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SYSTOLIC BLOOD PRESSURE TRENDS IN SCHOOL CHILDREN - YUSAD STUDY
94 PO22-313
Poster Sessions PO22 Epidemiology of CVD risk factors EMERGENT RISK FACTORS RECOGNITION, AS WAIST CIRCUMFERENCE AND ADIPONECTIN, IN THE CARDIOVASCULAR EVENT OCCURRENCE PROBABILITY (REFERENCE STUDY)
R. Gomez-Huelgas 1 , V. Barrios 2 , P. de Pablos-Velasco 3 , R. Rodriguez Azeredo 4 . 1 Department of Internal Medicine/Hospital Carlos Haya, Malaga, Spain; 2 Department of Cardiology/Hospital Ramon y Cajal, Madrid, Spain; 3 Department of Endocrinology/Las Palmas University, Las Palmas de Gran Canaria, Spain; 4 sanofi-aventis/Spain Background and aims: The REFERENCE study evaluated the association between the emergent cardiovascular disease risk factors and the probability of occurrence of a cardiovascular event (CVE). Methods: A retrospective, epidemiological, national case-control study was designed. Patients attending Internal Medicine, Cardiology and Endocrinology outpatient clinics were recruited. Patients were classified as cases or controls according to a previous CVE (ischemic heart disease, stroke, congestive heart failure or peripheral arterial disease). Demographic and analytical data were collected. Among emergent CV risk factors selected were: waist circumference, adiponectin and hs C reactive protein (hsCRP) levels. Results: A sample of 999 patients (aged 40-75) were included (523 cases and 476 controls); 70.4% of cases and 68.1% of controls were men. Ischemic heart disease was the most frequent CVE (70.9%). The blood pressure was controlled in the cases but in the range of hypertension in controls. Cases presented lower total cholesterol and LDL-C and higher HDL-C than controls (p<0.0001, p<0.001 and p=0.0021 respectively). Regarding emergent risk factors, 83% of patients had central obesity in both groups. We found significant lower levels of adiponectin in cases vs controls, 7.65±5.9 µg/mL vs 8.71±6.08 µg/mL, (p<0.0014). The hsCRP level was higher in cases vs controls (4.3±4.6 µg/mL vs 2.5±3.1 µg/mL (p<0.0001). Conclusions: Patients with a CVE had lower adiponectin and higher hsCRP levels. In the univariant analysis the emergent factors measured at present which presented a significantly association with the CVE were: adiponectin <4.5 µg/mL (OR 1.5, IC95:1.10-2.04) and hsCRP >1 µg/mL (OR 2.52, IC95:1.71-3.72). PO22-314
EVALUATION OF ATHEROSCLEROTIC RISK FACTORS AND CAROTIS INTIMA MEDIA THICKNESS IN HEALTHY OFFSPRING OF TYPE 2 DIABETIC PATIENTS
Y. Aydin 1 , A. Arduc 2 , D. Berker 1 , M. Yilmaz 2 , T. Delibasi 1 , E. Beyan Unlu 2 , S. Guler 1 , E. Abayli 2 . 1 Ankara Numune Education and Research Hospital, Endocrinology and Metabolism Department; 2 Ankara Numune Education and Research Hospital, Internal Medicine Department, Ankara, Turkey Aim: Offsprings of type 2 diabetic patients have higher risk of developing Diabetes Mellitus (DM). They have also increased atherosclerotic risk factors as well as developing DM as compared both healty subjects. Increased carotis intima media thickness (CIMT) is accepted as the most important sign of early atherosclerosis. We planned to evaluate CIMT and other risk factors in healty offsprings of type 2 DM patients. Material and Method: We examined 96 healthy offsprings of type 2 DM patients and 39 healthy subject whose age are between 20 and 40 years. All participants have no known disglisemia, hypertension (HT), hyperlipidemia, PCOS, alcohole intake drug usage affecting lipid and glucose metabolism. We evaluated the fasting blood glucose (FBG), insuline, lipid profile, glycliated hemoglobin A1c (HbA1c), oral glucose tolerance test, fibrinogen, C-peptide, homocystein, Hs CRP, postprandial blood glucose (PPG) and microalbuminuria. Insuline resistancy is calculated as in HOMA-IR. We measured the CIMT of patiens by doppler ultrasonography. Results: Offsprings of type 2 DM patients had statistically higher levels of systolic and diastolic HT, FBG, fasting insuline, C-peptide, Hs CRP, fibrinogen and HOMA-IR according to control group (p<0,05). Left, right and mean CIMT was statistically increased in offspring of type 2 DM patients as compared with controls (p<0,001). Increased CIMT had linear relationship with age, systolic blood pressure, body mass indexes and LDL-C. Conclusion: Offsprings of type 2 DM patients have more atherosclerotic risk factors and increased CIMT. So all of the offsprings of diabetic patients have higher risk of early atherosclerotic diseases.
