1
|
Prasad V PNSBSV, Syed AH, Himansh M, Jana B, Mandal P, Sanki PK. Augmenting authenticity for non-invasive in vivo detection of random blood glucose with photoacoustic spectroscopy using Kernel-based ridge regression. Sci Rep 2024; 14:8352. [PMID: 38594267 DOI: 10.1038/s41598-024-53691-z] [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: 08/01/2023] [Accepted: 02/03/2024] [Indexed: 04/11/2024] Open
Abstract
Photoacoustic Spectroscopy (PAS) is a potential method for the noninvasive detection of blood glucose. However random blood glucose testing can help to diagnose diabetes at an early stage and is crucial for managing and preventing complications with diabetes. In order to improve the diagnosis, control, and treatment of Diabetes Mellitus, an appropriate approach of noninvasive random blood glucose is required for glucose monitoring. A polynomial kernel-based ridge regression is proposed in this paper to detect random blood glucose accurately using PAS. Additionally, we explored the impact of the biological parameter BMI on the regulation of blood glucose, as it serves as the primary source of energy for the body's cells. The kernel function plays a pivotal role in kernel ridge regression as it enables the algorithm to capture intricate non-linear associations between input and output variables. Using a Pulsed Laser source with a wavelength of 905 nm, a noninvasive portable device has been developed to collect the Photoacoustic (PA) signal from a finger. A collection of 105 individual random blood glucose samples was obtained and their accuracy was assessed using three metrics: Root Mean Square Error (RMSE), Mean Absolute Difference (MAD), and Mean Absolute Relative Difference (MARD). The respective values for these metrics were found to be 10.94 (mg/dl), 10.15 (mg/dl), and 8.86%. The performance of the readings was evaluated through Clarke Error Grid Analysis and Bland Altman Plot, demonstrating that the obtained readings outperformed the previously reported state-of-the-art approaches. To conclude the proposed IoT-based PAS random blood glucose monitoring system using kernel-based ridge regression is reported for the first time with more accuracy.
Collapse
Affiliation(s)
- P N S B S V Prasad V
- Department of Electronics and Communication Engineering, SRM University -AP, Neerukonda, 522240, India
| | - Ali Hussain Syed
- Department of Electronics and Communication Engineering, SRM University -AP, Neerukonda, 522240, India
| | - Mudigonda Himansh
- Department of Computer Science and Engineering, SRM University -AP, Neerukonda, 522240, India
| | - Biswabandhu Jana
- Department of Electrical and Electronics Engineering, ABV-IIITM Gwalior, Gwalior, MP, 474015, India
| | - Pranab Mandal
- Department of Physics, SRM University -AP, Neerukonda, 522240, India
| | - Pradyut Kumar Sanki
- Department of Electronics and Communication Engineering, SRM University -AP, Neerukonda, 522240, India.
| |
Collapse
|
2
|
Cai Q, Shi S, Shen H, Ye B, Cheng W. Combined general and central obesity indices to predict gestational diabetes. J Matern Fetal Neonatal Med 2023; 36:2183765. [PMID: 36860096 DOI: 10.1080/14767058.2023.2183765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To investigate the relationship between general and central obesity in the first trimester of pregnancy and gestational diabetes and its predicted value. MATERIALS AND METHODS We recruited 813 women who registered at 6-12 weeks of gestation. Anthropometric measurements were done at the first antenatal visit. At 24-28 weeks of pregnancy, gestational diabetes was diagnosed using the 75 g oral glucose tolerance test. Binary logistic regression was used to determine odds ratios and 95% confidence intervals. The receiver-operating characteristic curve was used to evaluate the ability of obesity indices to predict the risk of gestational diabetes. RESULTS Odds ratios (95% confidence intervals) of gestational diabetes across increasing quartiles of waist-to-hip ratio were 1.00, 1.54 (0.65-3.66), 2.63 (1.18-5.85), and 4.96 (2.27-10.85), respectively (p < .001), while those for waist-to-height ratio were 1.00, 1.21 (0.47-3.08), 2.99 (1.26-7.10), and 4.01 (1.57-10.19), respectively (p < .001). Areas under the curve for general and central obesity were similar. However, the area under the curve of body mass index combined with the waist-to-hip ratio was the biggest. CONCLUSION Higher waist-to-hip ratio and waist-to-height ratio in the first trimester of pregnancy are associated with increased risks of gestational diabetes in Chinese women. The combination of body mass index and waist-to-hip ratio in the first trimester of pregnancy is a good predictor for gestational diabetes.
Collapse
Affiliation(s)
- Qunying Cai
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Shu Shi
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Hong Shen
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Baoying Ye
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Department of Ultrasound, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weiwei Cheng
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| |
Collapse
|
3
|
Kelly LA, Knox A, Gonzalez C, Lennartz P, Hildebrand J, Carney B, Wendt S, Haas R, Hill MD. Objectively Measured Physical Activity and Sedentary Time of Suburban Toddlers Aged 12-36 Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116707. [PMID: 35682292 PMCID: PMC9180469 DOI: 10.3390/ijerph19116707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/20/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022]
Abstract
Low levels of physical activity may predispose children to the development of obesity and related chronic diseases in later life. The aims of this study were as follows: (1) quantitatively describe the levels of habitual physical activity in a contemporary sample of suburban children aged 12 to 36 months; (2) assess for gender differences in physical activity and sedentary behavior; (3) examine the specific effects of ethnicity, gender and overweight status on the objectively measured physical activity; and (4) quantify the tracking of physical activity in a subset of children over 1 year. During year one, 142 participants wore the GT3X Actigraph for 3 days. At a 1-year follow-up, a subset of 25 participants wore the Actigraph for 7 consecutive days. GLM and t-tests as appropriate were carried out to assess the influence of gender on the physical activity level. Spearman rank correlations, percentage agreement and kappa statistics assessed the tracking of physical activity. The results showed no significant gender differences in any anthropometric measurements, sedentary behavior or MVPA (p > 0.05). There were also no significant gender, ethnicity or overweight interaction for sedentary behavior, time spent in light PA and time spent in MVPA (p > 0.05). For tracking, there was a moderate strength of agreement for MVPA. Considering the disproportionate effects of obesity in minority groups, culturally appropriate interventions targeting the reduction in sedentary behavior are urgently required.
Collapse
Affiliation(s)
- Louise A. Kelly
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
- Correspondence: ; Tel.: +1-805-493-3407
| | - Allan Knox
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| | - Carlos Gonzalez
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| | - Patrick Lennartz
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| | - Jordan Hildebrand
- Biology Department, California Lutheran University, Thousand Oaks, CA 93065, USA;
| | - Blake Carney
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| | - Spencer Wendt
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| | - Rebecca Haas
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| | - Mason D. Hill
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA 93065, USA; (A.K.); (C.G.); (P.L.); (B.C.); (S.W.); (R.H.); (M.D.H.)
| |
Collapse
|
4
|
Yates T, Zaccardi F, Islam N, Razieh C, Gillies CL, Lawson CA, Chudasama Y, Rowlands A, Davies MJ, Docherty AB, Openshaw PJM, Baillie JK, Semple MG, Khunti K. Obesity, Ethnicity, and Risk of Critical Care, Mechanical Ventilation, and Mortality in Patients Admitted to Hospital with COVID-19: Analysis of the ISARIC CCP-UK Cohort. Obesity (Silver Spring) 2021; 29:1223-1230. [PMID: 33755331 PMCID: PMC8251439 DOI: 10.1002/oby.23178] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the association of obesity with in-hospital coronavirus disease 2019 (COVID-19) outcomes in different ethnic groups. METHODS Patients admitted to hospital with COVID-19 in the United Kingdom through the Clinical Characterisation Protocol UK (CCP-UK) developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) were included from February 6 to October 12, 2020. Ethnicity was classified as White, South Asian, Black, and other minority ethnic groups. Outcomes were admission to critical care, mechanical ventilation, and in-hospital mortality, adjusted for age, sex, and chronic diseases. RESULTS Of the participants included, 54,254 (age = 76 years; 45.0% women) were White, 3,728 (57 years; 41.1% women) were South Asian, 2,523 (58 years; 44.9% women) were Black, and 5,427 (61 years; 40.8% women) were other ethnicities. Obesity was associated with all outcomes in all ethnic groups, with associations strongest for black ethnicities. When stratified by ethnicity and obesity status, the odds ratios for admission to critical care, mechanical ventilation, and mortality in black ethnicities with obesity were 3.91 (3.13-4.88), 5.03 (3.94-6.63), and 1.93 (1.49-2.51), respectively, compared with White ethnicities without obesity. CONCLUSIONS Obesity was associated with an elevated risk of in-hospital COVID-19 outcomes in all ethnic groups, with associations strongest in Black ethnicities.
Collapse
Affiliation(s)
- Thomas Yates
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)University Hospitals of Leicester NHS Trust and University of LeicesterLeicesterUK
| | - Francesco Zaccardi
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- Leicester Real World Evidence UnitDiabetes Research CentreUniversity of LeicesterLeicesterUK
| | - Nazrul Islam
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Cameron Razieh
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)University Hospitals of Leicester NHS Trust and University of LeicesterLeicesterUK
| | - Clare L. Gillies
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- Leicester Real World Evidence UnitDiabetes Research CentreUniversity of LeicesterLeicesterUK
| | - Claire A. Lawson
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
| | - Yogini Chudasama
- Leicester Real World Evidence UnitDiabetes Research CentreUniversity of LeicesterLeicesterUK
| | - Alex Rowlands
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)University Hospitals of Leicester NHS Trust and University of LeicesterLeicesterUK
| | - Melanie J. Davies
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)University Hospitals of Leicester NHS Trust and University of LeicesterLeicesterUK
| | - Annemarie B. Docherty
- Centre for Medical InformaticsUsher InstituteUniversity of EdinburghEdinburghUK
- Intensive Care UnitRoyal Infirmary EdinburghEdinburghUK
| | | | | | - Malcolm G. Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections and Institute of Translational Medicine, Faculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
- Respiratory MedicineAlder Hey Children’s HospitalInstitute in The ParkUniversity of LiverpoolAlder Hey Children’s HospitalLiverpoolUK
| | | | - Kamlesh Khunti
- Diabetes Research CentreUniversity of LeicesterLeicester General HospitalLeicesterUK
- Leicester Real World Evidence UnitDiabetes Research CentreUniversity of LeicesterLeicesterUK
- NIHR Applied Research Collaboration – East Midlands (ARC‐EM)University Hospitals of Leicester NHS Trust and University of LeicesterLeicesterUK
| |
Collapse
|
5
|
Yang Y, Xie M, Yuan S, Zeng Y, Dong Y, Wang Z, Xiao Q, Dong B, Ma J, Hu J. Sex differences in the associations between adiposity distribution and cardiometabolic risk factors in overweight or obese individuals: a cross-sectional study. BMC Public Health 2021; 21:1232. [PMID: 34174845 PMCID: PMC8234731 DOI: 10.1186/s12889-021-11316-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/08/2021] [Indexed: 12/15/2022] Open
Abstract
Background We aimed to assess the associations between adiposity distribution and cardiometabolic risk factors among overweight and obese adults in China, and to demonstrate the sex differences in these associations. Methods A total of 1221 participants (455 males and 766 females) were included in this study. Percentage of body fat (PBF) of the whole body and regional areas, including arm, thigh, trunk, android, and gynoid, were measured by the dual-energy X-ray absorptiometry method. Central adiposity was measured by waist circumference. Clustered cardiometabolic risk was defined as the presence of two or more of the six cardiometabolic risk factors, namely, high triglyceride, low high density lipoprotein, elevated glucose, elevated blood pressure, elevated high sensitivity C-reactive protein, and low adiponectin. Linear regression models and multivariate logistic regression models were used to assess the associations between whole body or regional PBF and cardiometabolic risk factors. Results In females, except arm adiposity, other regional fat (thigh, trunk, android, gynoid) and whole-body PBF are significantly associated with clustered cardiometabolic risk, adjusting for age, smoking, alcohol drinking, physical activity, and whole-body PBF. One-SD increase in Z scores of the thigh and gynoid PBF were significantly associated with 80 and 78% lower odds of clustered cardiometabolic risk (OR: 0.20, 95%CI: 0.12–0.35 and OR: 0.22, 95%CI: 0.12–0.41). Trunk, android and whole-body PBF were significantly associated with higher odds of clustered risk with OR of 1.90 (95%CI:1.02–3.55), 2.91 (95%CI: 1.75–4.85), and 2.01 (95%CI: 1.47–2.76), respectively. While in males, one-SD increase in the thigh and gynoid PBF are associated with 94% (OR: 0.06, 95%CI: 0.02–0.23) and 83% lower odds (OR: 0.17, 95%CI: 0.05–0.57) of clustered cardiometabolic risk, respectively. Android and whole-body PBF were associated with higher odds of clustered cardiometabolic risk (OR: 3.39, 95%CI: 1.42–8.09 and OR: 2.45, 95%CI: 1.53–3.92), but the association for trunk PBF was not statistically significant (OR: 1.16, 95%CI: 0.42–3.19). Conclusions Adiposity distribution plays an important role in the clustered cardiometabolic risk in participants with overweight and obese and sex differences were observed in these associations. In general, central obesity (measured by android PBF) could be the best anthropometric measurement for screening people at risk for CVD risk factors for both men and women. Upper body fat tends to be more detrimental to cardiometabolic health in women than in men, whereas lower body fat is relatively more protective in men than in women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11316-4.
