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1.
Medicine (Baltimore) ; 98(51): e18354, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860991

RESUMO

Many cancer patients develop diabetes, which may result in reduction of chemotherapy effectiveness and increased infection risk and cardiovascular mortality. Diabetes may also increase the risks of chemotherapy-related toxicity and post-operative mortality, or represent an obstacle to optimal cancer treatment. However, the clinical predictors of diabetes in cancer patients remain largely unknown. Therefore, the aim of our study was to evaluate the risk factors for developing diabetes and construct a nomogram to predict diabetes in cancer patients.We investigated patients from a national sample cohort obtained from the Korea National Health Insurance Service (KNHIS), which included 2% of the Korean population. Patients who had undergone routine medical evaluation by the KNHIS between 2004 and 2008 and been hospitalized due to cancer (ICD-10 codes C00-97) during the past 3 years were included. After excluding patients with type 2 diabetes and missing data, 10,899 patients were enrolled and followed-up until 2013. A total of 7630 (70%) patients were assigned as the training cohort and used to construct the nomogram which was based on a multivariable logistic regression model. The remaining patients (n = 3269) were used as the validation cohort.The incidence rate of diabetes was 12.1 per 1000 person-years over a mean follow-up of 6.6 ±â€Š1.8 years. Significant risk factors for developing diabetes were age, sex, obesity, fasting plasma glucose, hypertension, and hypercholesterolmia. A nomogram was constructed using these variables and internally validated. The area under the curve was 0.70 (95% confidence interval, .666-.730, P < .0001) and the calibration plot showed agreement between the actual and nomogram-predicted diabetes probabilities.The nomogram developed in this study is easy to use and convenient for identifying cancer patients at high-risk for type 2 diabetes, enabling early type 2 diabetes screening and management.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Neoplasias/epidemiologia , Medição de Risco , Fatores Etários , Idoso , Glicemia/análise , Estudos de Coortes , Feminino , Seguimentos , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Incidência , Masculino , Nomogramas , Obesidade/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais
2.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190005.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596376

RESUMO

OBJECTIVE: To analyze the prevalence of altered total cholesterol and fractions levels in the Brazilian population, according to biochemical data from the National Health Survey. METHODS: A descriptive study, using data from the National Health Survey, collected between 2014 and 2015. Total cholesterol and fractions were analyzed and population prevalences of altered values according to socio-demographic variables were calculated. The cutoff points considered were: total cholesterol ≥ 200mg/dl; low-density lipoprotein LDL ≥ 130mg/dL and high-density lipoprotein HDL < 40mg/dL. RESULTS: The prevalence of total cholesterol ≥200mg/dL in the population was 32.7%, and higher in women (35.1%). The prevalence of altered HDL was 31.8%, 22.0% in females and 42.8% in males. LDL ≥ 130mg/dL was found in 18.6% and was higher in women (19.9%). The population aged 45 years old and older and those with low levels of education presented a higher prevalence of altered cholesterol. CONCLUSION: Altered values of total cholesterol and fractions were frequent in the Brazilian population, especially among women, the elderly and people with low levels of education. These results may guide control and preventative actions such as healthy eating, physical activity and treatment, all of which aim to prevent coronary diseases.


Assuntos
HDL-Colesterol/sangue , LDL-Colesterol/sangue , Colesterol/sangue , Inquéritos Epidemiológicos/métodos , Hipercolesterolemia/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Brasil/epidemiologia , Estudos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de Referência , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
3.
J Sports Med Phys Fitness ; 59(9): 1577-1583, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31610641

RESUMO

BACKGROUND: Cardiometabolic disease (CMD) risk factors have reached epidemic proportions, with many people at risk of premature disability and death. There is insufficient data regarding the prevalence of CMD risk factors among firefighters in the Western Cape Province of South Africa. The purpose of this study was to examine the prevalence of CMD risk factors among South African firefighters in the Western Cape Province. Additional outcomes were to determine the relationship between BMI and CMD risk factors among firefighters. METHODS: A total of 219 healthy male firefighters with mean age 37.8±9.80 years volunteered to participate in the study. Anthropometric (ISAK protocol compliant) and physiological variables (ACSM protocol compliant) were assessed. Descriptive statistics, such as mean, standard deviation and percentages were used to examine the CMD risk factors prevalence among the participants. RESULTS: Based on the BMI categorization, majority (42.5%) of the participants were obese, 17.4% were overweight, 39.7% had a normal BMI, while 0.5% were underweight. The participants with systolic prehypertension were 45.7%, while 14.2% were hypertensive. Furthermore, 39.3% were prediabetic, 18.3% were diabetic, while 1.4% had blood sugar below normal level (hypoglycemic). In terms of total blood cholesterol levels, 45.7% were normal, 38.8% were borderline high, while 15.5% were high in hypercholesterolemia. The majority (51.1%) of the participants reported non-participation in regular physical activity. Between BMI and the typical risk factors, there is a significant correlation with abdominal obesity (r=0.71; P<0.001), systolic blood pressure (r=0.33; P<0.001), diastolic blood pressure (r=0.31; P<0.001), fasting blood glucose (r=0.22; P<0.01) and total cholesterol (r=0.15; P<0.05). CONCLUSIONS: There was a high prevalence of cardiometabolic disease risk factors among firefighters. Furthermore, urgent intervention focusing on the lifestyle modification and weight management is a necessity.


