Hypertriglyceridemic waist as a screening tool for CVD risk in indigenous Australian women.

Research has demonstrated that the simultaneous determination of waist circumference and fasting plasma triglyceride (TG) concentrations can identify men characterized by a metabolic triad of unconventional risk variables: increased levels of fasting insulin, apolipoprotein (apo) B, and a predominance of small, dense, low density lipoprotein (LDL) particles. The aim of this study was to assess the efficacy of using "hypertriglyceridemic waist" to identify individuals at high risk of CVD in a sample of indigenous Australian women, for whom 2 of the 3 non-traditional risk factors were measured (apo B and insulin). Subjects (N=80) were divided into subgroups on the basis of waist girth and TG levels. The TG/HDL ratio increased in women with both elevated waist (above 95 cm) and TG levels (above 2.0 mmol/L), who were also characterized by lower HDL and elevated LDL concentrations. Although there was no trend toward an increase in apo B with increasing waist girth and TG levels, apo B concentration was highest among subgroups with elevated waist and TG levels. Fasting insulin levels were higher with increasing waist girth, but not with increasing TG levels. Utilizing hypertriglyceridemic waist as a marker of high plasma insulin and apo B can be an important factor in assessing cardiovascular risk in indigenous Australian women, despite an unexpected apo B distribution.

Australian residence and heart disease risk in Vietnamese-born women.

SUMMARY: The aim of this study was to compare the disease risk profile of Vietnamese women who have lived in Australia for 2-15 years with a newly arrived group of Vietnamese women. The design was a comparison of two cross-sectional surveys (n = 256); one newly arrived (n = 159) and one (n = 97) who had lived in Australia for 2-15 years. The main outcome measures were body mass index (BMI), waist to hip ratio (WHR), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and TC/HDL ratio (atherogenic index). The longer-stay residents had similar BMI (21.5 ± 3.5 kg/m(2) vs. 21.1 ± 3.1 kg/m(2), p = 0.2); lower waist (69.3 ± 7.5 cm vs. 71.4 ± 7.6 cm, p = 0.8), WHR (0.76 ± 0.06 vs. 0.80 ± 0.06, p = 0.0001), TC (4.7 ± 1.0 mmol/L vs. 4.9 ± 0.9 mmol/L, p = 0.001), TC/HDL (3.0 ± 2.0 vs. 4.7 ± 2.0, p = 0.006) and higher hip measurement (91.1 ± 7.4 cm vs. 89.1 ± 5.6 cm, p = 0.009) than newly arrived Vietnamese women. After adjustment for BMI and age the odds of having a higher waist and WHR was significantly less for longer-stay residents, while the odds of having larger hips was doubled. The odds of having a high atherogenic index as estimated by the TC/HDL ratio was halved for the longer-stay residents (p = 0.15). We conclude that Vietnamese women we surveyed who have lived in Australia for 2-15 years have the same BMI, but lower levels of abdominal obesity and lower atherogenic index than newly arrived Vietnamese women surveyed.:

Low density lipoprotein subclasses in Asian and Caucasian adolescent boys.

South Asian adults are known to have very high rates of Coronary heart disease (CHD) and insulin resistance and, even as adolescents, may show higher risk factors for CHD. The aim of this study was to investigate the prevalence of small, dense low density lipoprotein (sdLDL) subclasses in a cohort of adolescent boys. The specific objective was to investigate the relationship between measures of fatness, ethnicity and LDL diameter in this cohort. Preformed native (non-denaturing) polyacrylamide 3-13% gradient gels and a multipurpose vertical electrophoresis system were used for the separation of LDL sub-fractions in a single school year cohort of boys aged 15-16 years (n=135). Latex beads and thyroglobulin standards were used to construct a calibration curve in order to calculate LDL particle diameters by regression (Total Lab Software v1.11). ANOVA was used to compare LDL size among different ethnic groups (SPSS and Stat View). The study sample was comprised of 45.2% Caucasians, 41.5% East Asians and 13.3% from the Indian subcontinent (South Asians). There was a non-significant trend for South Asians to have a lower LDL diameter than either Caucasians or East Asian boys which was independent of % total body fat (%TBF) and body mass index (BMI). This is the first adolescent cohort to examine sdLDL which included Caucasians, East and South Asians. It appears that the higher risk profile for CHD and diabetes noted in South Asian adults may be evident even during adolescence.

