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Wang W, Zhao T, Geng K, Yuan G, Chen Y, Xu Y. Smoking and the Pathophysiology of Peripheral Artery Disease. Front Cardiovasc Med 2021; 8:704106. [PMID: 34513948 PMCID: PMC8429807 DOI: 10.3389/fcvm.2021.704106] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022] Open
Abstract
Smoking is one of the most important preventable factors causing peripheral artery disease (PAD). The purpose of this review is to comprehensively analyze and summarize the pathogenesis and clinical characteristics of smoking in PAD based on existing clinical, in vivo, and in vitro studies. Extensive searches and literature reviews have shown that a large amount of data exists on the pathological process underlying the effects of cigarette smoke and its components on PAD through various mechanisms. Cigarette smoke extracts (CSE) induce endothelial cell dysfunction, smooth muscle cell remodeling and macrophage phenotypic transformation through multiple molecular mechanisms. These pathological changes are the molecular basis for the occurrence and development of peripheral vascular diseases. With few discussions on the topic, we will summarize recent insights into the effect of smoking on regulating PAD through multiple pathways and its possible pathogenic mechanism.
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Affiliation(s)
- Weiming Wang
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Department of General Surgery (Vascular Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Key Laboratory of Medical Electrophysiology, Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, China
| | - Tingting Zhao
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Kang Geng
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Gang Yuan
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Youhua Xu
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
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2
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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.
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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
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3
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Liu Y, Fujiyoshi A, Arima H, Kadota A, Kadowaki S, Hisamatsu T, Miyazawa I, Kondo K, Tooyama I, Miura K, Ueshima H. Anthropometric Obesity Indices were Stronger than CT-Based Indices in Associations with Carotid Intima-Media Thickness in Japanese Men. J Atheroscler Thromb 2019; 26:1102-1114. [PMID: 31092764 PMCID: PMC6927809 DOI: 10.5551/jat.47977] [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: 12/31/2022] Open
Abstract
AIM Computed tomography (CT) can directly provide information on body compositions and distributions, compared to anthropometric indices. It has been shown that various obesity indices are associated with carotid intima-media thickness (IMT). However, whether CT-based obesity indices are stronger than anthropometric indices in association with atherosclerosis remains to be determined in a general population. METHODS We cross-sectionally assessed carotid IMT using ultrasound in 944 community-dwelling Japanese men free of stroke and myocardial infarction. CT image at the L4-L5 level was obtained to compute areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Anthropometric measures assessed included body mass index (BMI), waist circumference, and waist-to-hip ratio. Using multivariable linear regression, slopes of IMT per 20th to 80th percentile of each index were compared. We also compared the slope of index with simultaneous adjustment for BMI in the same model. RESULTS Areas of VAT and SAT were positively associated with IMT, but not stronger than those of anthropometric indices in point estimates. Among all obesity indices, BMI was strongest in association with IMT after adjusting for age and lifestyle factors or further adjusting for metabolic factors. In simultaneous adjustment models, BMI, but not CT-based indices, remained significant and showed the strongest association. CONCLUSIONS In community-dwelling Japanese men, anthropometric obesity indices, BMI in particular, were more strongly associated with carotid atherosclerosis than CT-based obesity indices. The association of general obesity with carotid atherosclerosis was strong and adding CT-based obesity measure did not considerably influence in the association.
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Affiliation(s)
- Yuyan Liu
- Department of Public Health, Shiga University of Medical Science
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science.,Department of Hygiene, School of Medicine, Wakayama Medical University
| | - Hisatomi Arima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Sayaka Kadowaki
- Department of Public Health, Shiga University of Medical Science
| | - Takashi Hisamatsu
- Department of Public Health, Shiga University of Medical Science.,Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University
| | | | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science
| | - Ikuo Tooyama
- Molecular Neuroscience Research Center, Shiga University of Medical Science
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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4
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Lee J, Chen B, Kohl HW, Barlow CE, Lee CD, Radford NB, DeFina LF, Gabriel KP. The association of midlife cardiorespiratory fitness with later life carotid atherosclerosis: Cooper Center Longitudinal Study. Atherosclerosis 2019; 282:137-142. [PMID: 30731286 DOI: 10.1016/j.atherosclerosis.2019.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/19/2018] [Accepted: 01/10/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS While numerous cross-sectional studies have demonstrated an inverse relationship between cardiorespiratory fitness (CRF) and carotid atherosclerosis in middle age, much less is known about the association of midlife CRF with carotid atherosclerosis in later life. METHODS We studied 1094 participants, free of cardiovascular disease, who completed a maximal exercise test (GXT) for an objective measure of CRF between ages 40 and 59 and carotid ultrasound after the age of 59, with at least five years between studies. Carotid intima media thickness was measured. Assessments were also made regarding the presence of plaque and percent stenosis in four regions: common carotid, bulb, internal carotid and external carotid arteries. Multivariable logistic regression models were constructed to estimate the association of CRF with carotid artery disease. RESULTS At the time of GXT and carotid scan, participants were aged 50.7 ± 5.7 years and 69.3 ± 6.4 years, respectively. Almost half of participants had high midlife CRF (48.6%); 41.3% and 10.1% had moderate and low CRF, respectively. Over a mean follow-up period of 18.6 ± 8.5 years, the odds of having carotid artery disease in later life in the high CRF group was 0.50 (95% CI: 0.29-0.87) compared with the low CRF group. Each 1 MET increase in CRF was associated with 10% lower odds of having carotid artery disease (OR = 0.89, 95% CI: 0.80-0.98). CONCLUSIONS Midlife CRF was inversely associated with carotid artery disease measured almost two decades later. This may represent a mechanistic link between high midlife CRF and reduced risk of stroke in later life.
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Affiliation(s)
- Joowon Lee
- Department of Epidemiology, Human Genetics and Environmental Sciences, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHeath) at Houston School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA; Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, 801 Massachusetts Avenue Suite 470, Boston, MA, 02118, USA.
| | - Baojiang Chen
- Department of Biostatistics and Data Science, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) at Houston School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA
| | - Harold W Kohl
- Department of Epidemiology, Human Genetics and Environmental Sciences, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHeath) at Houston School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA; Department of Kinesiology and Health Education, The University of Texas at Austin, 1912 Speedway, Stop D5000, Austin, TX, 78712, USA
| | | | - Chong do Lee
- School of Nutrition and Health Promotion, Arizona State University, 550 N. Third St, Phoenix, AZ, 85004, USA
| | - Nina B Radford
- Cooper Clinic, 12200 Preston Road, Dallas, TX, 75230, USA
| | - Laura F DeFina
- Cooper Institute, 12330 Preston Road, Dallas, TX, 75230, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics and Environmental Sciences, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHeath) at Houston School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA; Department of Kinesiology and Health Education, The University of Texas at Austin, 1912 Speedway, Stop D5000, Austin, TX, 78712, USA; Department of Women's Health Dell Medical School, The University of Texas at Austin, 1501 Red River Street, Austin, TX, 78712, USA
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Scicali R, Rosenbaum D, Di Pino A, Giral P, Cluzel P, Redheuil A, Piro S, Rabuazzo AM, Purrello F, Bruckert E, Gallo A. An increased waist-to-hip ratio is a key determinant of atherosclerotic burden in overweight subjects. Acta Diabetol 2018; 55:741-749. [PMID: 29680968 DOI: 10.1007/s00592-018-1144-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/09/2018] [Indexed: 12/24/2022]
Abstract
AIMS The association of overweight status and cardiovascular disease is not clear. In this study we aimed to investigate coronary atherosclerotic disease, evaluated as coronary artery calcium score (CACs), in overweight patients with or without abdominal obesity as defined by waist-to-hip ratio (WHR). METHODS We enrolled 276 patients aged between 40 and 70 years, with a body mass index of 25-29.9 kg/m2 and at least one cardiovascular risk factor. Exclusion criteria were history of diabetes, cardiovascular or renal disease. Patients were stratified in high WHR (H-WHR) or low WHR (L-WHR) group according to WHR (≥ 0.85 for women and ≥ 0.90 for men) and underwent multi-detector computed tomography for CACs. Mean carotid intima-media thickness (IMT) and plaque presence were equally assessed. RESULTS CACs was higher in the H-WHR group compared to L-WHR (9.05 [0.0-83.48] vs 0.0 [0.0-64.7] AU, p < 0.01); the prevalence of CACs > 0 in the H-WHR group was significantly higher than subjects with L-WHR (59.6% vs 38.5%, p < 0.001). Moreover, H-WHR group had higher mean IMT (0.64 [0.56-0.72] vs 0.59 [0.55-0.67] mm, p < 0.05) and higher carotid plaque prevalence (63.7% vs 50.8%, p < 0.05) compared to subjects with L-WHR. Logistic regression showed that H-WHR was associated with presence of CACs and carotid plaque (p < 0.01). In a multiple linear regression, WHR was positively associated with CACs and IMT (p < 0.01). CONCLUSIONS H-WHR is a marker of coronary and peripheral atherosclerotic burden in overweight patients.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - David Rosenbaum
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - Philippe Giral
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), Paris, France
| | - Philippe Cluzel
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
- Département d'imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alban Redheuil
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
- Département d'imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - Agata Maria Rabuazzo
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy.
| | - Eric Bruckert
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), Paris, France
| | - Antonio Gallo
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
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6
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Elffers TW, de Mutsert R, Lamb HJ, Maan AC, Macfarlane PW, Willems van Dijk K, Rosendaal FR, Jukema JW, Trompet S. Relation of Overall and Abdominal Adiposity With Electrocardiogram Parameters of Subclinical Cardiovascular Disease in Individuals Aged 45 to 65 Years (from the Netherlands Epidemiology of Obesity Study). Am J Cardiol 2018; 121:570-578. [PMID: 29310809 DOI: 10.1016/j.amjcard.2017.11.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 11/18/2022]
Abstract
Overall and abdominal obesity are well-established risk factors for cardiometabolic disease. However, associations of overall and abdominal adiposity with electrocardiographic (ECG) markers of subclinical cardiovascular disease (CVD) have not yet been fully elucidated. Therefore, we investigated these associations in a population without preexisting CVD. We performed cross-sectional analyses in the Netherlands Epidemiology of Obesity Study. Body mass index (BMI), total body fat, and waist circumference were assessed in all participants, and abdominal subcutaneous adipose tissue and visceral adipose tissue (by magnetic resonance imaging) were assessed in a random subgroup. ECG parameters were determined using 12-lead electrocardiograms. We performed linear regression analyses, adjusting for potential confounding factors and, when investigating abdominal adiposity, additionally for total body fat. After exclusion of participants with preexisting CVD (n = 654), 5,939 individuals (42% men) were analyzed, with a mean (SD) age of 55 (6) years and BMI of 26.3 (4.4) kg/m2. Measures of both overall and abdominal adiposity were associated with ECG parameters but none of these measures was more strongly associated than the others. For example, heart rate (beats/min) increased per SD higher BMI (2.2; 95% confidence interval 1.9,2.5), total body fat (2.9; 2.4,3.4), subcutaneous adipose tissue (2.3;1.7,2.9), waist circumference (2.1; 1.4,2.8), and visceral adipose tissue (1.7; 0.8,2.5). In subgroup analyses based on gender and cardiovascular risk factors, no consistent interactions were observed. In conclusion, in a middle-aged population without preexisting CVD, measures of both overall and abdominal adiposity were associated with ECG parameters. Future studies should evaluate the added value of adiposity measures in electrocardiography-based diagnoses and the prognostic value of adding adiposity measures to risk prediction tools.