Assuntos
Doenças Cardiovasculares/etiologia , Bombeiros/estatística & dados numéricos , Síndrome Metabólica/etiologia , Adulto , Índice de Massa Corporal , Estudos Transversais , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Comportamento Sedentário , África do Sul/epidemiologia
4.
Biomed Environ Sci ; 32(8): 559-570, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31488232

RESUMO

OBJECTIVE To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. METHODS Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. RESULTS The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend < 0.001). CONCLUSION Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.


Assuntos
HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dislipidemias/epidemiologia , Triglicerídeos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
5.
Epidemiol Prev ; 43(2-3): 144-151, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31293133

RESUMO

OBJECTIVES: to describe and compare cardiovascular risk prevalence in a large sample of Italian and foreign fifty-year-old residents in Veneto Region (Northern Italy) who do not have a co-pay fee exemption for cardiovascular diseases. Data collection comes from standardized and objective measurements carried out by health personnel of the Department of Prevention of the Local Health Agency 7 of Veneto Region. DESIGN: cross-sectional study. SETTING AND PARTICIPANTS: Italian and foreign fifty-years-old residents who do not have a co-pay fee exemption for cardiovascular diseases were extracted from the registry list, excluding people already affected by diabetes, hypertension, hypercholesterolemia or cardiovascular diseases, and received a written invitation to participate. MAIN OUTCOMES MEASURES: adherents were studied through standardized questionnaires about their lifestyles (tobacco, alcohol, weight excess, central obesity, physical inactivity), anthropometric measurements (height, weight, body mass index, waist circumference), the direct measurement of blood pressure and a finger-stick for glucose and cholesterol. Educational level was also recorded in a large subgroup of adherents. Risk factor prevalence has been described and analyzed by geographical area of origin, separately for men and women and adjusted for educational level. RESULTS: among the invited people, 3,420 out of 5,088 accepted the invitation (67.2%); the adherence was lower among foreign women. Both foreign women and men showed lower prevalence of healthy lifestyles compared to Italian participants (women: 20.3% vs. 34.3%; men: 13.2 vs. 25.6%). These differences remained large and statistically significant after adjusting for educational level. The prevalence of hypertension and of hypercholesterolemia/hyperglycaemia (finger stick) was higher among foreign women than among Italian (39.1% vs. 28.4%); remarkably, the prevalence of hyperglycaemia was 8.7% vs.1.9%. CONCLUSIONS: the majority of foreign residents can be reached through a personal invitation to participate in a cardiovascular prevention intervention. Foreign participants show a higher prevalence of cardiovascular risk factors compared to Italian residents. It is advisable to implement a strategy involving both the health personnel of the Department of Prevention and the General practitioners aiming at improving individual and community healthy choices and at an early recognition of diabetes mellitus, hypertension, and hypercholesterolemia onset among foreign residents.


Assuntos
Automonitorização da Glicemia , Glicemia/análise , Pressão Sanguínea , Colesterol/sangue , Estilo de Vida , Antropometria , Doenças Cardiovasculares/epidemiologia , Comorbidade , Estudos Transversais , Diabetes Mellitus/epidemiologia , Emigrantes e Imigrantes , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Fatores de Risco , Fatores Socioeconômicos
6.
Rev Port Cardiol ; 38(6): 427-437, 2019 06.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31307727

