Cross-sectional relationship among different anthropometric parameters and cardio-metabolic risk factors in a cohort of patients with overweight or obesity

Nutraceutical Blends Promote Weight Loss, Inflammation Reduction, and Better Sleep: The Role of Faecalibacterium prausnitzii in Overweight Adults-A Double-Blind Trial

This study explores the effects of a nutraceutical blend with prebiotics, β-glucans, essential minerals, and silymarin on gut microbiota, inflammation, and sleep quality in obesity through microbiota reshaping and metabolic improvements over 90 days. A double-blind, randomized trial was conducted on 77 participants divided into two groups receiving either a standard nutraceutical blend (NSupple) or a silymarin-enriched blend (NSupple_Silybum). Fecal and plasma samples were collected at baseline and post-supplementation for gut microbiota, metabolic, and inflammatory marker analysis. The results showed a reduction in body weight, waist-to-height ratio, total cholesterol, and fractions in the NSupple_Silybum group. There was a dysbiosis recovery shown by the increase in beneficial gut bacteria, such as Lentisphaerae phylum, Lactobacillus and Faecalibacterium genera, and Faecalibacterium prausnitzii in the NSupple group, with a concurrent reduction in Adlercreutzia and Sutterella in the NSupple_Silybum group. Both groups demonstrated improved inflammatory profiles by the reduced TNF-α/IL-10 ratio, reduced cortisol levels, and reduced Firmicutes/Bacteroides ratio. Additionally, improvements in sleep quality were associated with reductions in pro-inflammatory cytokines and improved microbiota composition. The nutraceutical blend reshaped gut microbiota, enhanced anti-inflammatory species, and improved metabolic and sleep parameters, highlighting its potential as a nutritional strategy for managing obesity and reducing inflammation.

Copper biomarkers and their relationship with dyslipidemia in women with obesity

Adipose tissue dysfunction influences the development of dyslipidemias associated with obesity, however, the mechanisms are still unclear. In this sense, the literature highlights the role of copper in cholesterol synthesis, contributing to the increase in concentrations of this lipid fraction and consequently to the manifestation of dyslipidemia. The objective of the study was to investigate the relationship between copper parameters and lipid profile markers in women with obesity. This is a cross-sectional study involving women aged 20 to 50 years divided into a case group (BMI ≥ 35 kg/m2) and a control group (BMI between 18.5 and 24.9 kg/m2). Copper concentrations in plasma and erythrocytes were determined by inductively coupled plasma optical emission spectrophotometry and ceruloplasmin activity by spectrophotometry. The lipid fractions were analyzed according to the enzymatic colorimetric method, using an automatic biochemical analyzer. Participants with obesity had elevated concentrations of copper in plasma and reduced concentrations in erythrocytes compared to the control group, but there was no significant difference in ceruloplasmin activity between the groups. The research does not identify a correlation between copper parameters and serum concentrations of lipid fractions, which does not allow inferring the role of copper in the manifestation of dyslipidemia in obesity.

Effects of Specially Designed Energy-Restricted Diet on Anthropometric Parameters and Cardiometabolic Risk in Overweight and Obese Adults: Pilot Study

BACKGROUND/AIMS

This study examined the effects of a specially designed energy-restricted diet with alternate carbohydrate intake on body composition and cardiometabolic risk factors in overweight and obese adults. The aim was to assess whether the intervention could lead to significant weight loss, improve body composition, and reduce cardiometabolic risks.

METHODS

Sixty-five participants (34 women, 31 men) with an average BMI of 31.8 ± 9.1 kg/m2 (women) and 34.1 ± 6.4 kg/m2 (men) participated in a 14-week intervention. The diet included different days of carbohydrate intake and a 20% reduction in total daily energy consumption. Anthropometric measurements and biochemical parameters, including predictive indices of cardiometabolic risk, were determined at baseline and after the intervention.

