Novie O. Younger-Coleman

Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country

The objective of this study was to provide valid estimates of the burden of and risk factors for diabetes mellitus by sex in Jamaica, a predominantly Black, middle‐income and developing country.

High-sensitivity C-reactive protein is related to central obesity and the number of metabolic syndrome components in Jamaican young adults

Background: High-sensitivity C-reactive protein (hsCRP) has been shown to predict cardiovascular disease (CVD) endpoints and is associated with CVD risk factors and the metabolic syndrome. This study evaluated the association between hsCRP and CVD risk factors among Afro-Caribbean young adults in Jamaica. Methods: We conducted a cross-sectional analysis of data from the Jamaica 1986 Birth Cohort Study. Data were collected between 2005 and 2007 when participants were 18–20 years old. All participants completed an interviewer administered questionnaire and had anthropometric and blood pressure (BP) measurements performed. Fasting blood samples were collected for measurement of glucose, lipids, and hsCRP. Logistic regression models were used to identify factors independently associated with high hsCRP. Results: Analyses included 342 men and 404 women with mean age 18.8 ± 0.6 years. Approximately 15% of the participants had high risk hsCRP (>3 mg/L), with a higher prevalence among women (20 vs. 9%; p < 0.001). The prevalence of elevated hsCRP increased with body mass index category, high waist circumference (WC), high triglycerides, low high density lipoprotein, and lower parental education among women, but only for high WC and lower parental education among men. In logistic regression models controlling for sex and parental education, high WC was associated with significantly higher odds of high hsCRP (OR 7.8, 95% CI 4.8–12.9, p < 0.001). In a similar model, high hsCRP was also associated with the number of metabolic syndrome components. Compared to participants with no metabolic syndrome component, having one metabolic syndrome component was associated with a twofold higher odds of high hsCRP (OR 2.2, 95% CI 1.3–3.8, p = 0.005), while having three components was associated with a 14-fold higher odds of high hsCRP (OR 13.5, 95% CI 2.4–76.0, p < 0.001). Conclusion: High hsCRP is common among Jamaican young adults and is strongly associated with central obesity and the number of metabolic syndrome components.

Birth weight and maternal socioeconomic circumstances were inversely related to systolic blood pressure among Afro-Caribbean young adults

OBJECTIVES In this study, we examined the effects of birth weight (BWT) and early life socioeconomic circumstances (SEC) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) among Jamaican young adults. STUDY DESIGN AND SETTING Longitudinal study of 364 men and 430 women from the Jamaica 1986 Birth Cohort Study. Information on BWT and maternal SEC at childs birth was linked to information collected at 18-20 years old. Sex-specific multilevel linear regression models were used to examine whether adult SBP/DBP was associated with BWT and maternal SEC. RESULTS In unadjusted models, SBP was inversely related to BWT z-score in both men (β, -0.82 mm Hg) and women (β, -1.18 mm Hg) but achieved statistical significance for women only. In the fully adjusted model, one standard deviation increase in BWT was associated with 1.16 mm Hg reduction in SBP among men [95% confidence interval (CI): 2.15, 0.17; P = 0.021] and 1.34 mm Hg reduction in SBP among women (95% CI: 2.21, 0.47; P = 0.003). Participants whose mothers had lower SEC had higher SBP compared with those with mothers of high SEC (β, 3.4-4.8 mm Hg for men, P < 0.05 for all SEC categories and 1.8-2.1 for women, P > 0.05). CONCLUSION SBP was inversely related to maternal SEC and BWT among Jamaican young adults.

Educational Health Disparities in Cardiovascular Disease Risk Factors: Findings from Jamaica Health and Lifestyle Survey 2007–2008