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Affiliation(s)
- Theodora W Elffers
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arie C Maan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter W Macfarlane
- Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands; Division Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
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7
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Yang Z, Ding X, Liu J, Duan P, Si L, Wan B, Tu P. Associations between anthropometric parameters and lipid profiles in Chinese individuals with age ≥40 years and BMI <28kg/m2. PLoS One 2017. [PMID: 28632766 PMCID: PMC5478121 DOI: 10.1371/journal.pone.0178343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lipid abnormalities are associated with overweight and obesity. Some simple anthropometric measurements such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), may link to increased risk of dyslipidemia. However, diverse results were found in different population studies. We focused on the associations between these measurements and dyslipidemia in non-obese (BMI <28kg/m2) population aged more than 40 years. METHODS AND FINDINGS Cross-sectional study of 4185 non-obese adults aged more than 40 years was conducted in Nanchang, Jiangxi province, China. Questionnaire, anthropometric and laboratory tests were conducted. The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria were used to define high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia and dyslipidemia. The overall prevalence of high TC, high LDL-C, low HDL-C, hypercholesterolemia, hypertriglyceridemia and dyslipidemia were 15.68%, 27.98%, 20.12%, 44.01%, 21.98% and 49.06% respectively. Multiple logistic regressions showed only BMI (per quartile increment) increased risks for prevalent high LDL-C, low HDL-C, hypercholesterolemia, hypertriglyceridemia, and dyslipidemia. Regardless of sex, age and prevalent metabolic syndrome, increasing BMI was persistently independent risk factor for having low HDL-C, hypercholesterolemia and dyslipidemia, however was not associated with high TC. CONCLUSIONS In non-obese Chinese population aged more than 40 years, increasing BMI may better identify the prevalent dyslipidemia than other anthropometric measurements. However, due to the different meanings, both BMI and WC should be measured and monitored for metabolic risk assessment.
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Affiliation(s)
- Zhi Yang
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Xun Ding
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Jiang Liu
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Peng Duan
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Lian Si
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Binghua Wan
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Ping Tu
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
- * E-mail:
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8
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Khokhar A, Chin V, Perez-Colon S, Farook T, Bansal S, Kochummen E, Umpaichitra V. Differences between Metabolically Healthy vs Unhealthy Obese Children and Adolescents. J Natl Med Assoc 2017; 109:203-210. [DOI: 10.1016/j.jnma.2017.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/11/2017] [Accepted: 02/22/2017] [Indexed: 02/06/2023]
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9
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Shiina Y, Homma K, Ozawa H, Yoshizawa J, Kobayashi T, Igarashi M, Aikawa M, Shibata T, Homma Y. A Comparison of the Abdominal Fat Distribution and Coronary Risk Markers in Body Mass Index-matched Subjects with and without Fatty Liver. Intern Med 2016; 55:2549-54. [PMID: 27629946 DOI: 10.2169/internalmedicine.55.6731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective The close relationship between fatty liver and metabolic syndrome suggests that individuals with fatty liver may have multiple coronary risk factors. In the present study, we investigated the relationships among fatty liver, abdominal fat distribution, and coronary risk markers. Methods and Results Eighty-seven pairs of men and 42 pairs of women who were matched for age and body mass index were enrolled in the present study. The obesity-related markers, abdominal fat distribution (examined by CT), and coronary risk markers were compared in subjects with and without fatty liver. The visceral fat area was significantly larger in the men with fatty liver than in the men without fatty liver. The plasma levels of triglyceride and low-density lipoprotein cholesterol (LDL-C), as well as the homeostasis model assessment-insulin resistance level, were higher in both males and females with fatty liver than in those without fatty liver, while the plasma levels of high-density lipoprotein cholesterol (HDL-C) and adiponectin were lower in the males and females with fatty liver. The plasma levels of apolipoprotein B, remnant-like particle cholesterol (RLP-C), and oxidized LDL were higher in men with fatty liver, but not in women with fatty liver. Conclusion Both males and females with fatty liver had lower insulin sensitivity, lower plasma levels of HDL-C and adiponectin, and higher triglyceride and LDL-C levels. However, the plasma levels of apolipoprotein B, RLP-C, and oxidized LDL were only higher and closely associated with fatty liver in men. Men with fatty liver had a higher risk of coronary disease than women with fatty liver.
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Affiliation(s)
- Yutaka Shiina
- Department of Clinical Health Science, Tokai University School of Medicine, Japan
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10
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Dong J, Ni YQ, Chu X, Liu YQ, Liu GX, Zhao J, Yang YB, Yan YX. Association between the abdominal obesity anthropometric indicators and metabolic disorders in a Chinese population. Public Health 2015; 131:3-10. [PMID: 26576475 DOI: 10.1016/j.puhe.2015.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 03/11/2015] [Accepted: 08/04/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Obesity has become a major health problem in contemporary society and it is closely related to many chronic diseases, so it is an important issue for measuring adiposity accurately and predicting its future. Prevention and treatment of overweight and obesity has become one of the key prevention and treatment of metabolic disorders. OBJECTIVE In this study, we compared the ability of the four anthropometric indicators (body mass index, waist circumstance, waist-height ratio, waist-to-hip ratio) to identify metabolic disorders (hypertension, hyperlipidaemia, hyperglycemia and hyperuricemia) by receiver operating characteristic (ROC) curve analyses and to provide evidence for clinical practice. METHODS In this large scale cross-sectional study, 13,275 Han adults (including 7595 males and 5680 females) received physical examination between January, 2009 and January, 2010 in Xuanwu Hospital of Capital Medical University were investigated by the means of questionnaire, Meanwhile, the physical examination and serological results were recorded. A package known as Statistical Package for Social Scientist (SPSS) was employed to analyse the responses while t-test, one-way analysis of variance (ANOVA), ROC analysis and chi-square statistical methods were used to test the hypotheses. RESULTS WC, WHtR, WHR and BMI were all significantly (P < 0.001) correlated with all metabolic risk factors regardless of gender. And the area under the curve (AUC) of WHtR was significantly greater than that of WC, BMI or WHR in the prediction of hypertension, hyperlipidaemia, hyperglycemia and hyperuricemia. CONCLUSION Our data show that WHtR was the best predictor of various metabolic disorders. The diagnostic value in descending order was WHtR > WHR > WC > BMI. Therefore we recommend WHtR in assessment of obese patients, in order to better assess the risks of their metabolic diseases.
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Affiliation(s)
- J Dong
- Physical Examination Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Y-Q Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - X Chu
- Physical Examination Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Y-Q Liu
- Physical Examination Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - G-X Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - J Zhao
- Physical Examination Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Y-B Yang
- Department of Thoracic Surgery I, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Cancer Hospital, Peking University School of Oncology, No. 52 Fucheng Road, Haidian District, Beijing 100142, China.
| | - Y-X Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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11
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Antonini-Canterin F, Mateescu AD, Vriz O, La Carrubba S, Di Bello V, Carerj S, Zito C, Sparacino L, Uşurelu C, Ticulescu R, Ginghină C, Nicolosi GL, Popescu BA. Impact of metabolic syndrome traits on cardiovascular function: should the Adult Treatment Panel III definition be further stratified? J Cardiovasc Med (Hagerstown) 2015; 15:752-8. [PMID: 25050530 DOI: 10.2459/jcm.0000000000000118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aims of the study were to evaluate whether a further classification of metabolic syndrome according to the number of traits (based on the Adult Treatment Panel III definition) could better explain the impact on cardiovascular remodeling and function, and to assess the role of single metabolic syndrome components in this regard. METHODS We studied by echocardiography and carotid ultrasound 435 asymptomatic patients with metabolic syndrome. Patients with coronary artery disease or more than mild valvular heart disease were excluded. Carotid stiffness index (β) was measured using a high-resolution echo-tracking system. Patients with metabolic syndrome were divided into two groups: metabolic syndrome with three traits (Gr.1) and metabolic syndrome with four or five traits (Gr. 2). RESULTS Patients in Gr. 2 had higher left ventricular mass index (P < 0.001), left ventricular end-diastolic volume index (P = 0.029), left atrial volume index (P = 0.002), E/e' ratio (P = 0.002), intima-media thickness (P = 0.031), and prevalence of plaques (P = 0.01) than patients in Gr. 1. Left ventricular ejection fraction was similar in both groups. The mean carotid β index tended to be higher in Gr. 2. Considering metabolic syndrome traits separately, in an age-corrected multivariate analysis, abdominal obesity was found to have the strongest association with cardiac structure and carotid artery atherosclerosis and stiffness. CONCLUSION An increasing number of metabolic syndrome traits had a significantly worse impact on cardiac remodeling and function and carotid artery atherosclerosis. Abdominal obesity showed the strongest association with cardiac structure, carotid artery stiffness, and intima-media thickness. Prospective studies are needed to evaluate whether a new classification of metabolic syndrome using the number of traits could add prognostic information.