Collapse
Affiliation(s)
- Yide Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410006, China.,Department of Child and Adolescent Health, School of Medicine, Hunan Normal University, Changsha, 410006, China
| | - Ming Xie
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410006, China
| | - Shuqian Yuan
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410006, China
| | - Yuan Zeng
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410006, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Zhenghe Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Qiu Xiao
- College of Information Science and Engineering, Hunan Normal University, Changsha, 410081, China.
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, 4111, Australia
| |
Collapse
|
6
|
Razieh C, Zaccardi F, Davies MJ, Khunti K, Yates T. Body mass index and the risk of COVID-19 across ethnic groups: Analysis of UK Biobank. Diabetes Obes Metab 2020; 22:1953-1954. [PMID: 32602268 PMCID: PMC7362044 DOI: 10.1111/dom.14125] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Cameron Razieh
- Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)Leicester General HospitalLeicesterUK
| | - Francesco Zaccardi
- Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- Leicester Real World Evidence UnitDiabetes Research Centre, University of LeicesterLeicesterUK
| | - Melanie J. Davies
- Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)Leicester General HospitalLeicesterUK
- Leicester Diabetes CentreUniversity Hospitals of Leicester, Leicester General HospitalLeicesterUK
| | - Kamlesh Khunti
- Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- Leicester Real World Evidence UnitDiabetes Research Centre, University of LeicesterLeicesterUK
- Leicester Diabetes CentreUniversity Hospitals of Leicester, Leicester General HospitalLeicesterUK
- NIHR Applied Research Collaboration – East Midlands (ARC‐EM), Leicester General HospitalLeicesterUK
| | - Thomas Yates
- Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)Leicester General HospitalLeicesterUK
| |
Collapse
|
7
|
Michalsen VL, Braaten T, Kvaløy K, Melhus M, Broderstad AR. Relationships between metabolic markers and obesity measures in two populations that differ in stature-The SAMINOR Study. Obes Sci Pract 2020; 6:324-339. [PMID: 32523722 PMCID: PMC7278909 DOI: 10.1002/osp4.404] [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: 09/19/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 12/21/2022] Open
Abstract
Background The relationships between metabolic markers and obesity measures may differ by ethnicity, sex, and height. Questions have been posed whether these relationships differ by ethnicity in the population in Northern Norway, but this has not been explored yet. Objectives Investigate the relationships between metabolic markers and obesity measures in Sami and non‐Sami and explore the impact of stature. Methods In total, 13 921 men and women aged 30 and 36 to 79 years (22.0% Sami) from a population‐based cross‐sectional survey in Norway, the SAMINOR 1 Survey (2003‐2004, 57.2% attendance), were included. Relationships between triglycerides, high‐density lipoprotein cholesterol, glucose, systolic/diastolic blood pressure (BP), metabolic syndrome and diabetes mellitus as outcomes, and body mass index (BMI), waist circumference (WC), and waist‐to‐height ratio (WHtR), respectively, were modelled using fractional polynomial regression. Appropriate interaction analyses and adjustments were made. Results The non‐Sami were approximately 6 cm taller than the Sami. No interactions were found between ethnicity and obesity. At the same levels of WC, BMI, or WHtR, levels of lipids and BP differed marginally between Sami and non‐Sami, but these were eliminated by height adjustment, with one exception: At any given WC, BMI, or WHtR, Sami had approximately 1.4 mmHg (95% CI, −2.1 to −0.7) lower systolic BP than non‐Sami (P values < .001). Conclusions Height explained the marginal ethnic differences in metabolic markers at the same level of obesity, except for systolic BP, which was lower in Sami than in non‐Sami at any given BMI, WC, or WHtR.
Collapse
Affiliation(s)
- Vilde L Michalsen
- Centre for Sami Health Research, Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway
| | - Tonje Braaten
- Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway
| | - Kirsti Kvaløy
- Centre for Sami Health Research, Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway.,HUNT Research Centre, Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway
| | - Ann R Broderstad
- Centre for Sami Health Research, Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway.,Division of Internal Medicine, Department of Medicine The University Hospital of North Norway Harstad Norway
| |
Collapse
|
8
|
The Relationship Between White Adipose Tissue Inflammation and Overweight/Obesity in Chinese Female Breast Cancer: A Retrospective Study. Adv Ther 2020; 37:2734-2747. [PMID: 32410166 DOI: 10.1007/s12325-020-01368-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION This study aims to investigate the relationship between breast white adipose tissue (WAT) inflammation and being overweight or obese, menopausal status, and metabolic syndrome-related indicators in breast cancer patients as well as the association between adipocyte size and the severity of WAT inflammation and body mass index (BMI). METHODS The crown-like structures (CLS-B) formed by macrophages surrounding dying or dead adipocytes can be used to identify breast WAT inflammation. In this study, breast WAT and fasting blood from 136 Chinese women with breast cancer were collected for analysis. Cluster of differentiation 68 (CD68) immunohistochemical staining was performed to identify CLS-B, and the adipocyte size was measured by hematoxylin and eosin staining. RESULTS The results showed that breast WAT inflammation usually occurs in overweight/obese breast cancer patients, and the severity of inflammation is positively correlated with adipocyte hypertrophy. We did not observe a direct association between WAT inflammation and menopausal status. In addition, the presence of WAT inflammation is associated with abnormalities in circulating factors associated with metabolic syndrome such as higher serum lipid, glucose, and C-reactive protein levels. CONCLUSION Overweight/obese breast cancer patients may be more prone to breast WAT inflammation and may be associated with abnormalities in circulatory markers associated with metabolic syndrome.
Collapse
|
9
|
Park SK, Kim WJ, Kim HJ, Kim HW, Kim B, Lee HJ, Lee SY, Lee YH, Kim DJ, Jeong KH, Moon JY, Lee SH, Ahn SY, Ko GJ, Ryoo JH, Lee DY. High dose haemodialysis and haemodiafiltration parameters and the relationship with advanced vascular calcification. BMC Nephrol 2020; 21:86. [PMID: 32143589 PMCID: PMC7060583 DOI: 10.1186/s12882-020-01738-4] [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: 08/07/2019] [Accepted: 02/24/2020] [Indexed: 12/02/2022] Open
Abstract
Background Vascular calcification (VC) is a risk factor for cardiovascular disease in end-stage renal disease (ESRD) patients undergoing maintenance haemodialysis (MHD). However, evidence is still insufficient about the association between dialysis parameters and VC. Thus, this study was to evaluate association of dialysis parameters with VC. Methods We enrolled 297 ESRD patients undergoing MHD at six distinct centers in Korea. Study participants were categorized into 3 groups by the scoring system of abdominal aortic calcification based on lateral lumbar radiography (no VC group: 0, mild VC group: 1–7 and advanced VC group: 8–24). We compared the features of dialysis parameters according to the severity of VC. Multivariate logistic regression analysis was used to calculate adjusted odd ratios (ORs) and 95% confidence interval (CI) for mild and advanced VC in each haemodialysis parameter (adjusted OR [95% CI]). Results Pooled Kt/V (spKt/V), equilibrated Kt/V (eKt/V), standard Kt/V (stdKt/V) and the proportion of haemodiafiltration were increased along with the severity of VC. Multivariate regression analysis indicated that advanced VC was positively associated with spKt/V (5.27 [1.51–18.41]), eKt/V (6.16 [1.45–26.10]), stdKt/V (10.67 [1.74–65.52]) and haemodiafiltration (3.27 [1.74 to 6.16]). Conclusion High dose dialysis and haemodiafiltration were significantly associated with advanced VC.
Collapse
Affiliation(s)
- Sung Keun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Joong Kim
- Department of Internal Medicine, Hansol hospital, Seoul, Republic of Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea
| | - Hae Won Kim
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea
| | - Beom Kim
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea
| | - Hong Joo Lee
- Department of Nephrology, Seoul Red Cross Hospital, Seoul, Republic of Korea
| | - So-Young Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Yu Ho Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Dong-Jin Kim
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University Global Campus, Yongin, Republic of Korea
| | - Kyung-Hwan Jeong
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ju-Young Moon
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Ho Lee
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Shin Young Ahn
- Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Gang Jee Ko
- Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jae-Hong Ryoo
- Departments of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Dong-Young Lee
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea.
| |
Collapse
|
10
|
Park SK, Kim MH, Ha E, Jung JY, Oh CM, Choi JM, Kang HY, Choi YS, Kim MG, Kim JW, Ryoo JH. The Risk for Incident Ischemic Heart Disease According to Estimated Glomerular Filtration Rate in A Korean Population. J Atheroscler Thromb 2019; 27:461-470. [PMID: 31564682 PMCID: PMC7242231 DOI: 10.5551/jat.50757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Aim: Chronic kidney disease, evaluated by the estimated glomerular filtration rate (eGFR), is an established risk factor for cardiovascular disease. However, the association between renal function stratified by the eGFR and the risk of incident ischemic heart disease (IHD) in a community-based Asian population is still inconclusive. Study design: Retrospective longitudinal observational study. Method: In data from 206,919 Korean patients registered in the National Health Insurance Corporation (NHIC), we analyzed the risk of incident IHD according to the quartiles (Q) of eGFR (ml/min/1.73 m2) (Q1 < 71.07, Q2: 71.07–83.16, Q3: 83.17–95.49, Q4> 95.50). The identification of IHD was based on the International Classification of Diseases (ICD) for IHD (ICD code: I20–I25) registered in the NHIC. The Cox proportional hazards model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for IHD according to quartile groups of eGFR levels. Results: Q1 had the more unfavorable baseline metabolic conditions than the other quartile groups. Considering Q4 as the reference, the unadjusted HRs (95% CIs) for IHD increased significantly in the order of Q3 (1.42 [1.29–1.56]), Q2 (1.51 [1.38–1.67]), and Q1 (2.11 [1.93–2.30]), and fully adjusted HRs (95% CIs) increased significantly from Q2 (1.15 [1.04–1.27]) to Q1 (1.31 [1.18–1.44]). Conclusion: The risk of IHD increased significantly from individuals with an eGFR ≤ 83.16. Mildly decreased renal function is a potential risk factor for IHD.
Collapse
Affiliation(s)
- Sung Keun Park
- Total healthcare center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine
| | - Min-Ho Kim
- Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital
| | - Eunhee Ha
- Department of Occupational and Environment Medicine, College of Medicine, Ewha Womans University
| | - Ju Young Jung
- Total healthcare center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine
| | - Chang-Mo Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University
| | - Joong-Myung Choi
- Department of Preventive Medicine, School of Medicine, Kyung Hee University
| | - Hee Yong Kang
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital
| | - Yong-Sung Choi
- Department of Pediatrics, School of Medicine, Kyung Hee University
| | - Min Gi Kim
- Department of Occupational and Environmental Medicine, Dankook University College of Medicine
| | - Jung-Wook Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University School of Medicine
| | - Jae-Hong Ryoo
- Department of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University
| |
Collapse
|
11
|
Rahman MA, Rahman MM, Rahman MM, Jesmin SS. The double burden of under- and overnutrition among Bangladeshi women: Socioeconomic and community-level inequalities. PLoS One 2019; 14:e0219968. [PMID: 31344076 PMCID: PMC6657854 DOI: 10.1371/journal.pone.0219968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence of overweightness in Bangladesh is increasing, while underweightness also continues to persist. A better understanding of the patterns and socioeconomic risk factors of both conditions, particularly among women, is critical in order to promote the development of interventions to improve maternal health in Bangladesh. This study therefore sought to assess the patterns of under- and overweightness between 2004 and 2014 and to examine the predictors of individual and community-level inequalities of under- and overnutrition in Bangladesh. METHODS Cross-sectional data of 10, 431, and 16,478 ever-married nonpregnant women aged between 15 and 49 years who did not give birth in the two months preceding the survey were extracted from the 2004 and 2014 Bangladesh Demographic and Health Surveys, respectively. Body mass index was used to measure weight status, and underweightness, at-risk for overweightness, overweightness, and obesity were the main outcome variables. Patterns of nutritional change over time was examined by considering the annual average rate of change. Multilevel multinomial logistic regression and quantile regression were used to identify the inequalities. RESULTS In 2014, the age-adjusted prevalence values of underweightness, at-risk for overweightness, overweightness, and obesity were 19.7%, 14.9%, 18.1% and 4.0%, respectively. A higher average annual rate of reduction of underweightness was found among wealthier, highly educated, and wealthier community-living women, while a rate of increase of overweightness was found among poorer, uneducated, and poor community-living women. Individual and community-level inequalities of malnutrition were observed among these populations. In comparison with women living in low wealth communities, women from wealthier communities were at an increased risk of being at-risk for overweightness [adjusted odds ratio (AOR): 1.53, 95% confidence interval (CI): 1.23-1.91], overweight (AOR: 1.60, 95% CI: 1.27-2.00), and obese (AOR: 2.12, 95% CI: 1.42-3.18). CONCLUSIONS This study suggests the coexistence of a double burden of under- and overnutrition in Bangladesh and that the prevalence of overweightness surpasses that of underweightness. The burdens of under- and overnutrition are strongly associated with women's individual socioeconomic positions and the nature of the community in which they live.