RESUMO

INTRODUCTION: Cardiovascular (CV) disease is the leading cause of death in Portugal. The prevalence of hypertension, the second most important risk factor accounting for overall disability-adjusted life years (DALYs), is significant. Hypertension rarely occurs in isolation, but is usually associated with other determining risk factors that contribute to greater overall CV risk. The main objective of the PRECISE study, a cross-sectional epidemiological study, was to determine the prevalence of other concomitant modulating CV risk factors in hypertensive patients. METHODS: The prevalence of other CV risk factors and target organ damage was assessed in 2848 hypertensive patients of both sexes followed in primary health care centers. Demographic, anthropometric and clinical data and antihypertensive and lipid-lowering therapies prescribed were collected. RESULTS: Of the study population (mean age 65.8±11.0 years, 60.8% women), 98.0% were treated for hypertension, but only 56.7% had controlled blood pressure. Hypercholesterolemia was the most frequent concomitant CV risk factor (82.1%), followed by sedentary behavior (71.4%). Prevalences of concomitant modulating risk factors were significantly different between the sexes and age groups. Overall, 81.7% of hypertensive patients had three or more concomitant CV risk factors. CONCLUSIONS: The study showed that, in Portugal, hypertensive patients have a high prevalence of other CV risk factors, confirming the need to identify these factors, calculate overall CV risk and continuously monitor the care provided and the results obtained.


Assuntos
Pressão Sanguínea/fisiologia , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Atenção Primária à Saúde/normas , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Portugal/epidemiologia , Prevalência , Fatores de Risco
7.
Artigo em Inglês | MEDLINE | ID: mdl-31174416

RESUMO

The 738 oldest men who participated in the first survey of the population-based Tromsø Study (Tromsø 1) in Norway in 1974 have now had the chance to reach the age of 90 years. The men were also invited to subsequent surveys (Tromsø 2-7, 1979-2016) and have been followed up for all-cause deaths. This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, and 10.8 for never, former, and current smokers, respectively. Significant effects on survival were also found for physical inactivity, low income, being unmarried, high blood pressure, and high cholesterol. For men with 0-4 of these risk factors, the percentages reaching 90 years were 33.3, 24.9, 12.4, 14.4, and 1.5, respectively. Quitting smoking and increasing physical activity before 55 years of age improved survival significantly. Men should refrain from smoking and increase their physical activity, especially those with low income, those who are unmarried, and those with high blood pressure and high cholesterol.


Assuntos
Expectativa de Vida/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Exercício , Feminino , Inquéritos Epidemiológicos , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Fatores de Risco , Fumar/epidemiologia , Fatores Socioeconômicos , Análise de Sobrevida
8.
BMC Public Health ; 19(Suppl 4): 554, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196012

RESUMO

BACKGROUND: Rural coastal communities in Sabah are still overly represented in the hardcore poor economic status. The aim of this study was to determine the prevalence of hypertension, diabetes mellitus and hypercholesterolemia among adults, in relation to economic status. METHODS: A cross-sectional study using stratified random sampling was conducted in seven coastal villages in Semporna, Sabah: Kabogan Laut, Salimbangun, Pekalangan, Pokas, Tampi-Tampi Timbayan, Sum Sum and Selinggit. Socio-demographic data were obtained via interviewer administered questionnaires in Sabah Malay creole. Anthropometric measurements, blood pressure, fasting blood glucose and blood lipids were obtained. RESULTS: A total of 330 adults (133 males, 197 females) completed the study. Mean age was 43.7 ± 15.8 years. Most participants (87%) were living below the Poverty Line Income. Median per capita household income was RM83.33/month (≈ USD20/month). The number of newly diagnosed cases of hypercholesterolemia was 40.6%, diabetes mellitus was 5.8%, and hypertension was 24.5%. Adults from the hardcore poor economic status (household income ≤RM760/month (≈USD183/month) were the most represented in those who did not have a blood pressure, blood sugar and blood lipids check in the 12 months preceding the study (Χ2, p < 0.01). Adults from hardcore poor economic status were also the most represented in undiagnosed hypertension and uncontrolled blood pressure among those diagnosed (Χ2, p = 0.013). Among diabetics from the hardcore poor group, the undiagnosed fasting blood glucose was 11.2 ± 4.5 compared to 5.1 ± 0.6 mmol/L for diagnosed diabetics (p < 0.001). Among hypercholesterolemics from the hardcore poor group, total cholesterol and LDL cholesterol values were significantly higher in the undiagnosed group compared to the diagnosed group (p < 0.001). CONCLUSION: Many people in this rural coastal community were unaware that they had high cholesterol level (40.6%) and elevated blood pressure (24.5%). Routine health check is not common among low income adults in rural coastal communities in Semporna. The findings suggest public health initiatives should emphasize access to and the necessity of routine health checks for those aged 40 years.


