Gestational diabetes is a significant CVD risk factor

Within microfluidic technologies, the centrifugal microfluidic “Lab-on-a-Disc” (LoaD) platform offers great potential for use at the PoC and in low-resource settings due to its robustness and the ability to port and miniaturize ‘wet bench’ laboratory protocols. We present the combination of ‘event-triggered dissolvable film valves’ with a centrifugo-pneumatic siphon structure to enable control and timing, through changes in disc spin-speed, of the release and incubations of eight samples/reagents/wash buffers. Based on these microfluidic techniques, we integrated and automated a chemiluminescent immunoassay for detection of the CVD risk factor marker C-reactive protein displaying a limit of detection (LOD) of 44.87 ng mL−1 and limit of quantitation (LoQ) of 135.87 ng mL−1.

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Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana

BMJ Global Health ◽

10.1136/bmjgh-2020-003499 ◽

2021 ◽

Vol 6 (1) ◽

pp. e003499

Author(s):

Ryan G Wagner ◽

Nigel J Crowther ◽

Lisa K Micklesfield ◽

Palwende Romauld Boua ◽

Engelbert A Nonterah ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

South African ◽

Sub Saharan Africa ◽

African Countries ◽

Cvd Risk ◽

Genomic Studies ◽

Sub Saharan ◽

Context Specific ◽

The Impact

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.

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Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway

Scientific Reports ◽

10.1038/s41598-020-77877-3 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Sergi Trias-Llimós ◽

Lisa Pennells ◽

Aage Tverdal ◽

Alexander V. Kudryavtsev ◽

Sofia Malyutina ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cvd Risk ◽

Risk Factor Profile ◽

Emerging Risk ◽

The Absolute ◽

Absolute Age ◽

Relative Differences ◽

Mortality Rate Ratio ◽

Cvd Mortality

AbstractSurprisingly few attempts have been made to quantify the simultaneous contribution of well-established risk factors to CVD mortality differences between countries. We aimed to develop and critically appraise an approach to doing so, applying it to the substantial CVD mortality gap between Russia and Norway using survey data in three cities and mortality risks from the Emerging Risk Factor Collaboration. We estimated the absolute and relative differences in CVD mortality at ages 40–69 years between countries attributable to the risk factors, under the counterfactual that the age- and sex-specific risk factor profile in Russia was as in Norway, and vice-versa. Under the counterfactual that Russia had the Norwegian risk factor profile, the absolute age-standardized CVD mortality gap would decline by 33.3% (95% CI 25.1–40.1) among men and 22.1% (10.4–31.3) among women. In relative terms, the mortality rate ratio (Russia/Norway) would decline from 9–10 to 7–8. Under the counterfactual that Norway had the Russian risk factor profile, the mortality gap reduced less. Well-established CVD risk factors account for a third of the male and around a quarter of the female CVD mortality gap between Russia and Norway. However, these estimates are based on widely held epidemiological assumptions that deserve further scrutiny.

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Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2415-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Marta Claramonte Nieto ◽

Eva Meler Barrabes ◽

Sandra Garcia Martínez ◽

Mireia Gutiérrez Prat ◽

Bernat Serra Zantop

Keyword(s):

