Nuts - an update on their CVD impact

2010 ◽  
Vol 322 ◽  
pp. 1-4
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Lipid Peroxidation ◽  
Ldl Cholesterol ◽  
Adverse Impact ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Rich Mixture ◽  
Nut Intake

In a nutshellNuts contain a rich mixture of mainly MUFA and PUFA fat, antioxidants, fibre and minerals.Observationally, nut intake is associated with less CVD. Many recent RCTs have shown that they reduce total and LDL-cholesterol and have some benefit for other metabolic CVD risk factors, e.g. insulin resistance and hypertension. They do not appear to have adverse impact on weight or lipid peroxidation.

scholarly journals High prevalence of cardiovascular risk factors and insulin resistance 6 years after hyperglycemia first detected in pregnancy in Cape Town, South Africa

2019 ◽  
Vol 7 (1) ◽  
pp. e000740
Author(s):  
Tawanda Chivese ◽  
Shane A Norris ◽  
Naomi S Levitt
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Cape Town ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Index Pregnancy ◽  
High Prevalence ◽  
In Pregnancy

ObjectiveTo investigate the prevalence and associated cardiovascular risk factors 6 years after hyperglycemia first detected in pregnancy (HFDP) in Cape Town, South Africa.Research design and methodsData were collected during the index pregnancy from all women diagnosed with HFDP at a major referral hospital in Cape Town. Participants were evaluated 6 years later using a cross-sectional study. At follow-up participants had a 75 g oral glucose tolerance test, fasting lipogram, blood pressure and anthropometric measurements, and a fieldworker administered the questionnaire. We used the Adult Treatment Panel III criteria for the diagnosis of metabolic syndrome and individual risk factors. Insulin resistance was assessed using the homeostatic model of insulin resistance.ResultsAt follow-up 220 women were reviewed. Their mean age at follow-up was 37.2 (SD 6.0) years. The prevalence of cardiovascular disease (CVD) risk factors was 60.9% (95% CI 54.3 to 67.2) for metabolic syndrome, 75% (95% CI 65.9 to 82.3) for insulin resistance, 62.3% (95% CI 55.6 to 68.5) for dysglycemia, 41.4% (95% CI 35.0 to 48.0) for raised blood pressure, and 74.6% (95% CI 683 to 79.9) for dyslipidemia. Women with diabetes in pregnancy compared with those with gestational diabetes during the index pregnancy had a higher prevalence of metabolic syndrome (74.3% vs 54.7%, p=0.010) and dysglycemia (88.6% vs 50.0%, p<0.001) at follow-up. Lower school education attainment, having a subsequent pregnancy, waist circumference at follow-up, and fasting blood glucose at HFDP diagnosis were associated with metabolic syndrome.ConclusionWe found a high prevalence of CVD risk factors in South African women within 6 years of HFDP, which highlights the need to develop and evaluate interventions optimizing the cardiometabolic health of this vulnerable group. The main limitations of our research are the lack of a comparative group of women without HFDP and that we did not assess for CVD risk factors before HFDP.

P6222Changes in main CVD risk factors in Finland 1992–2017

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Jousilahti ◽  
T Laatikainen ◽  
T Harkanen ◽  
K Borodulin ◽  
K Harald ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Ldl Cholesterol ◽  
Venous Blood ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
P Value ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Background Systematic monitoring of cardiovascular disease (CVD) risk factors started in eastern Finland already in the 1970s as part of the North Karelia Project. Later on risk factor monitoring was extended to other parts of the country. Purpose In this study we report the trends of main CVD risk factors in Finland from 1992 to 2017. Methods Study population consists of a population-based random sample of 31 402 men and women aged 25–64 years who participated in the FINRISK Studies from 1992 to 2012, and in the FinHealth Study in 2017. Data collection was done every five years. Participation rate decreased from 76% in 1992 to 56% in 2017. Study protocol included self-reported questionnaire data on smoking and other health behavior, measurements of height, weight and blood pressure, and venous blood sample for laboratory analysis. Blood pressure was measured two times, and the average of the measurements was calculated, total serum cholesterol was analyzed using enzymatic method, and LDL cholesterol was calculated using Friedewald formula. Results Smoking prevalence, mean blood pressure and total and LDL cholesterol levels declined markedly during the 25 year follow up but BMI, waist circumference and prevalence of obesity increased (table). CVD risk factor change from 1992 to 2017 Risk factor Men 1992 Men 2017 p value Women 1992 Women 2017 p value Smoking (%) 36.7 20.6 <0.001 25.9 16.5 <0.001 SBP (mmHg) 136.6 131.2 <0.001 130.3 124.5 <0.001 DBP (mmHg) 82.7 81.6 <0.001 78.6 77.8 <0.001 Chol (mmol/L) 5.66 5.17 <0.001 5.42 5.18 <0.001 LDL chol (mmol/L) 3.54 3.16 <0.001 3.26 3.03 <0.001 BMI (kg/m2) 26.2 27.2 <0.001 25.1 26.4 <0.001 WC (cm) 92.8 96.1 <0.001 79.2 86.2 <0.001 Obesity (%) 15.7 23.2 <0.001 14.8 22.7 <0.001 Conclusions The levels of main traditional CVD risk factors have markedly decreased among the Finnish population during the last 25 years but in the same time, obesity has become a major public health challenge.

