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We-P11:160 Cardiovascular risk factors in Chinese-American children
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Wednesday, June 21, 2006: Poster Session Optimal atherosclerosis management ( lst part)
F I T N E S S C A P A C I T Y IS T H E M A J O R P R E D I C T O R OF T H E N U M B E R O F C A R D I O V A S C U L A R R I S K F A C T O R S IN O B E S E A D O L E S C E N T S
EA. Velasquez-Mieyer 1, EA. Cowan;, B.S. Alpert;, C. Villegas-Ba~eto;, S. Perez-Faustinelli 1 , G. Burghen 1 , A.J. Mendez 2 , F. Tylavsky 1. 1 Univ. of Tn
Health Science Ctt; Memphis, USA." 2 Univ. of Miami, Miami, USA Objective: The extent of atherosclerotic lesions in youth has been associated with the number of cardiovascular risk factors (NCVRF). Increased adiposity, deterioration of insulin sensitivity, and cardio-respiratory fitness capacity (CRF) axe linked in the pathogenesis of heart disease. M e t h o d s : We examined which of these 3 components best predicted higher NCVRF in severely obese adolescents. In 48 non-diabetic youth, (14.3 yr, 77% AA, 71% female, BMI 36-4-1.1 kg/m2), we measured percent (T%-fat) and total fat mass (T-fat), CRF (V02max ml/kg/min) and Composite Insulin Sensitivity Index (CISI). NCVRF was determined by evaluating blood pressure, lipid profile and lipo-protein subpopulation, inflammation markers homocysteine, and glucose metabolism. NCVRF was based on the sum of abnormal risk factors (range 0-12). Frequencies, Spearman correlation coefficients, and regression analyses were performed. Results: 27% had N C V R F < 2 , 73% had NCVRF >3, and 48% had N C V R F > 5 . The prevalence of individual abnormality included: 29% glucose, 38% total cholesterol, 10% triglycerides, 19% HDL, 34% LDL, 10% small LDL, 32% ApoA-1, 2% Apo-B and 2% Apo-CIII, 68% Fibrinogen, 44% CRR and 60% BP (92% SBP). NCVRF correlated with CISI (r=-0.39 p=0.006), VO2max ml/kg/min (r=0.45 p=0.0001), T-fat (r=0.39 p=0.006). NCVRF was predicted by VO2max ml/kg/min (R2=0.22 p=0.02) and CISI (R2=0.22 p=0.09). Conclusions: The prevalence of CVRF is extremely high in obese adolescents. Both insulin sensitivity and CRF are associated with NCVRF but CRF best predicted NCVRF. Our results stress the relevance of exercise to improve the CVRF profile in obese youth. I
I w e - P 11 159 Ii H Y P O C A L O R I C D I E T R A P I D L Y A N D S I G N I G N I F I C A N T L Y R E D U C E S IN S H O R T T E R M CARDIOVASCULAR INFLAMMATORY MARKERS IN O V E R W E I G H T A N D O B E S E P A T I E N T S E Giordano S d a c c a I , F. Graziani I , A. Sica 2, M. Conte I , A. Rebuzzi I , L.M. Biasucci 1 F. Crea 1 . l btstitute of Cardiology UCSC, Rome, Italy:
21nstitute of Nutrition And Dietetics, Rome, Italy B a c k g r o u n d : C-reactive protein, an inflammatory protein, is an established marker of cardiovascular risk. We hypothesized that hypocaloric diet may reduce CRP in overweight and obese patients. To this aim we assessed the effect on CRP of two different diets: hypocaloric and hypocaloric + linolenic acid. M a t e r i a l s a n d M e t h o d s : We studied 27 overweight and obese patients (BMI 26-41; Weight 63-113 kg) that received hypocalolic diet (1200-1800 kcal) with or without linolenic acid added. All patients were bled for CRP assessment before and aster one month of diet. CRP was assessed by high sensitivity immunonefelometric assay. Results: CRP levels decreased significantly (4.39 vs 3.44 rag/l) after one month of diet (P<0.005).We found a significant correlation between BMI reduction and CRP reduction (R=0.51; P < 0.0059). Patients undergoing diet with linolenic acid experienced a more pronounced reduction on CRP levels than those without, however this data was not statistically significant (P< 0.064). Conclusions: Hypocaloric diet rapidly and significantly reduces CRP levels after only one month. Our study suggests that weight reduction and hypocaloric diet, with or without linolenic acid, may reduce cardiovascular risk through decrease in inflammatory markers.
