Association of Visceral Obesity Indices With Incident Diabetic Retinopathy in Patients With Diabetes: Prospective Cohort Study

The potential role of adipokines and hepatokines in age-related ocular diseases

Age-related ocular diseases, including diabetic retinopathy (DR), age-related macular degeneration (AMD), cataract and glaucoma may lead to visual impairment and even to blindness. Metabolic diseases, such as obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) have emerged as potential risk factors of age-related ocular diseases, especially DR. Visceral adiposity has been associated with increased risk of DR and AMD in most clinical studies, although body mass index has to-date provided conflicting association with DR and AMD. In addition, obesity is recognized as a risk factor of cataract and glaucoma. Similarly to obesity, MASLD appears to be associated with DR in patients with type 1 diabetes mellitus, but probably not in those with type 2 diabetes mellitus. A potential positive association between MASLD and AMD, glaucoma and cataract is supported by limited evidence to-date, thus needing further investigation. Altered secretion patterns of adipokines (adiponectin, leptin, lipocalin-2, resistin) and hepatokines [adropin, fetuin-A, fibroblast growth factor (FGF)-21, retinol binding protein (RBP)-4] seem to disrupt ocular homeostasis and contribute to the development of age-related ocular diseases in the context of obesity and MASLD. In this regard, novel adipokine-based and hepatokine-based therapies may be added to the treatment options for ocular diseases in the future. This narrative review aimed to summarize evidence on the interconnection of obesity and MASLD with age-related ocular diseases, with a specific focus on the roles of adipokines and hepatokines as mediators of these potential associations.

The relationship between VAI, LAP, and depression and the mediation role of sleep duration-evidence from NHANES 2005-2020

BACKGROUND

The relationship between obesity and mental health has attracted attention. However, large sample studies on the relationship between visceral fat obesity and depression are lacking. This study aimed to explore the relationship between visceral fat obesity and depression by using visceral adiposity index (VAI) and lipid accumulation product (LAP). Additionally, it sought to explore the potential mediating role of sleep duration in these associations.

METHODS

The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2020, including 19,659 participants. Depression was measured using the nine-item Patient Health Questionnaire. Weighted multivariable regression analysis was used to evaluate the correlation of VAI and LAP with depression. The potential non-linear relationship was determined using smooth curve fitting and threshold effect analysis. Additionally, mediation analysis was performed to investigate the potential mediating role of sleep duration. The stability of the relationship was assessed through sensitivity analysis.

RESULTS

VAI and LAP were closely related to depression. In the fully adjusted model, VAI and LAP in the highest quartile increased the association of depression by 52% (OR = 1.52, 95% CI 1.20-1.92, P < 0.001) and 51% (OR = 1.51, 95% CI 1.19-1.91, P < 0.001), respectively, compared with the lowest quartile. Specific saturation effects for VAI, LAP, and depression were identified by smoothed curve fitting, with inflection points of 3.81 and 98.55, respectively. Additionally, mediation analysis revealed that 5.1% and 2.8% of the associations between VAI and LAP with depression were mediated through sleep duration. The results of the sensitivity analysis showed interactions between hypertension and cardiovascular disease in the associations of VAI, and depression (P < 0.05).

CONCLUSION

VAI and LAP are associated with depression in US adults. The associations between VAI and LAP with depression are non-linear, which may be mediated through sleep duration. The study highlights the potential of VAI and LAP as valuable tools for the prevention and management of depression.

Does 10-Year Atherosclerotic Cardiovascular Disease Risk Predict Incident Diabetic Nephropathy and Retinopathy in Patients with Type 2 Diabetes Mellitus? Results from Two Prospective Cohort Studies in Southern China

BACKGRUOUND

Diabetic macrovascular and microvascular complications often coexist and may share similar risk factors and pathological pathways. We aimed to investigate whether 10-year atherosclerotic cardiovascular disease (ASCVD) risk, which is commonly assessed in diabetes management, can predict incident diabetic nephropathy (DN) and retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).

