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Haroun D, Darwish M, Ehsanallah A. Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adults. PLoS One 2024; 19:e0302779. [PMID: 38709754 PMCID: PMC11073684 DOI: 10.1371/journal.pone.0302779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/12/2024] [Indexed: 05/08/2024] Open
Abstract
Body Adiposity Index (BAI), which relies on an individual's hip circumference and height, was proposed as an alternative anthropometric measurement to Body Mass Index (BMI). Although this measure has been validated across different populations, its accuracy in predicting percent body fat (%BF) in the United Arab Emirates has not yet been assessed. The objective of this study was to examine the association between BAI, BMI, Waist Circumference (WC), and %BF in young female Emirati adults and determine the relative accuracy of BAI when predicting %BF. A retrospective cross-sectional study was conducted among 95 Emirati women between the ages of 17 and 27. The %BF was measured using the dual-energy X-ray absorption (DXA) scanner. Anthropometric measurements were collected, and BMI and BAI were calculated. BMI and %BF (r = 0.823, p <0.001) showed a greater association than that between BAI and %BF (r = 0.702, p <0.001). A linear regression analysis revealed that BMI was the single best predictor of %BF in the sample (r2 = 0.678, p<0.001). The variation around the regression line for BAI comparisons with %BF (standard error of estimate = 4.879) was greater than BMI comparisons (standard error of estimate = 3.889). BAI was found to significantly underestimate %BF at higher adiposity levels (mean difference = 8.7%). The ROC curve analysis demonstrated that BMI had a higher discriminatory capacity (AUC = 0.891) over WC and BAI. The results demonstrated that BMI was a better predictor of %BF in the sample than BAI and WC. Thus, BMI may be more useful in assessing adiposity in young female Emirati adults than BAI. However, the potential of BAI as an alternative measure of adiposity should continue to be examined.
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Affiliation(s)
- Dalia Haroun
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Maryam Darwish
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Aseel Ehsanallah
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
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Rashidmayvan M, Mansoori A, Aghasizadeh M, Dianati M, Barati S, Sahranavard T, Darroudi S, Ahari RK, Esmaily H, Ferns G, Sarabi MRM, Faridni R, Ghayour-Mobarhan M, Moohebati M. Prediction of cardiovascular disease risk by serum zinc and copper concentrations and anthropometric measurements. J Trace Elem Med Biol 2024; 83:127385. [PMID: 38278053 DOI: 10.1016/j.jtemb.2024.127385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/28/2024]
Abstract
INTRODUCTION We aimed to investigate the association between cardiovascular disease (CVD) and various anthropometric indices, as well as the serum levels of copper (Cu) and zinc (Zn), copper-zinc ratio (Cu/Zn ratio) and zinc-copper ratio (Zn/Cu ratio), in a large population sample from northeastern Iranian. METHOD 9704 individuals aged 35 to 65 were enrolled in the first phase of the study. After a 10-year follow-up, 7560 participants were enrolled into the second phase. The variables used in this study included demographic characteristics, such as gender and age; biochemical parameters including: serum Zn, Cu, Cu/Zn ratio, and Zn/Cu ratio; anthropometric parameters including: waist circumference (WC), body mass index (BMI), and waist-to-hip ratio (WHR). The relationship between the aforementioned indices and CVD was examined using decision tree (DT) and logistic regression (LR) models. RESULTS A total of 837 individuals were diagnosed with CVD among the 7560 participants. LR analysis showed that BMI, age, WH zinc-copper ratio (Zn/Cu ratio), and serum Zn/Cu ratio were significantly associated the development of CVD in men, and WHR, age, BMI, serum Cu, and Cu/Zn ratio in women. DT analysis showed that, age was the most important predictor of CVD in both genders. 71% of women, older than 49 years, with a WHR≥ 0.89, serum Cu< 75 (µg/dl), BMI≥ 22.93 (kg/m2), and serum Cu≥ 14 (µg/dl), had the highest risk of CVD. In men, among those who were ≥ 53 years, with a WHR≥ 0.98, serum Zn/Cu ratio< 1.69, and BMI≥ 22.30, had the highest risk of CVD. CONCLUSION Among Iranian adult population, BMI, age, and WHR were one of the predictors of CVD for both genders. The Zn/Cu ratio was CVD predictor for men while Cu/Zn ratio was CVD predictor for women.
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Affiliation(s)
- Mohammad Rashidmayvan
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Amin Mansoori
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran; Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Aghasizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Dianati
- Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Sama Barati
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Sahranavard
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Rana Kolahi Ahari
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran; Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | | | - Reyhaneh Faridni
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Spencer C, Reed RG, Votruba-Drzal E, Gianaros PJ. Psychological stress and the longitudinal progression of subclinical atherosclerosis. Health Psychol 2024; 43:58-66. [PMID: 37917469 PMCID: PMC10842302 DOI: 10.1037/hea0001333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVE In a midlife sample of adults, the present study tested the extent to which changes in psychological stress relate to the progression of subclinical cardiovascular disease over multiple years and explored the potential moderating role of cardiometabolic risk. METHOD Participants were screened to exclude those with clinical cardiovascular, respiratory, metabolic, and other chronic illnesses, as well as those taking psychotropic, cardiovascular, lipid, and glucose control medications. At baseline (N = 331) and then again at follow-up an average of 3 years later (N = 260), participants completed the 10-item Perceived Stress Scale, underwent assessments of their cardiometabolic risk, and underwent ultrasonography to measure carotid artery intima-media thickness (IMT), which is a surrogate indicator of subclinical atherosclerosis. RESULTS Regression models showed that the change in psychological stress from baseline to follow-up was positively associated with the corresponding change in IMT, with covariate control for age at baseline, sex at birth, and variability in length of follow-up across participants. Cardiometabolic risk factors did not statistically moderate this longitudinal association. In exploratory analyses, cardiometabolic risk factors also did not statistically mediate this association. CONCLUSION These longitudinal findings suggest that increases in psychological stress in midlife relate to corresponding increases in subclinical atherosclerosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Re F, Oguntade AS, Bohrmann B, Bragg F, Carter JL. Associations of general and central adiposity with hypertension and cardiovascular disease among South Asian populations: a systematic review and meta-analysis. BMJ Open 2023; 13:e074050. [PMID: 38110373 DOI: 10.1136/bmjopen-2023-074050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The relevance of measures of general and central adiposity for cardiovascular disease (CVD) risks in populations of European descent is well established. However, it is less well characterised in South Asian populations, who characteristically manifest larger waist circumferences (WC) for equivalent body mass index (BMI). This systematic review and meta-analysis provide an overview of the literature on the association of different anthropometric measures with CVD risk among South Asians. METHODOLOGY MEDLINE and Embase were searched from 1990 to the present for studies in South Asian populations investigating associations of two or more adiposity measures with CVD. Random-effects meta-analyses were conducted on the associations of BMI, WC and waist-to-hip ratio (WHR) with blood pressure, hypertension and CVD. Quality assessment was performed using the Newcastle-Ottawa scale. RESULTS Titles and abstracts were screened for 7327 studies, yielding 147 full-text reviews. The final sample (n=30) included 2 prospective, 5 case-control and 23 cross-sectional studies. Studies reported generally higher risks of hypertension and CVD at higher adiposity levels. The pooled mean difference in systolic blood pressure (SBP) per 5 kg/m2 higher BMI was 3 mmHg (2.90 (95% CI 1.30 to 4.50)) and 6 mmHg (6.31 (95% CI 4.81 to 7.81) per 13 cm larger WC. The odds ratio (OR) of hypertension per 5 kg/m2 higher BMI was 1.33 (95% CI 1.18 to 1.51), 1.45 (95% CI 1.05 to 1.98) per 13 cm larger WC and 1.22 (95% CI 1.04 to 1.41) per 0.1-unit larger WHR. Pooled risk of CVD for BMI-defined overweight versus healthy-weight was 1.65 (95% CI 1.55 to 1.75) and 1.48 (95% CI 1.21 to 1.80) and 2.51 (95% CI 0.94 to 6.69) for normal versus large WC and WHR, respectively. Study quality was average with significant heterogeneity. CONCLUSIONS Measures of both general and central adiposity had similar, strong positive associations with the risk of CVD in South Asians. Larger prospective studies are required to clarify which measures of body composition are more informative for targeted CVD primary prevention in this population.
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Affiliation(s)
- Federica Re
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Ayodipupo S Oguntade
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bastian Bohrmann
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jennifer L Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Harborg S, Feldt M, Cronin-Fenton D, Klintman M, Dalton SO, Rosendahl AH, Borgquist S. Obesity and breast cancer prognosis: pre-diagnostic anthropometric measures in relation to patient, tumor, and treatment characteristics. Cancer Metab 2023; 11:8. [PMID: 37370158 DOI: 10.1186/s40170-023-00308-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE Examine the association between obesity and clinical outcomes in early breast cancer and assess if patient, tumor, and treatment characteristics modify such associations in Malmö Diet and Cancer Study patients (MDCS). METHODS The MDCS enrolled 17,035 Swedish women from 1991 to 1996. At enrollment, participants' body mass index (BMI), waist circumference and body fat percentage measures were collected. We identified all female MDCS participants with invasive breast cancer from 1991 to 2014. Follow-up began at breast cancer diagnosis and ended at breast cancer recurrence (BCR), death, emigration, or June 8, 2020. The World Health Organization guidelines were used to classify BMI, waist circumference, and body fat percentage into three categories of healthy weight, overweight, and obesity. We fit Cox regression models to compute adjusted hazard ratios (HRs) with 95% confidence intervals (CI) of BCR according to body composition. To evaluate effect measure modification, we stratified Cox models by patient, tumor, and treatment characteristics. RESULTS In total, 263 BCRs were diagnosed over 12,816 person-years among 1099 breast cancer patients with a median follow-up of 11.1 years. Obesity according to BMI (HR = 1.44 [95%CI 1.00-2.07]), waist circumference (HR = 1.31 [95%CI 0.98-1.77]), and body fat percentage (HR = 1.41 [95%CI 1.02-1.98]) was associated with increased risk of BCR compared with healthy weight. Obesity was stronger associated with BCR in patients with low socioeconomic position (HR = 2.55 [95%CI 1.08-6.02]), larger tumors > 20 mm (HR = 2.68 [95%CI 1.42-5.06]), estrogen-receptor-negative breast cancer (HR = 3.13 [95%CI 1.09-8.97]), and with adjuvant chemotherapy treatment (HR = 2.06 [95%CI 1.08-4.31]). CONCLUSION Higher pre-diagnostic BMI, waist circumference, and body fat percentage was associated with increased risk of BCR. The association between obesity and BCR appears dependent on patient, tumor, and treatment characteristics.
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Affiliation(s)
- Sixten Harborg
- Department of Oncology, Aarhus University/Aarhus University Hospital, Entrance C, Level 1, C106, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
| | - Maria Feldt
- Department of Clinical Sciences Lund, Oncology, Lund University, Skåne University Hospital, Lund, Sweden
| | | | - Marie Klintman
- Department of Clinical Sciences Lund, Oncology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Susanne O Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology & Palliative Services, Zealand University Hospital, Næstved, Denmark
| | - Ann H Rosendahl
- Department of Clinical Sciences Lund, Oncology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Signe Borgquist
- Department of Oncology, Aarhus University/Aarhus University Hospital, Entrance C, Level 1, C106, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Sciences Lund, Oncology, Lund University, Skåne University Hospital, Lund, Sweden
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Julian TH, Girach Z, Sanderson E, Guo H, Yu J, Cooper-Knock J, Black GC, Sergouniotis PI. Causal factors in primary open angle glaucoma: a phenome-wide Mendelian randomisation study. Sci Rep 2023; 13:9984. [PMID: 37340071 DOI: 10.1038/s41598-023-37144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 06/16/2023] [Indexed: 06/22/2023] Open
Abstract
Primary open angle glaucoma (POAG) is a chronic, adult-onset optic neuropathy associated with characteristic optic disc and/or visual field changes. With a view to identifying modifiable risk factors for this common neurodegenerative condition, we performed a 'phenome-wide' univariable Mendelian randomisation (MR) study that involved analysing the relationship between 9661 traits and POAG. Utilised analytical approaches included weighted mode based estimation, the weighted median method, the MR Egger method and the inverse variance weighted (IVW) approach. Eleven traits related to POAG risk were identified including: serum levels of the angiopoietin-1 receptor (OR [odds ratio] = 1.11, IVW p = 2.34E-06) and the cadherin 5 protein (OR = 1.06, IVW p = 1.31E-06); intraocular pressure (OR = 2.46-3.79, IVW p = 8.94E-44-3.00E-27); diabetes (OR = 5.17, beta = 1.64, IVW p = 9.68E-04); and waist circumference (OR = 0.79, IVW p = 1.66E-05). Future research focussing on the effects of adiposity, cadherin 5 and angiopoietin-1 receptor on POAG development and progression is expected to provide key insights that might inform the provision of lifestyle modification advice and/or the development of novel therapies.
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Affiliation(s)
- Thomas H Julian
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Zain Girach
- Sheffield Medical School, University of Sheffield, Sheffield, UK
| | - Eleanor Sanderson
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hui Guo
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jonathan Yu
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Johnathan Cooper-Knock
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Graeme C Black
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Panagiotis I Sergouniotis
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Cambridge, UK.