RESULTS

The intervention resulted in a significant reduction in body weight (mean weight loss of 17%, p < 0.001), with 64.6% of participants achieving a weight loss of at least 10%. Muscle mass as a percentage of total body weight increased. Cardiometabolic improvements were observed in fasting blood glucose (from 5.4 to 4.9 mmol/L, p < 0.001) and LDL cholesterol (from 3.38 to 2.81 mmol/L, p < 0.001). Gender-specific differences were found, particularly in HDL-C, which decreased significantly in women (p = 0.013), while there was a non-significant increase in men. Cardiometabolic indices, including the Visceral Adiposity Index (VAI) and the Cardiometabolic Index (CMI), also improved significantly.

CONCLUSIONS

The alternate carbohydrate diet improved body composition, cardiometabolic health, and treatment adherence through metabolic flexibility. However, the short duration of this study and the lack of a control group suggest that further research is needed to assess long-term sustainability.

Effects of vitamin D supplementation on metabolic syndrome parameters in patients with obesity or diabetes in Brazil, Europe, and the United States: A systematic review and meta-analysis

Plasma 25-dihydroxyvitamin D levels appear reduced in patients with obesity or type 2 diabetes, as reported in several observational studies. However, the association between these reduced hormone levels and metabolic parameters is unclear. In any case, vitamin D supplementation in patients with Metabolic Syndrome is standard. Still, the impacts of this supplementation on conditions such as glycemia, blood pressure, and lipidemia are debatable. Based on this question, we carried out a systematic review and meta-analysis of randomized clinical trials in Brazil, Europe, and the United States that analyzed the effects of vitamin D supplementation on Metabolic Syndrome parameters in patients with obesity or type 2 diabetes. Our search yielded 519 articles and included 12 randomized controlled trials in the meta-analysis. Vitamin D supplementation had no effect on any of the outcomes analyzed (fasting blood glucose and insulinemia, glycated hemoglobin, HOMA index, systolic and diastolic blood pressure, weight, waist circumference, total cholesterol, LDL and HDL, and triglycerides). However, subgroup analyses indicated that using vitamin D up to 2000 IU daily reduced participants' fasting blood glucose and glycated hemoglobin. Furthermore, the intervention reduced diastolic blood pressure only in participants with vitamin D deficiency. At least two studies showed a high risk of bias using the Rob2 protocol. According to the GRADE protocol, the evidence quality varied from moderate to very low. These results indicate that vitamin D supplementation does not improve patients' metabolic parameters and that the association between plasma 25-dihydroxyvitamin D levels and Metabolic Syndrome may not be causal but caused by other confounding characteristics. However, in any case, the quality of evidence is still low, and more randomized clinical trials are essential to clarify these relationships.

Evaluating the Association of Anthropometric Indices With Total Cholesterol in a Large Population Using Data Mining Algorithms

BACKGROUND

Unbalanced levels of serum total cholesterol (TC) and its subgroups are called dyslipidemia. Several anthropometric indices have been developed to provide a more accurate assessment of body shape and the health risks associated with obesity. In this study, we used the random forest model (RF), decision tree (DT), and logistic regression (LR) to predict total cholesterol based on new anthropometric indices in a sex-stratified analysis.

METHOD

Our sample size was 9639 people in which anthropometric parameters were measured for the participants and data regarding the demographic and laboratory data were obtained. Aiding the machine learning, DT, LR, and RF were drawn to build a measurement prediction model.

RESULTS

Anthropometric and other related variables were compared between both TC <200 and TC ≥200 groups. In both males and females, Lipid Accumulation Product (LAP) had the greatest effect on the risk of TC increase. According to results of the RF model, LAP and Visceral Adiposity Index (VAI) were significant variables for men. VAI also had a stronger correlation with HDL-C and triglyceride. We identified specific anthropometric thresholds based on DT analysis that could be used to classify individuals at high or low risk of elevated TC levels. The RF model determined that the most important variables for both genders were VAI and LAP.

CONCLUSION

We tend to present a picture of the Persian population's anthropometric factors and their association with TC level and possible risk factors. Various anthropometric indices indicated different predictive power for TC levels in the Persian population.

