Prevalence of obesity and an interrogation of the correlation between anthropometric indices and blood pressures in urban Lagos, Nigeria

Exploring the Science of Shape: How Physical Activity, Sleep, and Stress Affect Body Composition

In the contemporary context of health challenges, the focus on physical health has become a social and individual priority. Within this framework, body composition emerges as one of the key determinants of physical health, with deviations from normal body composition being associated with numerous pathological conditions that can lead to serious health issues. Consequently, there is an urgent need to synthesize the available knowledge and increase awareness regarding healthy body composition and the factors that shape its components. This narrative review aims to summarize the knowledge regarding the main components of body composition and the key factors that influence their development. The fundamental morphological characteristics and functions of the primary components of body composition-including adipose tissue, muscle mass, and bone tissue-are addressed. Furthermore, the available methods for assessing body composition are outlined. The role of three key factors that influence body composition is outlined, including, but not limited to, physical activity, sleep quality, and stress levels. Additionally, hormonal fluctuations that determine body composition in relation to the variability of these factors are discussed. The review provides evidence-based information that will be valuable both for disease prevention related to non-communicable diseases and for the promotion of health strategies aimed at long-term physical well-being.

The accuracy of anthropometric indices in detecting hypertension in Sudanese adults: a cross-sectional study

BACKGROUND

Hypertension is an increasing health problem; hence, efforts have been made to promote the disease's early detection and modify prognoses. We aim to evaluate the accuracy of body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) in detecting hypertension among adults in Northern Sudan.

METHODS

Adults were recruited for a multi-stage sampling survey in Northern Sudan. Sociodemographic and anthropometric index (BMI, WC, and WHtR) information were collected. A receiver operating characteristic (ROC) curve with its area under the curve (AUC) was obtained, and a multivariate binary analysis was performed.

RESULTS

Of the 301 included adults, 113 (37.5%) were females and 188 (62.5%) were males. The median (interquartile range, IQR) age was 45.0 (32.0‒59.0) years. The median (IQR) of BMI, WC, and WHtR was 25.6 (21.9‒29.7) kg/m2, 83.0 (73.0‒94.8) cm, and 0.51 (0.43‒0.58), respectively; these values were significantly higher in adults with hypertension compared with adults without hypertension. A total of 166 (55.1%) adults had hypertension. BMI (AUC = 0.69 at the cutoff 22.5 kg/m2, sensitivity = 0.89, specificity = 0.53, YI = 0.35) and WHtR for both males and females (AUC = 0.68 at the cutoff 0.48, sensitivity = 0.75, specificity = 0.60, YI = 0.35) were more accurate than WC (AUC = 0.66 at the cutoff 77.5 cm, sensitivity = 0. 77, specificity = 0.56, YI = 0.33). The multivariate binary analysis revealed that being female (adjusted odds ratio [AOR] = 2.23, 95.0% CI = 1.25‒3.97), having increased age (AOR = 1.04, 95% CI = 1.02‒1.05), and having a higher BMI (AOR = 1.10, 95% CI = 1.04‒1.16) were associated with hypertension.

CONCLUSION

BMI, WC, and WHtR showed moderate predictive power, suggesting that these indices have a limited role in diagnosing hypertension at the individual level and are more appropriate for population screening than for individual diagnosis. BMI performs better than WC in terms of hypertension detection.

Prediction of Hypertension Based on Anthropometric Parameters in Adolescents in Eastern Sudan: A Community-Based Study

Background

Anthropometric measures such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) are associated with elevated blood pressure and hypertension in adolescents. We aimed to assess these anthropometric measures (BMI, WC, and WHtR) and examine their association with hypertension in adolescents.

Methods

Adolescents' BMI, mid-upper arm circumference (MUAC), WC, body roundness index (BRI), waist-to-hip ratio (WHR), WHtR, and a body shape index(ABSI) values were measured and calculated. Receiver operating characteristic curves (ROCs) were created to determine the discriminatory capacities of these anthropometric parameters for hypertension. The cutoff points for these parameters were identified using Youden's index.

Results

A total of 401 adolescents [186(46.4%) were females and 215 (53.6%) were males] were included. The median (interquartile range, IQR) age was 14.0 (12.1‒16.2) years. Thirty-six adolescents were found to have hypertension. Among the anthropometric parameters, MUAC (area under the curve (AUC] = 0.76, at the cutoff 26.1 cm, sensitivity = 61.0, specificity = 83.0), WC (AUC= 0.74, at the cutoff 70.3 cm, sensitivity = 66.7, specificity = 77.0), BMI (AUC= 0.73, at the cutoff 17.4 kg/m2, sensitivity = 83.3, specificity = 59.0), and hip circumference (HC) (AUC= 0.72, at the cutoff 91.0 cm, sensitivity = 55.6, specificity = 83.0) performed fairly in detecting hypertension in adolescents, whereas WHR, WHtR, ABSI, and BRI performed poorly. A univariate analysis showed that, except for WHR, all anthropometric parameters (BMI, MUAC, WC, HC, WHtR, BRI, and ABSI) were associated with hypertension. However, in a multivariate analysis, only increased MUAC (adjusted odds ratio [AOR]= 1.24, 95% CI= 1.03‒1.50) was associated with hypertension.