METHODS

This prospective cohort study enrolled 2,891 patients with clinically diagnosed T2DM who were free of ASCVD, nephropathy, or retinopathy at baseline in the Guangzhou (2017-2022) and Shaoguan (2019-2021) Diabetic Eye Study in southern China. The 10-year ASCVD risk was calculated by the Prediction for ASCVD Risk in China (China-PAR) equations. Multivariable- adjusted Cox proportional hazard models were developed to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). The area under the receiver operating characteristic curve (AUC) was used to evaluate predictive capability.

RESULTS

During follow-up, a total of 171 cases of DN and 532 cases of DR were documented. Each 1% increment in 10-year ASCVD risk was associated with increased risk of DN (pooled HR, 1.122; 95% CI, 1.094 to 1.150) but not DR (pooled HR, 0.996; 95% CI, 0.979 to 1.013). The model demonstrated acceptable performance in predicting new-onset DN (pooled AUC, 0.670; 95% CI, 0.628 to 0.715). These results were consistent across cohorts and subgroups, with the association appearing to be more pronounced in women.

CONCLUSION

Ten-year ASCVD risk predicts incident DN but not DR in our study population with T2DM. Regular monitoring of ASCVD risk in routine diabetes practice may add to the ability to enhance population-based prevention for both macrovascular and microvascular diseases, particularly among women.

Association between Chinese visceral adiposity index and lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): a national cohort study

BACKGROUND

Benign prostatic hyperplasia (BPH) and its related lower urinary tract symptoms (LUTS) are commonly observed among aging males and have a substantial effect on quality of life. Metabolic syndrome, with a specific focus on obesity, is believed to play a role in the development of BPH. This study intends to explore the relationship between several obesity-related metrics, including the Chinese Visceral Adiposity Index (CVAI), and LUTS/BPH within a national cohort of Chinese men.

METHODS

Data from the China Health and Retirement Longitudinal Study (CHARLS) 2015 were analyzed, encompassing a sample of 5,735 male participants aged 45 and older. Eight obesity-related indices-namely Body mass index (BMI), Waist-height ratio (WHtR), Triglyceride-glucose.BMI (TyG.BMI), TyG. Waist circumference (TyG.WC), TyG.WHtR, CVAI, Visceral adiposity index (VAI), and A body shape index (ABSI)-were examined. Logistic regression models, adjusted for potential confounders, were utilized to evaluate the associations between these indices and LUTS or BPH. The predictive capabilities of these indices were further assessed using receiver operating curves (ROC).

RESULTS

Among the participants, 718 (12.5%) were diagnosed with LUTS/BPH. All obesity-related indices were significantly higher in the LUTS/BPH group compared to the healthy group. CVAI demonstrated the highest predictive ability for LUTS/BPH, with an area under the curve (AUC) of 0.58. The study highlighted a nonlinear relationship between LUTS/BPH and several obesity-related indices, including CVAI.

CONCLUSIONS

This study underscores the significant association between visceral fat, as measured by CVAI, and the risk of LUTS/BPH in Chinese men. CVAI emerged as the most effective predictor among the indices evaluated, suggesting its potential utility in identifying individuals at risk for LUTS/BPH. Further prospective studies are needed to confirm these findings and elucidate the underlying mechanisms.

Coffee intake, plasma caffeine levels, and diabetic microvascular complications: A Mendelian randomization study

BACKGROUND AND AIM

Diabetic microvascular complications pose significant health challenges for individuals. The influence of modifiable lifestyle factors, such as coffee intake, on these complications has not been conclusively determined, highlighting the need for a causality assessment.

METHODS AND RESULTS

Utilizing Mendelian randomization (MR), this study explored the causal links between coffee intake, plasma caffeine levels, and diabetic microvascular complications using data from FinnGen. Single nucleotide polymorphisms associated with coffee intake and plasma caffeine levels were identified through genome-wide association study meta-analyses. The univariable MR analysis indicated a slightly increased risk for diabetic retinopathy (OR 1.006; 95 % CI: 1.002-1.010; P = 0.003) and a suggestively elevated risk for nephropathy (OR 1.011; 95 % CI: 1.001-1.022; P = 0.036) associated with genetically predicted higher coffee intake, while no significant effect on neuropathy was observed. Multivariable MR analysis, adjusted for smoking, revealed a significant protective effect of coffee intake on diabetic retinopathy (OR 0.895; 95 % CI: 0.856-0.936; P = 9.468 × 10-7) and a suggestive reduction in risk for diabetic nephropathy (OR 0.828; 95 % CI: 0.712-0.963; P = 0.014). Higher plasma caffeine levels were also suggestively protective against these complications.