Collapse
Affiliation(s)
- Md. Aminur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Mosfequr Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
- Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Syeda S. Jesmin
- Sociology and Psychology Department, University of North Texas at Dallas, Dallas, Texas, United States of America
| |
Collapse
|
12
|
Pomeroy E, Mushrif-Tripathy V, Cole TJ, Wells JCK, Stock JT. Ancient origins of low lean mass among South Asians and implications for modern type 2 diabetes susceptibility. Sci Rep 2019; 9:10515. [PMID: 31324875 PMCID: PMC6642207 DOI: 10.1038/s41598-019-46960-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 07/05/2019] [Indexed: 12/21/2022] Open
Abstract
Living South Asians have low lean tissue mass relative to height, which contributes to their elevated type 2 diabetes susceptibility, particularly when accompanied by obesity. While ongoing lifestyle transitions account for rising obesity, the origins of low lean mass remain unclear. We analysed proxies for lean mass and stature among South Asian skeletons spanning the last 11,000 years (n = 197) to investigate the origins of South Asian low lean mass. Compared with a worldwide sample (n = 2,003), South Asian skeletons indicate low lean mass. Stature-adjusted lean mass increased significantly over time in South Asia, but to a very minor extent (0.04 z-score units per 1,000 years, adjusted R2 = 0.01). In contrast stature decreased sharply when agriculture was adopted. Our results indicate that low lean mass has characterised South Asians since at least the early Holocene and may represent long-term climatic adaptation or neutral variation. This phenotype is therefore unlikely to change extensively in the short term, so other strategies to address increasing non-communicable disease rates must be pursued.
Collapse
Affiliation(s)
- Emma Pomeroy
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge, CB2 3DZ, UK.
| | - Veena Mushrif-Tripathy
- Department of Archaeology, Deccan College Postgraduate and Research Institute, Yerwada, Pune, 411 006, India
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Jay T Stock
- ADaPt Project, PAVE Research Group, Department of Archaeology, University of Cambridge, Pembroke Street, Cambridge, CB2 3DZ, UK
- Department of Anthropology, University of Western Ontario, London, Ontario, N6A 5C2, Canada
- Department of Archaeology, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, Jena, Germany, Jena, Germany
| |
Collapse
|
13
|
Nyangasa MA, Buck C, Kelm S, Sheikh MA, Brackmann KL, Hebestreit A. Association between cardiometabolic risk factors and body mass index, waist circumferences and body fat in a Zanzibari cross-sectional study. BMJ Open 2019; 9:e025397. [PMID: 31278089 PMCID: PMC6615808 DOI: 10.1136/bmjopen-2018-025397] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To determine the prevalence of obesity indices (body mass index (BMI), waist circumference (WC), body fat per cent (BF%)) and cardiometabolic risk factors. To investigate the association between obesity indices and cardiometabolic risk factors in a Zanzibari population. DESIGNS Cross-sectional study. SETTINGS Participants randomly selected from 80 Shehias (wards) in Unguja, Zanzibar in 2013. PARTICIPANTS A total of 470 participants between 5 and 95 years were examined. Data on socioeconomic status, area of residence, anthropometry and venous blood were collected. Associations between obesity indices and cardiometabolic risk factors were investigated using multilevel logistic regression analyses in two steps: first, each obesity indicator was tested independently; second, all indicators combined in one model were tested for their association with cardiometabolic risk factors. RESULTS The proportion of overweight/obese individuals was 26.4%, high WC (24.9%) and high BF% (31.1%). Cardiometabolic risk factors with highest prevalence of abnormal values included hypertension (24.5%), low high-density lipoprotein cholesterol (HDL-C) (29.4%), high low-density lipoprotein cholesterol (LDL-C) (21.3%) and high glycated haemoglobin (HbA1c) (19.1%). Obesity and hypertension increased with age, and were most prevalent in participants aged 45 years and above. Low HDL-C was most prevalent among participants aged ≥18 to <45 years, while high LDL-C was more prevalent in those above 45 years. High WC and high BF% were associated with high levels of LDL-C (OR=2.52 (95% CI 1.24 to 5.13), OR=1.91 (95% CI 1.02 to 3.58), respectively). Additionally, BMI and WC were associated with high levels of HbA1c (OR=2.08 (95% CI 1.15 to 3.79), OR=3.01 (95% CI 1.51 to 6.03), respectively). In the combined regression model, WC was associated with higher chances for hypertension (OR=2.62 (95% CI 1.14 to 6.06)) and for high levels of HbA1c (OR=2.62 (95% CI 1.12 to 6.15)). CONCLUSION High BMI, WC and BF% were strongly associated with hypertension, with individuals with high WC being twice more likely to have hypertension; this calls for early and effective screening strategies for this study population.
Collapse
Affiliation(s)
- Maria Adam Nyangasa
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Soerge Kelm
- Centre for Biomolecular Interactions Bremen, Faculty for Biology and Chemistry, Bremen University, Bremen, Germany
| | - Mohammed Ali Sheikh
- Environmental Analytical Chemistry and Eco-toxicology Lab, State University of Zanzibar, Zanzibar, United Republic of Tanzania
| | - Kim Laura Brackmann
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| |
Collapse
|
14
|
Karnebeek K, Thapar S, Willeboordse M, van Schayck OCP, Vreugdenhil ACE. Comorbidities in primary versus secondary school children with obesity and responsiveness to lifestyle intervention. J Clin Endocrinol Metab 2019; 104:3803-3811. [PMID: 30776292 DOI: 10.1210/jc.2018-02318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 02/13/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Childhood obesity increases the risk of diseases as diabetes, cardiovascular disease and non-alcoholic fatty liver disease. OBJECTIVE To evaluate the prevalence of comorbidities in school-age children with obesity and to compare its prevalence and the effect of a lifestyle intervention between children in primary and secondary school and between boys and girls. DESIGN Cross-sectional analysis and lifestyle intervention. SETTING Centre for Overweight Adolescent and Children's Healthcare. PATIENTS Comorbidities were evaluated in 149 primary and 150 secondary school children with (morbid) obesity (162 girls). The effect of lifestyle intervention was studied in 82 primary and 75 secondary school children. INTERVENTION One-year interdisciplinary lifestyle intervention. RESULTS Insulin resistance (37%), impaired glucose tolerance (IGT) (3%), dyslipidemia (48%), hypertension (7%) and elevated liver transaminase levels (54%) were already common in primary school children. Glomerular hyperfiltration and insulin resistance were more prevalent in secondary school children. IGT was more prevalent in girls.The change in BMI z-score after intervention was greater in primary school children (primary vs. secondary: -0.25±0.32 vs. -0.11±0.47), even as the change in LDL cholesterol concentrations (primary vs. secondary: -0.30(-0.70;0.10) vs. -0.10(-0.40;0.30)) and systolic blood pressure z-score (primary vs. secondary: -0.32±1.27 vs. 0.24±1.3). The change in BMI z-score, but not in comorbidities, was greater in boys (boys vs. girls: -0.33±0.45 vs. -0.05±0.31). CONCLUSIONS The presence of comorbidities is already evident in primary school children with obesity. The effect of a lifestyle intervention on these comorbidities is greater in primary compared to secondary school children, stressing the need for early interventions.
Collapse
Affiliation(s)
- Kylie Karnebeek
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Supriya Thapar
- School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Maartje Willeboordse
- Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Anita C E Vreugdenhil
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
15
|
Luo J, Hendryx M, Laddu D, Phillips LS, Chlebowski R, LeBlanc ES, Allison DB, Nelson DA, Li Y, Rosal MC, Stefanick ML, Manson JE. Racial and Ethnic Differences in Anthropometric Measures as Risk Factors for Diabetes. Diabetes Care 2019; 42:126-133. [PMID: 30352893 PMCID: PMC6463546 DOI: 10.2337/dc18-1413] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/25/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The study objective was to examine the impact of race/ethnicity on associations between anthropometric measures and diabetes risk. RESEARCH DESIGN AND METHODS A total of 136,112 postmenopausal women aged 50-79 years participating in the Women's Health Initiative without baseline cancer or diabetes were followed for 14.6 years. BMI, waist circumference (WC), and waist-to-hip ratio (WHR) were measured in all participants, and a subset of 9,695 had assessment of whole-body fat mass, whole-body percent fat, trunk fat mass, and leg fat mass by DXA. Incident diabetes was assessed via self-report. Multivariate Cox proportional hazards regression models were used to assess associations between anthropometrics and diabetes incidence. RESULTS During follow-up, 18,706 cases of incident diabetes were identified. BMI, WC, and WHR were all positively associated with diabetes risk in each racial and ethnic group. WC had the strongest association with risk of diabetes across all racial and ethnic groups. Compared with non-Hispanic whites, associations with WC were weaker in black women (P < 0.0001) and stronger in Asian women (P < 0.0001). Among women with DXA determinations, black women had a weaker association with whole-body fat (P = 0.02) but a stronger association with trunk-to-leg fat ratio (P = 0.03) compared with white women. CONCLUSIONS In postmenopausal women across all racial/ethnic groups, WC was a better predictor of diabetes risk, especially for Asian women. Better anthropometric measures that reflect trunk-to-leg fat ratio may improve diabetes risk assessment for black women.
Collapse
Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Science, University of Illinois at Chicago, Chicago, IL
| | - Lawrence S Phillips
- Atlanta VA Health Care System, Decatur, GA.,Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | | | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Dorothy A Nelson
- Department of Sociology, Anthropology, Social Work, and Criminal Justice, Oakland University, Rochester, MI
| | - Yueyao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Milagros C Rosal
- Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
16
|
Hou X, Chen S, Hu G, Chen P, Wu J, Ma X, Yang Z, Yang W, Jia W. Stronger associations of waist circumference and waist-to-height ratio with diabetes than BMI in Chinese adults. Diabetes Res Clin Pract 2019; 147:9-18. [PMID: 30144478 DOI: 10.1016/j.diabres.2018.07.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/26/2018] [Accepted: 07/23/2018] [Indexed: 01/21/2023]
Abstract
AIMS To compare the magnitude of associations of the obesity indicators with the risk of prediabetes and diabetes. METHODS We performed an individually region-, sex-, and age-matched case and control analysis involving 42 918 Chinese adults aged 20-88 years (6876 matched prediabetes and normal glucose regulation [NGR] groups and 2873 matched newly diagnosed diabetes mellitus [NDM] and NGR groups). RESULTS Compared with their respective NGR controls, the participants with prediabetes or NDM had significantly higher mean levels of obesity indices as follows: waist circumference (cm), 85.3 vs. 81.8 and 87.9 vs. 82.9; waist-to-height ratio (WHtR), 0.531 vs. 0.509 and 0.546 vs. 0.514; and body mass index (BMI) (kg/m2), 25.4 vs. 24.1 and 25.9 vs. 24.2 (all P < 0.001). The odds ratios (95% confidence intervals) of NDM with waist circumference, WHtR, and BMI per standard deviation (SD) increase were 1.88 (1.80-1.97), 1.88 (1.80-1.97), and 1.69 (1.62-1.76) in the total population. CONCLUSIONS Mean differences in the three obesity indices were around 0.3 SD between matched prediabetes cases and NGR controls, and around 0.5 SD between matched NDM cases and NGR controls. Waist circumference and WHtR were more strongly associated with diabetes than BMI among Chinese adults.