Conclusion

This study showed that MUAC, WC, BMI, and HC could be used to detect hypertension in adolescents. Other parameters,namelyWHR, WHtR, ABSI, and BRI, perform poorly in this regard. Larger studies are needed in the future.

Relationship of anthropometrics and blood pressure to identify people at risk of hypertension and obesity-related conditions in Nigerian rural areas

The prevalence of obesity and hypertension is increasing, particularly in the urban areas. However, there is limited research on the relationship between obesity and hypertension in the rural areas of southeastern Nigeria. The present study aimed to investigate the association between anthropometric parameters and adiposity indicators and the risk of hypertension with obesity-related conditions, based on a descriptive study of people living in the southeastern rural areas of Nigeria. The cluster sampling procedure randomly recruited study participants. Finally, 200 participants (100 male and 100 female) aged 18 to 25 years were included in the study. A simplified correlation analysis was used to derive the adjusted indicators in relation to age and sex. This study found that females generally had a higher body mass index (BMI), waist circumference (WC), and Z-score, whereas systolic blood pressure (SBP) was higher in men. A high correlation was found between the body shape index (ABSI) and BMI (r = -.529, P < .001), WC (r = .399, P < .001) and Z-score (r = .982, P < .001) in male participants. In females, there was a high correlation between ABSI and BMI, blood pressure (BP), and Z score in female participants (r = -.481, P < .000; r = -.267, P = .007; r = .941, P < .000). In male participants, BMI was correlated with diastolic blood pressure (DBP; r = .236, P = .018), SBP (r = .282, P = .005), Z score (r = -.539, P < .000), and WC (r = .541, P < .001). This study highlights the importance of considering a range of anthropometric measurements and health parameters when assessing health risks and identifying potential interventions. In addition, the body shape index may be a particularly useful tool for predicting health risks in both men and women. In contrast, correlations between various health parameters can provide insights into the underlying mechanisms and risk factors.

Blood Pressure Pattern and Prevalence of Hypertension amongst Apparently Healthy Primary School Pupils in Abuja, Nigeria

OBJECTIVES

The objective of this study was to determine the blood pressure (BP) pattern and prevalence of hypertension amongst apparently healthy primary school pupils in Abuja.

METHODOLOGY

This was a descriptive, cross-sectional study carried out on apparently healthy primary school children aged 6-12 years. BP was measured using a standard mercury sphygmomanometer according to standard guidelines. Data were analysed using SPSS version 17.0. Pearson's correlation coefficient (r) and analysis of variance were used to determine the relationship between BP and various variables where applicable. P = 0.05 was considered statistically significant.

RESULTS

Out of 1011 pupils recruited for the study, 457 (42.2%) were male. The mean systolic and diastolic BP (SBP and DBP) increased significantly with age from 94.5 mmHg to 101.0 mmHg and from 61.5 mmHg to 65.3 mmHg from 6 to 12 years for SBP and DBP, respectively (P < 0.05). The prevalence of high BP was 9.1%. Age was the only predictor of SBP (β = -0.629, 95% confidence interval [CI] -1.115, -0.142), while age, height and body mass index (BMI) were the predictors of DBP (β = -0.686, 95% CI of -1.152, -0.221; β = 0.490, 95% CI of 0.172, 0.809; β = 1.753, 95% CI of 0.374, 3.160) for age, height and BMI, respectively, at P < 0.05.

CONCLUSION

The predictors of SBP and DBP as shown in this study support the recommendations by various reports for taking body size into consideration in developing reference values for various populations. Age and body size are important determinants of BP in children. Its measurement should be encouraged in schools.

Body composition is related to cognitive function among young adults in Ghana

BACKGROUND

A growing body of evidence suggests that obesity can affect cognitive function. However, it is unclear whether this effect is independent of obesity-related comorbidities. This study thus sought to determine the association between body composition and cognitive function of young adults in Ghana with less predisposition to obesity-related comorbidities.

METHODS

A cross-sectional study design was employed, involving 381 participants recruited by simple random sampling. After consenting, participants completed questionnaires that assessed sociodemographic characteristics, along with assessments for anthropometric measures and cognitive function. Analyses for associations were conducted by either Pearson's correlation test or chi-Square test of independence.

