The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study

Bryn Hummel; Mara A. Yerkes; Ralf E. Harskamp; Henrike Galenkamp; Anton E. Kunst; Anja Lok; Irene G.M. van Valkengoed

doi:10.1016/j.ssmph.2023.101432

The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study

Bryn Hummel^*, Mara A. Yerkes, Ralf E. Harskamp, Henrike Galenkamp, Anton E. Kunst, Anja Lok, Irene G.M. van Valkengoed

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011–2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (−0.65 mmol/mol, −0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.

Original language	English
Article number	101432
Pages (from-to)	1-9
Number of pages	9
Journal	SSM - Population Health
Volume	23
DOIs	https://doi.org/10.1016/j.ssmph.2023.101432
Publication status	Published - Sept 2023

Bibliographical note

Funding Information:
Dutch Heart Foundation (grant 2010T084 ), the Netherlands Organization for Health Research and Development (ZonMw; grant 200500003 ), the European Union (FP-7; grant 278901 ), and the European Fund for the Integration on non-EU immigrants (EIF; grant 2013EIF013 ). This work was additionally supported by the Netherlands Organization for Health Research and Development Gender and Health Program , and the Dutch Kidney Foundation (ZonMw, grant 849200008 ).

Publisher Copyright:
© 2023 The Authors

Funding

Dutch Heart Foundation (grant 2010T084 ), the Netherlands Organization for Health Research and Development (ZonMw; grant 200500003 ), the European Union (FP-7; grant 278901 ), and the European Fund for the Integration on non-EU immigrants (EIF; grant 2013EIF013 ). This work was additionally supported by the Netherlands Organization for Health Research and Development Gender and Health Program , and the Dutch Kidney Foundation (ZonMw, grant 849200008 ).

Funders	Funder number
Dutch Heart Foundation	2010T084
Netherlands Organization for Health Research and Development (ZonMw)	200500003
European Union	278901
European Fund for the Integration on non-EU immigrants (EIF)	2013EIF013
Netherlands Organization for Health Research and Development Gender and Health Program
Dutch Kidney Foundation (ZonMw)	849200008

Keywords

Cardiometabolic health
Cardiovascular disease
COVID-19
Ethnic differences
Sex differences
The HELIUS study

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.ssmph.2023.101432Licence: CC BY

1-s2.0-S2352827323000976-mainFinal published version, 1.48 MBLicence: CC BY

Cite this

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title = "The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study",

abstract = "The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011–2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (−0.65 mmol/mol, −0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.",

keywords = "Cardiometabolic health, Cardiovascular disease, COVID-19, Ethnic differences, Sex differences, The HELIUS study",

author = "Bryn Hummel and Yerkes, {Mara A.} and Harskamp, {Ralf E.} and Henrike Galenkamp and Kunst, {Anton E.} and Anja Lok and {van Valkengoed}, {Irene G.M.}",

note = "Funding Information: Dutch Heart Foundation (grant 2010T084 ), the Netherlands Organization for Health Research and Development (ZonMw; grant 200500003 ), the European Union (FP-7; grant 278901 ), and the European Fund for the Integration on non-EU immigrants (EIF; grant 2013EIF013 ). This work was additionally supported by the Netherlands Organization for Health Research and Development Gender and Health Program , and the Dutch Kidney Foundation (ZonMw, grant 849200008 ). Publisher Copyright: {\textcopyright} 2023 The Authors",

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doi = "10.1016/j.ssmph.2023.101432",

language = "English",

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AU - Harskamp, Ralf E.

AU - Galenkamp, Henrike

AU - Kunst, Anton E.

AU - Lok, Anja

AU - van Valkengoed, Irene G.M.

N1 - Funding Information: Dutch Heart Foundation (grant 2010T084 ), the Netherlands Organization for Health Research and Development (ZonMw; grant 200500003 ), the European Union (FP-7; grant 278901 ), and the European Fund for the Integration on non-EU immigrants (EIF; grant 2013EIF013 ). This work was additionally supported by the Netherlands Organization for Health Research and Development Gender and Health Program , and the Dutch Kidney Foundation (ZonMw, grant 849200008 ). Publisher Copyright: © 2023 The Authors

PY - 2023/9

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N2 - The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011–2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (−0.65 mmol/mol, −0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.

AB - The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011–2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (−0.65 mmol/mol, −0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.

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The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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