Waist to height ratio as a simple tool for predicting mortality: a systematic review and meta-analysis

BACKGROUND

The association of central obesity with higher rates of mortality is not well studied. This study evaluates the association between waist-to-height ratio (WHtR), as a measure of central obesity, with mortality.

METHODS

Documents were retrieved from PubMed, Web of Science, Scopus, and Google Scholar databases until May 2022. Data were extracted from cohort studies reporting effect size (hazard ratio (HR)) regarding the association between WHtR as a continuous (per 1 SD increment) or categorical (highest/lowest) measure and all-cause and cause-specific mortality. Screening of included studies was performed independently by two authors. Moreover, the quality assessment of included studies was performed based on the Newcastle-Ottawa assessment scale. Finally, random effect meta-analysis was performed to pool the data, and the outcomes' certainty level was assess based on the GRADE criteria.

RESULTS

Of the 815 initial studies, 20 were included in the meta-analysis. Random effect meta-analysis showed that in the general population, the all-cause mortality HRs for categorical and continuous measurements of WHtR increased significantly by 23% (HR:1.23; 95% CI: 1.04-1.41) and 16% (HR:1.16; 95% CI: 1.07-1.25), respectively. Moreover, the hazard of cardiovascular (CVD) mortality increased significantly for categorical and continuous measurements of WHtR by 39% (HR:1.39; 95% CI: 1.18-1.59) and 19% (HR:1.19; 95% CI: 1.07-1.31). The quality assessment score of all included studies was high.

CONCLUSIONS

Higher levels of WHtR, indicating central obesity, were associated with an increased hazard of CVD and all-cause mortality. This measure can be used in the clinical setting as a simple tool for predicting mortality.

Role of anthropometric indices as a screening tool for predicting metabolic syndrome among apparently healthy individuals of Karachi, Pakistan

INTRODUCTION

Anthropometric indices are affordable and non-invasive methods for screening metabolic syndrome (MetS). However, determining the most effective index for screening can be challenging.

OBJECTIVE

To investigate the accuracy of anthropometric indices as a screening tool for predicting MetS among apparently healthy individuals in Karachi, Pakistan.

METHODS

A community-based cross-sectional survey was conducted in Karachi, Pakistan, from February 2022 to August 2022. A total of 1,065 apparently healthy individuals aged 25 years and above were included. MetS was diagnosed using International Diabetes Federation guidelines. Anthropometric indices were defined based on body mass index (BMI), neck circumference (NC), mid-upper arm circumference (MUAC), waist circumference (WC), waist to height ratio (WHtR), conicity index, reciprocal ponderal index (RPI), body shape index (BSI), and visceral adiposity index (VAI). The analysis involved the utilization of Pearson's correlation test and independent t-test to examine inferential statistics. The receiver operating characteristic (ROC) analysis was also applied to evaluate the predictive capacities of various anthropometric indices regarding metabolic risk factors. Moreover, the area under the curve (AUC) was computed, and the chosen anthropometric indices' optimal cutoff values were determined.

RESULTS

All anthropometric indices, except for RPI in males and BSI in females, were significantly higher in MetS than those without MetS. VAI [AUC 0.820 (95% CI 0.78-0.86)], WC [AUC 0.751 (95% CI 0.72-0.79)], WHtR [AUC 0.732 (95% CI 0.69-0.77)], and BMI [AUC 0.708 (95% CI 0.66-0.75)] had significantly higher AUC for predicting MetS in males, whereas VAI [AUC 0.693 (95% CI 0.64-0.75)], WHtR [AUC 0.649 (95% CI 0.59-0.70)], WC [AUC 0.646 (95% CI 0.59-0.61)], BMI [AUC 0.641 (95% CI 0.59-0.69)], and MUAC [AUC 0.626 (95% CI 0.57-0.68)] had significantly higher AUC for predicting MetS in females. The AUC of NC for males was 0.656 (95% CI 0.61-0.70), while that for females was 0.580 (95% CI 0.52-0.64). The optimal cutoff points for all anthropometric indices exhibited a high degree of sensitivity and specificity in predicting the onset of MetS.