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Xu S, Nianogo RA, Jaga S, Arah OA. Development and validation of a prediction equation for body fat percentage from measured BMI: a supervised machine learning approach. Sci Rep 2023; 13:8010. [PMID: 37198237 DOI: 10.1038/s41598-023-33914-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/20/2023] [Indexed: 05/19/2023] Open
Abstract
Body mass index is a widely used but poor predictor of adiposity in populations with excessive fat-free mass. Rigorous predictive models validated specifically in a nationally representative sample of the US population and that could be used for calibration purposes are needed. The objective of this study was to develop and validate prediction equations of body fat percentage obtained from Dual Energy X-ray Absorptiometry using body mass index (BMI) and socio-demographics. We used the National Health and Nutrition Examination Survey (NHANES) data from 5931 and 2340 adults aged 20 to 69 in 1999-2002 and 2003-2006, respectively. A supervised machine learning using ordinary least squares and a validation set approach were used to develop and select best models based on R2 and root mean square error. We compared our findings with other published models and utilized our best models to assess the amount of bias in the association between predicted body fat and elevated low-density lipoprotein (LDL). Three models included BMI, BMI2, age, gender, education, income, and interaction terms and produced R-squared values of 0.87 and yielded the smallest standard errors of estimation. The amount of bias in the association between predicted BF% and elevated LDL from our best model was -0.005. Our models provided strong predictive abilities and low bias compared to most published models. Its strengths rely on its simplicity and its ease of use in low-resource settings.
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Affiliation(s)
- Shiming Xu
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA
| | - Roch A Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
- California Center for Population Research (CCPR), UCLA, Los Angeles, CA, USA.
| | | | - Onyebuchi A Arah
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA
- California Center for Population Research (CCPR), UCLA, Los Angeles, CA, USA
- Department of Statistics and Data Science, UCLA, Los Angeles, CA, USA
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark
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Pinto AJ, Rezende D, Sieczkowska SM, Meireles K, Bonfiglioli K, Ribeiro ACDM, Bonfá E, Owen N, Dunstan DW, Roschel H, Gualano B. Increased Prolonged Sitting in Patients with Rheumatoid Arthritis during the COVID-19 Pandemic: A Within-Subjects, Accelerometer-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3944. [PMID: 36900955 PMCID: PMC10001724 DOI: 10.3390/ijerph20053944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Social distancing measures designed to contain the COVID-19 pandemic can restrict physical activity, a particular concern for high-risk patient groups. We assessed rheumatoid arthritis patients' physical activity and sedentary behavior level, pain, fatigue, and health-related quality of life prior to and during the social distancing measures implemented in Sao Paulo, Brazil. METHODS Post-menopausal females diagnosed with rheumatoid arthritis were assessed before (from March 2018 to March 2020) and during (from 24 May to 7 July 2020) social distancing measures to contain COVID-19 pandemic, using a within-subjects, repeated-measure design. Physical activity and sedentary behavior were assessed using accelerometry (ActivPAL micro). Pain, fatigue, and health-related quality of life were assessed by questionnaires. RESULTS Mean age was 60.9 years and BMI was 29.5 Kg/m2. Disease activity ranged from remission to moderate activity. During social distancing, there were reductions in light-intensity activity (13.0% [-0.2 h/day, 95% CI: -0.4 to -0.04; p = 0.016]) and moderate-to-vigorous physical activity (38.8% [-4.5 min/day, 95% CI: -8.1 to -0.9; p = 0.015]), but not in standing time and sedentary time. However, time spent in prolonged bouts of sitting ≥30 min increased by 34% (1.0 h/day, 95% CI: 0.3 to 1.7; p = 0.006) and ≥60 min increased by 85% (1.0 h/day, 95% CI: 0.5 to 1.6). There were no changes in pain, fatigue, and health-related quality of life (all p > 0.050). CONCLUSIONS Imposed social distancing measures to contain the COVID-19 outbreak were associated with decreased physical activity and increased prolonged sedentary behavior, but did not change clinical symptoms sitting among patients with rheumatoid arthritis.
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Affiliation(s)
- Ana Jessica Pinto
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Diego Rezende
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Sofia Mendes Sieczkowska
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Karina Bonfiglioli
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Ana Cristina de Medeiros Ribeiro
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Eloisa Bonfá
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Neville Owen
- Baker Heart and Diabetes Institute, 99 Commercial Road, Melbourne, Victoria 3004, Australia
- Centre for Urban Transitions, Swinburne University of Technology, John St, Melbourne, Victoria 3122, Australia
| | - David W. Dunstan
- Baker Heart and Diabetes Institute, 99 Commercial Road, Melbourne, Victoria 3004, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo 01246-903, Brazil
- Food Research Center, University of Sao Paulo, R. do Lago, 250, Sao Paulo 05508-080, Brazil
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Lee X, Gao Y, Zhang Y, Feng Y, Gao L, Wang A, Jiang Y, Huang H. Comparison of 10 obesity-related indices for predicting hypertension based on ROC analysis in Chinese adults. Front Public Health 2022; 10:1042236. [PMID: 36504986 PMCID: PMC9732655 DOI: 10.3389/fpubh.2022.1042236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To compare the predictive performance of the percentage body fat (PBF), body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), waist-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), and conicity index (CI) for identifying hypertension. Methods A cross-sectional study was conducted among 2,801 adults (1,499 men and 1,302 women) aged 18 to 81 in Ningbo, China. The receiver operator characteristic (ROC) analysis and multiple non-parametric Z tests were used to compare the areas under the curve (AUC). The maximum Youden's indices were used to determine the optimal cut-off points of 10 obesity-related indices (ORI) for hypertension risk. Results The AUC of all the indices were statistically significant (P < 0.05). The AUC of all the indices in men and women were 0.67-0.73 and 0.72-0.79, respectively. Further non-parametric Z tests showed that WHR had the highest AUC values in both men [0.73 (95% CI: 0.70, 0.76)] and women (0.79 (95% CI: 0.75, 0.83)], and several central ORI (men: WHR, WC, BRI, AVI, and CI, 0.71-0.73; women: WC, WHR, and AVI, 0.77-0.79) were higher than general ORI (PBF and BMI, 0.68 in men; 0.72-0.75 in women), with adjusted P < 0.05. The optimal cut-off points for identifying hypertension in men and women were as follows: PBF (23.55%, 32.55%), BMI (25.72 kg/m2, 23.46 kg/m2), HC (97.59 cm, 94.82 cm), WC (90.26 cm, 82.78 cm), WHR (0.91, 0.88), WHtR (0.51, 0.55), ABSI (0.08 m7/6/kg2/3, 0.08 m7/6/kg2/3), BRI (4.05, 4.32), AVI (16.31 cm2, 13.83 cm2), and CI (1.23 m2/3/kg1/2, 1.27 m2/3/kg1/2). Multivariate logistic regression models showed that all indices were statistically significant (P < 0.05) with the adjusted ORs (per 1-SD increase) at 1.39-2.06 and ORs (over the optimal cut-off points) at 1.80-2.64. Conclusions All 10 ORI (PBF, BMI, HC, WC, WHR, WHtR, ABSI, BRI, AVI, and CI) can effectively predict hypertension, among which WHR should be recommended as the best predictor. Central ORI (WHR, WC, and AVI) had a better predictive performance than general ORIs (PBF and BMI) when predicting the risk of hypertension.
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Affiliation(s)
- Xiaohan Lee
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Yanan Gao
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Yuting Zhang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Yong Feng
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Linna Gao
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Aiwen Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Yongbao Jiang
- Affiliated Hospital of Ningbo University, Ningbo, China
| | - Huiming Huang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,*Correspondence: Huiming Huang
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Ma T, Li YH, Chen MM, Ma Y, Gao D, Chen L, Ma Q, Zhang Y, Liu JY, Wang XX, Dong YH, Ma J. [Associations between early onset of puberty and obesity types in children: Based on both the cross-sectional study and cohort study]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54. [PMID: 36241240 PMCID: PMC9568395 DOI: 10.19723/j.issn.1671-167x.2022.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To explore and analyze the relationship between early onset of puberty and different types of obesity in children, by combining large sample cross-sectional survey data with long-term longitudinal cohort data, so as to provide clues for further clarifying the health hazards of early onset of puberty and obesity prevention and control. METHODS The research data were from the cross-sectional survey data of seven provinces(autonomous regions, municipalities) in China and the cohort data of adolescent development in Xiamen. The study first found the association between early onset of puberty and obesity by Logistic regression on the cross-sectional data, and then used Poisson regression to analyze the association between early puberty initiation and various types of obesity risk. RESULTS In the study, 43 137 and 1 266 children were included in the cross-sectional survey and cohort survey respectively. The cross-sectional study found that among the girls aged 10-13 years, compared with the girls of the same age who did not start puberty, the body mass index (BMI)-Z score of the girls in the puberty start group was 0.5-0.8 higher, and the waist circumference Z score was 0.4-0.7 higher, and the risk of various types of obesity was higher. At the same time, the early onset of puberty was positively correlated with simple obesity, central obesity and compound obesity, the OR (95%CI) were 1.86 (1.42-2.44), 1.95 (1.65-2.32) and 1.86 (1.41-2.45), respectively. No significant association was found in boys. According to the cohort data, in girls, the risk of simple obesity was 6.00 times [RR (95%CI): 6.00 (1.07-33.60)], the risk of central obesity was 3.30 times [RR (95%CI): 3.30 (1.22-8.92)], and the risk of compound obesity was 5.76 times [RR (95%CI): 5.76 (1.03-32.30)], compared with the group without early puberty initiation, while no association between early puberty initiation and obesity was found in boys. CONCLUSION Based on the cross-sectional survey and longitudinal cohort survey, it is confirmed that the early onset of puberty in girls may increase the risk of simple obesity, central obesity and compound obesity, while there is no significant correlation between puberty onset and obesity in boys.
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Affiliation(s)
- T Ma
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - Y H Li
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - M M Chen
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - Y Ma
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - D Gao
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - L Chen
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - Q Ma
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - Y Zhang
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - J Y Liu
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - X X Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China
| | - Y H Dong
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - J Ma
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
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Liu T, Wang Y, Gao N, Zhou J, Wang Y, Fu C, Xu K. Central Adiposity Indicators Maintain a Stronger Association With the Risk of Hypertension: A Prospective Cohort Study in Southwest China. Int J Public Health 2022; 67:1605305. [PMID: 36275431 PMCID: PMC9579282 DOI: 10.3389/ijph.2022.1605305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: Studies have linked obesity to an increased risk of hypertension, but the optimal adiposity indicators to predict hypertension remains controversial. We comprehensively explored the correlation between body mass index, waist circumference (WC), waist-to-height ratio (WHtR), long-term weight and WC change, and hypertension in an adult population in Southwest China. Methods: We studied 9,280 participants from 48 townships of 12 districts with a follow-up of 10 years in the Guizhou Population Health Cohort Study. We used Pearson’s correlation coefficients combined with Dunn and Clark’s z test and Zou’s confidence interval test, receiver operating characteristic (ROC) analyses, and multivariate Cox proportional hazards regressions adjusting for demographic characteristics, lifestyle habits, disease history, and lipid information of participants. Results: Baseline central adiposity indicators (WC and WHtR) had closer associations with hypertension than BMI, and long-term WC change was more predictive of hypertension compared with weight change in the studied population. Conclusion: Central adiposity indicators maintain a stronger association with the risk of hypertension, hinting at the importance of WC management in the precaution of hypertension.
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Affiliation(s)
- Tao Liu
- Guizhou Centre for Disease Control and Prevention, Guiyang, China
- *Correspondence: Tao Liu, ; Kelin Xu,
| | - Yawen Wang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health and Safety of the Ministry of Education, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment, Ministry of Health, Fudan University, Shanghai, China
| | - Ningxin Gao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health and Safety of the Ministry of Education, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment, Ministry of Health, Fudan University, Shanghai, China
| | - Jie Zhou
- Guizhou Centre for Disease Control and Prevention, Guiyang, China
| | - Yiying Wang
- Guizhou Centre for Disease Control and Prevention, Guiyang, China
| | - Chaowei Fu
- Key Laboratory of Public Health and Safety of the Ministry of Education, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment, Ministry of Health, Fudan University, Shanghai, China
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Kelin Xu
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health and Safety of the Ministry of Education, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment, Ministry of Health, Fudan University, Shanghai, China
- *Correspondence: Tao Liu, ; Kelin Xu,
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Nadiger N, Anantharamu S, Priyanka CN, Vidal-Puig A, Mukhopadhyay A. Unique attributes of obesity in India: A narrative review. OBESITY MEDICINE 2022; 35:100454. [PMID: 38572212 PMCID: PMC7615800 DOI: 10.1016/j.obmed.2022.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Obesity has become a burgeoning epidemic in India, even though the country is still dealing with undernutrition. As a significant determinant of the Metabolic Syndrome (MetS) and non-communicable diseases (NCDs) such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), understanding the Indian context of the problem and learning how to deal with the obesity epidemic in this country has gained paramount importance. This narrative review points to the unique features of the obesity epidemic in India and its associated contributing factors, including the evolving nature of the Indian diet, the peculiarity of the increased adiposity at lower BMIs, unique obesity-associated genetic variants in Indians, the contribution of the gut microbiome, the impact of chronic inflammation and the role of ambient air pollution, and the contribution of decreased physical activity levels concerning the rapid urbanisation and the built environment. We believe that disseminating our insights into these unique features influencing the development of obesity in India will help increase global awareness and pave the way for better control and management of this obesity epidemic.