PO22-315
SYSTOLIC BLOOD PRESSURE TRENDS IN SCHOOL CHILDREN - YUSAD STUDY
D. Nikolic 1 , Z. Milincic 1 , S. Simeunovic 1 , I. Petronic 1 , I. Novakovic 2 , T. Damnjanovic 2 . 1 University childrens Hospital, Belgrade, Serbia; 2 Institute for Human Genetics, School of Medicine, Belgrade, Serbia Background and aim: Main objective of YUSAD study is to define and monitor risk factors for atherosclerosis in school children. Aim of our study was to determine systolic blood pressure trends in school children during 5 years period. Methods: We analyzed values of systolic blood pressure (BP) in 4243 children. All examinations were done twice on same population, first when children had 10 years and second time when they had 15 years. Results were compared with nomograms for age and gender. Results: During 5 years period 3968 (93.51%) children remained in same state of which 3960 (93.33%) had normal systolic BP, 7 (0.16%) had arterial hypertension and 1 (0.02%) remained with serious hypertension. In 151 (3.55%) children status worsened, of which from 147 (3.46%) children with normal systolic BP, 5 years after, 115 (2,71%) got arterial hypertension and 32(0.75%) serious hypertension. All of 4 (0.02%) children with arterial hypertension got serious hypertension. In 124 (2.92%) children there was improvement over 5 years, of which both 91 (2.14%) children with arterial hypertension and 30 (0.71%) children with serious hypertension got normal systolic BP and that 3 (0.07%) children with serious hypertension got arterial hypertension during 5 years. Conclusions: There is significant increase in systolic blood pressure in children of 15 years versus children of 10 years. PO22-316
LOW LEVELS OF HDL CHOLESTEROL ARE BETTER RELATED TO CARDIOVASCULAR EVENTS THAN LDL CHOLESTEROL
P. Koureta 1 , E. Gouveri 2 , A. Alaveras 2 , A. Zisaki 3 , C. Kalofoutis 4 , E. Pavlakis 5 , A. Kalofoutis 6 . 1 IKA, Tripoli, Greece; 2 1st Medical Department, Red Cross Hospital, Athens, Greece; 3 Department of Biological Chemistry, University of Athens Medical School; 4 Faculty of Sciences, School of Pharmacy, University of Central Lancashire, Preston UK; 5 HYGEIA’ Hospial, Athens, Greece; 6 Biological Chemistry, University of Athens Medical School President, European Centre for the Quality of Life, EC.Qua.L Aim: of the study was to investigate whether high density lipoprotein (HDL) cholesterol or low density lipoprotein (LDL) cholesterol is better related to cardiovascular events (coronary heart disease or fatal or non fatal strokes) in type 2 diabetes. Methods: The study examined 164 patients with type 2 diabetes followed in an outpatient clinic in a primary setting. The population was divided into tertiles according to the value of HDL cholesterol and then according to the value of LDL cholesterol as documented after the first visit to the clinic. Subjects with and without a history of cardiovascular events were analyzed using Pearson’s x2. Results: Mean measurement, ±SD, for every lipoprotein group as well as Pearson’s x2 between every lipoprotein group and presence or not of cardiovascular events is shown in the accompanying table. In this study we found more patients with cardiovascular events among those with low levels of HDL cholesterol (p=0.05), than among those with high levels of LDL cholesterol (p=0.194). Even though HDL cholesterol was of borderline significance it is obvious that it is a risk factor with an impressive impact on cardiovascular events.