scholarly journals Association between vegetarian diets and cardiovascular risk factors in non-Hispanic white participants of the Adventist Health Study-2

2019 ◽  
Vol 8 ◽  
Author(s):  
Seiji Matsumoto ◽  
W. Lawrence Beeson ◽  
David J. Shavlik ◽  
Gina Siapco ◽  
Karen Jaceldo-Siegl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ldl Cholesterol ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Vegetarian Diets ◽  
Prevalence Ratios ◽  
White Adults ◽  
Hispanic White ◽  
Adventist Health Study

AbstractThe association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3 %), lacto-ovo-vegetarians (44·3 %), pesco-vegetarians (10·6 %) and non-vegetarians (NV) (37·3 %). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95 % CI 0·45, 0·73), 0·72 (95 % CI 0·59, 0·88) and 0·72 (95 % CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95 % CI 0·25, 0·83) and 0·62 (95 % CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.

Insulin Resistance the Link between T2DM and CVD: Basic Mechanisms and Clinical Implications

2019 ◽  
Vol 17 (2) ◽  
pp. 153-163 ◽  
Author(s):  
Muhammad A. Abdul-Ghani ◽  
Amin Jayyousi ◽  
Ralph A. DeFronzo ◽  
Nidal Asaad ◽  
Jassim Al-Suwaidi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Molecular Mechanisms ◽  
Clinical Implications ◽  
Metabolic Abnormalities ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cardinal Feature

Insulin resistance (IR) is a cardinal feature of type 2 diabetes mellitus (T2DM). It also is associated with multiple metabolic abnormalities which are known cardiovascular disease (CVD) risk factors. Thus, IR not only contributes to the development of hyperglycemia in T2DM patients, but also to the elevated CVD risk. Improving insulin sensitivity is anticipated to both lower the plasma glucose concentration and decrease CVD risk in T2DM patients, independent of glucose control. We review the molecular mechanisms and metabolic consequences of IR in T2DM patients and discuss the importance of addressing IR in the management of T2DM.

Abstract P363: Circulating Soluble CD163 and Risk of Cardiovascular Disease and All-Cause Mortality in Older Persons: The Cardiovascular Heart Study (CHS)

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jon P Durda
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hypertension Status ◽  
Carotid Imt ◽  
Current Smoking ◽  
Soluble Cd163 ◽  
Overall Mortality

Introduction: Macrophages play important roles in atherosclerotic plaque formation and stability. CD163 is a macrophage specific receptor involved in the clearance and endocytosis of hemoglobin-haptoglobin complexes; soluble CD163 (sCD163) may be a useful biomarker to assess macrophage activation. We are not aware of epidemiologic studies of sCD163 levels and cardiovascular disease (CVD) risk. Also it is not known whether common genetic variants are associated with sCD163. Methods: We tested whether sCD163 was associated with carotid intima-media thickness (IMT) and incident clinical events (overall mortality, coronary heart disease [CHD], myocardial infarction [MI], stroke, and congestive heart failure [CHF]) in 4,577 Cardiovascular Health Study (CHS) participants (95% white, 5% black; age range 65-100 y). We used linear regression with adjustment for sex, age, race, study site, current smoking, BMI, hypertension status, systolic blood pressure (SBP) and LDL cholesterol to test for association between sCD163 and IMT. We used 2 Cox proportional hazards models for incident events analyses: (1) adjusting for sex, age, race, study site, and current smoking; (2) model 1 plus BMI, hypertension status, SBP, LDL-cholesterol, C-reactive protein (CRP), interleukin-6 (IL6), and fibrinogen. We also performed a genome-wide association study (GWAS) for sCD163 in 2,769 unrelated CHS white participants, using Hapmap 2 imputed SNPs. Results: sCD163 was positively associated with female sex, white race, age, BMI, SBP, CRP, IL6 and fibrinogen, negatively associated with current smoking status (p&lt0.0001), and not associated with LDL cholesterol or hypertension status. After adjustment for traditional CVD risk factors, sCD163 was positively associated with carotid IMT (p=0.027). In model 1, increased sCD163 levels were associated with overall mortality (p&lt0.0001), incident CHD (p=0.0034), incident stroke (p=0.016), and incident CHF (p&lt0.0001), but not incident MI (p=0.069). None of the model 2 analyses resulted in significant associations (all p&gt0.05). Five variants upstream of chromosome 2q gene MGAT5 (top result rs4954118, p=7.1x10-14) and a single variant (rs314253, p=6.0x10-13) on chromosome 17p between ASGR1 and DLG4 were significantly (p&lt5x10-8) associated with sCD163. The top result near the CD163 gene was for upstream variant rs6488429 (p=8.2x10-5). Conclusions: sCD163 was associated with carotid IMT after accounting for established CVD risk factors. There were associations of sCD163 with mortality and incident clinical CVD, although associations were attenuated after adjustment for other risk factors. Additional studies are needed to evaluate whether results are similar in younger age groups and other populations. The significant results in the GWAS for sCD163 implicate novel molecular pathways that warrant future fine-mapping and functional studies.