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Affiliation(s)
- Nikhil Nadiger
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
| | - Sahana Anantharamu
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
| | - CN Priyanka
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
| | - Antonio Vidal-Puig
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, MDU MRC, Addenbrooke's Hospital, Cambridge, UK
| | - Arpita Mukhopadhyay
- Division of Nutrition, St. John's Research Institute, St. John's Medical College, Koramangala, Bangalore, India
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Saki N, Karandish M, Cheraghian B, Heybar H, Hashemi SJ, Azhdari M. Prevalence of cardiovascular diseases and associated factors among adults from southwest Iran: Baseline data from Hoveyzeh Cohort Study. BMC Cardiovasc Disord 2022; 22:309. [PMID: 35804295 PMCID: PMC9270737 DOI: 10.1186/s12872-022-02746-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) were the number one cause of death in Iran. The main risk factors of CVDs include unhealthy lifestyles, insulin resistance, hypertension (HTN), and hyperlipidemia. Given that there are modifiable risk factors for CVDs, this cross-sectional study aimed to evaluate the prevalence of CVDs and their risk factors among adults. METHODS The present cross-sectional study was conducted on 9828 adults 35-70 years (both sexes). The demographic data, lifestyle habits, anthropometric data, and clinical and biochemical parameters were collected from the baseline data of the Hoveyzeh Cohort Study. The odds ratio (OR) of CVDs was assessed by multivariable logistic regression. RESULTS The prevalence of CVDs was higher in females than males (16.2 vs. 12.6, p ≤ 0.001). The prevalence of CVDs was related to age, gender, marital status, lifestyle, anthropometric measurements, cholesterol, high-density lipoprotein, HTN, and fasting plasma glucose (FPG) (p ≤ 0.05). The participants aged 65-70 y showed the highest odds of CVDs (OR: 3.97, 95% CI: (3.14, 5.01), (p ≤ 0.001)). Males (OR: 1.76, 95% CI: (1.51, 2.05), p ≤ 0.001), married status (OR: 1.63, 95% CI: (1.08, 2.47), p = 0.021), more using a mobile phone (OR: 1.26, 95% CI: (1.09, 1.46), p ≤ 0.002), and smoking cigarettes (OR: 1.44, 95% CI: (1.24, 1.68), p ≤ 0.001) associated with CVDs. Higher odds of CVDs were related to low physical activity (PA) (OR: 1.56, 95% CI: (1.34, 1.8), p ≤ 0.001), body mass index > 30 (OR: 1.68, 95% CI: (1.01, 2.8), p ≤ 0.047). Moreover, odds of CVDs were related to systolic blood pressure (SBP) ≥ 140 mm Hg (OR: 1.25, 95% CI: (1.04, 1.51), p = 0.017), FPG = 100-126 mg/dl (OR: 1.24, 95% CI: (1.07, 1.43), p = 0.003), and FPG > 126 mg/dl (OR: 1.71, 95% CI: (1.47, 1. 98), p ≤ 0.001). CONCLUSION The present study showed the main risk factors of CVDs were older age, married status, using a mobile phone, low PA, smoking, obesity, and abnormal FPG and SBP. The lower odds of CVDs were found in the participants with normal cholesterol.
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Affiliation(s)
- Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Heybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Department of Internal Medicine, School of Medicine, Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Azhdari
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
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Liu X, Liu Y, Guan H, Feng Y, Kuang J. Comparison of six anthropometric measures in discriminating diabetes: A cross-sectional study from the National Health and Nutrition Examination Survey. J Diabetes 2022; 14:465-475. [PMID: 35841213 PMCID: PMC9310044 DOI: 10.1111/1753-0407.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/07/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Traditional anthropometric measures, including body mass index (BMI), are insufficient for evaluating the risk of diabetes. This study aimed to evaluate the performance of new anthropometric measures and a combination of anthropometric measures for identifying diabetes. METHODS A total of 46 979 participants in the National Health and Nutrition Examination Survey program were included in this study. Anthropometric measures, including weight, BMI, waist circumference (WC), waist-to-height ratio (WtHR), conicity index (CI), and A Body Shape Index (ABSI), were calculated. Logistic regression analysis and restricted cubic splines were used to evaluate the association between the anthropometric indices and diabetes. The receiver operating characteristic (ROC) curve analysis was performed to compare the discrimination of different anthropometric measures. RESULTS All anthropometric measures were positively and independently associated with the risk of diabetes. After adjusting for covariates, the per SD increment in WC, WtHR, and CI increased the risk of diabetes by 81%, 83%, and 81%, respectively. In the ROC analysis, CI showed superior discriminative ability for diabetes (area under the curve 0.714), and its optimum cutoff value was 1.31. Results of the combined use of BMI and other anthropometric measures showed that among participants with BMI <30 kg/m2 , an elevated level of another metric increased the risk of having diabetes (P < .001). Similarly, at low levels of weight, CI, and ABSI, an elevated BMI increased diabetes risk (P < .001). CONCLUSIONS WtHR and CI had the best ability to identify diabetes when applied to the US noninstitutionalized population. Anthropometric measures containing WC information could improve the discrimination ability.
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Affiliation(s)
- Xiao‐cong Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Ying‐shan Liu
- Department of Endocrinology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- The Second School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
| | - Hai‐xia Guan
- Department of Endocrinology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Ying‐qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Jian Kuang
- Department of Endocrinology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
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Ejheisheh MA, Batran A, Ayed A, Correa-Rodríguez M, Fernández-Aparicio Á, Gómez-Urquiza JL, Schmidt-RioValle J. Correlation between anthropometric measurements and blood pressure in a population of Palestinian adults. Sci Prog 2022; 105:368504221102782. [PMID: 35635260 PMCID: PMC10450307 DOI: 10.1177/00368504221102782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Obesity can be a major problem due to its potential to cause a number of health issues, including high blood pressure and diabetes. Many reports have come out of Palestine on overweight and obesity and their direct link to non-communicable diseases, although there is only limited evidence available on the connection between obesity and hypertension in Palestinian adults. We aimed to look at the associations between anthropometric and body composition variables and blood pressure in a large population of Palestinian adults (1337 subjects) and determine which anthropometric indices most strongly correlate with high blood pressure. Anthropometric measurements including height, waist circumference (WC), hip circumference (HC), body mass index (BMI), and total body fat (TBF) were assessed. A body composition analyzer was used to measure body weight, fat mass and fat-free mass. Systolic (SBP) and diastolic (DBP) blood pressure were measured using a Dinamap vital signs monitor. In both males and females, all the anthropometric measurements showed significant strong positive correlations with mean SBP and mean DBP (p < 0.01). SBP correlated the most strongly with waist circumference in all subjects (r = 0.444 in females, r = 0.422 in males), while DBP correlated the most strongly with WC in males (r = 0.386), but with TBF in females (r = 0.256). By controlling fat percentage, WC, HC, and BMI, which are affected by extra weight and lack of exercise, blood pressure levels can be regulated.
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Affiliation(s)
- Moath Abu Ejheisheh
- Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Jenin, Palestine
| | - Ahmad Batran
- Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Jenin, Palestine
| | - Ahmad Ayed
- Faculty of nursing, Arab American University, Jenin, Palestine
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
- CTS-436 Aspectos psicosociales y Transculturales de la Salud y la Enfermedad, Granada, Spain
| | - Ángel Fernández-Aparicio
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
- CTS-436 Aspectos psicosociales y Transculturales de la Salud y la Enfermedad, Granada, Spain
| | - José Luis Gómez-Urquiza
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
| | - Jacqueline Schmidt-RioValle
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
- CTS-436 Aspectos psicosociales y Transculturales de la Salud y la Enfermedad, Granada, Spain
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Selected Organ and Endocrine Complications According to BMI and the Metabolic Category of Obesity: A Single Endocrine Center Study. Nutrients 2022; 14:nu14061307. [PMID: 35334964 PMCID: PMC8954480 DOI: 10.3390/nu14061307] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023] Open
Abstract
Obesity is a chronic and complex disease associated with metabolic, organ and endocrine complications. In the study, we analyzed a group of 105 patients suffering from obesity without any other previously recognized serious disorders who had been referred to a single endocrine center. The study aimed to assess the prevalence of selected organ and endocrine complications by subdividing the group, firstly according to body mass index (BMI) and secondly with regard to metabolic syndrome (MetS), pre-MetS and the metabolically healthy obesity (MHO) category. We have observed that in our groups, the prevalence of hyperlipidemia, hypertension, asthma, obstructive sleep apnea (OSA) depended on BMI category, whereas the incidence of hyperlipidemia, hypertension, OSA, hypothyroidism, non-alcoholic fatty liver disease, prediabetes, and type 2 diabetes was related to the metabolic category. We concluded that the distribution of particular organ and endocrine complications change significantly with increased BMI and with the shift from MHO to pre-MetS and MetS. Thus, to determine the risk of organ and endocrine complications more effectively, BMI and metabolic status should be assessed during the examination of patients with obesity.
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Nkondo-Ndaba MP, Joubert PM, Ballyram T, van Rensburg CJ. Influence of first- and second-generation antipsychotics on anthropometric parameters of male psychiatric patients. S Afr J Psychiatr 2022. [DOI: 10.4102/sajpsychiatry.v2i0.1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Ottino C, Strippoli MPF, Gholam M, Lasserre AM, Vandeleur CL, Vollenweider P, Marques-Vidal P, Clair C, Preisig M. Short-term and long-term effects of major depressive disorder subtypes on obesity markers and impact of sex on these associations. J Affect Disord 2022; 297:570-578. [PMID: 34718038 DOI: 10.1016/j.jad.2021.10.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 09/25/2021] [Accepted: 10/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Only a few studies with conflicting results have examined the effects of sex on the prospective association between depression and subsequent obesity. OBJECTIVE (1) To simultaneously assess the associations of the subtypes (atypical, melancholic, unspecified) of major depressive disorder (MDD) measured at baseline and subtypes of major depressive episodes (MDE) that emerged during a 5.5-year follow-up with changes in obesity markers (body mass index, waist circumference, fat mass) during this follow-up, and (2) to test the effect of sex on these associations. METHODS Data from CoLaus|PsyCoLaus, a population-based cohort study including 2702 participants (50.1% women, mean age 49.6 years). Criteria for mental disorders were elicited using semi-structured interviews. RESULTS History of atypical MDD at baseline was associated with a steeper increase in BMI and waist circumference, whereas atypical MDE during follow-up was associated with a steeper increase in the three studied obesity markers. Melancholic MDD at baseline was associated with a steeper increase in BMI. Several significant interactions with sex were found indicating higher increase in fat mass in men than in women following melancholic MDD reported at baseline, higher decrease in BMI and fat mass in women than in men related to melancholic MDE emerging during follow-up and higher increase in waist circumference in men than in women following unspecified MDD reported at baseline. LIMITATIONS Urban sample which may not be representative for the whole population. CONCLUSIONS Our results further advocate for the specific need of a thorough monitoring of obesity markers in patients with atypical MDD and suggest less favorable obesity marker changes mainly related to melancholic MDE in men.
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Affiliation(s)
- Clémentine Ottino
- Faculty of Biology and Medicine, University of Lausanne, Av. Edouard-Rod 28, Lausanne CH-1007, Switzerland.
| | - Marie-Pierre F Strippoli
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mehdi Gholam
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Aurélie M Lasserre
- Addiction Medicine, Department of psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Caroline L Vandeleur
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Carole Clair
- Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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19
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Sinatora RV, Chagas EFB, Mattera FOP, Mellem LJ, dos Santos ARDO, Pereira LP, Aranão ALDC, Guiguer EL, Araújo AC, Haber JFDS, Guissoni LC, Barbalho SM. Relationship of Inflammatory Markers and Metabolic Syndrome in Postmenopausal Women. Metabolites 2022; 12:73. [PMID: 35050195 PMCID: PMC8779625 DOI: 10.3390/metabo12010073] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
The increased deposition of visceral fat in the postmenopause period increases the production of inflammatory cytokines and the release of tumor necrosis factor- α (TNF-α), interleukin-6 (IL-6), and decrease in IL-10. This study investigated the relationship between inflammatory biomarkers and metabolic syndrome (MS) in postmenopausal women considering different diagnostic criteria. We conducted a cross-sectional observational study based on STROBE. Data were collected regarding the diagnostic criteria for MS (International Diabetes Federation; NCEP (International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III), and Harmonized criteria), body composition, comorbidities, time without menstruation, values of IL-6, IL-10, and TNF-α. ANOVA, Kruskal-Wallis, Levene tests, ROC, and odds ratio were performed to analyze the data. The results showed no significant difference between the methods and no interaction between the method and the presence of MS. However, for the values of WC, body fat percentage, TNF-α, and IL-10/TNF-α ratio, a significant effect of MS was observed. In subjects with MS, lower values of body fat percentage and TNF-α and higher values of the IL-10/TNF-α ratio were also observed. The higher IL-10/TNF-α ratio in the MS group is related to the greater anti-inflationary action of IL-10. The IL-10/TNF-α ratio showed significant accuracy to discriminate patients with MS according to the NCEP-ATP III criteria.
