Waist circumference as the predominant contributor to the micro-inflammatory response in the metabolic syndrome: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>The metabolic syndrome (MetS) is associated with the presence of low grade inflammation. Our aim was to analyze the inter-relations between each of the components of the metabolic syndrome (MetS) and four inflammatory markers, namely high sensitivity C-reactive protein (hs-CRP), the erythrocyte sedimentation rate, the concentration of fibrinogen and the white blood cell count.</p> <p>Methods</p> <p>We have analyzed data collected between September 2002 and June 2009 in the Tel-Aviv medical center inflammation survey (TAMCIS). We recruited both apparently healthy individuals and individuals presenting with atherothrombotic risk factors. All participants were enrolled during their routine annual health check-up and gave their written informed consent. This is a cross sectional study in which we have fitted linear regression models using inflammatory markers as the dependant variables and adjust them according to the different components of the MetS and multiple other confounders.</p> <p>Results</p> <p>Included were 12,072 individuals of whom there were 7,760 men at a mean (S.D.) age of 44 (11) years, and 4,312 women aged 44 (11) years. A significant correlation was noted between most components of the MetS and all inflammatory markers, the most significant one being with hs-CRP. In the multi-adjusted regression analysis, waist was the factor that best explained the variability of hs-CRP, in both women and men. It also remained a significant variable for the other inflammatory markers.</p> <p>Conclusions</p> <p>From amongst the various components of the MetS, waist circumference appears to exert the most influence upon the presence and intensity of the micro-inflammatory response.</p

Cardiac Screening of Young Athletes: a Practical Approach to Sudden Cardiac Death Prevention.

PURPOSE OF REVIEW: We aim to report on the current status of cardiovascular screening of athletes worldwide and review the up-to-date evidence for its efficacy in reducing sudden cardiac death in young athletes. RECENT FINDINGS: A large proportion of sudden cardiac death in young individuals and athletes occurs during rest with sudden arrhythmic death syndrome being recognised as the leading cause. The international recommendations for ECG interpretation have reduced the false-positive ECG rate to 3% and reduced the cost of screening by 25% without compromising the sensitivity to identify serious disease. There are some quality control issues that have been recently identified including the necessity for further training to guide physicians involved in screening young athletes. Improvements in our understanding of young sudden cardiac death and ECG interpretation guideline modification to further differentiate physiological ECG patterns from those that may represent underlying disease have significantly improved the efficacy of screening to levels that may make screening more attractive and feasible to sporting organisations as a complementary strategy to increased availability of automated external defibrillators to reduce the overall burden of young sudden cardiac death

Preventing Sudden Death of Athletes With Electrocardiographic Screening What Is the Absolute Benefit and How Much Will it Cost?

ObjectivesThis study sought to estimate the costs of a national electrocardiographic (ECG) screening of athletes in the United States and the number of lives that would be saved by that program.BackgroundA single study from Italy suggests that mandatory ECG screening of athletes reduces their risk of sudden cardiac death. Based on that study, ECG screening of athletes is endorsed by the European Society of Cardiology, though not by the American Heart Association. The widespread application of ECG screening remains controversial because the absolute reduction of sudden cardiac death risk provided, and its economic ramifications, have not been studied in detail.MethodsA cost-projection model was based on the Italian study, replicating its data in terms of athlete characteristics and physician performance. The size of the screening-eligible population was estimated from data provided by the National Collegiate Athletic Association and the National Federation of State High School Associations. The costs of diagnostic tests were obtained from Medicare reimbursement rates.ResultsA 20-year program of ECG screening of young competitive athletes in the United States would cost between $51 and$69 billion and could be expected to save 4,813 lives. Accordingly, the cost per life saved is likely to range between $10.6 and$14.4 million.ConclusionsOur cost-projection model suggests that replicating the Italian strategy of ECG screening in the United States would result in enormous costs per life saved