Dissertations / Theses on the topic 'Cardiovascular system Diseases Victoria Risk factors'
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Heydon, Emma Elizabeth. "Telomere length and cardiovascular disease risk factors in South Asians." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708496.
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Khan, Hassan. "Markers of glycaemia and risk of cardiovascular disease." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648585.
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Appannah, Geeta. "Dietary patterns, obesity and cardiovascular risk factors in young people." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648138.
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Black, James Alexander. "Optimising cardiovascular risk management early in the diabetes disease trajectory." Thesis, University of Cambridge, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709489.
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Ng, Kuen-to, and 伍權韜. "The gender difference and association between social position and cardiovascular risk factors in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45012775.
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Moore, Vivienne M. "Fetal growth and cardiovascular risk factors in an Australian cohort /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm824.pdf.
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Awotedu, Kofoworola Olajire. "Functional changes of the vasculature leading to some cardiovascular risk factors in HIV/AIDS patients." Thesis, Walter Sisulu University, 2013. http://hdl.handle.net/11260/d1015712.
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The present study sought to explore the functional changes that occur in the vasculature of HIV positive participants of African origin in Mthatha district of South africa which might lead to increased risk in their cardiovascular system. Available literature shows that arterial stiffness plays an important role in cardiovascular events such as stroke, vasculitis and myocardial infarction. Measurement of (aortic pulse wave velocity; PWV) provides some of the strongest evidence concerning the prognostic significance of large artery stiffening. This study was aimed at investigating the relationship between anthropometry, age, E-Selectin level, cytokine levels, haemodynamic variables, blood counts and blood lipid profile with pulse wave velocity. Some traditional cardiovascular risk factors such as alcohol, and smoking were also taken into account. This was a cross-sectional study comprising of 169 participants (62 males and 107 females). 63 were HIV negative (group A), 54 HIV positive on treatment (group B), and 52 were HIV positive not on treatment (group C). Pulse wave velocity (PWV) was assessed using the Sphygmocor Vx. Statistically, ANOVA was used for variables with normal distribution and non parametric tests were used for variables with skewed distribution. Notable significant differences were seen in the means of the following variables across all the 3 groups. The mean PWV value for group C (7.21±2.17) was greater than that for group B (6.84± 1.17) which in turn was more than group A (6.38±1.67); P=0.037. In participants who are HIV negative, In univariate analysis PWV correlated significantly with the following: Augmentation index; AIx (75): (r=0.850,p=0.004): Systolic aortic blood pressure; Spa: (r=0.635, p<.000); diastolic blood pressure; dbp: (r=0.436, p<0.000); aortic pulse pressure; Ppa: (r=0.472, p=0.000); Mean arterial pressure; MP: (r=0.446 p=<0.00) and age (r=0.606, p<0.000). In participants who are on HAART the following variables were positively correlated with PWV: Ppa: (r=0.338,p=0.012), MP: (r=0.400,p=0.400), monocytes (r=0.320,p=0.047). Neutrophils: (r=0.341,p=0.034), CD4: (r=-0.446,p=0.009). In participants who are HAART naïve and HIV positive the following correlated with PWV Spa: (r=0.369, p=0.012), MP: (r=0.400, r=0.003) Ppa: (r=0.338,p=0.012), waist to hip ratio: (r=0.319, p=0.037), platelets: (r=0.037, p=0.019), triglycerides: (r=0.490, p=0.002). With multiple linear regression Spa, age and triglycerides as the only independent and significant determinants of PWV among HIV negatives R2= 56.9% (adjusted R2=54.7%), model adjusted for gender, anthropometric parameters, HDL-C, TC, LDL-C, haematologic data, haemodynamic data, cytokines, smoking and alcohol. Only MP and waist circumference were identified as the most important and significant independent determinants of PWV in HIV positive participants not on treatment. Age, MP, HDL-C, and triglycerides were identified as the significant independent determinants of the variations of PWV in HIV positive participants on HAART. R2 =57 %(adjusted R2 =53.5%). Model adjusted for gender, anthropometric data, smoking, alcohol, cytokines, adhesion molecules, total cholesterol, LDL-C. Haematological data, CD4 count, and other haemodynamic parameters. For Aix(75) In HIV negatives the multiple linear regression model identified age (positive correlation), height (negative correlation), CD4 (positive correlation) and MP (positive correlation) as the independent and significant determinants of AIx (75) among HIV negatives. Spa and Age were independently and significantly associated with the variations of Aix(75) among HIV positives not on HAART. On the other hand height was negatively and significantly associated with Aix(75) amongst HIV positives not on HAART. After excluding confounding factors, height (negative correlation) age (positive correlation), MP (positive correlation, HDL-C (negative correlation), platelets (positive correlation) alcohol intake (excessive consummation associated with positive correlation) and TNFα (negative correlation) were identified as the independent and significant variables associated with increase in AIx(75) among HIV positive participants on HAART. Conclusion: This study showed that HIV infected patients with or without antiretroviral therapy have increase arterial stiffness which is associated with an increased cardiovascular risk. The sphygmocor is an accurate, non invassive and useful tool in the evaluation of arterial stiffness and its use in clinical practice should be encouraged. PWV and the augmentation index (AIx) are the two major non-invasive methods of assessing arterial stiffness. Life style modification should be incorporated into the management of HIV patients so as the continuous monitoring of their haematological and lipid profile.
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Kavikondala, Sushma. "Intergenerational and life course influences on cardiovascular risk factors from a developing country perspective, and implications foraetiology." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4633211X.
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Pennells, Lisa. "Assessing predictive ability using individual participant time to event data from multiple prospective studies : application to cardiovascular disease risk prediction." Thesis, University of Cambridge, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609800.
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Xu, Lin, and 徐琳. "Subclinical atherosclerosis, cardiovascular risk factors and metabolicsyndrome in older Chinese people." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B4451430X.
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Zilkens, Renate Ruth. "The effect of alcohol and beverage type on cardiovascular disease risk factors." University of Western Australia. School of Medicine and Pharmacology, 2004. http://theses.library.uwa.edu.au/adt-WU2004.0053.
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[Formulae and special characters can only be approximated here. Please see the pdf version of the abstract for an accurate reproduction.] Two randomised controlled trials were conducted to explore the relationship between the consumption of alcoholic beverages and cardiovascular disease risk factors. Study 1 was primarily designed to test the hypothesis that the cardio-protective effect of light alcohol could be mediated, in part, via improvements in endothelial function. Study 1 was also designed to explore the effect of alcohol on both traditional risk factors for cardiovascular disease, such as changes in lipid profile, haemostatic factors and blood pressure, and novel risk factors such as homocysteine, markers of inflammation and oxidative stress. The experimental design of this study also allowed us to determine whether reducing alcohol intake in these moderate-to-heavy drinkers could improvement insulin sensitivity, a component of the metabolic syndrome. In this group of sixteen healthy middle-aged men with a history of moderate to heavy alcohol intake of seven standard drinks per day, reducing intake down to approximately one standard drink per day for four weeks had no beneficial effects on conduit vessel endothelial function as assessed by post-ischaemic brachial artery flow-mediated dilatation, nor were there any detectable changes in soluble E-selectin, endothelin-1 and von Willebrand Factor, which are considered biomarkers of endothelial activation. As this study did not investigate the effect of alcohol on endothelial function in resistance vessels, it cannot exclude the possibility that alcohol may affect endothelial cells resident in that vascular bed. This study does show and confirm, however, that the relationship between alcohol and risk factors for cardiovascular disease is an extremely complex one. On the one hand it demonstrated that alcohol was potentially harmful, increasing blood pressure, plasma F2-isoprostane (oxidative stress), and homocysteine. On the other hand it showed that increasing alcohol intake led to significant reductions in two (i.e. fibrinogen and IL-6) of five inflammatory markers, in addition to improving the HDL-cholesterol profile of these subjects. Although the effects of alcohol on blood pressure, fibrinogen and HDL-cholesterol are not in themselves new, they support our choice of study design and strengthen the argument in favour of accepting the more novel findings of this study, specifically, the lack of effect on endothelial function and insulin sensitivity, and the harmful effect of alcohol in increasing oxidative stress and homocysteine. Study 2 was primarily designed to test the hypothesis that the consumption of red wine may confer greater cardio-protection than beer via improvements in endothelial function. Simultaneously, the study was also designed to determine whether drinking red wine for 4-weeks would have different effects than beer on either traditional risk factors for cardiovascular disease (i.e. blood pressure and lipid profile) or the more novel risk factors, homocysteine and oxidative stress. Using a randomised controlled cross-over study design, Study 2 provides evidence that the regular daily consumption of 4 standard drinks of either beer or red wine does not alter endothelial function, as measured by post-ischaemic flow-mediated vasodilatation of the brachial artery in healthy middle-aged men, nor was there evidence of any beneficial effect of de-alcoholised red wine on brachial artery response. As compliance with drinking protocol was confirmed with increased serum γ-GT and HDL during red wine and beer periods, and increased 24-hr urinary excretion of 4OMGA during red wine and de-alcoholised red wine periods, we are confident that there was excellent compliance with the beverage treatments. Study 2 also provides the first evidence from a carefully controlled intervention study that both red wine and beer elevate blood pressure to a similar degree, with no detectable difference in the magnitude of either treatment. As with endothelial function, there was also no evidence of any beneficial effect of de-alcoholised red wine on blood pressure. In addition, although post hoc analysis found evidence that alcohol increased both plasma homocysteine and urinary excretion of F2-isoprostane and endothelin-1, there was no apparent protective effect conferred from either red wine or de-alcoholised red wine on these cardiovascular risk markers. The results from this study cannot disprove the hypothesis that red wine is more beneficial for cardiovascular health; however, they suggest that if red wine has properties beyond those of beer to confer protection, they are not via any interactions with the nitric oxide regulatory function of the endothelium in conduit vessels nor are they via moderation of the vasopressor, homocysteine-raising, and oxidative stress effects of alcohol. The interpretation of the findings from both intervention studies and their place in the context of our current understanding of the role that alcoholic beverages play in the development and/or prevention of cardiovascular disease are explored in this thesis.
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Cheung, Yiu-fai, and 張耀輝. "An analysis of the determinants of peripheral conduit arterial stiffness in children and teenagers in health and disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29761815.
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Johns, David James. "Dietary patterns and cardiovascular disease in severe obesity." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610554.
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Kettle, Susan M. "Prevalence of cardiovascular disease risk factors in young Newfoundland and Labrador adults living in rural and urban communities." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0017/MQ54927.pdf.
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Henning, Andrea L. "Monitoring Monocyte Oxldl Phagocytosis As a Cardiovascular Disease Risk Factor Following a High-fat Meal." Thesis, University of North Texas, 2014. https://digital.library.unt.edu/ark:/67531/metadc700101/.
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Macrophage-derived foam cells play a predominant role in the deposition of arterial plaques during the early stages of atherosclerosis. The deposition of arterial plaques is known to be effected by several factors, including a person’s dietary habits. The consumption of a high-fat (>60% of calories from fat) meal is known to elevate serum LDL and triglycerides, which have been previously implicated in the formation pf foam cells. One limitation of current research models is that it is not possible to directly measure foam cells in vivo. Thus, the purpose of the present study was to validate the use of blood derived monocytes as a proxy measure of foam cells. In order to complete this objective, we evaluated monocyte oxLDL phagocytosis capacity following consumption of a high-fat meal. Eight men and women participated in the present study and venous blood samples were collected prior to the meal, 1-h, 3-h, and 5-h post-meal. Monocytes (CD14+/16- and CD14+/16+) were evaluated for adhesion molecule expression (CD11a, CD11b, and CD18), scavenger R (CD36) expression, and oxLDL phagocytosis using an image-based flow cytometry method developed in our laboratory for this purpose. Data was statistically analyzed for significance using a single-factor ANOVA with repeated measures and a p < 0.05. Consumption of a high-fat meal caused an increase significant increase in the proportion of pro-inflammatory monocytes (CD14+/16+) and a decrease in classic monocytes (CD14+/16-), with the greatest difference occurring at 5 h post prandial (p = 0.038). We also found that pro-inflammatory monocyte expression of adhesion molecules and CD36 increased in a manner that would promote in vivo movement of monocytes into the subendothelial space. Finally, over the course of the 5 h postprandial period, the majority of oxLDL uptake occurred in pro-inflammatory compared to classic monocytes. These results suggest that consuming a high-fat meal increases the potential of monocytes to become foam cells for at least 5 h postprandial.