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Affiliation(s)
- Renata Vargas Sinatora
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
| | - Eduardo Federighi Baisi Chagas
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Interdisciplinary Center on Diabetes (CENID), University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil;
- Postgraduate Program, Faculty of Medicine of Marília (FAMEMA), Marília 17519-030, SP, Brazil
| | - Fernando Otavio Pires Mattera
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Interdisciplinary Center on Diabetes (CENID), University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil;
| | - Luciano Junqueira Mellem
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Interdisciplinary Center on Diabetes (CENID), University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil;
| | - Ana Rita de Oliveira dos Santos
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil;
| | - Larissa Pires Pereira
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
| | - Ana Luíza de Carvalho Aranão
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
| | - Elen Landgraf Guiguer
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil;
- School of Food and Technology of Marilia (FATEC), Marília 17500-000, SP, Brazil
| | - Adriano Cressoni Araújo
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil;
| | - Jesselina F. dos Santos Haber
- Interdisciplinary Center on Diabetes (CENID), University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil;
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil;
| | - Leila Campos Guissoni
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil;
| | - Sandra Maria Barbalho
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil; (R.V.S.); (E.F.B.C.); (F.O.P.M.); (L.J.M.); (L.P.P.); (A.L.d.C.A.); (E.L.G.); (A.C.A.); (L.C.G.)
- Interdisciplinary Center on Diabetes (CENID), University of Marilia (UNIMAR), Marília 17525-902, SP, Brazil;
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil;
- School of Food and Technology of Marilia (FATEC), Marília 17500-000, SP, Brazil
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20
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Moreira NCDV, Mdala I, Hussain A, Bhowmik B, Siddiquee T, Fernandes VO, Montenegro RM, Meyer HE. Cardiovascular Risk, Obesity, and Sociodemographic Indicators in a Brazilian Population. Front Public Health 2021; 9:725009. [PMID: 34917567 PMCID: PMC8669243 DOI: 10.3389/fpubh.2021.725009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023] Open
Abstract
Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population. Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs. Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined. Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age <45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index. Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.
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Affiliation(s)
- Nayla Cristina do Vale Moreira
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway.,Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil.,Faculty of Health Sciences, NORD University, Bodø, Norway
| | - Ibrahimu Mdala
- Department of General Practice, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway
| | - Akhtar Hussain
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil.,Faculty of Health Sciences, NORD University, Bodø, Norway.,Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh.,International Diabetes Federation, Brussels, Belgium
| | - Bishwajit Bhowmik
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Tasnima Siddiquee
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | | | - Renan M Montenegro
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil
| | - Haakon E Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
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21
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Shrestha R, Upadhyay SK, Khatri B, Bhattarai JR, Kayastha M, Upadhyay MP. BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study. BMJ Open 2021; 11:e050096. [PMID: 34824112 PMCID: PMC8628118 DOI: 10.1136/bmjopen-2021-050096] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This non-inferiority study aimed to determine the burden of obesity in a hospital outpatient setting of a developing country, using three commonly employed metrics as predictors of hypertension (HTN). DESIGN A cross-sectional study design was adopted. SETTING This study was conducted in Health Promotion and Risk Factor Screening Services of a tertiary hospital for eye and ear, nose, throat in a semiurban area of Nepal. PARTICIPANTS 2256 randomly selected outpatients between 40 and 69 years old. OUTCOME MEASURES The three obesity metrics and HTN were analysed for association using correlation, the area under the receiver operating characteristic (ROC) curve and ORs. RESULTS The prevalence of obesity or overweight by body mass index (BMI) was 58.29%; by waist-to-height ratio (WHtR) was 85.95%, high waist circumference (WC) was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of HTN and pre-HTN were 40.67% and 36.77%, respectively. The areas under the ROC curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602) and WC (0.610). CONCLUSION This study showed that WHtR and WC measured were not inferior to BMI as a metric for obesity detection and HTN prediction. Because of its low cost, simplicity of measurement and better ability to predict HTN, it may become a more usable metric in health facilities of low-income and middle-income countries.
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Affiliation(s)
- Rajan Shrestha
- Hospital for Children, Eye, ENT and Rehabilitation Services, Academic and Research Department, B P Eye Foundation, Bhaktapur, Bagmati, Nepal
| | - Sanjib Kumar Upadhyay
- Hospital for Children, Eye, ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Bijay Khatri
- Hospital for Children, Eye, ENT and Rehabilitation Services, Academic and Research Department, B P Eye Foundation, Bhaktapur, Bagmati, Nepal
| | - Janak Raj Bhattarai
- Hospital for Children, Eye, ENT and Rehabilitation Services, Academic and Research Department, B P Eye Foundation, Bhaktapur, Bagmati, Nepal
| | - Manish Kayastha
- Hospital for Children, Eye, ENT and Rehabilitation Services, Academic and Research Department, B P Eye Foundation, Bhaktapur, Bagmati, Nepal
| | - Madan Prasad Upadhyay
- Hospital for Children, Eye, ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
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22
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de Almeida RT, Matos SMA, Aquino EML. Individual and Combined Performance of Indicators of Overall and Central Obesity to Estimate Coronary Risk in ELSA-Brasil Participants. Arq Bras Cardiol 2021; 117:701-712. [PMID: 34346941 PMCID: PMC8528349 DOI: 10.36660/abc.20200360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/08/2020] [Accepted: 11/04/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Anthropometric indicators have been used in clinical practice and epidemiological studies for screening of health risk factors. OBJECTIVES To evaluate the individual discriminatory power of body adiposity index (BAI), body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) to identify individuals at risk for coronary heart disease and to evaluate whether combinations of anthropometric indicators of overall obesity with indicators of central obesity improve predictive ability in adults. METHODS A total of 15,092 participants (54.4% women) aged 35-74years were assessed at baseline of the ELSA-Brasil study. Individuals at risk for coronary heart disease were identified using the Framingham risk score and divided into very-high risk (VHR 20%) and high risk (HR10%). Measures of diagnostic accuracy and area under the ROC curves (AUC) were analyzed. Associations were tested using Poisson regression analysis with robust variance, according to age and sex. Statistical significance was set at 5%. RESULTS WHR showed the highest discriminatory power for VHR20% in all groups, with higher predictive ability in women (AUC: 0.802; 95%CI: 0.748-0.856 vs 0.657; 95%CI: 0.630-0.683 in the age range of 35-59 years, and AUC: 0.668; 95%CI: 0.621-0.715 vs 0.611; 95%CI: 0.587-0.635 in the age range of 60-74 years). BAI + WHR and BMI + WHR had the highest predictive power in men and women, respectively. Combinations of indicators of overall obesity with indicators of central obesity were more strongly associated with VHR20% and HR10% in all subgroups. CONCLUSION Combined indicators had greater predictive ability than indicators taken individually. BAI+ WHR and BMI + WHR were the best estimators of coronary risk in men and women, respectively, and WHR had the best individual performance.
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Affiliation(s)
- Rogério Tosta de Almeida
- Universidade Estadual de Feira de SantanaDepartamento de SaúdeFeira de SantanaBABrasilUniversidade Estadual de Feira de Santana - Departamento de Saúde, Feira de Santana, BA – Brasil
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia - Instituto de Saúde Coletiva, Salvador, BA – Brasil
| | - Sheila Maria Alvim Matos
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia - Instituto de Saúde Coletiva, Salvador, BA – Brasil
| | - Estela M. L. Aquino
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia - Instituto de Saúde Coletiva, Salvador, BA – Brasil
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23
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Wang H, Zhao M, Magnussen CG, Xi B. Change in waist circumference over 2 years and the odds of left ventricular hypertrophy among Chinese children. Nutr Metab Cardiovasc Dis 2021; 31:2484-2489. [PMID: 34088584 DOI: 10.1016/j.numecd.2021.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/18/2021] [Accepted: 04/30/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS High waist circumference (WC) is associated with left ventricular mass index (LVMI) in childhood. However, no studies have assessed the association between WC change and left ventricular hypertrophy (LVH) in childhood. This study aimed to investigate the association between change in WC status over 2 years on LVH among Chinese children. METHODS AND RESULTS Data were from a population-based prospective cohort study in China. Children without LVH at baseline (n = 1067) were assigned to four WC status change groups (persistent normal WC, WC loss, WC gain, and persistent abdominal obesity). Over a 2-year follow-up, 103 (out of 1067) children had LVH. LVMI levels were the highest among the persistent abdominal obesity group (31.5 ± 3.8 g/m 2.7), lower in the WC gain group (31.0 ± 3.6 g/m 2.7) and the WC loss group (29.8 ± 3.7 g/m 2.7), and lowest in the persistent normal WC group (29.1 ± 3.7 g/m 2.7). Compared with children in the persistent normal WC group, the odds of LVH was highest in the persistent abdominal obesity group [odds ratio (OR) = 3.57, 95% confidence interval (CI): 2.18-5.83], followed by the WC gain group (OR = 2.85, 95% CI: 1.50-5.41). In contrast, the odds of LVH was not increased in the WC loss group (OR = 0.93, 95% CI: 0.21-4.07). CONCLUSION Although these findings highlight the importance of maintaining normal WC in childhood to reduce the odds of developing LVH, our data suggest the increased odds associated with abdominal obesity can be reversed by WC loss.
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Affiliation(s)
- Huan Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Min Zhao
- Department of Toxicology and Nutrition, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
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Ferreira HS, Soares ML, Krakauer NY, Santos EA, Krakauer JC, Uchôa TC, Santos TR, Dos Anjos LA. What is the best anthropometric predictor for identifying higher risk for cardiovascular diseases in afro-descendant Brazilian women? A cross-sectional population-based study. Am J Hum Biol 2021; 34:e23652. [PMID: 34292635 DOI: 10.1002/ajhb.23652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Excessive adiposity is associated with cardiovascular disease (CVD). Anthropometric indices are useful in screening individuals at higher risk for these diseases. However, there are no studies that show which of these indices has the best discriminatory power among Afro-descendant Brazilian women. The objective of this study was to assess the accuracy of anthropometric indices in identifying risk factors for CVD in Afro-descendant Brazilian women and define the one most suitable for use under the operating conditions prevailing in Quilombola communities. METHODS A household random sample of 1661 women descendants of African slaves were analyzed. The anthropometric predictors analyzed were waist circumference (WC), body mass index, waist-to-height ratio, conicity index (C-index), body shape index, and percentage of body fat (%BF; estimated by bioimpedance). The assessed risk factors for CVD were arterial hypertension, diabetes mellitus, and dyslipidemias (hypertriglyceridemia; hypercholesterolemia; low high-density lipoprotein). To identify the statistical significance between the differences in the areas under the ROC curves (AUC) obtained with the different predictors and outcomes, was used the Bonferroni test adjusted for multiple analyses by the Sidak method. RESULTS The AUC obtained with WC was higher (p < .05) or similar (p > .05) to those obtained with the other predictors 29 times out of 30 possibilities (six predictors x five outcomes). Only the AUC obtained with C-index in identifying hypercholesterolemia was significantly higher than that with WC. CONCLUSION Due to its accuracy and greater operational simplicity, WC was the most adequate predictor for identifying Afro-descendant women at greatest risk for CVD.
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Affiliation(s)
- Haroldo S Ferreira
- Faculty of Nutrition, Federal University of Alagoas (UFAL), Maceió, Brazil
| | - Mariana L Soares
- Master's Program in Nutrition, Faculty of Nutrition, UFAL, Maceió, Brazil
| | - Nir Y Krakauer
- Department of Civil Engineering, The City College of New York, New York, USA
| | | | | | - Tainá C Uchôa
- Undergraduate Course in Medicine. Faculty of Medicine, University of Brasilia, Brasilia, Brazil
| | - Tamara R Santos
- Doctoral Program in Health Sciences, Institute of Biological and Health Sciences, UFAL, Maceió, Brazil
| | - Luiz Antonio Dos Anjos
- Department of Social Nutrition and Nutritional Sciences Graduate Program, Fluminense Federal University, Rio de Janeiro, Brazil
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25
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Waist circumference change and risk of high carotid intima-media thickness in a cohort of Chinese children. J Hypertens 2021; 39:1901-1907. [PMID: 34054052 DOI: 10.1097/hjh.0000000000002881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Previous cross-sectional studies showed a positive association between waist circumference (WC) and carotid intima-media thickness (cIMT) among children and adolescents. We examined the association between change in WC and cIMT in a cohort study of Chinese children with 2-year follow-up. METHODS A school-based cohort study named 'Huantai Childhood Cardiovascular Health Cohort Study' was conducted in Zibo City, Shandong Province, China. WC and cIMT were measured in 2017 and 2019. Change in WC was categorized into four groups: persistently low WC, WC loss, WC gain and persistently high WC. We examined the association between WC change and cIMT during a 2-year follow-up. RESULTS A total of 1183 children aged 6-11 years at baseline were included in this study. After adjustment for potential covariates, WC change was associated positively with cIMT change (linear regression coefficient = 5.92 μm/cm per 2 years, 95% confidence interval [CI]: 4.55-7.30). Among the 1072 children (out of 1183 children) with normal cIMT at baseline, compared with persistently low WC, WC gain (odds ratio [OR] = 3.23, 95% CI: 1.14-9.17) and persistently high WC (OR = 7.94, 95% CI: 3.81-16.51) were associated with high cIMT at the end of the follow-up period. In contrast, WC loss during follow-up was not associated with high cIMT (OR = 1.33, 95% CI:0.35-5.11). CONCLUSION In this cohort of children, WC gain and persistently high WC were associated with increased cIMT whereas WC loss was not. These findings emphasize the importance of maintaining a normal WC in childhood to promote vascular health.
