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Risk Factor Profiles (risk + factor_profile)

Distribution by Scientific Domains

Medical Sciences	92%

Distribution within Medical Sciences

Neurology	30%
Diabetes	15%

Selected Abstracts

Obesity is Associated with Worsening Cardiovascular Risk Factor Profiles and Proteinuria Progression in Renal Transplant Recipients

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2005
Kirsten A. Armstrong
Obesity is associated with adverse cardiovascular (CV) parameters and may be involved in the pathogenesis of allograft dysfunction in renal transplant recipients (RTR). We sought the spectrum of body mass index (BMI) and the relationships between BMI, CV parameters and allograft function in prevalent RTR. Data were collected at baseline and 2 years on 90 RTR (mean age 51 years, 53% male, median transplant duration 7 years), categorized by BMI (normal, BMI , 24.9 kg/m2; pre-obese, BMI 25,29.9 kg/m2; obese, BMI , 30 kg/m2). Proteinuria and glomerular filtration rate (eGFRMDRD) were determined. Nine percent RTR were obese pre-transplantation compared to 30% at baseline (p < 0.001) and follow-up (25 ± 2 months). As BMI increased, prevalence of metabolic syndrome and central obesity increased (12 vs 48 vs 85%, p < 0.001 and 3 vs 42 vs 96%, p < 0.001, respectively). Systolic blood pressure, fasting blood glucose and lipid parameters changed significantly with BMI category and over time. Proteinuria progression occurred in 65% obese RTR (23 (13,59 g/mol creatinine) to 59 (25,120 g/mol creatinine)). BMI was independently associated with proteinuria progression (ß 0.01, p = 0.008) but not with changing eGFRMDRD. In conclusion, obesity is common in RTR and is associated with worsening CV parameters and proteinuria progression. [source]

Metabolic syndrome and three of its components as risk factors for recurrent ischaemic stroke presenting as large-vessel infarction

EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2008
C.-W. Liou
Background and purpose:, Although a clear protocol for reduction of recurrent ischaemic stroke (RIS) has been established, few studies have compared the stroke subtype distribution and risk factors between RIS and first-ever stroke (FES). Methods:, This one-year hospital-based study enrolled 587 FES and 475 RIS patients. Patients were categorized into four stroke subtypes according to a modified TOAST stroke subtype classification system. Risk factor profiles were compared between the two major stroke groups and between the corresponding four subtypes to discriminate the significant risk factors for RIS. Results:, A multivariate regression analysis identified hypertension (OR, 1.87; 95% CI, 1.34,2.62), diabetes mellitus (DM) (OR, 1.57; 95% CI, 1.22,2.02), low high-density lipoprotein (LHDL) (OR, 1.43; 95% CI, 1.08,1.88) and older age as significant RIS risk factors. The significance of the former three RIS factors was further recognized in its large-vessel subtype. Moreover, metabolic syndrome was significantly more common in the recurrent stroke group (P = 0.01), including its large-vessel subtype (P = 0.04). Progressively increasing odds ratios from 1.49 to 2.02, in accordance with increased number of diagnostic components of metabolic syndrome for recurrent large-vessel ischaemic stroke, were noted. Conclusions:, Metabolic syndrome likely plays a crucial role in the development of RIS, including large-vessel infarction in modern-day Taiwan. [source]

Type 2 diabetes in families and diabetes prevention

EUROPEAN DIABETES NURSING, Issue 2 2008
FRCP Professor of Diabetic Molecular Medicine, M Walker MD
Abstract Type 2 diabetes frequently clusters in families. Non-diabetic first-degree relatives (offspring and siblings) of patients with type 2 diabetes have a three-fold increased lifetime risk of developing diabetes compared with the background population. This increased diabetes risk results from the combined effects of shared genetic and lifestyle factors. Extensive studies of non-diabetic relatives of type 2 diabetic families show that impaired insulin secretion, insulin resistance and an adverse cardiovascular risk factor profile exist well before the development of frank diabetes. Despite this well-documented adverse metabolic predisposition, patients with type 2 diabetes and their non-diabetic relatives generally have a limited understanding of the risks. Several large-scale studies, such as the Finnish Diabetes Prevention and Diabetes Prevention Program studies, indicate unequivocally that lifestyle modification through dietary change and exercise can dramatically decrease risk of progression to diabetes in high-risk subjects. However, such individuals pursue lifestyle changes only if they understand their own risk of developing diabetes. Further work is therefore needed to investigate and develop optimal ways of improving knowledge of diabetes risk in families of patients with type 2 diabetes, so that they can appreciate the potential benefits of diabetes prevention strategies. Copyright © 2008 FEND [source]