Collapse
Affiliation(s)
- Xuhong Hou
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Siyu Chen
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Gang Hu
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA
| | - Peizhu Chen
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Jingzhu Wu
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Xiaojing Ma
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Zhaojun Yang
- Department of Endocrinology and Metabolism, China-Japan Friendship Hospital, Yinghua Dongjie, Chaoyang District, Beijing 100029, China
| | - Wenying Yang
- Department of Endocrinology and Metabolism, China-Japan Friendship Hospital, Yinghua Dongjie, Chaoyang District, Beijing 100029, China
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
| |
Collapse
|
17
|
Divia Paul A, Ashraf SM, Subramanyam K, Ramakrishna A. Gender-associated dimensional differences among normal to non-flow limiting coronary artery dimensions. Indian Heart J 2019; 70 Suppl 3:S295-S298. [PMID: 30595278 PMCID: PMC6309284 DOI: 10.1016/j.ihj.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/11/2018] [Accepted: 06/04/2018] [Indexed: 11/11/2022] Open
Abstract
Aim and objectives To study gender-specific differences in coronary artery diameters among subjects with normal to non-flow limiting disease (NFLD) coronary arteries (up to 0 - 20% of stenosis) and to assess the possible association of body-mass index (BMI) with coronary dimensions, among the west coastal population of Karnataka and Kerala. Materials and Methods A prospective cohort study was conducted for a period of one year. Two thousand angiograms samples were collected and assessed from two study centers (one from each state), after obtaining the ethical clearance. Patients with past history of myocardial infarction and those with recanalized normal looking coronary arteries and those who had diabetes for more than five years were excluded. Ten segments of coronary arteries- left main coronary artery, ostial and proximal segments of left anterior descending artery and its first diagonal branch, ostial and proximal segments of left circumflex coronary artery and its obtuse marginal branch, ramus intermedius and the ostial and proximal segments of the right coronary artery- were included in diameter measurement. BMI values of the patients were calculated. Results Out of 2000 patients included in the study, 454 (22.7%; mean age 53.4 ± 14.2 years) had normal to NFLD coronaries of which 253 (55.7%) were males and 201 (44.3%) were females. As compared to women, men had larger diameters of coronary arteries for eight segments, except the obtuse marginal branch and the proximal right coronary artery. A weak, yet statistically significant, negative correlation existed between BMI and coronary artery diameters in total cohort, indicating that an increase in BMI was associated with a decrease in artery diameters. No such association was seen when men and women were assessed separately. Conclusions The present study indicates that men have higher caliber for coronary arteries compared to women. The study also indicates that when BMI increases there is a relative decrease in the coronary artery diameter.
Collapse
Affiliation(s)
- A Divia Paul
- Department of Anatomy, Yenepoya Medical College, Karnataka, India.
| | - S M Ashraf
- Department of Cardio Vascular Sciences, Sahakarana Hrudayalaya, Pariyaram Medical college, Kerala, India.
| | - K Subramanyam
- Department of Cardiology, K.S Hegde Medical Academy and Hospital, Karnataka, India.
| | | |
Collapse
|
18
|
Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112589. [PMID: 30463276 PMCID: PMC6266413 DOI: 10.3390/ijerph15112589] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 01/16/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is thought to be the most common endocrine disorder found in women. Common symptoms include irregular menstrual cycle, polycystic ovaries, and hirsutism, as well as an increased risk for a multitude of conditions, including insulin resistance, dyslipidemia and infertility. The prevalence of polycystic ovarian syndrome is generally thought to be between 3% and 10% but it is widely unknown for specific subpopulations based on geographical location and race/ethnicity. Based on the high degree of variability and inconsistencies between the different diagnostic criteria, there is a unique challenge that exists when determining the prevalence of this syndrome. There are a large percentage of individuals that remain undiagnosed even after visiting multiple health care providers. Most studies conducted across the world are limited by small sample size, selection bias, and lack of comparability across studies. There have been very few studies that have examined the prevalence of polycystic ovary syndrome across the United States. Based on the National Institutes of Health (NIH)’s diagnostic criteria, there is a similar prevalence of PCOS documented across the United States, the United Kingdom, Spain, Greece, Australia, and Mexico. Other studies have shown some differences between geographical location and race. The existing data is not conclusive enough to determine whether or not there is any significant differences in the prevalence of PCOS across geographical location, racial or ethnic groups. This review will seek to determine the prevalence of polycystic ovarian syndrome based on geographical location and race/ethnicity.
Collapse
|
19
|
Can big data solve a big problem? Reporting the obesity data landscape in line with the Foresight obesity system map. Int J Obes (Lond) 2018; 42:1963-1976. [PMID: 30242238 PMCID: PMC6291418 DOI: 10.1038/s41366-018-0184-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/07/2018] [Accepted: 04/09/2018] [Indexed: 11/20/2022]
Abstract
Background Obesity research at a population level is multifaceted and complex. This has been characterised in the UK by the Foresight obesity systems map, identifying over 100 variables, across seven domain areas which are thought to influence energy balance, and subsequent obesity. Availability of data to consider the whole obesity system is traditionally lacking. However, in an era of big data, new possibilities are emerging. Understanding what data are available can be the first challenge, followed by an inconsistency in data reporting to enable adequate use in the obesity context. In this study we map data sources against the Foresight obesity system map domains and nodes and develop a framework to report big data for obesity research. Opportunities and challenges associated with this new data approach to whole systems obesity research are discussed. Methods Expert opinion from the ESRC Strategic Network for Obesity was harnessed in order to develop a data source reporting framework for obesity research. The framework was then tested on a range of data sources. In order to assess availability of data sources relevant to obesity research, a data mapping exercise against the Foresight obesity systems map domains and nodes was carried out. Results A reporting framework was developed to recommend the reporting of key information in line with these headings: Background; Elements; Exemplars; Content; Ownership; Aggregation; Sharing; Temporality (BEE-COAST). The new BEE-COAST framework was successfully applied to eight exemplar data sources from the UK. 80% coverage of the Foresight obesity systems map is possible using a wide range of big data sources. The remaining 20% were primarily biological measurements often captured by more traditional laboratory based research. Conclusions Big data offer great potential across many domains of obesity research and need to be leveraged in conjunction with traditional data for societal benefit and health promotion.
Collapse
|
20
|
LeBlanc ES, Patnode CD, Webber EM, Redmond N, Rushkin M, O'Connor EA. Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018; 320:1172-1191. [PMID: 30326501 DOI: 10.1001/jama.2018.7777] [Citation(s) in RCA: 267] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Overweight and obesity have been associated with adverse health effects. OBJECTIVE To systematically review evidence on benefits and harms of behavioral and pharmacotherapy weight loss and weight loss maintenance interventions in adults to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed Publisher-Supplied Records, PsycINFO, and the Cochrane Central Register of Controlled Trials for studies published through June 6, 2017; ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials through August 2017; and ongoing surveillance in targeted publications through March 23, 2018. Studies from previous reviews were reevaluated for inclusion. STUDY SELECTION Randomized clinical trials (RCTs) focusing on weight loss or weight loss maintenance in adults. DATA EXTRACTION AND SYNTHESIS Data were abstracted by one reviewer and confirmed by another. Random-effects meta-analyses were conducted for weight loss outcomes in behavior-based interventions. MAIN OUTCOMES AND MEASURES Health outcomes, weight loss or weight loss maintenance, reduction in obesity-related conditions, and adverse events. RESULTS A total of 122 RCTs (N = 62 533) and 2 observational studies (N = 209 993) were identified. Compared with controls, participants in behavior-based interventions had greater mean weight loss at 12 to 18 months (-2.39 kg [95% CI, -2.86 to -1.93]; 67 studies [n = 22065]) and less weight regain (-1.59 kg [95% CI, -2.38 to -0.79]; 8 studies [n = 1408]). Studies of medication-based weight loss and maintenance interventions also reported greater weight loss or less weight regain in intervention compared with placebo groups at 12 to 18 months (range, -0.6 to -5.8 kg; no meta-analysis). Participants with prediabetes in weight loss interventions had a lower risk of developing diabetes compared with controls (relative risk, 0.67 [95% CI, 0.51 to 0.89]). There was no evidence of other benefits, but most health outcomes such as mortality, cardiovascular disease, and cancer were infrequently reported. Small improvements in quality of life in some medication trials were noted but were of unclear clinical significance. There was no evidence of harm such as cardiovascular disease from behavior-based interventions; higher rates of adverse events were associated with higher dropout rates in medication groups than in placebo groups. CONCLUSIONS AND RELEVANCE Behavior-based weight loss interventions with or without weight loss medications were associated with more weight loss and a lower risk of developing diabetes than control conditions. Weight loss medications, but not behavior-based interventions, were associated with higher rates of harms. Long-term weight and health outcomes data, as well as data on important subgroups, were limited.
Collapse
Affiliation(s)
- Erin S LeBlanc
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Carrie D Patnode
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth M Webber
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan Rushkin
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth A O'Connor
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| |
Collapse
|
21
|
Leisure Time Physical Activity Levels in Immigrants by Ethnicity and Time Since Immigration to Canada: Findings from the 2011–2012 Canadian Community Health Survey. J Immigr Minor Health 2018; 21:801-810. [DOI: 10.1007/s10903-018-0789-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
22
|
Riediger ND, Clark K, Lukianchuk V, Roulette J, Bruce S. Fasting triglycerides as a predictor of incident diabetes, insulin resistance and β-cell function in a Canadian First Nation. Int J Circumpolar Health 2018; 76:1310444. [PMID: 28406758 PMCID: PMC5405443 DOI: 10.1080/22423982.2017.1310444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Diabetes prevalence is substantially higher among Canadian First Nations populations than the non-First Nation population. Fasting serum triglycerides have been found to be an important predictor of incident diabetes among non-indigenous populations. However, there is a great need to understand diabetes progression within specific ethnic groups, particularly First Nations populations. Objective: The purpose of this study was to test for an association between fasting serum triglycerides and incident diabetes, changes in insulin resistance and changes in β-cell function in a Manitoba First Nation cohort. Methods: Study data were from two diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort was composed of respondents to both screening studies (n=171). Fasting blood samples and anthropometric, health and demographic data were collected. A generalised linear model with Poisson distribution was used to test for an association between fasting triglycerides and incident diabetes. Results: There were 35 incident cases of diabetes among 128 persons without diabetes at baseline. Participants who developed incident type 2 diabetes were significantly older and had significantly higher body mass index (BMI; p=0.012), total cholesterol (p=0.007), fasting triglycerides (p<0.001), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p<0.001). Fasting triglyceride level was found to be a statistically significant positive predictor of incident diabetes independent of age, sex and waist circumference at baseline. Participants with triglycerides in the highest tertile (≥2.11 mmol/l) had a 4.0-times higher risk of developing incident diabetes compared to those in the lowest tertile (p=0.03). Notably, neither waist circumference nor BMI were significant predictors of incident diabetes independent of age, sex and triglycerides. Conclusion: Fasting triglycerides may be useful as a clinical predictor of insulin resistance and diabetes development among First Nations populations. Unlike other ethnic groups, BMI and waist circumference may be less important factors in diabetes development.
Collapse
Affiliation(s)
- Natalie D Riediger
- a Department of Community Health Sciences, Rady Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.,b Manitoba First Nations Centre for Aboriginal Health Research, Rady Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.,c Department of Human Nutritional Sciences, Faculty of Agricultural and Food Sciences , University of Manitoba , Winnipeg , Canada
| | - Kirsten Clark
- d Northern Remote Family Medicine Residency , University of Manitoba , Winnipeg , Canada
| | | | - Joanne Roulette
- e Sandy Bay First Nation Health Centre , Sandy Bay First Nation , Canada
| | - Sharon Bruce
- a Department of Community Health Sciences, Rady Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada
| |
Collapse
|
23
|
Kolahdooz F, Sadeghirad B, Corriveau A, Sharma S. Prevalence of overweight and obesity among indigenous populations in Canada: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2017; 57:1316-1327. [PMID: 26566086 DOI: 10.1080/10408398.2014.913003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Previous studies on overweight and obesity among indigenous peoples in Canada have been inconclusive. A systematic review was conducted on the prevalence of overweight and obesity among Canadian indigenous populations. Major bibliographic databases were searched for relevant studies published between January 1990 and June 2013. We reviewed 594 abstracts and included 41 studies in the meta-analyses. Using the heterogeneity test (Cochrane Q) results, the overall prevalence was estimated using fixed- or random-effects model. Nonadults (<18 years) had a pooled prevalence of overweight and obesity at 29.8% (95% CI: 25.2-34.4) and 26.5% (95% CI: 21.8-31.3), respectively. The pooled prevalence of overweight and obesity among adults were 29.7% (95% CI: 28.2-31.2) and 36.6% (95% CI: 32.9-40.2), respectively. Adult males had higher overweight prevalence than females (34.6% vs. 26.6%), but lower obesity prevalence (31.6% vs. 40.6%). Nonadult girls had higher prevalence than boys [overweight: 27.6%; 95% CI: 22.6-32.7 vs. 24.7%; 95% CI: 19.0-30.5; obesity: 28.6%; 95% CI: 20.3-36.9 vs. 25.1%; 95% CI: 13.8-36.4]. Nonadult Inuit had the highest overweight and lowest obesity prevalence. Although Inuit adult had the lowest prevalence of overweight (28.7%; 95% CI: 27.3-30.2) and obesity (32.3%; 95% CI: 25.5-39.1), it was relatively high. This study highlights the need for nutritional intervention programs for obesity prevention among indigenous populations in Canada.