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Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH. The Direct Effect of Body Mass Index on Cardiovascular Outcomes among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation. Arq Bras Cardiol 2021; 116:879-886. [PMID: 34008807 PMCID: PMC8121468 DOI: 10.36660/abc.20200231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/09/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Body mass index (BMI) is the most commonly used index to categorize a person as obese or non-obese, which is subject to important limitations. OBJECTIVE To evaluate the direct effect of BMI on cardiovascular outcomes among participants without central obesity. METHODS This analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities Study (ARIC). BMI was measured as general obesity, and waist circumference (WC), waist-to-hip ratio (WHR) and hip circumference as central obesity. Targeted maximum likelihood estimation (TMLE) was used to estimate the total effects (TEs) and the controlled direct effects (CDEs). The proportion of TE that would be eliminated if all participants were non-obese regarding central obesity was computed using the proportion eliminated (PE) index. P <0.05 was considered statistically significant. Analyses were performed in the TMLE R package. RESULTS The risk of cardiovascular outcomes attributed to BMI was significantly reversed by eliminating WHR obesity (p<0.001). The proportion eliminated of BMI effects was more tangible for non-obese participants regarding WC (PE=127%; 95%CI (126,128)) and WHR (PE=97%; 95%CI (96,98)) for coronary heart disease (CHD), and WHR (PE=92%; 95%CI (91,94)) for stroke, respectively. With respect to sex, the proportion eliminated of BMI effects was more tangible for non-obese participants regarding WHR (PE=428%; 95%CI (408,439)) for CHD in males, and WC (PE=99%; 95%CI (89,111)) for stroke in females, respectively. CONCLUSION These results indicate different potential effects of eliminating central obesity on the association between BMI and cardiovascular outcomes for males and females. (Arq Bras Cardiol. 2021; 116(5):879-886).
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Affiliation(s)
- Hossein Mozafar Saadati
- Departamento de Epidemiologia, Faculdade de Saúde Pública e Segurança, Shahid Beheshti University of Medical Sciences, Tehran - Irã
| | - Siamak Sabour
- Departamento de Epidemiologia, Faculdade de Saúde Pública e Segurança, Shahid Beheshti University of Medical Sciences, Tehran - Irã
| | - Mohammad Ali Mansournia
- Departamento de Epidemiologia e Bioestatística, Faculdade de Saúde Pública, Tehran University of Medical Sciences, Tehran - Irã
| | - Yadollah Mehrabi
- Departamento de Epidemiologia, Faculdade de Saúde Pública e Segurança, Shahid Beheshti University of Medical Sciences, Tehran - Irã
| | - Seyed Saeed Hashemi Nazari
- Centro de Pesquisa de Prevenção de Doenças Cardiovasculares, Faculdade de Saúde Pública e Segurança, Shahid Beheshti University of Medical Sciences, Tehran - Irã
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Knowles R, Carter J, Jebb SA, Bennett D, Lewington S, Piernas C. Associations of Skeletal Muscle Mass and Fat Mass With Incident Cardiovascular Disease and All-Cause Mortality: A Prospective Cohort Study of UK Biobank Participants. J Am Heart Assoc 2021; 10:e019337. [PMID: 33870707 PMCID: PMC8200765 DOI: 10.1161/jaha.120.019337] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/01/2021] [Indexed: 02/06/2023]
Abstract
Background There is debate whether body mass index is a good predictor of health outcomes because different tissues, namely skeletal muscle mass (SMM) and fat mass (FM), may be differentially associated with risk. We investigated the association of appendicular SMM (aSMM) and FM with fatal and nonfatal cardiovascular disease (CVD) and all-cause mortality. We compared their prognostic value to that of body mass index. Methods and Results We studied 356 590 UK Biobank participants aged 40 to 69 years with bioimpedance analysis data for whole-body FM and predicted limb muscle mass (to calculate aSMM). Associations between aSMM and FM with CVD and all-cause mortality were examined using multivariable Cox proportional hazards models. Over 3 749 501 person-years of follow-up, there were 27 784 CVD events and 15 844 all-cause deaths. In men, aSMM was positively associated with CVD incidence (hazard ratio [HR] per 1 SD 1.07; 95% CI, 1.06-1.09) and there was a curvilinear association in women. There were stronger positive associations between FM and CVD with HRs per SD of 1.20 (95% CI, 1.19-1.22) and 1.25 (95% CI, 1.23-1.27) in men and women respectively. Within FM tertiles, the associations between aSMM and CVD risk largely persisted. There were J-shaped associations between aSMM and FM with all-cause mortality in both sexes. Body mass index was modestly better at discriminating CVD risk. Conclusions FM showed a strong positive association with CVD risk. The relationship of aSMM with CVD risk differed between sexes, and potential mechanisms need further investigation. Body fat and SMM bioimpedance measurements were not superior to body mass index in predicting population-level CVD incidence or all-cause mortality.
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Affiliation(s)
- Rebecca Knowles
- Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Jennifer Carter
- Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordUnited Kingdom
| | - Derrick Bennett
- Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Sarah Lewington
- Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordUnited Kingdom
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Biteli P, Barbalho SM, Detregiachi CRP, Dos Santos Haber JF, Chagas EFB. Dyslipidemia influences the effect of physical exercise on inflammatory markers on obese women in post-menopause: A randomized clinical trial. Exp Gerontol 2021; 150:111355. [PMID: 33865923 DOI: 10.1016/j.exger.2021.111355] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 02/07/2023]
Abstract
The hormonal modifications observed in post-menopausal are related to increased adiposity and alteration in the lipid profile besides physical and psychological changes. Physical exercises may attenuate these conditions and have been associated with low-grade inflammatory status, reducing the risk of cardiovascular diseases. This study aimed to evaluate the influence of dyslipidemia on the effect of physical exercise on inflammatory markers IL6, IL10, and TNF-α in obese post-menopausal women. A randomized clinical trial was carried out in seventy women divided into four groups: exercise without dyslipidemia (EG/n = 11); exercise with dyslipidemia (EGD = 24); control with dyslipidemia (CGD/n = 22); and control without dyslipidemia (CG/n = 13). The serum values of IL-6, IL-10, and TNF-α were measured before and after the intervention period, and the exercise program lasted 20 weeks, in three weekly sessions of 75 min each, with aerobic and strength exercises. The comparison of means was performed using the ANOVA test, repeated measures to analyze the interaction between the group and intervention time. There were a significant reduction in IL-6 values and an increase in IL-10/IL-6 and IL-10/TNF-α ratios only in the EG group. For serum TNF-α values, the EG and EGD groups showed significant reductions. The groups that practiced exercises did not present significant variation in the levels of IL-10. However, the CGD and GC groups showed a significant reduction in IL-10 after the intervention period.
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Affiliation(s)
- Piero Biteli
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, UNIMAR, Marília, SP, Brazil
| | - Sandra Maria Barbalho
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, UNIMAR, Marília, SP, Brazil; School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília, São Paulo, Brazil; School of Food and Technology of Marilia (FATEC), Marilia, SP, Brazil.
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Mozafar Saadati H, Sabour S, Mansournia MA, Mehrabi Y, Hashemi Nazari SS. Effect modification of general and central obesity by sex and age on cardiovascular outcomes: Targeted maximum likelihood estimation in the atherosclerosis risk in communities study. Diabetes Metab Syndr 2021; 15:479-485. [PMID: 33662834 DOI: 10.1016/j.dsx.2021.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS To elucidate the effect modification of general and central obesity by sex and age on the risk of cardiovascular events. METHODS The analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities study. Obesity was defined with body mass index (BMI), waist-to-hip ratio (WHR) and body shape index (BSI) which categorized the participants as obese and non-obese. Targeted maximum likelihood estimation was used to estimate the risk ratio (RR) with the tmle package in R software. RESULTS After adjustment, the strongest effect of BMI on CHD was in females (RR (95%CI): 1.26 (1.11, 1.42)) and in age>54 (RR (95%CI): 1.16 (1.06, 1.27)) and for HF it was in age>54 (RR (95%CI): 1.18 (1.10, 1.26)) and in females (RR (95%CI): 1.17 (1.08, 1.28)). Regarding central obesity, WHR (RR (95%CI): 1.19 (1.05, 1.34)) had the strongest effects on CHD for males and BSI (RR (95%CI): 1.140 (1.02, 1.26)) for age ≤ 54, and for HF the WHR (RR (95%CI): 1.22 (1.10, 1.36)) and BSI (RR (95%CI): 1.18 (1.07, 1.30)) had the strongest effects for age≤54, respectively. CONCLUSION Among males and age≤54, WHR index was associated with a higher risk of CHD and HF while BMI was so for females and age>54.
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Affiliation(s)
- Hossein Mozafar Saadati
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Siamak Sabour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyed Saeed Hashemi Nazari
- Prevention of Cardiovascular Disease Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Differences in the Cardiovascular Risk Assessment in Cardiology Outpatients in Mali: Comparison between Framingham Body Mass Index-Based Tool and Low-Information World Health Organization Chart. Int J Hypertens 2021. [DOI: 10.1155/2021/8862762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective. This study aimed to compare 2 laborless tools, namely, the body mass index-based Framingham (bmi-Frm) and low-information WHO- (li-WHO-) based risk scores, and assess their agreement in outpatients in a cardiology department. Methodology. Data stem from a cross-sectional previous study performed from May to September 2016 in the Cardiology Department of University Hospital Gabriel Touré (UH-GT) in Bamako. All patients aged 40 and more were included in the study allowing the assessment of bmi-Frm and li-WHO prediction charts. The cardiovascular risk (CVR) was evaluated using a calculator prepared by D‘Agostino et al. for the bmi-Frm and the li-WHO chart for the Afro-D region of the WHO. The risk score for both ranged from <10 to ≥40. The data were entered in an ACCESS 2010 database, then processed by MS Excel 2010, and finally analysed using IBM SPSS Statistics 20. Continuous variables were presented as means and standard deviations, and categorical variables were presented as frequencies with percentages.
was considered the statistical significance level. After sample description, the risk score was assessed using bmi-Frm and li-WHO prediction tools. Finally, a kappa test was performed to check for the interreliability of both methods. For weighted kappa, coefficients were given all five classes of risk groups in 0, 25 steps from 1 for total concordance to 0 for total discordance. Results. This study involved 793 outpatients, 63.7% being female, 35.1% of them younger than 50 years, 57.9% with no formal education, and 67.7% with no medical insurance. Means for age, body mass index (BMI), and systolic blood pressure (SBP) were, respectively, 53.81 ± 16.729 years, 25.29 ± 06.151 kg/m2, and 139.49 ± 27.110 mm Hg. Using the li-WHO prediction chart gives a much higher proportion of low-risk patients compared to bmi-Frm (83.6 vs. 37.7). Sociodemographic characteristics such as education or income level were not different in risk score neither for the bmi-Frm nor for the li-WHO risk score. The percentage of agreement between both tools was 40.4%, and agreement (kappa of 0.1 and weighted kappa of 0.2) was found to be slight. Conclusion. Using the bmi-Frm and li-WHO tool gives a similar risk estimation in younger female patients. Older patients must be evaluated using high-information tools with cholesterol, e.g., versions of the Framingham risk equation or WHO using cholesterol. These must be confirmed in further studies and compared to data from prospective studies
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Dedov II, Shestakova MV, Melnichenko GA, Mazurina NV, Andreeva EN, Bondarenko IZ, Gusova ZR, Dzgoeva FK, Eliseev MS, Ershova EV, Zhuravleva MV, Zakharchuk TA, Isakov VA, Klepikova MV, Komshilova KA, Krysanova VS, Nedogoda SV, Novikova AM, Ostroumova OD, Pereverzev AP, Rozhivanov RV, Romantsova TI, Ruyatkina LA, Salasyuk AS, Sasunova AN, Smetanina SA, Starodubova AV, Suplotova LA, Tkacheva ON, Troshina EA, Khamoshina MV, Chechelnitskaya SM, Shestakova EA, Sheremet’eva EV. INTERDISCIPLINARY CLINICAL PRACTICE GUIDELINES "MANAGEMENT OF OBESITY AND ITS COMORBIDITIES". OBESITY AND METABOLISM 2021; 18:5-99. [DOI: 10.14341/omet12714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - M. S. Eliseev
- Research Institute of Rheumatogy named after V.A. Nasonova
| | | | | | | | - V. A. Isakov
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | - M. V. Klepikova
- Russian Medical Academy of Continuous Professional Education
| | | | | | | | - A. M. Novikova
- Research Institute of Rheumatogy named after V.A. Nasonova
| | - O. D. Ostroumova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - A. P. Pereverzev
- Russian National Research Medical University named after N.I. Pirogov
| | | | | | | | | | - A. N. Sasunova
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | | | | | | | - O. N. Tkacheva
- Russian National Research Medical University named after N.I. Pirogov
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32
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Zhang YX. Letter to the Editor: "International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years". J Clin Endocrinol Metab 2020; 105:5913409. [PMID: 32997789 DOI: 10.1210/clinem/dgaa578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/15/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
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Lampignano L, Zupo R, Donghia R, Guerra V, Castellana F, Murro I, Di Noia C, Sardone R, Giannelli G, De Pergola G. Cross-sectional relationship among different anthropometric parameters and cardio-metabolic risk factors in a cohort of patients with overweight or obesity. PLoS One 2020; 15:e0241841. [PMID: 33152746 PMCID: PMC7644056 DOI: 10.1371/journal.pone.0241841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Body fat distribution influences the risk of cardio-metabolic disease in people with overweight. This study was aimed at identifying the anthropometric parameters more strongly associated with the majority of cardio-metabolic risk factors. METHODS This study included 1214 subjects (840 women), with a body-mass-index (BMI) ≥ 25 Kg/m2, aged 39.2 ± 13 years. Fasting blood glucose (FBG), triglycerides (TG), total, HDL- and LDL-cholesterol, uric acid, vitamin D, high-sensitive C-reactive protein (hs-CRP), white blood cells (WBC), platelets, insulin and insulin resistance (HOMA-IR), systolic (SBP) and diastolic blood pressure (DBP), smoking habit and snoring were evaluated as cardio-metabolic risk factors.We also included the Systematic COronary Risk Evaluation (SCORE) to estimate cardiovascular risk in our study population. BMI, waist circumference (WC), waist-to-height-ratio (WHtR) and neck circumference (NC) were evaluated as anthropometric parameters. RESULTS All four anthropometric parameters were positively associated to SBP, DBP, TG, FBG, insulin, HOMA-IR, WBC, and snoring (p<0.001), and negatively associated with HDL-cholesterol (p<0.001). NC showed a positive association with LDL-cholesterol (β = 0.76; p = 0.01; 95% C.I. 0.19 to 1.32), while vitamin D was negatively associated to WC (β = -0.16; p<0.001; 95% C.I. -0.24 to -0.09), BMI (β = 0.42); p<0.001; 95% C.I. -0.56 to -0.28) and WHtR (β = -24.46; p<0.001; 95% C.I. -37 to -11.9). Hs-CRP was positively correlated with WC (β = 0.003; p = 0.003; 95% C.I. 0.001 to 0.006), BMI (β = 0.01; p = 0.02; 95% C.I. 0.001 to 0.012) and WHtR (β = 0.55; p = 0.01; 95% C.I. 0.14 to 0.96). SCORE was associated to NC (β = 0.15; 95% CI 0.12 to 0.18; p<0.001), BMI (β = -0.18; 95% CI -0.22 to 0.14; p<0.001) and WHtR (β = 7.56; 95% CI 5.30 to 9.82; p<0.001). CONCLUSIONS NC, combined with BMI and WC or WHtR could represent an essential tool for use in clinical practice to define the cardio-metabolic risk in individuals with excess body weight.