Objectives Socioeconomic disparities in health have emerged as an important area in public health, but studies from Afro-Caribbean populations are uncommon. In this study, we report on educational health disparities in cardiovascular disease (CVD) risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity), among Jamaican adults. Methods We analyzed data from the Jamaica Health and Lifestyle Survey 2007–2008. Trained research staff administered questionnaires and obtained measurements of blood pressure, anthropometrics, glucose and cholesterol. CVD risk factors were defined by internationally accepted cut-points. Educational level was classified as primary or lower, junior secondary, full secondary, and post-secondary. Educational disparities were assessed using age-adjusted or age-specific prevalence ratios and prevalence differences obtained from Poisson regression models. Post-secondary education was used as the reference category for all comparisons. Analyses were weighted for complex survey design to yield nationally representative estimates. Results The sample included 678 men and 1,553 women with mean age of 39.4 years. The effect of education on CVD risk factors differed between men and women and by age group among women. Age-adjusted prevalence of diabetes mellitus was higher among men with less education, with prevalence differences ranging from 6.9 to 7.4 percentage points (p < 0.05 for each group). Prevalence ratios for diabetes among men ranged from 3.3 to 3.5 but were not statistically significant. Age-specific prevalence of hypertension was generally higher among the less educated women, with statistically significant prevalence differences ranging from 6.0 to 45.6 percentage points and prevalence ratios ranging from 2.5 to 4.3. Similarly, estimates for obesity and hypercholesterolemia suggested that prevalence was higher among the less educated younger women (25–39 years) and among more educated older women (40–59 and 60–74 years). There were no statistically significant associations for diabetes among women, or for hypertension, high cholesterol, or obesity among men. Conclusion Educational health disparities were demonstrated for diabetes mellitus among men, and for obesity, hypertension, and hypercholesterolemia among women in Jamaica. Prevalence of diabetes was higher among less educated men, while among younger women the prevalence of hypertension, hypercholesterolemia, and obesity was higher among those with less education.

Investigation of effects of time of measurement and modes of administration on cadmium accumulation in rat liver under some medicinal plants food supplemented diet

Context and Objectives: Cadmium (Cd) toxicity leads to cell and organ damage, we comparatively examined the protection ability of different medicinal plants on Cd liver accumulation following different treatment interventions and modes of administration. Materials and Methods: Rats were fed either 7% w/w Zingiber officinale, 7% w/w Allium Sativum, 10% w/w Lycopersicon esculentum, 5%, w/w Garcinia kola (all in rat chow), while Cd (200 ppm) was given in drinking water. Additives were administered together with (mode 1), a week after (mode 2) or a week before metal exposure (mode 3) for a period of six weeks. Cd liver was determined using AAS and compared using analysis of variance (ANOVA). Results: All additives significantly (P <0.5) reduced the accumulation of Cd in the liver. After adjusting for time and mode of administration, mean %protection for week 4 was significantly lower by 14.1% (P=0.02) from that for week 2 but the means did not differ with respect to additive used or mode of administration, no statistically significant interaction between modes of administration and either of additives used or time of administration in their respective relationships to percentage protection from Cd. Conclusion: Additives significantly reduced Cd accumulation through a reduction in absorption and enhancement of metal excretion.

The effect of sildenafil on the elasticity of erythrocytes in homozygous sickle cell disease

PURPOSE One of the features of homozygous sickle cell disease (HbSS) is the impaired elasticity of the erythrocyte membrane that could impede microcirculatory blood flow and cause hypoxia and tissue damage. We investigated the effect of sildenafil, a phosphodiesterase 5 (PDE5) inhibitor that inhibits the breakdown of cyclic guanosine monophosphate (cGMP) resulting in vasodilatation, on the elasticity of HbSS erythrocyte. MATERIALS AND METHODS Blood samples from ten HbSS patients in steady state was exposed to different doses (5, 10, 20, and 40 μg/mL) of sildenafil and the elasticity of the erythrocytes measured at native hematocrit with the BioProfiler. An equal number of subjects with normal hemoglobin (HbAA) served as the control group. RESULTS There was a marginal increase in elasticity with 5 μg/mL of the drug and this became significant (P<0.05) with the 10 μg/mL dose. Thereafter, gradual nonsignificant decreases were observed with the 20 and 40 μg/mL doses. A similar trend was observed for the control group. The elasticity values for the HbSS subjects at native hematocrit were significantly (P<0.05) less when compared with the corresponding concentrations for the HbAA controls. This was reversed at a corrected hematocrit of 45%. CONCLUSION The result of this study shows that sildenafil caused an initial increase in erythrocyte membrane elasticity in both HbSS and HbAA subjects, and this later decreased with increasing concentration of the drug possibly due to the dual effect of cyclic adenosine monophosphate (cAMP).

Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: a cross-sectional study

Background Although several studies have identified risk factors for high blood pressure (BP), data from Afro-Caribbean populations are limited. Additionally, less is known about how putative risk factors operate in young adults and how social factors influence the risk of high BP. In this study, we estimated the relative risk for elevated BP or hypertension (EBP/HTN), defined as BP ≥ 120/80 mmHg, among young adults with putative cardiovascular disease (CVD) risk factors in Jamaica and evaluated whether relative risks differed by sex. Methods Data from 898 young adults, 18–20 years old, were analysed. BP was measured with a mercury sphygmomanometer after participants had been seated for 5 min. Anthropometric measurements were obtained, and glucose, lipids and insulin measured from a fasting venous blood sample. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution where the numbers meeting standard cut-points were small. Relative risks were estimated using odds ratios (OR) from logistic regression models. Results Prevalence of EBP/HTN was 30% among males and 13% among females (p < 0.001 for sex difference). There was evidence for sex interaction in the relationship between EBP/HTN and some of risk factors (obesity and household possessions), therefore we report sex-specific analyses. In multivariable logistic regression models, factors independently associated with EBP/HTN among men were obesity (OR 8.48, 95% CI [2.64–27.2], p < 0.001), and high glucose (OR 2.01, CI [1.20–3.37], p = 0.008), while high HOMA-IR did not achieve statistical significance (OR 2.08, CI [0.94–4.58], p = 0.069). In similar models for women, high triglycerides (OR 1.98, CI [1.03–3.81], p = 0.040) and high HOMA-IR (OR 2.07, CI [1.03–4.12], p = 0.039) were positively associated with EBP/HTN. Lower SES was also associated with higher odds for EBP/HTN (OR 4.63, CI [1.31–16.4], p = 0.017, for moderate vs. high household possessions; OR 2.61, CI [0.70–9.77], p = 0.154 for low vs. high household possessions). Alcohol consumption was associated with lower odds of EBP/HTN among females only; OR 0.41 (CI [0.18–0.90], p = 0.026) for drinking <1 time per week vs. never drinkers, and OR 0.28 (CI [0.11–0.76], p = 0.012) for drinking ≥3 times per week vs. never drinkers. Physical activity was inversely associated with EBP/HTN in both males and females. Conclusion Factors associated with EBP/HTN among Jamaican young adults include obesity, high glucose, high triglycerides and high HOMA-IR, with some significant differences by sex. Among women lower SES was positively associated with EBP/HTN, while moderate alcohol consumption was associated lower odds of EBP/HTN.

Test-retest reliability for pulse wave velocity and cardio-ankle vascular index among Afro-Caribbean young adults

To cite this article: Janeil M. Williams, Trevor S. Ferguson, Nadia R. Bennett, Amanda Rousseau, Renee Walters, Novie O. Younger-Coleman, Marshall K. Tulloch-Reid, Seeromanie Harding, J. Kennedy Cruickshank, Rainford J. Wilks (2017) P130: TESTRETEST RELIABILITY FOR PULSE WAVE VELOCITY AND CARDIO-ANKLE VASCULAR INDEX AMONG AFRO-CARIBBEAN YOUNG ADULTS, Artery Research 20:C, 82–82, DOI: https://doi.org/10.1016/j.artres.2017.10.112

WHO/ISH total risk approach for primary prevention of cardiovascular disease shows greater decrease in costs for women but not the elderly in Jamaica.

OBJECTIVES To investigate cost savings from and implications of replacing the single risk with a total cardiovascular risk approach in primary prevention of cardiovascular disease (CVD). STUDY DESIGN AND SETTING A cost analysis using data from the 2007-08 Jamaica Health and Lifestyle Survey of 1,432 persons aged 40 years and older with 10-year risk estimated from region-specific World Health Organization/International Society for Hypertension (WHO/ISH) CVD risk charts. The WHO/ISH and local treatment guidelines were used to cost lifestyle changes, medications, and provider visits. RESULTS Use of the total cardiovascular risk approach was less costly regardless of age. Women showed greater cost disparity. However, if 10-year CVD risk was estimated without measured cholesterol, both approaches resulted in similar costs in men ≥60 years. The annual per capita cost of lifestyle recommendations, critical in the absence of pharmacotherapy, was estimated at US

A comparative study of the effect of some nutritional medicinal plants effect on lead accumulation in the liver following different modes of administration

869.05 for diet and US