RESULTS

Over half (60%) of participants were females and 69.6% were in the first year with a mean age of 20.18 ± 2.52 years. Based on Pearson's correlation test, no significant association was found between Body Mass Index (BMI) and Waist to Hip Ratio (WHR), and Trail Making Test-A and B (TMT-A and TMT-B). Nonetheless, a chi-square test showed a significant association, between BMI and TMT-A (p = 0.01), and WHR and both TMT-A (p = 0.001) and TMT-B (p = 0.02). Weak direct correlations were found between body fat percentage and TMT-A (r = 0.120, p = 0.019) and TMT-B (r = 0.133, p = 0.009). Further, a weak inverse correlation was found between muscle mass and TMT-A (r = - 0.141, p = 0.006) and TMT-B (r = - 0.144, p = 0.005).

CONCLUSION

High body fat, low muscle mass and body fat distribution may have a significant association with cognitive functions and must be considered in obesity interventions. This study provided more insight on the association between BMI and cognitive function and would be helpful in designing new weight management interventions or modifying existing interventions to consider the influence of obesity on cognitive function.

Associations of trajectories in body roundness index with incident cardiovascular disease: a prospective cohort study in rural China

Aims

The body roundness index (BRI) has good predictive ability for both body fat and visceral adipose tissue. Longitudinal BRI trajectories can reveal the potential dynamic patterns of change over time. This prospective study assessed potential associations between BRI trajectories and incident cardiovascular disease (CVD) in rural regions of Northeast China.

Methods

In total, 13,209 participants (mean age: 49.0 ± 10.3 years, 6,856 [51.9%] male) were enrolled with three repeated times of BRI measurements at baseline (2004-2006), 2008, and 2010, and followed up until 2017 in this prospective study. Using latent mixture model, the BRI trajectories were determined based on the data from baseline, 2008 and 2010. Composite CVD events (myocardial infarction, stroke, and CVD death combined) was the primary endpoint. Cox proportional-hazards models were used to analyze the longitudinal associations between BRI trajectories and incident CVD.

Results

Three distinct BRI trajectories were identified: high-stable (n = 538), moderate-stable (n = 1,542), and low-stable (n = 11,129). In total, 1,382 CVD events were recorded during follow-up. After adjustment for confounders, the moderate-stable and high-stable BRI groups had a higher CVD risk than did the low-stable BRI group, and the HR (95%CI) were 1.346 (1.154, 1.571) and 1.751 (1.398, 2.194), respectively. Similar associations were observed between the trajectories of BRI and the risk of stroke and CVD death. The high-stable group was also significantly and independently associated with CVD, myocardial infarction, stroke, and CVD death in participants aged <50 years.

Conclusion

BRI trajectory was positively associated with incident CVD, providing a novel possibility for the primary prevention of CVD in rural regions of China.

Evaluating the performance of a novel anthropometric index: weight adjusted for waist-to-height ratio (W-WHR) - for predicting cardiometabolic risk among adults in Addis Ababa

OBJECTIVE

Various anthropometric indices had been proposed to predict cardiometabolic risk, yet few were validated in the African population. We evaluated the diagnostic accuracy of a novel anthropometric index-weight adjusted for waist-to-height ratio (W-WHR)-as a predictor of cardiometabolic risk among adults 18-64 years in Addis Ababa, Ethiopia; and compared its performance with other indices commonly used in the literature.

DESIGN

Cross-sectional study.

SETTING

Community-based study in Addis Ababa, Ethiopia.

PARTICIPANTS

Randomly selected adults (n=600) completed serum lipid, blood pressure, blood glucose and anthropometric measurements.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes of interest were dyslipidaemia, hypertension and hyperglycaemia. Having at least one of the three outcomes was considered as a secondary outcome. Receiver-operating characteristic curve (ROC) used to measure the diagnostic accuracy of W-WHR and another 13 indices for predicting the primary and secondary outcomes. Optimal thresholds were determined using Youden's index.

RESULTS

W-WHR demonstrated an acceptable diagnostic accuracy (area under the curve (AUC), 95% CI) for correctly classifying dyslipidaemia (0.80, 0.76 to 0.84), hypertension (0.74, 0.70 to 0.78), hyperglycaemia (0.76, 0.70 to 0.82) and the secondary outcome of interest (0.79, 0.75 to 0.83). Depending on the outcomes, thresholds between 32.6 and 36.7 concurrently maximised sensitivity and specificity of the index. ROC analysis indicated, W-WHR (AUC=0.80), abdominal volume index (AVI) (AUC=0.78) and waist circumference (WC) (AUC=0.78) for dyslipidaemia; W-WHR (AUC=0.74) and WC (AUC=0.74) for hypertension; and waist-to-height ratio (AUC=0.80) and body roundness index (AUC=0.80) for hyperglycaemia, had the highest diagnostic accuracy. Likewise, W-WHR (AUC=0.79), AVI (AUC=0.78) and WC (AUC=0.78) had better performance for the secondary outcome. Most indices have better utility among younger than older adults, and per cent body fat had the highest diagnostic accuracy among women (AUC 0.74-0.83).