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C A R D I O V A S C U L A R R I S K F A C T O R S IN CHINESE-AMERICAN CHILDREN
J. Chen, Y. Wu. Universi~ of California, San Francisco, USA Objective: To examine cardiovascular risk factors including increased blood pressure (BP), total cholesterol (TC), low-density lipoproteins (LDL), triglycerides (TG), and decreased high-density lipoproteins (HDL) in Chinese Chinese-American children. M e t h o d s : Chinese-American children ages 8 to 10 years old (n=65) and their parents in San Francisco Bay Area participated in the study. Children's weight, height, BP, blood sample, level of physical fitness, activity level,
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dietary intake, type of coping strategy, and quality of life data were collected by a trained research assistant. The primary caregivers completed surveys regarding family history of cardiovascular diseases (CVDs) and level of acculturation. Pearson correlation coefficient and multivariate linear regression models were computed to examine factors contributing to risk of CVD. Results: About 49% of the children were boys and 37% (n=24) of all children were overweight (body mass index -BMI greater than the 85th percentile). A high BMI and high birth weight were related to a high level of LDL (r=.492, p=.03; r=.487, p=.05, respectively). Regression model indicates that a low level of physical activity and high paternal BMI contributed to high systolic BP (adjusted R2=.24. F=8.88, p=.001), whereas a low level of physical activity was found to contribute to high LDL (adjusted R2=.337, F=8.64, p=.01). None of the factors was found to predict diastolic B E TC, TG, and HDL levels. Conclusions: Engaging in physical activities on a regular basis and proper weight management are critical in CVD prevention in Chinese-American children. ]
W e - P 1 1 : 1 6 1 / P L A S M A L E P T I N C O N C E N T R A T I O N IN S E R B I A N J P A T I E N T S W I T H TIP 2 D I A B E T E S MELLITUS:RELATIONSHIP TO OBESITY AND CHD RISK FACTORS A. Stefanovic I , J. Kotur-Stevuljevic I , S. Spasic I , N. Bujisic 2 . 1Department
of Biochemistry, Facul~ of Pharntacy, University of BelgrcMe, BelgrcMe, Serbia - Montenegro." 2Ixtboratoty Belladonna, Zemun, Serbia - Montenegro Objective: The aim of this study was to evaluate the relationship of leptin with obesity and coronary heart disease (CHD) risk factors in patients with Type 2 diabetes mellitus (DM) and matched control group (CG). M e t h o d s : Leptin, glucose, H b A l c and full lipid profile were determined in 99 Type 2 diabetic patients (47 male, 52 female) and in 105 control subjects (51 male, 54 female). Results were compared between diabetic and non-diabetic, as well as between normal and overweight (BMI>28) subjects in both groups. Results: Subjects with diabetes had significantly higher level of plasma glucose, total and non-HDL-cholesterol, triglycerides and a p t B than control group. There was no significant difference in other plasma biochemical and general chaxacteristics between diabetic and control group. Our results show that serum leptin levels are higher in DM subjects-12.9 ng/mL (3,8-44,0) than in CG-8.6 ng/mL (3.0-25.2). The leptin values in subjects who axe overweight were higher than in those with normal weight in both groups: DM group: 23.2 (8.3-65.0) vs. 6.9 (2.3-20.9); CG: 13.5 (4.540.6) vs. 6.8 (2.6-18.3). The difference between DM and CG subjects with normal weight was not significant. After adjustment for potential confounders (non-lipid and lipid risk factors) the only parameter significantly associated with hyperleptinemia was BMI: DM: r--0.379, beta coeff=2.096; CG: r=0.500, beta coeff=2.821. C o n d u s i o n s : Our data suggest that, in routine practice, plasma leptin might be useful in the selection of patients for more aggressive therapy. Funding: This study was supported by Ministry of science, Republic of Serbia. q
We-P 11:162 ] B A R I A T R I C S U R G E R Y , A L B U M I N U R I A A N D CARDIOVASCULAR RISK - INITIAL CHANGES M. Phillips, S. WaJalroos, L. Kow, J. Slavotinek, J. Toouli, C. Thompson.