Assuntos
Doenças não Transmissíveis/epidemiologia , Pobreza/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adulto , Idoso , Glicemia/análise , Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , LDL-Colesterol/sangue , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Lipídeos/sangue , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(5): 542-547, 2019 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-31177735

RESUMO

Objective: To analyze the longitudinal change of serum total cholesterol concentration in 733 rural residents in Shanxi province. Methods: Based on the residents of five rural areas in Shanxi province who participated in China nutrition and health survey in 2002, a follow-up survey was conducted in 2015. Fasting venous blood of the participants was collected and serum TC concentration was tested by cholesterol oxidase method. Results: Of 733 participants, 332 were male and 401 were female. In 2002 baseline survey, the age of the participants was (42.6±9.5) years old, 76.2% of male and 83.8% of female had junior middle school education or below. Proportion of smoking were 65.7% and 1.2%, drinking were 26.8% and 4.0%, obesity were 6.3% and 12.0%, and central obesity were 27.1% and 31.9%, respectively in male and female. The follow-up age of participants in 2015 was (55.8±9.5) years old, proportion of smoking changed to 48.2% and 1.5%, drinking were 49.7% and 3.0%, obesity increased to 11.8% and 18.2% and central obesity increased to 41.6% and 53.6%, respectively in male and female. The overall serum TC level increased from (3.82±0.89) mmol/L to (4.72±0.97) mmol/L with an average increase of 27.2%, which increased from (3.84±0.94) mmol/L to (4.54±0.93) mmol/L in male with an average increase of 22.7%, and increased from (3.81±0.84) mmol/L to (4.86±0.98) mmol/L in female with an average increase of 30.9%. The serum TC levels in 18-, 30-, 40-, and 50-59 years old group increased from (3.42±0.83), (3.72±0.77), (3.90±0.83) and (4.00±1.03) mmol/L to (4.38±1.01), (4.79±0.92), (4.73±0.99) and (4.76±0.96) mmol/L, with average increase range of 31.4%, 32.1%, 25.2% and 22.6%, respectively. The mean serum TC levels between two years all had statistically significant difference among groups of gender, age, education, marital status, family history of cardiovascular disease, smoking, drinking, BMI and waist circumference after paired t-test and ANOVA analysis (P<0.01). Conclusion: The longitudinal serum TC level of rural residents in Shanxi province increased rapidly.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Colesterol/sangue , Hipercolesterolemia/epidemiologia , População Rural , Adulto , Idoso , China/epidemiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade
10.
Rev Bras Epidemiol ; 22: e190015, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31038611

RESUMO

OBJECTIVE: To compare the prevalence of cardiovascular risk factors in the adult population of Vitória, Espírito Santo, Brazil, in two surveys conducted by telephone interview (VIGITEL) or by clinic and laboratory exams during the National Health Interview Survey (NHIS). METHOD: Data were collected from adults (≥ 18 years). In VIGITEL, 1,996 subjects (males = 38%) were interviewed. In NHIS, home visit followed by clinical and laboratory tests was made with 318 individuals (males = 48%) selected in 20 census tracts of the city. The prevalence of risk factors was adjusted to the estimated population of the city in 2013. Data are shown as prevalence and 95% confidence interval (95%CI). RESULTS: Similar values of prevalence were found in VIGITEL and NHIS, respectively, for smoking (8.2%; 95%CI 6.7-9.7% vs 10.0; 95%CI 6.4 - 13.6%) and hypertension (24.8%; 95%CI 22.6 - 27.0% vs 27.2%; 95%CI 21.8 - 32.5%). Statistical differences between surveys (p < 0.01) were found for diabetes (6.7%; 95%CI 5.6 - 7.9% vs 10.7%; 95%CI 7.1 - 14.5%), obesity (16.8%; 95%CI 14.1 - 18.1% vs 25.7%; 95%CI 20.4 - 30.9%) and high cholesterol (≥ 200mg/dL) (20.6%; 95%CI 18.6- 22.6% vs 42.3%; 95%CI 36.9 - 47.7%). The prevalence of diabetes was also higher (p < 0.01) in NHIS (6.7 vs 10.7%). CONCLUSION: Prevalence of smoking and hypertension, but not obesity, was adequately detected in VIGITEL, because there might have been information bias related to body weight during telephone interviews. Datashow the necessity to improve the diagnosis of dyslipidemias in primary care services, as the control of this risk factor is of utmost importance to prevent cardiovascular diseases.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Diabetes Mellitus/epidemiologia , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Complicações do Diabetes , Feminino , Inquéritos Epidemiológicos , Humanos , Hipercolesterolemia/complicações , Hipertensão/complicações , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Prevalência , Fatores de Risco , Autorrelato , Distribuição por Sexo , Fumar/efeitos adversos , Adulto Jovem
11.
Int J Clin Pract ; 73(9): 1-9, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31038781