Blood lipids of cardiac patients after acute exercise on land and in water.

OBJECTIVE: To compare the effect on lipids of a single bout of high-intensity interval training performed on land and in water in a group of cardiac patients involved in an intensive cardiac rehabilitation program. DESIGN: Single-group, quasiexperimental, crossover design. SETTING: Swimming pool at a cardiac rehabilitation hospital in Australia. PARTICIPANTS: Ten men, ages 55 to 77 years, with ischemic heart disease. INTERVENTION: Subjects performed 15 minutes of interval arm ergometer work at 65% to 75% of attained heart rate, as determined by treadmill testing on land and in water on the same day. Each patient had his own exercise prescription. MAIN OUTCOME MEASURES: At each endurance phase, the number of revolutions and rate-pressure product (RPP) during the final minute of work were taken. Fasting bloods were taken at baseline and after maximum exercise, and lipid profiles were determined; differences were analyzed by paired t test. RESULTS: No significant differences in revolutions or RPP were observed, which indicates that workload and heart work were similar in all experiments. There were no significant changes in total, low-density lipoprotein cholesterol, triglyceride, or apolipoproteins A-I or B after exercise (paired t test). High-density lipoprotein cholesterol (HDL-C) was increased significantly by exercise on land. In 6 patients with low baseline HDL-C (<0.9 mmol/L), HDL-C was increased only on land. CONCLUSIONS: A single bout of high-intensity interval training was more effective in improving HDL-C when performed on land than in water.

Relationship between measures of fatness, lipids and ethnicity in a cohort of adolescent boys.

BACKGROUND/AIM: The investigators were invited into a boys' high school to assess the lipid risk profile of a single year cohort and advise on how the findings could be incorporated into a healthy lifestyle program. The aim of the study was to investigate the relationship between measures of fatness, ethnicity and cardiac risk factors in a cohort of adolescent boys. METHODS: Anthropometric measurements of weight, height, waist and hips were used to calculate body mass index (BMI) and waist to hip ratio (WHR); percent total body fat (%TBF) was estimated by bioelectric impedance analysis. Demographic and behavioral variables were assessed by questionnaire. Total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG), apolipoprotein A1 (apoA1), apoliproprotein B (apoB) and insulin were measured in 137 subjects; low-density lipoprotein (LDL-C) was calculated. RESULTS: The study sample was comprised of 139 boys aged 15.7 +/- 0.04 years; 46% were Caucasians, 41% were East Asians and 13% were from the Indian subcontinent (South Asian). The crude mean BMI, %TBF and waist measurements were not significantly different between the ethnic groups. South Asians had a higher mean WHR than East Asians (p < 0.004; ANOVA), and also had higher mean %TBF than Caucasians when BMI was adjusted for, and lower BMI than either of the other groups when adjusted for waist (ANCOVA). There was no difference between groups in lipid profiles except for a higher apoB in East Asians compared with Caucasians (p < 0.04). Twenty-two percent of the subjects had TC higher than the desirable level for children (4.5 mmol/l), 7.3% had low HDL-C (<0.9 mmol/l) and 4.3% had high LDL-C (>3.5 mmol/l). Overweight and hypercholesterolemia had individual prevalences of around 20%, while hyperinsulinemia was 48%. CONCLUSION: The present study confirms that the relationship between BMI and %TBF is dependent on ethnicity, even in adolescent subjects of similar age and gender. The assessment of cardiovascular risk on a school year and age basis would suggest that there are enough affected individuals to support at least a nontargeted intervention which focuses on healthy eating and physical activity.