FlitMers Medical Centre, Adelaide, Australia Objective: Lapaxoscopic adjustable gastric banding (LAGB) is effective longterm treatment of obesity and, within a year, ameliorates hypertension and diabetes. We sought the early changes in adiposity, insulin sensitivity and other cardiovascular risk factors in 26 non-diabetic, obese females. We sought the effects of LAGB upon albuminuria, an early marker of nephropathy and endothelial dysfunction. M e t h o d s : We measured urine albumin/creatinine (ACR) and fasting blood homocysteine (hcy), glucose, insulin, lipids as well as visceral, subcutaneous (SC) and liver fat before and 12 weeks after LAGB. Results: Weight fell from 105 to 95 kg (p<0.001). Visceral fat (16630 to 13370 sq. mm; p < 0.001), abdominal SC fat (60090 to 52430 sq mm; p < 0.001) and NEFAs also fell (0.70 to 0.54 mM; p<0.02). There was no change in ACR, blood hcy, triglycerides, total-, LDL-, HDL-cholesterol, insulin sensitivity (HOMA) or systolic B E Diastolic BP rose (78.3 to 84.0 mmHg; p=0.025). The change in visceral fat related to the change in total- (r=0.54; p=0.005)
XIV bztemational Symposium on Atherosclerosis, Rome, Italy, June 18-22, 2006
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Wednesday, June 21, 2006: Poster Session Optimal atherosclerosis management ( lst part)
F I T N E S S C A P A C I T Y IS T H E M A J O R P R E D I C T O R OF T H E N U M B E R O F C A R D I O V A S C U L A R R I S K F A C T O R S IN O B E S E A D O L E S C E N T S
EA. Velasquez-Mieyer 1, EA. Cowan;, B.S. Alpert;, C. Villegas-Ba~eto;, S. Perez-Faustinelli 1 , G. Burghen 1 , A.J. Mendez 2 , F. Tylavsky 1. 1 Univ. of Tn
Health Science Ctt; Memphis, USA." 2 Univ. of Miami, Miami, USA Objective: The extent of atherosclerotic lesions in youth has been associated with the number of cardiovascular risk factors (NCVRF). Increased adiposity, deterioration of insulin sensitivity, and cardio-respiratory fitness capacity (CRF) axe linked in the pathogenesis of heart disease. M e t h o d s : We examined which of these 3 components best predicted higher NCVRF in severely obese adolescents. In 48 non-diabetic youth, (14.3 yr, 77% AA, 71% female, BMI 36-4-1.1 kg/m2), we measured percent (T%-fat) and total fat mass (T-fat), CRF (V02max ml/kg/min) and Composite Insulin Sensitivity Index (CISI). NCVRF was determined by evaluating blood pressure, lipid profile and lipo-protein subpopulation, inflammation markers homocysteine, and glucose metabolism. NCVRF was based on the sum of abnormal risk factors (range 0-12). Frequencies, Spearman correlation coefficients, and regression analyses were performed. Results: 27% had N C V R F < 2 , 73% had NCVRF >3, and 48% had N C V R F > 5 . The prevalence of individual abnormality included: 29% glucose, 38% total cholesterol, 10% triglycerides, 19% HDL, 34% LDL, 10% small LDL, 32% ApoA-1, 2% Apo-B and 2% Apo-CIII, 68% Fibrinogen, 44% CRR and 60% BP (92% SBP). NCVRF correlated with CISI (r=-0.39 p=0.006), VO2max ml/kg/min (r=0.45 p=0.0001), T-fat (r=0.39 p=0.006). NCVRF was predicted by VO2max ml/kg/min (R2=0.22 p=0.02) and CISI (R2=0.22 p=0.09). Conclusions: The prevalence of CVRF is extremely high in obese adolescents. Both insulin sensitivity and CRF are associated with NCVRF but CRF best predicted NCVRF. Our results stress the relevance of exercise to improve the CVRF profile in obese youth. I
