with increase in income while hypercholesterolaemia, hypertriglyceridaemia, hypertension and coronary artery disease showed no significant changes. Logistic regression analysis revealed that geographical area (higher social class) had a strong association with the components of the metabolic syndrome even after inclusion of other risk factors like age and body mass index in the model. Conclusions Significant differences exist in the prevalence of various components of the metabolic syndrome even within an urban environment and this appears to be influenced by socioeconomic status.
Kaytee Khaw - One of the best experts on this subject based on the ideXlab platform.
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heterogeneous impact of classic atherosclerotic risk factors on different arterial territories the epic norfolk prospective Population Study
European Heart Journal, 2016Co-Authors: Robert M Stoekenbroek, Robert Luben, Nicholas J Wareham, Kaytee Khaw, Matthijs S Boekholdt, Kees G Hovingh, Aeilko H Zwinderman, Ron J G PetersAbstract:Aims Particular atherosclerotic risk factors may differ in their association with atherosclerosis across vascular territories. Few studies have compared the associations between multiple risk factors and cardiovascular disease (CVD) manifestations in one Population. We studied the strength of the associations between traditional risk factors including coronary artery disease (CAD), ischaemic and haemorrhagic stroke, abdominal aortic aneurysms (AAAs), and peripheral arterial disease (PAD). Methods and results This analysis included 21 798 participants of the EPIC-Norfolk Population Study, without previous CVD. Events were defined as hospitalization or mortality, coded using ICD-10. The associations between the risk factors, such as low-density lipoprotein cholesterol, systolic blood pressure (SBP), and smoking, and the various CVD manifestations were compared using competing risk analyses. During 12.1 years, 3087 CVD events were recorded. The associations significantly differed across CVD manifestations. Low-density lipoprotein cholesterol was strongly associated with CAD [adjusted hazard rate (aHR) highest vs. lowest quartile 1.63, 95% CI 1.44–1.86]. Systolic blood pressure was a strong risk factor for PAD (aHR highest vs. lowest quartile 2.95, 95% CI 1.78–4.89) and ischaemic stroke (aHR highest vs. lowest quartile 2.48, 95% CI 1.55–3.97), but not for AAA. Smoking was strongly associated with incident AAA (aHR current vs. never 7.66, 95% CI 4.50–13.04) and PAD (aHR current vs. never 4.66, 95% CI 3.29–6.61), but not with haemorrhagic stroke. Conclusion The heterogeneity in the risk factor–CVD associations supports the concept of pathophysiological differences between atherosclerotic CVD manifestations and could have implications for CVD prevention.
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serum 25 hydroxyvitamin d mortality and incident cardiovascular disease respiratory disease cancers and fractures a 13 y prospective Population Study
The American Journal of Clinical Nutrition, 2014Co-Authors: Kaytee Khaw, Robert Luben, Nicholas J WarehamAbstract:Background: Vitamin D is associated with many health conditions, but optimal blood concentrations are still uncertain. Objectives: We examined the prospective relation between serum 25-hydroxyvitamin D [25(OH)D] concentrations [which comprised 25(OH)D3 and 25(OH)D2] and subsequent mortality by the cause and incident diseases in a prospective Population Study. Design: Serum vitamin D concentrations were measured in 14,641 men and women aged 42–82 y in 1997–2000 who were living in Norfolk, United Kingdom, and were followed up to 2012. Participants were categorized into 5 groups according to baseline serum concentrations of total 25(OH)D ,30, 30 to ,50, 50 to ,70, 70 to ,90, and $90 nmol/L. Results: The mean serum total 25(OH)D was 