Collapse
Affiliation(s)
- Fariba Kolahdooz
- a Indigenous and Global Health Research Group , Department of Medicine , University of Alberta , Edmonton, Alberta , Canada
| | - Behnam Sadeghirad
- b Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences , Kerman , Iran
| | - André Corriveau
- c Office of the Chief Public Health Officer , Department of Health and Social Services , Government of the Northwest Territories , Yellowknife , Northwest Territories , Canada
| | - Sangita Sharma
- a Indigenous and Global Health Research Group , Department of Medicine , University of Alberta , Edmonton, Alberta , Canada
| |
Collapse
|
24
|
Wu W, Huang Y, Qiu J, Sun J, Wang H. Self-Monitoring of Blood Glucose to Assess Dawn Phenomenon in Chinese People with Type 2 Diabetes Mellitus. Int J Endocrinol 2017; 2017:7174958. [PMID: 28421112 PMCID: PMC5379129 DOI: 10.1155/2017/7174958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 12/19/2016] [Accepted: 12/29/2016] [Indexed: 01/08/2023] Open
Abstract
Aims. We investigated whether self-monitoring of blood glucose could be used to assess dawn phenomenon in Chinese people with type 2 diabetes mellitus (T2DM). Methods. A total of 306 people with T2DM underwent continuous glucose monitoring and self-monitoring of blood glucose for 72 h. A linear model was used to fit the optimal linear formula of the magnitude of dawn phenomenon (ΔDawn) and self-monitoring of blood glucose values. Results. The prevalence of dawn phenomenon was similar within different oral antidiabetic drug groups (42.5%, 31.5%, and 40.9%, P = 0.216). Multiple variable linear regression showed that prebreakfast, prelunch, and predinner glucose measurements were independently and significantly correlated with ΔDawn. The linear formula between ΔDawn and blood glucose was as follows: ΔDawn (mg/dL) = 0.557 × prebreakfast - 0.065 × prelunch - 0.164 × predinner - 20.894 (mg/dL) (adjusted R2 = 0.302, P = 0.000). Conclusions. Dawn phenomenon could be partly assessed by blood glucose self-monitoring in Chinese people with T2DM using the abovementioned formula. The incidence of dawn phenomenon was similar among patients in different oral antidiabetic drug groups.
Collapse
Affiliation(s)
- Wen Wu
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yananxi Road, Shanghai 200040, China
| | - Yuxin Huang
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yananxi Road, Shanghai 200040, China
| | - Jieyuzhen Qiu
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yananxi Road, Shanghai 200040, China
| | - Jiao Sun
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yananxi Road, Shanghai 200040, China
| | - Haidong Wang
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yananxi Road, Shanghai 200040, China
- *Haidong Wang:
| |
Collapse
|
25
|
Mok A, Haldar S, Lee JCY, Leow MKS, Henry CJ. Postprandial changes in cardiometabolic disease risk in young Chinese men following isocaloric high or low protein diets, stratified by either high or low meal frequency - a randomized controlled crossover trial. Nutr J 2016; 15:27. [PMID: 26979583 PMCID: PMC4793530 DOI: 10.1186/s12937-016-0141-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/24/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Cardio-Metabolic Disease (CMD) is the leading cause of death globally and particularly in Asia. Postprandial elevation of glycaemia, insulinaemia, triglyceridaemia are associated with an increased risk of CMD. While studies have shown that higher protein intake or increased meal frequency may benefit postprandial metabolism, their combined effect has rarely been investigated using composite mixed meals. We therefore examined the combined effects of increasing meal frequency (2-large vs 6-smaller meals), with high or low-protein (40 % vs 10 % energy from protein respectively) isocaloric mixed meals on a range of postprandial CMD risk markers. METHODS In a randomized crossover study, 10 healthy Chinese males (Age: 29 ± 7 years; BMI: 21.9 ± 1.7 kg/m(2)) underwent 4 dietary treatments: CON-2 (2 large Low-Protein meals), CON-6 (6 Small Low-Protein meals), PRO-2 (2 Large High-Protein meals) and PRO-6 (6 Small High-Protein meals). Subjects wore a continuous glucose monitor (CGM) and venous blood samples were obtained at baseline and at regular intervals for 8.5 h to monitor postprandial changes in glucose, insulin, triglycerides and high sensitivity C-reactive protein (hsCRP). Blood pressure was measured at regular intervals pre- and post- meal consumption. Urine was collected to measure excretion of creatinine and F2-isoprostanes and its metabolites over the 8.5 h postprandial period. RESULTS The high-protein meals, irrespective of meal frequency were beneficial for glycaemic health since glucose incremental area under the curve (iAUC) for PRO-2 (185 ± 166 mmol.min.L(-1)) and PRO-6 (214 ± 188 mmol.min.L(-1)) were 66 and 60 % lower respectively (both p < 0.05), compared with CON-2 (536 ± 290 mmol.min.L(-1)). The iAUC for insulin was the lowest for PRO-6 (13.7 ± 7.1 U.min.L(-1)) as compared with CON-2 (28.4 ± 15.6 U.min.L(-)1), p < 0.001. There were no significant differences in postprandial responses in other measurements between the dietary treatments. CONCLUSIONS The consumption of composite meals with higher protein content, irrespective of meal frequency appears to be beneficial for postprandial glycemic and insulinemic responses in young, healthy Chinese males. Implications of this study may be useful in the Asian context where the consumption of high glycemic index, carbohydrate meals is prevalent. TRIAL REGISTRATION NCT02529228 .
Collapse
Affiliation(s)
- Alexander Mok
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
| | - Sumanto Haldar
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
| | - Jetty Chung-Yung Lee
- School of Biological Sciences, Kadoorie Biological Sciences Building, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, SAR China
| | - Melvin Khee-Shing Leow
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609 Singapore
- Division of Medicine, Department of Endocrinology, Tan Tock Seng Hospital, 11, Jalan Tang Tock Seng, Singapore, 308433 Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609 Singapore
- Department of Biochemistry, National University of Singapore, 8 Medical Drive, Singapore, 117596 Singapore
| |
Collapse
|
26
|
Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: Comparisons of representative nationwide sample data. Obes Res Clin Pract 2015; 10:642-651. [PMID: 26750428 DOI: 10.1016/j.orcp.2015.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/15/2015] [Accepted: 11/02/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUNDS Variation among ethnic groups in the association between obesity and insulin resistance (IR)/diabetes has been suggested, but studies reported inconsistent results. We evaluated ethnic differences in the association between obesity and insulin resistance (IR)/diabetes. METHODS We conducted a cross-sectional analysis using Korea (n=18,845) and the USA (n=4657) National Health and Nutrition Examination Survey(NHANES) 2007-2010. We performed statistical comparisons of AUC-ROC (area under the curve in a receiver operating characteristic curve) values for body mass index (BMI), waist circumference (WC) and homeostasis model assessment of insulin resistance (HOMA-IR) to predict IR or diabetes among different ethnic groups. RESULTS AUC-ROC values for BMI and WC for predicting IR were highest in Whites (0.8324 and 0.8468) and lowest in Koreans (0.7422 and 0.7367). Whites showed the highest AUC-ROC values for BMI (0.6869) and WC (0.7421) for predicting diabetes, while the AUC-ROC for HOMA-IR was highest in Koreans (0.8861). Linear regression showed significant interactions between ethnicity and the main effects (all P<0.0001). Increases in BMI were associated with a larger increase in HOMA-IR in Whites (β=0.0719) and WC in Hispanics (β=0.0324), while BMI was associated with a larger increase in fasting glucose in Koreans (β=0.8279) and WC in Blacks (β=0.4037). In addition, the slope for fasting glucose with increasing HOMA-IR was steeper in Koreans (β=16.5952, P<0.001) than in other groups. CONCLUSION The ability of BMI and WC to predict IR and diabetes was highest in Whites, while the ability of HOMA-IR to predict diabetes was highest in Koreans.
Collapse
|
27
|
Goh GBB, Kwan C, Lim SY, Venkatanarasimha NK, Abu-Bakar R, Krishnamoorthy TL, Shim HH, Tay KH, Chow WC. Perceptions of non-alcoholic fatty liver disease - an Asian community-based study. Gastroenterol Rep (Oxf) 2015; 4:131-5. [PMID: 26463276 PMCID: PMC4863187 DOI: 10.1093/gastro/gov047] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 08/23/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is closely related to metabolic syndrome and its risk factors. Worldwide, epidemiological studies have reported NAFLD prevalence rates of 5% to 30% depending on geographical variations. While epidemiological data suggest a progressively increasing prevalence of metabolic risk factors in Singapore, there are limited data about NAFLD per se in the community. We aim to explore the prevalence and perceptions of NAFLD in Singapore. METHODS Attendees at a gastroenterology public forum were enrolled in a cross-sectional observational study evaluating demographic, anthropometric and clinical information. The diagnosis of NAFLD was based on sonographic criteria. Metabolic syndrome was defined according to International Diabetes Federation guidelines. Perceptions of NAFLD were explored using a self-administered survey questionnaire. RESULTS A total of 227 subjects were recruited, with NAFLD being diagnosed in 40% of the cohort. Relative to those without NAFLD, subjects with NAFLD had higher male preponderance, older age, higher body mass index, waist circumference and more metabolic syndrome (all P < 0.05). Although 71.2% subjects had heard about NAFLD before, only 25.4% of them felt that they were at risk of NAFLD. Comparable responses were observed in subjects with no metabolic risk factors relative to subjects with one or more metabolic risk factors (P > 0.05). Of note, 75.6% of subjects with one or more metabolic risk factors did not think that they were at risk of NAFLD. CONCLUSION Our study suggests a significant local prevalence of NAFLD in the community including non-obese individuals. Considering the tendency to underestimate risk of NAFLD, enhanced public education about NAFLD is warranted to improve understanding.
Collapse
Affiliation(s)
- George B B Goh
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Duke-NUS Graduate Medical School, Singapore and
| | - Clarence Kwan
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore
| | - Sze Ying Lim
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | | | - Rafidah Abu-Bakar
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | | | - Hang Hock Shim
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore
| | - Kiang Hiong Tay
- Duke-NUS Graduate Medical School, Singapore and Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - Wan Cheng Chow
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Duke-NUS Graduate Medical School, Singapore and
| |
Collapse
|
28
|
Body Composition in Asians and Caucasians: Comparative Analyses and Influences on Cardiometabolic Outcomes. ADVANCES IN FOOD AND NUTRITION RESEARCH 2015; 75:97-154. [PMID: 26319906 DOI: 10.1016/bs.afnr.2015.07.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Within the last four decades Asia has witnessed major transformation in its population demographics, which gave rise to changes in food availability, food habits and lifestyle. A significant consequence of these changes has been the continuing rise in overweight and obesity across Asia. In parallel, there has been a significant rise in Asians in the incidence of the major chronic diseases, particularly in cardiometabolic disorders such as metabolic syndrome, type 2 diabetes, hypertension, and other cardiovascular diseases. Given that the majority of the evidence, to date, investigating the associations between adiposity and cardiometabolic disorder risk have been obtained from studies undertaken either in European or in North American Caucasians, in this chapter, we have reviewed differences in body fat content and distribution between East Asians, South Asians, and Caucasians. The evidence is consistent that the content and distribution of body fat are markedly different between the various ethnic groups. We found that Asians have a greater predisposition towards adiposity at higher BMI than in Caucasians. Moreover, at any given level of adiposity, Asians have a much greater predisposition to risk of cardiometabolic disorders than Caucasians. We therefore strongly endorse the need for different adiposity cutoffs in Asians as compared to the Caucasians. We have also reviewed the predictive abilities of the various body composition/adiposity measures in determining risk of cardiometabolic disorders in Asians.
Collapse
|
29
|
Huang BT, Peng Y, Liu W, Zhang C, Huang FY, Wang PJ, Zuo ZL, Liao YB, Chai H, Huang KS, Huang DJ, Chen M. Lean mass index, body fat and survival in Chinese patients with coronary artery disease. QJM 2015; 108:641-7. [PMID: 25609701 DOI: 10.1093/qjmed/hcv013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND 'Obesity paradox' was not consistently observed in Asians with coronary artery disease (CAD). AIM The study investigated the association between body composition and outcomes in Chinese patients with CAD. DESIGN Cohort study. METHOD A total of 3280 patients with angiographically validated CAD were consecutively included. Body fat (BF) percentage and lean mass index (LMI) were evaluated using the Clínica Universidad de Navarra-Body Adiposity Estimator. The rate of mortality from any cause was compared across groups classified by the quartiles of LMI. RESULTS During a median period of 24 months, 288 (8.8%) participants died. There was a close association between increasing LMI and reducing mortality rate. However, univariate analyses did not find protective effect of BF on survival. After adjusting for age, sex, diabetes, current smoking, systolic blood pressure, creatinine, white blood cell count, haemoglobin and medication, Cox regression analyses showed that the significant relation between higher quartiles (Q) of LMI and survival benefit (Q4, hazard ratio 0.58 (95% confidence interval: 0.36-0.94) vs. Q3, 0.60 (0.39-0.91) vs. Q2, 0.60 (0.41-0.88) vs. Q1, reference) remained. CONCLUSION Low LMI but not BF predicts all-cause mortality in Chinese patients with CAD.
