Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 22;18(1):276.
doi: 10.1186/s12889-018-5162-x.

Ethnic differences in infectious burden and the association with metabolic risk factors for cardiovascular disease: a cross-sectional analysis

Lara Hartog  1 , Martijn S van Rooijen  2 , Joanne Ujčič-Voortman  3 , Maria Prins  2   4 , Irene G M van Valkengoed  5
Affiliations

Ethnic differences in infectious burden and the association with metabolic risk factors for cardiovascular disease: a cross-sectional analysis

Lara Hartog et al. BMC Public Health. .

Abstract

Background: The burden of metabolic risk factors for cardiovascular disease (CVD), such as type 2 diabetes, elevated cholesterol and hypertension, is unequally distributed across ethnic groups. Recent findings suggest an association of infectious burden (IB) and metabolic risk factors, but data from ethnic groups are scarce. Therefore, we investigated ethnic differences in IB and its association with metabolic risk factors.

Methods: We included 440 Dutch, 320 Turkish and 272 Moroccan participants, 18-70 years, of the 2004 general health survey in Amsterdam, the Netherlands. IB was defined by seropositivity to the sum of 6 infections: Herpes Simplex Virus 1 and 2; Hepatitis A, B and C; and Helicobacter pylori. Associations between IB categories 4-6 (high), 3 (intermediate) and 0-2 (low) infections and metabolic risk factors were assessed by logistic regression. Finally, we determined the contribution of IB to the association between ethnicity and the metabolic risk factors by comparing adjusted logistic regression models with and without IB categories.

Results: A high IB was more frequently observed among the Turkish and Moroccans than among the Dutch. After adjustment for age, sex, ethnicity, educational level, physical activity and body mass index, high IB was associated with type 2 diabetes (odds ratio high vs low IB (OR) =2.14, 95%-confidence interval (CI) 1.05-4.36). The association was weaker and not statistically significant, for elevated cholesterol (OR = 1.39, 95%-CI 0.82-2.34) and hypertension (OR = 1.49, 95%-CI 0.88-2.51). IB attenuated ethnic differences particularly for type 2 diabetes.

Conclusions: Our study showed that Turkish and Moroccan adults in Amsterdam have a higher IB than Dutch adults, which was associated with the differences in type 2 diabetes. Due to the cross-sectional nature of the study, we cannot draw a conclusions with regards to the time-sequence of cause and effect. Nevertheless, the findings ask for further research into the nature of association of IB with metabolic risk factors in a longitudinal setting.

Keywords: Diabetes; Ethnicity; Hypercholesterolemia; Hypertension; Infections; Infectious burden.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Institutional Review Board of the Academic Medical Center in Amsterdam, and performed performed in accordance with the Declaration of Helsinki. All participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Anand SS, Yusuf S. Stemming the global tsunami of cardiovascular disease. Lancet. 2016;377:529–532. doi: 10.1016/S0140-6736(10)62346-X. - DOI - PubMed
    1. Cardiovascular diseases (CVDs) [Internet]. Reviewed June 2016. 2016 [cited 10 Mar 2015]. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/.
    1. Ujcic-Voortman JK, Schram MT, Jacobs-van der Bruggen MA, Verhoeff AP, Baan CA. Diabetes prevalence and risk factors among ethnic minorities. Eur J Pub Health. 2009;19:511–515. doi: 10.1093/eurpub/ckp096. - DOI - PubMed
    1. Ujcic-Voortman JK, Bos G, Baan CA, Uitenbroek DG, Verhoeff AP, Seidell JC. Ethnic differences in total and HDL cholesterol among Turkish, Moroccan and Dutch ethnic groups living in Amsterdam, the Netherlands. BMC Public Health. 2010;10:1–8. doi: 10.1186/1471-2458-10-740. - DOI - PMC - PubMed
    1. Agyemang C, Ujcic-voortman J, Uitenbroek D, Foets M. Prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands: the Amsterdam health monitor survey. J Hypertens. 2006;24:2169–2176. doi: 10.1097/01.hjh.0000249693.73618.c9. - DOI - PubMed

Publication types

MeSH terms