scholarly journals Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with rheumatoid arthritis

2008 ◽  
Vol 68 (2) ◽  
pp. 242-245 ◽  
Author(s):  
A Stavropoulos-Kalinoglou ◽  
G S Metsios ◽  
V F Panoulas ◽  
K M J Douglas ◽  
A M Nevill ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Metabolic Syndrome ◽  
And Gender

Objectives:To assess the association of body mass index (BMI) with modifiable cardiovascular disease (CVD) risk factors in patients with rheumatoid arthritis (RA).Methods:BMI, disease activity, selected CVD risk factors and CVD medication were assessed in 378 (276 women) patients with RA. Patients exceeding accepted thresholds in ⩾3 CVD risk factors were classified as having the metabolic syndrome (MetS).Results:BMI independently associated with hypertension (OR = 1.28 (95% CI = 1.22 to 1.34); p = 0.001), high-density lipoprotein (OR = 1.10 (95% CI = 1.06 to 1.15); p = 0.025), insulin resistance (OR = 1.13 (95% CI = 1.08 to 1.18); p = 0.000) and MetS (OR = 1.15 (95% CI = 1.08 to 1.21); p = 0.000). In multivariable analyses, BMI had the strongest associations with CVD risk factors (F1–354 = 8.663, p = 0.000), and this was followed by lipid-lowering treatment (F1–354 = 7.651, p = 0.000), age (F1–354 = 7.541, p = 0.000), antihypertensive treatment (F1–354 = 4.997, p = 0.000) and gender (F1–354 = 4.707, p = 0.000). Prevalence of hypertension (p = 0.004), insulin resistance (p = 0.005) and MetS (p = 0.000) was significantly different between patients with RA who were normal, overweight and obese, and BMI differed significantly according to the number of risk factors present (p = 0.000).Conclusions:Increasing BMI associates with increased CVD risk independently of many confounders. RA-specific BMI cut-off points better identify patients with RA at increased CVD risk. Weight-loss regimens should be developed and applied in order to reduce CVD in patients with RA.

Abstract P315: Three-year Progression of Sleep-disordered Breathing is Associated with Cardiovascular Disease Risk Factors in Young Adults

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Christopher E Kline ◽  
Thomas B Rice ◽  
Patrick J Strollo ◽  
Emma Barinas-Mitchell
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Body Weight ◽  
Weight Change ◽  
Sleep Disordered Breathing ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Disordered Breathing

