<p>During the past decades the knowledge concerning risk factors and pathophysiology of coronary heart disease (CHD) has substantially increased. However, despite identification of important risk factors CHD remains the leading cause of death in the western world.</p><p>The metabolic syndrome is a cluster of metabolic disorders such as hypertension, hypertriglyceridemia, low HDL-cholesterol, and glucose intolerance associated with an increased risk of cardiovascular morbidity and mortality.</p><p>The studies in this thesis are epidemiological in their character, and examine the relationships between different aspects of CHD and the metabolic syndrome in a population-based study of middle-aged men (ULSAM).</p><p>The findings indicated that serum lipids were important risk factors for the development of both angina pectoris demanding revascularisation and acute myocardial infarction (MI). Proinsulin and blood pressure were independent predictors of MI only, suggesting these factors to be involved in thrombosis and plaque rupture. </p><p>It was also found that antihypertensive treatment with beta-blockers and thiazide diuretics resulted in increased fasting blood glucose concentrations in subjects with an insulin resistant state with elevated proinsulin concentrations. Both proinsulin concentrations and increase in fasting blood glucose were associated with increased risk of developing future MI. </p><p>The finding of a new Q/QS-pattern on the resting ECG, regardless of history of MI, was associated with impaired insulin secretion and was an independent predictor of total and cardiovascular mortality. </p><p>A risk prediction score for MI including proinsulin and the ratio between apolipoprotein B and apolipoprotein A1 was developed in middle-aged men. This score was predictive for future fatal and nonfatal MI, and proved to be at least as good as the Framingham and the PROCAM scores, being based on traditional risk factors.</p><p>In summary these studies provide further knowledge about the associations between CHD and the metabolic syndrome and the possible importance of new markers of cardiovascular risk such as proinsulin and the apolipoproteins.</p>

Übergewicht, Diabetes oder Fettstoffwechselstörungen sind mit erniedrigten Adiponectinspiegeln assoziiert. Eine Modulation des Adiponectins kann durch genetische und metabolische Gegebenheiten erfolgen. Das Ziel dieser Arbeit war die Analyse von Faktoren, welche die Adiponectinspiegel beeinflussen können, sowie eine Charakterisierung der Oligomerverteilung unter verschiedenen metabolischen Bedingungen. In der MeSyBePo-Kohorte waren die zirkulierenden Adiponectinspiegel mit den Promotorpolymorphismen ADIPOQ -11377 C/G und ADIPOQ -11391 G/A im Adiponectingen assoziiert. Im Hinblick auf die metabolischen Faktoren korrelierte Adiponectin eng mit Parametern des Glukose- und Fettstoffwechsels sowie dem Übergewicht. Innerhalb von hyperinsulinämischen euglykämischen Clamps führte eine akute Hyperinsulinämie zu einer Abnahme der Adiponectinspiegel. Adiponectin zirkuliert im Serum als hochmolekulare (HMW), mittelmolekulare (MMW) und niedrigmolekulare (LMW) Spezies. Mit zunehmendem Körpergewicht konnte eine Verlagerung von HMW-Spezies hin zu den LMW-Spezies beobachtet werden. Durch eine moderate Gewichtsabnahme erhöhten sich die Anteile an HMW- und MMW-Adiponectin wieder. Während sich in Abhängigkeit vom Glukosemetabolismus keine Unterschiede in den Gesamtspiegeln ergaben, wurden bei Personen mit normaler Glukosetoleranz signifikant höhere Anteile an MMW-Adiponectin detektiert als bei Personen mit einem gestörten Glukosestoffwechsel. Insgesamt scheinen die HMW- und MMW-Spezies gegensätzlich zur LMW-Spezies reguliert zu werden. Die Arbeit unterstreicht die wichtige Rolle des Adiponectins im Glukose- und Fettstoffwechsel sowie bei einer Adipositas in vivo. Dabei waren Änderungen der Adiponectinspiegel bei Vorliegen von Insulinresistenz und Adipositas stets mit einer Umverteilung der Oligomerfraktionen verbunden. Vor allem die HMW- und MMW-Spezies des Adiponectins scheinen von entscheidender Bedeutung zu