Waist circumference cut-off points to identify major cardiovascular events and incident diabetes in Latin America: findings from the prospective Urban rural epidemiology study Colombia

Circulating hs-CRP, IL-18, Chemerin, Leptin, and Adiponectin Levels Reflect Cardiometabolic Dysfunction in Adults with Excess Weight

Up to 30% of individuals with obesity may exhibit normal insulin sensitivity, a favorable lipid profile, and no signs of hypertension. This prompts the exploration of factors distinguishing cardiometabolically healthy individuals from those developing complications. This cross-sectional study included 116 individuals categorized into four groups by combining abdominal obesity and cardiometabolic health statuses. We compared circulating adipokines and gut microbiota composition between these groups. Individuals with abdominal obesity had higher levels of hs-CRP, TNF-α, MCP-1, IL-18, chemerin, and leptin, and a less favorable gut microbiota composition, including higher levels of potentially harmful bacteria (CAG-Pathogen) and lower levels of beneficial bacteria (CAG-Ruminococcaceae and CAG-Akkermansia), compared to those with adequate waist circumference. Those with obesity but cardiometabolically healthy displayed similar adipokine levels and microbiota composition to those with adequate waist. In contrast, individuals with abdominal obesity cardiometabolically abnormal exhibited significantly higher levels of hs-CRP, IL-18, chemerin, and leptin, and lower levels of adiponectin and CAG-Ruminococcaceae compared to those with abdominal obesity cardiometabolically healthy and adequate waist. Additionally, they differed in hs-CRP and adiponectin/leptin ratio from individuals with obesity cardiometabolically healthy. These findings suggest that altered adipokine profiles and gut microbiota may contribute to the development or persistence of cardiometabolic complications in obesity.

2024 Latin American Society of Hypertension guidelines on the management of arterial hypertension and related comorbidities in Latin America

Hypertension is responsible for more than two million deaths due to cardiovascular disease annually in Latin America (LATAM), of which one million occurs before 70 years of age. Hypertension is the main risk factor for cardiovascular morbidity and mortality, affecting between 20 and 40% of LATAM adults. Since the publication of the 2017 LASH hypertension guidelines, reports from different LATAM countries have confirmed the burden of hypertension on cardiovascular disease events and mortality in the region. Many studies in the region have reported and emphasized the dramatically insufficient blood pressure control. The extremely low rates of awareness, treatment, and control of hypertension, particularly in patients with metabolic disorders, is a recognized severe problem in LATAM. Earlier implementation of antihypertensive interventions and management of all cardiovascular risk factors is the recognized best strategy to improve the natural history of cardiovascular disease in LATAM. The 2024 LASH guidelines have been developed by a large group of experts from internal medicine, cardiology, nephrology, endocrinology, general medicine, geriatrics, pharmacology, and epidemiology of different countries of LATAM and Europe. A careful search for novel studies on hypertension and related diseases in LATAM, together with the new evidence that emerged since the 2017 LASH guidelines, support all statements and recommendations. This update aims to provide clear, concise, accessible, and useful recommendations for health professionals to improve awareness, treatment, and control of hypertension and associated cardiovascular risk factors in the region.

Anthropometric Measurements in Predicting Haemorrhagic Stroke Among Bangladeshi Population: The MAGPIE Study

Background

Anthropometric measurements used to predict cardiovascular disease vary worldwide but are mostly derived from those of Caucasian ancestry. We sought to undertake such measurements in the little studied Bangladeshi population.

Methods

The MAGPIE (Multidimensional Approach of Genotype and Phenotype in Stroke Etiology) study is a Bangladeshi stroke case-control study that recruited nationwide between January 2022 and June 2024. The univariate analysis was utilised to curtail the risk of independent variables, and a receiver operating characteristic (ROC) curve was employed to identify the cut-off values of Body Mass Index (BMI), Waist Circumference (WC), and Hip Circumference (HC). Furthermore, a multivariate logistic regression (LR) model demonstrated the risk of independent predictors of haemorrhagic stroke (HS) among sexes.