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Mashinya, Felistats. "Cardiovascular risk factors in an HIV infected rural population of Limpopo Province, South Africa." Thesis, University of Limpopo, 2016. http://hdl.handle.net/10386/1717.
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Thesis (Ph. D. (Medical Sciences)) -- University of Limpopo, 2016Refer to document
The Belgium Development Co-operation through VLIR-UOS, The University of Limpopo,and The Flemish Universities
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Masoud, Mohamed Abdulsalam. "Validation of a recently proposed equation for the estimation of small, dense LDL particles from routine lipid measures in a population of mixed ancestry South Africans." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2490.
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Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016.Cardiovascular diseases (CVD) are the leading cause of global mortality, of which over 75% occurred in low- and middle-income countries such as South Africa. The lipid profile, specifically decreased levels of high density lipoprotein cholesterol (HDL-C), elevated triglyceride levels and the presence of small-dense low density lipoprotein (sdLDL) has been reported associated with CVD. An increased number of sdLDL is also common in metabolic syndrome (MetS), visceral obesity and diabetes mellitus, the last a known risk factor for CVD. The modification of low density lipoprotein (LDL) size, or number of sdLDL particles, has been reported to significantly reduce CVD risk, but not conclusively so and needs further investigation. In this regard, sdLDL particles are seldom estimated routinely for clinical use because of financial and other limitations. Currently, an alternative approach for estimating sdLDL is to use equations derived from routine lipid measures, as has been proposed by several groups. However, there is a need for extensive evaluation of this equation across different ethnic and disease groups, especially since reports showed an inadequate performance of the equation in a Korean population. The aim of this study was to assess the performance of a recently proposed equation for the estimation of sdLDL in healthy and diabetic mixed ancestry South Africans. Furthermore, we also investigated the role of sdLDL as a cardiometabolic risk factor, as measured against known risk factors such as the glycemic and lipid profiles.
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林文健 and Man-kin Lam. "A cross-sectional study of leisure-time physical activity prevalence and its association with cardiovascular biochemical risk factors inHong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970631.
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Martin, Luci A. "Negative affect, introversion and physiological markers of cardiovascular disease." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9063/.
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Cardiovascular risk factors have expanded to include personality and other psychological characteristics. Negative affect (NA) has a longstanding history in cardiovascular health, but the path by which NA leads to cardiovascular disease (CVD) is yet to be defined. The following study examined the relationship of high NA and low extroversion (EX) with physiological cardiovascular markers in a sample of non-medical, professional adults. Our results indicated that individuals high in NA and low in EX displayed a significantly lower platelet count and a significantly higher mean platelet volume. Individuals high in NA displayed a significantly lower cholesterol risk ratio, while individuals high in EX displayed significantly higher platelet counts. Personality was not significantly related to blood pressure, high or low density lipoproteins. Understanding the relationships among psychological variables and physiological markers will help clinical researchers design interventions that reduce the likelihood of CVD.
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Link-Malcolm, Jessica. "Health message framing : motivating cardiovascular risk factor screening in young adults." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9066/.
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As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.
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Smith, Jessica 1980. "Elevated waist to hip ratio and cardiovascular disease risk, assessed by the apoBapoA1 ratio, in Asian Indian immigrants." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98800.
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Traditional indicators of cardiovascular disease (CVD) risk may not be appropriate for Asian Indians. We designed a cross-sectional study of body fat distribution, apoB/apoA1 ratio and adipokines of Northern Indians compared to Caucasians to determine if there is a different relationship between these parameters. Indian (men: n = 54; women n = 28) and Caucasian (men: n= 32; women, n = 51) subjects were recruited who were between the ages of 20 and 60 years. Subjects were excluded if they had a history of CVD or were taking lipid lowering medications. Body fat percentage (BF%) was measured using bioelectrical impedance analysis. Indian subjects had a substantially higher waist-to-hip ratio (WHR) ratio than Caucasian subjects (men: 0.93 +/- 0.01 vs. 0.86 +/- 0.01, p < 0.001; women: 0.88 +/- 0.01 vs. 0.76 +/- 0.01, p < 0.0001). Interestingly, while WHR correlated strongly with BF% in Caucasians (men: r = 0.63 p = 0.0002; women: r = 0.74, p < 0.0001, respectively) there was no correlation in Indians (men: r = 0.22, ns; women: r = 0.23, ns). The regression lines for WHR vs. BF% of Indians compared to Caucasians was significantly different (men p = 0.02, women p = 0.002). A similar pattern of correlation was seen with WHR and BMI. In addition, Indian men and women had a higher apoB/A1 ratio than Caucasians: the most powerful lipoprotein measure of CVD risk (men: 0.84+/-0.04 vs. 0.66+/-0.04, p=0.001; women: 0.70+/-0.04 vs. 0.56+/-0.03, p = 0.003, respectively). Leptin levels were higher and adiponectin levels in lower in the Indian men and women. Hypothetically, these alterations in body composition, apoB/apoA1 and adipokines could be due to alterations in adipocyte number.
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Maloney, Kelly Veronica. "Awareness, reported behaviour, and dietary intake of fat and fiber as risk factors for cardiovascular disease." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0020/MQ54935.pdf.
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Vu, Manh Tuan. "Feasibility, acceptability and utilization of a moblie cardiovascular risk factor profile e-platform amongst physicians and patients in HongKong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47869823.
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Study methods: Mixed-method study design was used to investigate feasibility of implementing a mobile-phone based behavioural intervention to reduce CVD risk factors among the Chinese population. Patients, who were 45-79 years old, fair English literacy, had access to a JAVA enabled mobile phone and had no mental health problems, cognitive impairment or severe illness, were eligible to the study.
Intervention: Patients recruited from three settings (1 GP, 1 specialist and 1 public clinics) had the study software installed to their phone. The software enabled patients to access their CVD risk profiles (including weight, BP, HbA1c, and lipoprotein profile), 10-year CVD risk prediction (based on Framingham Cardiac Risk Score), and pre-set behavioural recommendations. Patients’ CVD risk profiles were updated at 1-month and 3-month follow-up when their test results were available. Patients were alerted with healthy behaviours recommendations.
Outcomes: Outcomes were measured at baseline and 3-month follow-up. Clinical outcomes included Cardiac Risk Factor Score and its components (BMI, Systolic & Diastolic BP, total cholesterol, HDL and HbA1c). Two sets of questionnaires were used to measure knowledge, risk reduction behaviour and attitude toward usefulness of medical records (pre-intervention) and perceived ease of use, usefulness, satisfaction and utilisation of the software (post-intervention).
Results and Discussion: 19 patients were recruited at baseline. 75% (14) aged 45-55 years, 58% (11) were male, 79% (15) had secondary or lower education, 63% (12) were married, and 95% (18) never smoked. Patients’ understanding about CVD risk factors and risk reduction behaviour was moderate. Patients’ attitude toward electronic medical record was positive. Overall patients’ perception of usefulness, ease of use and satisfaction with the software was satisfactory. Post-intervention, a decreasing trend was observed in patients’ CVD risk profiles i.e. weight, BMI, SBP&DBP, HbA1c and Lipoprotein profile.
Focus group discussions revealed that there was a mismatch between physicians and patients perspectives about the use of mobile phone in a behavioural intervention. Physicians tended to express their concern about the quality of records, security of technology, and patients’ actual benefit, while patients showed little concern about security and great excitement about further use of mobile phone technology in assisting their disease self-management. The public sector physicians admitted that their patients were passive in term of seeking information about their health. Patients were willing to use this software for future care if it could provide more real-time data, tailored recommendations for behavioural change, and an interactive communication tool with their physicians. Physicians would like to try the software if it could ease patient-management process, especially enhance patient-physician communication, and be a decision support system to help them keep track with changes that their patients made.
Conclusion: This pilot study has provided preliminary evidence of the feasibility, acceptability, and utility of an e-platform in primary interventions for CVD in Hong Kong.published_or_final_version
Community Medicine
Master
Master of Philosophy
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黃佩儀 and Pui-yi Wong. "The relationships among habitual physical activity, daily eating habits, aerobic fitness and cardiovascular risk factors in Hong Kongmales." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B3125732X.
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Zhou, Haiyun, and 周海韵. "Risk factors driving ambulatory care sensitive conditions hospitalisation among elderly with chronic obstructive pulmonarydisease or heart disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47055819.
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Kuinchtner, Gabriela Castro. "ASSOCIAÇÃO ENTRE RISCO CARDIOVASCULAR E CONTROLE AUTONÔMICO CARDÍACO EM PORTADORES DE HIV." Universidade Federal de Santa Maria, 2015. http://repositorio.ufsm.br/handle/1/5855.
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Introduction: The increase of cardiovascular disease risk has been demonstrated in subjects with HIV infection. The dysfunction in the regulation of the autonomic system has been identified as a mechanism underlying to cardiac death in this group of patients. This study aimed to analyze the association between cardiovascular risk and cardiac autonomic control in patients with HIV. Methods: The sample consisted of 25 patients with HIV, of both genders, in use of antiretroviral therapy and with undetectable viral load, treated on the of Infectious Diseases Ambulatory, from the University Hospital of Santa Maria (HUSM), between August and December of 2014. Patients with cardiovascular disease, metabolic, respiratory, neurological or kidney were excluded. The cardiovascular risk was assessed by Framingham score, used to estimate the probability of cardiovascular events in ten years. The cardiac autonomic control was assessed by measuring the heart rate variability, analyzing the following variables: 1) in the time domain were measured SDNN, triangular index (overall variability) and rMSSD (parasympathetic activity); 2) in the frequency domain understood the low frequency components (LF; sympathetic activity) and high frequency (HF; parasympathetic activity), both normalized, and the LF/HF ratio (sympatho-vagal balance). Results: The sample (12 women and 13 men) had a mean age of 48.7±10.9 years, body mass index of 25.7±5.1 kg/m2, heart rate of 72.1±13.4 bpm, respiratory rate of 16.3±3.8 bpm, systolic blood pressure of 125.2±18.7 mmHg and diastolic 83.3±12.2 mmHg. The average time since diagnosis of the disease was 10.2±5.0 years, the medication time of 7.2±4.2 years and the CD4 count of 628.6±223.8 mm3 of blood. The score obtained in the Framingham score was 9.5±5.1 and the risk of cardiovascular events was 9.5±7.9%, with 7 patients classified as low risk, 14 as intermediate risk and 4 as high cardiovascular risk. The Framingham score presented a correlation with the medication time (r=0.53), with the LFnu component (r=0.45) and with the ratio LF/HF (r=0.44), but it was inversely correlated with SDNN (r=-0.43), rMSSD (r=-0.47) and with the triangular index (r=-0.49). The risk of cardiovascular events was positively correlated with the medication time (r=0.54), with the LFnu component (r=0.45) and with the ratio LF/HF (r=0.45), but had negative correlation with SDNN (r=-0.40), rMSSD (r=-0.43) and the triangular index (r=-0.48). Conclusion: Patients with HIV classified into different bands of Framingham score, presented association between cardiovascular risk and increased sympathetic activity, decreased parasympathetic activity and sympatho-vagal balance. This demonstrates that even in patients with undetectable viral load, cardiovascular autonomic dysfunctions may be associated with cardiovascular risk in ten years. These findings point to the importance of routine assessments of cardiovascular autonomic nervous system in this population.Introdução: o aumento do risco de doença cardiovascular tem sido demonstrado em sujeitos com infecção por HIV. A disfunção na regulação do sistema autônomo tem sido apontada como mecanismo subjacente a morte cardíaca nesse grupo de pacientes. Este estudo objetivou analisar a associação entre risco cardiovascular e controle autonômico cardíaco em portadores de HIV. Métodos: a amostra foi composta por 25 pacientes com HIV, de ambos os sexos, em uso de antirretrovirais e com carga viral não detectável, oriundos do Ambulatório de Doenças Infecciosas do Hospital Universitário de Santa Maria (HUSM), entre agosto e dezembro de 2014. Pacientes com doença cardiovascular, metabólica, respiratória, neurológica ou renal foram excluídos. O risco cardiovascular foi avaliado pelo Escore de Framingham, utilizado para estimar a probabilidade de eventos cardiovasculares em dez anos. O controle autonômico cardíaco foi avaliado pela medida da variabilidade da frequência cardíaca, analisando-se as seguintes variáveis: 1) no domínio do tempo foram mensurados o SDNN, índice triangular (variabilidade global) e rMSSD (atividade parassimpática); 2) o domínio da frequência compreendeu os componentes de baixa frequência (LF; atividade simpática) e de alta frequência (HF; atividade parassimpática), ambos normalizados, e a relação LF/HF (balanço simpato-vagal). Resultados: a amostra (12 mulheres e 13 homens) apresentavam idade média de 48,7±10,9 anos, índice de massa corporal de 25,7±5,1 kg/m2, frequência cardíaca de 72,1±13,4 bpm, frequência respiratória de 16,3±3,8 rpm, pressão arterial sistólica de 125,2±18,7 mmHg e diastólica de 83,3±12,2 mmHg. O tempo médio de diagnóstico da doença foi de 10,2±5,0 anos, o tempo de medicação de 7,2±4,2 anos e a contagem de CD4 de 628,6±223,8 mm3 de sangue. A pontuação obtida no Escore de Framingham foi de 9,5±5,1 e o risco de eventos cardiovasculares foi de 9,5±7,9%, sendo 7 pacientes classificados como baixo risco, 14 como risco intermediário e 4 como alto risco cardiovascular. A pontuação do Escore de Framingham apresentou correlação com o tempo de medicação (r= 0,53), com o componente LFnu (r=0,45) e com a relação LF/HF (r=0,44), mas correlacionou-se inversamente com o SDNN (r=-0,43), rMSSD (r=-0,47) e com o índice triangular (r=-0,49). O risco de eventos cardiovasculares esteve correlacionado positivamente com o tempo de medicação (r=0,54), com o componente LFnu (r=0,45) e com a relação LF/HF (r=0,45), porém, apresentou correlação negativa com o SDNN (r=-0,40), rMSSD (r=-0,43) e com o índice triangular (r=-0,48). Conclusão: Pacientes portadores de HIV, classificados em diferentes faixas do Escore de Framingham, apresentam associação entre o risco cardiovascular e o aumento da atividade simpática, redução da atividade parassimpática e do balanço simpato-vagal. Isso demonstra que, mesmo em pacientes com carga viral não detectável, as disfunções autonômicas cardiovasculares podem estar associadas ao risco cardiovascular em dez anos. Estes achados apontam para a importância de avaliações rotineiras do sistema nervoso autonômico cardiovascular nesta população.
