Cardiometabolic Risk Factors

BackgroundThis study sought to elucidate the associations of cardiometabolic index (CMI), as a metabolism-related index, with all-cause and cardiovascular mortality among the older population. Utilizing data from the National Health and Nutrition Examination Survey (NHANES), we further explored the potential mediating effect of inflammation within these associations.MethodsA cohort of 3029 participants aged over 65 years old, spanning six NHANES cycles from 2005 to 2016, was enrolled and assessed. The primary endpoints of the study included all-cause mortality and cardiovascular mortality utilizing data from National Center for Health Statistics (NCHS). Cox regression model and subgroup analysis were conducted to assess the associations of CMI with all-cause and cardiovascular mortality. The mediating effect of inflammation-related indicators including leukocyte, neutrophil, lymphocyte, systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR) were evaluated to investigate the potential mechanism of the associations between CMI and mortality through mediation package in R 4.2.2.ResultsThe mean CMI among the enrolled participants was 0.74±0.66, with an average age of 73.28±5.50 years. After an average follow-up period of 89.20 months, there were 1,015 instances of all-cause deaths and 348 cardiovascular deaths documented. In the multivariable-adjusted model, CMI was positively related to all-cause mortality (Hazard Ratio (HR)=1.11, 95% CI=1.01-1.21). Mediation analysis indicated that leukocytes and neutrophils mediated 6.6% and 13.9% of the association of CMI with all-cause mortality.ConclusionElevated CMI is positively associated with all-cause mortality in the older adults. The association appeared to be partially mediated through inflammatory pathways, indicating that CMI may serve as a valuable indicator for poor prognosis among the older population.

This study estimated the prevalence of cardiovascular disease (CVD) risk factors, cardiometabolic (CM) risk factors, and cardiovascular health metrics (CVHMs) among US adults and across race/ethnicity groups. The study comprised 8370 US adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2018, free of coronary heart disease/heart failure, angina/angina pectoris, heart attack, and stroke, who provided complete data for the outcome variables of interest. Age-adjusted prevalence of CVD and CM risk factors, and CVHMs were computed for all adults and across race/ethnicity groups. All analyses accounted for the complex, multi-stage survey sampling design of the NHANES. Hypertension (45.0%), obesity (40.0%), fasting plasma glucose ≥ 100 mg/dL or hypoglycemic medication (51.0%), ideal physical activity (59.2%) and ideal smoking status (56.9%) were most prevalent for the whole sample. Mexican Americans and non-Hispanic Blacks had elevated risk for some, but not all, CVD and CM risk factors compared to non-Hispanic Whites and non-Hispanic Asians. Reducing further health disparities and persisting differences among racial and ethnic groups is vital to achieving the American Heart Association vision of all people having ideal cardiovascular health, living healthier and longer.

This study aims to assess the effects of central and general adiposity on development of cardiovascular diseases (CVDs) mediated by cardiometabolic risk factors and to analyze their degree of dependency for mediating their effects. To this end, data from the the Tehran Lipid and Glucose Study cohort with 6280 participants were included in this study. The hazard ratios were calculated using a 2-stage regression model in the context of a survival model. Systolic blood pressure (BP), total serum cholesterol, and fasting plasma glucose were designated as mediators. Assessing the interactions revealed that BP was the most important mediator for general ( (HRNIE: 1.11, 95% CI 1.17-1.24) and central obesity (CO) (HRNIE: 1.11, 95% CI 1.07-1.15) with 60% and 36% proportion of the effects mediated in the total population, respectively. The proportion of mediated risk for all three metabolic risk factors was 46% (95% CI 31-75%) for overweight, 66% (45-100%) for general obesity and 52% (39-87%) for central obesity. BP was the most important mediator for overweight and central obesity in men, comprising 29% and 36% of the risk, respectively. The proportion of the risk mediated through all three metabolic risk factors in women was 23% (95% CI 13-50%) for overweight, 36% (21-64%) for general obesity and 52% (39-87%) for central obesity. Based on the results of this study, cardiometabolic mediators have conciliated more than 60% of the adverse effects of high BMI on CVDs in men. Controlling the metabolic risk factors in women does not efficiently contribute to decreasing CVDs as effectively.

There is a lack of meta-analyses focusing on low-intensity endurance training (LIT), including considerations of the lowest effective intensity across different outcomes. This systematic review and meta-analysis examined the effects of LIT on aerobic fitness and cardiometabolic health. Randomized controlled trials involving healthy adults aged 18-65 were included if the training intervention was ≥ 3 weeks, intensity was exclusively below the first lactate/ventilatory threshold (VT1), or ≤ 60% heart rate reserve, or maximum oxygen uptake (VO2max), or ≤ 75% maximum heart rate. Outcome variables were VO2max, VT1, systolic and diastolic blood pressure, plasma/serum low-density, high-density, and total cholesterol, triglycerides, and glucose. Effect sizes (ES) were calculated according to Hedge's g. The subgroup analyses (Q-test) examined the effects of training and background characteristics on outcomes. A total of 50 studies with 824 participants in the intervention groups were included. LIT had a large effect on relative VO2max (ES = 0.94, p 2 = 0.73) and a moderate effect (ES = 0.74, p = 0.003, I2 = 0.57) on VT1 compared with the control group. Small but significant effects (|ES| = 0.29-0.44, p 2 = 0.39-0.79) were observed for other variables, excluding glucose. According to the subgroup analysis, exercise intensity was associated with the adaptations only in VO2max (p = 0.02). LIT improved aerobic fitness and cardiometabolic health, but effects on fitness were more pronounced. Although higher exercise intensity was associated with greater adaptations in VO2max, no minimum intensity for adaptations was detected for most outcomes. Notable heterogeneity in responses was observed, which likely reflects both methodological differences (e.g., intensity prescription) between studies and uncertainty regarding the response magnitude. Trial Registration: The review protocol was registered at PROSPERO (CRD42023469528).