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Affiliation(s)
- Francesco Antonini-Canterin
- aCardiologia Preventiva e Riabilitativa, ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone bCardiologia, Ospedale S. Antonio, San Daniele del Friuli cMedicina Interna, Ospedale Villa Sofia, Palermo dCardiologia, Università di Pisa, Pisa eCardiologia, Università di Messina, Messina, Italy f'Carol Davila' University of Medicine and Pharmacy, 'Prof. Dr C.C. Iliescu' Institute of Cardiovascular Diseases, Bucharest, Romania gCardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy
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12
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Gast KB, den Heijer M, Smit JWA, Widya RL, Lamb HJ, de Roos A, Jukema JW, Rosendaal FR, de Mutsert R. Individual contributions of visceral fat and total body fat to subclinical atherosclerosis: The NEO study. Atherosclerosis 2015; 241:547-54. [PMID: 26100677 DOI: 10.1016/j.atherosclerosis.2015.05.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/05/2015] [Accepted: 05/22/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Both overall and abdominal adiposity are established risk factors for cardiovascular disease. Visceral adipose tissue (VAT) and total body fat (TBF) are strongly correlated and previous studies did not make this distinction. OBJECTIVE We aimed to distinguish individual contributions of TBF, VAT, and the ratio of VAT to abdominal subcutaneous adipose tissue (VAT/SAT) to subclinical atherosclerosis in men and women. METHODS In this cross-sectional analysis of the Netherlands Epidemiology of Obesity (NEO) study, we assessed VAT and SAT with magnetic resonance imaging, TBF with bio-electrical impendence analysis, and carotid Intima-Media Thickness (cIMT) with ultrasound. We performed linear regression analyses of standardized values of TBF, VAT, VAT/SAT with cIMT. We adjusted the models for confounding factors (age, sex, ethnicity, education, smoking, alcohol, physical activity), and either for VAT or TBF. RESULTS This analysis included 2451 participants, 53% men with mean (SD) cIMT of 615 (91)μm. After adjustment for confounding factors, the difference in cIMT (95% CI) per SD in VAT was 14 (8,21)μm in men and 18 (13,24)μm in women. After adjustment for TBF, this attenuated to 5 (-3,13)μm in men and 13 (5,20)μm in women. In the full model, differences in cIMT (95% CI) per SD of TBF were 14 (6,22)μm in men and 8 (0,16)μm in women, and per SD of VAT/SAT were 7 (-1,15)μm and 9 (3,16)μm respectively. CONCLUSIONS In this population-based study, VAT contributed beyond overall adiposity to subclinical atherosclerosis, particularly in women. This implies a specific role of VAT in the early development of atherosclerosis.
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Affiliation(s)
- Karin B Gast
- Department of Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - Martin den Heijer
- Department of Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Endocrinology, VU Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Johannes W A Smit
- Department of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Internal Medicine, The Radboud University Nijmegen Medical Center, PO Box 9102, 6525 HP Nijmegen, The Netherlands.
| | - Ralph L Widya
- Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
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13
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Clemente G, Mancini M, Giacco R, Tornatore A, Ragucci M, Riccardi G. Visceral adiposity and subclinical atherosclerosis in healthy young men. Int J Food Sci Nutr 2015; 66:466-70. [DOI: 10.3109/09637486.2015.1042845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Association of simple anthropometric indices and body fat with early atherosclerosis and lipid profiles in Chinese adults. PLoS One 2014; 9:e104361. [PMID: 25090639 PMCID: PMC4121270 DOI: 10.1371/journal.pone.0104361] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 07/11/2014] [Indexed: 12/28/2022] Open
Abstract
Objective The discriminatory capability of different adiposity indices for atherosclerosis and lipid abnormalities remains uncertain. This study aimed to identify the best adiposity index for predicting early atherosclerosis and abnormal lipid profiles among anthropometric parameters and body fat measures in middle-aged and elderly Chinese. Method A total of 2,063 women and 814 men (57.6±5.2 y) were recruited for this community-based cross-sectional study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were assessed. Body fat mass and its percentage values for the whole body and trunk were measured by bioelectrical impedance analysis (BIA). The intima-media thicknesses (IMTs) of the common carotid arteries (CCA), internal carotid arteries (ICA) and bifurcation (BIF) were determined via B-mode ultrasound. The fasting lipid profiles were assessed. Results With per SD increase of adiposity indices, the magnitude of the changes of IMT values and lipid profiles was more substantial for WC, WHR and WHtR in both genders. A multivariate logistic regression analysis indicated that WC, WHR and WHtR were more sensitive in predicting the presence of intima-media thickening at the three segments as well as the lipids disturbances in women and men. In general, BIA-derived measures have no added predictive value for IMT-thickening as opposed to those three traditional abdominal measures. Conclusion Our findings suggest that abdominal anthropometric measures including WC, WHR and WHtR are sensitive for discriminating carotid atherosclerosis and lipids abnormalities. WC is the best index because of its simplicity in routine use.
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15
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Iaccarino Idelson P, Scalfi L, Vaino N, Mobilia S, Montagnese C, Franzese A, Valerio G. Healthy behaviours and abdominal adiposity in adolescents from southern Italy. Public Health Nutr 2014; 17:353-60. [PMID: 23351439 PMCID: PMC10282262 DOI: 10.1017/s1368980012005654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 12/07/2012] [Accepted: 12/11/2012] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The present study aimed to evaluate the prevalence of meeting health recommendations on diet and physical activity (having breakfast, eating fruit and vegetables, consumption of milk/yoghurt, performing moderate-to-vigorous physical activity, limiting television watching) and to assess junk snack food consumption in adolescents from southern Italy. The association between healthy behaviours and abdominal adiposity was also examined. DESIGN In a cross-sectional protocol, anthropometric data were measured by trained operators while other data were collected through a structured interview. SETTING Three high schools in Naples, Italy. SUBJECTS A sample of 478 students, aged 14-17 years, was studied. RESULTS The proportion of adolescents who met each of the health recommendations varied: 55·4% had breakfast on ≥6 d/week; 2·9% ate ≥5 servings of fruit and vegetables/d; 1·9% had ≥3 servings of milk/yoghurt daily; 13·6% performed moderate-to-vigorous physical activity for ≥60 min/d; and 46·3% watched television for <2 h/d. More than 65% of adolescents consumed ≥1 serving of junk snack foods/d. Only 5% fulfilled at least three recommendations. Healthy habits tended to correlate with each other. As the number of health recommendations met decreased, the percentage of adolescents with high abdominal adiposity (waist-to-height ratio ≥0·5) increased. The trend was not significant when the proportion of overweight/obese adolescents was considered. Logistic regression analysis indicated that male gender and watching television for ≥2 h/d were independently associated with a higher waist-to-height ratio. CONCLUSIONS Most adolescents failed to meet the five health recommendations considered. Male gender and excessive television watching were associated with abdominal adiposity.
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Affiliation(s)
| | - Luca Scalfi
- Dipartimento di Scienza degli Alimenti, Università degli Studi di Napoli Federico II, Napoli, Italia
| | - Nicola Vaino
- Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, Università degli Studi di Napoli Parthenope, Via Medina 40, 80133 Napoli, Italia
| | - Sara Mobilia
- Dipartimento di Pediatria, Università degli Studi di Napoli Federico II, Napoli, Italia
| | - Concetta Montagnese
- Dipartimento di Scienza degli Alimenti, Università degli Studi di Napoli Federico II, Napoli, Italia
| | - Adriana Franzese
- Dipartimento di Pediatria, Università degli Studi di Napoli Federico II, Napoli, Italia
| | - Giuliana Valerio
- Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, Università degli Studi di Napoli Parthenope, Via Medina 40, 80133 Napoli, Italia
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Gharipour M, Sadeghi M, Dianatkhah M, Bidmeshgi S, Ahmadi A, Tahri M, Sarrafzadegan N. The cut-off values of anthropometric indices for identifying subjects at risk for metabolic syndrome in Iranian elderly men. J Obes 2014; 2014:907149. [PMID: 24782923 PMCID: PMC3981184 DOI: 10.1155/2014/907149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 01/27/2014] [Indexed: 11/23/2022] Open
Abstract
AIM This study aimed to investigate which anthropometric indices could be a better predictor of metabolic syndrome (MetS) and the cut-off points for these surrogates to appropriately differentiate MetS in the Iranian elderly. METHOD The present cross-sectional study was conducted on a sample of Isfahan Healthy Heart Program (IHHP). MetS was defined according to Third Adult Treatment Panel (ATPIII). In total, 206 elderly subjects with MetS criteria were selected. Anthropometric indices were measured and plotted using receiver operating characteristic (ROC) curves. RESULTS WC followed by WHtR yielded the highest area under the curve (AUC) (0.683; 95% CI 0.606-0.761 and 0.680; 95% CI 0.602-0.758, resp.) for MetS. WC at a cut of 94.5 cm resulted in the highest Youden index with sensitivity 64% and 68% specificity to predict the presence of ≥2 metabolic risk factors. BMI had the lowest sensitivity and specificity for MetS and MetS components. WC has the best ability to detect MetS which followed by WHtR and BMI had a lower discriminating value comparatively. CONCLUSION WC is the best predictor for predicting the presence of ≥2 metabolic risk factors among Iranian elderly population and the best value of WC is 94.5 cm. This cut-off values of WC should be advocated and used in Iranian men until larger cross-sectional studies show different results.
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Affiliation(s)
- Mojgan Gharipour
- Metabolic Syndrome Department, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute (WHO Collaborating Center), Isfahan University of Medical Sciences, Isfahan, Iran
- *Masoumeh Sadeghi:
| | - Minoo Dianatkhah
- Interventional Cardiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Bidmeshgi
- Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ahmadi
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Tahri
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Guleria AK, Syal SK, Kapoor A, Kumar S, Tiwari P, Dabadghao P. Cardiovascular disease risk in young Indian women with polycystic ovary syndrome. Gynecol Endocrinol 2014; 30:26-9. [PMID: 24020937 DOI: 10.3109/09513590.2013.831835] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is associated with significant risk factors for cardiovascular disease (CVD) like insulin resistance, hyperinsulinism, hypertension and dyslipidemia. We studied CVD risk in young women (18-35 years age) with PCOS using carotid intima media thickness (CIMT) and brachial artery flow mediated dilation (FMD) which are markers of subclinical atherosclerosis. Fifty women with PCOS (age: 24.3 ± 4 years; body mass index [BMI]: 24.6 ± 4 kg/m(2)) were compared with 50 age and BMI matched healthy controls (age: 24.6 ± 5 years; BMI: 23.9 ± 4 kg/m(2)). CIMT was significantly higher (0.55 ± 0.09 mm versus 0.40 ± 0.1 mm, p value <0.0001) and FMD was significantly lower (9.39 ± 4.36% versus 13.89 ± 4.77%, p value <0.0001) in cases as compared to controls. These differences in CIMT and FMD remained significant when subgroup were analyzed, obese PCOS versus obese controls and non obese PCOS versus non-obese controls. In stepwise linear regression PCOS was associated with CIMT and FMD independent of age, BMI and blood pressure. Young women with PCOS irrespective of their BMI have evidence for increased CVD risk as shown by increased CIMT and a lower FMD.