CONCLUSION

W-WHR is a useful index for predicting cardiometabolic risk, especially among young adults.

The Novelty of using Obesity Indices as Blood Pressure Predictors

AIMS

To study the association between selected obesity indices, systolic blood pressure (SBP), and diastolic blood pressure (DBP).

METHODS

A cross-sectional study on 491 Jordanian adults (19-65 years old). The sociodemographic data, anthropometrics, and blood pressure were measured and recorded. Obesity indices (Conicity Index (CI), Abdominal volume index (AVI), Body Roundness Index (BRI), and Weight-adjusted-waist index (WWI)) were calculated using standard validated formulas.

RESULTS

Based on age, the SBP had a significant moderate correlation with BRI and AVI in all age groups. In the age group 20 to 34 years, SBP had a significantly moderate correlation with CI, and DBP had a significantly moderate correlation with BRI and AVI. In the age group 35 to 44 years, DBP had a significantly moderate correlation with CI, BRI, WWI, and AVI. For the age group 45 to 65 years, the SBP had a significantly moderate correlation with all the obesity indexes, opposite to DBP. Obesity indices explain 23.6% to 24.1% of the changeability in SBP, and one unit increase in them resulted in an increase in SBP range from 0.61 ± 0.14 to 19.88 ± 4.45. For DBP, obesity indices explained 15.9% to 16.3% of the variability in DBP, and raising them by one unit led to an increase in the DBP range from 0.27 ± 0.11 to 10.08 ± 4.83.

CONCLUSION

All the studied obesity indices impacted SBP and DBP with the highest reported effect for AVI and BRI and a lower impact for WWI. The impact of obesity indices on DBP was affected by age group.

Predictive ability of anthropometric indices in identifying metabolic syndrome among US adolescents 10 to 19 years old: Analysis from the National Health and Nutrition Examination Survey 2011 to 2018 data set

OBJECTIVE

The aim of this study was to identify the best anthropometric indices for predicting metabolic syndrome in US adolescents.

METHODS

A cross-sectional study analyzed data of adolescents ages 10 to 19 y using the National Health and Nutrition Examination Survey 2011 to 2018 data. The receiver operating characteristic areas under the curve (AUCs) of waist circumference z score, body roundness index, body mass index, and A Body Shape Index in identifying predicting metabolic syndrome were assessed. Furthermore, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios of all anthropometric indices were calculated.

RESULTS

A total of 5496 adolescents were included in the analysis. Waist circumference z score had an AUC of 0.90 (95% CI, 0.89-0.91), sensitivity of 95.0% (95% CI, 89.4-98.1), and specificity of 74.8% (95% CI, 73.6, 76.0). Body roundness index had an AUC of 0.88 (95% CI, 0.87-0.89), sensitivity of 96.7% (95% CI, 91.7-99.1), and specificity of 75.2% (95% CI, 74.1-76.4). Body mass index z score had an AUC of 0.83 (95% CI, 0.81-0.85), sensitivity of 97.5% (95% CI, 92.9-99.5), and specificity of 68.2% (95% CI, 66.9-69.4). A Body Shape Index had an AUC of 0.59 (95% CI, 0.56-0.61), sensitivity of 75.0% (95% CI, 66.3-82.5), and specificity of 50.9% (95% CI, 49.5-52.2).

CONCLUSIONS

Our study found waist circumference z score and body roundness index were the best predictors of predicting metabolic syndrome compared with body mass index z score and A Body Shape Index in both boys and girls. We recommend that future studies develop global cutoff points for these anthropometric indices and examine their performance in a multi-country setting.

Effect of price and income on the demand for sugar-sweetened beverages in Nigeria: an analysis of household consumption data using an almost ideal demand system (AIDS)

OBJECTIVES

To estimate the own-price, cross-price and income elasticities for carbonated soft drinks (CSDs), malt drinks, chocolate powder, sachet water and sugar in Nigeria. These elasticities can be used to estimate the potential demand response to the recently-introduced sugar tax in Nigeria.

SETTING

The study uses household data from the 2018/2019 Nigeria Living Standards Survey (NLSS).

PARTICIPANTS

The NLSS is a national household survey. 21 114 households were included in the final sample for this analysis.

PRIMARY AND SECONDARY OUTCOMES

We used Deaton's almost ideal demand system, which controls for the goods' quality, to estimate the effect of price and income changes on the demand for CSDs, chocolate powder, malt drinks, sachet water and sugar.

RESULTS

We found that the own-price elasticity (ordered from most to least price-responsive) was -0.99 (p<0.01) for sachet water, -0.76 (p<0.01) for CSDs, -0.72 (p<0.01) for chocolate powder, -0.62 (p<0.01) for sugar and -0.19 (p<0.01) for malt drinks. The cross-price elasticities indicate that malt drinks and chocolate powders are substitutes of CSDs. The income elasticities indicate that all the commodities are normal goods. Sachet water had the highest income elasticity at 0.62 (p<0.01), followed by chocolate powder at 0.54 (p<0.01), CSDs at 0.47 (p<0.01), malt drinks at 0.43 (p<0.01) and sugar at 0.13 (p<0.01).

