Dynapenic abdominal obesity in hospitalized elderly patients with acute myocardial infarction

Association between waist-to-hip ratio and risk of myocardial infarction: a systematic evaluation and meta-analysis

Background

Myocardial infarction(MI) is one of the most serious health threats. Despite the increasing number of clinical methods used to predict the onset of MI, the prediction of MI is still unsatisfactory and necessitates new methods.

Objective

To systematically review observational studies from the past two decades on the association between waist-to-hip ratio (WHR) and MI risk.

Methods

Original literature on the correlation between WHR and MI was searched in PubMed, Embase, Web of Science, Cochrane Library, Science Direct, CNKI, and Wanfang up to January 31, 2024. Two researchers independently screened, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS) and Revman5.3. Meta-analysis with Stata 16.0 calculated the combined Odd ratio (OR) for WHR and MI risk. Heterogeneity was assessed with the I 2 statistic to select the appropriate effects model. Subgroup analysis, meta-regression, sensitivity analysis, and funnel plots tested for heterogeneity and publication bias.

Results

A total of 22 observational studies were included, involving 709,093 participants. The meta-analysis showed that an elevated WHR was significantly associated with an increased risk of MI, with a pooled odds ratio (OR) of 1.98 [95% Confidence interval (CI): 1.75-2.24] and high heterogeneity (I 2 = 91.5%, P < 0.0001). Subgroup analysis revealed a stronger association between WHR and MI in women (OR: 1.99, 95% CI: 1.43-2.77) compared to men (OR: 1.74, 95% CI: 1.36-2.22). Regional analysis indicated that the association between WHR and MI risk was highest in Asian populations (OR: 2.93 95% CI: 1.61-5.33), followed by American (OR: 1.73, 95% CI: 1.45-2.08) and European populations (OR: 2.19, 95% CI: 1.49-3.22). Sensitivity analysis demonstrated that the results remained stable after excluding one study.

Conclusion

In the general adult population, a higher WHR is a potentially significant association for MI and has predictive value for MI.

Dynapenic Abdominal Obesity and Metabolic Health in Non-Geriatric Patients with Obesity

Background: Dynapenic abdominal obesity (DAO) is the combination of low muscle strength and high central adiposity, which can lead to functional and cardiometabolic impairments. Objective: The aim of this study was to examine the relationship between DAO and metabolic parameters in non-geriatric patients with obesity. Methods: All patients seen in the obesity outpatient clinic during a random month, along with 30 healthy individuals, were included in the study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), serum fasting blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein (LDL), insulin, and glycated hemoglobin (HbA1c) levels were measured. Muscle function tests were conducted. Hypertension and diabetes mellitus diagnoses were recorded. DAO was determined using handgrip strength and WC. Metabolic syndrome was defined based on International Diabetes Federation (IDF) criteria. Data were analyzed using SPSS. Results: A total of 106 individuals participated in the study, including 76 individuals with obesity as the case group and 30 healthy individuals as the control group. In the case group, BMI, WC, HC, and chair stand test results were higher compared to the control group. There was no significant difference between the case and control groups in terms of gait speed or handgrip test results. In the case group, 30 people (39.5%) had dynapenic obesity (DO), and in the control group, 8 people (26.7%) had DO. There was no significant difference in DO rates between the case and control groups. In the case group, the HbA1c level was higher in DO (+) group than DO (-) group. In the control group, DO (+) group had higher LDL and HbA1c level than DO (-) group. No significant difference was observed in other search parameters between the DO (+) and DO (-) groups in both the case and control groups. Conclusion: DAO is common among people with obesity and contributes to a poor prognosis, increased morbidity, and mortality. Therefore, including its treatment in the management of obesity is crucial for individuals of all age ranges.