Risk Factor ◽

Gestational Diabetes ◽

Maternal Age ◽

Placenta Previa ◽

Significant Risk ◽

Advanced Maternal Age ◽

Obstetric Outcomes ◽

Chronic Hypertension ◽

Mediterranean Population ◽

Confounding Factors

Abstract Background Women of advanced maternal age (AMA) are a growing population, with higher obstetric risks. The Mediterranean population has specific characteristics different from other areas. Thus, the objective of this study was to establish a cut-off to define AMA in a selected mediterranean population coming from a tertiary referral private/mutual health hospital in Barcelona. Methods Retrospective cohort of euploid singleton pregnancies delivered from January 2007 to June 2017. Main maternal outcomes were: gestational diabetes, preeclampsia, placenta previa, c-section and prolonged hospitalization (≥ 7 days). Main adverse perinatal outcomes were: stillbirth, prematurity, preterm prelabor rupture of membranes, low birth weight, need of admission at a neonatal intensive care unit and perinatal mortality. Adjustment for confounding factors (smoking, previous comorbilities, parity, assisted reproductive techniques (ART) and obesity) was performed. Results A total of 25054 pregnancies were included. Mean maternal age was 34.7 ± 4.2 years, with 2807 patients in the group of age between 40 and 44 years (11.2%) and 280 patients ≥45 years (1.1%). Women at AMA had higher incidence of previous comorbilities (compared to the reference group of women < 30 years): prior c-section, chronic hypertension and obesity. In addition, they were more likely to use ART. After adjusting for confounding factors, maternal age was an independent and statistically significant risk factor for gestational diabetes (OR 1.66/2.80/3.14) for ages 30–39, 40–44 and ≥ 45 years respectively, c-section (OR 1.28/2.41/7.27) and placenta previa (OR 2.56/4.83) for ages 40–44 and ≥ 45 years respectively, but not for preeclampsia (neither early-onset nor late-onset). Risk of emergency c-section was only increased in women ≥45 years (OR, 2.03 (95% CI, 1.50–2.74). In the other groups of age, the increase in c-section rate was because of elective indications. Age ≥ 45 years was associated with iatrogenic prematurity < 37 weeks (OR 2.62, 95% CI 1.30–5.27). No other relevant associations between AMA and maternal or neonatal outcomes were found. Conclusions Maternal age is an independent risk factor for adverse obstetric outcomes. Age ≥ 40 years was associated to relevant increased risks and reveals to be an adequate cut-off to define AMA in our population.

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Abstract P439: Risk Factor Profile and Prevalence of Subclinical Disease in African Americans with Diabetes and Metabolic Syndrome: The Jackson Heart Study

Circulation ◽

10.1161/circ.127.suppl_12.ap439 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Kamel A Gharaibeh ◽

Vanessa Xanthakis ◽

Jung Hye Sung ◽

Tandaw S Samdarshi ◽

Herman A Taylor ◽

...

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

African Americans ◽

Left Ventricular ◽

Jackson Heart Study ◽

Cvd Risk ◽

Metabolic Derangement ◽

Risk Factor Profile ◽

Subclinical Disease ◽

Heart Study

Background . Metabolic derangements such as diabetes (DM) and metabolic syndrome (MetS) are common in African Americans (AA) and contribute to the higher cardiovascular disease (CVD) mortality in this group. A greater prevalence of subclinical disease (ScD) among those with DM and MetS in the AA community may be an explanatory factor. Objective . We assessed the CVD risk factor profile and distribution of ScD among AA with DM and MetS in the Jackson Heart Study (JHS). Methods . We evaluated 4,365 AA participants [mean age (SD) of 53.8 (12.3) years, 64.5% women] free of overt CVD who attended JHS Exam 1 (between 2000- 2004), when ScD assessment was routinely performed(with the exception of CT for coronary calcium that occurred in Exam2). SCD measures included 1) peripheral artery disease (PAD, defined as ankle-brachial index<0.9), 2) high coronary artery calcium (CAC, defined as score>100), 3) left ventricular (LV) hypertrophy (LVH defined as left ventricular mass index>51 g/m 2.7 , 4) low LV ejection fraction (low EF, defined as an EF<50%), and 5) microalbuminuria (MA, defined as an albumin-to-creatinine ratio>25 μg/mg in men and >35 μg/mg in women). We compared the distribution of standard CVD risk factors and ScD prevalence in 1) those without DM or MetS (referent), 2) those with MetS but no DM and 3) those with DM. Results . In our study sample, 1,089 (24.9%) had MetS with no DM and 752 (17.2%) had DM. Compared to the referent group, groups with metabolic derangement tended to be older, female, hypertensive, obese, and had lower HDL, higher fasting glucose, and higher triglycerides levels. Table 1 compares the distribution of ScD for the three groups, and demonstrates the greater odds of. CAC, LVH and microalbuminuria in participants with MetS or DM. Conclusion . In our large community-based sample of AAs, we observed a significantly high prevalence of ScD overall, especially so in participants with MetS and DM. These findings likely contribute to the high CVD rates in AA with MetS and DM. -->