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Ollila, M. M. (Meri-Maija). "The role of polycystic ovary syndrome (PCOS) and overweight/obesity in women’s metabolic and cardiovascular risk factors and related morbidities." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526222592.
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Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive aged women, with reproductive, metabolic and cardiovascular implications across the life span. The typical features of PCOS include irregular menstruation, androgen excess and polycystic ovaries in ultrasonography. The majority of women with PCOS are overweight or obese, and, at least partly, obesity-driven metabolic abnormalities often coexist with PCOS. Despite intensive research, it has remained unclear whether PCOS per se is a risk factor of metabolic abnormalities, and cardiovascular disease and events. The main aim of the current work was to investigate whether PCOS is an independent risk factor of metabolic abnormalities and cardiovascular diseases. The study population consisted of the prospective population-based Northern Finland Birth Cohort 1966, and we used data collected at ages 14, 31 and 46. The definition of PCOS was based on self-reported PCOS symptoms at age 31 and/or PCOS diagnosis by age 46. The results revealed that weight gain in early life was a risk factor for the development of PCOS. As for metabolic outcomes, at age 46, normal-weight women with PCOS did not display increased odds of abnormal glucose metabolism. However, weight gain during early adulthood was significantly associated with abnormal glucose metabolism in women with PCOS by age 46. Interestingly, PCOS per se was already associated with elevated blood pressure at age 31 and hypertension at age 46, independently of obesity. Women with PCOS also displayed reduced cardiac vagal activity, which was associated with metabolic abnormalities and hypertension. Furthermore, even though no major anatomical or functional impairments were observed in echocardiography, women with PCOS displayed a significantly greater prevalence of myocardial infarction and a two-fold higher prevalence of cardiovascular events than controls. In conclusion, our findings indicate that even though PCOS is an independent risk factor of metabolic derangements, related obesity is a major metabolic risk factor in these women. The role of PCOS in cardiovascular events per se remains controversial and requires follow-up of this cohort. Given all this, maintaining normal weight and preventing weight gain, especially during early adulthood, should be the main priority in the prevention of adverse metabolic changes in women with PCOSTiivistelmä Munasarjojen monirakkulaoireyhtymä (polycystic ovary syndrome, PCOS) on lisääntymisikäisten naisten yleisin hormonaalinen häiriö aiheuttaen runsaasti sairastavuutta ja terveydenhuollon kustannuksia. PCOS:n diagnostisiin kriteereihin kuuluvat epäsäännöllinen kuukautiskierto, lisääntynyt miessukupuoli-hormonivaikutus sekä monirakkulaiset munasarjat. Merkittävä osa oireyhtymää sairastavista naisista on ylipainoisia tai lihavia ja oireyhtymän kanssa yhtä aikaa esiintyykin useita, ainakin osittain ylipainosta johtuvia, metabolisia häiriöitä. Lukuisista tutkimuksista huolimatta on kuitenkin epäselvää, altistaako PCOS itsessään metabolisille häiriöille sekä sydän- ja verisuonisairauksille. Väitöskirjatutkimuksen tavoitteena oli selvittää, onko PCOS itsenäinen metabolisten ja sydän- ja verisuonisairauksien riskiä lisäävä tekijä. Tutkimus pohjautui Pohjois-Suomen syntymäkohortti 1966 tutkimuksen 14-, 31- ja 46-vuotisseurantoihin. PCOS luokittelu perustui 31- ja 46-vuotiskyselyissä itse ilmoitettuihin tyypillisiin PCOS oireisiin ja/tai diagnoosiin. Tutkimuksessa havaittiin, että 14- ja 31-ikävuoden välillä tapahtuva painonnousu oli yhteydessä PCOS diagnoosiin myöhemmällä iällä. 46-vuotiaana normaalipainoisilla PCOS naisilla ei ollut suurentunut tyypin 2 diabetes riski, mutta painonnousu varhaisaikuisuudessa oli merkittävästi yhteydessä sokeriaineenvaihdunnan häiriöön PCOS naisilla. PCOS oli yhteydessä kohonneeseen verenpaineeseen 31-vuotiaana ja hypertensioon 46-vuotiaana ylipainosta riippumatta. Oireyhtymään liittyvät metaboliset häiriöt olivat tärkein sydämen autonomisen hermoston säätelyyn vaikuttava tekijää, kun taas PCOS itsessään ei vaikuttanut autonomisen hermoston toimintaan. PCOS:ään sairastavien naisten sydämen rakenne ja funktio eivät merkitsevästi poikenneet kontrolloiden vastaavista muuttujista. Kuitenkin suhteellisen nuoresta iästä huolimatta PCOS naisilla esiintyi enemmän sydäninfarkteja ja kaksi kertaa enemmän sydän- ja verisuonitapahtumia, kuin kontrolleilla. Tutkimuksen tulokset osoittavat, että vaikkakin PCOS on itsenäinen riskitekijä metabolisille häiriöille, oireyhtymään liittyvä ylipaino vaikuttaa merkittävästi metabolisten häiriöiden esiintymiseen. PCOS:n ja sydän- ja verisuonitautitapahtumien yhteyden tarkempi tutkiminen vaatii kohortin jatkoseurantaa. Painonhallinnan tukemisen tulisi olla PCOS:ää sairastavien naisten hoidon kulmakivi
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Martin, Nailú Angélica Sinicato 1989. "Síndrome metabólica e composição corporal nos pacientes com lúpus eritematoso sistêmico juvenil." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312095.
Full textAbstract:
Orientador: Simone AppenzellerDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Lupus Eritematoso Sistêmico (LES) e uma doença autoimune, crônica e mutissistemica, caracterizada por períodos de atividade e remissão. Anormalidades como leucopenia, anemia hemolítica, presença de auto-anticorpos como anti-DNA de fita dupla (anti-dsDNA), anti-Smith (anti-Sm) e fator antinuclear (FAN) podem ser encontradas. Quando diagnosticado ate os 16 anos de idade e denominado LESj. Devido ao elevado acometimeto cardíaco nesses pacientes e muito importante avaliar os fatores de risco para o desenvolvimento de doenças coronarianas. O presente estudo, de característica transversal, teve como objetivo avaliar a presença de SM nos pacientes com LESj e comparar com controles sem histórico de doença autoimune e cardiovasculares e avaliar a composição corporal e observar a associação com a atividade e dano da doença, uso de corticosteróides e TNF-?. Foram selecionados pacientes consecutivos com LESj acompanhados na Unidade de Reumatologia Pediátrica da UNICAMP entre 2010/2012. Manifestações clinicas, laboratoriais e medicação em uso foram avaliadas. A atividade da doença [SLE Disease Activity Index (SLEDAI)], dano cumulativo [Lupus International Collaborating Clinics (SLICC)] foi determinado para cada paciente no dia da coleta de sangue. A SM foi avaliada através do critério da IDF - International diabetes federation. A dosagem da citocina foi realizada por ELISA (Enzyme Linked Immuno Sorbent Assay). Observamos uma prevalência de SM de aproximadamente 20% dos pacientes incluídos. Observamos um numero similar de pacientes com LES <18 anos com síndrome metabólica quando comparada com ? 18 anos de idade (p = 0,202). Observamos que pacientes com LES <18 anos apresentaram mais hipertrigliceridemia e pacientes ? 18 anos apresentaram mais frequentemente hipercolesterolemia, altos níveis de LDL-C e hipertrigliceridemia, Observamos correlação do SLEDAI ajustado ao longo do tempo com a definição do IDF nos pacientes com LES ? 18 anos (r = 0,229, p = 0,033). Observamos também uma maior razão CA/CQ em pacientes com LESj quando comparado ao grupo controle (p <0,001). Observou-se correlação com o IMC e CA (r = 0,58, p <0,001) e CQ (r = 0,53, p <0,001) nos pacientes com LESj e entre IMC e peso (r = 0,86, p <0,001), altura (r = 0,26, p = 0,030), CA (r = 0,59, p <0,001) e CQ (r = 0,55, p <0,001) nos controles. Observamos uma correlação entre CA e IMC (r = 0,53, p <0,001) e o IAC (r = 0,39, p <0,001) nos pacientes com LESj. Observamos uma correlação entre o IAC e o IMC (r = 0,48, p <0,001). A analise da DXA mostrou que em pacientes com SLEj 36,8% de massa de corpo inteiro corresponde a gordura, e 42,3% esta localizada na região do tronco. Em nosso estudo observamos um aumento dos níveis séricos de TNF-? em pacientes com LESj, houve o aumento dos níveis de TNF-? em pacientes com doença ativa, alem de uma correlação positiva entre a pontuação de SLEDAI, níveis de TNF-? também se correlacionaram com a porcentagem de gordura e a massa gorda na região do tronco. De acordo com nossos resultados, os pacientes com LESj, possuem maior prevalência de SM e uma distribuição central de gordura corporal maior do que indivíduos controlem. Devido ao grande aumento do risco cardiovascular nesses pacientes e necessario a avaliacao rotineira da SM e da composição corporal
Abstract: Systemic lupus erythematosus (SLE) is a chronic, multisystemic, relapsing and remitting autoimmune disease. Abnormalities such as leukopenia, hemolytic anemia, presence of autoantibodies such as anti-double-stranded DNA (anti-dsDNA), anti-Smith (anti-Sm) and antinuclear antibodies (ANA) can be found. When the diagnosis was made until 16 years old the patients was called childhood-onset SLE. Because of the greatest rate of cardiac involvement of these patients is very important to evaluate the risk factors to coronary diseases development The present cross-sectional study aimed to evaluate the presence of MetS in SLE patients and to compare with controls without autoimmune disease history and to evaluate the body composition and observe its association with the activity disease, laboratory data and corticosteroid treatment and TNF-?. We selected consecutive pediatric SLE patients followed at the Pediatric Rheumatology Unit of UNICAMP between 2010/2012. Clinical, laboratory, disease activity [SLE Disease Activity Index (SLEDAI)], cumulative damage [Systemic Lupus International Collaborating Clinics / American College of Rheumatology Damage Index (SDI)] and current drug exposure were evaluated. The MetS was evaluated by IDF - International diabetes federation criteria. The measurement of cytokines was performed by ELISA (Enzyme Linked Immuno Sorbent Assay). The prevalence of MetS in approximately 20% of patients included. We observed a similar number of SLE patients <18 years with MetS compared with ? 18 years of age (p = 0.202). We found that SLE patients <18 years presented with hypertriglyceridemia and patients ? 18 years were more frequently hypercholesterolemia, high LDL-C and hypertriglyceridemia observed correlation of SLEDAI adjusted over time with the definition of the IDF in SLE patients ? 18 years (r = 0.229, p = 0.033). We also observed a higher ratio HC / WC procedures in patients with SLE compared to the control group (p <0.001). Correlation with BMI and WC (r = 0.58, p <0.001) and HC (r = 0.53, p <0.001) in patients with SLE and between BMI and weight (r = 0.86, p <0.001), height (r = 0.26, p = 0.030), WC (r = 0.59, p <0.001) and HC (r = 0.55, p <0.001) in controls. We observed a correlation between WC and BMI (r = 0.53, p <0.001) and BAI (r = 0.39, p <0.001) in patients with SLE. We observed a correlation between the BAI and BMI (r = 0.48, p <0.001). The DXA analysis showed that in patients with cSLE 36.8% by weight of the whole body matches the fat, and 42.3% is located in the trunk. In our study we observed an increase in serum levels of TNF-? in patients with cSLE, there were increased levels of TNF-? in patients with active disease, and a positive correlation between the SLEDAI score, levels of TNF-? also correlated with the percentage of fat and fat mass in the trunk region. According to our results, patients with cSLE, have a higher prevalence of MetS and a central distribution of body fat greater than control subjects. Due to the large involvement of CVD in these patients is necessary routine assessment of MetS and body composition
Mestrado
Pediatria
Mestra em Ciências
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Almeida, Raitany Costa de 1977. "Hipertensão arterial sistêmica e outros fatores de risco cardiovascular em uma amostra da população de Porto Velho - RO = comparação urbana versus ribeirinha = Hypertesion and other cardiovascular risk factors in a sample of the population of Porto Velho - RO : urban area versus riverside area." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311543.
