Comparison of anthropometric parameters as predictors of serum lipids in premenopausal women

Which Life Style Anthropometric Index is a Better Predictor of Renal Function?

BACKGROUND

Obesity is a risk factor that has been associated scientifically with hypertension, diabetes, hyperlipidemia, cancer and other life threatening diseases. The results of some studies have also shown that obesity is an independent risk factor for the development and progression of renal damage.

OBJECTIVES

The aim of the current study is to define which general and central obesity anthropometric indices are better predictors for ceratinine clearance (CC) in healthy, normal and obese Iranian women.

PATIENTS AND METHODS

In this case-controlled study, a total of 62 healthy, normal and obese women from 18 to 30 years of age in Zahedan City, the Islamic Republic of Iran, were studied. The subjects were classified into two groups; case group (31 subjects) of healthy obese women (30 ≤ BMI ≤ 39.9 kg/m(2)) and control group (31 subjects) of healthy normal women (18.5 ≤ BMI ≤ 24.9 kg/m(2)). An assessment of body mass index (BMI) was considered as a general obesity index and an assessment of waist circumference (WC) and waist to hip ratio (WHR) were considered as central obesity indices. A measurement of CC was considered for renal function.

RESULTS

The means of CC in subjects with increased BMI, WC, and WHR were significantly higher than those in subjects with normal BMI, WC, and WHR. Pearson correlation coefficient revealed that there was a stronger correlation between CC with WC than with WHR and BMI (r = 0.4, P = 0.009; r = 0.4, P = 0.01 in the case and control groups, respectively).

CONCLUSIONS

It is suggested that in clinical practice, WC can be used as a better predictor of CC than WHR and BMI in both normal and obese, healthy women.

A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value

This systematic review collated seventy-eight studies exploring waist-to-height ratio (WHtR) and waist circumference (WC) or BMI as predictors of diabetes and CVD, published in English between 1950 and 2008. Twenty-two prospective analyses showed that WHtR and WC were significant predictors of these cardiometabolic outcomes more often than BMI, with similar OR, sometimes being significant predictors after adjustment for BMI. Observations from cross-sectional analyses, forty-four in adults, thirteen in children, supported these predictions. Receiver operator characteristic (ROC) analysis revealed mean area under ROC (AUROC) values of 0·704, 0·693 and 0·671 for WHtR, WC and BMI, respectively. Mean boundary values for WHtR, covering all cardiometabolic outcomes, from studies in fourteen different countries and including Caucasian, Asian and Central American subjects, were 0·50 for men and 0·50 for women. WHtR and WC are therefore similar predictors of diabetes and CVD, both being stronger than, and independent of, BMI. To make firmer statistical comparison, a meta-analysis is required. The AUROC analyses indicate that WHtR may be a more useful global clinical screening tool than WC, with a weighted mean boundary value of 0·5, supporting the simple public health message 'keep your waist circumference to less than half your height'.

Waist circumference, body mass index, and their association with cardiometabolic and global risk

Total body fat and adipose tissue distribution are associated with cardiometabolic risk, yet there are conflicting data as to whether waist circumference (WC) or body mass index (BMI) is a better predictor of cardiovascular risk. To determine whether WC or BMI was more strongly associated with cardiometabolic risk, family members of patients with cardiac disease were studied (N=501; mean age, 48 years; 66% female; 36% nonwhite). Height, weight, WC, BMI, blood pressure, high-density lipoprotein cholesterol, triglycerides, glucose, high-sensitivity C-reactive protein, and lipoprotein-associated phospholipase A(2) were systematically measured. Global risk was calculated using the Framingham function. Increased WC and BMI were equally strong predictors of cardiometabolic and global risk. The prevalence of cardiometabolic risk factors and their correlation with WC and BMI varied by race/ethnicity. Our data support inclusion of WC and BMI in screening guidelines for diverse populations to identify individuals at increased cardiometabolic risk.