CONCLUSION

BMI, WC, WHtR, and VAI were the most important anthropometric predictors for MetS in apparently healthy individuals of Pakistan, while BSI was found to be the weakest indicator.

Predictive Factors for Obstructive Sleep Apnea Diagnosis in Bariatric Surgery Candidates with or Without Chronic Insomnia Complaints

OBJECTIVE

This study aims to evaluate the frequency of insomnia complaints in bariatric patients and to assess obstructive sleep apnea (OSA) predictors according to the presence or absence of chronic insomnia.

METHODS

Insomnia was defined as the presence of at least one specific symptom: difficulty falling asleep, difficulty maintaining sleep, and/or waking up earlier than expected. Diagnosis of OSA was objectively obtained from in-laboratory polysomnography. Multivariate logistic regression analysis was used to assess OSA predictors.

RESULTS

This cross-sectional study contains 1,737 bariatric surgery candidates: 59.6% without insomnia and 40.4% with insomnia. OSA prevalence was similar among participants with or without insomnia either for any OSA (p = 0.168) or for moderate-to-severe OSA (p = 0.185). Patients without insomnia showed a higher prevalence of severe OSA than those with insomnia (p = 0.005). In both cohorts, five parameters were independent OSA predictors: sex, age, body mass index (BMI), neck circumference (NC), and excessive daytime sleepiness (EDS). Male sex was the most important predictor, whether in individuals without insomnia (adjusted odds ratio [OR] ranging from 4.874 to 8.369) or in those with insomnia (adjusted OR ranging from 5.672 to 12.441).

CONCLUSIONS

A considerable proportion of bariatric patients report insomnia complaints. The probability of suffering from OSA was similar among bariatric candidates with or without insomnia, except for severe OSA diagnosis. Sex, age, BMI, NC, and EDS were independent predictors for OSA diagnosis irrespective of insomnia symptoms, and male sex was the main predictor for OSA in bariatric individuals with or without insomnia.

Influence of nocturnal insomnia symptoms on obstructive sleep apnea diagnosis in a clinical referral cohort

STUDY OBJECTIVES

To assess whether nocturnal symptoms of insomnia influence the prevalence of obstructive sleep apnea (OSA) in a clinical referral cohort.

METHODS

Insomnia was defined by the presence of one or more of the following complaints: difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakenings. OSA severity was based on an apnea-hypopnea index: ≥ 5.0/h (any OSA), ≥ 15.0/h (moderate/severe OSA), and ≥ 30/h (severe OSA). Multivariate logistic regression analysis was used to evaluate predictive factors for OSA diagnosis and severity.

RESULTS

Overall, 12,021 outpatients referred for polysomnography (PSG) were grouped into two cohorts: without insomnia (58.2%) and with insomnia (41.8%). Individuals without insomnia had a higher prevalence of OSA than those with insomnia (p < 0.001, for all OSA severity levels). The presence of insomnia was negatively associated with diagnosis of any OSA (adjusted odds ratio [OR]: 0.852; 95% confidence interval [CI]: 0.769-0.944), moderate/severe OSA (adjusted OR: 0.819; 95% CI: 0.751-0.892), and severe OSA (adjusted OR: 0.816; 95% CI: 0.746-0.892). Moreover, the number of nocturnal symptoms of insomnia was associated with a lower likelihood of OSA, even when adjusted for other confounders such as sex, age, body mass index, neck circumference, excessive daytime sleepiness, hypertension, and type 2 diabetes mellitus.

CONCLUSIONS

In this present study that included a large sample of consecutive outpatients, there was an inverse relationship between the number of nocturnal symptoms of insomnia and OSA diagnosis.