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Orientador: Otávio Rizzi CoelhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Hipertensão arterial sistêmica (HAS) é uma importante causa evitável de morbidade e mortalidade cardiovascular. Vários estudos apontam para o aumento de sua prevalência no mundo e baixo controle pressórico, mas existem poucos dados referentes as comunidades ribeirinhas. Esta pesquisa compara a prevalência, consciência, tratamento e controle de HAS entre população urbana e ribeirinha em Porto Velho, região Amazônica, assim como avalia outros fatores de risco cardiovascular. Foi conduzido um estudo transversal, fundamentado em inquérito domiciliar em indivíduos de 35 a 80 anos, recrutados entre julho e dezembro de 2013. Realizado entrevista com questionário padronizado, medidas de pressão arterial (PA), peso, altura e circunferência abdominal (CA). HAS foi definido através de indivíduos que relataram ter a doença, ou prescritos para uso de medicações anti-hipertensivas ou aqueles que tinham PA sistólica ? 140 mmHg ou PA diastólica ? 90 mmHg, na média de duas medidas usando dispositivo digital automático. Consciência foi baseada em autorrelatos, tratamento no uso de medicamento anti-hipertensivo, e controle foi definido quando indivíduos apresentavam PA menor do que 140/90 mmHg. Foi calculado índice de massa corpórea (IMC) e CA para avaliação de obesidade e obesidade abdominal. Também foi avaliado, através de autorrelatos, a taxa de diabetes, dislipidemia, tabagismo. Entre 1410 participantes, 750 (53,19%) tinham HAS e 473 (63,06%) eram cientes do diagnóstico. Daqueles que tinham consciência do diagnóstico, a maioria 404 (85.41%) recebia tratamento farmacológico, mas a taxa de controle foi baixa. As percentagens de prevalência e tratamento foram maiores na área urbana, respectivamente, (55,48% vs. 48,87%)(p=0,02) e (61,25% vs. 52,30%)(p<0,01). A consciência de HAS foi maior na área ribeirinha (61,05% vs. - 67,36%)(p<0,01), mas as taxas de controle, tanto entre todos os hipertensos quanto naqueles que faziam tratamento farmacológico, foram similares, respectivamente, (22,11% vs. 23,43%)(p=0,69) e (33,88% vs. 34,32%) (p=0,77). Não houve diferença significativa no sobrepeso (40,93% vs. 40,28%)(p=0,73); obesidade (19,10% vs 19,63%)(p=0,68) e tabagismo (18,56% vs. 16,76%)(p=0,09). Cerca de metade dos participantes apresentavam HAS. A prevalência foi mais alta nos urbanos, mas a diferença para os ribeirinhos foi pequena. Dos indivíduos hipertensos, tanto na área urbana quanto ribeirinha, menos de um quarto tinham HAS controlada
Abstract: High blood pressure (hypertension) is a major preventable cause of cardiovascular morbidity and mortality. Several studies indicate to the increase its prevalence in the world and low control rate, but there are few data on the riverside communities. This research compares the prevalence, awareness, treatment and control of hypertension between urban and riverside population in Porto Velho, the Amazon region, as well as evaluating other cardiovascular risk factors. A cross-sectional study was conducted, based on a household survey in individuals 35-80 years recruited between July and December 2013. Directed interview with standardized questionnaire, blood pressure measurements (PA), weight, height and waist circumference (WC). Hypertension was defined by individuals who reported having the disease, or prescribed for use of antihypertensive medications or those who had systolic blood pressure ? 140 mmHg or diastolic BP ? 90 mmHg, the mean of two measurements using automatic digital device. Awareness was based on self-reports, treatment in the use of antihypertensive medication, and control was defined as a BP ? 140/90 mm Hg. We calculated body mass index (BMI) and WC for assessing obesity and abdominal obesity. We also assessed through self-report, the rate of diabetes, dyslipidemia, smoking. Among 1410 participants, 750 (53.19%) had hypertension and 473 (63.06%) were aware of their diagnosis. Of those who were aware of the diagnosis, 404 (85.41%) received pharmacological treatment, but the control rate was low. The percentages of prevalence and treatment were higher in urban areas, respectively (55.48% vs. 48.87%) (p = 0:02) and (61.25% vs. 52.30%) (p <0.01). Awareness was higher in the riverside area (61.05% vs. 67.36%) (p <0.01), but control rates, both among all hypertensive patients and in those who were pharmacological treatment were similar, respectively, (22.11% vs . 23.43%) (p = 0.69) and (33.88% vs. 34.32%) (p = 0.77). - There was no significant difference in the overweight (40.93% vs. 40.28%) (p = 0.73); obesity (19.10% vs. 19.63%) (p = 0.68) and smoking (18.56% vs. 16.76%) (p = 0.09). Hypertension prevalence was higher in the urban population than in the riverside population. Of the hypertensive individuals in both areas, < 25% had controlled blood pressure
Doutorado
Clinica Medica
Doutor em Clínica Médica
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Leboeuf, Charlotte. "Potential predictors and outcomes of physical activity : comparisons between physically active and inactive adolescent boys." Title page, table of contents and abstract only, 1991. http://web4.library.adelaide.edu.au/theses/09MPM/09mpml447.pdf.
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Al-Lage, Jéssica Guimarães. "Perfil epidemiológico, modulação autonômica cardíaca e escores de risco cirúrgico de indivíduos eletivos para cirurgia de revascularização do miocárdio /." Rio Claro, 2019. http://hdl.handle.net/11449/190800.
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Orientador: Robison José QuitérioResumo: Introdução: Em decorrência do número elevado de comorbidades associadas à Doença Arterial Coronariana (DAC), os modelos de previsão de risco para cirurgia cardíaca foram desenvolvidos com a finalidade de melhor caracterizar os fatores que influenciam os resultados deste procedimento. Além dos escores de risco utilizados mundialmente “European System for Cardiac Operative Risk Evaluation” (EUROSCORE II) e “Society of Thoracic Surgeons” (STS), a Variabilidade da Frequência Cardíaca (VFC) tem surgido como um novo instrumento de previsão do risco cardiovascular e cirúrgico. Objetivo: Caracterizar os pacientes eletivos para cirurgia de revascularização do miocárdio na região de Marília-SP-Brasil, quanto aos fatores de risco e controle neural do coração; Verificar se existe correlação entre os índices da VFC e os escores de risco cirúrgico EUROSCORE II e STS. Amostra: Foi composta por indivíduos de ambos os sexos, acima de 50 anos, eletivos para cirurgia de revascularização do miocárdio (Hospital Santa Casa de Misericórdia de Marília). O Grupo Controle (GC) foi composto por indivíduos de ambos os sexos, acima de 50 anos, saudáveis. Procedimentos do Estudo: Foi realizada a anamnese na qual foram avaliados os fatores de risco para doença cardiovascular. O registro do intervalos RR foi obtido na postura decúbito dorsal, por 20 minutos, em respiração espontânea. Os índices da VFC (lineares e não lineares) foram analisados, comparados com um grupo controle e correlacionados com valores ... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: Due to the high number of comorbidities associated with Coronary Artery Disease (CAD), risk prediction models for cardiac surgery were developed with the purpose of better characterizing the factors that influence the results of this procedure. In addition to the European System for Cardiac Operative Risk Evaluation (EUROSCORE II) and Society of Thoracic Surgeons (STS) worldwide, Heart Rate Variability (HRV) has emerged as a new tool for predicting cardiovascular risk and surgical. Objective: To characterize elective patients for myocardial revascularization surgery in the Marília-SP-Brazil region, regarding risk factors and neural control of the heart; To verify if there is a correlation between the HRV indices and the surgical risk scores EUROSCORE II and STS. Sample: It was composed of individuals of both sexes, over 50 years old, elective for myocardial revascularization surgery (Santa Casa de Misericórdia Hospital of Marília). The Control Group (CG) was composed of individuals of both genders, over 50 years, healthy. Study Procedures: An anamnesis was performed in which the risk factors for cardiovascular disease were evaluated. RR interval recording was obtained in the dorsal decubitus position for 20 minutes in spontaneous breathing. The HRV indices (linear and non-linear) were analyzed, compared to a control group and correlated with values obtained from EUROSCORE II and STS. The data were organized as descriptive statistics, with values of mean and stan... (Complete abstract click electronic access below)
Mestre
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Pretorius, Jakobus. "Investigation of the relationship between genetic and environmental risk factors associated with obesity and insulin resistance in South African patients with non-alcoholic fatty liver disease(NAFLD)." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71689.