CONCLUSION

Even though the price elasticities for CSDs, malt drinks and chocolate powder are less than one, in absolute terms, they are significantly different from zero. Increases in the sugar-sweetened beverage tax could curb the demand for these beverages, and, in turn, reduce the incidence and prevalence of sugar-attributable diseases.

Unrecognized hypertension among a general adult Ghanaian population: An urban community-based cross-sectional study of prevalence and putative risk factors of lifestyle and obesity indices

Hypertension (HTN) is the leading cause of cardiovascular diseases. Nevertheless, most individuals in developing countries are unaware of their blood pressure status. We determined the prevalence of unrecognized hypertension and its association with lifestyle factors and new obesity indices among the adult population. This community-based study was conducted among 1288 apparently healthy adults aged 18-80 years in the Ablekuma North Municipality, Ghana. Sociodemographic, lifestyle characteristics, blood pressure and anthropometric indices were obtained. The prevalence of unrecognized HTN was 18.4% (237 / 1288). The age groups 45-54 years [aOR = 2.29, 95% CI (1.33-3.95), p = 0.003] and 55-79 years [aOR = 3.25, 95% CI (1.61-6.54), p = 0.001], being divorced [aOR = 3.02 95% CI (1.33-6.90), p = 0.008], weekly [aOR = 4.10, 95% CI (1.77-9.51), p = 0.001] and daily alcohol intake [aOR = 5.62, 95% CI (1.26-12.236), p = 0.028] and no exercise or at most once a week [aOR = 2.25, 95% CI (1.56-3.66), p = 0.001] were independently associated with HTN. Among males, the fourth quartile (Q4) of both body roundness index (BRI) and waist to height ratio (WHtR) [aOR = 5.19, 95% CI (1.05-25.50), p = 0.043] were independent determinants of unrecognized HTN. Among females, the third quartile (Q3) [aOR = 7.96, 95% CI (1.51-42.52), p = 0.015] and Q4 [aOR = 9.87 95% CI (1.92-53.31), p = 0.007] of abdominal volume index (AVI), the Q3 of both BRI and WHtR [aOR = 6.07, 95% CI (1.05-34.94), p = 0.044] and Q4 of both BRI and WHtR [aOR = 9.76, 95% CI (1.74-54.96), p = 0.010] were independent risk factors of HTN. Overall, BRI (AUC = 0.724) and WHtR (AUC = 0.724) for males and AVI (AUC = 0.728), WHtR (AUC = 0.703) and BRI (AUC = 0.703) for females yielded a better discriminatory power for predicting unrecognized HTN. Unrecognized hypertension is common among the apparently healthy adults. Increased awareness of its risk factors, screening, and promoting lifestyle modification is needed to prevent the onset of hypertension.

Fetal glycated albumin levels in offspring of obese women

OBJECTIVE

To determine the association between maternal obesity and fetal glycated albumin (GA) levels among pregnant women.

METHODS

A comparative, cross-sectional study of 59 consenting, normoglycemic, pregnant women, who met the criteria for maternal obesity, attending the antenatal clinic of the University College Hospital, Nigeria, from June 2019 to December 2019. They were recruited at 36 weeks of gestation, followed up until delivery, and compared with 58 nonobese, normoglycemic pregnant controls. At delivery, blood samples were taken from the mothers and from the umbilical cords of their newborns for serum GA assay. Maternal and newborn variables were recorded, and comparisons were made using χ² tests, independent t tests, odds ratios, analysis of variance, and Pearson correlates. Statistical significance was set at P < 0.05.

RESULTS

The odds of elevated newborn GA were 3.21 times higher in obese women compared with nonobese women (P = 0.005) and 5-min APGAR scores were higher in the newborns of nonobese women (P = 0.039). There was a significant correlation between maternal and neonatal GA for all participants (r = 0.346, P = 0.000).

CONCLUSION

These findings suggest that maternal obesity is associated with elevated fetal GA and low APGAR scores at 5 min in normoglycemic women.

Relationship of masked obesity to self-reported lifestyle habits, ideal body image, and anthropometric measures in Japanese university students: A cross-sectional study

INTRODUCTION

Masked obesity (MO) is defined as a normal body mass index (BMI) with a high body fat percentage (%BF), and is associated with the onset of lifestyle-related diseases. However, little is known about the current status of MO. Therefore, we investigated the relationship of MO to physical characteristics and lifestyle habits among Japanese university students.

