Cardiovascular Risk Factors in American Indian and African American Women of Child Bearing Age and the Relationship of These Factors to Blood Leptin Concentration, Insulin Resistance and Waist Circumference

Abstract

Health disparities and cardiovascular diseases are major concerns in the nation. Cardiovascular disease is the leading cause of death among American Indian (AI) and African American (AA) women. Leptin concentrations, insulin resistance, and waist circumference have been found to be predictors of cardiovascular disease in American Indians and African Americans but little is known about AI and AA women of child bearing age. This study was designed to compare leptin levels, insulin resistance and waist circumference in AI and AA women and to determine the relationship of these variables with systolic blood pressure, HDL cholesterol and total cholesterol. This is a prospective epidemiological study of 81 women (48 AI, 33 AA women) of child bearing age from rural Oklahoma. Anthropometric, blood pressure and biochemical data were collected from this cohort and analyzed using SAS (Version 9.1.3). Ninety percent of the women were overweight to obese with a mean BMI of 33.27.3 kg/m2. Fifty eight percent of the AI women and 61% of the AA women were obese. Leptin concentrations were significantly higher for AA women when compared to AI women. Waist circumference (10717 cm) and insulin resistance (50.9) were not significantly different between the groups but are alarmingly morbid. There was a positive but weak correlation between leptin and systolic blood pressure (SBP, r=0.335, p<0.005) and between waist circumference and SBP (r=0.269, p<0.05) but not insulin resistance with SBP. The mean SBP in this cohort was 12612 mm Hg, within the borderline high range. Although leptin concentrations were significantly different between both groups, insulin resistance and waist circumference were not. This suggests that there is a phenotypic difference in the etiology of CVD and the involvement of leptin in the development of heart disease.