sein. / Experimental data suggest that a dysregulation of adiponectin might be involved in the development of the metabolic syndrome. Adiponectin circulates as a variety of multimeric forms and its concentration was found to be decreased in obesity, type 2 diabetes mellitus, and dyslipidemia. Polymorphisms within the adiponectin gene, as well as the metabolic status, may modulate the adiponectin level. The aim of this work was to evaluate factors that may modulate total adiponectin levels as well as the distribution of its multimeric complexes under specific metabolic conditions. In the caucasian MeSyBePo population, serum adiponectin concentrations were associated with two promoter polymorphisms, ADIPOQ -11377 C/G and ADIPOQ -11391 G/A, respectively. Mean serum adiponectin levels were related to obesity, glucose metabolism, and lipid metabolism. Additionally, hyperinsulinemic euglycemic clamps acutely lowered serum adiponectin concentration. Adiponectin circulates in serum as low-, medium-, and high-molecular-weight complexes (LMW, MMW, and HMW, respectively). Adiponectin oligomer composition was related to BMI, with decreased HMW and MMW fractions in case of high BMI levels. According to this, HMW and MMW adiponectin increased after moderate weight reduction. While total adiponectin levels were comparable between patients with type 2 diabetes and control subjects, a reduction of MMW oligomers was observed in patients with impaired glucose metabolism. Finally, these studies all suggested a differential regulation of HMW and MMW species compared to the LMW fraction. The data presented underline the important role of adiponectin within the glucose- and lipid metabolism as well as in obesity. We showed that modulation of total adiponectin levels in case of insulin resistance or obesity are always accompanied with changes of adiponectin oligomer composition. Thereby the HMW and MMW species seem to play a crucial role in affecting metabolic changes.

During the past decades the knowledge concerning risk factors and pathophysiology of coronary heart disease (CHD) has substantially increased. However, despite identification of important risk factors CHD remains the leading cause of death in the western world. The metabolic syndrome is a cluster of metabolic disorders such as hypertension, hypertriglyceridemia, low HDL-cholesterol, and glucose intolerance associated with an increased risk of cardiovascular morbidity and mortality. The studies in this thesis are epidemiological in their character, and examine the relationships between different aspects of CHD and the metabolic syndrome in a population-based study of middle-aged men (ULSAM). The findings indicated that serum lipids were important risk factors for the development of both angina pectoris demanding revascularisation and acute myocardial infarction (MI). Proinsulin and blood pressure were independent predictors of MI only, suggesting these factors to be involved in thrombosis and plaque rupture. It was also found that antihypertensive treatment with beta-blockers and thiazide diuretics resulted in increased fasting blood glucose concentrations in subjects with an insulin resistant state with elevated proinsulin concentrations. Both proinsulin concentrations and increase in fasting blood glucose were associated with increased risk of developing future MI. The finding of a new Q/QS-pattern on the resting ECG, regardless of history of MI, was associated with impaired insulin secretion and was an independent predictor of total and cardiovascular mortality. A risk prediction score for MI including proinsulin and the ratio between apolipoprotein B and apolipoprotein A1 was developed in middle-aged men. This score was predictive for future fatal and nonfatal MI, and proved to be at least as good as the Framingham and the PROCAM scores, being based on traditional risk factors. In summary these studies provide further knowledge about the associations between CHD and the metabolic syndrome and the possible importance of new markers of cardiovascular risk such as proinsulin and the apolipoproteins.