Introduction: Sleep-disordered breathing (SDB) is a common sleep disorder that is significantly associated with cardiovascular disease (CVD) risk. Less is known about the short-term cardiovascular implications of mild-severity SDB progression, as mild SDB is less commonly associated with CVD but often develops into more severe SDB over time if left untreated. Hypothesis: We hypothesized that worsening of SDB severity over 3 years would be associated with greater changes in common CVD risk factors (body weight, heart rate [HR], blood pressure [BP], insulin resistance, and C-reactive protein [CRP]). Methods: A sample of 32 adults (38.6±6.4 y; 31.9±4.0 kg/m2; 72% female) who previously had participated in a 1-year lifestyle intervention were followed from 1-year post-intervention (2Y) for an additional 3 years (5Y). At 2Y and 5Y, SDB was assessed with an ambulatory monitor (ResMed ApneaLink); the oxygen desaturation index (ODI; the number of times per hour of recording that the blood oxygen saturation [SaO2] level was reduced by ≥4%) and mean SaO2 served as the primary indices of SDB severity. At 2Y and 5Y, body weight and resting BP and HR were assessed using standard procedures and fasting blood samples were obtained and measured for glucose, insulin, and CRP. Insulin resistance was measured via the Homeostatic Model Assessment method. Multiple linear regression and analysis of covariance were used to examine the associations between changes in SDB severity and changes in CVD risk factors, adjusting for 2Y values of CVD risk factors. Results: ODI at 2Y was 5.3±6.6. At 5Y, ODI had changed (i.e., improved) by -0.2±4.9, with ODI worsening by ≥2 in 7 adults and improving by ≥2 in 11 adults. Mean SaO2 at 2Y was 95.5±1.6% and changed (i.e., improved) by +0.1±1.1% at 5Y; mean SaO2 worsened in 10 adults and improved in 12 adults. Three-year change in ODI, but not SaO2, was significantly associated with weight change (β=.42, P=.02). Compared to those whose ODI worsened or did not change, improved ODI was associated with more favorable changes in CRP (-1.8 vs. +0.8 mg/L; P=.04) and heart rate (-5.0 vs. +0.2 beats/min; P=.05); however, these associations were weakened after further adjustment for weight change (P=.16 and P=.07, respectively). Compared to those whose SaO2 remained unchanged or improved, worsened SaO2 was associated with increased insulin resistance (+1.1 vs. -0.4; P<.01); results were unchanged following adjustment for weight change (P=.01). Changes in ODI and SaO2 were not related to changes in BP. Conclusions: Even marginal worsening of SDB severity over 3 years is associated with elevation in some CVD risk markers. Treatment of mild SDB in young- to middle-aged adults may reduce risk for CVD.

scholarly journals Plant Protein Intake Is Not Associated with Cardiovascular Disease Risk Factors in Diabetic Patients with Chronic Kidney Disease (P08-055-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alexis Moore ◽  
Kathleen Woolf ◽  
David St-Jules ◽  
Collin Popp ◽  
Mary Lou Pompeii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Cholesterol ◽  
Total Protein ◽  
Protein Intake ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Total Protein Intake ◽  
Plant Sources

Abstract Objectives A higher percentage of protein consumed from plants may have cardiovascular benefits and be associated with lower mortality in chronic kidney disease (CKD) patients. The purpose of this study was to examine the association of self-reported dietary protein intake with cardiovascular disease (CVD) risk factors in patients with type 2 diabetes (T2D) and CKD. Methods Baseline 3-day food records were obtained from 202 participants of an ongoing lifestyle intervention study, and analyzed using Nutrition Data System for Research (2014). Participants were categorized into tertiles based on total protein intake (<66.9 g, 66.9–92.4 g, > 92.4 g) and percent of total protein coming from plant sources (<27.9%, 27.9–37.8%, >37.8%). CVD risk factors included estimated glomerular filtration rate (eGFR), pulse wave velocity (PWV), fasting lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides [TG]), and hemoglobin A1c [HbA1c]). Analyses of covariance examined mean differences in CVD risk factors among the tertiles, controlling for age and total energy intake. Results The participants were 57% male, 89% non-Hispanic, 69% white, and 66 ± 9 years of age with a mean body mass index of 33.6 ± 5 kg/m2. Prior myocardial infarction was reported by 25(12.6%) of participants. Average daily protein intake was 83.3 ± 29.3 g (0.9 ± 0.3 g/kg body weight), with the average % of protein consumed from plant sources 34 ± 13%. There were no statistically significant differences between the total protein intake tertiles for the CVD risk factors (eGFR [P = .36], PWV [P = .86], total cholesterol [P = .09], LDL-cholesterol [P = .26], HDL-cholesterol [P = .88], TG [P = .88], HbA1c [P = .82]. Additionally, there were no statistically significant differences between the % of total protein intake from plant sources tertiles for the CVD risk factors (eGFR [P = .32], PWV [P = .92], total cholesterol [P = .29], LDL-cholesterol [P = .10], HDL-cholesterol [P = .57], TG [P = .13], HbA1c [P = .93]. Conclusions Contrary to expectations, CVD risk factors did not differ among tertiles for total protein intake or % of total protein from plant sources. These findings suggest that, at baseline, dietary protein was not associated with CVD risk factors in patients with T2D and CKD. Funding Sources National Institutes of Health (NIDDK, NINR).

