Loss of Anthropometry-Lipids Relationship in Obese Adults: A Cross-Sectional Study in Southern China

Reproducibility and relative validity of a quantitative food frequency questionnaire developed for adults in the coastal area of southeast China

PURPOSE

To evaluate the reproducibility and validity of a 93-item food frequency questionnaire (FFQ) designed to assess usual dietary habits over the past year among adults in the southeast coastal region of China.

METHODS

Qualified dietary data of 477 subjects (75.26% female, mean age = 59.7 years) were collected via two FFQs over approximately 15 months, alongside four 4-day 24-hour dietary recalls (24 h-DRs) at average intervals of four months. The analysis included 25 general nutrients, 14 particular nutrients and 12 food groups. Wilcoxon signed-rank test, correlation coefficients, cross-classification with weighted kappa statistic and Bland-Altman plots were used for comparison.

RESULTS

For reproducibility, the Spearman, Pearson, and intraclass correlation coefficients between two FFQs ranged from 0.24 to 0.53, 0.21 to 0.53 and 0.19 to 0.53, respectively. After adjusting for energy intake, most coefficients either decreased or remained unchanged. The rates of agreement in classifying subjects in the same or adjacent quartile fell between 62% and 84% for both FFQs. Regarding validity, the crude Spearman, energy-adjusted and de-attenuated Pearson correlation coefficients between FFQs and 24 h-DRs ranged from 0.17 to 0.59, 0.12 to 0.54, and 0.13 to 0.57, respectively. Over 58% of subjects were classified into the same and adjacent categories by both methods. Weighted kappa statistic and Bland-Altman plots demonstrated acceptable concordance.

CONCLUSION

The FFQ developed for adults in the specific coastal region of China, aiming to be used in a population-based cohort study, demonstrates acceptable reproducibility and validity to measure the dietary intakes of certain nutrients and foods.

The Mediation Role of Insulin Resistance and Chronic Systemic Inflammation in the Association Between Obesity and NAFLD: Two Cross-Sectional and a Mendelian Randomization Study

Purpose

We aimed to identify the association between obesity and nonalcoholic fatty liver disease (NAFLD) and to quantify the mediating effects of insulin resistance (IR) and chronic inflammation through observational studies and Mendelian randomization (MR).

Patients and Methods

In the current study, three IR-related indicators and three indicators of inflammation were included. The individual and combined mediated effects of IR and inflammation in the association between obesity and NAFLD were investigated in two cross-sectional studies, the Fuqing Cohort from China and the National Health and Nutrition Examination Survey (NHANES). Total, direct, and indirect effects were estimated through direct counterfactual imputation estimation, and the proportion of mediating effects was calculated. We applied a two-step MR to determine the causal mediating role of IR and chronic inflammation in the pathway between obesity and NAFLD by using single nucleotide polymorphisms as instrumental variables to predict obesity, IR, and inflammation genetically.

Results

In the Fuqing Cohort, all obese phenotypes were associated with an elevated NAFLD risk. Moreover, indicators of IR such as homeostatic model assessment of insulin resistance (HOMA-IR) and indicators of inflammation such as C-reactive protein (CRP) were significantly and positively associated with NAFLD risk. Individuals with obesity had significantly higher levels of IR and inflammation indicators compared to non-obese individuals. The indirect proportions of insulin and HOMA-IR accounted for 50.97-66.72% in the associations between obese phenotypes and NAFLD risk, while the proportions of inflammation indicators were < 14%. Similar results were observed in the NHANES analysis. In the MR analysis, the indirect effects of HOMA-IR and CRP were statistically significant with a greater mediated proportion explained by HOMA-IR than CRP.

Conclusion

Through two population-based studies and MR, we found the causal mediation roles of IR and inflammation in the association between obesity and NAFLD, in which HOMA-IR and CRP showed stable, significant mediation effects. Furthermore, HOMA-IR showed a higher mediation effect than CRP. We emphasize the vital role of HOMA-IR in NAFLD monitoring.

Sources of variation in the serum metabolome of female participants of the HUNT2 study

The aim of this study was to explore the intricate relationship between serum metabolomics and lifestyle factors, shedding light on their impact on health in the context of breast cancer risk. Detailed metabolic profiles of 2283 female participants in the Trøndelag Health Study (HUNT study) were obtained through nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS).We show that lifestyle-related variables can explain up to 30% of the variance in individual metabolites. Age and obesity were the primary factors affecting the serum metabolic profile, both associated with increased levels of triglyceride-rich very low-density lipoproteins (VLDL) and intermediate-density lipoproteins (IDL), amino acids and glycolysis-related metabolites, and decreased levels of high-density lipoproteins (HDL). Moreover, factors like hormonal changes associated with menstruation and contraceptive use or education level influence the metabolite levels.Participants were clustered into three distinct clusters based on lifestyle-related factors, revealing metabolic similarities between obese and older individuals, despite diverse lifestyle factors, suggesting accelerated metabolic aging with obesity. Our results show that metabolic associations to cancer risk may partly be explained by modifiable lifestyle factors.

The ratio of systolic and diastolic pressure is associated with carotid and femoral atherosclerosis

Background

Although the impact of hypertension on carotid intima-media thickness (IMT) and plaques has been well established, its association with femoral IMT and plaques has not been extensively examined. In addition, the role of the ratio of systolic and diastolic pressure (SDR) in the subclinical atherosclerosis (AS) risk remains unknown. We assessed the relationship between SDR and carotid and femoral AS in a general population.

Methods

A total of 7,263 participants aged 35-74 years enrolled from January 2019 to June 2021 in a southeast region of China were included in a cross-sectional study. Systolic and diastolic blood pressure (SBP and DBP) were used to define SDR. Ultrasonography was applied to assess the AS, including thickened IMT (TIMT) and plaque in the carotid and femoral arteries. Logistic regression and restricted cubic spline (RCS) models were the main approaches.

Results

The prevalence of TIMT, plaque, and AS were 17.3%, 12.4%, and 22.7% in the carotid artery; 15.2%, 10.7%, and 19.5% in the femoral artery; and 23.8%, 17.9% and 30.0% in either the carotid or femoral artery, respectively. Multivariable logistic regression analysis found a significant positive association between high-tertile SDR and the higher risk of overall TIMT (OR = 1.28, 95% CI = 1.10-1.49), plaques (OR = 1.36, 95%CI = 1.16-1.61), or AS (OR = 1.36, 95% CI = 1.17-1.57), especially in the carotid artery. RCS analysis further revealed the observed positive associations were linear. Further analyses showed that as compared to the low-tertile SDR and non-hypertension group, high-tertile SDR was associated with increased risks of overall and carotid TIMT, plaques, or AS in both groups with or without hypertension.

Conclusions

SDR is related to a higher risk of subclinical AS, regardless of hypertension or not, suggesting that as a readily obtainable index, SDR can contribute to providing additional predictive value for AS.