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Thesis (MSCMedSc)--Stellenbosch University, 2012.Includes bibliography
ENGLISH ABSTRACT: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in the world. The disease spectrum of NAFLD extends from steatosis (types 1,2) to non-alcoholic steatohepatitis (NASH) with inflammation (types 3,4). The aims of the study were 1) to analytically validate high-throughput real time polymerase chain reaction (RT-PCR) assays for three selected single nucleotide polymorphisms (SNPs), FTO rs9939609 (intron 1 T>A), TNF-α rs1800629 (-308 G>A) and PPARγ rs1801282 (Pro12Ala, 34 C>G), and 2) to perform genotype-phenotype association studies in relation to biochemical abnormalities, disease severity and age of onset. A total of 119 patients with fatty liver identified on ultrasound, including 88 histologically confirmed NAFLD patients, and 166 control individuals were genotyped for the three selected SNPs. RT-PCR validated against direct sequencing as the gold standard was used for detection of genetic variation. All three SNPs were in Hardy Weinberg equilibrium in the study population, except for a deviation in genotype distribution detected for PPARγ rs1801282 in the NAFLD patient subgroup (p<0.001). After adjustment for age and gender, the risk-associated FTO rs9939609 A-allele was detected at a significantly higher frequency in the Caucasian compared with Coloured patients (p=0.005). The opposite was detected for the risk-associated TNF-α rs1800629 A-allele, which occurred at a significantly higher frequency in the Coloured compared with Caucasian NAFLD patients (p=0.034). The onset of fatty liver disease symptoms was on average 5 years younger in the presence of each risk-associated TNF-α rs1800629 A-allele (p=0.028). When considered in the context of an inferred genotype risk score ranging from 0-6, disease onset occurred on average 3 years earlier (p=0.008) in the presence of each risk-associated FTO A-allele, TNF-α A-allele or PPARγ C-allele. After adjustment for age, gender and race, no differences in genotype distribution or allele frequencies were observed between histologically confirmed NAFLD (types 1,2) and NASH (types 3,4) patients, while the minor allele frequency for the TNF-α rs1800629 was significantly higher in the total NAFLD (types 1-4) (p=0.047) as well as NASH subgroup (NAFLD types 3,4) (p=0.030) compared with obese patients without a histologically confirmed NAFLD diagnosis. A significant correlation was furthermore observed between the number of TNF-α rs1800629 A-alleles and increasing CRP levels (p=0.029), with a favourable reduced effect in the presence of low- to moderate alcohol intake. The average waist circumference of physically active NAFLD patients was 12% lower than in physically inactive patients (p=0.004). In view of the results presented in this study, the inclusion of the selected SNPs, and in particular the pro-inflammatory TNF-α rs1800629 polymorphism, may be considered as part of a comprehensive cardiovascular risk evaluation of NAFLD patients. Ultimately, early detection of patients with fatty liver disease symptoms and effective intervention based on the underlying disease mechanism may prevent progression from NAFLD to NASH, shown to be an independent risk factor for cardiovascular diseases.
AFRIKAANSE OPSOMMING: Nie-alkoholiese lewervervetting (NALV) is die mees algemene kroniese lewersiekte in die wêreld. Die siektespektrum van NALV strek van steatose (vervette lewer tipes 1,2) tot steatohepatitis met inflammasie (NASH tipes 3,4). Die doel van die studie was 1) om analities die hoë omset polimerase kettingreaksie (RT-PKR) metode te valideer vir die geselekteerde enkel nukleotied polimorfismes (ENPs) FTO rs9939609 (intron 1 T>A), TNF-α rs1800629 (-308 G>A) en PPARγ rs1801282 (Pro12Ala, 34 C>G), en 2) om genotipe-fenotipe assosiasie studies uit te voer ten opsigte van relevante biochemiese abnormaliteite, graad van die siekte en aanvangsouderdom. ’n Totaal van 119 pasiënte met vervette lewers is geïdentifiseer met behulp van ultraklank, insluited 88 histologies-bevestigde NALV pasiënte, en 166 kontrole individue. Hierdie pasiënte is gegenotipeer vir die 3 geselekteerde ENP’s. RT-PKR gevalideer met direkte DNA volgorde bepaling as die goue standaard, is gebruik vir opsporing van genetiese variasie. Al die ENP’s was in Hardy Weinberg ekwilibrium in die studie populasie, behalwe vir ’n afwyking in genotipe verspreiding waargeneem vir PPARγ in die NALV subgroep (p<0.001). Nadat aanpassings gemaak is vir ouderdom en geslag, is die risiko-geassosieerde FTO rs9939609 A-alleel waargeneem teen ’n betekenisvol hoër frekwensie in die Kaukasiese pasiënte in vergelyking met Kleurling pasiënte (p=0.005). Die teenoorgestelde is waargeneem vir die risiko-geassosieerde TNF-α rs1800629 A-alleel wat voorgekom het teen ’n betekenisvol hoër frekwensie in die Kleurling NALV pasiënte, in vergelyking met Kaukasiese NALV pasiënte (p=0.034). Die aanvang van NALV was gemiddeld 5 jaar vroeër in die teenwoordigheid van elke risiko-geassosieerde TNF-α rs1800629 A-alleel (p=0.028). Met inagneming van ’n genotipe risiko telling tussen 0–6, het aanvang van siekte gemiddeld 3 jaar vroeër voorgekom (p=0.008) in die teenwoordigheid van elke toenemende risiko-geassosieerde FTO A-alleel, TNF-α A-alleel en PPARγ C-alleel. Nadat aanpassings gemaak is vir ouderdom, geslag en ras, is geen verskille waargeneem in genotipe verspreiding of alleel frekwensies tussen histologies bevestigde NALV (tipes 1,2) en NASH (tipes 3,4) pasiënte nie, terwyl die minor alleel telling vir die TNF-α rs1800629 betekenisvol hoër was in die totale NALV (tipes 1–4) (p=0.047) asook die NASH subgroep (NALV tipes 3,4) (p=0.03) in vergelyking met vetsugtige pasiënte sonder ’n histologies bevestigde diagnose. ‘n Statisties beteknisvolle korrelasie is verder waargeneem tussen die aantal TNF-α rs1800629 A-allele en toenemende CRP vlakke (p=0.029), met n gunstige verlaagde effek in die teenwoordigheid van lae alcohol gebruik. Die gemiddelde middellyf-omtrek van fisies aktiewe NALV pasiënte was 12% minder as fisies onaktiewe pasiente (p=0.004). Na aanleiding van die resultate van hierdie studie behoort insluiting van geselekteerde ENP’s, en in besonder die pro-inflammatoriese TNF-α rs1800629 polimorfisme, as deel van ’n omvattende kardiovaskulere risiko evaluasie oorweeg te word. Aan die einde van die dag mag vroeë identifikasie van NALV pasiente en effektieve intervensie gebasseer op die onderliggende siekte meganisme, vordering tot NASH verhoed wat getoon is om ’n onafhanklike risiko faktor vir kardiovaskulêre siekte te wees.
Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology
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Rodrigues, Sara. "Avaliação da rigidez arterial e da resistência vascular periférica em pacientes recém-diagnosticados com síndrome metabólica." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-24102016-115125/.
Full textAbstract:
Além das alterações autonômicas, a síndrome metabólica (SMet) causa disfunção vascular relacionada a eventos cardiovasculares e morte. Considerando que a resistência à insulina é associada à hiperativação simpática, testamos a hipótese de que a presença da glicemia de jejum alterada (GLI) é a principal causa das alterações estruturais e funcionais em grandes e pequenos vasos, via aumento do tônus simpático nesses pacientes. Foram avaliados pacientes com SMet recém diagnosticados (ATP-III) e não medicados, divididos em: glicemia de jejum alterada >=100mg/dL (SMet+GLI, n=35; 50±1 anos) e glicemia normal < 100mg/dL (SMet-GLI, n=24, 46 ± 1). Um grupo de indivíduos saudáveis foi estudado como controle (CS, n=17, 50±1 anos). Foram medidas rigidez arterial (velocidade de onda de pulso, VOP), atividade nervosa simpática muscular (ANSM, microneurografia) fluxo sanguíneo muscular (FSM, pletismografia), pressão arterial média (PAM, oscilométrico), resistência vascular periférica (RVP=PAM/FSM) e dimetilarginina assimétrica (ADMA). SMet+GLI apresentou maior VOP que SMet-GLI e CS (8,0[7,2-8,6], 7,3[6,9-7,9] e 6,9[6,6-7,2]m/s, respectivamente, P=0,001), não havendo diferença entre SMet-GLI e CS. Além disso, SMet+GLI foi similar ao SMet-GLI mas teve maior RVP que CS (P=0,008), não havendo diferença entre SMet-GLI e CS. Adicionalmente, SMet+GLI teve maior ANSM que SMet-GLI e CS; enquanto SMet-GLI teve maior ANSM que CS (31+-1; 26+-1; 19+-1 disparos /min, P < 0,001). ADMA foi similar entre os grupos (0,62 [0,56-0,71], 0,67 [0,59-0,92] e 0,60 [0,54-1,43] umol/L). Dentre os fatores de risco da SMet, GLI foi preditor do aumento da ANSM. ANSM foi associada à VOP (R=0.39; P=0,002) e à RVP (R=0,30, P=0,034). Em conclusão, a hiperativação simpática, que está aumentada na presença da glicemia alterada, é o mecanismo básico que pode explicar, pelo menos em parte, o aumento na VOP e na RVP. GLI parece ser o principal fator de risco no prejuízo da função e estrutura vascular nos pacientes com SMetBesides autonomic alterations, metabolic syndrome (MetS) causes vascular dysfunction related to cardiovascular events and death. Since insulin resistance is associated with sympathetic hyperactivation, we tested the hypothesis that the presence of impaired fasting glucose (IFG) is the main cause of structural and functional changes of large and small vessels via elevated sympathetic tonus in these patients. We evaluated never treated, newly diagnosed MetS (ATP-III) patients divided into: impaired fasting glucose >100mg/dL (MetS+IFG, n=35; 50±1 y) and normal fasting glucose <100mg/dL (MetS-IFG, n=24, 46±1 y). A healthy control group was also studied (C, n=17, 50±1 y). We measured the arterial stiffness (pulse wave velocity, PWV), muscle sympathetic nerve activity (MSNA, microneurography), forearm blood flow (FBF, plethysmography), mean blood pressure (MBP, oscillometric), peripheral vascular resistance (PVR=MBP/FBF) and asymmetric dimethylarginine (ADMA). MetS+IFG had higher PWV than MetS-IFG and C (8.0[7.2-8.6], 7.3[6.9-7.9] and 6.9[6.6-7.2]m/s, respectively, P=0.001), whereas SMet-GLI was similar to CS. Moreover, MetS+IFG was similar to MetS-IFG, but had higher PVR than C (P=0.008) and SMet-GLI was similar to CS. In addition, MetS+IFG had higher MSNA than MetS-IFG and C; whereas MetS-IFG had higher MSNA than C (31 +- 1; 26+- 1; 19+-1 bursts/min, P < 0.001). ADMA were similar among groups (0.62 [0.56-0.71] vs 0.67 [0.59-0.92] and 0.60 [0.54-1.43] umol/L). Among MetS risk factors, IFG was predictor of increased MSNA. Further, MSNA was associated with PWV (R=0.39; P=0.002) and PVR (R=0.30, P=0.034). In conclusion, sympathetic hyperactivation, which is enhanced in the presence of high blood glucose, is the basic mechanism that could explain, at least in part, the increase in PWV and PVR. IFG appears to be the main risk factor in the vascular function and structure damage in MetS patients
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Pizzi, Oswaldo Luiz. "Velocidade da onda de pulso em adultos jovens acompanhados por 18 anos: impacto de variáveis pressóricas, antropométricas, metabólicas, inflamatórias e de função endotelial. Estudo do Rio de Janeiro." Universidade do Estado do Rio de Janeiro, 2013. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=4851.