56.6 nmol/L, which consisted predominantly of 25(OH)D3 (mean: 56.2 nmol/L; 99% of total). The age-, sex-, and month-adjusted HRs (95% CIs) for allcause mortality (2776 deaths) for men and women by increasing vitamin D category were 1, 0.84 (0.74, 0.94), 0.72 (0.63, 0.81), 0.71 (0.62, 0.82), and 0.66 (0.55, 0.79) (P-trend , 0.0001). When analyzed as a continuous variable and with additional adjustment for body mass index, smoking, social class, education, physical activity, alcohol intake, plasma vitamin C, history of cardiovascular disease, diabetes, or cancer, HRs for a 20-nmol/L increase in 25(OH)D were 0.92 (0.88, 0.96) (P , 0.001) for total mortality, 0.96 (0.93, 0.99) (P = 0.014) (4469 events) for cardiovascular disease, 0.89 (0.85, 0.93) (P , 0.0001) (2132 events) for respiratory disease, 0.89 (0.81, 0.98) (P = 0.012) (563 events) for fractures, and 1.02 (0.99, 1.06) (P =0 .21) (3121 events) for incident total cancers. Conclusions: Plasma 25(OH)D concentrations predict subsequent lower 13-y total mortality and incident cardiovascular disease, respiratory disease, and fractures but not total incident cancers. For mortality, lowest risks were in subjects with concentrations .90 nmol/L, and there was no evidence of increased mortality at high concentrations, suggesting that a moderate increase in Population mean concentrations may have potential health benefit, but ,1% of the Population had concentrations .120 nmol/L. Am J Clin Nutr doi: 10.3945/ajcn.114.086413.
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metabolic dyslipidemia and risk of future coronary heart disease in apparently healthy men and women the epic norfolk prospective Population Study
International Journal of Cardiology, 2010Co-Authors: Jamal S Rana, Nicholas J Wareham, J J P Kastelein, Matthijs S Boekholdt, Erik S G Stroes, Maartje E Visser, Benoit J Arsenault, Jeanpierre Despres, Kaytee KhawAbstract:Abstract Background The association of metabolic syndrome and risk of CHD is now well established. The association between ‘metabolic dyslipidemia' as defined by high triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) levels and the risk of coronary heart disease (CHD) risk is not known. The aim of this Study was to investigate the association between metabolic dyslipidemia, and risk of coronary heart disease (CHD) in apparently healthy men and women. Methods Metabolic dyslipidemia was defined by combination of increased triglyceride (TG) levels (≥150 mg/dl) and low high-density lipoprotein cholesterol (HDL-C) levels (≤50 mg/dl for women and ≤40 mg/dl for men). In the EPIC-Norfolk prospective Population Study, 21,340 participants without diabetes (9326 men and 12,014 women) were followed for a mean of 11.4 years during which 2075 CHD events occurred. Three multivariate models were used adjusting for other metabolic risk factors including low-density lipoprotein cholesterol (LDL-C). Results Compared to men with normal HDL and normal TG, men with metabolic dyslipidemia had an increased risk for CHD (HR 1.61, 95% CI 1.40–1.86). The increased risk remained significant after adjustment for LDL-C and other metabolic risk factors. Among women, metabolic dyslipidemia was associated with increased CHD risk (HR 1.78, 95% CI 1.47–2.15). This association was lost when the model was additionally adjusted for other metabolic syndrome risk factors. In men and women Kaplan-Meier survival curves according to HDL and TG levels revealed that participants with metabolic dyslipidemia had poorer survival compared to people without metabolic dyslipidemia (logrank p Conclusions Metabolic dyslipidemia is associated with an increased risk of CHD. This relationship was independent from LDL-C and other risk factors of the metabolic syndrome in men, but not in women. A better management of this phenotype via lifestyle modification or pharmacotherapy may be warranted.