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Ge W, Parvez F, Wu F, Islam T, Ahmed A, Shaheen I, Sarwar G, Demmer RT, Desvarieux M, Ahsan H, Chen Y. Association between anthropometric measures of obesity and subclinical atherosclerosis in Bangladesh. Atherosclerosis 2013; 232:234-41. [PMID: 24401245 DOI: 10.1016/j.atherosclerosis.2013.11.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/23/2013] [Accepted: 11/04/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anthropometric measures such as waist-hip-ratio (WHR), waist-height-ratio (WHtR), waist circumference, Mid-upper arm circumference (MUAC), and upper thigh circumference, have been linked to the risk of cardiovascular disease (CVD). However, their relationships with subclinical atherosclerosis are unclear. Studies in normal-weight populations, especially in Asian countries where leanness is prevalent, are lacking. METHODS We conducted a cross-sectional study to assess the associations of WHR, WHtR, waist circumference, hip circumference, body mass index (BMI), MUAC and upper thigh circumference with carotid intima-media thickness (cIMT) among 562 middle-aged participants free of CVD in rural Bangladesh. RESULTS After adjusting for age and sex, WHR and waist circumference but not BMI showed a positive significant association with cIMT. In multivariate analysis, each standard deviation (SD) increase of WHR (0.08) or WHtR (0.07) was associated with an 8.96 μm (95% CI, 1.12-16.81) or 11.45 μm (95%CI, 0.86-22.04) difference in cIMT, respectively, after controlling for age, sex, BMI, smoking status, education level, and systolic blood pressure (SBP). The associations of WHR and WHtR with cIMT were independent of the influence of other anthropometric measures. The associations of other anthropometric measures and cIMT were not apparent. CONCLUSIONS In our relatively lean, healthy Asian population, WHR and WHtR appear to be better predictors of early atherosclerosis than other common surrogates of adiposity.
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Affiliation(s)
- Wenzhen Ge
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Fen Wu
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Tariqul Islam
- Columbia University Arsenic Research Project, Dhaka, Bangladesh
| | - Alauddin Ahmed
- Columbia University Arsenic Research Project, Dhaka, Bangladesh
| | - Ishrat Shaheen
- Columbia University Arsenic Research Project, Dhaka, Bangladesh
| | - Golam Sarwar
- Columbia University Arsenic Research Project, Dhaka, Bangladesh
| | - Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France; École des Hautes Études en Santé Publique, Paris and Rennes, France
| | - Habibul Ahsan
- Department of Health Studies, The University of Chicago, Chicago, IL, USA; Department of Medicine, The University of Chicago, Chicago, IL, USA; Department of Human Genetics, The University of Chicago, Chicago, IL, USA; Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA.
| | - Yu Chen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.
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Oike M, Yokokawa H, Fukuda H, Haniu T, Oka F, Hisaoka T, Isonuma H. Association between abdominal fat distribution and atherosclerotic changes in the carotid artery. Obes Res Clin Pract 2013; 8:e448-58. [PMID: 25263834 DOI: 10.1016/j.orcp.2013.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/26/2013] [Accepted: 09/05/2013] [Indexed: 12/16/2022]
Abstract
AIM We aimed to evaluate the association between abdominal fat distribution (e.g., abdominal visceral fat area [VFA], subcutaneous fat area [SFA], and total fat area [TFA]), waist circumference (WC), or body mass index (BMI) and atherosclerotic changes in the carotid artery after adjusting for common risk factors. METHODS The present study is a hospital-based, cross-sectional study. Study participants included 223 Japanese individuals who underwent a medical health checkup at Juntendo University Hospital, Tokyo, between December 2005 and August 2011. Multivariate logistic regression analysis was used to examine the association between abdominal VFA, SFA, TFA, the VFA/SFA ratio, WC, or BMI and intima-media thickness [IMT] (mean IMT≥1.1mm or maximum IMT≥1.2mm) as atherosclerotic changes in the carotid artery. RESULTS Multivariate logistic regression analysis showed that VFA (OR for ≥150cm(2) versus <100cm(2), 3.88; 95% CI, 1.39-10.85), BMI (OR for ≥27.6kg/m(2) versus <25kg/m(2), 5.22; 95% CI, 1.69-16.16), and TFA (OR for 200-285cm(2) versus <200cm(2), 4.15; 95% CI, 1.34-12.86: OR for ≥285cm(2) versus <200cm(2), 5.53; 95% CI, 1.76-17.35) were significantly associated with atherosclerotic changes in men. After adjustment for BMI, only TFA (OR for ≥285cm(2) versus <200cm(2), 3.76; 95%CI, 1.03-13.79) in men was significantly associated with atherosclerotic changes in the carotid artery. CONCLUSIONS Our results indicate that VFA, TFA, and BMI are independently associated with atherosclerotic changes in Japanese men. TFA may be considered as a valuable measure of atherosclerotic changes.
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Affiliation(s)
- Miki Oike
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hirohide Yokokawa
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Hiroshi Fukuda
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Tomomi Haniu
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Fukuko Oka
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Teruhiko Hisaoka
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hiroshi Isonuma
- Department of General Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
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Lee OG, Hur YI, Kang JH, Park HA, Kim KW, Cho YG, Choi WY, Park H, Lee HA. The cutoff value of waist circumference for predicting metabolic risks in pre- and post-menopausal korean women: analysis of 2010 korean national health and nutrition examination survey data. Korean J Fam Med 2013; 34:307-18. [PMID: 24106583 PMCID: PMC3791338 DOI: 10.4082/kjfm.2013.34.5.307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 08/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background With metabolic syndrome (MS) being a major risk factor for cardiovascular disease, and central obesity being a major predisposing factor for MS, intensive research is currently being performed on cutoff values according to race and sex. Menopause is an especially significant factor in designating cutoff values for female central obesity, as menopause brings sudden bodily changes that induce central obesity and increased prevalence of MS. Therefore this study aimed to investigate the cutoff values for the obesity index and its validity in predicting the criteria for MS in Korean women according to menstrual status. Methods The study focused on 3,103 women 20 years of age or older participating in the 2007 Korea National Health and Nutrition Examination Survey. Definitions of non-adipose components of MS were defined by the International Diabetes Federation, and menstrual status was judged on the basis of survey results. The sensitivity, specificity, and positive and negative predictive values of the central obesity index (body mass index [BMI], waist circumference [WC], waist-to-height ratio [WHtR]) according to menstrual status for two or more non-adipose components of MS were calculated based on the Youden index. Results Area under the curve (AUC) values predicting the presence of two or more metabolic risk factors were higher in pre-menopausal women, with AUC values for BMI, WC, and WHtR being, in pre- and post-menopausal women, 23.1 kg/m2 vs. 23.9 kg/m2, 76.1 cm vs. 82.5 cm, and 0.49 vs. 0.53, respectively. The WC cut off (76 cm) for pre-menopausal women was found to be more sensitive and more effective at screening for MS risks than the cutoff value given by the Korea Society for the Study of Obesity. Conclusion The central obesity index showed better predictability for MS risk in pre-menopausal women. Because the central obesity index cutoff values are lower in pre-menopausal women, the possibility of metabolic risk can be considered for pre-menopausal women with WC lower than 85 cm. Assessment and control of other risks are needed accordingly for preventing the development of MS.
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Affiliation(s)
- Ok-Gyu Lee
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Zhang ZQ, Deng J, He LP, Ling WH, Su YX, Chen YM. Comparison of various anthropometric and body fat indices in identifying cardiometabolic disturbances in Chinese men and women. PLoS One 2013; 8:e70893. [PMID: 23951031 PMCID: PMC3741370 DOI: 10.1371/journal.pone.0070893] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 06/25/2013] [Indexed: 12/28/2022] Open
Abstract
Background Although many adiposity indices may be used to predict obesity-related health risks, uncertainty remains over which of them performs best. Objective This study compared the predictive capability of direct and indirect adiposity measures in identifying people at higher risk of metabolic abnormalities. Methods This population-based cross-sectional study recruited 2780 women and 1160 men. Body weight and height, waist circumference (WC), and hip circumference (HC) were measured and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were calculated. Body fat (and percentage of fat) over the whole body and the trunk were determined by bioelectrical impedance analysis (BIA). Blood pressure, fasting lipid profiles, and glucose and urine acid levels were assessed. Results In women, the ROC and the multivariate logistic regression analyses both showed that WHtR consistently had the best performance in identifying hypertension, dyslipidemia, hyperuricemia, diabetes/IFG, and metabolic syndrome (MetS). In men, the ROC analysis showed that WHtR was the best predictor of hypertension, WHtR and WC were equally good predictors of dyslipidemia and MetS, and WHtR was the second-best predictor of hyperuricemia and diabetes/IFG. The multivariate logistic regression also found WHtR to be superior in discriminating between MetS, diabetes/IFG, and dyslipidemia while BMI performed better in predicting hypertension and hyperuricemia in men. The BIA-derived indices were the second-worst predictors for all of the endpoints, and HC was the worst. Conclusion WHtR was the best predictor of various metabolic abnormalities. BMI may be used as an alternative measure of obesity for identifying hypertension in both sexes.
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Affiliation(s)
- Zhe-qing Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Juan Deng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Li-ping He
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangzhou Panyu Central Hospital, Guangzhou, People's Republic of China
| | - Wen-hua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yi-xiang Su
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
- * E-mail: (Y-MC); (Y-XS)
| | - Yu-ming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
- * E-mail: (Y-MC); (Y-XS)
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Singh AS, Atam V, Patel ML, Chaudhary SC, Sawlani KK, Das L. Carotid Intima Media Thickness as a Reflection of Generalized Atherosclerosis is Related to Body Mass Index in Ischemic Stroke Patients. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:228-34. [PMID: 23626961 PMCID: PMC3632029 DOI: 10.4103/1947-2714.109200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Carotid artery intima media thickness reflects the ongoing process of atherosclerosis in the body. The pathologic process occurring in the obese patients in the vascular system is atherosclerosis which is an important cause of ischemic stroke. Body mass index is an indirect measure of obesity in general population. Aim: The study was to assess the role of carotid artery intima media thickness as a marker of atherosclerosis and its relation with body mass index in ischemic stroke patients. Materials and Methods: Body mass index of the all stroke patients was calculated by using formula body mass in kilograms divided by the square of height in meters. The patients were classified in four groups of body mass index according to Indian standards. Carotid sonography was done to assess the common carotid artery intima media thickness in millimeters by using high resolution 7.5 MHz sonography technique. Results: The average Carotid intima media thickness in this study was 9.23mm. There was a significant association found between increasing carotid artery intima media thickness and groups of body mass index (P- <0.05) in ischemic stroke patients. Conclusions: Body mass index as an indicator of obesity and carotid intima media thickness both are very important risk factors for ischemic stroke and are associated with each other.