CONCLUSIONS

Our findings suggest that genetically predicted higher coffee intake and plasma caffeine levels are protective for diabetic retinopathy and nephropathy. Further research is necessary to substantiate these findings and to investigate their potential impact on diabetes management strategies.

Higher body roundness index (BRI) increases infertility among U.S. women aged 18-45 years

OBJECTIVE

Infertility is associated with obesity. The Body Roundness Index (BRI) is a body measurement index related to obesity that more accurately assesses body and visceral fat levels. However, the relationship between BRI and infertility remains unclear. Therefore, this study aims to determine the relationship between BRI and infertility.

METHODS

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018 and included 3,528 women aged 18-45 years. Multivariate logistic regression was employed to investigate the association between BRI and infertility. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between BRI and infertility. Interaction analyses were conducted on subgroups to validate the findings. To verify the robustness of the results, we performed several sensitivity analyses, including propensity score matching(PSM) and multiple imputations for missing data. Furthermore, the predictive capabilities of various anthropometric indices-including BRI, weight-adjusted waist index (WWI), body mass index (BMI), and weight-on infertility incidence were assessed using Receiver Operating Characteristic (ROC) curve analysis.

RESULTS

There was a significant positive association between BRI and infertility. After adjusting for covariates, for each unit increase in BRI, there was a 12% increase in the probability of infertility (P < 0.001). This positive correlation persisted when BRI was categorized into quartiles. Moreover, as BRI increased, there was a trend towards higher infertility prevalence (P for trend < 0.001). The dose-response curve indicated a linear association between BRI and infertility, with higher BRI associated with higher infertility risk. The correlation between BRI and infertility persisted in subgroup analysis and multiple imputations. The ROC curve analysis revealed that BRI had a superior predictive capability compared to traditional obesity indices, with an area under the curve (AUC) of 0.618 (95% CI, 0.588-0.648).

CONCLUSION

The results of this study show a strong positive correlation between BRI and the prevalence of infertility.

CLINICAL TRIAL NUMBER

Not Applicable.

Chinese Visceral Adipose Index is Associated with Arterial Stiffness in Type 2 Diabetes Patients: A Cross-Sectional Study

Purpose

The purpose of this study is to investigate the association between Chinese Visceral Adipose Index(CVAI) and brachial-ankle pulse wave velocity (baPWV) in type 2 diabetes (T2D) patients, in order to provide scientific evidence for the prevention and treatment of macrovascular complications in T2D.

Patients and Methods

This research adopts the cross-sectional study design. Anthropometric assessment, baPWV assessment and biochemical assessment were performed in 2906 T2D patients. CVAI was calculated from the combination of triglycerides, age, high-density lipoprotein cholesterol, waist circumference, body mass index. Multivariate regression analysis and generalized additive model were used to analyze the association between bapwv and CVAI. Subgroup analysis and interaction analysis were used to analyze the influencing factors.

Results

After adjustment for covariates, baPWV tended to increase in the quartiles of CVAI. In males, As CVAI increases by a unit, baPWV was increased by 0.28 cm/s (95% CI: -0.05, 0.61 P=0.0934). In females, As CVAI increases by a unit, baPWV was increased by 1.60 cm/s (95% CI: 1.07, 2.14). A non-linear connection in males and a linear connection in females between the CVAI and baPWV was revealed. In males, we found that CVAI interacted with baPWV in different duration of diabetes (P interaction = 0.0052), alcohol consumption status (P interaction = 0.0375). In females, CVAI interacted with baPWV in glycated hemoglobin (P interaction = 0.0003), systolic blood pressure (P interaction = 0.0001), diastolic blood pressure (P interaction<0.0001), duration of diabetes (P interaction = 0.0014), the use or non-use of glucose-lowering drugs (P interaction = 0.0006), the use or non-use antihypertensive drugs (P interaction = 0.0004), females' menopausal status (P interaction = 0.0012).