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differential leucocyte count and the risk of future coronary artery disease in healthy men and women the epic norfolk prospective Population Study
Journal of Internal Medicine, 2007Co-Authors: Jamal S Rana, S M Boekholdt, Paul M Ridker, J W Jukema, Robert Luben, Sheila Bingham, Nicholas J Wareham, J J P Kastelein, Kaytee KhawAbstract:Abstract. Rana JS, Boekholdt SM, Ridker PM, Jukema JW, Luben R, Bingham SA, Day NE, Wareham NJ, Kastelein JJP, Khaw K-T. (Academic Medical Center, Amsterdam, The Netherlands; University of Pittsburgh, Pittsburgh, PA, USA; Leiden University Medical Center, The Netherlands; and Institute of Public Health, University of Cambridge, Cambridge, UK). Differential leucocyte count and the risk of future coronary artery disease in healthy men and women: the EPIC-Norfolk Prospective Population Study. J Intern Med 2007; 262: 678–689. Background: We examined the relationship between granulocyte, lymphocyte and monocyte counts and risk of coronary heart disease (CHD) and cardiovascular disease (CVD) in men and women. There is paucity of data on the differential leucocyte count and its relationship with the risk of CHD and CVD. Methods: This prospective Study comprised 7073 men and 9035 women who were 45–79 years of age and were residents of Norfolk. United Kingdom. Results: During an average of 8 years of follow-up we identified 857 incident CHD events and 2581 CVD incident events. Increased total leucocyte count was associated with increased risk for both CHD and CVD. The highest quartile of granulocyte count was associated with increased risk when compared to lowest quartile for CHD (men HR 1.70 95% CI: 1.30–2.21; women HR 1.24 95% CI: 0.91–1.69) and for CVD (men HR 1.46 95% CI: 1.24–1.71; women HR 1.20 95% CI: 1.02–1.42). The association remained unchanged when the analyses were restricted to nonsmokers and when risk was assessed for every 1000 cells L−1 increase in cell count. In multivariable models, despite adjusting for C-reactive protein (CRP), the granulocyte count remained an independent predictor of CHD and CVD risk, especially amongst men. Lymphocyte or monocyte counts were not significantly associated with increased risk. In all analyses, additionally adjusting for CRP did not affect the results materially. Conclusions: In conclusion, we found that the higher risk for CHD and CVD associated with increased total leucocyte count seems to be accounted for by the increased granulocyte count.
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serum myeloperoxidase levels are associated with the future risk of coronary artery disease in apparently healthy individuals the epic norfolk prospective Population Study
Journal of the American College of Cardiology, 2007Co-Authors: Marijn C Meuwese, Robert Luben, Nicholas J Wareham, J J P Kastelein, Erik S G Stroes, Stanley L Hazen, Joram N I Van Miert, Jan Albert Kuivenhoven, Robert G Schaub, Kaytee KhawAbstract:Objectives We evaluated whether serum myeloperoxidase (MPO) levels are associated with the risk of future development of coronary artery disease (CAD) in apparently healthy individuals. Background An enzyme of the innate immune system, MPO exhibits a wide array of proatherogenic effects. These include induction of oxidative damage to low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and promotion of plaque vulnerability. Recent studies revealed that MPO independently predicts adverse outcomes in patients with chest pain or suspected acute coronary syndrome. Methods Myeloperoxidase was measured in baseline samples of a case-control Study nested in the prospective EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk Population Study. Case subjects (n = 1,138) were apparently healthy men and women who developed CAD during 8-year follow-up. Control subjects (n = 2,237), matched for age, gender, and enrollment time, remained free of CAD. Results The MPO levels were significantly higher in case subjects than in control subjects and correlated with C-reactive protein (CRP) (ρ = 0.25; p 728 pmol/l) similarly predicted increased risk of future CAD among participants with either LDL-cholesterol 50 mg/dl, or CRP Conclusion Elevated MPO levels predict future risk of CAD in apparently healthy individuals. This Study suggests that inflammatory activation precedes the onset of overt CAD by many years.
Christina L Wassel - One of the best experts on this subject based on the ideXlab platform.