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Affiliation(s)
- Amit Shankar Singh
- Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
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Hwang IC, Suh SY, Seo AR, Ahn HY, Yim E. Association between Metabolic Components and Subclinical Atherosclerosis in Korean Adults. Korean J Fam Med 2012; 33:229-36. [PMID: 22916325 PMCID: PMC3418342 DOI: 10.4082/kjfm.2012.33.4.229] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 06/12/2012] [Indexed: 01/21/2023] Open
Abstract
Background Many studies have attempted to develop relatively simple and easy noninvasive measurements of atherosclerosis (NIMA), and each NIMA assesses different atherosclerotic properties. We, therefore, investigated the association between metabolic syndrome (MetS) components and different NIMAs. Methods This study included 1,132 Korean subjects over 20 years of age who had visited a Health Promotion Center in Korea. Carotid injury (increased carotid intima-media thickness or plaques) was evaluated by ultrasonography and arterial stiffness by brachial-ankle pulse wave velocity. The MetS components were assessed according to the Asian criteria of the American Heart Association/National Heart, Lung, and Blood Institute. Results Both arterial stiffness and carotid injury gradually deteriorated with increase in the number of MetS components. Arterial stiffness and carotid injury were associated with different MetS components, each of which had varying impact. After adjustment for all possible confounders such as age, sex, and lifestyle, elevated blood pressure (BP) was found to have the strongest association with arterial stiffness, whereas central obesity, impaired fasting plasma glucose, and elevated BP had comparable connection with carotid atherosclerosis. Conclusion Individual MetS components were related with subclinical atherosclerosis in different ways. Elevated BP showed the strongest association with arterial stiffness, while central obesity, impaired fasting plasma glucose, and elevated BP showed good correlation with carotid atherosclerosis.
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Affiliation(s)
- In Cheol Hwang
- Department of Family Medicine, Gachon University Gil Hospital, Incheon, Korea
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Ozari HO, Oktenli C, Celik S, Tangi F, Ipcioglu O, Terekeci HM, Top C, Uzun M, Sanisoglu YS, Nalbant S. Are increased carotid artery pulsatility and resistance indexes early signs of vascular abnormalities in young obese males? JOURNAL OF CLINICAL ULTRASOUND : JCU 2012; 40:335-340. [PMID: 22532370 DOI: 10.1002/jcu.21927] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/19/2012] [Indexed: 05/31/2023]
Abstract
PURPOSE To provide insight into the factors by which obesity in itself may directly lead to early arterial damage, we aimed to determine early sonographic markers of obesity-related vascular dysfunction in young obese males. METHODS Thirty-five young obese males and 23 age-matched healthy male volunteers were recruited into the study. Common carotid artery pulsatility index and resistance index were calculated from blood flow velocities curves obtained by pulsed Doppler ultrasonography. RESULTS The mean pulsatility index, resistance index, body mass index, waist circumference, systolic and diastolic blood pressure, homeostasis model assessment for insulin resistance, plasma fasting glucose, insulin, C-peptide, triglycerides, low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were statistically higher in obese subjects than in healthy controls. CONCLUSIONS Our results suggest that depressed vessel compliance and increased vascular resistance are features of young, obese, normotensive subjects independently of and in addition to cardiovascular risk factors. As changes in arterial wall properties may be incipient in young obese subjects, future studies will be required to demonstrate whether early intervention such as diet and exercise in this population can improve vascular functions.
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Affiliation(s)
- H Onur Ozari
- Division of Internal Medicine, GATA Haydarpasa Training Hospital, Tibbiye Caddesi TR-34668 Uskudar-Istanbul, Turkey
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Scuteri A, Orru' M, Morrell CH, Tarasov K, Schlessinger D, Uda M, Lakatta EG. Associations of large artery structure and function with adiposity: effects of age, gender, and hypertension. The SardiNIA Study. Atherosclerosis 2012; 221:189-97. [PMID: 22222417 PMCID: PMC3713416 DOI: 10.1016/j.atherosclerosis.2011.11.045] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 11/23/2011] [Accepted: 11/30/2011] [Indexed: 12/17/2022]
Abstract
UNLABELLED In the context of obesity epidemic, no large population study has extensively investigated the relationships between total and abdominal adiposity and large artery structure and function nor have such relationships been examined by gender, by age, by hypertensive status. We investigated these potential relationships in a large cohort of community dwelling volunteers participating the SardiNIA Study. METHODS AND RESULTS Total and visceral adiposity and arterial properties were assessed in 6148 subjects, aged 14-102 in a cluster of 4 towns in Sardinia, Italy. Arterial stiffness was measured as aortic pulse wave velocity (PWV), arterial thickness and lumen as common carotid artery (CCA) intima-media thickness (IMT) and diameter, respectively. We reported a nonlinear relationship between total and visceral adiposity and arterial stiffness, thickness, and diameter. The association between adiposity and arterial properties was steeper in women than in men, in younger than in older subjects. Waist correlated with arterial properties better than BMI. Within each BMI quartile, increasing waist circumference was associated with further significant changes in arterial structure and function. CONCLUSION The relationship between total or abdominal adiposity and arterial aging (PWV and CCA IMT) is not linear as described in the current study. Therefore, BMI- and/or waist-specific reference values for arterial measurements might need to be defined.
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Affiliation(s)
- Angelo Scuteri
- Laboratory of Cardiovascular Science, National Institute on Aging, NIH, Baltimore, USA.
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Song YM, Lee K, Sung J, Kim YS, Lee JY. Sex-specific relationships between adiposity and anthropometric measures and carotid intima-media thickness in Koreans: the Healthy Twin Study. Eur J Clin Nutr 2011; 66:39-46. [PMID: 21878958 DOI: 10.1038/ejcn.2011.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Increased adiposity, shorter stature, shorter leg length and carotid intima-media thickening are associated with cardiovascular (CV) disease. This study aimed to evaluate the sex-specific phenotypic and genetic associations between adiposity and anthropometric measures and carotid intima-media thickness (IMT). SUBJECTS/METHODS We measured IMT at common carotid artery (CCA-IMT), carotid bifurcation and internal carotid artery (ICA-IMT) using B-mode ultrasound, and adiposity and anthropometric measures, including body mass index (BMI), height, leg length, waist circumference (WC), waist-to-hip ratio and percentage of body fat; we also assessed conventional CV risk factors among 706 Korean adults from the Healthy Twin Study. The associations were analyzed using quantitative genetic and linear mixed analyses. RESULTS In linear mixed analyses, BMI and WC had independent associations with the IMT at CCA-IMT and ICA-IMT and CCA-IMT, respectively, after adjusting for age and conventional CV risk factors in men. By comparison, in women, adiposity and anthropometric measures were associated with carotid IMT only before adjusting for the covariates. In men, there were significant genetic correlations between BMI and CCA-IMT (ρ(G)=0.32±0.11), BMI and ICA-IMT (ρ(G)=0.35±0.11) and WC and ICA-IMT (ρ(G)=0.32±0.13) after adjusting for covariates, whereas in women the cross-trait genetic correlations were no longer significant after adjusting for the covariates. CONCLUSIONS In this Korean twins and families, we found sex-specific associations between adiposity and anthropometric measures and the IMT at each segment of the carotid artery, and BMI and WC in men can be indicators predicting carotid intima-media thickening regardless of age and CV risk factors.
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Affiliation(s)
- Y-M Song
- Department of Family Medicine, Samsung Medical Center and Center for Clinical Research, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea
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Nam JS, Cho M, Park JS, Ahn CW, Cha BS, Lee EJ, Lim SK, Kim KR, Lee HC. Change in waist circumference and the progression of subclinical atherosclerosis in type 2 diabetes patients. Obes Res Clin Pract 2011; 5:e169-266. [DOI: 10.1016/j.orcp.2011.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2010] [Revised: 12/29/2010] [Accepted: 01/18/2011] [Indexed: 10/18/2022]
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Sasakabe T, Haimoto H, Umegaki H, Wakai K. Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes. Diabetes Metab Syndr Obes 2011; 4:167-74. [PMID: 21779148 PMCID: PMC3138148 DOI: 10.2147/dmso.s19635] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Reports have shown that visceral adipose tissue (VAT) is more closely linked to cardiovascular risk factors (CRFs) than subcutaneous adipose tissue (SAT). We aimed to elucidate preferential abdominal fat loss and the correlations between abdominal fat reductions and changes in CRFs achieved with a moderate low-carbohydrate diet (LCD) in patients with type 2 diabetes (T2DM). PATIENTS AND METHODS Fifty-two outpatients (28 men and 24 women, mean age ± SD: 60.0 ± 10.5 years) with hemoglobin A(1c) (HbA(lc)) levels ≥ 6.5% were on an LCD for 6 months. Over a 6-month period, we measured their abdominal fat distribution (using CT) and assessed CRFs, including body mass index (BMI), HbA(1c), fasting blood glucose (FBG), serum insulin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels. RESULTS The patients showed good compliance with the LCD (1812 ± 375 kcal/day, % carbohydrate:fat:protein = 35:40:19 for men; 1706 ± 323 kcal/day, % carbohydrate:fat:protein = 41:36:21 for women). Significant decreases (P = 0.05) in BMI and HbA(1c) levels were observed, along with an increase in HDL-C (P = 0.021) in men and a decrease in LDL-C (P = 0.001) in women. VAT (-21.6 cm(2), P < 0.001 in men; -19.6 cm(2), P < 0.001 in women) and SAT (-13.5 cm(2), P = 0.004 in men; -19.1 cm(2), P = 0.003 in women) significantly decreased. The loss of VAT (%ΔVAT) was greater than that of SAT (%ΔSAT) in women (P = 0.022). A similar but not significant predominance of VAT loss was detected in men (P = 0.111). In women, the %ΔSAT significantly correlated with changes in FBG (ΔFBG) (r = 0.417) and HDL-C (ΔHDL) (r = -0.720), as was %ΔVAT with changes in triglyceride (ΔTG) (r = 0.591). CONCLUSION Six months of a moderate LCD resulted in preferential VAT loss only in women, with significant correlations between %ΔSAT and both ΔHDL and ΔFBG, as well as between %ΔVAT and ΔTG. Our results suggest that an LCD has the potential to reduce abdominal fat in patients with T2DM and deterioration of serum lipid profiles.