METHODS

Between 2011 and 2019, we conducted a survey of 10,168 males and 4,954 females with BMI within the normal range (18.5 ≤ BMI < 25 kg/m2). MO was defined as %BF ≥ 20% in males and %BF ≥ 30% in females. Students completed a questionnaire containing items about lifestyle habits. Systolic and diastolic blood pressures were measured, and hypertension was defined as systolic above 140 mmHg and/or diastolic blood pressure above 90 mmHg. A multivariate logistic regression analysis was performed to evaluate the relationships as follows: the relationship of masked obesity to self-reported lifestyle habits, ideal body image, and anthropometric measures; the relationship between hypertension and body indices.

RESULTS

The proportion of students with MO in 2019 was 13.4% in males and 25.8% in females, and the proportion of females increased over time. MO was associated with desire for weight loss (odds ratio, 95% confidence interval: 1.76, 1.53-2.02), intake of five macronutrients (0.79, 0.67-0.93), rice and wheat intakes (1.22, 1.01-1.47), sleep duration of < 7hr (0.85, 0.74-0.98), and exercise habit (0.71, 0.63-0.81) in males; and with balanced diet intake (0.79, 0.64-0.99) and exercise habit (0.65, 0.51-0.82) in females. There was a significant association of MO with hypertension in males (1.29, 1.09-1.53).

CONCLUSION

The percentage of female students with MO increased during the study period, and in males, MO may be a risk factor for hypertension. These results suggest that intervention for MO is needed in Japanese university students.

A nonlinear association between body roundness index and all-cause mortality and cardiovascular mortality in general population

OBJECTIVE

The aim of the study was to investigate the association between body roundness index (BRI) and all-cause mortality and cardiovascular mortality in general population.

DESIGN

A retrospective cohort study.

SETTING

The status of cardiovascular mortality and all-cause mortality of participants were followed through 31 December 2015. Multivariate adjusted Cox restricted cubic spline regression models and Kaplan-Meier survival curves were used to evaluate the relationship between BRI and cardiovascular mortality and all-cause mortality.

PARTICIPANTS

A sample of 47 356 participants from the National Health and Nutrition Examination Surveys 1999-2014 with aged ≥18 years.

RESULTS

Mean age was 47 years and female were 49·9 %. During a median follow-up of 92 months, 4715 participants died from any cause, with 985 died of CVD. In multivariate adjusted Cox regression, compared with the lowest quartile of Body roundness index (BRI), the hazard ratios (HR) for all-cause mortality from other quartiles were 0·83, 95 % CI (0·75, 0·92), 0·73, 95 % CI (0·65, 0·81) and 0·80, 95 % CI (0·72, 0·89), respectively (P_{for trend} < 0·05) and the HR for cardiovascular mortality from other quartiles were 0·79, 95 % CI (0·62, 1·00), 0·78, 95 % CI (0·62, 0·99) and 0·79, 95 % CI (0·62, 1·01), respectively (P for trend > 0·05). In the restricted cubic spline regression models, the relationship was showed U-shaped between BRI and all-cause mortality and cardiovascular mortality. In Kaplan-Meier survival curves, the lowest cumulative survival rate of cardiovascular mortality and all-cause mortality was recorded in the highest BRI quartile.

CONCLUSIONS

The U-shaped association between BRI and all-cause mortality and cardiovascular mortality in a large population-based cohort was observed.

The impact of sex on blood pressure and anthropometry trajectories from early adulthood in a Nigerian population: insights into women's cardiovascular disease risk across the lifespan

BACKGROUND

Sex disparities in blood pressure and anthropometry may account for differences in cardiovascular (CV) risk burden with advancing age; modulated by ethnic variability. We explored trajectories of blood pressures (BPs) and anthropometric indices with age on the basis of sex in an urban Nigerian population.

METHODS

We conducted a secondary analysis on data from 5135 participants (aged 16-92 years; 2671(52%) females) from our population-based cross-sectional study of BP profiles. We utilized the WHO STEPS and standardized methods for documenting BPs, body mass index (BMI) and waist circumference (WC). Data was analyzed using Analysis of variance (ANOVA), Spearman correlation analysis and mean difference in variables (with 95% confidence interval). We explored the influence of age and sex on BP profiles and specific anthropometric indices using generalized regression analysis.

RESULTS

In those aged 15-44 years, males had significantly higher systolic BP (SBP) and pulse pressure (PP). However, mean SBP and PP rose more steeply in females from 25 to 34 years, intersected with that of males from 45 to 54 years and remained consistently higher. Difference in mean BPs (95% Confidence Interval) (comparing < and > 45 years) was higher in females compared to males for SBP (17.4 (15.8 to 19.0) v. 9.2 (7.7 to 10.7), DBP (9.0 (7.9 to 10.1) v. 7.8 (6.7 to 8.9)), and PP (8.4 (7.3 to 9.5) v. 1.4 (0.3 to 2.5)). Females had significantly higher BMI and WC across all age groups (p < 0.001). Age more significantly correlated with BPs, BMI and WC in females. Interaction models revealed that SBP was significantly predicted by age category in females from (15-54 years), while DBP was only significantly predicted by age in the 15-34-year category (p < 0.01). BMI and WC were significantly predicted by age only in the 25-34-year category in females, (p < 0.01).