Zusammenfassung: Effekte der L-Carnitinsupplementierung auf das metabolische Profil adipöser und insulinre- sistenter Ponys im Verlaufe einer mehrwöchigen Körpergewichtsreduktion Author: Uta Schmengler Institut für Tierernährung, Ernährungsschäden und Diätetik, Veterinärmedizinische Fakultät, Universität Leipzig Eingereicht im September 2012 76 S., 16 Abb., 23 Tab., 169 Lit., Anhang Einleitung: Das ”Equine Metabolische Syndrom” ist gekennzeichnet durch eine regionale oder generalisierte Adipositas, eine periphere Insulinresistenz sowie akute oder chronische Hufreheschübe. Die Ursache ist in einer bedarfsübersteigenden, hochkalorischen Fütterung und einem relativen Bewegungsmangel zu suchen, wobei auch der genetischen Prädisposition spezieller Rassen eine gewisse Bedeutung zukommt. Ziel dieser Studie war die Untersuchung der Effekte einer L-Carnitinsupplementierung in Kombination mit einer restriktiven Füt- terung und täglicher moderater Bewegung auf Körpermasseverlust, Insulinsensitivität und ausgewählte Parameter des Energiestoffwechsels adipöser und insulinresistenter Ponys. Material und Methoden: Für die placebokontrollierte Doppelblindstudie wurden 16 adipöse Ponys per Losverfahren in zwei Gruppen (N=8) eingeteilt. Zu Versuchsbeginn wiesen die Ponys einen mittleren Body Condition Score von 8,0±2,0 (Skala 1-9) und einen mittleren Cresty Neck Score von 4,0±1,0 (Skala 0-5) auf. Während des 14-wöchigen Körpermassere- duktionsprogramms wurden die Ponys restriktiv gefüttert mit 1 - 1,2 kg Heu/100 kg KM/d. Zusätzlich erhielten 8 Ponys eine L-Carnitin-Zulage (1,3 g/100 kg KM/2d) und 8 Tiere ein Placebo in Form einer Kieselsäureverbindung (1,3 g/100 kg KM/ 2d). Die Ergänzungen wur- den in einem Gemisch aus Grünmehl (50 g/2d) und Mineralfutter verabreicht. Über die 14-wöchige Versuchszeit wurde ein Bewegungsprogramm an sechs Tagen in der Woche durch- geführt, das 25 Minuten Schritt und 15 Minuten Trab beinhaltete. Zu Versuchsbeginn und nach Versuchsende wurde mit beiden Versuchsgruppen ein Frequently sampled intravenous glucose tolerance test (FSIGTT) zur Überprüfung der Insulinsensitivität durchgeführt. Über die gesamte Versuchszeit wurden wöchentlich Blutproben gewonnen zur Bestimmung der ba- salen Serum-Insulinaktivität und Plasma-Glucosekonzentration sowie der Konzentration der Freien Fettsäuren (FFS), Triacylglyceride (TAG), Harnstoff und Betahydroxybutyrat (BHB) im Serum. Die Körpermasseverluste wurden über wöchentliche Wägungen sowie Ermittlung von BCS und CNS kontrolliert. Die statistische Überprüfung wurde anhand parametrischer (ANOVA) und nicht-parametrischer Tests (Wilcoxon signed rank test) durchgeführt, die Kal- kulation der Insulinsensitivität erfolgte über das Minimalmodell anhand eines Computerpro- gramms (MINMOD). Ergebnisse: Im Mittel verloren die Ponys über den Versuchszeitraum von 14 Wochen 1- 3% ihrer Körpermasse pro Woche (Zeit: p < 0, 01, Behandlung: p=0,79), was einem totalen Körpermasseverlust von 14,3±% entsprach. Der BCS reduzierte sich in beiden Versuchs- gruppen um eine Differenz von 3 Einheiten, der CNS verringerte sich in der Carnitingrup- pe (GC ) um eine Differenz von 1,4 und in der Placebogruppe (GP ) um eine Differenz von 1,9 Einheiten. Der Körpermasseverlust war von einer signifikanten Verbesserung der Insu- linsensitivität (Zeit p < 0, 01, Behandlung: p=0,39) begleitet. Die Kalkulation der Insulin- sensitivität im Minimalmodell zeigte eine signifikante Erhöhung der SI-Werte am Versuch- sende in beiden Versuchsgruppen (Beginn Studie GC : 0,76±0,88 l/min/μU*10−4 und GP : 1,61±1,31 l/min/μU*10−4 ; Ende Studie GC : 5,45±0,81 l/min/μU*10−4 und GP : 6,08±2,98 l/min/μU*10−4 ). Signifikante, zeitabhängige Veränderungen wurden auch für die metabo- lischen Parameter beobachtet: Plasma-Glucose und Serum-Insulin reagierten mit einem si- gnifikanten Abfall (Glucose GC : 4,5±0,32 mmol/l vs. 4,21±0,61 mmol/l und Glucose GP : 4,34±0,62 mmol/l vs. 3,86±0,34 mmol/l; Insulin GC : 23,71±32,77 μU/ml vs. 3,67±3,94 μU/ml und GP : 13,55±12,67 μU/ml vs. 1,01±1,09 μU/ml). Dabei kam es zu einem signi- fikanten Anstieg des Serum-Harnstoffs (GC : 3,47±0,73 mmol/l vs. 4,31±1,06 mmol/l und GP : 3,71±0,79 mmol/l vs. 4,9±1,23 mmol/l) sowie der Serum-FFS (GC : 157±95 μmol/l vs. 731±138 μmol/l und GP : 113±63 μmol/l vs. 686±142 μmol/l) und Serum-TAG (GC : 0,53±0,28 mmol/l vs. 0,94±0,61 mmol/l und GP : 0,45±0,23 mmol/l vs. 0,64±0,25 mmol/l). Bezüglich der L-Carnitinsupplementierung wurden keine weiteren Effekte verzeichnet. Schlussfolgerungen: Die restriktive Energiezufuhr von 7 MJ DE/100 kg KM entspre- chend einer Heuzulage von 1 kg/100 kg KM führte zu KM-Verlusten von 1-3 %. Eine Kör- permassereduktion zeigte deutliche Auswirkungen auf den Glucose- und Lipidmetabolismus und führte zu einer signifikanten Verbesserung der Insulinsensitivität, wohingegen die L- Carnitinsupplementierung keine weiteren Effekte auf den Glucosestoffwechsel herbeiführte. Eine bedarfsdeckende Eigensynthese von L-Carnitin ist beim Pony offensichtlich auch im Zu- stand der Insulinresistenz gewährleistet und reicht aus um die obligatorischen Funktionen L-Carnitins im Energiestoffwechsel zu erfüllen. / Summary: The effects of L-carnitine supplementation on body weight losses and metabolic profile in obese and insulin resistant ponies during a several weeks lasting bodyweight reduction pro- gramme Author: Uta Schmengler Institute of Animal Nutrition, Nutrition Diseases and Dietetics, Faculty of Veterinary Medi- cine, University of Leipzig Submitted in September 2012 76 p., 16 fig., 23 tab., 169 ref., appendix Introduction: Insulin resistance, local or general adiposity and the predisposition towards acute or chronical laminitis are components of the equine metabolic syndrome. Contributing factors for this syndrome are the intake and the quality of a high caloric feed by a lack of physical exersice. Howewer, the genetically predisposition of so called ”easy keepers” seems to play a role in pathogenesis. The objective of this study was to investigate the effects of L- carnitine supplementation in combination with a body weight reduction programme (BWRP) on body weight (BW) losses, insulin sensitivity and selected metabolic parameters in obese and insulin resistant ponies. Material