Significance and agreement between obesity anthropometric measurements and indices in adults: a population-based study from the United Arab Emirates

BACKGROUND

The rates of overweight and obese adults in the United Arab Emirates (UAE) have increased dramatically in recent decades. Several anthropometric measurements are used to assess body weight status. Some anthropometric measurements might not be convenient to use in certain communities and settings. The objective of this study was to assess the agreement of four anthropometric measurements and indices of weight status and to investigate their associations with cardiometabolic risks.

METHODS

The study design was a cross-section population-based study. Adults living in the Northern Emirates were surveyed. Fasting blood samples, blood pressure readings and anthropometric measurements were also collected.

RESULTS

A total of 3531 subjects were included in this study. The prevalence of obesity/overweight was 66.4% based on body mass index (BMI), 61.7% based on waist circumference (WC), 64.6% based on waist-hip ratio (WHR) and 71% based on neck circumference (NC). There were moderate agreements between BMI and WC and between WC and WHR, with kappa (k) ranging from 0.41 to 0.60. NC showed poor agreement with BMI, WC and WHR, with k ranging from 0 to 0.2. Overweight and obesity based on BMI, WC and WHR were significantly associated with cardiometabolic risks.

CONCLUSION

Overall, there was a moderate to a poor agreement between BMI, WC, WHR and NC. Particularly, NC showed poor agreement with BMI, WC and WHR. BMI and WC showed better performance for identifying cardiometabolic risks than WHR and NC.

Effect of BMI on Central Arterial Reflected Wave Augmentation Index, Toe-Brachial Index, Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index in Chinese Elderly Hypertensive Patients with Hemorrhagic Stroke

BACKGROUND

Hypertensive cerebral hemorrhage seriously endangers the health of the elderly. However, the relationship between obesity and arterial elasticity in hypertensive cerebral hemorrhage remains to be clarified. The purpose of our study is to explore the associations between body mass index (BMI) and central arterial reflected wave augmentation index (cAIx), toe-brachial index (TBI), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) in the elderly hypertensive patients with hemorrhagic stroke.

MATERIALS AND METHODS

A total of 502 elderly hypertensive patients with hemorrhagic stroke and 100 healthy controls were collected. According to the BMI, patients were divided into normal BMI, overweight, obesity, and obese groups. The multivariate logistic regression model was used to establish a risk model for elderly hypertensive hemorrhagic stroke.

RESULTS

Compared with the normal BMI group, systolic blood pressure (SBP), diastolic blood pressure (DBP), cAIx, and baPWV in the abnormal BMI group were significantly increased (P < 0.05), while TBI and ABI were significantly decreased (P < 0.05). Logistic regression showed that BMI (OR = 1.031, 95%CI: 1.009-1.262), cAIx (OR = 1.214, 95%CI: 1.105-1.964), TBI (OR = 0.913, 95%CI: 0.885-0.967), baPWV (OR = 1.344, 95%CI: 1.142-2.147), and ABI (OR = 0.896, 95%CI: 0.811-0.989) are important factors for the occurrence of hemorrhagic stroke in the elderly hypertensive patients. ROC curve analysis showed that the AUC of cAIx, TBI, baPWV, ABI, and BMI were 0.914, 0.797, 0.934, 0.833, and 0.608, respectively. The final prediction model of hemorrhagic stroke elderly hypertensive patients was Y_(P)= 65.424 + 0.307(cAIx) - 13.831(TBI) + 0.012(baPWV) - 0.110(ABI) + 0.339(BMI).

CONCLUSIONS

Obesity is associated with decreased arterial elasticity. Therefore, reasonable weight management of the elderly may be of great significance for reducing the risk of hemorrhagic stroke in patients with hypertension.

Vitamin D Deficiency and Risk of Metabolic Syndrome in Aging Men

The elderly population is rapidly increasing; hence, the disability due to age-related diseases has become an important socioeconomic burden. Amongst age-related diseases cardiovascular ones (CVD) have a huge impact on morbidity and mortality and are associated with metabolic syndrome (MetS). Several studies investigated the role of hypovitaminosis D in the pathogenesis of MetS and of CVD, this review unravels the relationship between aging/senescence, vitamin D, gender, and pathogenesis of MetS.

Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults

Aims

Results of previous studies of abdominal adiposity and risk of vascular-metabolic mortality in Hispanic populations have been conflicting. We report results from a large prospective study of Mexican adults with high levels of abdominal adiposity.

Methods and results

A total of 159 755 adults aged ≥35 years from Mexico City were enrolled in a prospective study and followed for 16 years. Cox regression, adjusted for confounders, yielded mortality rate ratios (RRs) associated with three markers of abdominal adiposity (waist circumference, waist–hip ratio, and waist–height ratio) and one marker of gluteo-femoral adiposity (hip circumference) for cause-specific mortality before age 75 years. To reduce reverse causality, deaths in the first 5 years of follow-up and participants with diabetes or other prior chronic disease were excluded. Among 113 163 participants without prior disease and aged 35–74 years at recruitment, all adiposity markers were positively associated with vascular-metabolic mortality. Comparing the top versus bottom tenth of the sex-specific distributions, the vascular-metabolic mortality RRs at ages 40–74 years were 2.32 [95% confidence interval (CI) 1.84–2.94] for waist circumference, 2.22 (1.71–2.88) for the waist–hip ratio, 2.63 (2.06–3.36) for the waist–height ratio, and 1.58 (1.29–1.93) for hip circumference. The RRs corresponding to each standard deviation (SD) higher usual levels of these adiposity markers were 1.34 (95% CI 1.27–1.41), 1.31 (1.23–1.39), 1.38 (1.31–1.45), and 1.18 (1.13–1.24), respectively. For the markers of abdominal adiposity, the RRs did not change much after further adjustment for other adiposity markers, but for hip circumference the association was reversed; given body mass index and waist circumference, the RR for vascular-metabolic mortality for each one SD higher usual hip circumference was 0.80 (0.75–0.86).

Conclusions

In this study of Mexican adults, abdominal adiposity (and in particular the waist–height ratio) was strongly and positively associated with vascular-metabolic mortality. For a given amount of general and abdominal adiposity, however, higher hip circumference was associated with lower vascular-metabolic mortality.

Markers of Chronic Inflammation in Overweight and Obese Individuals and the Role of Gender: A Cross-Sectional Study of a Large Cohort

Objective

During the last decade, obesity has become an epidemic. As obesity is now considered a state of low-grade inflammation, the purpose of this study was to assess the prevalence of four common elements of inflammation, in individuals with increased BMI. These findings were compared to those of subjects with normal BMI. The effect of gender was also noted.

Methods

Data were collected from medical records of individuals examined at a screening center in Israel between the years 2000–2014. Cross-sectional analysis was carried out on 7526 men and 3219 women. White blood cell count (WBC); platelet (PLT) count; erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed in four BMI categories: normal, overweight, obese and morbidly obese.

Results

Mean (SD) age of the study sample was 47.5 (9.7) and 46.7 (9.8) years for men and women, respectively. The prevalence of each inflammatory marker increased significantly when comparing abnormal to normal BMI (p<0.0001). The odds ratio (OR) of the prevalence of increased inflammatory markers was compared between subjects with overweight, obese and morbid obesity and subjects with normal BMI. This study showed that the higher the BMI, the higher the OR. For those in the morbid obesity group, the OR for the different inflammatory markers adjusting for age, diabetes mellitus hypertension and kidney function were as follows: WBC levels, 5.1 (2.9–8.7) and 4.7 (2.4–9.1) for men and women, respectively; PLT levels, 1.7 (0.3–8.5) and 2.0 (0.6–7.2) for men and women, respectively; ESR levels, 4.2 (3.2–5.4) and 4.6 (3.2–6.6) for men and women, respectively, and CRP levels, 13.4 (10.0–18.2) and 19.2 (12.9–28.6) for men and women, respectively.

Conclusion

Inflammatory markers are significantly higher in subjects with abnormal compared to normal BMI. This difference was found to be greater in women than in men.