RESUMO

OBJECTIVE: There are lack of studies considering the suboptimal management of dyslipidemia especially in cardiology outpatient clinics. This study was conducted to assess the patient adherence to cholesterol treatment recommendations and attainment of low-density-lipoprotein cholesterol (LDL-C) goals. METHODS: EPHESUS (NCT02608645) is a national, observational and multicenter registry which has been designed as a cross-sectional study to allow inclusion of all consecutive patients with hypercholesterolemia in cardiology outpatient clinics. The present subgroup analyses of the EPHESUS trial included patients with known peripheral artery disease or atherosclerotic cerebrovascular disease, and coronary heart disease namely secondary prevention. RESULTS: The present analysis of the EPHESUS study included 1482 patients (62.79 ± 10.4 years, 38.2% female) with secondary prevention from 40 sites in Turkey. Regarding recommended lipid targets for LDL-C, only 267 patients (18%) were below the target of 70 mg/dL. Females were significantly more off-target when compared with male patients (396, 85.5% vs 67, 14.5%; P = 0.017). Moreover, the achievement of LDL-C goal was significantly decreased with illiteracy (233, 19.2% vs 35, 13.1%; P = 0.02). Patients who think that the cholesterol treatment should be terminated when the cholesterol level of a patient has normalised were higher in the off-target group (34.0% vs 24.7%, P < 0.001). Besides, physician perceptions about LDL-C goal for secondary prevention were significantly related with LDL-C target attainment. CONCLUSIONS: EPHESUS is an important study with large population in terms of representing real-life practice of the adherence to dyslipidemia guidelines in secondary prevention patients in Turkey. Perceptions, knowledge, and compliance with the guidelines for secondary prevention have increased, but it is far below from the desired levels even in cardiology outpatient clinics. There is a need for patients' and physicians' education regarding the treatment of hyperlipidemia.


Assuntos
LDL-Colesterol , Hipercolesterolemia/tratamento farmacológico , Cooperação do Paciente/estatística & dados numéricos , Prevenção Secundária/métodos , Idoso , Doença das Coronárias/prevenção & controle , Estudos Transversais , Dislipidemias/tratamento farmacológico , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevenção Secundária/estatística & dados numéricos , Turquia/epidemiologia
12.
J Dermatol ; 46(7): 557-563, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31090237

RESUMO

The present study (B-1201 clinical trial) was conducted as a multicenter, open-label, single-arm phase II study to evaluate the long-term safety, tolerability and efficacy of bexarotene. This study enrolled 10 Japanese adults aged more than 20 years with cutaneous T-cell lymphoma (CTCL) who completed the 24-week study period of the B-1101 trial. The objective response rate (ORR) was 53.8% (95% confidence interval, 25.1-80.8). In the early stage (IB), the ORR was 60% (3/5 cases). In the advanced stage (IIB and IIIA), the ORR was 57.1% (4/7 cases). The median time to response was 58 days (range, 27-168). The median treatment duration was 380 days (range, 33-1674). The median duration of response (DOR) could not be reached during the study period. The longest DOR reached 1618 days at the end of the B-1201 trial. Nine patients (56.3%) in the full analysis set (FAS) population experienced dose reduction of bexarotene. Common drug-related adverse events in the FAS population included hypothyroidism (93.8%), hypertriglyceridemia (81.3%), hypercholesterolemia (81.3%), leukopenia (68.8%) and neutropenia (56.3%). Dose-limiting toxicity (DLT) was present in five (38.5%) of the 13 patients in the 300 mg/m2 cohort. Of the five patients, four developed grade 3 neutropenia and one developed grade 4 hypertriglyceridemia. All DLT cases recovered after the discontinuation of bexarotene. None of the five patients discontinued this trial because of DLT. The B-1201 trial shows the long-term safety of oral bexarotene for Japanese patients with CTCL, despite frequent dose reduction.


Assuntos
Antineoplásicos/administração & dosagem , Bexaroteno/administração & dosagem , Linfoma Anaplásico Cutâneo Primário de Células Grandes/tratamento farmacológico , Micose Fungoide/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Antineoplásicos/efeitos adversos , Bexaroteno/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Hipercolesterolemia/induzido quimicamente , Hipercolesterolemia/epidemiologia , Hipertrigliceridemia/induzido quimicamente , Hipertrigliceridemia/epidemiologia , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/epidemiologia , Japão , Leucopenia/induzido quimicamente , Leucopenia/epidemiologia , Linfoma Anaplásico Cutâneo Primário de Células Grandes/patologia , Masculino , Micose Fungoide/patologia , Estadiamento de Neoplasias , Neutropenia/induzido quimicamente , Neutropenia/epidemiologia , Neoplasias Cutâneas/patologia , Fatores de Tempo , Adulto Jovem
13.
PLoS One ; 14(4): e0215378, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31009492

