Genetic Risk Factors for Alzheimer’s Disease in Racial/Ethnic Minority Populations in the U.S.: A Scoping Review

As the United States (U.S.) population rapidly ages, the incidence of Alzheimer\u27s Disease and Related Dementias (ADRDs) is rising, with racial/ethnic minorities affected at disproportionate rates. Much research has been undertaken to test, sequence, and analyze genetic risk factors for ADRDs in Caucasian populations, but comparatively little has been done with racial/ethnic minority populations. We conducted a scoping review to examine the nature and extent of the research that has been published about the genetic factors of ADRDs among racial/ethnic minorities in the U.S. Using an established scoping review methodological framework, we searched electronic databases for articles describing peer-reviewed empirical studies or Genome-Wide Association Studies that had been published 2005-2018 and focused on ADRD-related genes or genetic factors among underrepresented racial/ethnic minority population in the U.S. Sixty-six articles met the inclusion criteria for full text review. Well-established ADRD genetic risk factors for Caucasian populations including , and have not been studied to the same degree in minority U.S. populations. Compared to the amount of research that has been conducted with Caucasian populations in the U.S., racial/ethnic minority communities are underrepresented. Given the projected growth of the aging population and incidence of ADRDs, particularly among racial/ethnic minorities, increased focus on this important segment of the population is warranted. Our review can aid researchers in developing fundamental research questions to determine the role that ADRD risk genes play in the heavier burden of ADRDs in racial/ethnic minority populations

Blood Pressure Self-Monitoring in Pregnancy: Examining Feasibility in a Prospective Cohort Study

BACKGROUND: Raised blood pressure (BP) affects approximately 10% of pregnancies worldwide, and a high proportion of affected women develop pre-eclampsia. This study aimed to evaluate the feasibility of self-monitoring of BP in pregnancy in women at higher risk of pre-eclampsia. METHODS: This prospective cohort study of self-monitoring BP in pregnancy was carried out in two hospital trusts in Birmingham and Oxford and thirteen primary care practices in Oxfordshire. Eligible women were those defined by the UK National Institute for Health and Care Excellence (NICE) guidelines as at higher risk of pre-eclampsia. A total of 201 participants were recruited between 12 and 16 weeks of pregnancy and were asked to take two BP readings twice daily three times a week through their pregnancy. Primary outcomes were recruitment, retention and persistence of self-monitoring. Study recruitment and retention were analysed with descriptive statistics. Survival analysis was used to evaluate the persistence of self-monitoring and the performance of self-monitoring in the early detection of gestational hypertension, compared to clinic BP monitoring. Secondary outcomes were the mean clinic and self-monitored BP readings and the performance of self-monitoring in the detection of gestational hypertension and pre-eclampsia compared to clinic BP. RESULTS: Of 201 women recruited, 161 (80%) remained in the study at 36 weeks or to the end of their pregnancy, 162 (81%) provided any home readings suitable for analysis, 148 (74%) continued to self-monitor at 20 weeks and 107 (66%) at 36 weeks. Self-monitored readings were similar in value to contemporaneous matched clinic readings for both systolic and diastolic BP. Of the 23 who developed gestational hypertension or pre-eclampsia and self-monitored, 9 (39%) had a raised home BP prior to a raised clinic BP. CONCLUSIONS: Self-monitoring of BP in pregnancy is feasible and has potential to be useful in the early detection of gestational hypertensive disorders but maintaining self-monitoring throughout pregnancy requires support and probably enhanced training

The Association between Physical Activity levels and Insulin Resistance in College Women

Introduction: The World Health Organization recommends young adults engage in physical activity (PA) daily. Regular PA has been shown to promote a better quality of life and improve overall health. Insulin resistance is a strong indicator of metabolic health in women because of its link to the development of disorders like polycystic ovarian syndrome (PCOS) and diabetes. The objective of this research was to determine the relationships between insulin resistance, and amount of time spent in sedentary, light, moderate, and vigorous PA. Methods: Thirty-eight women (20.8±2.7 years, 28.57±4.11kg/m2, 42.1% white) were asked to wear an accelerometer (Actigraph GT3X) on the waist over the course of 5 days to record their free-living physical activity. Insulin resistance was assessed using fasting blood samples and was estimated using Homeostatic Model Assessment of Insulin Resistance HOMA-IR. HOMA-IR = fasting insulin[microU/L] x fasting glucose [nmol/L]/22.5). To determine associations between HOMA-IR and levels of PA, a Pearson Correlation test was performed. Results: No correlation was found between any level of PA and HOMA-IR (sedentary: r=0.240, p=0.147, light: r=0.275, p=0.095, moderate: r=0.158, p=0.344, vigorous: r=0.239, p=0.148). Conclusion: Our findings did not show an association among different levels of PA and insulin resistance. This is inconsistent with other existing studies. To further confirm the results of this study, more research on accelerometer usage may be needed. Key Words: HOMA-IR, accelerometry, physical activity, healt

The association between Age, BMI, and Gestational Weight Gain with HOMA-IR during pregnancy

Introduction: The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is used to determine insulin resistance in individuals. During pregnancy, several variables may be related to HOMA-IR, including age, gestational weight gain (GWG), and body mass index (BMI), which classifies an individual\u27s weight as healthy or unhealthy. The objective of this research is to test the relationships of age, GWG at 20-weeks, and BMI at 20-weeks with log HOMA-IR. Methods: Twenty-six women (27.8±4.2 years; 74.1% white) completed this study between 2015 and 2016. HOMA-IR was measured using fasting plasma insulin and blood glucose (fasting insulin[microU/L] x fasting glucose [nmol/L]/22.5). The Pearson Correlation test was used to determine correlations between the variables. Results: Mean GWG at 20-weeks was 5.3kg±5.1 (range -5.4 kg to 15.9 kg). BMI at 20-weeks ranged from 19.7 kg/m2 to 43.5 kg/m2, with an average of 29.6444 kg/m2, ±5.99733. There was a correlation between (r=0.614, p=0.001) HOMA-IR and BMI at 20-weeks. There was no correlation between HOMA-IR and age (r=0.044, p=0.83), nor between HOMA-IR and GWG at 20-weeks (r=0.173, p=0.39). Conclusion: Our study showed there was no correlation between age and HOMA-IR, nor between GWG at 20-weeks and HOMA-IR; however, a correlation between BMI at 20-weeks and HOMA-IR was found. These findings may allow practitioners to understand how HOMA-IR relates to female body fat and thus monitor this variable during pregnancy to avoid complications