und methods: 16 obese ponies (mean BCS = 8.0±2.0, mean CNS = 4.0±1.0) were assigned to a randomized double blind, placebo-controlled study. The ponies werde di- vided into two equal groups (N=8). During a 14 weeks lasting BWRP the ponies were fed 1.0-1.2 kg hay/100 kg BW daily. Additionally, 8 ponies were supplemented with L-carnitine (1.3g/100 kg BW) and 8 ponies were supplemented with a placebo (1.3g/100 kg BW). The supplements were offered in a mixture of 50 g grass meal and 50 g of a commercial mineral mixture, twice a day. During BWRP ponies were exercised a low-intensity protocol 6 days a week (daily 25 min walk and 15 min trot across the countryside). A frequently sampled intravenous glucose tolerance test (FSIGTT) was undertaken in order to assess insulin sen- sitivity at the beginning and the end of the study. Routine blood samples were collected for analysis of plasma glucose, serum insulin, free fatty acids (FFA), triglycerides (TG), urea and beta-hydroxybutyrate (BHB). Ponies were weighed weekly after 12 h of feed restriction by using an electronic scale for large animals. BCS and CNS were recorded weekly by the same 2 observers throughout the study. The statistical analysis was performed by parametric and non-parametric tests (ANOVA and Wilcoxon ranked test). The minimal modell calcu- lation of insulin sensitivity (SI) from FSIGTT was calculated by the computer programme (MINMOD). Results: Ponies lost 1-3% BW per week over the BWRP (time P<0.01, L-carnitine supple- mentation P=0.79), meaning a total body weight loss of 14.3%. BCS decreased in both groups with a difference of three points and CNS was reduced with a difference of 1.4-1.9 points. BW losses were accompanied by a significant improvement in insulin sensitivity (Time: P<0.01, L-carnitine supplementation: P=0.39). The calculation for SI-values by the minimalmodell showed a significant increase in L-carnitine group (GC ) and placebo group (GP ) in the end of the study. (GC : 0.76±0.88 L/min/μU*10−4 to 5.45±0.81 L/min/μU*10−4 , GP : 1.61±1.31 L/min/μU*10−4 to 6.08±2.98 L/min/μU*10−4 ). Significant time related decreases were observed for plasma glucose (GC : 4.5±0.32 mmol/L to 4.21±0.61 mmol/L, GP : 4.34±0.62 mmol/L to 3.86±0.34 mmol/L) and serum insulin (GC : 23.71±32.77 μU/mL to 3.67±3.94 μU/mL, GP : 13.55±12.67 μU/mL to 1.01±1.09 μU/mL). A significant increase was observed for serum urea (GC : 3.47±0.73 mmol/L to 4.31±1.06 mmol/L, GP : 3.71±0.79 mmol/L to 4.9±1.23 mmol/L), FFA (GC : 157±95 μmol/L to 731±138 μmol/L und GP : 113±63 μmol/L to 686±142 μmol/L) and TG (GC : 0.53±0.28 mmol/L to 0.94±0.61 mmol/L, GP : 0.45±0.23 mmol/L to 0.64±0.25 mmol/L) during BWRP. There was no further improvement in metabolic responses by L-carnitine supplementation. Conclusions: Energy intake of 7 MJ DE/100 kg BW leads to bodyweight losses of 1- 3%, herby improving insulin sensitivity and glucose metabolism. L-carnitine supplementation does not further improve glucose or fat metabolism, suggesting that endogenous L-carnitine synthesis was sufficient to facilitate energy metabolism in obese and insulin resistant ponies.