Collapse
Affiliation(s)
- B-T Huang
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - Y Peng
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - W Liu
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - C Zhang
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - F-Y Huang
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - P-J Wang
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - Z-L Zuo
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - Y-B Liao
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - H Chai
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - K-S Huang
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - D-J Huang
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| | - M Chen
- From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China
| |
Collapse
|
30
|
Rao G, Powell-Wiley TM, Ancheta I, Hairston K, Kirley K, Lear SA, North KE, Palaniappan L, Rosal MC. Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations: A Scientific Statement From the American Heart Association. Circulation 2015; 132:457-72. [PMID: 26149446 DOI: 10.1161/cir.0000000000000223] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
31
|
Gadgil MD, Anderson CAM, Kandula NR, Kanaya AM. Dietary patterns are associated with metabolic risk factors in South Asians living in the United States. J Nutr 2015; 145:1211-7. [PMID: 25904730 PMCID: PMC4442115 DOI: 10.3945/jn.114.207753] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 03/23/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND South Asians are at high risk of metabolic syndrome, and dietary patterns may influence this risk. OBJECTIVES We aimed to determine prevalent dietary patterns for South Asians in the United States and their associations with risk factors for metabolic syndrome. METHODS South Asians aged 40-84 y without known cardiovascular disease were enrolled in a community-based cohort called Mediators of Atherosclerosis in South Asians Living in America. A validated food frequency questionnaire and serum samples for fasting and 2-h glucose, insulin, glycated hemoglobin, triglycerides, and total and HDL cholesterol were collected cross-sectionally. We used principal component analysis with varimax rotation to determine dietary patterns, and sequential linear and logistic regression models for associations with metabolic factors. RESULTS A total of 892 participants were included (47% women). We identified 3 major dietary patterns: animal protein; fried snacks, sweets, and high-fat dairy; and fruits, vegetables, nuts, and legumes. These were analyzed by tertile of factor score. The highest vs. the lowest tertile of the fried snacks, sweets, and high-fat dairy pattern was associated with higher homeostasis model assessment of insulin resistance (HOMA-IR) (β: 1.88 mmol/L ⋅ uIU/L) and lower HDL cholesterol (β: -4.48 mg/dL) in a model adjusted for age, sex, study site, and caloric intake (P < 0.05). The animal protein pattern was associated with higher body mass index (β: 0.73 m/kg(2)), waist circumference (β: 0.84 cm), total cholesterol (β: 8.16 mg/dL), and LDL cholesterol (β: 5.69 mg/dL) (all P < 0.05). The fruits, vegetables, nuts, and legumes pattern was associated with lower odds of hypertension (OR: 0.63) and metabolic syndrome (OR: 0.53), and lower HOMA-IR (β: 1.95 mmol/L ⋅ uIU/L) (P < 0.05). CONCLUSIONS The animal protein and the fried snacks, sweets, and high-fat dairy patterns were associated with adverse metabolic risk factors in South Asians in the United States, whereas the fruits, vegetables, nuts, and legumes pattern was linked with a decreased prevalence of hypertension and metabolic syndrome.
Collapse
Affiliation(s)
- Meghana D Gadgil
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA;
| | - Cheryl AM Anderson
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA; and
| | - Namratha R Kandula
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alka M Kanaya
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
| |
Collapse
|
32
|
Tillin T, Sattar N, Godsland IF, Hughes AD, Chaturvedi N, Forouhi NG. Ethnicity-specific obesity cut-points in the development of Type 2 diabetes - a prospective study including three ethnic groups in the United Kingdom. Diabet Med 2015; 32:226-34. [PMID: 25186015 PMCID: PMC4441277 DOI: 10.1111/dme.12576] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 12/13/2022]
Abstract
AIMS Conventional definitions of obesity, e.g. body mass index (BMI) ≥ 30 kg/m² or waist circumference cut-points of 102 cm (men) and 88 cm (women), may underestimate metabolic risk in non-Europeans. We prospectively identified equivalent ethnicity-specific obesity cut-points for the estimation of diabetes risk in British South Asians, African-Caribbeans and Europeans. METHODS We studied a population-based cohort from London, UK (1356 Europeans, 842 South Asians, 335 African-Caribbeans) who were aged 40-69 years at baseline (1988-1991), when they underwent anthropometry, fasting and post-load (75 g oral glucose tolerance test) blood tests. Incident Type 2 diabetes was identified from primary care records, participant recall and/or follow-up biochemistry. Ethnicity-specific obesity cut-points in association with diabetes incidence were estimated using negative binomial regression. RESULTS Diabetes incidence rates (per 1000 person years) at a median follow-up of 19 years were 20.8 (95% CI: 18.4, 23.6) and 12.0 (8.3, 17.2) in South Asian men and women, 16.5 (12.7, 21.4) and 17.5 (13.0, 23.7) in African-Caribbean men and women, and 7.4 (6.3, 8.7), and 7.2 (5.3, 9.8) in European men and women. For incidence rates equivalent to those at a BMI of 30 kg/m² in European men and women, age- and sex-adjusted cut-points were: South Asians, 25.2 (23.4, 26.6) kg/m²; and African-Caribbeans, 27.2 (25.2, 28.6) kg/m². For South Asian and African-Caribbean men, respectively, waist circumference cut-points of 90.4 (85.0, 94.5) and 90.6 (85.0, 94.5) cm were equivalent to a value of 102 cm in European men. Waist circumference cut-points of 84.0 (74.0, 90.0) cm in South Asian women and 81.2 (71.4, 87.4) cm in African-Caribbean women were equivalent to a value of 88 cm in European women. CONCLUSIONS In prospective analyses, British South Asians and African-Caribbeans had equivalent diabetes incidence rates at substantially lower obesity levels than the conventional European cut-points.
Collapse
Affiliation(s)
- T Tillin
- UCL Institute of Cardiovascular Science, University College London, London
| | | | | | | | | | | |
Collapse
|
33
|
Vahabi M, Damba C. A Feasibility Study of a Culturally and Gender-specific Dance to Promote Physical Activity for South Asian Immigrant Women in the Greater Toronto Area. Womens Health Issues 2015; 25:79-87. [DOI: 10.1016/j.whi.2014.09.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 11/28/2022]
|
34
|
L. Jackson H. RISK OF TYPE 2 DIABETES AMONG US AND FOREIGN BORN NON-HISPANIC ASIANS: EVIDENCE FROM NHANES. ACTA ACUST UNITED AC 2015. [DOI: 10.15436/2376-0494.15.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
35
|
Manjoo P, Dannenbaum D, Joseph L, Torrie J, Dasgupta K. Utility of current obesity thresholds in signaling diabetes risk in the James Bay Cree of Eeyou Istchee. BMJ Open Diabetes Res Care 2015; 3:e000114. [PMID: 26301098 PMCID: PMC4537917 DOI: 10.1136/bmjdrc-2015-000114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 07/14/2015] [Accepted: 07/25/2015] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The anthropometric thresholds signaling type 2 diabetes risk have not been well defined for Aboriginal communities. This study examined current thresholds in terms of ability to capture diabetes risk in the Cree of Eeyou Istchee in northern Quebec, Canada. RESEARCH DESIGN AND METHODS The study cohort for this analysis included adult participants from the Nituuchischaayihtitaau Aschii Multi-Community Environment and Health Study with complete data on anthropometric measures, fasting glucose, and insulin. Diabetes risk was defined as Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value >2. Positive and negative likelihood ratios (PLR, NLR) of existing obesity thresholds were evaluated (WHO; International Diabetes Federation, IDF; Adult Treatment Panel III, ATP III). Receiver operating curves were examined to estimate optimal thresholds. In a sensitivity analysis, diabetes risk was defined as HOMA-IR >2.7. RESULTS The WHO 30 kg/m(2) body mass index (BMI) threshold performed well in women (PLR 5.56, 95% CI 1.95 to 15.9; NLR 0.24, 95% CI 0.19 to 0.31) and men (PLR 7.51, 95% CI 2.94 to 19.2; NLR 0.33, 95% CI 0.27 to 0.41). It was close to the estimated optimal threshold (28.5 kg/m(2)). The ATP III waist circumference threshold (102 cm) performed well in men (PLR 4.64, 95% CI 2.47 to 8.71; NLR 0.21, 95% CI 0.16 to 0.28) and was close to the estimated optimal threshold (101 cm). With diabetes risk defined at HOMA-IR >2.7, PLR values were slightly lower with narrower 95% CIs and optimal thresholds were slightly higher; PLR values remained above 3. For other current thresholds, estimated optimal values were higher and none had a PLR above 2. CONCLUSIONS A BMI of 30 kg/m(2) in women and men, and a 102 cm waist circumference in men, are meaningful obesity thresholds in this Aboriginal population. Other thresholds require a further evaluation.
Collapse
Affiliation(s)
- Priya Manjoo
- Department of Medicine, University of Victoria, Victoria, British Columbia, Canada
| | - David Dannenbaum
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- Public Health Department of the Cree Territory, Cree Board of Health & Social Services of James Bay, Chisasibi, Quebec, Canada
| | - Lawrence Joseph
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jill Torrie
- Public Health Department of the Cree Territory, Cree Board of Health & Social Services of James Bay, Chisasibi, Quebec, Canada
| | - Kaberi Dasgupta
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
36
|
Iqbal M, Al-Regaiey KA, Ahmad S, Al Dokhi L, Al Naami M, Habib SS. Body composition analysis to determine gender specific physical fitness equations in a cohort of Saudi population. Pak J Med Sci 2014; 30:798-903. [PMID: 25097520 PMCID: PMC4121701 DOI: 10.12669/pjms.304.4974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 02/13/2014] [Accepted: 04/02/2014] [Indexed: 01/17/2023] Open
Abstract
Objective: To determine an association between body composition analysis and physical fitness in the Saudi population and derive gender specific physical fitness equations. Methods: A total of 530 healthy Saudi adults aged 15-72 years (mean 37.16±14.12 years) were enrolled in this study. Body composition analysis was assessed by bioelectrical impedance analysis (BIA), with a commercially available body analyzer according to standard protocols. Results: Different body composition parameters, such as age, height, BSA (body surface area), obesity degree, body mass index (BMI), body fat mass (BFM) and percent body fat (% BF) contents were significantly different in males and females except weight which was non-significant (p=0.649). There was significant positive or negative correlation among different body composition parameters except weight with age in males and weight with age, height and BSA in females. In males, all the body composition characteristics contributed to the fitness score except BMI and BFM, while in females, the most significant effect was contributed by weight and BFM. Female body composition characteristics were strongly related to fitness score compared to males (R2 = 93.8% vs R2 = 78.5%). Conclusions: Different body composition parameters like BFM and %BF played an important role in determining physical fitness of healthy male individuals instead of BMI, weight and BSA, while in females weight was the best predictor of physical fitness.