Acute ischemic stroke and transient ischemic attack in the very old , risk factor profile and stroke subtype between patients older than 80 years and patients aged less than 80 years

EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2007
J. I. Rojas
Old age groups have different risk profile and stroke features compared to younger groups. Our aim was to examine the risk factor profile and stroke subtype in patients older than 80 years with ischemic stroke. Data of 535 patients with ischemic stroke or transient ischemic attack (TIA) were prospectively recorded. Cardiovascular risk factors and stroke subtype in individuals aged 80 years or older were compared with patients under 80. Of 535 patients a total of 179 were over 80 years (33.5%). The mean age was 84.4 ± 4.4 years (61.8%; 111 women). The most common risk factors included hypertension (82.7%) and hyperlipidemia (40.2%). Lacunar stroke was the most frequent subtype of stroke (41.7%). When the groups were compared, we observed the following risk factors more frequently in the group older than 80: female patients (P = <0.001), hypertension (OR = 1.62), atrial fibrillation (OR = 2.64); whereas diabetes (OR = 0.54), hyperlipidemia (OR = 0.57), smoking (OR = 0.17) and obesity (OR = 0.58) were more frequent in the group younger than 80. In the old group we found a high incidence of ischemic stroke in women. We also found a higher frequency of hypertension and atrial fibrillation. The available and future epidemiological data will provide a better knowledge about the effect of typical risk factors in old people. [source]

Low-risk factor profile, estrogen levels, and breast cancer risk among postmenopausal women

INTERNATIONAL JOURNAL OF CANCER, Issue 8 2009
Naja Hulvej Rod
Abstract Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI , 30 kg/m2, alcohol <1 drink/week, physically active and no current hormone use) and to evaluate their associations with estrogen. The 5,054 postmenopausal women in the Copenhagen City Heart Study were asked about risk factors at baseline in 1981,3 and were followed until 2002 in the Danish Cancer Registry, with <0.1% loss to follow-up. Estradiol was measured in a subset of 1,042 women. During follow-up, 263 women developed breast cancer. Twenty-six percent of the women had a favourable risk factor profile, and their breast cancer rates were markedly lower (154 per 100,000 years) than women with 3+ risk factors (460 per 100,000 years). One, two and three risk factors were associated with hazard ratios of 1.38 (95% CI: 0.99; 1.92), 1.84 (1.26; 2.67) and 2.79 (1.59; 4.88) compared to women with a favourable profile. Each of the risk factors was associated with estrogen. In conclusion, the risk of breast cancer was markedly lower for women with a favourable risk profile than for other women and lower estrogen levels is a possible explanation. © 2008 Wiley-Liss, Inc. [source]

Functional Limitations, Socioeconomic Status, and All-Cause Mortality in Moderate Alcohol Drinkers

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2009
Sei J. Lee MD
OBJECTIVES: To determine whether the survival benefit associated with moderate alcohol use remains after accounting for nontraditional risk factors such as socioeconomic status (SES) and functional limitations. DESIGN: Prospective cohort. SETTING: The Health and Retirement Study (HRS), a nationally representative study of U.S. adults aged 55 and older. PARTICIPANTS: Twelve thousand five hundred nineteen participants were enrolled in the 2002 wave of the HRS. MEASUREMENTS: Participants were asked about their alcohol use, functional limitations (activities of daily living, instrumental activities of daily living, and mobility), SES (education, income, and wealth), psychosocial factors (depressive symptoms, social support, and the importance of religion), age, sex, race and ethnicity, smoking, obesity, and comorbidities. Death by December 31, 2006, was the outcome measure. RESULTS: Moderate drinkers (1 drink/d) had a markedly more-favorable risk factor profile, with higher SES and fewer functional limitations. After adjusting for demographic factors, moderate drinking (vs no drinking) was strongly associated with less mortality (odds ratio (OR)=0.50, 95% confidence interval (CI)=0.40,0.62). When traditional risk factors (smoking, obesity, and comorbidities) were also adjusted for, the protective effect was slightly attenuated (OR=0.57, 95% CI=0.46,0.72). When all risk factors including functional status and SES were adjusted for, the protective effect was markedly attenuated but still statistically significant (OR=0.72, 95% CI=0.57,0.91). CONCLUSION: Moderate drinkers have better risk factor profiles than nondrinkers, including higher SES and fewer functional limitations. Although these factors explain much of the survival advantage associated with moderate alcohol use, moderate drinkers maintain their survival advantage even after adjustment for these factors. [source]