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Affiliation(s)
- Tae Sasakabe
- Department of Clinical Nutrition, Haimoto Clinic, Yayoi, Kasugai, Aichi, Japan
- Correspondence: Tae Sasakabe, Haimoto Clinic, 1-80 Yayoi, Kasugai, Aichi 486-0838, Japan, Tel +81 568 85 8226, Fax +81 568 85 8315, Email
| | - Hajime Haimoto
- Department of Internal Medicine, Haimoto Clinic, Yayoi, Kasugai, Aichi, Japan
| | - Hiroyuki Umegaki
- Department of Geriatrics, Nagoya University Graduate School of Medicine, Tsurumai, Showa, Nagoya, Aichi, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Tsurumai, Showa, Nagoya, Aichi, Japan
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Asymmetric dimethylarginine levels and carotid intima-media thickness in obese patients with polycystic ovary syndrome and their relationship to metabolic parameters. Fertil Steril 2010; 93:1227-33. [DOI: 10.1016/j.fertnstert.2008.10.073] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Revised: 10/29/2008] [Accepted: 10/30/2008] [Indexed: 11/21/2022]
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The associations between visceral fat and calcified atherosclerosis are stronger in women than men. Atherosclerosis 2010; 208:531-6. [DOI: 10.1016/j.atherosclerosis.2009.08.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 08/04/2009] [Accepted: 08/11/2009] [Indexed: 11/19/2022]
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Oda E, Kawai R. Comparison among body mass index (BMI), waist circumference (WC), and percent body fat (%BF) as anthropometric markers for the clustering of metabolic risk factors in Japanese. Intern Med 2010; 49:1477-82. [PMID: 20686277 DOI: 10.2169/internalmedicine.49.3363] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To compare body mass index (BMI), waist circumference (WC), and percent body fat (%BF) as markers for the clustering of metabolic risk factors in Japanese. METHODS Age-adjusted correlation coefficients (Rs) were calculated between the three anthropometric markers of obesity and metabolic risk factors in 2,444 men and 1,442 women among Japanese. Areas under receiver operating characteristic curves (AUCs) of BMI, WC, and %BF were calculated for diagnosing the clustering of 1 or more, 2 or more, 3 or more, and 4 risk factors among increased blood pressure, impaired fasting glucose, increased triglycerides, and decreased HDL cholesterol and for the clustering of 1 or more, 2 or more, 3 or more, 4 or more, 5 or more, and 6 risk factors among the upper four risk factors as well as increased high-sensitivity C-reactive protein and increased LDL cholesterol. RESULTS The Rs were not significantly different among BMI, WC, and %BF except for the difference between the R of BMI (0.217) and that of %BF (0.283) with LDL cholesterol in men (p=0.014). The AUCs of BMI, WC, and %BF for diagnosing any of the risk factor clustering patterns defined above were not significantly different in both men and women. CONCLUSION The AUCs for diagnosing the clustering of metabolic risk factors were not significantly different among BMI, WC, and %BF.
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Affiliation(s)
- Eiji Oda
- Medical Check-up Center, Tachikawa Medical Center, Nagaoka.
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Seo JA, Kim BG, Cho H, Kim HS, Park J, Baik SH, Choi DS, Park MH, Jo SA, Koh YH, Han C, Kim NH. The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study. BMC Public Health 2009; 9:443. [PMID: 19951442 PMCID: PMC2797519 DOI: 10.1186/1471-2458-9-443] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Accepted: 12/02/2009] [Indexed: 11/21/2022] Open
Abstract
Background In Korea, the cutoff values of waist circumference (WC) for the identification of metabolic syndrome (MetS) were suggested to be 90 cm for men and 85 cm for women based on the analysis mainly in middle-aged adults. As aging is associated with increased fat, especially abdominal visceral fat, the cutoff value of WC may differ according to age. In addition, the usefulness of visceral abdominal fat area (VFA) to predict MetS in the elderly has not been studied yet. We aimed to suggest WC and VFA criteria and to compare the predictability of WC and VFA to identify people at risk for MetS. Methods A total of 689 elderly subjects aged ≥63 years (308 men, 381 women) were chosen in this cross-sectional study from an ongoing, prospective, population-based study, the Ansan Geriatric (AGE) cohort study. VFA was measured by single slice abdominal computed tomography scanning. The metabolic risk factors except WC (plasma glucose, blood pressure, serum triglycerides and HDL cholesterol levels) were defined using modified NCEP-ATP III criteria. We estimated the accuracy of VFA and WC for identifying at least two of these factors by receiver operating characteristic (ROC) curve analysis. Results Two hundred three of 308 men and 280 of 381 women had ≥2 metabolic risk factors. The area under the ROC curve (AUC) value for VFA to predict the presence of ≥2 metabolic risk factors was not significantly different from that for WC (men, 0.735 and 0.750; women, 0.715 and 0.682; AUC values for VFA and WC, respectively). The optimal cutoff points for VFA and WC for predicting the presence of ≥2 metabolic risk factors were 92.6 cm2 and 86.5 cm for men and 88.9 cm2 and 86.5 cm for women. Conclusion WC had comparable power with VFA to identify elderly people who are at risk for MetS. Elderly Korean men and women had very similar cutoff points for both VFA and WC measurements for estimating the risk of MetS. Age-specific cutoff point for WC might be considered to identify subjects at risk for MetS.
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Affiliation(s)
- Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, 516 Gojan-1-dong, Danwon-gu, Ansan, Gyeonggi-do 425-707, Republic of Korea.
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Pieringer H, Schumacher S, Stuby U, Biesenbach G. Augmentation Index and Large-Artery Remodeling in Patients with Longstanding Rheumatoid Arthritis Compared with Healthy Controls. Semin Arthritis Rheum 2009; 39:163-9. [DOI: 10.1016/j.semarthrit.2008.08.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 07/22/2008] [Accepted: 08/09/2008] [Indexed: 11/26/2022]
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The differential association between various anthropometric indices of obesity and subclinical atherosclerosis. Atherosclerosis 2009; 207:232-8. [DOI: 10.1016/j.atherosclerosis.2009.03.053] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 02/10/2009] [Accepted: 03/31/2009] [Indexed: 11/23/2022]
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Lear SA, James PT, Ko GT, Kumanyika S. Appropriateness of waist circumference and waist-to-hip ratio cutoffs for different ethnic groups. Eur J Clin Nutr 2009; 64:42-61. [DOI: 10.1038/ejcn.2009.70] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Gotoh H, Gohda T, Tanimoto M, Gotoh Y, Horikoshi S, Tomino Y. Contribution of subcutaneous fat accumulation to insulin resistance and atherosclerosis in haemodialysis patients. Nephrol Dial Transplant 2009; 24:3474-80. [DOI: 10.1093/ndt/gfp290] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lee DE, Kehlenbrink S, Lee H, Hawkins M, Yudkin JS. Getting the message across: mechanisms of physiological cross talk by adipose tissue. Am J Physiol Endocrinol Metab 2009; 296:E1210-29. [PMID: 19258492 DOI: 10.1152/ajpendo.00015.2009] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obesity is associated with resistance of skeletal muscle to insulin-mediated glucose uptake, as well as resistance of different organs and tissues to other metabolic and vascular actions of insulin. In addition, the body is exquisitely sensitive to nutrient imbalance, with energy excess or a high-fat diet rapidly increasing insulin resistance, even before noticeable changes occur in fat mass. There is a growing acceptance of the fact that, as well as acting as a storage site for surplus energy, adipose tissue is an important source of signals relevant to, inter alia, energy homeostasis, fertility, and bone turnover. It has also been widely recognized that obesity is a state of low-grade inflammation, with adipose tissue generating substantial quantities of proinflammatory molecules. At a cellular level, the understanding of the signaling pathways responsible for such alterations has been intensively investigated. What is less clear, however, is how alterations of physiology, and of signaling, within one cell or one tissue are communicated to other parts of the body. The concepts of cell signals being disseminated systemically through a circulating "endocrine" signal have been complemented by the view that local signaling may similarly occur through autocrine or paracrine mechanisms. Yet, while much elegant work has focused on the alterations in signaling that are found in obesity or energy excess, there has been less attention paid to ways in which such signals may propagate to remote organs. This review of the integrative physiology of obesity critically appraises the data and outlines a series of hypotheses as to how interorgan cross talk takes place. The hypotheses presented include the "fatty acid hypothesis,", the "portal hypothesis,", the "endocrine hypothesis,", the "inflammatory hypothesis,", the "overflow hypothesis,", a novel "vasocrine hypothesis," and a "neural hypothesis," and the strengths and weaknesses of each hypothesis are discussed.
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Affiliation(s)
- Do-Eun Lee
- Department of Internal Medicine, Division of Endocrinology, Winthrop University Hospital, London, United Kingdom
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Tokita A, Ishigaki Y, Okimoto H, Hasegawa H, Koiwa Y, Kato M, Ishihara H, Hinokio Y, Katagiri H, Kanai H, Oka Y. Carotid arterial elasticity is a sensitive atherosclerosis value reflecting visceral fat accumulation in obese subjects. Atherosclerosis 2009; 206:168-72. [PMID: 19296951 DOI: 10.1016/j.atherosclerosis.2009.01.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Revised: 01/29/2009] [Accepted: 01/30/2009] [Indexed: 11/15/2022]
Abstract
BACKGROUND We previously reported the arterial elasticity value we measured to reflect the characteristic features of vessel walls, and to possibly be useful for detecting early stage atherosclerosis in type 2 diabetes. Obesity, especially visceral adiposity, is well known to play a crucial role in the development of metabolic disorders and atherosclerosis. To assess whether arterial elasticity value reflects the effect of obesity on atherosclerosis, we examined the associations of obesity characteristics with atherosclerosis values including arterial elasticity, carotid intima-media thickness (IMT) and pulse wave velocity (PWV). METHODS Three atherosclerosis values were measured in 78 obese subjects (body mass index >/=30). We investigated the associations of atherosclerosis values with obesity-related parameters including abdominal fat accumulation determined by computed tomography. RESULTS Arterial elasticity values were positively related to established atherosclerosis values, carotid IMT and PWV, in obese subjects. Age, systolic blood pressure and hypertension also correlated with these atherosclerosis values. Single regression analysis showed all three atherosclerosis values to correlate significantly with visceral fat area. Intriguingly, visceral fat area is an independent variable affecting arterial elasticity, but not IMT or PWV. Furthermore, multiple regression analysis revealed that arterial elasticity correlates strongly with visceral fat area. CONCLUSIONS Arterial elasticity value we measure is a new parameter for evaluating atherosclerosis in subjects with visceral adiposity and more sensitive than the currently established atherosclerosis values, carotid IMT and PWV. Measuring arterial elasticity has the potential to reveal minute vascular changes, and may have broad clinical applications for evaluating early stage atherosclerosis.