Full textAbstract:
Dados sobre a avaliação não invasiva da rigidez vascular e suas relações com variáveis de risco cardiovascular são escassos em jovens. Objetiva avaliar a relação entre a velocidade de onda de pulso (VOP) e a pressão arterial (PA),
variáveis antropométricas, metabólicas, inflamatórias e de disfunção endotelial em indivíduos adultos jovens. Foram estudados 96 indivíduos (51 homens) do Estudo do Rio de Janeiro, em duas avaliações, A1 e A2, com intervalo de 17,691,58 anos (16 a 21 anos). Em A1 foram avaliados em suas escolas (10-15 anos - média 12,421,47 anos) e em A2 foram novamente avaliados em nível ambulatorial (26-35
anos - média 30,091,92 anos). Em A1 foram obtidos pressão arterial (PA) e índice de massa corporal (IMC). Em A2 foram obtidos a velocidade da onda de pulso (VOP)-método Complior, PA, IMC, circunferência abdominal (CA), glicose, perfil lipídico, leptina, insulina, adiponectina, o índice de resistência à insulina HOMA-IR, proteína C-Reativa ultrassensível (PCRus) e as moléculas de adesão E-selectina,
Vascular Cell Adhesion Molecule-1(VCAM-1) e Intercellular Adhesion Molecule-1 (ICAM-1). Foram obtidos, ainda, a variação da PA e do IMC entre as 2 avaliações. Em A2 os indivíduos foram estratificados segundo o tercil da VOP para cada sexo. Como resultados temos: 1) Os grupos foram constituídos da seguinte forma: Tercil 1:homens com VOP < 8,69 m/s e mulheres com VOP < 7,66 m/s; Tercil 2: homens
com VOP ≥ 8,69 m/s e < 9,65m/s e mulheres com VOP ≥ 7,66 m/s e < 8,31m/s;Tercil 3:homens com VOP ≥ 9,65 m/s e mulheres com VOP ≥ 8,31 m/s. 2) O grupo com maior tercil de VOP mostrou maiores médias de PA sistólica (PAS) (p=0,005), PA diastólica (PAD) (p=0,007), PA média (PAM) (p=0,004), variação da PAD (p=0,032), variação da PAM (p=0,003), IMC (p=0,046), variação do IMC (p=0,020), insulina (p=0,019), HOMA-IR (p=0,021), E-selectina (p=0,032) e menores médias de adiponectina (p=0,016), além de maiores prevalências de diabetes mellitus/intolerância à glicose (p=0,022) e hiperinsulinemia (p=0,038); 3) Houve correlação significativa e positiva da VOP com PAS (p<0,001), PAD (p<0,001), PP (p=0,048) e PAM (p<0,001) de A2, com a variação da pressão arterial (PAS, PAD e PAM) (p<0,001) entre as duas avaliações, com o IMC de A2 (p=0,005) e com a variação do IMC (p<0,001) entre as duas avaliações, com CA (p=0,001), LDLcolesterol
(p=0,049) e E-selectina (p<0,001) e correlação negativa com HDLcolesterol (p<0,001) e adiponectina (p<0,001); 4)Em modelo de regressão múltipla, após ajuste do HDL-colesterol, LDLcolesterol e adiponectina para sexo, idade, IMC e PAM, apenas o sexo masculino e a PAM mantiveram correlação significativa com a VOP. A VOP em adultos jovens mostrou relação significativa com variáveis de risco
cardiovascular, destacando-se o sexo masculino e a PAM como importantes variáveis no seu determinismo. Os achados sugerem que a medida da VOP pode ser útil para a identificação do acometimento vascular nessa faixa etária.Data on non-invasive evaluation of vascular stiffness in the young and its relationship with cardiovascular (CV) risk variables are scarce. Objective to assess the relationship between pulse wave velocity (PWV) and blood pressure (BP), anthropometric, metabolic, inflammatory and endothelial dysfunction variables in young adults. Ninety-six individuals (51 males) from The Rio de Janeiro Study cohort were studied in two evaluations, A1 and A2, with an interval of 17.69 1.58 years (16-21 years). In A 1 they were evaluated at their schools (10-15 years average 12.42 1.47 years) and in A2 they were all re-evaluated as outpatients (26-35 years - average 30.09 1.92 years). In A1 BP and body mass index (BMI) were obtained. In A2 pulse wave velocity (PWV) by Complior method, BP, BMI, waist circumference (WC), glucose, lipid profile, leptin, insulin, adiponectin, the HOMA-IR insulin resistance index, high sensitive C-Reactive protein (CRPhs) and E-selectin, Vascular Cell Adhesion Molecule 1 (VCAM-1) and Intercellular Adhesion Molecule 1 (ICAM-1) adhesion molecules were obtained. The BP and BMI variation over the time interval between the two evaluations were also obtained. Subjects were stratified according to tertile of PWV for each sex in A2. As results: 1) The groups were constituted as follows: Tertile 1: males with PWV <8.69 m/s and females with PWV <7.66 m/s; Tertile 2: males with PWV ≥ 8.69 m/s and <9.65 m/s and females with PWV ≥ 7.66 m/s and <8.31 m/s; Tertile 3: males with PWV ≥ 9.65 m/s and females with PWV ≥ 8.31 m/s 2) The group with the highest PWV tertile showed higher values of systolic BP (SBP) (p=0.005), diastolic BP (DBP) (p=0.007), mean BP (MBP) (p=0,004), DBP variation (p=0,032), MBP variation (p=0.033), BMI (p=0.046), BMI variation (p=0.020), insulin (p=0.019), HOMA-IR (p=0.021), E-Selectin (p=0.032) and lower values of adiponectin (p=0.016), besides higher prevalence of diabetes mellitus/glucose intolerance (p=0.022) and hyperinsulinemia (p=0.038); 3) There were a significant positive correlation of PWV with SBP (p<0,001), DBP (p<0,001), PP (p=0,048) and MBP (p<0,001) from A2, variation in blood pressure (SBP, DBP, and MBP) (p<0,001) between the two assessments, BMI (p=0.005) and BMI variation between the two evaluations (p<0,001), WC (p=0.001), LDL-cholesterol (0.049), and E-selectin (p<0,001) and negative correlation with HDL-cholesterol (p<0,001) and adiponectin (p<0,001); 4) In the multiple regression model, HDL-cholesterol, LDL-cholesterol and adiponectin lost statistical significance after adjustment for sex, age, BMI and MBP, only the male gender and MBP remained significantly correlated with PWV. PWV in young adults showed a significant association with CV risk variables, highlighting the male gender and MBP as important variables in its determining. The findings suggest that measurement of PWV can be useful for the identification of vascular impairment in this age group.
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Bennett, Stanley Arthur. "Trends and social inequalities in cardiovascular risk factors." Phd thesis, 1996. http://hdl.handle.net/1885/143647.
Full text
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Miller, Kelli A. "The relationship of sociocultural factors and lifestyle cognitive representations to cardiovascular risk factors." 1998. http://catalog.hathitrust.org/api/volumes/oclc/166884767.html.
Full text
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"Work-related stress and cardiovascular risk factors in Chinese." 2004. http://library.cuhk.edu.hk/record=b6073711.
Full textAbstract:
Xu Liying."April 2004."
Thesis (Ph.D.)--Chinese University of Hong Kong, 2004.
Includes bibliographical references (p. 159-175)
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Mode of access: World Wide Web.
Abstracts in English and Chinese.
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Mui, Suet-Lam. "A cardiovascular disease policy model for Australia using a microsimulation approach." Phd thesis, 1999. http://hdl.handle.net/1885/147334.
Full text
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Munthali, Richard Junganiko. "Longitudinal analysis of genetic risk factors for cardiovascular disease: the birth to twenty plus cohort." Thesis, 2017. http://hdl.handle.net/10539/23491.
Full textAbstract:
A thesis
submitted to the School of Molecular and Cell Biology, Faculty of Science, University
of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree
of
Doctor of Philosophy
June 2017
Johannesburg, South AfricaNon-communicable diseases (NCDs) pose an increasing burden on public health and economic growth worldwide. The highest increase in prevalence and death rates of NCDs has been seen in low and middle-income countries (LMICs). World Health Organization (WHO) estimates that by 2030, NCDs will account for five times as many deaths as communicable diseases in LMICs and that there will be more than 2.16 billion overweight and 1.12 billion obese individuals in the world. It is also estimated that by 2020 NCDs will contribute 80 percent of the global burden of disease and the largest increase in NCD deaths will occur in Africa. Recent reports indicate that six of the ten leading natural causes of death in South Africa are NCDs. There are few studies that have used longitudinal data to understand the effects of life-course childhood adiposity on future health risks and the early life factors responsible for variations in lifecourse childhood obesity. However, it is not known whether there is a genetic basis for the variability in BMI developmental patterns over time. Lack of comprehensive longitudinal and genetic association data for obesity have made it difficult to do such studies in an African setting. It is still not clear whether the same genetic variants associated with obesity in Europeans and other populations are also associated with these traits in African populations. Understanding the genetic contribution to obesity in the black South African population may help to come up with effective interventions to deal with this emerging epidemic in Africa. The aim of this thesis was to better understand the contribution of genetics and explain the longitudinal genetic basis of childhood and adolescence obesity in black South African children. To deal with this, I firstly studied identification of distinct trajectories of BMI and then relate the established BMI trajectories to the future health risks of elevated blood pressure. Secondly, I explored the early life factors behind BMI trajectory membership, this would help to identify factors that may accelerate an individual’s progression from a normal BMI trajectory pattern membership to the one characterized with elevated BMI. Then lastly, I looked at the additive genetic effect for BMI and determine whether genetic risk of obesity in early adulthood was mediated by early life rapid growth. Results showed variation in BMI developmental patterns between boys and girls; three and four distinct sex-specific BMI trajectories were identified in boys and girls respectively. Children belonging to early onset overweight or obese BMI trajectories, characterized by elevated BMI, had an increased risk of elevated blood pressure in late adolescence, compared to their peers in the normal trajectories. Rapid conditional relative weight gain in early life was associated with increased risk of belonging to a BMI trajectory characterized by consistent elevated BMI over time. Individuals in overweight or obese trajectories had a higher chance of being overweight or obese in early adulthood. I found that a genetic risk score, based on known adult BMI Caucasian risk variants, showed significant longitudinal effects of genetic loci with BMI in childhood and adolescent and significant age-GRS interactions were observed. A higher genetic risk score predicted membership of early onset obese or overweight BMI trajectories. The genetic risk of obesity at 18 years of age was mediated by pre-adolescence and adolescence rapid weight gain. The results from this thesis emphasize the importance of studying individual’s BMI developmental patterns when studying development and progression of obesity. These findings also show that the information obtained from GWAS done in other populations can be equally relevant to African populations and this could be used in early identification of individuals at increased risk of obesity and other NCDs risk factors. Combing genetic risk score, BMI trajectories membership and weight status can be used to help improve the screening process of individuals to be targeted in coming up with targeted educational and behavior intervention programmes for obesity. These programmes should target individuals at risk at early stage in order to reduce the adverse health risk outcomes later in life.
MT 2017
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Moore, Vivienne Marie. "Fetal growth and cardiovascular risk factors in an Australian cohort / Vivienne Moore." Thesis, 1997. http://hdl.handle.net/2440/19017.
Full textAbstract:
Bibliography: leaves 192-212.xv, 212 leaves ; 30 cm.
The present study investigates the relationships between fetal growth, as manifest in size and shape at birth, and later blood pressure and blood lipids, in an Australian cohort. Data on these outcomes for cohort members at age 8 years are available from a previous study. Birth details (body weight, placental weight, head circumference, chest circumference and length) are abstracted from hospital records. In addition, a follow up of cohort members is undertaken to collect new data pertaining to the two cardiovascular risk factors at 20 years of age. Socio-economic circumstances are characterised at birth, age 8 and age 20.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 1997?
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"Microalbuminuria, heavy metals and cardiovascular risk factors in Hong Kong Chinese school children." 2011. http://library.cuhk.edu.hk/record=b5894630.
Full textAbstract:
Xiao, Kang.Thesis (M.Phil.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 83-103).
Abstracts in English and Chinese.