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Affiliation(s)
- Luisa Lampignano
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Rossella Donghia
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Vito Guerra
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Isanna Murro
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Carmen Di Noia
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Rodolfo Sardone
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
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Darbandi M, Pasdar Y, Moradi S, Mohamed HJJ, Hamzeh B, Salimi Y. Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis. Prev Chronic Dis 2020; 17:E131. [PMID: 33092686 PMCID: PMC7587303 DOI: 10.5888/pcd17.200112] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Obesity is one of the main risk factors for cardiovascular disease (CVD) and cardiometabolic disease (CMD). Many studies have developed cutoff points of anthropometric indices for predicting these diseases. The aim of this systematic review was to differentiate the screening potential of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for adult CVD risk. METHODS We used relevant key words to search electronic databases to identify studies published up to 2019 that used receiver operating characteristic (ROC) curves for assessing the cut-off points of anthropometric indices. We used a random-effects model to pool study results and assessed between-study heterogeneity by using the I2 statistic and Cochran's Q test. RESULTS This meta-analysis included 38 cross-sectional and 2 cohort studies with 105 to 137,256 participants aged 18 or older. The pooled area under the ROC curve (AUC) value for BMI was 0.66 (95% CI, 0.63-0.69) in both men and women. The pooled AUC values for WC were 0.69 (95% CI, 0.67-0.70) in men and 0.69 (95% CI, 0.64-0.74) in women, and the pooled AUC values for WHR were 0.69 (95% CI, 0.66-0.73) in men and 0.71 (95% CI, 0.68-0.73) in women. CONCLUSION Our findings indicated a slight difference between AUC values of these anthropometric indices. However, indices of abdominal obesity, especially WHR, can better predict CVD occurrence.
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Affiliation(s)
- Mitra Darbandi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Jan Jan Mohamed
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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King SE, Skinner MK. Epigenetic Transgenerational Inheritance of Obesity Susceptibility. Trends Endocrinol Metab 2020; 31:478-494. [PMID: 32521235 PMCID: PMC8260009 DOI: 10.1016/j.tem.2020.02.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023]
Abstract
The prevalence of obesity and associated diseases has reached pandemic levels. Obesity is often associated with overnutrition and a sedentary lifestyle, but clearly other factors also increase the susceptibility of metabolic disease states. Ancestral and direct exposures to environmental toxicants and altered nutrition have been shown to increase susceptibility for obesity and metabolic dysregulation. Environmental insults can reprogram the epigenome of the germline (sperm and eggs), which transmits the susceptibility for disease to future generations through epigenetic transgenerational inheritance. In this review, we discuss current evidence and molecular mechanisms for epigenetic transgenerational inheritance of obesity susceptibility. Understanding ancestral environmental insults and epigenetic transgenerational impacts on future generations will be critical to fully understand the etiology of obesity and to develop preventative therapy options.
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Affiliation(s)
- Stephanie E King
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA
| | - Michael K Skinner
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA.
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Martin CJ, Muller E, Labadarios D, Veldman FJ, Kassier SM. Body composition of HIV-positive candidates for and recipients of a kidney transplant: comparative analysis between DEXA and anthropometric indices. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2020. [DOI: 10.1080/16070658.2020.1741902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- CJ Martin
- Dietetics and Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - E Muller
- Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - D Labadarios
- Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - FJ Veldman
- Department of Human Nutrition and Dietetics, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - SM Kassier
- Dietetics and Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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Xi B, Zong X, Kelishadi R, Litwin M, Hong YM, Poh BK, Steffen LM, Galcheva SV, Herter-Aeberli I, Nawarycz T, Krzywińska-Wiewiorowska M, Khadilkar A, Schmidt MD, Neuhauser H, Schienkiewitz A, Kułaga Z, Kim HS, Stawińska-Witoszyńska B, Motlagh ME, Ruzita AT, Iotova VM, Grajda A, Ismail MN, Krzyżaniak A, Heshmat R, Stratev V, Różdżyńska-Świątkowska A, Ardalan G, Qorbani M, Świąder-Leśniak A, Ostrowska-Nawarycz L, Yotov Y, Ekbote V, Khadilkar V, Venn AJ, Dwyer T, Zhao M, Magnussen CG, Bovet P. International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years. J Clin Endocrinol Metab 2020; 105:5625521. [PMID: 31723976 PMCID: PMC7059990 DOI: 10.1210/clinem/dgz195] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/12/2019] [Indexed: 01/26/2023]
Abstract
CONTEXT No universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents. OBJECTIVE To develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk. DESIGN AND SETTING We used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data from 3 countries that had available data (China, Iran, and Korea). We also examined which WC percentiles linked with WC cutoffs for central obesity in adults (at age of 18 years). MAIN OUTCOME MEASURE WC measured based on recommendation by the World Health Organization. RESULTS We validated the performance of the age- and sex-specific 90th percentile WC cutoffs calculated in children and adolescents (6-18 years of age) with normal weight (excluding youth with obesity, overweight, or underweight) by linking the percentile with cardiovascular risk (area under the curve [AUC]: 0.69 for boys; 0.63 for girls). In addition, WC percentile among normal weight children linked relatively well with established WC cutoffs for central obesity in adults (eg, AUC in US adolescents: 0.71 for boys; 0.68 for girls). CONCLUSION The international WC cutoffs developed in this study could be useful to screen central obesity in children and adolescents aged 6 to 18 years and allow direct comparison of WC distributions between populations and over time.
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Affiliation(s)
- Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
- Correspondence and Reprint Requests: Bo Xi, Department of Epidemiology, School of Public Health, Shandong University, Jinan, China. E-mail: OR
| | - Xin’nan Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing, China
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mieczysław Litwin
- Department of Nephrology and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Young Mi Hong
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Bee Koon Poh
- Nutritional Sciences Programme and Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesotas School of Public Health, Minneapolis, USA
| | - Sonya V Galcheva
- Department of Pediatrics, Varna Medical University, Varna, Bulgaria
| | - Isabelle Herter-Aeberli
- Institute of Food, Nutrition and Health, Human Nutrition Laboratory, ETH Zurich, Zürich, Switzerland
| | - Tadeusz Nawarycz
- Department of Biophysics, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz, Poland
| | | | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
| | - Michael D Schmidt
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany and DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Zbigniew Kułaga
- Department of Public Health, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Barbara Stawińska-Witoszyńska
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Abd Talib Ruzita
- Nutritional Sciences Programme and Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Violeta M Iotova
- Department of Pediatrics, Varna Medical University, Varna, Bulgaria
| | - Aneta Grajda
- Department of Public Health, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Mohd Noor Ismail
- Faculty of Social Sciences and Leisure Management, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Alicja Krzyżaniak
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Velin Stratev
- Department of Internal Medicine, Varna Medical University, Varna, Bulgaria
| | | | - Gelayol Ardalan
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Anna Świąder-Leśniak
- Department of Anthropometry, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Lidia Ostrowska-Nawarycz
- Department of Biophysics, Chair of Experimental and Clinical Physiology, Medical University of Lodz, Lodz, Poland
| | - Yoto Yotov
- Department of cardiology, Medical University Varna, Varna, Bulgaria
| | - Veena Ekbote
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
| | - Vaman Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- George Institute for Global Health, Oxford Martin School and Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK
| | - Min Zhao
- Departments of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Pascal Bovet
- Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Kerkadi A, Suleman D, Abu Salah L, Lotfy C, Attieh G, Bawadi H, Shi Z. Adiposity Indicators as Cardio-Metabolic Risk Predictors in Adults from Country with High Burden of Obesity. Diabetes Metab Syndr Obes 2020; 13:175-183. [PMID: 32021363 PMCID: PMC6983675 DOI: 10.2147/dmso.s238748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In Qatar more than 70% 0f the adults are overweight and obese. Different adiposity assessment methods have been proposed to identify individuals at cardio-metabolic risk. PURPOSE This study aimed to compare anthropometric indicators with Dual-energy X-ray absorptiometry (DXA) -derived adiposity indicators in predicting cardio-metabolic risk among Qatari adults. PATIENTS AND METHODS A random sample of five hundred and fifty-eight (558) healthy Qatari adults (men and women) aged 20 to 50 years was obtained from Qatar Biobank survey data. Anthropometric data (weight, height, and waist circumference), the DXA-derived data, and cardio-metabolic (CM) risk parameters were analyzed. A Spearman partial correlation coefficient, Receiver Operating Characteristics (ROC) curve and an area under curve (AUC) were used to assess the predicting ability of adiposity indicators for CM risk factors. RESULTS Adiposity indices (anthropometric and DXA) were significantly correlated with most of the CM indicators (r= -0.292 to 0.486, p< 0.001). The AUC of waist to height ratio (WHtR) was significantly higher than that of body mass index (BMI) and waist circumference (WC) in the prediction of low high density lipoprotein (HDL) (AUC=0.65, AUC=0.59; AUC=0.64), high low density lipoprotein (LDL) (AUC=0.67; AUC=0.62; AUC=0.66), high cholesterol (AUC=0.66; AUC=0.63; AUC=0.63), and high Homeostatic Model Assessment- (HOMA) (AUC= 0.81; AUC= 0.78; AUC=0.78). Among DXA- parameters, trunk fat had the highest AUCs for total cholesterol (AUC= 0.64, CI=0.56, 0.73), triglycerides and glucose index (TyG) (AUC=0.69, CI=0.64, 0.74), and HOMA (AUC=0.78, CI= 0.73, 0.84). CONCLUSION Results of the present study show that adiposity indicators (WC and WHtR) are clinically valuable tools to identify individuals at risk of CVD compared to DXA-derived parameters, while DXA can provide more accurate estimates.
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Affiliation(s)
- Abdelhamid Kerkadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
- Correspondence: Abdelhamid Kerkadi Tel +974 4403 4806Fax +974 4403 4801 Email
| | - Dana Suleman
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Lana Abu Salah
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Christina Lotfy
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Grace Attieh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
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Stewart J, Addy K, Campbell S, Wilkinson P. Primary prevention of cardiovascular disease: Updated review of contemporary guidance and literature. JRSM Cardiovasc Dis 2020; 9:2048004020949326. [PMID: 32994926 PMCID: PMC7502686 DOI: 10.1177/2048004020949326] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/01/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular disease remains a substantial concern in terms of global mortality and morbidity, while prevalence of cardiovascular disease is increasing as treatment modalities improve survival. With an ageing population and increasing costs of chronic medical care, primary prevention of cardiovascular disease is an important target for healthcare providers. Since the previous iteration of this paper, new international guidelines have been produced regarding hypertension and lipid lowering therapies, whilst there is a growing body of evidence and new therapies emerging in other areas of lifestyle and pharmacotherapeutic intervention. This review outlines emerging evidence in the field and compares and contrasts contemporary recommendations from European and American guidelines.