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Affiliation(s)
- Ai Tokita
- Division of Molecular Metabolism and Diabetes, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Japan
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Debette S, Leone N, Courbon D, Gariépy J, Tzourio C, Dartigues JF, Ritchie K, Alpérovitch A, Ducimetière P, Amouyel P, Zureik M. Calf circumference is inversely associated with carotid plaques. Stroke 2008; 39:2958-65. [PMID: 18703804 DOI: 10.1161/strokeaha.108.520106] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The association of carotid atherosclerosis with body composition and fat distribution is poorly understood. We aimed to test the cross-sectional association of carotid plaques and common carotid artery intima-media thickness with calf circumference (CC), representing peripheral fat and lean mass, and with waist circumference and waist-to-hip ratio, 2 markers of abdominal obesity. METHODS The study was performed on 6265 subjects aged >or=65 years recruited prospectively from the electoral rolls of 3 French cities. Ultrasound examination and anthropometric measures were performed according to a standardized protocol. RESULTS Carotid plaques were less frequent with increasing CC, the ORs for the second, third, and fourth quartile of CC compared with the first quartile being 0.98 (95% CI, 0.84 to 1.15), 0.85 (95% CI, 0.72 to 1.01), and 0.71 (95% CI,:0.58 to 0.86; P for trend=0.0002), respectively, independently of age, gender, body mass index, and other vascular risk factors. There was an opposite and multiplicative effect of CC and waist-to-hip ratio on the frequency of carotid plaques (55.1% of individuals in the fourth waist-to-hip ratio quartile and the first CC quartile had carotid plaques, against 31.8% in the first waist-to-hip ratio and the fourth CC quartile). Mean common carotid artery intima-media thickness was larger with increasing waist circumference, waist-to-hip ratio, and CC, but the association with CC disappeared after adjusting for body mass index. CONCLUSIONS The present study shows, for the first time, an inverse relationship between carotid plaques and CC. Although this needs to be confirmed in other populations, it may suggest an antiatherogenic effect of large CC.
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Valsamakis G, Jones A, Chetty R, McTernan PG, Boutsiadis A, Barnett AH, Banerjee AK, Kumar S. MRI total sagittal abdominal diameter as a predictor of metabolic syndrome compared to visceral fat at L4-L5 level. Curr Med Res Opin 2008; 24:1853-60. [PMID: 18507894 DOI: 10.1185/03007990802185757] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare associations between anteroposterior (AP) diameter or sagittal abdominal diameter - a measure of total central fat, and visceral fat alone with the metabolic syndrome as defined by ATPIII criteria. RESEARCH DESIGN AND METHODS Twenty-four Caucasian male with type 2 diabetes and 24 non-diabetic Caucasian male subjects [body mass index (BMI) (+/-SD): 32.23 +/- 7.52 kg/m(2), age (+/-SD): 51.35 +/- 13.80 years] were studied by magnetic resonance imaging (MRI) scan to measure central fat at L4-L5 level. The visceral and total central adipose tissue was calculated in cm(2) and total sagittal MRI diameter and visceral sagittal MRI diameters in cm. Components of the ATPIII definition of the metabolic syndrome and circulating adipocytokine concentrations were also measured. RESULTS MRI total sagittal abdominal diameter was positively associated with waist circumference in controls (r=0.62, p=0.007) and in diabetic subjects (r=0.81, p<0.001). Binary logistic regression analysis showed that MRI-calculated total sagittal diameter (r=0.61, p=0.002) was a more significant predictor of the adverse metabolic profile of the metabolic syndrome than MRI-assessed visceral fat. Receiver operating characteristic curves revealed that MRI-calculated total sagittal diameter most effectively identified subjects with the metabolic syndrome. CONCLUSIONS MRI-calculated total sagittal abdominal diameter is a non-validated MRI method that predicts the adverse metabolic profile of the ATPIII definition of the metabolic syndrome. Antero-posterior fat is a dimension of central fat that seems to be more closely associated with cardiovascular risk compared to visceral fat.
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Affiliation(s)
- G Valsamakis
- Endocrine and Diabetes Unit, Evgenideion University Hospital, Athens Medical School, Ethnikon and Kapodistriakon University of Athens, Athens, Greece
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Yu RHY, Ho SC, Ho SSY, Woo JLF, Ahuja AT. Association of general and abdominal obesities and metabolic syndrome with subclinical atherosclerosis in asymptomatic Chinese postmenopausal women. Menopause 2008; 15:185-92. [PMID: 17621242 DOI: 10.1097/gme.0b013e31806458c9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE This study aimed to investigate the relationships between obesity, especially abdominal obesity, andmetabolic syndrome (MS) with carotid intima-media thickness (IMT) and plaque, markers of subclinical atherosclerosis, in asymptomatic Chinese postmenopausal women in Hong Kong. DESIGN A total of 518 postmenopausal women aged 50 to 64 years were recruited through random telephone dialing. Body mass index (BMI), waist circumference, waist-to-hip ratio, sociodemographic characteristics, blood pressures, medical, biochemical and lifestyle factors were obtained. MS was defined on the basis of the National Cholesterol and Education Program, Adult Treatment Panel III criteria. Subclinical atherosclerosis was determined by measuring IMT and plaque using high-resolution B-mode ultrasonography. RESULTS Women with a BMI of 25 kg/mor greater, a waist circumference of 80 cm or greater, a waist-to-hip ratio of 0.85 or greater, or MS were observed to have higher IMT values and prevalence of plaque. Multivariate analyses revealed that waist circumference was significantly associated with IMT independent of age, hormone therapy, lifestyle and sociodemographic factors, and BMI (P < 0.05), whereas a waist-to-hip ratio of 0.85 or greater was significantly associated with plaque (odds ratio = 1.7; 95% CI: 1.0-2.8) after controlling for age, hormone therapy, lifestyle and sociodemographic factors, BMI, and the traditional cardiovascular risk factors. MS was also associated with IMT after adjustment for age, hormone therapy, lifestyle and sociodemographic factors, and BMI (P < 0.05), whereas its association with plaque was also significant (odds ratio = 1.7; 95% CI: 1.0-2.6) after controlling for age. CONCLUSIONS Abdominal obesity and MS are independent of general obesity markers of subclinical atherosclerosis in Chinese postmenopausal women.
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Affiliation(s)
- Ruby H Y Yu
- Department of Community and Family Medicine, Chinese University of Hong Kong, School of Public Health, NT, Hong Kong, SAR
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42
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Exercise and Carotid Atherosclerosis. Eur J Vasc Endovasc Surg 2008; 35:264-72. [DOI: 10.1016/j.ejvs.2007.08.022] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2007] [Accepted: 08/08/2007] [Indexed: 11/22/2022]
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Naya T, Hosomi N, Ohyama H, Ichihara SI, Ban CR, Takahashi T, Taminato T, Feng A, Kohno M, Koziol JA. Smoking, fasting serum insulin, and obesity are the predictors of carotid atherosclerosis in relatively young subjects. Angiology 2008; 58:677-84. [PMID: 18216377 DOI: 10.1177/0003319707303589] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to identify predictors of atherosclerosis in a healthy young cohort comprised of 241 subjects who underwent a regular employee medical check-up at Ohshima National Sanatorium over a 9-month period. All subjects underwent carotid ultrasound examinations to determine maximal common carotid artery intima media thickness. In addition, serum total cholesterol, triglycerides, high-density lipoprotein cholesterol, blood urea nitrogen, creatinine, glucose, and insulin were evaluated. The subjects were relatively young (mean age, 44 years; range, 18 to 62 years), with 130 females (54%) and 111 males (46%). Maximal common carotid artery intima media thickness was predicted by smoking habit, body mass index, fasting blood sugar, fasting serum insulin, and systolic blood pressure (F(5,235) = 52.8, P < 10(-5)). There was clear separation in common carotid artery intima media thickness values based on body mass index, smoking, and fasting serum insulin, and somewhat more overlap with systolic blood pressure and fasting blood sugar. These findings suggest that smoking and high values of body mass index, fasting serum insulin, systolic blood pressure, and fasting blood sugar are warning factors for early atherosclerosis development, and could conceivably serve as the basis of diagnostic screening. Smoking is particularly deleterious, as smokers with high body mass index, high fasting serum insulin, or high systolic blood pressure tend to have larger common carotid artery intima media thickness values than would have been predicted by consideration solely of the individual risk factors.
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Affiliation(s)
- Takayuki Naya
- Department of Cardiorenal and Cerebrovascular Medicine, Division of Stroke, Kagawa University School of Medicine, Kagawa, Japan
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Distribution of adipose tissue: quantification and relationship with hepatic steatosis and vascular profiles of type 2 diabetic patients with metabolic syndrome. DIABETES & METABOLISM 2008; 34:68-74. [PMID: 18243026 DOI: 10.1016/j.diabet.2007.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 10/01/2007] [Accepted: 10/08/2007] [Indexed: 11/21/2022]
Abstract
AIM As the distribution of fat is increasingly related to cardiovascular events, we examined whether or not abdominal-fat quantification using magnetic resonance imaging (MRI) software is reliable, and whether or not it is related to clinical markers of fat distribution as well as to metabolic and vascular status. METHODS We recorded the anthropometric measurements of 34 obese type 2 diabetic patients with metabolic syndrome. The patients were enrolled to evaluate their abdominal (visceral and subcutaneous) adipose tissue by single-slice L3-L4 MRI. Manual and automated analyses were compared. The relationships between anthropometric measurements, biological markers and intima-media thickness of the common carotid artery were also assessed. RESULTS We validated the automated software to quantify abdominal-fat deposition with MRI compared with manual measurements (r2=0.95). The waist-to-hip-circumference ratio (WHR) was the only clinical parameter that correlated with the proportion and quantity of visceral and subcutaneous abdominal-adipose tissue evaluated by MRI (r=0.60). In addition, fat repartition as evaluated by WHR was related to hepatic steatosis parameters (ferritin and ALAT) and to intima-media thickness, whereas simple waist circumference was not a determinant in these obese patients. We also showed that the adiponectin-to-leptin ratio was related to adipose tissue distribution. CONCLUSION Distribution of abdominal fat, as evaluated by MRI, can be reflected by clinical determination of the WHR. Differences in regional accumulations of abdominal fat may be specifically related to variations in the risks of steatosis and vascular rigidity among obese type 2 diabetic patients.