I w e - P 11 159 Ii H Y P O C A L O R I C D I E T R A P I D L Y A N D S I G N I G N I F I C A N T L Y R E D U C E S IN S H O R T T E R M CARDIOVASCULAR INFLAMMATORY MARKERS IN O V E R W E I G H T A N D O B E S E P A T I E N T S E Giordano S d a c c a I , F. Graziani I , A. Sica 2, M. Conte I , A. Rebuzzi I , L.M. Biasucci 1 F. Crea 1 . l btstitute of Cardiology UCSC, Rome, Italy:
21nstitute of Nutrition And Dietetics, Rome, Italy B a c k g r o u n d : C-reactive protein, an inflammatory protein, is an established marker of cardiovascular risk. We hypothesized that hypocaloric diet may reduce CRP in overweight and obese patients. To this aim we assessed the effect on CRP of two different diets: hypocaloric and hypocaloric + linolenic acid. M a t e r i a l s a n d M e t h o d s : We studied 27 overweight and obese patients (BMI 26-41; Weight 63-113 kg) that received hypocalolic diet (1200-1800 kcal) with or without linolenic acid added. All patients were bled for CRP assessment before and aster one month of diet. CRP was assessed by high sensitivity immunonefelometric assay. Results: CRP levels decreased significantly (4.39 vs 3.44 rag/l) after one month of diet (P<0.005).We found a significant correlation between BMI reduction and CRP reduction (R=0.51; P < 0.0059). Patients undergoing diet with linolenic acid experienced a more pronounced reduction on CRP levels than those without, however this data was not statistically significant (P< 0.064). Conclusions: Hypocaloric diet rapidly and significantly reduces CRP levels after only one month. Our study suggests that weight reduction and hypocaloric diet, with or without linolenic acid, may reduce cardiovascular risk through decrease in inflammatory markers.
IW e - P 1 1 : 1 6 0 1
I i
C A R D I O V A S C U L A R R I S K F A C T O R S IN CHINESE-AMERICAN CHILDREN
J. Chen, Y. Wu. Universi~ of California, San Francisco, USA Objective: To examine cardiovascular risk factors including increased blood pressure (BP), total cholesterol (TC), low-density lipoproteins (LDL), triglycerides (TG), and decreased high-density lipoproteins (HDL) in Chinese Chinese-American children. M e t h o d s : Chinese-American children ages 8 to 10 years old (n=65) and their parents in San Francisco Bay Area participated in the study. Children's weight, height, BP, blood sample, level of physical fitness, activity level,
381
dietary intake, type of coping strategy, and quality of life data were collected by a trained research assistant. The primary caregivers completed surveys regarding family history of cardiovascular diseases (CVDs) and level of acculturation. Pearson correlation coefficient and multivariate linear regression models were computed to examine factors contributing to risk of CVD. Results: About 49% of the children were boys and 37% (n=24) of all children were overweight (body mass index -BMI greater than the 85th percentile). A high BMI and high birth weight were related to a high level of LDL (r=.492, p=.03; r=.487, p=.05, respectively). Regression model indicates that a low level of physical activity and high paternal BMI contributed to high systolic BP (adjusted R2=.24. F=8.88, p=.001), whereas a low level of physical activity was found to contribute to high LDL (adjusted R2=.337, F=8.64, p=.01). None of the factors was found to predict diastolic B E TC, TG, and HDL levels. Conclusions: Engaging in physical activities on a regular basis and proper weight management are critical in CVD prevention in Chinese-American children. ]