RESUMO

OBJECTIVE: Hispanics/Latinos have some of the highest prevalence rates for cardiovascular disease risk factors, but stark differences exist by self-reported background. Cardiovascular disease risk factors negatively impact cognition in Hispanics/Latinos; less is known about these relationships by Hispanic/Latino backgrounds. We investigated cognitive associations with cardiovascular disease risk factor burden in a diverse cohort, the Hispanic Community Health Study/Study of Latinos. METHODS: Baseline data from this observational study of cardiovascular disease and its antecedents was collected from 2008-2011. We included 7,121 participants 45-74 years old from Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American backgrounds. Dichotomous indicators for hypertension, diabetes, hypercholesterolemia, obesity, and smoking were evaluated and totaled, with participants grouped by lowest (0-2), middle (3) or highest (4-5) burden. Cognitive testing included the Brief Spanish English Verbal Learning Test, letter fluency, and digit symbol substitution. RESULTS: In separate fully-adjusted linear regression models, lower fluency and digit symbol substitution performance were restricted to the highest compared to the lowest burden group; whereas the middle burden group displayed impaired memory performance compared to the lowest burden group (p-values≤0.05). Background interacted with burden for learning and memory performance. That is, the association of burden level (i.e., lowest, middle, or highest) with cognitive performance was modified by background (e.g., Mexicans vs Cuban). CONCLUSIONS: Hispanics/Latinos with higher levels of cardiovascular disease risk factor burden displayed lower levels of cognitive performance, with learning and memory performance modified by background.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Cognição/fisiologia , Diversidade Cultural , Hispano-Americanos/estatística & dados numéricos , Saúde Pública/estatística & dados numéricos , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Hipercolesterolemia/etnologia , Hipertensão/epidemiologia , Hipertensão/etnologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etnologia , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia
14.
PLoS One ; 14(4): e0215687, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31017966

RESUMO

BACKGROUND: Long-term variability of cardiometabolic risk factors have been suggested as the risk factors for cardiovascular disease and mortality. However, the effect of long-term variability of total cholesterol (TC) on incident atrial fibrillation (AF) has not been examined. METHODS AND FINDINGS: We explored whether visit-to-visit TC variability are associated with the risk of incident AF in 160,165 Korean adults, using the population-based Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) database, over a median duration of 8.4 years. TC variability was measured as coefficients of variance (TC-CV), standard deviation (TC-SD), and variability independent of the mean (TC-VIM). Kaplan-Meier analysis demonstrated a decreased disease-free probability in the highest quartile group of TC variability compared to that in the other groups. In the multivariate Cox proportional hazard analysis, the risk of AF increased significantly in the highest quartile group of TC variability. After multivariate adjustment for confounding variables including mean TC levels, the hazard ratio for incident AF was 1.15 (95% confidence interval 1.05-1.25; P = 0.0035) when comparing the highest with the lowest TC variability quartile (TC-CV). These relationships were consistent with TC variability defined using TC-SD or TC-VIM. Subgroup analyses, including age, sex, body mass index, and cardiometabolic disorders, showed similar results. CONCLUSIONS: The present study is the first to demonstrate that high TC variability was associated with an increased risk of AF.


Assuntos
Fibrilação Atrial/sangue , Fibrilação Atrial/epidemiologia , Colesterol/sangue , Adulto , Idoso , Análise de Variância , Fibrilação Atrial/etiologia , Estudos de Coortes , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Hipercolesterolemia/epidemiologia , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco
15.
Horm Metab Res ; 51(6): 367-374, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30974472

RESUMO

An elevated serum uric acid (SUA) level is closely associated with increased arterial stiffness. However, whether this association is independent of conventional cardiovascular risk factors is controversial. This study aimed to investigate whether SUA is independently associated with arterial stiffness as assessed by Brachial-ankle pulse wave velocity (baPWV), and to what extent this association is dependent on cardiovascular risk factors. Increased arterial stiffness was defined as baPWV>1 400 cm/s. Cardiovascular risk factors were defined as hypertension, diabetes, dyslipidaemia, and a BMI≥24.0 kg/m2. A total of 3 342 subjects (1 334 men and 2008 women, mean age 53.79±13.18 years) were included. SUA levels exhibited a graded elevation with an increasing number of cardiovascular risk factors. In female subjects with more than two cardiovascular risk factors, compared with the first quartile of SUA, higher SUA quartiles were associated with a higher probability of increased baPWV (OR=1.500, 1.478, 1.774 for SUA Q2-Q4). In further stratified association analysis, compared with Q1, SUA quartiles showed a graded association with increased baPWV in subjects with TC≥5.2 mmol/l (OR=1.758, 1.942, 2.354 for Q2, Q3, and Q4 respectively), LDL-C≥3.3 mmol/l (OR=1.510, 2.255 for Q3 and Q4) and FBG≥7.0 mmol/l (OR=1.516, 1.748 for Q3 and Q4). In the Chinese coastal female population, the association of high SUA and increased arterial stiffness is dependent on the coexistence of at least one cardiovascular risk factor, especially hypercholesterolemia.


