Search

A number of factors used to define the metabolic syndrome (MS) differ between African-American and European-American patients, which raises the question whether the individual constellation of MS components would impact cardiovascular risk. Our objectives were to assess the association between the MS and coronary artery disease (CAD) across ethnicities and to explore whether the constellation used to define the syndrome would impact any such association. We studied the distribution of the MS and its relation to CAD in 304 European-American subjects and 224 African-American subjects undergoing diagnostic coronary angiography. The overall prevalence of the MS in European-American and African-American subjects were 65.5% and 49.1%, respectively. Compared with European-American subjects, the lipid components of the syndrome were less frequent among African-American subjects (44% vs 64% [p <0.001] for high-density lipoprotein [HDL] cholesterol and 21% vs 51% [p <0.001] for triglyceride, respectively). The prevalence of CAD was significantly higher in subjects with MS across ethnicity (71.1% of European-American subjects and 56.6% of African-American subjects, p = 0.017 and p = 0.046, respectively). Multiple regression analyses demonstrated an association of blood pressure and HDL cholesterol with CAD among European-American subjects, which remained significant taking other risk factors into account (r(2) = 0.542, p <0.001). In conclusion, presence of CAD was more common among subjects with MS independently of ethnicity. Of the MS components, blood pressure was associated with CAD among European-American subjects. Although our findings may not be directly extrapolated to the population at large, they illustrate the importance of a high-risk metabolic environment as a cardiovascular risk factor.

Objective: Obesity and hyperinsulinemia are associated with dyslipidemia in adults and older children, but little is known about these relationships in very young children. We examined the relation of fasting insulin to lipid levels and lipid particle size in young healthy children., Research Methods and Procedures: Analyses were performed on data from 491 healthy 2- and 3-year old Hispanic children enrolled in a dietary study conducted in New York City, 1992-1995. Obesity measures included BMI, ponderal index, skinfold thickness, and waist circumference. Low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol particle size were measured by nuclear magnetic resonance., Results: Fasting insulin level was positively correlated with triglyceride levels (r = 0.24 for boys and r = 0.23 for girls; p < 0.001 for both) and inversely correlated with HDL-cholesterol level in boys (r = -0.20; p < 0.01). Higher fasting insulin level was also correlated with smaller mean HDL particle size in both boys (r = -0.21; p < 0.001) and girls (r = -0.14; p < 0.05) and smaller mean LDL particle size in boys (r = -0.13; p < 0.05). The associations of fasting insulin level with triglyceride and HDL-cholesterol levels and HDL and LDL particle size remained significant after multivariate regression adjustment for age, sex, and BMI or ponderal index., Discussion: Fasting insulin level is associated with relative dyslipidemia in healthy 2- and 3-year-old Hispanic children.

Information on determinants of plasma lipids and lipoproteins and how these factors would differ among race/ethnic groups in elderly populations is scarce. We studied cross-sectionally the distribution and predictors of lipids and lipoproteins in 1,118 free-living elderly subjects (> or =65 years of age), in a multiethnic urban community (22% non-Hispanic Caucasian, 34% African-American, and 44% Hispanic). Mean levels of total cholesterol, total/high-density lipoprotein (HDL) cholesterol ratio, and triglycerides decreased with increasing age (p <0.001). Low-density lipoprotein cholesterol and total cholesterol were lower among men, whereas women had higher levels of HDL cholesterol (p <0.001). Hispanics had lower low-density lipoprotein cholesterol, total cholesterol, and HDL cholesterol levels, whereas African-Americans had a lower total/HDL cholesterol ratio and triglyceride levels along with higher HDL cholesterol levels (p <0.001). Diabetes was more prevalent among Hispanics and African-Americans (p = 0.002), and body mass index was higher in African-Americans (p = 0.009). Hispanics were less likely to drink alcohol (p <0.0001), but more likely to drink larger amounts of coffee (p <0.0001). A greater proportion of African-Americans were active smokers (p <0.001). In multivariate regression models, body mass index was a significant independent predictor of total cholesterol (beta = 0.74, p <0.001). Waist circumference predicted lower HDL cholesterol levels (0.57 mg/dl lower per inch, p <0.001) and a higher total/HDL cholesterol ratio (beta = 0.05, p <0.001). Alcohol intake (>2 g/day) predicted higher HDL cholesterol (beta = 6.20, p <0.001). Diabetic status predicted lower HDL cholesterol (beta = -2.47, p <0.05), higher total/HDL cholesterol ratio (beta = 0.35, p <0.001), and triglycerides (beta = 37.10, p <0.001). Physical activity, coffee intake, and a calorie-adjusted atherogenicity index did not show independent predictive value. These findings indicate that obesity, alcohol intake, and diabetes mellitus are potentially modifiable independent determinants of lipids and lipoprotein levels in an elderly multiethnic population.

Higher plasma fibrinogen levels are associated with increased risk of myocardial infarction in adults, but little is known about factors that influence fibrinogen levels in childhood. The authors examined the associations of measures of obesity, presence of the (G-455-->A) allele in the beta-fibrinogen promoter gene, and family history of early onset of ischemic heart disease with plasma fibrinogen levels in children. Children (n = 299) were recruited during 1994-1997 from 276 families living in a racially mixed area of New York City. The mean age of the study children was 9.9 years; 79% were Hispanic. The frequency of the (G-455-->A) allele was lower in Hispanics than in non-Hispanic Whites (15.5% vs. 28.3% in children (p < 0.01) and 13.9% vs. 28.3% in parents (p < 0.001)). Graded relations of children's plasma fibrinogen levels were found with tertiles of body mass index (weight (kg)/height (m)2) and sum of skinfolds (tests for linear trend: p < 0.001). Plasma fibrinogen levels in the children were not related to race/ethnicity, presence of the (G-455-->A) allele, or family history. Multiple linear regression analyses adjusting plasma fibrinogen levels for age, sex, race/ethnicity, the (G-455-->A) allele, and family history of early onset of heart disease showed a significant association with either body mass index or sum of skinfolds (p < 0.001 for both models) but not with the other variables.

Background and Purpose: Risk factors for carotid atherosclerosis have been studied in white populations but infrequently in multiethnic cohorts. The aim of this study was to determine the importance of race-ethnicity and other factors associated with carotid atherosclerosis in a mixed population of Hispanics, blacks, and whites., Methods: As part of the Northern Manhattan Stroke Study, 526 stroke-free community residents (aged > or = 40 years; 41% men, 59% women; 46% Hispanic, 31% black, 23% white) were recruited through random-digit dialing and had vascular risk factor evaluations. Maximum internal carotid artery plaque thickness (MICPT) was measured with B-mode ultrasound. The frequency distribution of MICPT was examined in the three race-ethnic groups, and multivariate regression was performed to identify factors that were independently associated with MICPT., Results: Mean MICPT in the entire sample was 1.5 +/- 1.4 mm, increased directly with age, and was greater in whites and blacks than Hispanics. Other independent determinants of MICPT included smoking, glucose, LDL cholesterol, and hypertension. After we controlled for these covariates, Hispanic (versus non-Hispanic) race-ethnicity was still an independent determinant of less carotid plaque. There was a significant interaction between race-ethnicity and LDL cholesterol, with a greater effect of increasing LDL cholesterol among Hispanics., Conclusions: Atherosclerotic risk factors were predictive of MICPT in this mixed-ethnic cohort. Hispanics had significantly less carotid plaque after adjustment for other known risk factors, but they also had a greater impact of increasing LDL cholesterol.