Abstract --- p.I
摘要 --- p.VI
Chapter Chapter 1 --- Background --- p.1
Chapter 1.1 --- Introduction --- p.1
Chapter 1.2 --- Albuminuria --- p.3
Chapter 1.2.1 --- Definition --- p.3
Chapter 1.2.2 --- Albuminuria in adolescents/children --- p.6
Chapter 1.2.3 --- Prevalence of albuminuria in adults and adolescents --- p.8
Chapter 1.2.4 --- Pathogenesis of albuminuria --- p.10
Chapter 1.3 --- CVD and risk factors --- p.12
Chapter 1.4 --- The associations between microalbuminuria and CVD risk factors --- p.17
Chapter 1.5 --- Heavy metals --- p.18
Chapter 1.5.1 --- Definition of heavy metals --- p.18
Chapter 1.5.2 --- Adverse effects of heavy metals --- p.19
Chapter 1.5.3 --- Heavy metals exposure In Hong Kong population: the local scene --- p.28
Chapter 1.6 --- MicroRNAs --- p.29
Chapter 1.6.1 --- The discovery of microRNAs --- p.29
Chapter 1.6.2 --- The biogenesis of microRNAs --- p.30
Chapter 1.6.3 --- The function of microRNAs --- p.31
Chapter 1.7 --- Hypothesis --- p.40
Chapter Chapter 2 --- Methodology --- p.41
Chapter 2.1 --- Population --- p.41
Chapter 2.2 --- Laboratory assays --- p.42
Chapter 2.3 --- Statistical analysis --- p.44
Chapter Chapter 3 --- Results --- p.46
Chapter 3.1 --- Demographic and baseline clinical data --- p.46
Chapter 3.2 --- Microalbuminuria and cardiovascular risk factors --- p.48
Chapter 3.3 --- Microalbuminuria and heavy metals --- p.51
Chapter 3.4 --- Microalbuminuria and miRNAs --- p.54
Chapter 3.5 --- "Microalbuminuria, miRNAs, heavy metals and cardiovascular risk factors" --- p.57
Chapter 3.6 --- miRNAs and heavy metals --- p.60
Chapter Chapter 4 --- Discussion --- p.62
Chapter 4.1 --- Heavy metals and microalbuminuria --- p.62
Chapter 4.2 --- Heavy metals and CVD risk factors --- p.68
Chapter 4.3 --- Microalbuminuria and CVD risk factors --- p.75
Chapter 4.4 --- miRNAs and Heavy metals --- p.76
Chapter 4.5 --- miRNAs and microalbuminuria --- p.77
Chapter 4.6 --- Conclusion --- p.79
Acknowledgement --- p.82
References --- p.83
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"Cardiovascular complications of childhood obstructive sleep apnea syndrome." 2007. http://library.cuhk.edu.hk/record=b5893248.
Full textAbstract:
Au, Chun Ting.Thesis (M.Phil.)--Chinese University of Hong Kong, 2007.
Includes bibliographical references (leaves xxvii-lv).
Abstracts in English and Chinese.
ACKNOWLEDGEMENTS --- p.i
ABSTRACT
In English --- p.ii
In Chinese --- p.v
LIST OF TABLES --- p.vii
ABBREVIATIONS
For Units --- p.ix
For Prefixes of the international system of units --- p.ix
For Terms commonly used in the report --- p.x
STATEMENT OF WORK DONE --- p.xvi
Chapter CHAPTER 1 --- Overview of Childhood Obstructive Sleep Apnea Syndrome (OSAS)
Chapter 1.1. --- Clinical Features of Childhood OSAS --- p.1
Chapter 1.2. --- Definition of Childhood OSAS --- p.2
Chapter 1.3. --- Prevalence of Childhood OSAS --- p.3
Chapter 1.4. --- Pathophysiology --- p.4
Chapter 1.5. --- Risk Factors --- p.6
Chapter 1.6. --- Diagnosis --- p.10
Chapter 1.7. --- Treatment
Chapter 1.7.1. --- Tonsillectomy and Adenoidectomy (T&A) --- p.12
Chapter 1.7.2. --- Continuous Positive Airway Pressure (CPAP) --- p.14
Chapter 1.7.3. --- Corticosteroids --- p.15
Chapter 1.7.4. --- Leukotriene Receptor Antagonist --- p.16
Chapter 1.8. --- Complications of Childhood OSAS
Chapter 1.8.1. --- Growth Failure --- p.17
Chapter 1.8.2. --- Neurocognitive Abnormalities --- p.19
Chapter 1.8.3. --- Cardiovascular Abnormalities --- p.20
Chapter CHAPTER 2 --- Cardiovascular Complications of OSAS in Adults (Literature Review)
Chapter 2.1. --- Acute Effects of OSAS on Cardiovascular System --- p.21
Chapter 2.2. --- Chronic Effects of OSAS on Cardiovascular System --- p.23
Chapter 2.3. --- Hypertension --- p.24
Chapter 2.4. --- Heart Failure --- p.28
Chapter 2.5. --- Pulmonary Hypertension --- p.30
Chapter 2.6. --- Arrhythmias --- p.31
Chapter 2.7. --- Cardiac Ischemia and Vascular Disease --- p.33
Chapter 2.8. --- Stroke --- p.34
Chapter CHAPTER 3 --- Cardiovascular Complications of Childhood OSAS (Literature Review)
Chapter 3.1. --- Blood Pressure --- p.37
Chapter 3.2. --- Ventricular Structure and Function --- p.40
Chapter 3.3. --- Arterial Distensibility --- p.42
Chapter 3.4. --- Heart Rate Variability --- p.42
Chapter CHAPTER 4 --- Ambulatory Blood Pressure in Children with OSAS
Chapter 4.1. --- Introduction --- p.44
Chapter 4.2. --- Methods
Chapter 4.2.1. --- Subjects and Study Design --- p.46
Chapter 4.2.2. --- Polysomnography (PSG) --- p.47
Chapter 4.2.3. --- Ambulatory Blood Pressure Measurement (ABPM) --- p.49
Chapter 4.2.4. --- Statistical Analysis --- p.50
Chapter 4.3. --- Results
Chapter 4.3.1. --- Subject Characteristics --- p.52
Chapter 4.3.2. --- Blood Pressure during Wakefulness --- p.55
Chapter 4.3.3. --- Blood Pressure during Sleep --- p.57
Chapter 4.4. --- Discussion --- p.62
Chapter 4.5. --- Conclusion --- p.70
Chapter CHAPTER 5 --- Cardiac Remodeling and Dysfunction in Children with OSAS
Chapter 5.1. --- Introduction --- p.71
Chapter 5.2. --- Methods
Chapter 5.2.1. --- Subjects and Study Design --- p.72
Chapter 5.2.2. --- Polysomnography (PSG) --- p.74
Chapter 5.2.3. --- Conventional Echocardiography --- p.75
Chapter 5.2.4. --- Tissue Doppler Imaging --- p.76
Chapter 5.2.5. --- Statistical Analysis --- p.77
Chapter 5.3. --- Results
Chapter 5.3.1. --- Study Population --- p.79
Chapter 5.3.2. --- Polysomnographic Findings --- p.79
Chapter 5.3.3. --- Echocardiographic Findings
Chapter 5.3.3.1. --- Right Ventricle --- p.81
Chapter 5.3.3.2. --- Left Ventricle --- p.83
Chapter 5.3.4. --- Treatment Effect --- p.86
Chapter 5.4. --- Discussion --- p.90
Chapter 5.5. --- Conclusion --- p.95
Chapter CHAPTER 6 --- Conclusion --- p.96
APPENDIX I Hong Kong Children Sleep Questionnaire (Chinese) --- p.xvii
APPENDIX II Hong Kong Children Sleep Questionnaire (English) --- p.xxii
REFERENCES --- p.xxvii
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Sengwayo, Duduzile Gladys. "The prevalence of arterial thrombosis predisposing risk parameters in a rural black community in the Limpopo province." Thesis, 2012. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1000286.
Full textAbstract:
M. Tech. Biomedical Sciences.Aims to assess the prevalence rates of hyperlipidaemia, hyperglycaemia, elevated homocysteine levels, elevated FVII levels and high blood pressure, as risk parameters of arterial thrombosis, in a rural black community in the Limpopo Province South Africa.
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"Follow-up study of childhood obstructive sleep apnoea syndrome: a cardiovascular perspective." 2010. http://library.cuhk.edu.hk/record=b5894309.
Full textAbstract:
Ng, Mei.Thesis (M.Phil.)--Chinese University of Hong Kong, 2010.
Includes bibliographical references (leaves xvi-xlviii).
Abstracts in English and Chinese.
ACKNOWLEDGEMENTS --- p.i
ABSTRACT
In English --- p.ii
In Chinese --- p.iv
LIST OF TABLES --- p.vi
LIST OF FIGURE --- p.viii
ABBREVIATIONS
For Units --- p.ix
For Prefixes of the International System of Units --- p.ix
For Terms Commonly Used --- p.X
Chapter CHAPTER 1 --- Overview of Childhood Obstructive Sleep Apnoea Syndrome (OSAS)
Chapter 1.1 --- Prevalence --- p.1
Chapter 1.2 --- Clinical Features --- p.3
Chapter 1.3 --- Definitions and Cutoffs --- p.4
Chapter 1.4 --- Pathophysiology --- p.6
Chapter 1.5 --- Risk Factors
Chapter 1.5.1 --- Gender --- p.8
Chapter 1.5.2 --- Obesity --- p.9
Chapter 1.5.3 --- Adenotonsillar Hypertrophy --- p.10
Chapter 1.5.4 --- Genetic --- p.11
Chapter 1.5.5 --- Atopic Diseases --- p.12
Chapter 1.6 --- Complications
Chapter 1.6.1 --- Neurobehavioural Deficits --- p.13
Chapter 1.6.2 --- Growth Defects --- p.14
Chapter 1.6.3 --- Metabolic Disorders --- p.16
Chapter 1.6.4 --- Systemic inflammation --- p.17
Chapter 1.6.5 --- Cardiovascular Consequences --- p.19
Chapter 1.7 --- Diagnosis --- p.20
Chapter 1.8 --- Treatment
Chapter 1.8.1 --- Surgical Treatment --- p.22
Chapter 1.8.2 --- Continuous Positive Airway Pressure (CPAP) --- p.24
Chapter 1.8.3 --- Corticosteroids --- p.24
Chapter 1.8.4 --- Leukotriene Receptor Antagonist --- p.25
Chapter 1.8.5 --- Oral Appliances --- p.26
Chapter 1.8.6 --- Weight Control --- p.27
Chapter CHAPTER 2 --- OSAS and Cardiovascular Complications in Adults
Chapter 2.1 --- Mechanism
Chapter 2.1.1 --- Acute Cardiovascular Responses --- p.28
Chapter 2.1.2 --- Chronic Cardiovascular Responses --- p.29
Chapter 2.2 --- Hypertension
Chapter 2.2.1 --- Epidemiological and Clinical Data --- p.31
Chapter 2.2.2 --- Characteristics --- p.32
Chapter 2.2.3 --- Mechanisms --- p.33
Chapter 2.2.4 --- Treatment --- p.34
Chapter 2.3 --- Heart Failure --- p.35
Chapter 2.4 --- Stroke --- p.37
Chapter 2.5 --- Cardiac Arrhythmias --- p.39
Chapter 2.6 --- Myocardial Ischemia and Vascular Disease --- p.41
Chapter 2.7 --- Pulmonary Hypertension --- p.43
Chapter CHAPTER 3 --- OSAS and cardiovascular complication in children
Chapter 3.1 --- Blood Pressure --- p.45
Chapter 3.2 --- Ventricular Hypertrophy and Dysfunctions --- p.48
Chapter 3.3 --- Heart Rate Variability --- p.50
Chapter 3.4 --- Arterial Tone --- p.51
Chapter 3.5 --- Endothelial Function --- p.51
Chapter CHAPTER 4 --- Longitudinal follow-up study of children with OSAS - a cardiovascular perspective
Chapter 4.1 --- Introduction --- p.53
Chapter 4.2 --- Methods
Chapter 4.2.1 --- Subjects and Study Design --- p.57
Chapter 4.2.2 --- Polysomnography --- p.59
Chapter 4.2.3 --- Ambulatory Blood Pressure Measurement --- p.61
Chapter 4.2.4 --- Statistical Analysis --- p.62
Chapter 4.3 --- Results
Chapter 4.3.1 --- Subject Characteristics --- p.64
Chapter 4.3.2 --- Blood Pressure During Wakefulness --- p.71
Chapter 4.3.3 --- Blood Pressure During Sleep --- p.76
Chapter 4.3.4 --- Nocturnal Blood Pressure Dipping --- p.83
Chapter 4.3.5 --- Blood Profile --- p.86
Chapter 4.4 --- Discussion --- p.87
Chapter 4.5 --- Conclusion --- p.99
Reference List --- p.xvi
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"Pharmacogenetics of rosuvastatin therapy and genetic determinants of some cardiovascular risk factors in Chinese patients." Thesis, 2010. http://library.cuhk.edu.hk/record=b6074864.