Assuntos
Índice Tornozelo-Braço , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Hipercolesterolemia/complicações , Análise de Onda de Pulso , Ácido Úrico/sangue , Rigidez Vascular , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , China/epidemiologia , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Fatores Sexuais
16.
Atheroscler Suppl ; 36: 6-11, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30876532

RESUMO

BACKGROUND AND AIMS: Achilles tendon lesions have long been associated with genetic defects in lipid metabolism and increased risk of cardiovascular diseases (CVD). With this study we aimed to evaluate the usefulness of Achilles tendon ultrasonography in identifying people at greater risk among subjects with severe hypercholesterolemia (SH) in a high-risk population. METHODS: During the period of 2016-2017 a total of 213 participants were enrolled in this case-control study. Data of 110 patients with SH and 103 age and sex matched controls without dyslipidaeplemia and established CVD was collected. RESULTS: Achilles tendinopathy (AT) was present in 42.7% of subjects with SH and in 29.1% of controls (p = 0.039). Stronger association between SH and AT was seen in women - 24.1% vs 2.0% (p = 0.001). SH increased odds of AT by 1.815 (95% CI, 1.028-3.206). Prevalence of AT was higher in males despite presence (SH+) or absence (SH-) of severe hypercholesterolemia (SH+ 60.7% vs 24.1%, SH- 55.8% vs 2.0%, p < 0.001). AT was associated with higher proportion of subjects exceeding normal mean values of TC (80.5% vs 52.9%, p = 0.001), LDL-C (76.6% vs 52.2%), TG (54.5% vs. 22.1%), ApoB (57.1% vs 22.2%), ApoE (44.0% vs 22.4%) levels and ApoB/ApoA ratio (46.1% vs 21.5%) (p = 0.001) and family history of premature coronary heart disease (CHD). CONCLUSIONS: AT is more prevalent among subjects with SH and is associated with higher levels of TC, TG, LDL-C, ApoB, ApoE, ApoB/ApoA ratio, family history of premature CHD. SH increases the odds of developing AT.


Assuntos
Tendão do Calcâneo/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Colesterol/sangue , Hipercolesterolemia/sangue , Tendinopatia/diagnóstico por imagem , Ultrassonografia , Adulto , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Estudos de Casos e Controles , Feminino , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/epidemiologia , Lituânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Tendinopatia/epidemiologia
17.
Mymensingh Med J ; 28(1): 49-53, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755550

RESUMO

The present cross-sectional analytical study was carried out in the department of Physiology, Mymensingh Medical College, Mymensingh, from January 2016 to December 2016 to observe serum total cholesterol in type 2 diabetes mellitus patients. For this purpose, a total number of 200 subjects of both sexes with age ranged from 30-60 years were selected of whom 100 were type 2 diabetic person and 100 were apparently healthy. Serum total cholesterol was significantly higher (p<0.0001) in both male and female of the study group in comparison to healthy control group. From this study, it may conclude that type 2 persons are considered to have significant positive relation for formation of hypercholesterolemia, and metabolic abnormalities that have high morbidity and mortality. So, prevention of type 2 diabetes mellitus by taking necessary steps like regular physical exercise, intake of healthy diet and behavior therapy may help in prevention of type 2 diabetes mellitus related complication.


Assuntos
Glicemia , Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Jejum , Hipercolesterolemia/sangue , Adulto , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Glucose , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Pessoa de Meia-Idade
18.
BMC Public Health ; 19(1): 211, 2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30786876