Conclusion: The presence of cardiovascular events seems to be better related to lower levels of HDL cholesterol, than to higher levels of LDL cholesterol in patients with type 2 diabetes, regardless of use of hypolipidaemic agents
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO22 Epidemiology of CVD risk factors EMERGENT RISK FACTORS RECOGNITION, AS WAIST CIRCUMFERENCE AND ADIPONECTIN, IN THE CARDIOVASCULAR EVENT OCCURRENCE PROBABILITY (REFERENCE STUDY)
R. Gomez-Huelgas 1 , V. Barrios 2 , P. de Pablos-Velasco 3 , R. Rodriguez Azeredo 4 . 1 Department of Internal Medicine/Hospital Carlos Haya, Malaga, Spain; 2 Department of Cardiology/Hospital Ramon y Cajal, Madrid, Spain; 3 Department of Endocrinology/Las Palmas University, Las Palmas de Gran Canaria, Spain; 4 sanofi-aventis/Spain Background and aims: The REFERENCE study evaluated the association between the emergent cardiovascular disease risk factors and the probability of occurrence of a cardiovascular event (CVE). Methods: A retrospective, epidemiological, national case-control study was designed. Patients attending Internal Medicine, Cardiology and Endocrinology outpatient clinics were recruited. Patients were classified as cases or controls according to a previous CVE (ischemic heart disease, stroke, congestive heart failure or peripheral arterial disease). Demographic and analytical data were collected. Among emergent CV risk factors selected were: waist circumference, adiponectin and hs C reactive protein (hsCRP) levels. Results: A sample of 999 patients (aged 40-75) were included (523 cases and 476 controls); 70.4% of cases and 68.1% of controls were men. Ischemic heart disease was the most frequent CVE (70.9%). The blood pressure was controlled in the cases but in the range of hypertension in controls. Cases presented lower total cholesterol and LDL-C and higher HDL-C than controls (p<0.0001, p<0.001 and p=0.0021 respectively). Regarding emergent risk factors, 83% of patients had central obesity in both groups. We found significant lower levels of adiponectin in cases vs controls, 7.65±5.9 µg/mL vs 8.71±6.08 µg/mL, (p<0.0014). The hsCRP level was higher in cases vs controls (4.3±4.6 µg/mL vs 2.5±3.1 µg/mL (p<0.0001). Conclusions: Patients with a CVE had lower adiponectin and higher hsCRP levels. In the univariant analysis the emergent factors measured at present which presented a significantly association with the CVE were: adiponectin <4.5 µg/mL (OR 1.5, IC95:1.10-2.04) and hsCRP >1 µg/mL (OR 2.52, IC95:1.71-3.72). PO22-314
EVALUATION OF ATHEROSCLEROTIC RISK FACTORS AND CAROTIS INTIMA MEDIA THICKNESS IN HEALTHY OFFSPRING OF TYPE 2 DIABETIC PATIENTS
Y. Aydin 1 , A. Arduc 2 , D. Berker 1 , M. Yilmaz 2 , T. Delibasi 1 , E. Beyan Unlu 2 , S. Guler 1 , E. Abayli 2 . 1 Ankara Numune Education and Research Hospital, Endocrinology and Metabolism Department; 2 Ankara Numune Education and Research Hospital, Internal Medicine Department, Ankara, Turkey Aim: Offsprings of type 2 diabetic patients have higher risk of developing Diabetes Mellitus (DM). They have also increased atherosclerotic risk factors as well as developing DM as compared both healty subjects. Increased carotis intima media thickness (CIMT) is accepted as the most important sign of early atherosclerosis. We planned to evaluate CIMT and other risk factors in healty offsprings of type 2 DM patients. Material and Method: We examined 96 healthy offsprings of type 2 DM patients and 39 healthy subject whose age are between 20 and 40 years. All participants have no known disglisemia, hypertension (HT), hyperlipidemia, PCOS, alcohole intake drug usage affecting lipid and glucose metabolism. We evaluated the fasting blood glucose (FBG), insuline, lipid profile, glycliated hemoglobin A1c (HbA1c), oral glucose tolerance test, fibrinogen, C-peptide, homocystein, Hs CRP, postprandial blood glucose (PPG) and microalbuminuria. Insuline resistancy is calculated as in HOMA-IR. We measured the CIMT of patiens by doppler ultrasonography. Results: Offsprings of type 2 DM patients had statistically higher levels of systolic and diastolic HT, FBG, fasting insuline, C-peptide, Hs CRP, fibrinogen and HOMA-IR according to control group (p<0,05). Left, right and mean CIMT was statistically increased in offspring of type 2 DM patients as compared with controls (p<0,001). Increased CIMT had linear relationship with age, systolic blood pressure, body mass indexes and LDL-C. Conclusion: Offsprings of type 2 DM patients have more atherosclerotic risk factors and increased CIMT. So all of the offsprings of diabetic patients have higher risk of early atherosclerotic diseases.