Collapse
Affiliation(s)
- Muhammad Iqbal
- Muhammad Iqbal, Khalid A Al-Regaiey, Department of Physiology, College of Medicine & King Khalid University Hospital, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Khalid A Al-Regaiey
- Shafiq Ahmad, Department of Management, College of Business, Al-Yamamah University, P.O. Box 45180, Riyadh 11512, Saudi Arabia
| | - Shafiq Ahmad
- Laila Al Dokhi, Department of Physiology, College of Medicine & King Khalid University Hospital, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Laila Al Dokhi
- Mohammad Al Naami, Department of Surgery, College of Medicine & King Khalid University Hospital, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Mohammad Al Naami
- Mohammad Al Naami, Department of Physiology, College of Medicine & King Khalid University Hospital, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Syed Shahid Habib
- Syed Shahid Habib, Department of Physiology, College of Medicine & King Khalid University Hospital, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| |
Collapse
|
37
|
Rana A, de Souza RJ, Kandasamy S, Lear SA, Anand SS. Cardiovascular risk among South Asians living in Canada: a systematic review and meta-analysis. CMAJ Open 2014; 2:E183-91. [PMID: 25295238 PMCID: PMC4183167 DOI: 10.9778/cmajo.20130064] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND South Asians represent about 3% of the Canadian population and have a higher burden of certain cardiovascular risk factors and cardiovascular disease (CVD) compared with white people. The objective of this study was to review the literature to compare cardiovascular risk factors and disease management practices among adult South Asian and white Canadians. METHODS We searched MEDLINE, Embase, Cochrane and Cumulative Index to Nursing and Allied Health Literature databases from their inception through Feb. 17, 2014 and the reference lists of the selected articles. English-language studies of interventions and observational studies of biological mechanisms underlying CVD risk in South Asians conducted in Canada were eligible for inclusion. Where appropriate, we used random-effects meta-analyses to integrate results comparing the CVD risk profiles of South Asian and white Canadians. RESULTS We included 50 articles (n = 5 805 313 individuals) in this review. Compared with white Canadians, South Asian Canadians had a higher prevalence and incidence of CVD, an increased prevalence of diabetes (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.81 to 2.80, p < 0.001) and hypertension (OR 1.11, 95% CI 1.02 to 1.22, p = 0.02), lower high-density lipoprotein cholesterol levels (mean difference -0.19 mmol/L, 95% CI -0.25 to -0.13 mmol/L, p < 0.001) and a higher percentage of body fat (men: absolute mean difference 3.23%, 95% CI 0.83% to 5.62%, p = 0.008; women: absolute mean difference 4.09%, 95% CI 3.46% to 4.72%, p < 0.001). South Asian people are also more sedentary, consume higher levels of carbohydrates and are less likely to smoke tobacco (OR 0.38, 95% CI 0.24 to 0.60, p < 0.001]) than white Canadians. No differences in access to diagnostic tests, outcomes following cardiovascular surgery or use of cardiac rehabilitation programs were apparent. INTERPRETATION Compared with white people, South Asian people living in Canada have a higher prevalence and incidence of CVD and possess a unique cardiovascular risk profile.
Collapse
Affiliation(s)
- Ayesha Rana
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. ; Chanchlani Research Centre, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont
| | - Russell J de Souza
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. ; Chanchlani Research Centre, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont. ; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ont
| | - Sujane Kandasamy
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. ; Chanchlani Research Centre, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC ; Division of Cardiology, Providence Health Care, Vancouver, BC
| | - Sonia S Anand
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. ; Chanchlani Research Centre, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ont. ; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ont
| |
Collapse
|
38
|
Shih M, Du Y, Lightstone AS, Simon PA, Wang MC. Stemming the tide: rising diabetes prevalence and ethnic subgroup variation among Asians in Los Angeles County. Prev Med 2014; 63:90-5. [PMID: 24657547 DOI: 10.1016/j.ypmed.2014.03.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 01/22/2014] [Accepted: 03/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The primary objective of this analysis was to examine the burden of diabetes among Asians and Asian subgroups in Los Angeles County, which has the largest county population of Asians in the U.S. METHOD Data were analyzed from 6cycles of the Los Angeles County Health Survey, 1997-2011 (n=47,282). Asian adults (n=4672) were categorized into the following ethnic subgroups: Chinese, Filipino, Korean, Japanese, Vietnamese, South Asian, and Other Asian. Descriptive and multivariable logistic regression analyses were conducted to examine trends in prevalence, prevalence among Asian subgroups, and factors associated with diabetes. RESULTS In 2005, we observed a rapid increase in diabetes prevalence among Asians compared to whites despite consistently lower BMI relative to other racial/ethnic groups. Diabetes prevalence was significantly higher among Filipinos and South Asians (>10%) compared to East Asians and Vietnamese (<7%). After adjusting for all covariates, Asians who were older, non-drinkers, insured, and overweight or obese were found to have increased odds of diabetes. CONCLUSION Diabetes prevalence is increasing more rapidly among Asians compared to whites despite overall lower BMI. The significant heterogeneity among Asian subgroups highlights the need for disaggregated data and additional research to develop culturally appropriate interventions for diabetes prevention and control.
Collapse
Affiliation(s)
- Margaret Shih
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Rm 127, Los Angeles, CA 90012, USA.
| | - Yajun Du
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Rm 127, Los Angeles, CA 90012, USA.
| | - Amy S Lightstone
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Rm 127, Los Angeles, CA 90012, USA.
| | - Paul A Simon
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA 90010, USA; UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA.
| | - May C Wang
- UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA.
| |
Collapse
|
39
|
Goh LGH, Dhaliwal SS, Welborn TA, Lee AH, Della PR. Ethnicity and the association between anthropometric indices of obesity and cardiovascular risk in women: a cross-sectional study. BMJ Open 2014; 4:e004702. [PMID: 24852299 PMCID: PMC4039846 DOI: 10.1136/bmjopen-2013-004702] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES The objectives of this study were to determine whether the cross-sectional associations between anthropometric obesity measures, body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR), and calculated 10-year cardiovascular disease (CVD) risk using the Framingham and general CVD risk score models, are the same for women of Australian, UK and Ireland, North European, South European and Asian descent. This study would investigate which anthropometric obesity measure is most predictive at identifying women at increased CVD risk in each ethnic group. DESIGN Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. SETTING Population-based survey in Australia. PARTICIPANTS 4354 women aged 20-69 years with no history of heart disease, diabetes or stroke. Most participants were of Australian, UK and Ireland, North European, South European or Asian descent (97%). OUTCOME MEASURES Anthropometric obesity measures that demonstrated stronger predictive ability of identifying women at increased CVD risk and likelihood of being above the promulgated treatment thresholds of various risk score models. RESULTS Central obesity measures, WC and WHR, were better predictors of cardiovascular risk. WHR reported a stronger predictive ability than WC and BMI in Caucasian women. In Northern European women, BMI was a better indicator of risk using the general CVD (10% threshold) and Framingham (20% threshold) risk score models. WC was the most predictive of cardiovascular risk among Asian women. CONCLUSIONS Ethnicity should be incorporated into CVD assessment. The same anthropometric obesity measure cannot be used across all ethnic groups. Ethnic-specific CVD prevention and treatment strategies need to be further developed.
Collapse
Affiliation(s)
- Louise G H Goh
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Satvinder S Dhaliwal
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Timothy A Welborn
- Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, Western Australia, Australia
| | - Andy H Lee
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Phillip R Della
- School of Nursing and Midwifery, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
40
|
Chong PW, Beah ZM, Grube B, Riede L. IQP-GC-101 reduces body weight and body fat mass: a randomized, double-blind, placebo-controlled study. Phytother Res 2014; 28:1520-6. [PMID: 24797657 PMCID: PMC4235473 DOI: 10.1002/ptr.5158] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 03/06/2014] [Accepted: 03/26/2014] [Indexed: 12/19/2022]
Abstract
IQP-GC-101 is a patented blend of the standardized extracts of Garcinia cambogia, Camellia sinensis, unroasted Coffea arabica, and Lagerstroemia speciosa. These individual ingredients of IQP-GC-101 have each shown promise in promoting weight loss; however, the efficacy of the blend has not been established. This randomized, placebo-controlled, double-blind, parallel group study conducted over 14 weeks (including a 2-week run-in phase) aimed to investigate the efficacy and safety of IQP-GC-101 in reducing body weight and body fat mass in overweight Caucasian adults. Subjects took three IQP-GC-101 or placebo tablets, twice a day, 30 min before main meals. All subjects also adhered to a 500 kcal/day energy deficit diet with 30% of energy from fat. Ninety-one overweight and mildly obese subjects (46 in the IQP-GC-101 group, 45 in the placebo group) completed the study. After 12-week intervention, IQP-GC-101 resulted in a mean (±SD) weight loss of 2.26 ± 2.37 kg compared with 0.56 ± 2.34 kg for placebo (pU = 0.002). There was also significantly more reduction in body fat mass, waist circumference, and hip circumference in the IQP-GC-101 group. No serious adverse events were reported. The use of IQP-GC-101 has been shown to result in body weight and body fat reduction in the current study, with good tolerability.
Collapse
Affiliation(s)
- Pee-Win Chong
- InQpharm Europe Ltd, Invision House, Wilbury Way, Hitchin, Hertfordshire, SG4 0TY, UK
| | | | | | | |
Collapse
|
41
|
Anthropometric parameters in relation to glycaemic status and lipid profile in a multi-ethnic sample in Italy. Public Health Nutr 2014; 18:438-45. [PMID: 24762650 DOI: 10.1017/s1368980014000615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine the health status of ethnic minorities in Italy. Furthermore, we aimed to assess the association between anthropometric and blood parameters connected with health status. DESIGN A cross-sectional study. Anthropometric data were collected by direct measurements and blood glucose, total cholesterol and TAG were analysed. SETTING Bologna, northern Italy. SUBJECTS A multi-ethnic sample of adult immigrants and Roma. RESULTS Significant correlations between anthropometric and blood parameters were found. Among the ethnic groups, Roma males had the highest values of glucose, total cholesterol and TAG. In the females the situation was more balanced among ethnic groups. CONCLUSIONS The data from this survey indicate that poor health status is a very common problem among ethnic groups living in Italy, especially the Roma. The use of anthropometric parameters as rapid indicators of health status in screenings of a large number of subjects could be an effective and cheap method to provide preliminary indications on individuals or ethnic groups at greater risk of poor health.
Collapse
|
42
|
Katz EG, Stevens J, Truesdale KP, Cai J, North KE, Steffen LM. Associations of body mass index with incident hypertension in American white, American black and Chinese Asian adults in early and middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Atherosclerosis Risk in Communities (ARIC) study and the People's Republic of China (PRC) study. Asia Pac J Clin Nutr 2014; 22:626-34. [PMID: 24231024 DOI: 10.6133/apjcn.2013.22.4.12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The association of body mass index (BMI) with blood pressure may be stronger in Asian than non-Asian populations, however, longitudinal studies with direct comparisons between ethnicities are lacking. We compared the relationship of BMI with incident hypertension over approximately 9.5 years of follow-up in young (24-39 years) and middle-aged (45-64 years) Chinese Asians (n=5354), American Blacks (n=6076) and American Whites (n=13451). We estimated risk differences using logistic regression models and calculated adjusted incidences and incidence differences. To facilitate comparisons across ethnicities, standardized estimates were calculated using mean covariate values for age, sex, smoking, education and field center, and included the quadratic terms for BMI and age. Weighted least-squares regression models with were constructed to summarize ethnic-specific incidence differences across BMI. Wald statistics and p-values were calculated based on chi-square distributions. The association of BMI with the incidence difference for hypertension was steeper in Chinese (p<0.05) than in American populations during young and middle-adulthood. For example, at a BMI of 25 vs 21 kg/m2 the adjusted incidence differences per 1000 persons (95% CI) in young adults with a BMI of 25 vs those with a BMI of 21 was 83 (36- 130) for Chinese, 50 (26-74) for Blacks and 30 (12-48) for Whites; among middle-aged adults it was 137 (77-198) for Chinese, 49 (9-88) for Blacks and 54 (38-69) for Whites. Whether hypertension carries the same level of risk of stroke or cardiovascular disease across national or ethnic groups remains uncertain.
Collapse
Affiliation(s)
- Eva G Katz
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7461, Chapel Hill 27599, U.S.A.
| | | | | | | | | | | |
Collapse
|
43
|
Bajaj HS, Pereira MA, Anjana RM, Deepa R, Mohan V, Mueller NT, Rao GHR, Gross MD. Comparison of relative waist circumference between Asian Indian and US adults. J Obes 2014; 2014:461956. [PMID: 25328687 PMCID: PMC4189975 DOI: 10.1155/2014/461956] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/29/2014] [Accepted: 06/15/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Relative to Europeans, Asian Indians have higher rates of type 2 diabetes and cardiovascular disease. Whether differences in body composition may underlie these population differences remains unclear. METHODS We compared directly measured anthropometric data from the Chennai Urban Rural Epidemiology Study (CURES) survey of southern Indians (I) with those from three US ethnic groups (C: Caucasians, A: African Americans, and M: Mexican Americans) from NHANES III (Third National Health and Nutrition Examination Survey). A total of 15,733 subjects from CURES and 5,975 from NHANES III met inclusion criteria (age 20-39, no known diabetes). RESULTS Asian Indian men and women had substantially lower body mass index, waist circumference, hip circumference, waist-to-hip ratio, and body surface area relative to US groups (P values <0.0001). In contrast, the mean (±se) waist-weight ratio was significantly higher (P < 0.001) in I (men 1.35 ± 0.002 and women 1.45 ± 0.002) than in all the US groups (1.09, 1.21, and 1.14 in A, M, and C men; 1.23, 1.33, and 1.26 in A, M, and C women (se ranged from 0.005 to 0.006)). CONCLUSIONS Compared to the US, the waist-weight ratio is significantly higher in men and women from Chennai, India. These results support the hypothesis that Southeast Asian Indians are particularly predisposed toward central adiposity.
