Associations of Serum Folate and Holotranscobalamin with Cardiometabolic Risk Factors in Rural and Urban Cameroon

A low intake of fruit and vegetables and a high intake of meat are associated with higher cardiometabolic disease risk; however much prior research has relied on subjective methods for dietary assessment and focused on Western populations. We aimed to investigate the association of blood folate as an objective marker of fruit and vegetable intake and holotranscobalamin (holoTC) as a marker of animal-sourced food intake with cardiometabolic risk factors. We conducted a population-based cross-sectional study on 578 adults (mean ± SD age = 38.2 ± 8.6 years; 64% women). The primary outcome was a continuous metabolic syndrome score. The median serum folate was 12.9 (IQR: 8.6–20.5) nmol/L and the mean holoTC was 75 (SD: 34.3) pmol/L. Rural residents demonstrated higher serum folate concentrations (15.9 (9.8–25.9) nmol/L) than urban residents (11.3 (7.9–15.8) nmol/L), but lower holoTC concentrations (rural: 69.8 (32.9) pmol/L; urban: 79.8 (34.9)) pmol/L, p < 0.001 for both comparisons. There was an inverse association between serum folate and metabolic syndrome score by −0.20 in the z-score (95% CI, −0.38 to −0.02) per 10.8 (1 SD) of folate) in a model adjusted for socio-demographic factors, smoking status, alcohol intake, BMI, and physical activity. HoloTC was positively associated with the metabolic syndrome score in unadjusted analysis (0.33 (95% CI, 0.10 to 0.56)) but became non-significant (0.17 (−0.05 to 0.39)) after adjusting for socio-demographic and behavioural characteristics. In conclusion, serum folate and holoTC were associated with the metabolic syndrome score in opposite directions. The positive association between serum holoTC and the metabolic syndrome score was partly dependent on sociodemographic characteristics. These findings suggest that, based on these biomarkers reflecting dietary intakes, public health approaches promoting a higher intake of fruit and vegetables may lower cardiometabolic risk factors in this population.

Trajectory patterns for continuous metabolic syndrome score in childhood and the cardiovascular risk in adolescence

We explored the association between the trajectory of the continuous metabolic syndrome score (cMetS) in childhood with high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (CIMT), which are known to increase cardiovascular disease risk in adolescence. The trajectory of cMetS in childhood (from 3 to 12 years of age) was identified in 833 children who participated in the Ewha Birth and Growth Study. The associations between cMetS and hs-CRP and CIMT were analyzed in 204 out of 833 children who participated in the follow-up at 13–15 years of age and measured hs-CRP and CIMT. Among the 833 children, three groups were classified: cMetS maintained at a low level (n = 198, 23.77%), middle level (n = 530, 63.63%), and at high levels (n = 105, 12.61%). The group with a stable-high cMetS trajectory showed significantly higher hs-CRP levels, and the statistical significance was maintained after adjusting for covariates. This study found that a consistently high cMetS in childhood was significantly associated with higher hs-CRP levels in adolescents, suggesting that it is necessary to intervene in metabolic risk factors early in life to reduce the risk of cardiovascular disease later in life.

Circulating extracellular DNA is in association with continuous metabolic syndrome score in healthy adolescents

Obesity is associated with chronic low-grade inflammation that eventually leads to metabolic complications. Extracellular DNA (ecDNA) is a damage-associated molecular pattern. Extracellular mitochondrial DNA can activate innate immunity. We hypothesized that ecDNA, especially of mitochondrial origin could be associated with components of the metabolic syndrome in young healthy probands. In a cross-sectional study healthy adolescents (n=1249) provided blood samples. Anthropometric data, blood pressure and blood counts were assessed. In addition, biochemical analysis of sera or plasma was conducted including the quantification of advanced oxidation protein products (AOPP) as a marker of oxidative stress induced by neutrophil or monocyte activation. Plasma ecDNA was isolated and measured using fluorometry. Nuclear and mitochondrial DNA were quantified using real time PCR. Males had higher total plasma ecDNA (15 (11-21) vs 11 (8-17) ng/ml; median (IQR)), nuclear (1760 (956-3273) vs 1153 (600-2292) GE/ml) and mitochondrial DNA (37181 (14836-90896) vs 30089 (12587-72286) GE/ml). EcDNA correlated positively with the continuous metabolic syndrome score (r= 0.158 for males and r= 0.134 for females). Stronger correlations were found between ecDNA of mitochondrial origin and AOPP (r= 0.202 and 0.186 for males and females respectively). Multivariate regression analysis revealed associations of nuclear DNA with leukocyte and erythrocyte counts. The results of this study on healthy adolescents show that circulating ecDNA is associated with the risk of metabolic syndrome, not with obesity per se. The association between mitochondrial ecDNA and AOPP requires further attention as it supports a potential role of mitochondria-induced sterile inflammation in the pathogenesis of the metabolic syndrome.