Full textAbstract:
Although the clinical efficacy of statins has been well established, there is a wide inter-individual variation in the lipid responses to statins. Pharmacogenetic studies have identified some genetic differences that contribute to the variation, but overall the results have been disappointing. The studies described in this thesis were performed to examine whether certain genetic variants predicted the lipid responses to rosuvastatin in Chinese patients. Over 400 Chinese patients with increased risk of cardiovascular disease (CVD) who were treated with rosuvastatin 10 mg daily for at least 4 weeks (more than 97% of patients had at least 6 weeks treatment) were studied, including 166 having familial hypercholesterolaemia (FH) and 36 having rheumatoid arthritis (RA). They were genotyped for 135 polymorphisms in 62 candidate genes/loci potentially related to pharmacokinetics or pharmacodynamics of statins and lipid metabolism. Associations between genetic polymorphisms and the lipid responses to rosuvastatin were analyzed in 386 patients with good compliance. The associations between genetic polymorphisms and some risk factors for CVD including baseline lipid levels, high-sensitivity C-reactive protein (hsCRP), uric acid and bilirubin levels were also analyzed.Some novel genetic determinants of the LDL-C response to rosuvastatin treatment have been identified in this study. The responses in HDL-C and triglycerides were related more closely to the baseline levels of these lipids than to any of the polymorphisms examined. Genetic associations with baseline lipid parameters, hsCRP, uric acid and bilirubin were identified and generally correspond with some of the previous reports of studies in Chinese and other ethnic groups.
The key findings of the study are as follows: 1. The polymorphisms most highly associated with the low-density lipoprotein cholesterol (LDL-C) response were 421C>A in the ATP-binding cassette G2 (ABCG2) gene (P=9.2x10 -7), followed by 18281G>A (V257M) in the flavin-containing monooxygenase 3 (FMO3) gene (P=0.0002), 1421C>G in the lipoprotein lipase (LPL) gene (P=0.002), and rs4420638 in the apolipoprotein E/C-I/C-IV/C-II (APOE/C1/C4/C2) gene cluster (P=0.004). These genetic polymorphisms and having FH totally explained 13.6% of the variance in percentage change in LDL-C in response to rosuvastatin. The greater percentage reduction in LDL-C in patients with the ABCG2 421AA genotype compared to those with the ABCG2 421CC genotype was equivalent to at least doubling the dose of rosuvastatin. 2. Three SNPs (glucokinase regulator [ GCKR] rs1260326, apolipoprotein AS [APOA5] -1131T>C and the solute carrier organic anion transporter 1B1 [SLCO1B1] 521T>C) tended to be associated with percentage changes in high-density lipoprotein cholesterol (HDL-C) (P<0.05), but none of these reached the overall significance level. In multivariate stepwise regression analysis, baseline HDL-C (P=1.6x10 -6), having diabetes (P=0.0004) or RA (P=0.002) and the SLCO1B1 521T>C polymorphism (P=0.03) were determinants of HDL-C responses, contributing 9.9% of the variance in percentage change in HDL-C, but the genetic factors only contributed to 0.8% of the variance. 3. The triglyceride response to rosuvastatin was highly variable and was strongly related to baseline levels. The diacylglycerol acyltransferase-2 (DGAT2) rs10899113 C>T polymorphism tended to be associated with reduced triglyceride response in a gene-dose dependent manner. However, in multivariate stepwise regression analysis, baseline triglyceride level was the only factor that strongly related to the triglyceride response, explaining 14.4% of the variance. 4. This study has also analyzed relationships between on-treatment plasma hsCRP concentrations and cardiovascular risk factors and 14 single nucleotide polymorphisms in CRP and other candidate genes, which showed that central obesity, low HDL-C and CRP polymorphisms are major determinants of higher hsCRP levels in Chinese patients on treatment with rosuvastatin. 5. The association between genetic polymorphisms and lipid traits were analyzed in FH and non-FH patients separately due to their different lipid profiles. The analysis has shown that there were different genetic predictors of lipid levels in patients with and without FH and that more genetic factors appeared to affect the baseline lipid levels in patients with FH compared to non-FH patients, suggesting complex interactions between genetic and environmental factors and plasma cholesterol levels in patients with and without FH. 6. The SLC2A9 (solute carrier family 2, member 9) rs1014290 T>C was significantly associated with plasma uric acid levels in a gene-dose dependent manner (P=1.0x10-5) and the relationship was more pronounced in women or in patients without hypertension than in men or patients with hypertension. The ABCG2 421 C>A did not show a significant effect on uric acid levels. 7. The UGT1A1 (uridine diphosphate glucuronosyltransferases family, polypeptide A1) variants *28 (P=1.5x10 -9) and *6 (P=2.2x10-7) were independently associated with increased baseline bilirubin levels. Polymorphisms in SLCO1B1 did not appear to affect bilirubin levels in this study.
Hu, Miao.
Adviser: Brian Tomlinson.
Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: .
Thesis (Ph.D.)--Chinese University of Hong Kong, 2010.
Includes bibliographical references (leaves 230-264).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.
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Adelekan, Adeboye Mutiu. "Establishment of screening procedures for genetic disorders and risk factors in the South African Caucasian population." Diss., 2003. http://hdl.handle.net/2263/26738.
Full text
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Motsko, Stephen Paul. "The relationship between Cox-2 inhibitors and cardiovascular risk: a retrospective analysis using the Veteran Affairs (VA) database." Thesis, 2005. http://hdl.handle.net/2152/1637.
Full text
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Palma, Anton. "Cardiovascular Disease Risk Behaviors in Human Immunodeficiency Virus-Positive Populations: Exploring a Stress-Coping Hypothesis." Thesis, 2020. https://doi.org/10.7916/d8-b7n0-n029.
Full textAbstract:
Cardiovascular disease (CVD) risk behaviors, namely tobacco smoking, hazardous alcohol use, poor diet and sedentary behavior, are more prevalent among people living with HIV (PLWH) than the general population. Qualitative evidence shows that PLWH report adopting unhealthy behaviors as a means of coping with the stress of living with HIV, including the adverse physiological symptoms of HIV infection, the psychological stress of being aware of one’s HIV status, and the physiological and psychological impacts of being on HIV treatment. These observations suggest that being HIV-positive may have a causal influence on CVD risk behaviors and that these causal effects likely differ across stages of the HIV continuum. To date, few quantitative studies have been conducted to examine these causal relationships. The goal of this dissertation was to explore the effects of HIV continuum stage on CVD risk behaviors and assess several plausible stress-coping mechanisms, as motivated by established stress-coping theory. This dissertation consisted of three studies. First, a systematic review was conducted to examine the existing quantitative evidence for the causal effects of HIV continuum stage on CVD risk behaviors. Findings from this review revealed that being HIV-positive is associated with excess smoking and drinking, and that while receipt of a positive HIV diagnosis is associated with short-term improvements in some CVD risk behaviors, these improvements are unlikely to be maintained long-term. Overall, however, the existing studies suffer important methodological limitations, notably inadequate characterization of HIV continuum stage. The second study was an empirical analysis of patterns of self-reported CVD risk behaviors across the HIV continuum among a population-based sample of 4,061 adults aged 40 years and over living in rural Agincourt district in South Africa. Results showed no consistent evidence of an association between HIV continuum stage and hazardous alcohol use or sedentary behavior. However, higher prevalence of smoking was observed specifically among males who were HIV-positive and aware of their status but not on treatment, compared to those who were HIV-negative. There was no evidence of mediation by various measures of physiological and/or psychological stress. The third study was an analysis of whether perceived life expectancy (PLE) modifies the effects of HIV continuum stage on CVD risk behaviors. Observed associations were most prominent among individuals with low PLE and null among those with high PLE. Overall, this dissertation contributed to greater understanding of the relationship between CVD risk behaviors among HIV-infected persons across the HIV continuum. Findings did not support a stress-coping hypothesis; however, PLE was found to be a potentially useful indicator of individuals who are most likely to smoke in the presence of HIV. This dissertation also fills evidence gaps among older adults in sub-Saharan Africa, an under-studied population with high and increasing burdens of both HIV and CVD. As HIV-positive population survive longer on antiretroviral therapy and the prevention of age-related conditions becomes increasingly important, these findings may help inform future research and the development of CVD prevention interventions.
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Bordelois, Paula M. "Internalizing and Externalizing Behavior Problems in Childhood and Early Development of Cardiovascular and Diabetes Risk: A Life Course Perspective." Thesis, 2019. https://doi.org/10.7916/d8-71rm-m138.
Full textAbstract:
An accumulating evidence-base indicates that internalizing mental health disorders in adulthood are causally associated with cardiovascular diseases (CVD) and type-2 diabetes (T2DM). It is plausible, however, that the relationship between mental and cardiometabolic ill-health becomes established long before adulthood, and that externalizing problems (the other central domain of common psychopathology) are also involved. These questions, as well as questions on the mechanisms that underlie the relationships, have been insufficiently investigated.
The overarching goal of this dissertation was to expand current knowledge on how common mental health problems increase cardiometabolic risk over the life course.
First, the prospective association between childhood internalizing (emotional problems) and externalizing problems (hyperactivity and conduct problems) with CVD and T2DM risk in adolescence was assessed in data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N=7,730). Results showed that hyperactivity problems were associated with insulin resistance (high HOMA-IR); that hyperactivity and conduct problems were each associated with high triglyceride levels; and that emotional problems were inversely associated with high triglyceride levels. These results suggest that childhood externalizing problems are an early life risk factor for CVD and T2DM and that childhood internalizing problems are not a risk factor or, that risk in these children does not become apparent until after adolescence.
Second, the mechanisms underlying the prospective association of childhood hyperactivity and conduct problems with high levels of triglycerides in adolescence were investigated using causal mediation methods. Results showed that despite being associated with hyperactivity and with conduct problems, body mass index and lifestyle health behaviors including sleep, diet, physical activity, alcohol, and smoking, together these variables, as measured, mediated only 19.6 % and 19.3% of the associations of hyperactivity and conduct problems with triglycerides, respectively. These results would suggest that mechanisms other than body adiposity and unhealthy behaviors are also involved and that those mechanisms have a larger role in mediating these relationships. Alternatively, It is possible that the observed small role of health behaviors is due to error in measurement and therefore improving measurements for health behaviors should be a central focus of future work.
Third and last, a systematic review of the literature on the relationship between childhood externalizing problems with CVD and T2DM risk was conducted. Studies were graded for propensity to bias. Evidence was summarized and assessed for consistency. Results strongly supported positive associations of externalizing problems with insulin resistance, T2DM, and with increased blood lipids among children and adolescents. Evidence suggested that associations are at least partly independent of body adiposity. Evidence provided mix support for the associations with T2DM and blood lipids in adults and with other outcomes in children or adults. Studies in children tended to be cross-sectional and to use valid and reliable assessment methods, whereas studies of adults tended to be prospective and to rely on less-valid, less reliable assessment methods. These results warrant more research, specifically prospective studies that track children into young adulthood, that employ well-validated measures of externalizing behaviors, that rely on repeated assessments of T2DM and CVD risk throughout follow-up, and that investigate mechanisms other than body adiposity and health behaviors.
Overall, this dissertation has found that childhood externalizing problems are prospectively associated with elevated CVD and T2DM risk, specifically with elevated risk of increased levels of blood lipids and insulin resistance. Unlike studies in adults, this dissertation does not support a role of internalizing problems as risk factors. Among children with externalizing problems, risk becomes evident before adolescence and appears to be largely driven by pathways independent of unhealthy behaviors and body adiposity. Implications of this research’s findings for health practice were proposed. This dissertation identified several gaps and methodological shortcoming in the extant literature. Recommendations were made for future research, including fundamental next questions to investigate, and study designs and methodologies that are best suited to tackle those questions.
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San, Miguel Michelle M. "The relationship between Lp-PLA2 mass and activity and carotid intima media thickness (CIMT) in women." 2010. http://liblink.bsu.edu/uhtbin/catkey/1610825.
Full textAbstract:
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School of Physical Education, Sport, and Exercise Science