Development of models for predicting biological age (BA) with physical, biochemical, and hormonal parameters

Individual differences are the hallmark of aging. Chronological age (CHA) is known that fails to provide an accurate indicator of the aging but biological age (BA) estimates the functional status of an individual in reference to his or her chronological peers on the basis of how well he or she functions in comparison with others of the same CHA. Therefore, we developed models for predicting BA that can be applicable in clinical practice settings. This was a community-based cross-sectional study. Subjects were recruited from the health promotion center in Korea from 2001 to 2005. Among these, data obtained from the 3575 participants (1302 men and 2273 women) was used for clinical evaluation and statistical analysis. For our test battery we selected 25 parameters among the routine tests. For males, the best models were developed using 15, 7, 5, and 4 of the 25 chosen parameters for total, physical, biochemical and hormonal characteristics, respectively (R(2)=0.62, 0.38, 0.33, and 0.36, respectively). Similar to males, for the females, 14, 6, 8, and 3 parameters were developed as the models (R(2)=0.66, 0.40, 0.42, and 0.37, respectively). Our BA prediction models may be used as supplementary tools adding knowledge in the evaluation of aging status.

Anthropometric indexes for visceral fat estimation in overweight/obese women attending to age and menopausal status

The objective of the present study was to assess the usefulness and accuracy of different anthropometric measurements in the diagnosis of abdominal visceral obesity in overweight/obese women attending to age and menopausal status. The secondary objective was to evaluate the usefulness of waist circumference (WC) in two different sites. Different anthropometric indicators were assessed in 55 overweight/obese women (n=22 premenopausal, n=33 postmenopausal; BMI > 25 kg/m(2)) and compared with computed tomography measurements of abdominal visceral adipose tissue (VA) performed as a single scan at L4-L5. Our results show that VA significantly differs between both groups of women. Waist2-hip ratio (W2HR) was significantly correlated to VA in both groups of women. After multiple regression analysis, sagittal diameter was an independent parameter to predict VA. However, no significant differences were obtained in this diameter between both groups. None of the waist circumferences were significantly associated to VA. Moreover, the two sites of WC were statistically different. In conclusion, waist-to-hip ratio, measured immediately above the iliac crest (W2HR) seems to be the more appropriated anthropometric index for the estimation of visceral fat in women, independently of age. Although sagittal diameter is a fine parameter to predict visceral fat area, it is not adequate to discriminate between women of different age or menopausal status. In contrast with previous findings, waist circumferences do not seem to be useful for predicting VA.

Predictive performance of anthropometric indexes of central obesity for the risk of type 2 diabetes

BACKGROUND

In spite of several available anthropometric indexes, the relative merit of these indexes for the prediction of type 2 diabetes remains unknown. Considering that obesity and diabetes commonly coexist as co-morbidities, our objective was to directly compare the performance of measures of central and general obesity to predict the risk of type 2 diabetes.

METHODS

We conducted a case-control study of type 2 diabetes on 150 cases and 150 age- and gender-matched controls. We directly compared the predictive performance of five anthropometric indexes: four related to central obesity--waist circumference (WC), waist/hip ratio (WHR), abdominal volume index (AVI) and conicity index (CI); and one related to general obesity--body mass index (BMI). We used various statistical approaches like area under (AUC) receiver-operating characteristic (ROC) curves, likelihood ratios, logistic regression and Shannon's entropy to compare the performance of the indexes in the study sample as well as bootstrapped samples.

RESULTS

WC had the highest overall predictive accuracy that was gender insensitive (AUC=0.77 in males and 0.74 in females); a comparable information content as that of AVI (Shannon's entropy=1.81 for WC and 1.84 for AVI) and was a better predictor of the risk of type 2 diabetes than all the remaining indexes. WC also correlated strongly with the biochemical markers of diabetes like blood sugar and lipid profile.

CONCLUSIONS

WC is a simple, non-invasive and accurate predictor of the risk of type 2 diabetes that can potentially be used in screening programs in developing countries.