Conclusion

The relationship between CVAI and baPWV in T2D patients is positively non-linear in males and linear in females. In all subjects, this relationship was influenced by diabetes duration. In males, drinking status affected this relationship, and in females, It is influenced by blood pressure, glycemic control, menopausal status, and the use of glucose-lowering and hypotensive drug, highlighting the complex interplay between visceral fat and arterial stiffness in the T2D population.

Utility of Anthropometric Indexes for Detecting Metabolic Syndrome in Resource-Limited Regions of Northwestern China: Cross-Sectional Study

Background

Anthropometric indexes offer a practical approach to identifying metabolic syndrome (MetS) and its components. However, there is a scarcity of research on anthropometric indexes tailored to predict MetS in populations from resource-limited regions.

Objective

This study aimed to examine the association between 8 easy-to-collect anthropometric indexes and MetS, and determine the most appropriate indexes to identify the presence of MetS for adults in resource-limited areas.

Methods

A total of 10,520 participants aged 18-85 years from Ningxia Hui Autonomous Region, China, were included in this cross-sectional study. Participants were recruited through a stratified sampling approach from January 1, 2020, to December 31, 2021. MetS was defined using the International Diabetes Federation (IDF) criteria. Eight anthropometric indexes were examined, including BMI, waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), conicity index, a body shape index (ABSI), lipid accumulation products (LAP), visceral obesity index (VAI), and the triglyceride-glucose (TyG) index. Logistic regression analysis and restricted cubic splines (RCSs) were applied to identify the association between the anthropometric indexes. The receiver operating characteristic curve and the area under the curve (AUC) were analyzed to identify and compare the discriminative power of anthropometric indexes in identifying MetS. The Youden index was used to determine a range of optimal diagnostic thresholds. Logistic regression analysis was applied to identify the association between the anthropometric indexes.

Results

A total of 3324 (31.60%) participants were diagnosed with MetS. After adjusting for age, ethnicity, current residence, education level, habitual alcohol consumption, and tobacco use, all the 8 indexes were positively correlated with the risks of MetS (P<.05). LAP presented the highest adjusted odds ratios (adjOR 35.69, 95% CI 34.59-36.80), followed by WHtR (adjOR 29.27, 95% CI 28.00-30.55), conicity index (adjOR 11.58, 95% CI 10.95-12.22), TyG index (adjOR 5.53, 95% CI 5.07-6.04), BMI (adjOR 3.88, 95% CI 3.71-4.05), WWI (adjOR 3.23, 95% CI 3.02-3.46), VAI (adjOR 2.11, 95% CI 2.02-2.20), and ABSI (adjOR 1.71, 95% CI 1.62-1.80). Significantly nonlinear associations between the 8 indexes and the risk of MetS (all Pnonlinear<.001) were observed in the RCSs. WHtR was the strongest predictor of MetS for males (AUC 0.91, 95% CI 0.90-0.92; optimal cutoff 0.53). LAP were the strongest predictor of MetS for females (AUC 0.89, 95% CI 0.89-0.90; optimal cutoff 28.67). Statistical differences were present between WHtR and all other 7 anthropometric indexes among males and overall (all P<.05). In females, the AUC values between LAP and BMI, WWI, ABSI, conicity index, VAI, and TyG index were significantly different (P<.001). No statistical difference was observed between LAP and WHtR among females.

Conclusions

According to 8 anthropometric and lipid-related indices, it is suggested that WHtR and LAP are the most appropriate indexes for identifying the presence of MetS in resource-limited areas.

Longitudinal analysis of insulin resistance and sarcopenic obesity in Chinese middle-aged and older adults: evidence from CHARLS

Objective

The correlation between surrogate insulin resistance (IR) indices and sarcopenic obesity (SO) remains uncertain. This study aimed to assess the association between six IR surrogates-triglyceride-glucose (TyG), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglyceride-to-high-density lipoprotein-cholesterol ratio (TG/HDL), metabolic score for insulin resistance (METS-IR), and Chinese visceral adiposity index (CVAI)-and SO risk in a middle-aged and older population in China.