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an exploratory factor analysis of inflammatory and coagulation markers associated with femoral artery atherosclerosis in the san diego Population Study
Thrombosis Research, 2018Co-Authors: Natalie Suder Egnot, Michael H Criqui, Joachim H Ix, Matthew A Allison, Emma Barinasmitchell, Nancy S Jenny, Christina L WasselAbstract:Abstract Background and aims Several biomarkers of inflammation and coagulation have been implicated in lower extremity atherosclerosis. We utilized an exploratory factor analysis (EFA) to identify distinct factors derived from circulating inflammatory and coagulation biomarkers then examined the associations of these factors with measures of lower extremity subclinical atherosclerosis, including the ankle-brachial index (ABI), common and superficial femoral intima-media thickness (IMT), and atherosclerotic plaque presence, burden, and characteristics. Methods The San Diego Population Study (SDPS) is a prospective, community-living, multi-ethnic cohort of 1103 men and women averaged age 70. Regression analysis was used to assess cross-sectional associations between the identified groupings of biomarkers (factors) and the ABI and femoral artery atherosclerosis measurements. Results Two biomarker factors emerged from the factor analysis. Factor 1 consisting of C-reactive protein (CRP), interleukin (IL)-6, and fibrinogen was significantly associated with higher odds (OR = 1.99, p p p Conclusions Two groupings of biomarkers were identified via EFA of seven circulating biomarkers of inflammation and coagulation. These distinct groups are differentially associated with markers of lower extremity subclinical atherosclerosis. Our findings suggest that high inflammatory and coagulation burden were better markers of more severe lower-extremity disease as indicated by low ABI rather than early atherosclerotic lesion development in the femoral artery.
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ankle brachial index predicts change over time in functional status in the san diego Population Study
Journal of Vascular Surgery, 2016Co-Authors: Christina L Wassel, Dena E Rifkin, Nketi I Forbang, Julie O. Denenberg, Joachim H Ix, Matthew A Allison, Michael H CriquiAbstract:Background Peripheral artery disease (PAD) affects millions of people, both in the U.S. and worldwide. Even when asymptomatic, PAD and the ankle-brachial index (ABI), the major clinical diagnostic criterion for PAD, are associated with decreased functional status and quality of life, as well as mobility impairment. Whether the ABI or change in the ABI predicts decline in functional status over time has not been previously assessed in a Population-based setting. Methods Participants were 812 non-Hispanic white, African American, Hispanic, and Asian men and women from the San Diego Population Study (SDPS) who attended a baseline examination (1994-1998), and follow-up clinic examination approximately 11 years later. The Medical Outcomes Study 36-Item Short Form (SF-36) was obtained at both the baseline and follow-up examinations, and the summary performance score (SPS) at the follow-up examination. Associations of the baseline ABI and clinically relevant change in the ABI ( Results Mean ± standard deviation (SD) for the baseline ABI was 1.11 ± 0.10, and 50.8 ± 9.0 for the baseline Physical Component Score (PCS), 50.1 ± 9.5 for the baseline Mental Component Score (MCS), and 11.2 ± 1.9 for the SPS at the follow-up examination. In fully adjusted models, each SD lower of the baseline ABI was significantly associated with an average decrease over time of 0.6 (95% confidence interval [CI], −1.1 to −0.1; P = .02) units on SF-36 PCS. Each SD lower of the baseline ABI was also significantly associated with an average decrease over time of 1.2 units (95% CI, −2.3 to −0.2; P = .02) on the SF-36 physical functioning subscale, and a decrease of 1.3 units (95% CI, −2.3 to −0.3; P = .01) on the SF-36 energy/vitality subscale in fully adjusted models. Baseline ABI was not significantly associated with change in the SF-36 MCS over time, or the SPS at the follow-up examination. Change in the ABI was not associated with SF-36 PCS, MCS, or the SPS. Conclusions In this multiethnic Population of healthy middle-aged community-living men and women, we showed that participants with a lower baseline ABI had declines in functional status over 11 years. Findings suggest that small differences in the ABI, even within the normal range, may identify subclinical lower extremity PAD, which in turn may help to identify individuals at risk for declining functional status with age.
Michael H Criqui - One of the best experts on this subject based on the ideXlab platform.