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Stamatelopoulos KS, Lekakis JP, Vamvakou G, Katsichti P, Protogerou A, Revela I, Karatzi K, Alevizaki M, Zakopoulos N, Papamichael CM. The relative impact of different measures of adiposity on markers of early atherosclerosis. Int J Cardiol 2007; 119:139-46. [PMID: 17045678 DOI: 10.1016/j.ijcard.2006.07.098] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2006] [Revised: 06/20/2006] [Accepted: 07/15/2006] [Indexed: 01/30/2023]
Abstract
BACKGROUND Although there are several methods available to assess adiposity, there is still controversy on the relative clinical utility of each of these methods. This study examines the relative impact of different measures of adiposity on markers of early atherosclerosis. In particular weight changes over time have been poorly assessed in this setting. METHODS Eighty-six healthy individuals (31 men, age 36.5+/-8.9 years) with a wide range of body-mass index (28.7+/-7.0, 18.9-57.9 kg/m2) without hypertension, diabetes or smoking were examined. In addition to waist circumference and waist-to-hip ratio self-reported weight change since adolescence was also calculated. Ultrasonography was used to measure abdominal fat layers and their ratio. Flow-mediated dilatation of the brachial artery, serum levels of intercellular adhesion molecule (sICAM-1) and mean intima-media thickness of the carotid artery were measured as markers of early atherosclerosis. RESULTS Stepwise multivariate regression analysis showed waist circumference and waist-to-hip ratio as the only independent predictor of flow-mediated dilatation. Waist circumference and weight change but not current body-mass index were independent predictors of intima-media thickness. These correlations were not influenced by ultrasonographically measured fat layers, C-reactive protein and basal insulin resistance. Body-mass index and weight gain were associated with sICAM-1 but not independently of basal insulin resistance and C-reactive protein. CONCLUSIONS Waist circumference and weight gain were the strongest predictors of early atherosclerosis in a population of apparently healthy adults. The ultrasonographically measured fat layers did not provide additional information in this population.
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Affiliation(s)
- Kimon S Stamatelopoulos
- Vascular laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece.
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Hassinen M, Lakka TA, Komulainen P, Haapala I, Nissinen A, Rauramaa R. Association of waist and hip circumference with 12-year progression of carotid intima-media thickness in elderly women. Int J Obes (Lond) 2007; 31:1406-11. [PMID: 17372615 DOI: 10.1038/sj.ijo.0803613] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To test the hypothesis that waist and hip circumferences together provide additional information on the progression of preclinical atherosclerosis beyond either of them alone in elderly women. DESIGN A 12-year follow-up study. SUBJECTS A population-based sample of 102 women 60-70 years of age at baseline. MEASUREMENTS Waist and hip circumferences and body mass index (BMI) were assessed and carotid intima-media thickness (IMT) was quantified noninvasively by ultrasonography. RESULTS There was a significant increase in the 12-year carotid IMT progression across the thirds of waist circumference (0.080, 0.277, 0.279 mm, P=0.02 for difference) and hip circumference (0.030, 0.342, 0.260 mm, P=0.001 for difference) adjusted for conventional risk factors (age, smoking, systolic blood pressure, serum low-density lipoprotein and high-density lipoprotein cholesterol, blood glucose). The association of waist circumference with IMT progression was not significant after further adjustment for hip circumference or BMI. Further adjustment for waist circumference and BMI did not change the association of hip circumference with IMT progression. The IMT progression was greatest in women with waist circumference >83 cm and hip circumference </=98 cm adjusted for conventional risk factors (P=0.003 for interaction). CONCLUSION Not only waist circumference but also hip circumference is associated with the progression of carotid atherosclerosis during 12 years in elderly women. Women with both a larger waist circumference and a smaller hip circumference had the greatest progression of carotid atherosclerosis.
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Affiliation(s)
- M Hassinen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
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Mesa JL, Ortega FB, Ruiz JR, Castillo MJ, Tresaco B, Carreño F, Moreno LA, Gutiérrez A, Bueno M. Anthropometric Determinants of a Clustering of Lipid-Related Metabolic Risk Factors in Overweight and Non-Overweight Adolescents – Influence of Cardiorespiratory Fitness. ANNALS OF NUTRITION AND METABOLISM 2007; 50:519-27. [PMID: 17191028 DOI: 10.1159/000098144] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2006] [Accepted: 06/09/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS To explore in adolescents the associations between simple anthropometric variables with a continuously distributed summary score for lipid-related metabolic risk in both overweight and non-overweight adolescents, and to test whether these associations are modified by the level of cardiorespiratory fitness. METHODS Cardiorespiratory fitness, BMI, skinfold thicknesses, body circumferences, and a continuously distributed clustering of lipid- related metabolic risk (calculated from LDL and HDL cholesterol, triglycerides, and glucose) were measured in 524 adolescents (265 males, 259 females, 15.3 +/- 1.4 years) from the cross-sectional multicentric AVENA study. Participants were classified as overweight (including obesity) or non-overweight. RESULTS Most anthropometric parameters were univariately related to the continuous lipid-related metabolic risk. However, after multicollinear analysis and generalized linear modelling, suprailiac skinfold thickness in males (p < 0.001, explained variance 12.2%) and waist-to-height ratio in females (p < 0.001, explained variance 10.0%) were the best determinants of the continuous metabolic risk score, after adjustment for age, sexual maturation, and economic status. These associations were slightly weakened in overweight males (p = 0.034) and females (p = 0.087), and did not interact with cardiorespiratory fitness. CONCLUSION Our data emphasize the usefulness of suprailiac skinfold thickness in males and waist-to-height ratio in females as simple anthropometric measurements associated to an overall lipid-related metabolic risk, mainly in non-overweight adolescents and regardless their cardiorespiratory status.
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Affiliation(s)
- José L Mesa
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain.
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Farin HMF, Abbasi F, Reaven GM. Comparison of body mass index versus waist circumference with the metabolic changes that increase the risk of cardiovascular disease in insulin-resistant individuals. Am J Cardiol 2006; 98:1053-6. [PMID: 17027570 DOI: 10.1016/j.amjcard.2006.05.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 05/08/2006] [Accepted: 05/09/2006] [Indexed: 11/16/2022]
Abstract
This study compared the abilities of body mass index (BMI) and waist circumference (WC) to identify resistance to insulin-mediated glucose uptake and related metabolic abnormalities in 261 apparently healthy patients. Insulin resistance and associated metabolic abnormalities occur more commonly in the overweight/obese, and these changes increase the risk of cardiovascular disease (CVD). Determining either their BMI or WC can identify patients more likely to experience the adverse effects of excess adiposity on CVD risk, and the relative clinical utility of these measurements is not clear. Therefore, insulin-mediated glucose uptake was quantified in 261 apparently healthy adults by determining the steady-state plasma glucose concentrations during the insulin suppression test; the higher the concentration, the greater the defect in insulin action. The fasting plasma glucose, triglyceride, and total, low-density lipoprotein, and high-density lipoprotein cholesterol concentrations were also measured, and the associations between these variables and the measurements of BMI and WC were determined. The greater the degree of adiposity, the higher the steady-state plasma glucose, fasting plasma glucose, and triglyceride concentrations, irrespective of the index of adiposity used. However, increases in the total and low-density lipoprotein cholesterol and decreases in the high-density lipoprotein cholesterol concentrations were only seen in those with higher BMI values. In conclusion, because BMI performed at least as well as WC in identifying differences in insulin sensitivity and multiple CVD risk factors, either estimate can be used to identify patients at increased CVD risk.
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Affiliation(s)
- Helke M F Farin
- Stanford University School of Medicine, Stanford, California, USA
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Thomas GN, McGhee SM, Schooling M, Ho SY, Lam KSL, Janus ED, Lam TH. Impact of sex-specific body composition on cardiovascular risk factors: the Hong Kong Cardiovascular Risk Factor Study. Metabolism 2006; 55:563-9. [PMID: 16631430 DOI: 10.1016/j.metabol.2005.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2004] [Accepted: 08/04/2005] [Indexed: 11/24/2022]
Abstract
The aim of the study was to analyze the effects of sex-specific distribution of adiposity, particularly emphasizing the independent contribution of waist and hip circumferences relative to body mass index (BMI), on cardiovascular risk factors in a Chinese population. Blood pressure and anthropometric and biochemical parameters were measured in 2510 population-based Chinese subjects. The relative contributions of waist and hip circumferences to the presence of cardiovascular risk factors were determined. The Chinese men were significantly larger than women, with greater BMI and central adiposity. Waist and hip circumferences were both positively associated with the presence of hypertension, dyslipidemia, and diabetes. However, after adjustment for BMI and age, hip circumference exhibited a significant dose-dependent inverse relationship with dyslipidemia and diabetes in women, but not men. Sex-specific differences exist. After adjustment for age and BMI, hip circumferences independently and inversely contribute to cardiovascular risk in women, but not in men. Increasing adjusted waist circumference was associated with increased risk of hypertension and diabetes in Chinese and dyslipidemia in women only.
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Affiliation(s)
- G Neil Thomas
- Department of Community Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Seow A, Yuan JM, Koh WP, Lee HP, Yu MC. Diabetes Mellitus and Risk of Colorectal Cancer in the Singapore Chinese Health Study. ACTA ACUST UNITED AC 2006; 98:135-8. [PMID: 16418516 DOI: 10.1093/jnci/djj015] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The incidence of colorectal cancer is highest in populations that consume an energy-dense diet, have low intakes of vegetables and fruit, or lead a sedentary lifestyle. These factors may influence colorectal carcinogenesis via insulin pathways. We examined whether diabetes mellitus was associated with colorectal cancer in Singapore Chinese, whose body type and lifestyle profiles are distinct from those of Western populations. Between April 1993 and December 1998, 63,257 Singapore Chinese men and women aged 45 to 74 years were enrolled in a prospective study of diet and cancer. Each subject provided dietary, medical, and lifestyle information through an in-person interview. As of December 31, 2002, 636 incident colorectal cancer cases had been diagnosed. A history of physician-diagnosed diabetes was statistically significantly associated with colorectal cancer risk in both men (relative risk [RR] = 1.5, 95% confidence interval [CI] = 1.2 to 2.1) and women (RR = 1.4, 95% CI = 1.0 to 1.9). In stratified analyses, this association remained statistically significant among the subset of diabetics with high total calorie intake and low physical activity levels. Our results support the hypothesis that hyperinsulinemia may play a role in colorectal carcinogenesis, even in a relatively lean population.
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Affiliation(s)
- Adeline Seow
- Department of Community, Occupational and Family Medicine, National University of Singapore, Singapore.
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