Tesis por compendio de publicaciones / La gran preocupación que existe actualmente alrededor del peso corporal, está colaborando a la proliferación de innumerables dietas de adelgazamiento entre las personas “no satisfechas con su peso”. En este sentido hemos estudiado la obesidad desde un punto de vista cronobiológico, para poder dilucidar la importancia que tiene la alteración circadiana de ciertos ritmos biológicos en la ganancia de peso o la no pérdida del mismo. El acúmulo de grasa corporal y el grado de lipogénesis en el tejido adiposo podría ser diferente a distintas horas del día, ingiriendo las mismas calorías. A su vez uno de los aspectos más interesantes, es poder conseguir una caracterización cronobiológica de cada individuo, establecer mejoras en las terapias de comportamiento alimentario, introducir nuevos índices que permitan detectar pacientes de riesgo y poder establecer pautas alimentarias y hábitos de vida individualizados que ayuden a estos pacientes a alcanzar la meta de peso propuesta. / The great controversy now there about body weight, is collaborating with the proliferation of countless diets among people "not satisfied with their weight." In this sense, we have studied obesity from a chronobiological viewpoint, to elucidate the importance of the alteration of circadian biological rhythms in weight gain or no loss. The accumulation of body fat and the degree of lipogenesis in adipose tissue may be different n accordance with the time of day, even eating the same calories. In turn one of the most interesting aspect, is to be able to characterize the individual chronobiology of each patient, establish improved therapies feeding behavior, introducing new indices to detect patients at risk and to establish dietary patterns and lifestyle habits that help these patients to achieve the proposed weight goal.

Background: Several selected population-based studies have emphasized the significance of resting heart rate as an independent cardiovascular risk factor. However, there are no data available for using resting heart rate as a cardiovascular risk predictor in contemporary primary care. Thus, the aim of our analysis was to examine the clinical value of the measurement of resting heart rate in a large, unselected population-based cohort of primary care subjects under the conditions of contemporary primary prevention. Design: Prospective, population-based cohort study. Methods: We examined a subgroup of 5320 unselected primary care subjects free of coronary artery disease from the nationwide, longitudinal Diabetes Cardiovascular Risk Evaluation Targets and Essential Data for Commitment of Treatment (DETECT) cohort study, which was conducted from 2003 to 2008. Results: During the follow-up time of 5 years, 258 events were reported. Elevated resting heart rate was not associated with an increased risk for cardiovascular events (HR = 0.75, p = 0.394), cardiovascular mortality (HR = 0.71, p = 0.616) or major cardiovascular events (HR = 0.77, p = 0.376). By cross-sectional analysis, elevated heart rate clustered with markers of the metabolic syndrome, like increased blood pressure (systolic: OR = 5.54, p < 0.0001; diastolic: OR = 3.82, p < 0.0001), elevated fasting plasma glucose levels (OR = 8.84, p < 0.0001), hypertriglyceridaemia (OR = 22.16, p = 0.001), and obesity (body mass index OR = 0.89, p < 0.0001). Assessment of resting heart rate in clinical practice had minimal and non-significant additional prognostic value compared to established cardiovascular risk factors as judged by C statistics (C = 0.001, p = 0.979). Conclusion: The measurement of resting heart rate in the daily routine of primary care does not provide incremental prognostic information for cardiovascular risk stratification.

published_or_final_version / Community Medicine / Master / Master of Philosophy

Several research studies indicate the increasing problem obesity has become over the past few decades (Andersen 1999:41; Fox, 1999:56-60; Kuczmarshi et al., 1994:205-212). Obesity, after cigarette smoke, is the leading cause of death in the USA and a combination of diet factors and physical inactivity (two primary contributors of obesity) leads to an average of 300,000 deaths per year (McGinnis & Foege, 1993:2207-2212). Previously little information was available on the effect of obesity on the peripheral vascularization, and even less about the effect of obesity on arterial compliance (Raison et al., 1998:299-303). Research indicated a decrease in arterial compliance with an increase in body weight (Kumaran et al., 2002:7; Sutton-Tyrrell et al., 2001:431; Tounian et al., 2001:1400-1404; Stepniakowski & Egan, 1995:R567) however, contradictory research where no association between obesity and arterial compliance was indicated, has also been found (Singhal et al., 2002:1920; Mangoni et al., 1995:986). Mackey et al. (2002:16) also found that an increased aortic stiffness is positively associated with lowered physical activity