Collapse
Affiliation(s)
| | - Mark A. Pereira
- Division of Epidemiology & Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA
- *Mark A. Pereira:
| | - Rajit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu 600 086, India
| | - Raj Deepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu 600 086, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu 600 086, India
| | | | | | | |
Collapse
|
44
|
Yu D, Shu XO, Li H, Xiang YB, Yang G, Gao YT, Zheng W, Zhang X. Dietary carbohydrates, refined grains, glycemic load, and risk of coronary heart disease in Chinese adults. Am J Epidemiol 2013; 178:1542-9. [PMID: 24008907 PMCID: PMC3888273 DOI: 10.1093/aje/kwt178] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/24/2013] [Indexed: 11/13/2022] Open
Abstract
The potential long-term association between carbohydrate intake and the risk of coronary heart disease (CHD) remains unclear, especially among populations who habitually have high-carbohydrate diets. We prospectively examined intakes of carbohydrates and staple grains as well as glycemic index and glycemic load in relation to CHD among 117,366 Chinese women and men (40-74 years of age) without history of diabetes, CHD, stroke, or cancer at baseline in Shanghai, China. Diet was assessed using validated food frequency questionnaires. Incident CHD cases were ascertained during follow-ups (in women, the mean was 9.8 years and in men, the mean was 5.4 years) and confirmed by medical records. Carbohydrate intake accounted for 67.5% of the total energy intake in women and 68.5% in men. Seventy percent of total carbohydrates came from white rice and 17% were from refined wheat products. Positive associations between carbohydrate intakess and CHD were found in both sexes (all P for heterogeneity > 0.35). The combined multivariate-adjusted hazard ratios for the lowest to highest quartiles of carbohydrate intake, respectively, were 1.00, 1.38, 2.03, and 2.88 (95% confidence interval: 1.44, 5.78; P for trend = 0.001). The combined hazard ratios comparing the highest quartile with the lowest were 1.80 (95% confidence interval: 1.01, 3.17) for refined grains and 1.87 (95% confidence interval: 1.00, 3.53) for glycemic load (both P for trend = 0.03). High carbohydrate intake, mainly from refined grains, is associated with increased CHD risk in Chinese adults.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Xianglan Zhang
- Correspondence to Dr. Xianglan Zhang, Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, 2525 West End Avenue, Suite 600, Nashville, TN 37203-1738 (e-mail: )
| |
Collapse
|
45
|
Sulistyoningrum DC, Gasevic D, Lear SA, Ho J, Mente A, Devlin AM. Total and high molecular weight adiponectin and ethnic-specific differences in adiposity and insulin resistance: a cross-sectional study. Cardiovasc Diabetol 2013; 12:170. [PMID: 24225161 PMCID: PMC4225823 DOI: 10.1186/1475-2840-12-170] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/08/2013] [Indexed: 12/02/2022] Open
Abstract
Background Ethnic-specific differences in insulin resistance (IR) are well described but the underlying mechanisms are unknown. Adiponectin is an insulin sensitizing adipocytokine that circulates as multiple isoforms, with high molecular weight (HMW) adiponectin associated with greatest insulin sensitivity. The objective of this study is to determine if plasma total and HMW adiponectin concentrations underlie ethnic-specific differences in IR. Methods Healthy Canadian Aboriginal, Chinese, European, and South Asian adults (N = 634) were assessed for sociodemographics; lifestyle; fasting plasma insulin, glucose, and total and HMW adiponectin; and adiposity measures [BMI, waist circumference, waist-to-hip ratio, percent body fat, and subcutaneous and visceral adipose tissue (quantified by computed tomography)]. The homeostasis model assessment-insulin resistance (HOMA-IR) assessed IR. Results South Asians had the greatest HOMA-IR, followed by Aboriginals, Chinese, and Europeans (P < 0.001). Plasma total and HMW adiponectin concentrations were lower in Chinese and South Asians than Aboriginal and Europeans (P < 0.05). Total and HMW adiponectin were inversely associated with HOMA-IR (P < 0.001). Ethnicity modified the relationship between HMW adiponectin and HOMA-IR with stronger effects observed in Aboriginals (P = 0.001), Chinese (P = 0.002), and South Asians (P = 0.040) compared to Europeans. This was not observed for total adiponectin (P = 0.431). At mean total adiponectin concentrations South Asians had higher HOMA-IR than Europeans (P < 0.001). Conclusions For each given decrease in HMW adiponectin concentrations a greater increase in HOMA-IR is observed in Aboriginals, Chinese, and South Asians than Europeans. Ethnic-specific differences in HMW adiponectin may account for differences in IR.
Collapse
Affiliation(s)
- Dian C Sulistyoningrum
- Department of Pediatrics, University of British Columbia, Child and Family Research Institute, 272-950 West 28th Avenue, Vancouver, V5Z 4H4, Canada.
| | | | | | | | | | | |
Collapse
|
46
|
Kohli S, Lear SA. Differences in subcutaneous abdominal adiposity regions in four ethnic groups. Obesity (Silver Spring) 2013; 21:2288-95. [PMID: 23703792 DOI: 10.1002/oby.20102] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 08/29/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Previous studies have identified ethnic specific differences in visceral adipose tissue (VAT), which may account for ethnic differences in cardio-metabolic risk. However, two distinctive sub-compartments of abdominal subcutaneous adipose tissue (SAT) have been recently identified that may also differ among ethnic groups. Therefore, the relationship between SAT compartments and body fat mass (BFM) between Aboriginal, Chinese, and South Asian cohorts compared to Europeans was investigated. DESIGN AND METHODS Healthy Aboriginal, Chinese, European, and South Asian (n = 822) men and women (30-65 years) were assessed for BFM via dual energy X-ray absorptiometry, and SAT areas using computer tomography. SAT was subdivided into superficial SAT (SSAT) and deep SAT (DSAT) via the fascia-superficialis. Linear regression was performed using DSAT and SSAT as separate dependent variables and BFM and ethnicity as primary independent variables adjusting for confounders. RESULTS Aboriginal (181.0 cm(2) ; p = 0.045) and South Asians (178.3 cm(2) ; p = 0.013) had significantly higher amounts of DSAT, whereas the Chinese cohort had significantly less when compared with Europeans (114.3 cm(2) ; p = <0.001). The Aboriginal cohort had a significantly higher amount of SSAT than Europeans (123.13 cm(2) vs. 108.7 cm(2) ; p = 0.04). Ethnicity modified the relationship between DSAT and BFM (p < 0.001 for interaction) such that Aboriginals and majority of South Asians had a significantly greater DSAT. CONCLUSION These data further demonstrate ethnic differences in body fat distribution such that Aboriginals and South Asians have greater amounts of DSAT. This may contribute to the increased cardio-metabolic risk in these groups.
Collapse
Affiliation(s)
- Simi Kohli
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | | |
Collapse
|
47
|
Alangh A, Chiu M, Shah BR. Rapid increase in diabetes incidence among Chinese Canadians between 1996 and 2005. Diabetes Care 2013; 36:3015-7. [PMID: 23723356 PMCID: PMC3781544 DOI: 10.2337/dc13-0052] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine trends in diabetes incidence among Ontario residents with Chinese and European origins. RESEARCH DESIGN AND METHODS Respondents to population-based health surveys in 1996, 2001, 2003, and 2005 who were aged≥30 years, who did not have diabetes, and who self-identified as having European (n=76,285) or Chinese (n=1,041) origins were followed for diabetes incidence through a validated administrative data-derived diabetes registry. RESULTS Age- and sex-standardized diabetes incidence increased from 1.3 to 19.6 per 1,000 person-years in the Chinese population and from 7.8 to 10.0 in the European population. Relative to the 1996 European population, the adjusted hazard ratio for diabetes was 4.50 (95% CI 1.89-7.49) for the 2005 Chinese population and 1.22 (1.05-1.39) for the 2005 European population. CONCLUSIONS Diabetes incidence increased much more rapidly between 1996 and 2005 in the Chinese population than in the European population, independent of age, obesity, and other risk factors.
Collapse
|
48
|
Andersen S, Fleischer Rex K, Noahsen P, Sørensen HCF, Mulvad G, Laurberg P. Raised BMI cut-off for overweight in Greenland Inuit--a review. Int J Circumpolar Health 2013; 72:21086. [PMID: 23986904 PMCID: PMC3755182 DOI: 10.3402/ijch.v72i0.21086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. Objective This led us to reconsider the cut-off point for overweight among Inuit in Greenland. Design and findings We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Conclusion Defining overweight according to the WHO cut-off of a BMI above 25 kg/m2 in Greenland Inuit may overestimate the number of individuals with elevated BMI.
Collapse
Affiliation(s)
- Stig Andersen
- Arctic Health Research Centre, Aalborg University Hospital, Aalborg, Denmark.
| | | | | | | | | | | |
Collapse
|
49
|
Wahi G, Wilson J, Miller R, Anglin R, McDonald S, Morrison KM, Teo KK, Anand SS. Aboriginal birth cohort (ABC): a prospective cohort study of early life determinants of adiposity and associated risk factors among Aboriginal people in Canada. BMC Public Health 2013; 13:608. [PMID: 23800270 PMCID: PMC3702421 DOI: 10.1186/1471-2458-13-608] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/19/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Aboriginal people living in Canada have a high prevalence of obesity, type 2 diabetes, and cardiovascular disease (CVD). To better understand the pre and postnatal influences on the development of adiposity and related cardio-metabolic factors in adult Aboriginal people, we will recruit and follow prospectively Aboriginal pregnant mothers and their children - the Aboriginal Birth Cohort (ABC) study. METHODS/DESIGN We aim to recruit 300 Aboriginal pregnant mothers and their newborns from the Six Nations Reserve, and follow them prospectively to age 3 years. Key details of environment and health including maternal nutrition, glucose tolerance, physical activity, and weight gain will be collected. At birth, cord blood and placenta samples will be collected, as well as newborn anthropometric measurements. Mothers and offspring will be followed annually with serial measurements of diet and physical activity, growth trajectory, and adiposity. DISCUSSION There is an urgent need to understand maternal and child factors that underlie the early development of adiposity and type 2 diabetes in Aboriginal people. The information generated from this cohort will assist the Six Nations community in developing interventions to prevent early adiposity in Aboriginal children.
Collapse
Affiliation(s)
- Gita Wahi
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Julie Wilson
- Six Nations Health Services, 1745 Chiefswood Rd, Ohsweken, ON N0A 1M0, Canada
| | - Ruby Miller
- Six Nations Health Services, 1745 Chiefswood Rd, Ohsweken, ON N0A 1M0, Canada
| | - Rebecca Anglin
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Sarah McDonald
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Katherine M Morrison
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
| | - Koon K Teo
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
| | - Sonia S Anand
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Canada
| |
Collapse
|
50
|
Nightingale CM, Rudnicka AR, Owen CG, Wells JCK, Sattar N, Cook DG, Whincup PH. Influence of adiposity on insulin resistance and glycemia markers among U.K. Children of South Asian, black African-Caribbean, and white European origin: child heart and health study in England. Diabetes Care 2013; 36:1712-9. [PMID: 23315600 PMCID: PMC3661837 DOI: 10.2337/dc12-1726] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Ethnic differences in type 2 diabetes risk between South Asians and white Europeans originate before adult life and are not fully explained by higher adiposity levels in South Asians. Although metabolic sensitivity to adiposity may differ between ethnic groups, this has been little studied in childhood. We have therefore examined the associations among adiposity, insulin resistance, and glycemia markers in children of different ethnic origins. RESEARCH DESIGN AND METHODS Cross-sectional study of 4,633 9- to 10-year-old children (response rate 68%) predominantly of South Asian, black African-Caribbean, and white European origin (n = 1,266, 1,176, and 1,109, respectively) who had homeostasis model assessments of insulin resistance (HOMA-IR), glycemia markers (HbA1c and fasting glucose), and adiposity (BMI, waist circumference, skinfold thicknesses, and bioimpedance [fat mass]). RESULTS All adiposity measures were positively associated with HOMA-IR in all ethnic groups, but associations were stronger among South Asians compared to black African-Caribbeans and white Europeans. For a 1-SD increase in fat mass percentage, percentage differences in HOMA-IR were 37.5% (95% CI 33.3-41.7), 29.7% (25.8-33.8), and 27.0% (22.9-31.2), respectively (P interaction < 0.001). All adiposity markers were positively associated with HbA1c in South Asians and black African-Caribbeans but not in white Europeans; for a 1-SD increase in fat mass percentage, percentage differences in HbA1c were 0.04% (95% CI 0.03-0.06), 0.04% (0.02-0.05), and 0.02% (-0.00 to 0.04), respectively (P interaction < 0.001). Patterns for fasting glucose were less consistent. CONCLUSIONS South Asian children are more metabolically sensitive to adiposity. Early prevention or treatment of childhood obesity may be critical for type 2 diabetes prevention, especially in South Asians.
Collapse
Affiliation(s)
- Claire M Nightingale
- Division of Population Health Sciences and Education, St George’s, University of London, London, UK.
| | | | | | | | | | | | | |
Collapse
|