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Abstract 19005: Staying Connected: a CVD Risk Intervention for Young Black Women

Circulation ◽

10.1161/circ.130.suppl_2.19005 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Jo-Ann Eastwood ◽

Debra K Moser ◽

Nabil Alshurafa ◽

Lynn V Doering ◽

Karol Watson ◽

...

Keyword(s):

Risk Factor ◽

Black Women ◽

Risk Reduction ◽

Self Care ◽

Cardiac Risk ◽

High Risk Population ◽

Long Term Effects ◽

Cvd Risk ◽

Lipid Panel ◽

Young Black Women

Fifty thousand Black women, disproportionately affected by cardiovascular disease (CVD), die annually; 49% of Black women ≥ 20 years have CVD. Implementing proactive risk reduction is essential. The purpose of this community - based pilot was to test the feasibility of a program combining self-care education with wireless individualized feedback via a unique smartphone designed to appeal specifically to young Black women (YBW). Methods: Using church-based recruitment, 49 YBW (aged 25-45 years, 60% single) were randomized to treatment (TX) and control groups by church site. The TX group participated in 4 interactive self-care classes on CVD risk reduction. Each participant set individualized goals. Risk factor profiles (waist circumference (WC), BP, lipid panel by Cholestech [Alere]), medical and reproductive history and a battery of psychosocial instruments were assessed prior to classes and 6 months later. Participants were given smartphones with embedded accelerometers and WANDA-CVD, an application that delivered prompts and messages specifically for this pilot. For activity monitoring, phones were worn on the hip during waking hours. Participants obtained and transmitted BP measurements wirelessly via the phone. Changes over time were measured with paired t-tests and linear regression controlling for age and weight. Effect sizes were calculated using Cohen’s D. Results: In risk factor profiles, significant differences favoring the TX group occurred in DBP, WC, and TC/HDL ratio; similar changes in triglycerides yielded a medium-large effect size (Table). TX participants had greater drops in stress, anxiety, and better adherence to heart healthy habits. Conclusion: These interim pilot data validate the feasibility of a combined education/wireless monitoring-feedback program in YBW. Further testing in a large randomized trial is warranted to determine long-term effects on behavior change and cardiac risk profiles in this high risk population.

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Age at menarche: risk factor for gestational diabetes

Journal of Obstetrics and Gynaecology ◽

10.1080/01443615.2021.1929116 ◽

2021 ◽

pp. 1-7

Author(s):

Ayla Ergin ◽

Ünal Türkay ◽

Suzi Özdemir ◽

Ayşe Taşkın ◽

Hasan Terzi ◽

...

Keyword(s):

Risk Factor ◽

Gestational Diabetes ◽

Age At Menarche

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Association of risk factors of GDM with outcome of GCT in obstetrical population

Annals of King Edward Medical University ◽

10.21649/akemu.v10i1.1141 ◽

2016 ◽

Vol 10 (1) ◽

Author(s):

