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      Neck circumference is independently associated with relative systemic hypertension in young adults with sickle cell anaemia

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          Abstract

          Background

          A seemingly interesting observation in patients with sickle cell anaemia (SCA) is that they usually have lower systemic blood pressures (BP) and insulin resistance than persons in the general population in spite of chronic inflammation and vasculopathy. However, relative systemic hypertension (rHTN) has been linked to pulmonary hypertension, increased blood viscosity and renal insufficiency, which could indicate a risk of developing cardiometabolic disorder (CMD) in SCA.

          We therefore hypothesized that neck circumference (NC) and CMD marker; triglyceride glucose (TyG) index would independently predict rHTN in young adults with SCA in steady state.

          Methods

          We compared the anthropometrical, hematological, hemorheological and CMD markers between SCA patients with normal BP < 120/70 mmHg; nHTN, n = 65) and those with rHTN (BP ≥ 120/70 mmHg, n = 32).

          Results

          Our results showed that SCA with rHTN had significantly higher body weight, waist circumference, NC, plasma viscosity, systolic and diastolic BP. Results also indicated that NC (OR: 2.98; 95% CI 1.46 to 6.10, p < 0.01) was a predictor of rHTN in SCA independent of gender, age, weight, waist circumference, BMI, blood viscosity, triglyceride or TyG. A receiver operating characteristic curve analysis also showed that NC was the most efficient predictor of rHTN than other CMD markers.

          Conclusion

          The present study demonstrates that increased NC is a salient risk factors that is independently associated with rHTN in SCA. The finding therefore underscores the utility of NC in early detection and stratification of systemic hypertension, particularly in individuals with SCA.

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          Most cited references37

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          Splanchnic lipolysis in human obesity.

          Elevated FFA concentrations have been shown to reproduce some of the metabolic abnormalities of obesity. It has been hypothesized that visceral adipose tissue lipolysis releases excess FFAs into the portal vein, exposing the liver to higher FFA concentrations. We used isotope dilution/hepatic vein catheterization techniques to examine whether intra-abdominal fat contributes a greater portion of hepatic FFA delivery in visceral obesity. Obese women (n = 24) and men (n = 20) with a range of obesity phenotypes, taken together with healthy, lean women (n = 12) and men (n = 12), were studied. Systemic, splanchnic, and leg FFA kinetics were measured. The results showed that plasma FFA concentrations were approximately 20% greater in obese men and obese women. The contribution of splanchnic lipolysis to hepatic FFA delivery ranged from less than 10% to almost 50% and increased as a function of visceral fat in women (r = 0.49, P = 0.002) and in men (r = 0.52, P = 0.002); the slope of the relationship was greater in women than in men (P < 0.05). Leg and splanchnic tissues contributed a greater portion of systemic FFA release in obese men and women than in lean men and women. We conclude that the contribution of visceral adipose tissue lipolysis to hepatic FFA delivery increases with increasing visceral fat in humans and that this effect is greater in women than in men.
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            Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study.

            Neck circumference, a proxy for upper-body sc fat, may be a unique fat depot that confers additional cardiovascular risk above and beyond central body fat. Participants with neck circumference measures who underwent multidetector computed tomography to assess visceral adipose tissue (VAT) were included [n=3307, 48% women; mean age=51 yr; mean body mass index (BMI)=27.8 kg/m2; mean neck circumference=40.5 cm (men) and 34.2 cm (women)]. Sex-specific linear regression models were used to assess the association between sd increase in neck circumference and cardiovascular disease (CVD) risk factors (systolic and diastolic blood pressure; total, low-density lipoprotein, and high-density lipoprotein cholesterol and triglycerides; and fasting plasma glucose, insulin, proinsulin, and homeostasis model assessment of insulin resistance). Neck circumference was correlated with VAT [r=0.63 (men); r=0.74 (women); P<0.001] and BMI [r=0.79 (men); r=0.80 (women); P<0.001]. After further adjustment for VAT, neck circumference was positively associated with systolic blood pressure, diastolic blood pressure in men only, triglycerides, fasting plasma glucose in women only, insulin, proinsulin, and homeostasis model assessment of insulin resistance and was inversely associated with high-density lipoprotein (all P values<0.01). Similar results were observed in models that adjusted for both VAT and BMI. In a secondary analysis of incident CVD as an outcome, there was no statistically significant association observed for neck circumference in multivariable-adjusted models. Neck circumference is associated with CVD risk factors even after adjustment for VAT and BMI. These findings suggest that upper-body sc fat may be a unique, pathogenic fat depot.
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              Prevalence of overweight among children in Europe.

              Estimates of the prevalence of childhood overweight and obesity have been made in several European countries during the last decade. The methods used and the assessment criteria differ from survey to survey. The present paper reports the prevalence data from 21 surveys in Europe using a single, internationally accepted definition of overweight in childhood, allowing direct comparisons to be made. A tendency for a higher prevalence of overweight among children in western and especially southern Europe is shown and some possible reasons for this are discussed.
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                Author and article information

                Contributors
                +2348035755360 , tunjilaw04@yahoo.com
                gbengamik@yahoo.com
                madrid4life@yahoo.com
                tunjilaw@unilorin.edu.ng
                ayotunji03@yahoo.co.in
                seun.aremu@yahoo.com
                Journal
                Clin Hypertens
                Clin Hypertens
                Clinical Hypertension
                BioMed Central (London )
                2056-5909
                16 February 2018
                16 February 2018
                2018
                : 24
                : 3
                Affiliations
                [1 ]ISNI 0000 0001 0625 9425, GRID grid.412974.d, HOPE Cardiometabolic Research Team and Department of Physiology, College of Health Sciences, , University of Ilorin, ; P.M.B 1515, Ilorin, Kwara State 240003 Nigeria
                [2 ]ISNI 0000 0000 9777 3851, GRID grid.411270.1, Department of Medicine, , Ladoke Akintola University of Technology, ; Ogbomoso, Oyo State Nigeria
                [3 ]ISNI 0000 0001 0625 9425, GRID grid.412974.d, Department of Haematology and Blood Transfusion, College of Health Sciences, , University of Ilorin, ; P.M.B 1515, Ilorin, Kwara State 240003 Nigeria
                [4 ]ISNI 0000 0000 8878 5287, GRID grid.412975.c, Department of Ophthalmology, , University of Ilorin Teaching Hospital, ; P.M.B 1515, Ilorin, Kwara State 240003 Nigeria
                Article
                88
                10.1186/s40885-018-0088-2
                5815221
                29468088
                a5fa9919-7089-493f-9fe3-acce45b1bbbf
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 November 2017
                : 12 February 2018
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                arterial blood pressure,cardiometabolic disorder,neck circumference,sickle cell disease,upper-body fat accumulation

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