PO22-315
SYSTOLIC BLOOD PRESSURE TRENDS IN SCHOOL CHILDREN - YUSAD STUDY
D. Nikolic 1 , Z. Milincic 1 , S. Simeunovic 1 , I. Petronic 1 , I. Novakovic 2 , T. Damnjanovic 2 . 1 University childrens Hospital, Belgrade, Serbia; 2 Institute for Human Genetics, School of Medicine, Belgrade, Serbia Background and aim: Main objective of YUSAD study is to define and monitor risk factors for atherosclerosis in school children. Aim of our study was to determine systolic blood pressure trends in school children during 5 years period. Methods: We analyzed values of systolic blood pressure (BP) in 4243 children. All examinations were done twice on same population, first when children had 10 years and second time when they had 15 years. Results were compared with nomograms for age and gender. Results: During 5 years period 3968 (93.51%) children remained in same state of which 3960 (93.33%) had normal systolic BP, 7 (0.16%) had arterial hypertension and 1 (0.02%) remained with serious hypertension. In 151 (3.55%) children status worsened, of which from 147 (3.46%) children with normal systolic BP, 5 years after, 115 (2,71%) got arterial hypertension and 32(0.75%) serious hypertension. All of 4 (0.02%) children with arterial hypertension got serious hypertension. In 124 (2.92%) children there was improvement over 5 years, of which both 91 (2.14%) children with arterial hypertension and 30 (0.71%) children with serious hypertension got normal systolic BP and that 3 (0.07%) children with serious hypertension got arterial hypertension during 5 years. Conclusions: There is significant increase in systolic blood pressure in children of 15 years versus children of 10 years. PO22-316
LOW LEVELS OF HDL CHOLESTEROL ARE BETTER RELATED TO CARDIOVASCULAR EVENTS THAN LDL CHOLESTEROL
P. Koureta 1 , E. Gouveri 2 , A. Alaveras 2 , A. Zisaki 3 , C. Kalofoutis 4 , E. Pavlakis 5 , A. Kalofoutis 6 . 1 IKA, Tripoli, Greece; 2 1st Medical Department, Red Cross Hospital, Athens, Greece; 3 Department of Biological Chemistry, University of Athens Medical School; 4 Faculty of Sciences, School of Pharmacy, University of Central Lancashire, Preston UK; 5 HYGEIA’ Hospial, Athens, Greece; 6 Biological Chemistry, University of Athens Medical School President, European Centre for the Quality of Life, EC.Qua.L Aim: of the study was to investigate whether high density lipoprotein (HDL) cholesterol or low density lipoprotein (LDL) cholesterol is better related to cardiovascular events (coronary heart disease or fatal or non fatal strokes) in type 2 diabetes. Methods: The study examined 164 patients with type 2 diabetes followed in an outpatient clinic in a primary setting. The population was divided into tertiles according to the value of HDL cholesterol and then according to the value of LDL cholesterol as documented after the first visit to the clinic. Subjects with and without a history of cardiovascular events were analyzed using Pearson’s x2. Results: Mean measurement, ±SD, for every lipoprotein group as well as Pearson’s x2 between every lipoprotein group and presence or not of cardiovascular events is shown in the accompanying table. In this study we found more patients with cardiovascular events among those with low levels of HDL cholesterol (p=0.05), than among those with high levels of LDL cholesterol (p=0.194). Even though HDL cholesterol was of borderline significance it is obvious that it is a risk factor with an impressive impact on cardiovascular events.
Conclusion: The presence of cardiovascular events seems to be better related to lower levels of HDL cholesterol, than to higher levels of LDL cholesterol in patients with type 2 diabetes, regardless of use of hypolipidaemic agents
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey