Association of Body Shape Index (ABSI) with Hand Grip Strength

Modified Metabolic Syndrome Criteria Considering Cardio-Ankle Vascular Index (CAVI) and A Body Shape Index (ABSI): Implications for Kidney Risk

Waist circumference (WC), an abdominal obesity index in the current metabolic syndrome (MetS) criteria, may not adequately reflect visceral fat accumulation. This brief review aims to examine the clinical significance of utilizing a body shape index (ABSI), a novel abdominal obesity index, to modify the MetS criteria, considering the predictive ability for vascular dysfunction indicated by the cardio-ankle vascular index (CAVI), as well as kidney function decline. First, the relationship of CAVI with kidney function is presented. Next, whether modification of the MetS diagnostic criteria by replacing the current high waist circumference (WC-MetS) with high ABSI (ABSI-MetS) improves the predictive ability for vascular and kidney dysfunction is discussed. Although limited to Asian populations, several cross-sectional and longitudinal studies support the relationship of CAVI with kidney function. Increased CAVI is associated with kidney function decline, and the CAVI cutoff for kidney outcomes is considered to be 8-9. In urban residents who underwent health screening, an increase in ABSI, but not body mass index (BMI) or WC, was associated with increased CAVI, suggesting that ABSI reflects vasoinjurious body composition. In several cross-sectional studies, ABSI-MetS was superior to WC-MetS in identifying individuals with increased CAVI. Furthermore, the predictive ability of ABSI-MetS in assessing kidney function decline was enhanced only in individuals with MetS, as determined in a longitudinal analysis. Using WC as a major criterion for MetS diagnosis may not adequately identify individuals at risk of vascular dysfunction and kidney function decline. This review shows that this problem may be solved by replacing WC with ABSI. Future research should explore whether ABSI-MetS also predicts cardiovascular events, and whether therapeutic intervention that reduces ABSI improves clinical outcomes.

Grip strength of law enforcement officers and its implications

Grip strength (GS) plays a vital role for law enforcement officers (LEOs). This study aimed to establish a baseline for LEO GS, compare it with the general population, determine the correlation between LEO GS and body dimensions, and evaluate the implications for occupational performance. A total of 756 male and 218 female LEOs from across the U.S. participated in the study. On average, male LEOs exhibit stronger GS (49.53 kg) than female officers (32.14 kg). Significant differences between LEOs and the general population were observed. GS correlated with hand breadth, hand length, stature, and bideltoid breadth. Approximately 26%-46% of males and 5%-39% of females were identified as being at risk of health, fit, or occupational performance based on their measured GS. Enhancing GS training or avoiding implementing heavy equipment (such as pistols with heavy trigger weight), could improve officer occupational performance, safety, or health.

Impact of Body Mass Index and VO2 Max on Symptoms, Physical Activity, and Physical Function in a Multinational Sample of People with HIV

People with HIV (PWH) are at increased risk for metabolic disorders affecting body mass index (BMI), chronic symptoms, and impaired physical function and capacity. Although physical activity improves health and well-being, PWH often do not meet activity recommendations necessary to achieve these benefits. Despite the known impact of symptoms, physical activity, and physical function on health, little is known about the relationships and interactions between these variables and BMI and maximum oxygen consumption during exercise (VO2 max) in a multinational population of PWH. We examined the relationship of BMI with PROMIS-29 measures, physical activity, strength, flexibility, and VO2 max in a diverse sample of PWH. Additionally, we examined the relationship of VO2 max with PROMIS-29 measures. Data from 810 PWH who participated in a cross-sectional study conducted by the International Nursing Network for HIV Research (Study VII) were analyzed. Participants were recruited from 8 sites across the United States, Thailand, and South Africa. BMI was calculated from collected height and weight data. Physical function and symptoms were assessed using the PROMIS-29 measure. Physical activity was assessed using the 7-day Physical Activity Recall. VO2 max was calculated using sex at birth, age, BMI and the 6-minute Walk Test. Data were analyzed using descriptive, correlational, and regression statistical analyses. Participants had an average age of 49.1 (± 11.1) years, 44% were female, and the average BMI of the sample group was 27 kg/m2 (± 6.7). Increased BMI was associated with decreased 6-minute Walk Test (β=-2.18, p < 0.001), flexibility (β=-0.279, p < 0.001), and VO2 max (β=-0.598, p < 0.001), even after controlling for covariates (age, sex at birth, country, years living with HIV, and antiretroviral therapy status). BMI was not associated with self-reported physical activity. Increased VO2 max was associated with increased physical function (β = 0.069, p < 0.001), and decreased pain (β=-0.047, p < 0.006), even after controlling for covariates (country, years living with HIV, and antiretroviral therapy status). Future research should explore development of effective and sustainable symptom self-management interventions in PWH accounting for the potential impact of BMI and VO2 max.

Association of body indices with mortality in older population: Japan Specific Health Checkups (J-SHC) Study

BACKGROUND

Obesity indices reflect not only fat mass but also muscle mass and nutritional status in older people. Therefore, they may not accurately reflect prognosis. This study aimed to investigate associations between a body shape index (ABSI), body mass index (BMI), and mortality in the general older population.

METHODS

This nationwide observational longitudinal study included individuals aged between 65 and 74 years who underwent annual health checkups between 2008 and 2014. Exposures of interest were ABSI and BMI, and the primary outcome was all-cause mortality. Association between the ABSI and BMI quartile (Q1-4) and mortality was assessed using Cox regression analysis. A restricted cubic spline was also used to investigate nonlinear associations. The missing values were imputed using multiple imputation by chained equations.

RESULTS

Among 315,215 participants, 5074 died during a median follow-up period of 42.5 (interquartile range: 26.2-59.3) months. Compared with ABSI Q1, ABSI Q3 and Q4 were associated with increased risk of mortality, with the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of 1.13 (1.05-1.22) and 1.23 (1.13-1.35), respectively. Compared with BMI Q3, BMI Q1 and Q2 were associated with an increased risk of mortality, with aHRs and 95% CIs of 1.51 (1.39-1.65) and 1.12 (1.03-1.22), respectively. The impacts of these indices were greater in male than in female. The heatmap of the aHR for mortality by continuous ABSI and BMI showed that higher ABSI was consistently associated with higher mortality risk regardless of BMI, and that the combination of low BMI and high ABSI was strongly associated with increased mortality risk.

CONCLUSIONS

High ABSI and low BMI are additively associated with the risk of all-cause mortality in the general older population in Japan. Combination of ABSI and BMI is useful for evaluating mortality risk in older people.

Body surface scan anthropometrics are associated with grip strength in the general population

BACKGROUND AND AIM

Body shape and anthropometrics are well-known risk factors for cardiovascular diseases (CVD) and mortality. Hand-grip strength (HGS) is also a meaningful marker of health and a promising predictor of CVD and mortality. There is a lack of studies that have systematically investigated associations between body shape and anthropometrics with HGS. In a population-based study, we investigated if anthropometric markers derived from 3D body scanning are related to HGS.

METHODS AND RESULTS

We used the data of 1,599 individuals aged 36 to 93 years, who participated in the Study of Health in Pomerania. A total of 87 anthropometric markers, determined by a 3D body scanner, were included in the analysis. Anthropometric measurements were standardized and used as exposure variables. HGS was measured with a hand dynamometer and used as outcome. Sex-stratified linear regression models adjusted for age and height were used to relate standardized anthropometrics and HGS. Anthropometric markers were ranked according to -log-p-values. In men, left and right forearm circumference, left arm length to neck (C7), left forearm length, and forearm-fingertip length were most strongly related to HGS. In women, right forearm circumference, forearm-fingertip length, shoulder breadth, left forearm circumference, and right wrist circumference showed the most significant associations with HGS. The final prediction models contained 13 anthropometric markers in males (R2=0.54) and eight anthropometric markers in females (R2=0.37).

CONCLUSIONS

The identified parameters may help estimate HGS in the clinical setting. However, studies in clinical settings are essential to validating our findings.

The predictive ability of ABSI compared to BMI for mortality and frailty among older adults

Introduction

To study the utility of A Body Shape Index (ABSI) alongside body mass index (BMI) to predict mortality and frailty in an aging community population.

Materials and methods

Participants (n = 1,580) were drawn from the first Israeli national health and nutrition survey of older adults ("Mabat Zahav") conducted from 2005 to 2006, constituting adults aged ≥65 years. Socio-demographic, clinical, behavioral, and psychosocial data were collected. Baseline weight, height, and waist circumference (WC) were measured and expressed as the allometric indices BMI (kg/m2) and ABSI, a BMI-independent measure of abdominal obesity [WC/(BMI2/3*m1/2)]. Mortality follow-up lasted through 2019. Frailty was assessed in 2017-2019 by the Fried Biological Phenotype in a sub-cohort of 554 survivors. Cox and logistic regression models assessed associations of BMI and ABSI with mortality and frailty.

Results

At baseline, mean [SD] age was 74.5 [6.1] years, and 52.4% were women. The correlation between BMI and WC Z scores was 0.71, reduced to -0.11 for BMI and ABSI. Over a median follow-up of 13 years, 757 deaths occurred. The multivariable-adjusted hazard ratios (95% CIs) for mortality per standard deviation increase in BMI and ABSI were 1.07 (0.99;1.17) and 1.13 (1.05;1.21), respectively. Among participants assessed for frailty, 77 (14%) met the frailty criteria. After multivariable adjustment, the odds ratios (95% CIs) for frailty were 0.83 (0.69-1.01) for BMI and 1.55 (1.34-1.79) for ABSI.