CONCLUSIONS

Our population demonstrates sex disparity in trajectories of SBP, PP, BMI and WC with age; with steeper rise in females. There is a need to focus on CV risk reduction in females, starting before, or during early adulthood.

Emergent Anthropometric Indices in Differential Prediction of Prehypertension and Hypertension in Mexican Population: Results according to Age and Sex

Background

Hypertension (HTN) is recognized as a significant public health problem in the world. The objective of this study is to evaluate emergent anthropometric indices as predictors of preHTN and HTN according to age and sex in a sample of Mexican adults.

Methods

A cross-sectional study was conducted in 1,150 participants aged 18-80 years old. Anthropometric data and blood pressure measurements were analyzed. Comparisons between men and women were carried out by independent analysis. Cutoff points for each emergent anthropometric index were obtained using the values' upper second and third tertiles. Logistic regression models and receiver operating characteristics curve analyses were used to assess the association and the predictive value of several emergent anthropometric indices with the presence of preHTN and HTN.

Results

The prevalence of preHTN and HTN was 29.74% and 14.35%, respectively. In a logistic regression analysis adjusted by age and sex, the body roundness index (BRI) (OR = 2.08, p < 0.001) and conicity index (CI) (OR = 1.37, p=0.044) were associated with preHTN, while CI (OR = 2.47, p < 0.001) and waist to height squared (W/Ht2) (OR = 2.19, p < 0.001) were associated with HTN. Furthermore, in both sexes, BRI was the main predictor of preHTN (AUC: 0.634 and 0.656, respectively). Particularly, according to sex and age range, the predictive emergent anthropometric indices in men were the body shape index (ABSI) and waist to height cubic (W/Ht3) (AUC = 0.777 and 0.771, respectively), whereas in women, the predictors were CI and ABSI (AUC = 0.737 and 0.729, respectively). In men ≤40 years old, central body fat indices were predictors of preHTN and HTN, but in men >40 years old, the predictor indices were W/Ht3 and W/Ht2. In women ≤40 years, the pulse mass index (PMI) was the best main predictor (AUC = 0.909) of HTN.

Conclusion

CI, PMI, W/Ht3, W/Ht2, and ABSI could represent differential predictors of preHTN and HTN between men and women according to age range.

Sex Difference in the Associations among Obesity-Related Indices with Incident Hypertension in a Large Taiwanese Population Follow-Up Study

Hypertension is a major risk factor for stroke, atherosclerosis, and other cardiovascular diseases, and obesity is a major risk factor for hypertension. The aim of this longitudinal study was to investigate sex differences in the correlations among obesity-related indices and incident hypertension in a large Taiwanese cohort. We included 21,466 enrollees in the Taiwan Biobank and followed them for 4 years. Of the 21,466 patients enrolled in this study, 6899 (mean age, 49.6 ± 10.9 years) were male and 14,567 (mean age, 49.7 ± 10.0 years) were female. Data on visceral adiposity index (VAI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), lipid accumulation product (LAP), conicity index (CI), body roundness index (BRI), body mass index (BMI), body adiposity index (BAI), and abdominal volume index (AVI) were collected and analyzed. The results showed that all of the studied obesity-related indices were significantly associated with incident hypertension. Among them, WHtR was the strongest predictor of hypertension in both sexes. In addition, interactions between VAI, LAP, CI, BMI, and AVI with sex on incident hypertension were also statistically significant. CI and AVI were more strongly associated with hypertension in the men than in the women, while VAI, LAP, and BMI were more strongly associated with hypertension in the women. In conclusion, the studied obesity-related indices were found to be predictors of incident hypertension, and there were differences in the associations between the male and female participants. Our findings may imply that reducing body weight may be associated with a lower risk of developing hypertension.