Age-related anthropometric remodelling resulting in increased and redistributed adiposity is associated with increases in the prevalence of cardiovascular risk factors in Chinese subjects

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 1 2006
G. Neil Thomas
Abstract Background Ageing promotes increases in the prevalence of components of the metabolic syndrome, which obesity often underlies. Methods We report the relationship between ageing, obesity and other cardiovascular risk factors in 694 community-based Chinese subjects in gender-specific groups of three age ranges: 20.0,39.9 (young), 40.0,59.9 (middle-aged) and 60.0,79.9 (old-aged) years. Results Body mass index (BMI) values were similar in males in each age group, but waist and percentage body fat increased (6.6, and 39.5%, both p < 0.001, respectively), from young to old-age groups, as did blood pressure and glycated haemoglobin levels (all p < 0.001). In the females, increases (all p < 0.001) in percentage body fat (29.3%) were accompanied by greater increases in BMI (10.3%) and waist (19.2%) than the males. Blood pressure, glycated haemoglobin, total and LDL-cholesterol and triglyceride levels increased linearly with age (all p < 0.001). Conclusion Age-related increases in central adiposity and percentage body fat were associated with increasingly adverse cardiovascular risk factor profiles. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Functional Limitations, Socioeconomic Status, and All-Cause Mortality in Moderate Alcohol Drinkers

Cladistic Analysis of Human Apolipoprotein A4 Polymorphisms in Relation to Quantitative Plasma Lipid Risk Factors of Coronary Heart Disease

ANNALS OF HUMAN GENETICS, Issue 2 2003
G. Q. Wang
Summary Genetic variation in several genes involved in lipid metabolism is known to affect population variation in quantitative lipid risk factor profiles for coronary heart disease (CHD). The apolipoprotein A-IV gene (APOA4) is one such candidate gene. We genotyped five polymorphisms in the APOA4 gene (codon 127, codon 130, codon347, codon 360 and 3' VNTR) and investigated their impact on plasma lipid trait levels in three populations comprising 604 U.S. non-Hispanic Whites (NHWs), 408 U.S. Hispanics and 708 Nigerian Blacks. Cladistic analysis was carried out to identify 5-site haplotypes that were associated with significant phenotypic differences in each population. The distribution of APOA4 genotypes was significantly different between ethnic groups. The Africans were monomorphic for two of the five sites (codons 130 and 360), but possess a unique 12 bp insertion that was not observed in NHWs and Hispanics. Due to linkage disequilibrium between the sites, only 6 haplotypes were observed in NHWs and Hispanics, and 4 in Africans. Several gender-and ethnic-specific associations between genotypes and plasma lipid traits were observed when single sites were used. Several haplotypes were identified by cladistic analysis that may carry functional mutations that affect plasma lipid trait levels. [source]

Health status differentials across rural and remote Australia

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2009
Andrew Phillips
Abstract This paper describes mortality and disease patterns across five broad remoteness categories of Australia, with reference to the context in which those outcomes develop and are treated. Health and its outcomes become worse as remoteness increases. Some of this phenomenon reflects proportionally greater numbers of Aboriginal and Torres Strait Islander people in remote areas coupled with their poorer overall health outcomes; however, mortality for non-indigenous people is clearly higher outside compared with inside major cities. Migration of people seeking services likely reduces the size of interregional health disparity. Poorer health outcomes stem from worse risk factor profiles and average lower levels of income and of education, poorer physical and financial access to services, higher occupational and environmental risk, as well as factors unique to Aboriginal and Torres Strait Islander health. Little is known about the health benefits of living outside major cities. Diseases of the circulatory system and injuries account, respectively, for 40% and 18% of the excess mortality outside major cities. Death rates are declining over time in all (particularly remote) areas, but rates of death due to certain lung diseases in rural women are not, and rates of suicide have increased in remote areas. Ostensibly, prevalence of mental ill-health appears roughly similar in all remoteness areas. Dental health is poorer and disability is more prevalent outside major cities, as are a range of infectious diseases. Although pertinent, the effects on rural health of climate change and resource degradation generally have not been addressed in this paper. [source]