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Affiliation(s)
- Jack Stewart
- Department of Cardiology, St Thomas’ Hospital London,
Guy’s & St Thomas’ NHS Trust, London, UK
| | - Katherine Addy
- St Peter’s Hospital Chertsey, Ashford & St Peter’s
NHS Trust, Surrey, UK
| | - Sarah Campbell
- Department of Cardiology, Princess Royal University
Hospital, Kings College Hospital NHS Trust, Kent, UK
| | - Peter Wilkinson
- Department of Cardiology, Ashford & St Peter’s
Hospital NHS Trust, Chertsey, UK
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Eslami O, Shahraki M, Shahraki T. Obesity Indices in relation to Lipid Abnormalities among Medical University Students in Zahedan, South-East of Iran. Int J Prev Med 2019; 10:15. [PMID: 30820302 PMCID: PMC6390505 DOI: 10.4103/ijpvm.ijpvm_177_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 10/30/2017] [Indexed: 01/03/2023] Open
Abstract
Background: There is no statement on the ability of obesity indices in prediction of lipid abnormalities among young adults. The present study was conducted to determine the ability of obesity indices as predictors of lipid abnormalities among a group of young adults. Materials and Methods: A total of 353 medical university students aged 18–25 years (188 males and 165 females) participated in this cross-sectional study in 2014. Weight, height, waist circumference (WC), and hip circumference were measured to calculate obesity indices including body mass index (BMI), waist-to-hip ratio, and waist-to-height ratio (WHtR). Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured by commercially available kits and were applied to calculate low-density lipoprotein cholesterol (LDL-C) and atherogenic parameters including LDL-C/ HDL-C ratio, TC/HDL-C ratio, non-HDL-C, and atherogenic index of plasma (AIP). Results: Subjects with BMI ≥25 kg/m2 had a greater value of all lipid profiles and atherogenic parameters (P < 0.05) except for HDL-C (P > 0.05) compared to subjects with BMI <25 kg/m2. In logistic regression model, BMI ≥25 kg/m2 was significantly associated with the highest odds for elevated TC (odds ratio [OR] = 7.67, P = 0.003), LDL-C (OR = 3.24, P = 0.01), TC:HDL-C (OR = 4.98, P = 0.01), and non-HDL-C(OR = 4.32, P = 0.001) in males, as well as high values of TG (OR = 8.80, P = 0.002), LDL-C:HDL-C (OR = 3.64, P = 0.01), and AIP (OR = 9.65, P < 0.001) in females. In terms of central obesity indices, males with WC ≥102 cm and females with WC ≥88 cm had the highest odds of increased LDL-C:HDL-C (OR = 6.71, P = 0.01) and TC:HDL-C (OR = 3.25, P = 0.050), respectively. In addition, females with WHtR ≥0.50 had the highest odds of high TC (OR = 3.56, P = 0.02) and non-HDL-C (OR = 2.70, P = 0.02). Conclusions: Overall, the findings of the present study showed that BMI was a stronger index for prediction of classical lipid parameters and atherogenic parameters than central obesity indices in medical students.
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Affiliation(s)
- Omid Eslami
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mansour Shahraki
- Department of Nutrition, Faculty of Medicine and Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Touran Shahraki
- Department of Pediatrics, Faculty of Medicine and Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
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Fortin A, Rabasa-Lhoret R, Lemieux S, Labonté ME, Gingras V. Comparison of a Mediterranean to a low-fat diet intervention in adults with type 1 diabetes and metabolic syndrome: A 6-month randomized trial. Nutr Metab Cardiovasc Dis 2018; 28:1275-1284. [PMID: 30459054 DOI: 10.1016/j.numecd.2018.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS The metabolic syndrome (MS) is an emerging complication in patients with type 1 diabetes (T1D), with no preventive or therapeutic treatment reported yet. We wanted to compare the impact of two 6-month nutritional interventions, based on a Mediterranean (MED) or a low-fat diet, on waist circumference, anthropometric and metabolic outcomes in patients with both T1D and the MS. METHODS AND RESULTS Participants were randomized into 2 intervention groups: 1) MED-diet or 2) low-fat diet. The 6-month study included 9 teaching sessions with a registered dietitian. Anthropometric (primary outcome: waist circumference), metabolic and nutritional assessments were performed at inclusion, 3 and 6-month. We used mixed effects models to assess the effects of both interventions. 28 participants were included (50.9 ± 10.3 years old) with a mean BMI of 30.7 ± 3.3 kg/m2 and a waist circumference of 105.5 ± 8.9 cm at inclusion. A trend towards a greater reduction of dietary fat intakes in the low-fat diet group was observed (P-interaction = 0.09). Waist circumference was reduced at 6-month in both groups (-3.5 cm low-fat; -1.5 cm MED-diet) with no significant difference between groups (P-interaction = 0.43). Body mass index also significantly decreased in both groups (-0.7 kg/m2 low-fat; -1.1 kg/m2 MED-diet; P-interaction = 0.56). No significant differences between groups were observed for other metabolic parameters. CONCLUSIONS This study suggests that a 6-month non-restrictive dietary intervention in patients with T1D and MS could contribute to weight management, without significant differences between interventions for anthropometric and metabolic parameters. Further studies should investigate the long-term benefits of these diets. CLINICAL TRIAL REGISTRY NCT02821585 (https://clinicaltrials.gov/).
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Affiliation(s)
- A Fortin
- Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of nutrition, Université de Montréal, Montreal, Quebec, Canada
| | - R Rabasa-Lhoret
- Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of nutrition, Université de Montréal, Montreal, Quebec, Canada.
| | - S Lemieux
- Institut sur la nutrition et les aliments fonctionnels, Laval University, Quebec, Canada; School of Nutrition, Laval University, Quebec, Canada
| | - M-E Labonté
- Institut sur la nutrition et les aliments fonctionnels, Laval University, Quebec, Canada; School of Nutrition, Laval University, Quebec, Canada
| | - V Gingras
- Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of nutrition, Université de Montréal, Montreal, Quebec, Canada
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Carrillo-Larco RM, Miranda JJ, Gilman RH, Checkley W, Smeeth L, Bernabé-Ortiz A. Trajectories of body mass index and waist circumference in four Peruvian settings at different level of urbanisation: the CRONICAS Cohort Study. J Epidemiol Community Health 2018; 72:397-403. [PMID: 29472520 PMCID: PMC5909748 DOI: 10.1136/jech-2017-209795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 12/31/2017] [Accepted: 01/26/2018] [Indexed: 11/29/2022]
Abstract
Background Studies have reported the incidence/risk of becoming obese, but few have described the trajectories of body mass index (BMI) and waist circumference (WC) over time, especially in low/middle-income countries. We assessed the trajectories of BMI and WC according to sex in four sites in Peru. Methods Data from the population-based CRONICAS Cohort Study were analysed. We fitted a population-averaged model by using generalised estimating equations. The outcomes of interest, with three data points over time, were BMI and WC. The exposure variable was the factorial interaction between time and study site. Results At baseline mean age was 55.7 years (SD: 12.7) and 51.6% were women. Mean follow-up time was 2.5 years (SD: 0.4). Over time and across sites, BMI and WC increased linearly. The less urbanised sites showed a faster increase than more urbanised sites, and this was also observed after sex stratification. Overall, the fastest increase was found for WC compared with BMI. Compared with Lima, the fastest increase in WC was in rural Puno (coefficient=0.73, P<0.001), followed by urban Puno (coefficient=0.59, P=0.001) and Tumbes (coefficient=0.22, P=0.088). Conclusions There was a linear increase in BMI and WC across study sites, with the greatest increase in less urbanised areas. The ongoing urbanisation process, common to Peru and other low/middle-income countries, is accompanied by different trajectories of increasing obesity-related markers.
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,Área de Investigación y Desarrollo, AB PRISMA, Lima, Peru
| | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Liam Smeeth
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Wang F, Chen Y, Chang Y, Sun G, Sun Y. New anthropometric indices or old ones: which perform better in estimating cardiovascular risks in Chinese adults. BMC Cardiovasc Disord 2018; 18:14. [PMID: 29378513 PMCID: PMC5789564 DOI: 10.1186/s12872-018-0754-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/22/2018] [Indexed: 12/11/2022] Open
Abstract
Background Various anthropometric indices can be used to estimate obesity, and it is important to determine which one is the best in predicting the risk of coronary heart disease (CHD) and to define the optimal cut-off point for the best index. Methods This cross-sectional study investigated a consecutive sample of 11,247 adults, who had lived in rural areas of China and were older than 35 years of age. Eight obesity indices, including the body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI) and a body shape index (ABSI) were investigated. The risk of CHD was evaluated by the 10-year coronary event risk (Framingham risk score). Receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive ability of the obesity indices for CHD risk. Results Of the whole population, 3636 (32.32%) participants had a risk score higher than 10%. Those who suffered medium or high CHD risk were more likely to have higher mean anthropometric indices, except for BMI in males. In the multivariate-adjusted logistic regression, all these anthropometric measurements were statistically associated with CHD risk in males. After adjusting for all the possible confounders, these anthropometric measurements, except for ABSI, remained as independent indicators of CHD risk in females. According to the ROC analyses, ABSI provided the largest area under the curve (AUC) value in males, and BMI showed the lowest AUC value, with AUC varying from 0.52 to 0.60. WHtR and BRI provided the largest AUC value in female, and similarly, BMI showed the lowest AUC value, with AUC varying from 0.59 to 0.70. The optimal cut-off values were as follows: WHtR (females: 0.54), BRI (females: 4.21), and ABSI (males: 0.078). Conclusions ABSI was the best anthropometric index for estimating CHD risk in males, and WHtR and BRI were the best indicators in females. Males should maintain an ABSI of less than 0.078, and females should maintain a WHtR of less than 0.54 or a BRI of less than 4.21. Electronic supplementary material The online version of this article (10.1186/s12872-018-0754-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fei Wang
- Department of Cardiology, Jinhua Municipal Central Hospital, 351 Mingyue Street, Wucheng District, Jinhua, 321000, People's Republic of China
| | - Yintao Chen
- Department of Cardiology, the First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, People's Republic of China
| | - Ye Chang
- Department of Cardiology, the First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, People's Republic of China.
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Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord 2017; 18:215-225. [PMID: 28229265 DOI: 10.1007/s11154-017-9410-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Low vitamin D status and obesity have concomitantly reached epidemic levels worldwide. Up to now the direction of the association between low vitamin D status and obesity, the exact mechanisms responsible for this association and the clinical usefulness to increase vitamin D status for reducing adiposity still warrant further evaluation. The aim of the present review was to examine the current evidence linking low vitamin D status and obesity in relation to the role of the nutritionist. On the one side, considering obesity as a causal factor, low sun exposure in obese individuals due to their sedentary lifestyle and less outdoor activity, vitamin D sequestration in adipose tissue, and volumetric dilution of ingested or cutaneously synthesized vitamin D3 in the large fat mass of obese patients, might represent some of the factors playing a major role in the pathogenesis of the low vitamin D status. On the other side, the expression of both vitamin D3 receptors and enzymes responsible for vitamin D3 metabolism in adipocytes depicted a role for the low vitamin D status per se in the development of obesity by modulating adipocyte differentiation and lipid metabolism. Nutritionists need to accurately address the aspects influencing the low vitamin D status in obesity and the vitamin D supplementation in obese individuals.
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Affiliation(s)
- Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Barrea
- I.O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | | | | | | | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
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Pinto AJ, Roschel H, de Sá Pinto AL, Lima FR, Pereira RMR, Silva CA, Bonfá E, Gualano B. Physical inactivity and sedentary behavior: Overlooked risk factors in autoimmune rheumatic diseases? Autoimmun Rev 2017; 16:667-674. [PMID: 28479487 DOI: 10.1016/j.autrev.2017.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/15/2017] [Indexed: 12/17/2022]
Abstract
This review aims to (1) summarize the estimates of physical inactivity and sedentary behavior in autoimmune rheumatic diseases; (2) describe the relationship between physical (in)activity levels and disease-related outcomes; (3) contextualize the estimates and impact of physical inactivity and sedentary behavior in autoimmune diseases compared to other rheumatic diseases and chronic conditions; and (4) discuss scientific perspectives around this theme and potential clinical interventions to attenuate these preventable risk factors. We compiled evidence to show that estimates of physical inactivity and sedentary behavior in autoimmune rheumatic diseases are generally comparable to other rheumatic diseases as well as to other chronic conditions (e.g., type 2 diabetes, cardiovascular diseases, and obesity), in which a lack of physical activity and excess of sedentary behavior are well-known predictors of morbimortality. In addition, we also showed evidence that both physical inactivity and sedentary behavior may be associated with poor health-related outcomes (e.g., worse disease symptoms and low functionality) in autoimmune rheumatic diseases. Thus, putting into practice interventions to make the patients "sit less and move more", particularly light-intensity activities and/or breaking-up sedentary time, is a simple and prudent therapeutic approach to minimize physical inactivity and sedentary behavior, which are overlooked yet modifiable risk factors in the field of autoimmune rheumatic diseases.
