Beyond type 2 diabetes, obesity and hypertension: an axis including sleep apnea, left ventricular hypertrophy, endothelial dysfunction, and aortic stiffness among Mexican Americans in Starr County, Texas

Cardiovascular Diabetology

Original Investigation

David Aguilar¹  Graeme I. Bell²  Brian E. Cade³  Susan Redline⁴  Jennifer E. Below⁵  Craig L. Hanis⁵  Eric L. Brown⁶  Nancy J. Cox⁷ 

[1] Cardiology, Baylor College of Medicine, 77030, Houston, TX, USA;Departments of Medicine and Human Genetics, The University of Chicago, 60637, Chicago, IL, USA;Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 02115, Boston, MA, USA;Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 02115, Boston, MA, USA;Beth Israel Hospital, 02215, Boston, MA, USA;Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, 77225, Houston, TX, USA;Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, 77225, Houston, TX, USA;Center for Infectious Disease, School of Public Health, The University of Texas Health Science Center at Houston, 77225, Houston, TX, USA;Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, 37232, Nashville, TN, USA;

关键词: Type 2 diabetes;    Obesity;    Hypertension;    Aortic stiffness;    Endothelial function;    Sleep apnea;    Left ventricular mass;    Prevalence;    Hispanic;    Mexican American;   

DOI  :  10.1186/s12933-016-0405-6

 received in 2016-03-08, accepted in 2016-05-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThere is an increasing appreciation for a series of less traditional risk factors that should not be ignored when considering type 2 diabetes, obesity, hypertension, and cardiovascular disease. These include aortic stiffness, cardiac structure, impaired endothelial function and obstructive sleep apnea. They are associated to varying degrees with each disease categorization and with each other. It is not clear whether they represent additional complications, concomitants or antecedents of disease. Starr County, Texas, with its predominantly Mexican American population has been shown previously to bear a disproportionate burden of the major disease categories, but little is known about the distribution of these less traditional factors.MethodsType 2 diabetes, obesity and hypertension frequencies were determined through a systematic survey of Starr County conducted from 2002 to 2006. Individuals from this examination and an enriched set with type 2 diabetes were re-examined from 2010 to 2014 including assessment of cardiac structure, sleep apnea, endothelial function and aortic stiffness. Individual and combined frequencies of these inter-related (i.e., axis) conditions were estimated and associations evaluated.ResultsHousehold screening of 5230 individuals aged 20 years and above followed by direct physical assessment of 1610 identified 23.7 % of men and 26.7 % of women with type 2 diabetes, 46.2 and 49.5 % of men and women, respectively with obesity and 32.1 and 32.4 % with hypertension. Evaluation of pulse wave velocity, left ventricular mass, endothelial function and sleep apnea identified 22.3, 12.7, 48.6 and 45.2 % of men as having “at risk” values for each condition, respectively. Corresponding numbers in women were 16.0, 17.9, 23.6 and 28.8 %. Cumulatively, 88 % of the population has one or more of these while 50 % have three or more.ConclusionsThe full axis of conditions is high among Mexican Americans in Starr County, Texas. Individual and joint patterns suggest a genesis well before overt disease. Whether they are all mediated by common underlying factors or whether there exist multiple mechanisms remains to be seen.

【 授权许可】

CC BY   
© The Author(s) 2016