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Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry
A. Elshorbagy, AJ. Vallejo-Vaz, F. Barkas, ARM. Lyons, CAT. Stevens, KI. Dharmayat, AL. Catapano, T. Freiberger, GK. Hovingh, P. Mata, FJ. Raal, RD. Santos, H. Soran, GF. Watts, M. Abifadel, CA. Aguilar-Salinas, KF. Alhabib, M. Alkhnifsawi, W....
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
Grant support
Beatriz Galindo
Ministry of Universities
University of Seville
National Institute for Health and Care Research
Ministry of Higher Education
MOHE
National Professorial Council
MPN
Universiti Teknologi MARA
UiTM
NIHR Applied Research Collaboration Northwest London
Imperial NIHR Biomedical Research Centre
- MeSH
- Child MeSH
- Adult MeSH
- Heterozygote MeSH
- Hyperlipoproteinemia Type II * epidemiology complications MeSH
- Body Mass Index MeSH
- Cardiovascular Diseases epidemiology etiology MeSH
- Cholesterol, LDL blood metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Overweight * epidemiology complications MeSH
- Obesity * complications epidemiology MeSH
- Prevalence MeSH
- Cross-Sectional Studies MeSH
- Registries * MeSH
- Risk Factors MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
BACKGROUND AND AIMS: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear. METHODS: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD. RESULTS: Globally, 52% of adults and 27% of children with HeFH were overweight or obese, with the highest prevalence noted in Northern Africa/Western Asia. A higher overweight/obesity prevalence was found in non-high-income vs. high-income countries. Median age at familial hypercholesterolaemia diagnosis in adults with obesity was 9 years older than in normal weight adults. Obesity was associated with a more atherogenic lipid profile independent of lipid-lowering medication. Prevalence of coronary artery disease increased progressively across body mass index categories in both children and adults. Compared with normal weight, obesity was associated with higher odds of coronary artery disease in children (odds ratio 9.28, 95% confidence interval 1.77-48.77, adjusted for age, sex, lipids, and lipid-lowering medication) and coronary artery disease and stroke in adults (odds ratio 2.35, 95% confidence interval 2.10-2.63 and odds ratio 1.65, 95% confidence interval 1.27-2.14, respectively), but less consistently with peripheral artery disease. Adjusting for diabetes, hypertension and smoking modestly attenuated the associations. CONCLUSIONS: Overweight and obesity are common in patients with HeFH and contribute to ASCVD risk from childhood, independent of LDL-C and lipid-lowering medication. Sustained body weight management is needed to reduce the risk of ASCVD in HeFH.
Admiralty Medical Centre and Khoo Teck Puat Hospital Yishun Health Singapore
Advanced Lipid Management and Research Centre Tallaght University Hospital Dublin Ireland
Atherothrombosis Research Centre University of Ioannina Ioannina Greece
CarDia National Institute for Metabolic and Cardiovascular Disease Research Czech Republic
Cardiovascular Research Centre University of Zielona Gora Zielona Gora Poland
Centre for Advanced Metabolic Medicine and Nutrition Santiago Chile
Centres Hospitaliers Universitaires HELORA at La Louvière and University of Mons Mons Belgium
Chemical Pathology University of Cape Town Health Science Faculty Cape Town South Africa
Cleveland Clinic Abu Dhabi Heart and Vascular Institute Abu Dhabi United Arab Emirates
College of Medicine Korea University Seoul Korea
College of Medicine University of Warith Al Anbiyaa Karbala Iraq
College of Pharmacy University of Al Qadisiyah Al Diwaniyah Iraq
DACH Society for the Prevention of Heart and Circulatory Diseases Hamburg Germany
Department of Cardiology Ege University Medical School İzmir Turkey
Department of Child Health University of Benin Teaching Hospital Benin City Nigeria
Department of Laboratory Medicine Medical University of Vienna Vienna Austria
Department of Laboratory Medicine PD Hinduja Hospital and Medical Research Centre Mahim Mumbai India
Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
Department of Preventive Cardiology and Lipidology Medical University of Lodz Lodz Poland
Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
Department of Vascular Medicine Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
Department of Vascular Medicine D3 330 AMC Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
Directorate of Research Shifa Tameer e Millat University Islamabad Pakistan
Faculty of Medicine and Surgery Department of Medicine University of Malta Msida Malta
Faculty of Medicine Cantonal Hospital Zenica University of Zenica Zenica Bosnia and Herzegovina
Faculty of Medicine Department of Cardiology Menoufia University Al Minufiyah Egypt
Faculty of Medicine Department of Medicine University of Seville Seville Spain
Faculty of Medicine Macau University of Science and Technology Macau China
Faculty of Medicine Phenikaa University Vietnam Atherosclerosis Society Hanoi Vietnam
Faculty of Medicine University of Basel Basel Switzerland
Faculty of Medicine University of Ljubljana Ljubljana Slovenia
Fundación Hipercolesterolemia Familiar Madrid Spain