Methods

The study employed longitudinal data obtained from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2015, involving 6,395 participants. We used multivariate logistic regression models to examine the link between six surrogates and SO. Nonlinear relationships were evaluated using restricted cubic spline analysis, and subgroup analyses were conducted for validation. Receiver operating characteristic (ROC) curves were used to assess predictive capabilities.

Results

Over the course of a 4-year follow-up period, 319 participants (5.0%) developed SO. In the fully adjusted model, all six surrogates were significantly associated with SO. The adjusted odds ratios (ORs) with a 95% confidence interval (95% CI) per standard deviation increase were 1.21 (1.08-1.36) for TyG, 1.56 (1.39-1.75) for TyG-WC, 2.04 (1.81-2.31) for TyG-WHtR, 1.11 (1.01-1.21) for TG/HDL, 1.67 (1.50-1.87) for METS-IR, and 1.74 (1.55-1.97) for CVAI. Notably, TyG-WC, TyG-WHtR, TG/HDL, METS-IR, and CVAI exhibited nonlinear correlations with SO. Conversely, TG/HDL did not exhibit a significant association during subgroup analysis. Furthermore, TyG-WHtR had a significantly larger area under the receiver operating characteristic curve than other indices.

Conclusion

The results indicated that TyG, TyG-WC, TyG-WHtR, METS-IR, and CVAI were significantly and positively associated with SO incidence. Meanwhile, TyG-WC, TyG-WHtR, METS-IR, and CVAI showed nonlinear relationships with SO. Specifically, TyG-WHtR may be the most appropriate indicator for predicting SO among middle-aged and older Chinese adults.

Association of diabetic retinopathy with plasma atherosclerotic index, visceral obesity index, and lipid accumulation products: NHANES 2005-2008

BACKGROUND

Abdominal obesity, a significant risk factor for the progression of diabetic retinopathy (DR), may lead to improved visual outcomes through early assessment. This study aims to evaluate any potential associations between DR and novel lipid metabolism markers, including the Atherogenic Index of Plasma (AIP), Visceral Adiposity Index (VAI), and Lipid Accumulation Product (LAP).

METHODS

This study aimed to elucidate the association between various lipid markers and DR by screening the National Health and Nutrition Examination Survey (NHANES) database in the United States from 2005 to 2008. To examine the correlation, multifactor logistic regression analysis, subgroup analysis, threshold effect analysis, interaction test, and smooth curve fitting were used.

RESULTS

Among the 2591 participants included, the incidence of DR was 13.6% and the mean age was 59.55 ± 12.26 years. After adjusting for important confounding covariates, logistic regression studies suggested a possible positive association between LAP, VAI, AIP, and DR occurrence (odds ratio [OR] = 1.004; 95% confidence interval [CI]: 1.002, 1.006; P < 0.0001; [OR] = 1.090; 95% [CI]: 1.037, 1.146; P = 0.0007; [OR] = 1.802; 95% [CI]: 1.240, 2.618; P = 0.0020). The nonlinear association between LAP and DR was further illustrated using an S-shaped curve by smoothing curve fitting, with the inflection point of the curve located at 63.4. Subgroup analyses and interaction tests were performed with full variable adjustment (P > 0.05 for all interactions).

CONCLUSION

Studies have shown that elevated levels of LAP, VAI, and AIP increase the likelihood of DR, suggesting that they have the potential to be predictive markers of DR, emphasizing their potential utility in risk assessment and prevention strategies, and advocating for early intervention to mitigate the likelihood of DR.

Association between severe headache or migraine and lipid accumulation product and visceral adiposity index in adults: a cross-sectional study from NHANES

BACKGROUND

Existing literature on the impact of lipid accumulation product (LAP) and visceral adiposity index (VAI) on severe headache or migraine is limited. This study aims to elucidate the association between LAP and VAI and the prevalence of migraine.

METHODS

Data for this study were sourced from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). A database-self-administered questionnaire was used to assess severe headache or migraine. A weighted logistic regression model was employed to assess the relationship between LAP and VAI with migraine prevalence. Complementary analytical approaches included subgroup analysis, restricted cubic spline (RCS), and threshold effect analysis to validate the findings.

