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Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance

OBJECTIVES: While global measures of cardiovascular (CV) risk are used to guide prevention and treatment decisions, these estimates fail to account for the considerable interindividual variability in pre-clinical risk status. This study investigated heterogeneity in CV risk factor profiles and its a...

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Autores principales: Dowling, N. Maritza, Gleason, Carey E., Manson, JoAnn E., Hodis, Howard N., Miller, Virginia M., Brinton, Eliot A., Neal-Perry, Genevieve, Santoro, M. Nanette, Cedars, Marcelle, Lobo, Rogerio, Merriam, George R., Wharton, Whitney, Naftolin, Frederick, Taylor, Hugh, Harman, S. Mitchell, Asthana, Sanjay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714288/
https://www.ncbi.nlm.nih.gov/pubmed/23874743
http://dx.doi.org/10.1371/journal.pone.0068741
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author Dowling, N. Maritza
Gleason, Carey E.
Manson, JoAnn E.
Hodis, Howard N.
Miller, Virginia M.
Brinton, Eliot A.
Neal-Perry, Genevieve
Santoro, M. Nanette
Cedars, Marcelle
Lobo, Rogerio
Merriam, George R.
Wharton, Whitney
Naftolin, Frederick
Taylor, Hugh
Harman, S. Mitchell
Asthana, Sanjay
author_facet Dowling, N. Maritza
Gleason, Carey E.
Manson, JoAnn E.
Hodis, Howard N.
Miller, Virginia M.
Brinton, Eliot A.
Neal-Perry, Genevieve
Santoro, M. Nanette
Cedars, Marcelle
Lobo, Rogerio
Merriam, George R.
Wharton, Whitney
Naftolin, Frederick
Taylor, Hugh
Harman, S. Mitchell
Asthana, Sanjay
author_sort Dowling, N. Maritza
collection PubMed
description OBJECTIVES: While global measures of cardiovascular (CV) risk are used to guide prevention and treatment decisions, these estimates fail to account for the considerable interindividual variability in pre-clinical risk status. This study investigated heterogeneity in CV risk factor profiles and its association with demographic, genetic, and cognitive variables. METHODS: A latent profile analysis was applied to data from 727 recently postmenopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). Women were cognitively healthy, within three years of their last menstrual period, and free of current or past CV disease. Education level, apolipoprotein E ε4 allele (APOE4), ethnicity, and age were modeled as predictors of latent class membership. The association between class membership, characterizing CV risk profiles, and performance on five cognitive factors was examined. A supervised random forest algorithm with a 10-fold cross-validation estimator was used to test accuracy of CV risk classification. RESULTS: The best-fitting model generated two distinct phenotypic classes of CV risk 62% of women were “low-risk” and 38% “high-risk”. Women classified as low-risk outperformed high-risk women on language and mental flexibility tasks (p = 0.008) and a global measure of cognition (p = 0.029). Women with a college degree or above were more likely to be in the low-risk class (OR = 1.595, p = 0.044). Older age and a Hispanic ethnicity increased the probability of being at high-risk (OR = 1.140, p = 0.002; OR = 2.622, p = 0.012; respectively). The prevalence rate of APOE-ε4 was higher in the high-risk class compared with rates in the low-risk class. CONCLUSION: Among recently menopausal women, significant heterogeneity in CV risk is associated with education level, age, ethnicity, and genetic indicators. The model-based latent classes were also associated with cognitive function. These differences may point to phenotypes for CV disease risk. Evaluating the evolution of phenotypes could in turn clarify preclinical disease, and screening and preventive strategies. ClinicalTrials.gov NCT00154180
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spelling pubmed-37142882013-07-19 Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance Dowling, N. Maritza Gleason, Carey E. Manson, JoAnn E. Hodis, Howard N. Miller, Virginia M. Brinton, Eliot A. Neal-Perry, Genevieve Santoro, M. Nanette Cedars, Marcelle Lobo, Rogerio Merriam, George R. Wharton, Whitney Naftolin, Frederick Taylor, Hugh Harman, S. Mitchell Asthana, Sanjay PLoS One Research Article OBJECTIVES: While global measures of cardiovascular (CV) risk are used to guide prevention and treatment decisions, these estimates fail to account for the considerable interindividual variability in pre-clinical risk status. This study investigated heterogeneity in CV risk factor profiles and its association with demographic, genetic, and cognitive variables. METHODS: A latent profile analysis was applied to data from 727 recently postmenopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). Women were cognitively healthy, within three years of their last menstrual period, and free of current or past CV disease. Education level, apolipoprotein E ε4 allele (APOE4), ethnicity, and age were modeled as predictors of latent class membership. The association between class membership, characterizing CV risk profiles, and performance on five cognitive factors was examined. A supervised random forest algorithm with a 10-fold cross-validation estimator was used to test accuracy of CV risk classification. RESULTS: The best-fitting model generated two distinct phenotypic classes of CV risk 62% of women were “low-risk” and 38% “high-risk”. Women classified as low-risk outperformed high-risk women on language and mental flexibility tasks (p = 0.008) and a global measure of cognition (p = 0.029). Women with a college degree or above were more likely to be in the low-risk class (OR = 1.595, p = 0.044). Older age and a Hispanic ethnicity increased the probability of being at high-risk (OR = 1.140, p = 0.002; OR = 2.622, p = 0.012; respectively). The prevalence rate of APOE-ε4 was higher in the high-risk class compared with rates in the low-risk class. CONCLUSION: Among recently menopausal women, significant heterogeneity in CV risk is associated with education level, age, ethnicity, and genetic indicators. The model-based latent classes were also associated with cognitive function. These differences may point to phenotypes for CV disease risk. Evaluating the evolution of phenotypes could in turn clarify preclinical disease, and screening and preventive strategies. ClinicalTrials.gov NCT00154180 Public Library of Science 2013-07-17 /pmc/articles/PMC3714288/ /pubmed/23874743 http://dx.doi.org/10.1371/journal.pone.0068741 Text en © 2013 Dowling et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Dowling, N. Maritza
Gleason, Carey E.
Manson, JoAnn E.
Hodis, Howard N.
Miller, Virginia M.
Brinton, Eliot A.
Neal-Perry, Genevieve
Santoro, M. Nanette
Cedars, Marcelle
Lobo, Rogerio
Merriam, George R.
Wharton, Whitney
Naftolin, Frederick
Taylor, Hugh
Harman, S. Mitchell
Asthana, Sanjay
Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance
title Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance
title_full Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance
title_fullStr Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance
title_full_unstemmed Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance
title_short Characterization of Vascular Disease Risk in Postmenopausal Women and Its Association with Cognitive Performance
title_sort characterization of vascular disease risk in postmenopausal women and its association with cognitive performance
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714288/
https://www.ncbi.nlm.nih.gov/pubmed/23874743
http://dx.doi.org/10.1371/journal.pone.0068741
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