GENYCO Program Comisión Honoraria para la Salud Cardiovascular Montevideo Uruguay
German Centre for Cardiovascular Research Partner Site Munich Heart Alliance Munich Germany
Heart Institute University of São Paulo and Hospital Israelita Albert Einstein São Paulo Brazil
Institute of Pathology Laboratory and Forensic Medicine Sungai Buloh Selangor Malaysia
Istituto di Biofisica Consiglio Nazionale delle Ricerche Palermo Italy
Istituto di Ricovero e Cura a Carattere Scientifico MultiMedica Milan Italy
Klinik und Poliklinik für Kardiologie Universitätsklinikum Leipzig Leipzig Germany
Kyrgyz State Medical Academy Bishkek Kyrgyzstan
Lipid Clinic Mater Dei Hospital Msida Malta
Manchester University NHS Foundation Trust Manchester UK
Medical Faculty Mannheim Department of Internal Medicine Heidelberg University Mannheim Germany
Medical University of Sofia Sofia Bulgaria
National Advisory Unit on Familial Hypercholesterolemia Oslo University Hospital Oslo Norway
North Estonia Medical Centre Tallinn University of Technology Tallinn Estonia
Osaka Medical and Pharmaceutical University Takatsuki Japan
Pharmacology Department FASTA University School of Medicine Mar del Plata Argentina
Portuguese Atherosclerosis Society Lisbon Portugal
Research Health Institute Al Farabi Kazakh National University Almaty Kazakhstan
Rigshospitalet Copenhagen University Hospital University of Copenhagen Copenhagen Denmark
Rinku General Medical Centre Osaka Japan
Sabah Al Ahmad Cardiac Centre Kuwait City Kuwait
Synlab Akademie Synlab Holding Deutschland Mannheim and Augsburg Germany
Tecnológico de Monterrey Escuela de Medicina y Ciencias de la Salud Monterrey Mexico
Universidad de Oriente Núcleo Bolívar Ciudad Bolívar Venezuela
References provided by Crossref.org
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- $a Elshorbagy, Amany $u Department of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK $u Department of Physiology, Faculty of Medicine, University of Alexandria, Mowassat Campus, Alexandria, Egypt
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- $a Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry / $c A. Elshorbagy, AJ. Vallejo-Vaz, F. Barkas, ARM. Lyons, CAT. Stevens, KI. Dharmayat, AL. Catapano, T. Freiberger, GK. Hovingh, P. Mata, FJ. Raal, RD. Santos, H. Soran, GF. Watts, M. Abifadel, CA. Aguilar-Salinas, KF. Alhabib, M. Alkhnifsawi, W. Almahmeed, F. Alnouri, R. Alonso, K. Al-Rasadi, A. Al-Sarraf, M. Arca, TF. Ashavaid, M. Averna, M. Banach, M. Becker, CJ. Binder, M. Bourbon, LR. Brunham, K. Chlebus, P. Corral, D. Cruz, K. Davletov, OS. Descamps, B. Dwiputra, M. Ezhov, U. Groselj, M. Harada-Shiba, KB. Holven, SE. Humphries, M. Kayikcioglu, W. Khovidhunkit, K. Lalic, G. Latkovskis, U. Laufs, E. Liberopoulos, MM. Lima-Martinez, V. Maher, AD. Marais, W. März, E. Mirrakhimov, AR. Miserez, O. Mitchenko, H. Nawawi, BG. Nordestgaard, AG. Panayiotou, G. Paragh, Z. Petrulioniene, B. Pojskic, A. Postadzhiyan, A. Reda, Ž. Reiner, X. Reyes, F. Sadiq, WE. Sadoh, H. Schunkert, AB. Shek, E. Stroes, TC. Su, T. Subramaniam, AV. Susekov, M. Tilney, B. Tomlinson, TH. Truong, AD. Tselepis, A. Tybjærg-Hansen, A. Vázquez-Cárdenas, M. Viigimaa, B. Vohnout, S. Yamashita, KK. Ray
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- $a BACKGROUND AND AIMS: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear. METHODS: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD. RESULTS: Globally, 52% of adults and 27% of children with HeFH were overweight or obese, with the highest prevalence noted in Northern Africa/Western Asia. A higher overweight/obesity prevalence was found in non-high-income vs. high-income countries. Median age at familial hypercholesterolaemia diagnosis in adults with obesity was 9 years older than in normal weight adults. Obesity was associated with a more atherogenic lipid profile independent of lipid-lowering medication. Prevalence of coronary artery disease increased progressively across body mass index categories in both children and adults. Compared with normal weight, obesity was associated with higher odds of coronary artery disease in children (odds ratio 9.28, 95% confidence interval 1.77-48.77, adjusted for age, sex, lipids, and lipid-lowering medication) and coronary artery disease and stroke in adults (odds ratio 2.35, 95% confidence interval 2.10-2.63 and odds ratio 1.65, 95% confidence interval 1.27-2.14, respectively), but less consistently with peripheral artery disease. Adjusting for diabetes, hypertension and smoking modestly attenuated the associations. CONCLUSIONS: Overweight and obesity are common in patients with HeFH and contribute to ASCVD risk from childhood, independent of LDL-C and lipid-lowering medication. Sustained body weight management is needed to reduce the risk of ASCVD in HeFH.
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- $p National Institute for Health and Care Research
- GRA __
- $p Ministry of Higher Education
- GRA __
- $p MOHE
- GRA __
- $p National Professorial Council
- GRA __
- $p MPN
- GRA __
- $p Universiti Teknologi MARA
- GRA __
- $p UiTM
- GRA __
- $p NIHR Applied Research Collaboration Northwest London
- GRA __
- $p Imperial NIHR Biomedical Research Centre
- LZP __
- $a Pubmed-20250415