Rubina Sohail ◽

Tahir Bashir ◽

Khalida Javaid ◽

Farrukh Zaman

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Risk Factor ◽

Gestational Diabetes ◽

Predictive Value ◽

Challenge Test ◽

Antenatal Clinic ◽

Factor Group ◽

Glucose Challenge Test ◽

Glucose Challenge

Objective: To determine the association of risk factors of Gestational Diabetes Mellitus (GDM) to outcome of Glucose Challenge Test (GCT). Place and Duration of Study: From February 2000 to October 2000 at the antenatal clinic of Unit-II at Services Hospital. Subject and Methods: One thousand pregnant women attending antenatal clinic at 24-28 weeks of gestation at Services Hospital were included. Glucose challenge test was performed after a history with special reference to diabetic risk factors. Results: Risk factors were identified in 198 (19.8%); while there were no risk factors in 802 (80.2%) women. An oral glucose tolerance test (OGTT) was carried out in all glucose challenge test positive patients. Out of 198 women with risk factors, 50 women were glucose challenge test positive while 148 were screen negative. Out of 802 women without risk factors 54 were GCT positive while 748 were screen negative. The positive predictive value was 48% and the negative predictive value was 83% Out of ten gestational diabetic women, six (3%) belonged to the risk factor group While four (0.5%) were in the no risk factor group. Conclusion: pregnant women with positive risk factors for diabetes mellitus were found to have a six times greater chance of developing gestational diabetes as compared to those with no risk factors.

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Abstract P400: The Association Between Cross-sex Hormone Therapy and Cardiovascular Disease Risk Factors Among Male-to-female Transgender Persons in Chiang Mai, Thailand

Circulation ◽

10.1161/circ.141.suppl_1.p400 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Rebecca L Molinsky ◽

Kanokwan Kulprachakarn ◽

Sakaewan Ounjaijean ◽

Ryan Demmer ◽

Kittipan Rerkasem

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Risk Factor ◽

Hormone Therapy ◽

Sex Hormone ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Transgender Persons ◽

The Relationship ◽

Male To Female

Background: Cross-sex hormone therapy (CSHT) is prescribed to transition secondary sexual characteristics among individuals undergoing male-to-female (MtF) transitions (age range 18-41, mean age=24). Limited data exist to inform the cardiovascular disease (CVD) risk factor profile associated with CSHT. We investigated the relationship between CSHT and cardiovascular risk factors in MtF transgender persons and hypothesize that CSHT will be associated with adverse CVD risk factor profiles. Methods: A cross-sectional study was conducted from October 1 st , 2018 to November 30 th , 2018 in 100 MtF transgender people not receiving CSHT vs. 100 receiving CSHT. CSHT use was defined by self-report use of up to 23 medications. Serum testosterone and 17-beta estradiol were assessed to validate CSHT use. Systolic and diastolic blood pressure was measured. Lipid profiles, fasting plasma glucose (FPG), C-reactive protein, cardiac troponin I and pro b-type natriuretic peptide (proBNP) were assessed from fasting blood. Non-invasive arterial examinations included: carotid intima-media thickness (CIMT), ankle-brachial index (ABI), cardio-ankle vascular index (CAVI), and pulse wave velocity (PWV). Multivariable linear regression models, regressed CVD risk factors on CSHT status. Among the subgroup of CSHT users, we assessed the relationship between duration of use and CVD risk factors. Multivariable models included age, gender, education, income, drinking, smoking, exercise, and BMI. Results: Participant mean age was 24±0.38 years and did not differ by CSHT use. Mean±SE values of testosterone were in the CSHT vs. control group were 4.8±0.3 vs. 5.8±0.3 ng/ml, p=0.06 and 17-beta estradiol levels were 45.6±14.9 vs. 34.7±14.8, p=0.7). CIMT was modestly lower among CSHT vs. controls (0.35±0.01 vs. 0.38±0.01, p=0.09). The average duration of CSHT use was 6.65±0.522 years. Among CSHT users, for every 1-year increase in duration of CSHT use total cholesterol decreased by -2.360 ± 1.096, p=0.0341 mg/dL, LDL-cholesterol decreased by -3.076 ± 1.182, p=0.0109 mg/dL, ABI decreased by -0.006 ± 0.002, p=0.0087 while FPG increased by 2.558 ± 0.899 mg/dL, p=0.0055. Conclusion: Among MtF transgender persons, using CSHT was not associated with increased CVD risk factors levels.

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