Results

Of a total of 1491 age- and sex-matched study population, 918 were haemorrhagic stroke (61.5%) with female predominance (n=489; 53.3%) and significantly older than men (P=0.003). The BMI (22.9 ±3.0 vs 21.3 ±3.0; P<0.001), WC (84.0 ±7.3 vs 80.8 ±7.3; P<0.001) and HC (90.6 ±7.1 vs 85.5 ±7.7; P<0.001) was significantly higher among women compared to men. A ROC curve demonstrated that the cut-off values of BMI, WC, and HC are 20.6kg/m2, 78.8cm, and 84.6cm, respectively, in men and 21.1 kg/m2, 81.5cm, and 88.1cm, respectively, in women haemorrhagic stroke population. Furthermore, an age-adjusted multivariate LR model identified a HC of ≥84.6 cm in men (OR 2.8, 95% CI 1.61-4.97; P <0.001) and a WC of ≥81.5cm in women (OR 1.6, 95% CI 1.01-2.37; P=0.001) as potential independent predictors of haemorrhagic stroke.

Conclusion

Bangladeshi men with a hip circumference of ≥84.6cm have about threefold, and women with a waist circumference of ≥81.1cm have about twofold heightened risk of haemorrhagic stroke.

Effect of Nuts Combined with Energy Restriction on the Obesity Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Obesity is a multifactorial disease that is difficult to control worldwide. Although nuts are recognized health foods, the application of food in obesity management is unclear. We systematically reviewed the literature and performed a meta-analysis to evaluate if nut consumption favors people on energy restriction (ER) dietary interventions. Four databases were used to search for eligible articles in May 2024. This review was conducted according to the PRISMA guide, and the bias risk of papers was evaluated. For the meta-analysis, we extracted the endpoint values of the group's variables and estimated the effect sizes by the random-effects model. Sixteen and ten articles were included in the systematic review and meta-analysis, respectively. Almonds were evaluated in the majority of studies (n = 6). The consumption of nuts (28 to 84 g/d, 4 to 72 months) included in ER (-250 to 1000 kcal/d) did not differently affect anthropometry (weight loss, BMI, waist and hip circumferences), body composition (fat mass, fat-free mass, or lean mass), markers of glucose (glycemia and insulinemia), lipid metabolism (total cholesterol, HDL-c, LDL-c, LDL-c/HDL-c, or triglycerides), and systolic and diastolic blood pressure. In most analyses, stratifying studies by type of nut or intervention time did not present different results in the meta-analysis. As there are few studies, in addition to great methodological variability, more high-quality trials are needed to confirm these results. The PROSPERO registration number is CRD42023444878.

Association between the weight-adjusted waist index and the odds of type 2 diabetes mellitus in United States adults: a cross-sectional study

Objective

To examine the association between the weight-adjusted waist index (WWI) and the odds of type 2 diabetes mellitus(T2DM)among U.S. adults.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) spanning six years (2007-2018) were utilized, encompassing 31001 eligible participants. Weighted multivariate logistic regression models and smoothed fit curves were employed to assess the association between WWI and the odds of T2DM, as well as dose-response relationships in the overall population and the odds of T2DM in various subgroups.

Results

In the fully adjusted continuous model, each one-unit increase in WWI was associated with a 1.14-fold increase in the odds of T2DM within the entire study population (2.14 [1.98,2.31], P < 0.0001). In the fully adjusted categorical model, when using the lowest tertile of WWI (T1) as the reference group, the second tertile (T2) and the third tertile (T3) were associated with a 0.88-fold (1.88 [1.64,2.17], P < 0.0001) and a 2.63-fold (3.63 [3.11,4.23], P < 0.0001) increase in the odds of T2DM. These findings indicated a positive correlation between WWI values and the odds of T2DM, aligning with the results of the smoothed-fitted curves. In the analysis of subgroups, in addition to maintaining consistency with the overall population results, we found interactions between age and hypertension subgroups.

Conclusion

In conclusion, WWI was found to be positively associated with the odds of T2DM in U.S. adults.