RESULTS

In the end, 4572 people were recruited for the research, including 880 with migraine and 3692 without migraine. Following adjustment for the relevant covariables, weighted logistic regression analysis (OR = 1.409, 95% CI: 1.054, 1.883, P = 0.022; OR = 1.288, 95% CI: 1.010, 1.642, P = 0.042) revealed significantly elevated odds of migraine prevalence in participants within the highest tertile (T3) of LAP and VAI than those in the lowest tertile (T1). The nonlinear association between migraine prevalence and both VAI and LAP was further elucidated through a restricted cubic spline. The threshold analysis pinpointed 2.142 (log-likelihood ratio = 0.016) as the critical inflection point for VAI. Subgroup analysis and interaction testing revealed the significant association was independent in different subgroup factors.

CONCLUSIONS

The data indicate a robust association between higher levels of LAP and VAI and an increased prevalence of migraine.

Sex-based differences in the associations between abdominal obesity and diabetic retinopathy in diabetic patients with normal weight

Purpose

To investigate sex-specific differences in associations of abdominal obesity indexes, systemic factors, and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) subjects with normal body mass index (BMI).

Methods

This cross-sectional study comprised 653 T2DM subjects (402 women and 251 men) with normal BMI (18.5 kg/m2

Results

In the multivariate logistic regressions, the presence of any DR was associated with a longer duration of T2DM (OR = 1.07, p = 0.007) and higher HbA1c (OR = 1.40, p = 0.001) in women, while any DR was associated with younger age at T2DM diagnosis (OR = 0.94, p = 0.020) and higher HbA1c (OR = 1.29, p = 0.011) in men. For women, we identified a positive association between WC (OR = 1.07, p = 0.011), WHR (OR = 1.67, p = 0.002), and WHtR (OR = 1.57, p = 0.004) with any DR after adjusting for confounders, and the third tertiles of WC (OR = 2.29, p = 0.028), WHR (OR = 3.03, p = 0.003), and WHtR (OR = 2.84, p = 0.007) were at high risk of any DR. For men, there were no associations between abdominal obesity indexes and any DR in either continuous variables or categorical variables (all p > 0.05).

Main conclusions

There were sex differences in the relationships between WC, WHR, WHtR, and DR in this T2DM population with normal BMI. Our findings provide new insight into a sex-specific mechanism of DR and management of the condition.

Collapse

Key Words

• Abdominal obesity
• Body mass index
• Diabetic retinopathy
• Sex differences

Collapse

MESH Headings Collapse

Grants Collapse

Affiliation(s)

Yuan Liu State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
Kaiqun Liu State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
Liqiong Xie State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
Chengguo Zuo State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
Lanhua Wang State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
Wenyong Huang State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China

Collapse

Nonlinear association between visceral adipose tissue area and remnant cholesterol in US adults: a cross-sectional study

BACKGROUND

Excessive visceral adipose tissue (VAT) is associated with a spectrum of diseases, including diabetes, cancer, and cardiovascular diseases. Remnant cholesterol (RC), denoting cholesterol within triglyceride-rich lipoproteins and their metabolic byproducts, has been identified as a key contributor to cardiovascular diseases and related mortality. However, the association between the VAT and RC remains unclear. In this study, the objective is to provide new evidence regarding the association between VAT and RC concentrations.

METHODS

4727 individuals aged 18-59 were selected from the National Health and Nutrition Examination Survey conducted between 2011 and 2018 as study participants. This study utilized several weighted linear regression models and a restricted cubic spline (RCS) to explore the association and potential nonlinearities between VAT and RC. Subgroup analyses were performed to determine the consistency of findings.