W e - P 1 1 : 1 6 1 / P L A S M A L E P T I N C O N C E N T R A T I O N IN S E R B I A N J P A T I E N T S W I T H TIP 2 D I A B E T E S MELLITUS:RELATIONSHIP TO OBESITY AND CHD RISK FACTORS A. Stefanovic I , J. Kotur-Stevuljevic I , S. Spasic I , N. Bujisic 2 . 1Department
of Biochemistry, Facul~ of Pharntacy, University of BelgrcMe, BelgrcMe, Serbia - Montenegro." 2Ixtboratoty Belladonna, Zemun, Serbia - Montenegro Objective: The aim of this study was to evaluate the relationship of leptin with obesity and coronary heart disease (CHD) risk factors in patients with Type 2 diabetes mellitus (DM) and matched control group (CG). M e t h o d s : Leptin, glucose, H b A l c and full lipid profile were determined in 99 Type 2 diabetic patients (47 male, 52 female) and in 105 control subjects (51 male, 54 female). Results were compared between diabetic and non-diabetic, as well as between normal and overweight (BMI>28) subjects in both groups. Results: Subjects with diabetes had significantly higher level of plasma glucose, total and non-HDL-cholesterol, triglycerides and a p t B than control group. There was no significant difference in other plasma biochemical and general chaxacteristics between diabetic and control group. Our results show that serum leptin levels are higher in DM subjects-12.9 ng/mL (3,8-44,0) than in CG-8.6 ng/mL (3.0-25.2). The leptin values in subjects who axe overweight were higher than in those with normal weight in both groups: DM group: 23.2 (8.3-65.0) vs. 6.9 (2.3-20.9); CG: 13.5 (4.540.6) vs. 6.8 (2.6-18.3). The difference between DM and CG subjects with normal weight was not significant. After adjustment for potential confounders (non-lipid and lipid risk factors) the only parameter significantly associated with hyperleptinemia was BMI: DM: r--0.379, beta coeff=2.096; CG: r=0.500, beta coeff=2.821. C o n d u s i o n s : Our data suggest that, in routine practice, plasma leptin might be useful in the selection of patients for more aggressive therapy. Funding: This study was supported by Ministry of science, Republic of Serbia. q
We-P 11:162 ] B A R I A T R I C S U R G E R Y , A L B U M I N U R I A A N D CARDIOVASCULAR RISK - INITIAL CHANGES M. Phillips, S. WaJalroos, L. Kow, J. Slavotinek, J. Toouli, C. Thompson.
FlitMers Medical Centre, Adelaide, Australia Objective: Lapaxoscopic adjustable gastric banding (LAGB) is effective longterm treatment of obesity and, within a year, ameliorates hypertension and diabetes. We sought the early changes in adiposity, insulin sensitivity and other cardiovascular risk factors in 26 non-diabetic, obese females. We sought the effects of LAGB upon albuminuria, an early marker of nephropathy and endothelial dysfunction. M e t h o d s : We measured urine albumin/creatinine (ACR) and fasting blood homocysteine (hcy), glucose, insulin, lipids as well as visceral, subcutaneous (SC) and liver fat before and 12 weeks after LAGB. Results: Weight fell from 105 to 95 kg (p<0.001). Visceral fat (16630 to 13370 sq. mm; p < 0.001), abdominal SC fat (60090 to 52430 sq mm; p < 0.001) and NEFAs also fell (0.70 to 0.54 mM; p<0.02). There was no change in ACR, blood hcy, triglycerides, total-, LDL-, HDL-cholesterol, insulin sensitivity (HOMA) or systolic B E Diastolic BP rose (78.3 to 84.0 mmHg; p=0.025). The change in visceral fat related to the change in total- (r=0.54; p=0.005)
XIV bztemational Symposium on Atherosclerosis, Rome, Italy, June 18-22, 2006