The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study

Background: Several aspects of chronic kidney disease (CKD) such as the incidence rate and mortality rate are concerning. Oxidative stress contributes to progression and mortality in patients with CKD; however, a specific correlation between several markers of oxidative stress and the estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) in the Indonesian population has not been sufficiently described yet. Methods: This study was an analytic observational study with a sample of 56 patients with CKD in Universitas Airlangga Hospital, Surabaya, Indonesia, from December 2019 – March 2020. The markers for oxidative stress investigated were urinary 8-hydroxy-2 deoxyguanosine (8-OHdG), serum symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA). The correlations between each variable of oxidative stress and CKD were analyzed using Pearson analysis. Results: There was a positive correlation between 8-OHdG and eGFR (p=0.00, r=0.51); however, there was a negative correlation between 8-OHdG and ACR (p=0.025, r=-0.30). SDMA and eGFR showed a negative correlation (p=0.00, r=-0.648), while SDMA and ACR showed a positive correlation (p=0.03, r=0.349). ADMA showed a negative correlation with eGFR (p=0.00, r=-0.476). There were significantly decreased 8-OHdG but increased ADMA and SDMA as the CKD stage progressed (p=0.001, p=0.00, and p = 0.00, respectively). Higher urine 8-OHdG was detected in patients without history of hemodialysis, whereas ADMA and SDMA showed higher value in patients with hemodialysis (p=0.00, p=0.00, and p=0.004, respectively), patients with history of diabetes mellitus (DM) had higher mean 8-OHdG (p 0.000) yet lower serum ADMA and SDMA (p=0.004 and p=0.003, respectively). Conclusions: In patients with CKD in Indonesia, the markers for oxidative stress 8-OHdG, SDMA, and ADMA are correlated with eGFR and ACR levels. There were also significant difference in 8-OHdG, SDMA, and ADMA levels among CKD stages, between dialysis vs non dialysis, and DM vs non DM patients.

Multilevel Analysis of Urban-Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey

Background: An unhealthy body weight is an adverse effect of malnutrition associated with morbidity among women of childbearing age. While there is increasing attention being paid to the body weights of children and adolescents in Nigeria and South Africa, a major surge of unhealthy body weight in women has received less attention in both countries despite its predominance. The purpose of this study was to explore the prevalence of body weights (underweight, normal, overweight, and obese) and individual-level factors among women of childbearing age by urban-rural variations in Nigeria and South Africa. Methods: This study used the 2018 Nigeria Demographic Health Survey data (n = 41,821) and 2016 South Africa Demographic Health Survey (n = 8514). Bivariate, multilevel, and intracluster correlation coefficient analyses were used to determine individual-level factors associated with body weights across urban-rural variations. Results: The prevalence of being overweight or obese among women was 28.2% and 44.9%, respectively, in South Africa and 20.2% and 11.4% in Nigeria. A majority, 6.8%, of underweight women were rural residents in Nigeria compared to 0.8% in South Africa. The odds of being underweight were higher among women in Nigeria who were unemployed, with regional differences and according to breastfeeding status, while higher odds of being underweight were found among women from poorer households, with differences between provinces and according to cigarette smoking status in South Africa. On the other hand, significant odds of being overweight or obese among women in both Nigeria and South Africa were associated with increasing age, higher education, higher wealth index, weight above average, and traditional/modern contraceptive use. Unhealthy body weights were higher among women in clustering areas in Nigeria who were underweight (intracluster correlation coefficient (ICC = 0.0127), overweight (ICC = 0.0289), and obese (ICC = 0.1040). Similarly, women of childbearing age in clustering areas in South Africa had a lower risk of experiencing underweight (ICC = 0.0102), overweight (ICC = 0.0127), and obesity (ICC = 0.0819). Conclusions: These findings offer a deeper understanding of the close connection between body weights variations and individual factors. Addressing unhealthy body weights among women of childbearing age in Nigeria and South Africa is important in preventing disease burdens associated with body weights in promoting Sustainable Development Goal 3. Strategies for developing preventive sensitization interventions are imperative to extend the perspectives of the clustering effect of body weights on a country level when establishing social and behavioral modifications for body weight concerns in both countries.

Diabetes/Dementia in Sub-saharian Africa and Nigerian Women in the Eye of Storm

In the next few years, the prevalence of diabetes mellitus (DM) is projected to dramatically increase globally, but most of the cases will occur in low-to-middle-income countries. Some of the major risk factors for diabetes accelerate the development of dementia in African-Americans, thus leading to a higher prevalence of dementia than Caucasians. Sub-Saharan Africa women have a disproportionately two-to-eight fold increased prevalence of dementia. In the eye of this storm, Nigeria holds the highest number of diabetics on the African continent, and its prevalence is rising in parallel to obesity, hypertension, and the population's aging. The socio-economic impact of the rising prevalence of DM and dementia will be huge and unsustainable for the healthcare system in Nigeria, as has been recognized in developed economies. Here, we analyze the current situation of women's health in Nigeria and explore future perspectives and directions. The complex interplay of factors involved in diabetes and dementia in Nigerian women include key biological agents (metabolic syndrome, vascular damage, inflammation, oxidative stress, insulin resistance), nutritional habits, lifestyle, and anemia, that worsen with comorbidities. In addition, restricted resources, lack of visibility, and poor management result in a painful chain that increases the risk and burden of disease in Nigerian women from youth to elderly ages. Heath policies to increase the ra- tio of mental health professionals per number of patients, mostly in rural areas, foment of proactive primary care centers, and interventions targeting adolescents and adult women and other specific mothers-children pairs are strongly required for a sustainable development goal.