levels. A lifestyle consisting of moderate physical activity, has a positive effect on the health, lowering of chronic illness risks, the prevention of cardiovascular diseases and the improvement of quality of lie in overweight and obese patients (Adams et al., 2003542; Ferreira et al., 2003:1670-1678; Macera, 2003:123; Mclnnis, 200396; Kolden et al., 2002:447). Moderate aerobic exercise is also seen as a potential non-pharmaceutical therapeutic method to increase age associated decrease in arterial compliance in young, middle aged and older adults (Gates et al., 2003:2213; Havlik et al., 2003:156; Seals, 2003:68; Moreau et al., 2003:865; Joyner, 2000:1214; Cameron et al., 1999:653). The objective of this study was firstly to determine the correlation between obesity and vascular function in Caucasian women between the ages 19 and 56 and to determine which marker of obesity is the best predictor of a weakened vascular function (see article one). The second objective was to determine the correlation between physical activity, obesity and arterial compliance in Caucasian women between the ages 19 and 56 years (see article 2). A total of 115 Caucasian women were recruited to participate in this study. Anthropometric measurements and a comprehensive body composition profile was taken using the BOD POD. The Finometer apparatus was used to measure the arterial compliance and the sphygmomanometer to measure the subjects blood pressure. The subjects completed the Yale Physical Activity Survey questionnaire to determine their physical activity index. This study seems to indicate a positive relationship between arterial compliance and obesity which could be explained by the influence blood volume had in determining arterial compliance. A negative correlation was found between obesity and blood pressure where an increase in obesity caused an increase in both systolic and diastolic blood pressure. A positive correlation was found between physical activity and obesity. The higher the activity levels were in this study, the less obese the subjects tended to be. No correlation was found between physical activity and arterial compliance. A clear trend, even though no statistically significant differences, was found between physical activity and blood pressure. The more active the subjects were, the lower their blood pressure tended to be. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2005

Good health is a fundamental resource for social and economic development. Non-communicable chronic diseases (NCDs) such as cardiovascular diseases (CVD), cancer, chronic respiratory diseases and diabetes mellitus are reaching epidemic proportions worldwide. Over the last decades NCDs remain the main public health problem in Lithuania also. The leading NCD’s in the Lithuania are CVD and cancer. The key targets of the Health 21 policy for WHO European Region as well as of Lithuanian Health Programme are reduction of morbidity and mortality from CVD, cancer and other NCD’s. The leading strategy to tackle NCDs is control and prevention of risk factors. Common, modifiable risk factors underlie the major NCD’s. Seven risk factors are responsible for the majority of NCD in the European region: high blood pressure, tobacco, alcohol, high cholesterol, being overweight, low intake of fruits and vegetables, and physical inactivity. The lifestyle habits start to develop in childhood. Children and adolescents begin to smoke and use alcohol, adopt unhealthy nutrition habits and sedentary lifestyle. Harmful lifestyle choices lead to children’s overweight, increase of their blood pressure (BP), and metabolic disorders. Many epidemiological studies designed to assess the association between health indices in childhood and adulthood were conducted over the last years. However, the number of longitudinal, cohort studies that would follow people from childhood to middle age and would apply the... [to full text]

Metabolic syndrome is a cluster of disorders including central obesity, hypertension, dyslipidemia, and hyperglycemia. Today's metabolic syndrome definitions identify central obesity by waist circumference (WC) measurements. A recent pilot study suggests that cut-points derived from a waist-to-height ratio (WHtR), or Index of Central Obesity (ICO), is a more accurate measurement of central obesity. This study compared the association between the metabolic syndrome components and central obese parameters (ICO and WC) among the white, black, and Hispanic adults in the United States. The subjects' data was obtained from the 2005-2006 National Health and Nutrition Examination Survey. ICO was highly correlated with metabolic syndrome components among white subjects and the least correlated in Hispanic subjects. Multivariate logistic regression analysis did not indicate that ICO was a better parameter for metabolic syndrome than WC. Other WHtR cut-points may be more sensitive in predicting metabolic syndrome components than the values used in this study.