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Endothelial Dysfunction and Cardiometabolic Risk Factors in Mexican American Adults: The Cameron County Hispanic Cohort - 18/09/23

Doi : 10.1016/j.amjcard.2023.07.165 
Enrique Garcia-Sayan, MD a, Miryoung Lee, PhD b, James R. Stone, MD c, Danielle M. Stone, MD c, Beverly Smulevitz, BS c, David D. McPherson, MD c, Susan P. Fisher-Hoch, MD b, Joseph B. McCormick, MD b, Susan T. Laing, MD c,
a Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas 
b Department of Epidemiology, Human Genetics and Environmental Sciences, the University of Texas Health Science Center-Houston, School of Public Health, Brownsville Campus, Brownsville, Texas 
c Division of Cardiology, Department of Internal Medicine, the University of Texas Health Science Center-Houston, Houston, Texas 

Corresponding author: Tel: 713-500-6585; fax 713-500-6556.

Riassunto

Endothelial dysfunction assessed by impaired brachial flow-mediated dilation (FMD) predicts incident cardiovascular disease (CVD). We have previously shown that clustering of diabetes mellitus, obesity, and metabolic syndrome in young Hispanic patients was associated with subclinical atherosclerosis. This study aimed to assess determinants of impaired FMD response (%FMD), an earlier marker of atherosclerosis, in a population-based sample of asymptomatic Mexican Americans. Cardiometabolic biomarkers and FMD were obtained from 960 Cameron County Hispanic Cohort participants. Gender-specific median values of %FMD were used to categorize participants into those with %FMD below or above the median. The sample was further stratified into those younger and older than 55 years. Survey-weighted logistic regression analyses were conducted to evaluate the effects of cardiometabolic biomarkers on the %FMD groups. The low %FMD group was significantly older, had higher visceral adipose tissue, systolic blood pressure, or plasma glucose, and had metabolic syndrome compared with those in the high %FMD group. Multivariable-adjusted age-stratified logistic regression analyses showed that in older participants, male gender (odds ratio [OR] = 2.4 [1.4 to 4.2]) and having hypertension (OR = 2.3 [1.3 to 4.3]) or prediabetes mellitus (OR = 3.4 [1.5 to 7.5]) remained significantly associated with odds of low %FMD. In younger participants, high low-density lipoprotein (OR = 2.8 [1.6 to 4.9]) or having the metabolic syndrome (OR = 1.9 [1.1 to 3.6]) were significantly associated with odds of low %FMD. In conclusion, we found age-dependent associations between cardiometabolic biomarkers and an FMD response below the gender-specific median in a sample composed of Mexican Americans without previous CVD. Targeting specific risk factors by age may mitigate progression to incident CVD in this high-risk racial disparity group.

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Keywords : cardiometabolic risk, endothelial dysfunction, flow-mediated dilation, Hispanic


Mappa


 Funding: This study was funded by the National Institutes of Health, National Center for Minority Health Disparity, MD000170 P20, McCormick, PI; UL1 TR000371, National Heart, Lung, and Blood Institute, 1R01 HL142302, 2R01 HL142302, National Center for Advancing Translational Sciences, (NCATS), Clinical and Translational Science Awards (CTSA), UL1 9/30/06-6/30/11, UL1TR000371 6/27/12-/31/17, UL1TR003167 7/1/19-6/30/24.


© 2023  The Authors. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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