Circadian rhythm of stroke onset during the month of Ramadan

ACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010
A. El-Mitwalli
El-Mitwalli A, Zaher AA, El Menshawi E. Circadian rhythm of stroke onset during the month of Ramadan. Acta Neurol Scand: 2010: 122: 97,101. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Background and purpose,,, The onset of acute stroke exhibits a circadian pattern occurring more frequently in late morning hours. The objective of this study was to investigate the diurnal pattern of stroke during the month of Ramadan. Patients and methods,,, We studied consecutive stroke patients 1 month before Ramadan (BR) and during Ramadan (DR) over two successive years 2007 and 2008. The age, gender, risk factor profiles were analyzed. The National Institute of Health and Stroke Scale Score (NIHSS) was used for clinical assessment at admission. The exact time of stroke onset in both groups was obtained. Results,,, A total of 507 patients were studied: 245 patients in the DR group and 262 patients in the BR group. The age distribution of patients was not significantly different between the two groups. There was no statistically significant difference in the sex ratio, risk factors, and NIHSS score between the two groups (P > 0.05). The higher frequency of stroke onset time in the BR group was in the time between 6:00 a.m. and noon; whereas the frequency was higher between noon and 6:00 p.m. in the DR group. Conclusion,,, A significant shift of the circadian pattern of stroke onset time from the period between 6:00 a.m. and noon to that between noon and 6:00 pm has been found during the month of Ramadan. [source]

Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages

ACTA PAEDIATRICA, Issue 5 2009
U Kiechl-Kohlendorfer
Abstract Aim: Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in preterm infants with a gestational age <30 weeks (Group I) and 30,32 weeks (Group II). Methods: Between January 2003 and December 2006, we prospectively enrolled 310 live-born infants between 23 and 32 weeks of gestation. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of infant development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis. Results: Two hundred and fifty infants were eligible for follow-up, and 205 (82.0%) completed the follow-up visit. Intracerebral haemorrhage, small for gestational age and late-onset sepsis were associated with an increased risk for delayed development in Group I (p < 0.05, each). Premature rupture of membranes was a risk condition relevant to Group II. Antenatal steroids were associated with a decreased risk of neurodevelopmental delay in both groups. Conclusion: This study identified distinct risk factors for adverse outcome in preterm infants of lower (<30 weeks) and higher (30,32 weeks) gestational age. In the lower gestational age group, neonatal risk predictors are most important. Antenatal steroids appear to decrease the risk for adverse outcome in both age groups. [source]

Chronic rejection with or without transplant vasculopathy

CLINICAL TRANSPLANTATION, Issue 3 2003
Yvo WJ Sijpkens
Abstract: Background: Chronic allograft nephropathy (CAN) is defined and graded in the Banff '97 scheme by the severity of interstitial fibrosis and tubular atrophy. It has been denoted that chronic rejection can be diagnosed if the typical vascular lesions are seen, consisting of fibrointimal thickening. We observed several patients who developed CAN without vascular changes or signs of cyclosporine toxicity. Therefore, we assessed the risk factor profiles of CAN with and without transplant vasculopathy. Methods: A cohort of 654 cadaveric renal transplants performed between 1983 and 1997 that functioned for more than 6 months was studied. Fifty-four transplants had CAN defined by a significant decline in renal function together with interstitial fibrosis and tubular atrophy without signs of cyclosporine nephrotoxicity or recurrent disease. Using the Banff chronic vascular (CV) score, 23 of 54 cases (43%) had a chronic vasculopathy score of 0 or 1 whereas 31 cases (57%) had a CV score of 2 or 3. Applying multivariate logistic regression, predictor variables of the two groups were compared with 231 transplants with a stable function for at least 5 yr. Results: Graft histology was obtained at a mean of 2.4 and 2.9 yr after transplantation in the group with or without vasculopathy, respectively. Acute rejection episodes (AREs) after 3 months post-transplantation were the strongest risk factor for both forms of CAN, odds ratio (OR) 14.7 (6.0,36.0). CAN with vasculopathy was also associated with transplants performed in the 1980s, OR 4.95 (1.65,14.9) and with creatinine clearance at 6 months, OR 0.58 (0.44,0.75) per 10 mL/min increase. In contrast, young recipient age, OR 0.69 (0.47,0.99) per 10-yr increase, and the presence of panel reactive antibodies at the time of transplantation, OR 1.26 (1.08,1.47) per 10% increase, were independent risk factors for CAN without vasculopathy. Conclusions: After exclusion of cyclosporine toxicity or recurrent disease CAN occurred without moderate or severe transplant vasculopathy in 43% of the cases. The correlation with young recipient age, sensitization and late ARE suggest an immune pathogenesis, consistent with chronic rejection. [source]