THU0465 SERUM LEVEL OF ADRENOCORTICOTROPHIC HORMONE IS A CONTRIBUTING HORMONE OF METABOLIC SYNDROME IN NEWLY DIAGNOSED FIBROMYALGIA

Background:Evidence of components of metabolic syndrome including. Obesity dyslipidemia, abnormal glucose tolerance rate and hypertension are associated with fibromyalgia. Adrenocorticotrophic hormone (ACTH) is reported to be significantly higher in fibromyalgia patients, and it causes obesity, high blood pressure.Objectives:This study aimed to assess the serum level of ACTH as a contributing as well as a discriminator hormone in newly diagnosed fibromyalgia women presented with variable components of metabolic syndrome.Methods:This cross-sectional study comprised 100 women with newly diagnosis fibromyalgia and 30 apparent healthy women served as control from Kurdistan region-Iraq. Clinical data including the score of fibromyalgia impact questionnaire-revised (FIQR), tender point, body mass index, waist circumference, blood pressure and fasting serum levels of glucose and lipid profile, and ACTH level. The score of metabolic syndrome was calculated using the formula:Results:Compared to the controls, the Fibromyalgia women displayed significantly higher values of waist circumference (88.9 ± 5.7cm versus 87.1 ± 2.7cm, p=0.019), systolic blood pressure (136.1 ±13.5mmHg versus 131.4 ± 7.1, p=0.014), metabolic syndrome score (3.10 ±0.25 versus 3.03±0.19, p=0.039), and serum ACTH levels (16.66 ± 3.23pg/ml versus 14.42 ± 2.18pg/ml. p<0.001). Serum ACTH levels significantly and inversely correlated with the total score of the FIQR (r = - 0.320. p=0.001) and number of tender points (r= - 0.374, p<0.001). Metabolic syndrome score is significantly and inversely correlated with the total FIQR score (r = - 0.296, p=0.003). Multivariable regression analysis using showed that serum level of ACTH is a significant (p= predictor of 19.7% of fibromyalgia patients (Figure 1), and it is a significant (p=0.007) discriminator of tender points as the area under the curve is 0.325(95%C.I.: 0.212-0.438) (Figure 2).Figure 1.Multivariable regression analysis withposthocANOVA test showed significant correlations between serum level adrenocorticotrophic hormone as a dependent variable with the score s of fibromyalgia impact questionnaire and metabolic syndrome, and the number of tender points. R=0.443, F=7.777, P<0.001, prediction 19.7%),Figure 2.serum level of ACTH (cutoff level ≥14.5pg/ml, sensitivity=72%, specificity=50%) as a discriminator of the tender points (AUC95% C.I: 0.325[0.212-0.438], p=0.007), score of fibromyalgia symptoms (AUC95% C.I: 0.474[0.313-0.581], p=0.409), and metabolic syndrome score (AUC95% C.I: 0.546[0.423-0.668], p=0.480)Conclusion:Fibromyalgia women responded to the stress of pain by increasing the serum level of ACTH which effectively improves the clinical feature of fibromyalgia symptoms, but at the same time elevates the score of metabolic syndrome. Therefore, assessment of serum level of ACTH can serve as a predictor and discriminator of fibromyalgia comorbidity.References:[1]Acosta-Manzano P, Segura-Jiménez V, Estévez-López F, Álvarez-Gallardo IC, Soriano-Maldonado A, Borges-Cosic M, Gavilán-Carrera B, Delgado-Fernández M, Aparicio VA. Do women with fibromyalgia present higher cardiovascular disease risk profile than healthy women? The al-Ándalus project. Clin Exp Rheumatol. 2017; 35 Suppl 105(3):61-67.[2]Marwan S.M. Al-Nimer, Talar A.M. Mohammad, Avin M.A. Maroof. Dysfunction of anterior pituitary gland in women patients with recent fibromyalgia: A cross-sectional observational study. Electron J Gen Med 2018;15(4):em58[3]Soldatovic I, Vukovic R, Culafic D, Gajic M, Dimitrijevic-Sreckovic V. siMS score: simple method for quantifying metabolic syndrome. PLoS One. 2016; 11(1):e0146143Disclosure of Interests: :None declared