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an exploratory factor analysis of inflammatory and coagulation markers associated with femoral artery atherosclerosis in the san diego Population Study
Thrombosis Research, 2018Co-Authors: Natalie Suder Egnot, Michael H Criqui, Joachim H Ix, Matthew A Allison, Emma Barinasmitchell, Nancy S Jenny, Christina L WasselAbstract:Abstract Background and aims Several biomarkers of inflammation and coagulation have been implicated in lower extremity atherosclerosis. We utilized an exploratory factor analysis (EFA) to identify distinct factors derived from circulating inflammatory and coagulation biomarkers then examined the associations of these factors with measures of lower extremity subclinical atherosclerosis, including the ankle-brachial index (ABI), common and superficial femoral intima-media thickness (IMT), and atherosclerotic plaque presence, burden, and characteristics. Methods The San Diego Population Study (SDPS) is a prospective, community-living, multi-ethnic cohort of 1103 men and women averaged age 70. Regression analysis was used to assess cross-sectional associations between the identified groupings of biomarkers (factors) and the ABI and femoral artery atherosclerosis measurements. Results Two biomarker factors emerged from the factor analysis. Factor 1 consisting of C-reactive protein (CRP), interleukin (IL)-6, and fibrinogen was significantly associated with higher odds (OR = 1.99, p p p Conclusions Two groupings of biomarkers were identified via EFA of seven circulating biomarkers of inflammation and coagulation. These distinct groups are differentially associated with markers of lower extremity subclinical atherosclerosis. Our findings suggest that high inflammatory and coagulation burden were better markers of more severe lower-extremity disease as indicated by low ABI rather than early atherosclerotic lesion development in the femoral artery.
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ankle brachial index predicts change over time in functional status in the san diego Population Study
Journal of Vascular Surgery, 2016Co-Authors: Christina L Wassel, Dena E Rifkin, Nketi I Forbang, Julie O. Denenberg, Joachim H Ix, Matthew A Allison, Michael H CriquiAbstract:Background Peripheral artery disease (PAD) affects millions of people, both in the U.S. and worldwide. Even when asymptomatic, PAD and the ankle-brachial index (ABI), the major clinical diagnostic criterion for PAD, are associated with decreased functional status and quality of life, as well as mobility impairment. Whether the ABI or change in the ABI predicts decline in functional status over time has not been previously assessed in a Population-based setting. Methods Participants were 812 non-Hispanic white, African American, Hispanic, and Asian men and women from the San Diego Population Study (SDPS) who attended a baseline examination (1994-1998), and follow-up clinic examination approximately 11 years later. The Medical Outcomes Study 36-Item Short Form (SF-36) was obtained at both the baseline and follow-up examinations, and the summary performance score (SPS) at the follow-up examination. Associations of the baseline ABI and clinically relevant change in the ABI ( Results Mean ± standard deviation (SD) for the baseline ABI was 1.11 ± 0.10, and 50.8 ± 9.0 for the baseline Physical Component Score (PCS), 50.1 ± 9.5 for the baseline Mental Component Score (MCS), and 11.2 ± 1.9 for the SPS at the follow-up examination. In fully adjusted models, each SD lower of the baseline ABI was significantly associated with an average decrease over time of 0.6 (95% confidence interval [CI], −1.1 to −0.1; P = .02) units on SF-36 PCS. Each SD lower of the baseline ABI was also significantly associated with an average decrease over time of 1.2 units (95% CI, −2.3 to −0.2; P = .02) on the SF-36 physical functioning subscale, and a decrease of 1.3 units (95% CI, −2.3 to −0.3; P = .01) on the SF-36 energy/vitality subscale in fully adjusted models. Baseline ABI was not significantly associated with change in the SF-36 MCS over time, or the SPS at the follow-up examination. Change in the ABI was not associated with SF-36 PCS, MCS, or the SPS. Conclusions In this multiethnic Population of healthy middle-aged community-living men and women, we showed that participants with a lower baseline ABI had declines in functional status over 11 years. Findings suggest that small differences in the ABI, even within the normal range, may identify subclinical lower extremity PAD, which in turn may help to identify individuals at risk for declining functional status with age.