RESUMO

BACKGROUND: Vitamin-D deficiency is a universal health problem caused primarily by inadequate exposure to sunlight. This study aimed to assess the vitamin D status and investigate the factors affecting vitamin D distribution among Saudi males. METHODS: A cross-sectional study was conducted at the King Saud University Medical City from December 2015 to August 2016. Saudi males attending the outpatient primary health care clinics were invited to participate in the study. Data were collected on the current and past health status along with biochemical investigations for total 25-hydroxyvitamin D (25OHD), blood sugar, and cholesterol. RESULTS: Majority of the participants (76.1%) had vitamin D deficiency. Blood sugar level, age, and cholesterol level were the most significant factors associated with vitamin D status. The highest percentage of deficiency was observed in the youngest age group (30-40 years). With increasing age, the percentage of deficiency decreased significantly. Those with normal blood sugar and cholesterol level had higher serum vitamin D levels compared to those with diabetes and hypercholesterolemia. CONCLUSIONS: Vitamin D deficiency is still endemic in Saudi Arabia, particularly among younger males and those with diabetes and hypercholesterolemia. Vitamin D screening, supplementations, and vitamin D-fortified foods should be provided especially for these groups.


Assuntos
Deficiência de Vitamina D/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia , Colesterol/sangue , Estudos Transversais , Diabetes Mellitus/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Homens , Pessoa de Meia-Idade , Arábia Saudita/epidemiologia , Luz Solar
19.
J Med Syst ; 43(3): 52, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30689048

RESUMO

Clinical notes provide a comprehensive and overall impression of the patient's health. However, the automatic extraction of information within these notes is challenging due to their narrative style. In this context, our goal was to identify clusters of patients based on fourteen comorbidities related to obesity, automatically extracted with the cTAKES tool from the i2b2 Obesity Challenge data. Furthermore, results were compared with clusters obtained from experts' annotated data. The sparse K-means algorithms were used in both experiment at two levels: at the first level, three clusters were found, and at the second, new clusters were found by applying the same algorithm to each of the clusters from the former level. The results show that three types of clusters could be identified based on the number of comorbidities and the percentage of patients suffering from them. Diabetes, hypercholesterolemia, atherosclerotic cardiovascular diseases, congestive heart failure, obstructive sleep apnea, and depression were the diseases with the highest weights contributing to the cluster distribution.


Assuntos
Algoritmos , Análise por Conglomerados , Obesidade/epidemiologia , Comorbidade , Doença da Artéria Coronariana/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Insuficiência Cardíaca/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia
20.
Prostate ; 79(6): 583-591, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30652328

RESUMO

BACKGROUND: Improved prostate cancer (PCa) survival by statin use has been reported among PCa patients managed with radiation or androgen deprivation therapy (ADT), while results are controversial for men managed surgically. We evaluate the association between cholesterol-lowering medication with initiation of ADT and disease-specific death among PCa cases who underwent radical prostatectomy in Finland between 1995 and 2013. METHODS: The study cohort included 14 424 men with PCa who underwent radical prostatectomy in Finland between 1995 and 2013. Cases were identified from national hospital discharge registry. Clinical data were amended from patient files of the treating hospitals. Information on co-morbidities, additional radiation- or chemotherapy, and causes of deaths were collected from national registries. Personal-level data on medication use during 1995-2014 were gathered from national prescription database. Registry linkages were carried out using personal identification number. Lipid-lowering drugs were categorized into statins and non-statin drugs. Risk of PCa death and initiation of ADT was analyzed using Cox-regression model with adjustment for age, radiation therapy, chemotherapy, co-morbidities and other drug use. Statin use was analyzed as time-dependent variable. Delayed risk associations were evaluated in lag-time analysis. RESULTS: Compared to non-users the risk of PCa death was significantly lower among statin users before PCa diagnosis (HR 0.70, 95%CIs 0.52-0.95). For statin use after PCa diagnosis the risk was lowered in age-adjusted analysis (HR 0.76 95%CIs 0.62-0.93) but not after multivariable-adjustment. Post-diagnostic statin use was associated with improved PCa-specific survival in 1, 3 and 5 years lag-time analyses. The risk reduction was clearest for statin use initiated 5 years earlier (HR 0.71 95%CIs 0.55-0.92). Use of statins both before and after PCa diagnosis was associated with reduced risk of ADT use (HR 0.72 95%CIs 0.65-0.80 and HR 0.73, 95%CI 0.67-0.80, respectively). The risk of ADT decreased by increasing intensity of statin use before diagnosis. CONCLUSION: Statin use among surgically treated PCa patients has significant association with decreased risk of starting ADT and PCa death. The risk is lowered especially among men with statin use before PCa diagnosis and in men who used statins at high-dose. Our results are hypothesis generating due to retrospective study design.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Prostatectomia , Neoplasias da Próstata , Idoso , Causas de Morte , Estudos de Coortes , Comorbidade , Relação Dose-Resposta a Droga , Finlândia/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Próstata/patologia , Próstata/cirurgia , Prostatectomia/métodos , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos , Análise de Sobrevida
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