scholarly journals Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Elko Randrianarisoa ◽  
Angela Lehn-Stefan ◽  
Anja Hieronimus ◽  
Robert Wagner ◽  
Jakob Maucher ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Subclinical Atherosclerosis ◽  
Insulin Clearance ◽  
Cvd Risk Factors ◽  
Cvd Risk

AbstractHyperglycemia and insulin resistance contribute to vascular damage and are regulated by different pathophysiological processes. The aim of the study was to systematically investigate the relative contributions of multiple fasting state- and oral glucose tolerance test (oGTT)-derived glycemic traits to carotid intima-media thickness (cIMT), a surrogate parameter of subclinical atherosclerosis, in individuals with increased risk for type 2 diabetes mellitus (T2D). 667 volunteers (417 women and 250 men, mean age 44.1 years), who were free of cardiovascular disease (CVD), were included in this cross-sectional study. Glucose tolerance, insulin sensitivity, insulin secretion and insulin clearance were assessed by frequently sampled 75 g oGTT. CIMT was measured by high-resolution ultrasound. Insulin clearance was associated with cIMT in univariate analysis (ßst = − 0.17, p < 0.0001) and in a stepwise regression analysis on 15 variables possibly affecting cIMT, age (r2 = 0.3923, p < 0.0001), insulin clearance (r2 = 0.4564, p < 0.0001), systolic blood pressure (r2 = 0.4733, p < 0.0001), body mass index (BMI) (r2 = 0.4804, p = 0.002), gender (r2 = 0.4831, p = 0.013), and fasting insulin clearance (r2 = 0.4857, p = 0.030) turned out to be significant determinants of cIMT. In a cross-validated model resulting from this analysis, insulin clearance was found to be an independent determinant of cIMT (ßst = − 0.16, p < 0.0001) even after adjusting for traditional CVD risk factors. Reduced insulin clearance may be an early marker of damage on the vasculature, independent of classical CVD risk factors. Reduced insulin clearance should be considered with regard to vascular insulin resistance.

scholarly journals Ethnicity, CVD Risk Factor Clustering and the Progression of Microvascular Disease: The Insulin Resistance and Atherosclerosis Study

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1356-1357
Author(s):  
Ronny A. Bell ◽  
Daniel J. Zaccaro ◽  
Lynne E. Wagenknecht ◽  
Elizabeth J. Mayer-Davis
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Risk Factor ◽  
High Risk ◽  
Hispanic Americans ◽  
Ethnic Disparities ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Diabetes Status

P31 Ethnic disparities in cardiovascular disease (CVD) and end-stage renal disease exist in the US, with African Americans (AAs) and Hispanic Americans (HAs) being at greater risk compared to non-Hispanic whites (NHWs). This maybe related to variations in individual and/or clusters of CVD risk factors across ethnic groups. We have previously shown ethnic differences in cross-sectional analyses from the Insulin Resistance and Atherosclerosis Study (IRAS) data in the effect of CVD risk factor clustering, with AAs being more greatly affected for nephropathy risk, and NHWs being more affected for CVD. We examined the effect of CVD risk factor clustering on the 5-year progression of albuminuria, which itself is a known CVD risk factor. Data were analyzed from the IRAS study, a multi-center epidemiologic cohort study that included roughly similar numbers of persons with normal and impaired glucose tolerance and type 2 diabetes, at baseline and 5-year follow-up. Comparisons were made forAAs and NHWs (Oakland/LAclinics), and for HAs and NHWs (San Antonio/San Luis Valley clinics). Data were available on 1256 IRAS subjects on nephropathy progression status, of which about 10% progressed from normal, defined as albumin/creatinine ratio less than 30 mg/g, to microalbuminuria (ACR of ≥30 and < 300) or macroalbuminuria (ACR ≥300) or from microalbuminuria to macroalbuminuria. CVD risk factors (dyslipidemia, BMI, waist-hip ratio, PAI-1, hypertension, diabetes status) at baseline were dichotomized, and subjects were classified as having high (≥ risk factors) or low (< 3 risk factors) risk. Overall 30.9% of the sample were classified as high risk. After adjusting for age, gender, and baseline nephropathy status, risk factor clustering predicted nephropathy progression in both ethnic comparisons (OR 2.24, p< 0.001 in AAs/NHWs group; OR 2.81, p< 0.001 in the HAs/NHWs group). With risk status in the model, HAs were at no greater risk for progression compared to NHWs, but risk was about 80% greater for AAs compared to NHWs (p < 0.05). These data indicate a risk of nephropathy among AAs that extends beyond the traditional CVD risk factor clusters.

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