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Affiliation(s)
- Ana Jéssica Pinto
- Applied Physiology and Nutrition Research Group, Universidade de Sao Paulo, Av. Professor Mello Moraes, 65 - Cidade Universitaria, Sao Paulo/SP 05508-030, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, Universidade de Sao Paulo, Av. Professor Mello Moraes, 65 - Cidade Universitaria, Sao Paulo/SP 05508-030, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Ana Lúcia de Sá Pinto
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Fernanda Rodrigues Lima
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Rosa Maria Rodrigues Pereira
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Clovis Artur Silva
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Eloisa Bonfá
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, Universidade de Sao Paulo, Av. Professor Mello Moraes, 65 - Cidade Universitaria, Sao Paulo/SP 05508-030, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
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Araújo J, Severo M, Santos S, Ramos E. Life course path analysis of total and central adiposity throughout adolescence on adult blood pressure and insulin resistance. Nutr Metab Cardiovasc Dis 2017; 27:360-365. [PMID: 28216283 DOI: 10.1016/j.numecd.2016.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/14/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIM We aimed to study whether the effect of adolescent adiposity on adult blood pressure and insulin resistance was mediated by adult adiposity. METHODS AND RESULTS Data from the EPITeen cohort at 13, 17 and 21 years was used (n = 2211). Sex- and age-specific body mass index z-scores (BMIz) and waist-to-hip ratio (WHR) were used as indicators of total and central adiposity, respectively. Systolic blood pressure (SBP), glucose and insulin were assessed at 21 years and the homeostasis model assessment (HOMA-IR) was used as a marker of insulin resistance. Path analysis was applied to evaluate direct and indirect effects of adiposity (13, 17 and 21y) on adult SBP and HOMA-IR, separately for total and central adiposity and for each outcome. Results are presented as standardized regression coefficients [β (95%CI)]. The total effect of BMIz at 13 years on SBP at 21 years was 0.211 (0.178; 0.244), totally mediated by adult BMIz. Total effect of BMIz 13y on HOMA-IR was 0.248 (0.196; 0.299). Although this effect was mostly mediated by BMIz 21y, an additional direct effect from BMIz 17y was found [β = -0.240 (-0.315; -0.164)]. Central adiposity was also positively associated with SBP and HOMA-IR at 21 years, and the effect of adolescent WHR was totally mediated by adult WHR for both outcomes. CONCLUSIONS The effect of adolescent adiposity on adult SBP and HOMA-IR was mostly mediated by adult adiposity. However, for HOMA-IR an additional direct effect from total adiposity at 17 years was found.
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Affiliation(s)
- J Araújo
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
| | - M Severo
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - S Santos
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - E Ramos
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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Bucci L, Ostan R, Cevenini E, Pini E, Scurti M, Vitale G, Mari D, Caruso C, Sansoni P, Fanelli F, Pasquali R, Gueresi P, Franceschi C, Monti D. Centenarians' offspring as a model of healthy aging: a reappraisal of the data on Italian subjects and a comprehensive overview. Aging (Albany NY) 2017; 8:510-9. [PMID: 26979133 PMCID: PMC4833142 DOI: 10.18632/aging.100912] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Within the scenario of an increasing life expectancy worldwide it is mandatory to identify determinants of healthy aging. Centenarian offspring (CO) is one of the most informative model to identify trajectories of healthy aging and their determinants (genetic and environmental), being representative of elderly in their 70th whose lifestyle can be still modified to attain a better health. This study is the first comprehensive investigation of the health status of 267 CO (mean age: 70.2 years) and adopts the innovative approach of comparing CO with 107 age-matched offspring of non-long-lived parents (hereafter indicated as NCO controls), recruited according to strict inclusion demographic criteria of Italian population. We adopted a multidimensional approach which integrates functional and cognitive assessment together with epidemiological and clinical data, including pro- and anti-inflammatory cytokines and adipokines, lipid profile, and insulin resistance. CO have a lower prevalence of stroke, cerebral thrombosis-hemorrhage, hypertension, hypercholesterolemia, and other minor diseases, lower BMI and waist circumference, a better functional and cognitive status and lower plasma level of FT4 compared to NCO controls. We conclude that a multidimensional approach is a reliable strategy to identify the health status of elderly at an age when interventions to modify their health trajectory are feasible.
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Affiliation(s)
- Laura Bucci
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Elisa Cevenini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Elisa Pini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Maria Scurti
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Giovanni Vitale
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy.,Laboratory of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Cusano Milanino (MI) 20095, Italy
| | - Daniela Mari
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy.,Laboratory of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Cusano Milanino (MI) 20095, Italy.,Geriatric Unit, Fondazione Ca' Granda, IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Calogero Caruso
- Department of Pathobiology and Medical and Forensic Biotechnologies, University of Palermo, 90134 Palermo, Italy
| | - Paolo Sansoni
- Department of Clinical and Experimental Medicine, University of Parma, 43126 Parma, Italy
| | - Flaminia Fanelli
- Endocrinology Unit, and Department of Medical and Surgical Sciences and Center for Applied Biomedical Sciences, St Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | - Renato Pasquali
- Endocrinology Unit, and Department of Medical and Surgical Sciences and Center for Applied Biomedical Sciences, St Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | - Paola Gueresi
- Department of Statistical Sciences "Paolo Fortunati", University of Bologna, 40126 Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) and Interdepartmental Centre "L. Galvani" (CIG), University of Bologna, 40126 Bologna, Italy
| | - Daniela Monti
- Department of Clinical, Experimental and Biomedical Sciences, University of Florence, 50134 Florence, Italy
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Vikram NK, Latifi AN, Misra A, Luthra K, Bhatt SP, Guleria R, Pandey RM. Waist-to-Height Ratio Compared to Standard Obesity Measures as Predictor of Cardiometabolic Risk Factors in Asian Indians in North India. Metab Syndr Relat Disord 2016; 14:492-499. [PMID: 27740885 DOI: 10.1089/met.2016.0041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The aim of this study was to compare the discriminatory ability of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in identifying the presence of cardiometabolic risk factors in Asian Indians. METHODS This cross-sectional study involved 509 subjects (278 males and 231 females) aged 20-60 years from New Delhi, India. Measurements included complete clinical examination, blood pressure, weight, height, WC, BMI, WHR and WHtR, fasting blood glucose, lipid profile, and fasting insulin levels. Receiver operating characteristic curve analyses were performed to compare predictive validity of various adiposity measures against the cardiometabolic risk factors (dyslipidemia, hyperinsulinemia, impaired fasting glucose, hypertension, and metabolic syndrome). The odds ratio for the presence of individual cardiometabolic risk factors in the presence of overweight, abdominal obesity, and high WHtR were calculated using logistic regression analysis. RESULTS WC had the highest area under ROC for all other cardiometabolic risk factors except hyperinsulinemia in males and for dyslipidemia, metabolic syndrome and presence of at least one cardiometabolic risk factor in females. For metabolic syndrome, WC, followed by WHtR, was observed to be the better predictor than other measures of adiposity, and WHtR appeared to be the best predictor for hypertension in both genders, particularly in women. CONCLUSIONS In the northern Asian Indian population with high prevalence of cardiometabolic risk factors, a combination of WC and WHtR appeared to be having better clinical utility than BMI and WHR in identifying individuals with cardiometabolic risk factors.
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Affiliation(s)
- Naval K Vikram
- 1 Department of Medicine, All India Institute of Medical Sciences , New Delhi, India
| | - Ahmad Nawid Latifi
- 1 Department of Medicine, All India Institute of Medical Sciences , New Delhi, India
| | - Anoop Misra
- 2 Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology , New Delhi, India .,3 Diabetes Foundation (India) , New Delhi, India .,4 National Diabetes, Obesity and Cholesterol Foundation (N-DOC) , New Delhi, India
| | - Kalpana Luthra
- 5 Department of Biochemistry, All India Institute of Medical Sciences , New Delhi, India
| | - Surya Prakash Bhatt
- 1 Department of Medicine, All India Institute of Medical Sciences , New Delhi, India
| | - Randeep Guleria
- 6 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences , New Delhi, India
| | - Ravindra M Pandey
- 7 Biostatistics, All India Institute of Medical Sciences , New Delhi, India
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Chimeddamba O, Gearon E, Stevenson C, Liviya Ng W, Baasai B, Peeters A. Trends in adult overweight and obesity prevalence in Mongolia, 2005-2013. Obesity (Silver Spring) 2016; 24:2194-201. [PMID: 27580924 DOI: 10.1002/oby.21595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/16/2016] [Accepted: 06/06/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To analyze trends in the prevalence of overweight and obesity among Mongolian adults during the past decade as measured by body mass index (BMI) and waist circumference (WC). METHODS Data from the repeated cross-sectional surveys on the prevalence of noncommunicable disease risk factors conducted in 2005, 2009, and 2013 in Mongolia were used. Linear regression was used to quantify trends in mean BMI and WC, adjusted for age group, sex, and survey year. RESULTS The age-standardized prevalence of obesity, denoted by the international BMI cutoff values, in men and women between 2005 and 2013 increased from 10.8% to 17.6% and from 18.9% to 26.4%, respectively. Using Asian-specific BMI cutoff values for men and women, the age-standardized prevalence of obesity between 2005 and 2013 increased from 20.0% to 32.8% and 33.4% to 43.7%, respectively. CONCLUSIONS The prevalence of overweight and obesity has increased markedly between 2005 and 2013 similarly across all age groups and sexes. It is important to consider the use of Asian-specific cut-offs as the burden of obesity is twice as high as when using international BMI cutoffs. These data demonstrate the urgent need for obesity treatment, prevention, and monitoring in Mongolia.
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Affiliation(s)
- Oyun Chimeddamba
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Emma Gearon
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Christopher Stevenson
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Winda Liviya Ng
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Bulganchimeg Baasai
- Department of Health Policy Implementation and Coordination, Ministry of Health, Ulaanbaatar, Mongolia
| | - Anna Peeters
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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50
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Feigl AB, Bloom DE, Danaei G, Pillay D, Salomon JA, Tanser F, Bärnighausen TW. The Effect of HIV and the Modifying Effect of Anti-Retroviral Therapy (ART) on Body Mass Index (BMI) and Blood Pressure Levels in Rural South Africa. PLoS One 2016; 11:e0158264. [PMID: 27552195 PMCID: PMC4995007 DOI: 10.1371/journal.pone.0158264] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/13/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND High BMI and blood pressure are leading chronic disease risk factors in South Africa. Longterm effects of HIV and ART on adiposity and blood pressure are poorly understood, and direct comparisons of risk factor trajectories in HIV- versus HIV+ populations are rare. METHODS In 2003 and 2010, height, weight, and blood pressure were recorded in a study population (n = 505) in KwaZulu-Natal, South Africa (30% adult HIV prevalence). We modeled change in BMI and BP longitudinally in HIV- individuals (n = 315), seroconverters (n = 32), HIV+ patients not on ART (HIV+ART-; n = 52), HIV+ patients on ART for 0-<2 years as of 2010 (HIV+ART0-<2 yrs; n = 18), patients on ART for 2-5 years (HIV+ART2-5yrs; n = 44), and a subgroup with unknown HIV status (n = 44). Difference-in-differences were assessed in reference to the HIV- population. RESULTS Between 2003 and 2010, BMI increased significantly in the HIV- group, by 0.874 (95% CI 0.339, 1.41; p = 0.001), to 30.4. BMI drop was significantly greater in HIV+ART0-<2yrs than in HIV+ART2-5yrs (p = 0.005). DID in BMI in HIV+ART0-<2yrs versus the reference was -5.21 (95% CI -7.53, -2.90; p = 0.001), and DID in HIV+ART2-5yrs versus reference was -1.35 (95% CI -2.89, 0.189; p = 0.086). DID in SBP in HIV+ART-vs HIV- DID was -7.55 mmHg (95% CI -13.2 to -1.90; p = 0.009). CONCLUSION Short-term ART (0-<2 years) was associated with larger weight loss than either no ART or long-term ART. Once on ART for 2+ years, individuals 'caught up' on weight gain with the HIV- population. Our results showcase the importance of health system readiness to address the burgeoning double burden of disease in South Africa.
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Affiliation(s)
- Andrea B. Feigl
- Harvard Medical School, Department of Global Health and Social Medicine, 641 Huntington Ave, 02115, Boston, MA, United States of America
- Africa Health Research Institute, Somkhele, South Africa
| | - David E. Bloom
- Harvard TH Chan School of Public Health, Dept. of Global Health and Population, 677 Huntington Ave, 02115, Boston, MA, United States of America
| | - Goodarz Danaei
- Harvard TH Chan School of Public Health, Dept. of Global Health and Population, 677 Huntington Ave, 02115, Boston, MA, United States of America
| | - Deenan Pillay
- Africa Health Research Institute, Somkhele, South Africa
- Division of Infection & Immunology, University College London, London, United Kingdom
| | - Joshua A. Salomon
- Harvard TH Chan School of Public Health, Dept. of Global Health and Population, 677 Huntington Ave, 02115, Boston, MA, United States of America
| | - Frank Tanser
- Africa Health Research Institute, Somkhele, South Africa
- Division of Infection & Immunology, University College London, London, United Kingdom
| | - Till W. Bärnighausen
- Harvard TH Chan School of Public Health, Dept. of Global Health and Population, 677 Huntington Ave, 02115, Boston, MA, United States of America
- Africa Health Research Institute, Somkhele, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
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