RESULTS

The mean VAT value was 103.82 ± 1.42 cm2, and the median RC value was 18 mg/dl. VAT demonstrated a positive association with RC in a fully adjusted model, with a β and 95% confidence interval (CI) of 0.09 (0.08, 0.11) after adjustment for potential confounders. Analysis using RCS revealed a nonlinear association between the VAT area and RC (P < 0.001 for nonlinearity). Adjusted two-piecewise regression models demonstrated β coefficients of 0.13 (95%CI: 0.11 ~ 0.16, P < 0.001) for RC in individuals with VAT < 143 cm2, and 0.02 (95%CI: -0.01 ~ 0.06, P = 0.15) for those with VAT ≥ 143 cm2. Interactions were observed among the body mass index (BMI) subgroup; the β coefficients for RC were 0.14 (95%CI: 0.12 ~ 0.16) in those with BMI < 30 kg/m2 and 0.05 (95%CI:0.04 ~ 0.07) in those with BMI ≥ 30 kg/m2, with a P-value of < 0.001 for interaction.

CONCLUSIONS

This study identified a nonlinear association between VAT and RC in American adults. Reducing the VAT area may be beneficial in lowering RC concentration, particularly when VAT is < 143 cm2 and those with a BMI < 30 kg/m2.

Obesity, body fat distribution and eye diseases

BACKGROUND

The prevalence of obesity, a chronic disease, is increasing, and obesity is now considered a global epidemic. Eye diseases are also increasing worldwide and have serious repercussions on quality of life as well as increasingly high costs for the community. The relationships between obesity and ocular pathologies are not yet well clarified and are not pathologically homogeneous: they seem to be somehow linked to excess body fat, especially to the distribution of adipose tissue and its ectopic deposits.

PURPOSE

Our objective was to examine the associations between obesity and anthropometric indices, including body mass index (BMI), waist circumference (WC), and the waist/hip ratio (WHR), and the risk of most widespread eye diseases, with particular attention given to the most significant metabolic mechanisms.

METHODS

This article provides a narrative overview of the effect of obesity and anthropometric measurements of body fat on prevalent eye diseases. We used the MEDLINE/PubMed, CINAHL, EMBASE, and Cochrane Library databases from 1984 to 2024. In addition, we hand-searched references from the retrieved articles and explored a number of related websites. A total of 153 publications were considered.

RESULTS

There is significant evidence that obesity is associated with several eye diseases. Waist circumference (WC) and the waist/hip ratio (WHR) have been observed to have stronger positive associations with eye diseases than BMI.

CONCLUSIONS

Obesity must be considered a significant risk factor for eye diseases; hence, a multidisciplinary and multidimensional approach to treating obesity, which also affects ocular health, is important. In the prevention and treatment of eye diseases related to obesity, lifestyle factors, especially diet and physical activity, as well as weight changes, both weight loss and weight gain, should not be overlooked.

LEVEL OF EVIDENCE

Level V narrative review.

Association between obstructive sleep apnea and visceral adiposity index and lipid accumulation product: NHANES 2015-2018

BACKGROUND

Obesity refers to a significant contributor to the development of obstructive sleep apnea (OSA). Early prediction of OSA usually leads to better treatment outcomes, and this study aims to employ novel metabolic markers, visceral adiposity index (VAI), and lipid accumulation product (LAP) to evaluate the relationship to OSA.

METHODS

The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES), which was carried out between 2015 and 2018. To examine the correlation between LAP and VAI levels and OSA, multivariate logistic regression analysis was adopted. In addition, various analytical methods were applied, including subgroup analysis, smooth curve fitting, and threshold effect analysis.

RESULTS

Among totally 3932 participants, 1934 were included in the OSA group. The median (Q1-Q3) values of LAP and VAI for the participants were 40.25 (21.51-68.26) and 1.27 (0.75-2.21), respectively. Logistic regression studies indicated a positive correlation between LAP, VAI, and OSA risk after adjusting for potential confounding variables. Subgroup analysis revealed a stronger correlation between LAP, VAI levels, and OSA among individuals aged < 60 years. Through smooth curve fitting, specific saturation effects of LAP, VAI, and BMD were identified, with inflection points at 65.684 and 0.428, respectively.

CONCLUSION

This study demonstrates that elevated levels of LAP and VAI increase the risk of OSA, suggesting their potential as predictive markers for OSA and advocating for dietary and exercise interventions to mitigate OSA risk in individuals with high LAP and VAI levels.