Discussion

In a nationwide cohort of older adults, ABSI was independently associated with mortality risk. Furthermore, ABSI, but not BMI, was a strong predictor of frailty.

Relationship between a body shape index and muscle strength index in Chinese university students: a cross-sectional survey

BACKGROUND

The problem of overweight obesity and decrease in muscle strength among university students has become an indisputable fact. In this study, a comprehensive index reflecting obesity degree a body shape index (ABSI) and a comprehensive index reflecting muscle strength muscle strength index (MSI) were studied to analyze the cross-sectional correlations existing between them.

METHODS

This study began recruiting participants and conducting the test survey in April 2022 and closed in July 2022. Basic condition, height, weight, waist circumference, grip strength, pull-up (boys), bent-leg sit-up (girls), and standing long jump were tested on 12,046 (boys: 6011, 49.90%) university students aged 19-22 years in China, and ABSI and MSI were calculated separately. ABSI was categorized into 5 groups according to age and sex, namely ABSI < 5th percentile (A), 5th ≤ ABSI < 25th percentile (B), 25th ≤ ABSI < 75th percentile (C), 75th ≤ ABSI < 95th percentile (D) and ABSI ≥ 95th percentile (E). The comparison of MSI between different ABSI groups was performed using effect size, and the association between them was performed by curve estimation analysis.

RESULTS

The association between ABSI and MSI of Chinese university students showed an inverted "U" curve. The effect of increased ABSI on MSI was greater in university girls compared to boys. The ABSI of boys was (0.080 ± 0.010) and MSI was (-0.005 ± 2.080); the ABSI of girls was (0.079 ± 0.008) and MSI was (-0.017 ± 1.867). Overall, university students ABSI was at a relatively high point for MSI between 0.050 and 0.100. The university students ABSI at 0.150 had an MSI of -1.229 for boys and - 2.779 for girls.

CONCLUSION

The ABSI of Chinese university students showed an inverted "U"-shaped curve relationship with MSI, and university students with low or high ABSI had lower MSI. The effect of increasing ABSI on the decrease of MSI was more obvious for girls than for boys.

A body shape index is useful for BMI-independently identifying Japanese patients with obesity at high risk of cardiovascular disease

BACKGROUND AND AIM

Obesity with multiple metabolic syndrome (MetS) components and/or with skeletal muscle loss is at high risk of cardiovascular disease (CVD). This study aimed to clarify the utility of anthropometric indices for identifying patients with overweight/obese at high risk of CVD based on having multiple MetS components and skeletal muscle loss.

METHODS & RESULTS

This cross-sectional study included 188 overweight/obese (BMI ≥25 kg/m2, Japanese patients; 73 men and 115 women, mean age 55.7 years). First, we performed correlation analysis among seven anthropometric indices, body mass index (BMI), percentage body fat, waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI). Unlike the others, only ABSI was not correlated with BMI. Then, we conducted receiver operating characteristic analysis to assess the predictive abilities of anthropometric indices for having multiple MetS components. WC, WHpR, WHtR, BRI, and ABSI had significant predictive abilities for having multiple MetS components. Furthermore, multiple regression analysis showed that only ABSI had significantly negative associations with all sarcopenia-evaluated indices (skeletal muscle mass index [SMI], handgrip strength [HGS], and muscle quality [MQ]), irrespective of sex and age. Finally, an analysis of covariance showed that the high ABSI group had significantly lower SMI and HGS than the low ABSI group, irrespective of sex and age.

CONCLUSION

ABSI was deemed useful for BMI-independently identifying Japanese patients with overweight/obese at high risk of CVD based on having multiple MetS components and skeletal muscle loss. Clinical trials (the unique trial number and the name of the registry) ID: UMIN000042726.

Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study

AIM

To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness.

METHODS

Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0.

RESULTS

Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks.

CONCLUSION

Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.

Influence of hand dominance, gender, and body mass index on hand grip strength

Background

Hand grip strength (HGS) measurements serve as an objective measure of upper extremity function. Reliable hand strength evaluation is vital for assessing treatment effectiveness.

Objectives

To determine the influence of hand dominance, gender, and body mass index (BMI) on HGS among university students in Ghana.

Method

In our cross-sectional study of 304 participants, height, weight, and BMI were measured using a stadiometer and weighing scale. Hand grip strength was assessed with a dynamometer. We compared HGS in dominant and non-dominant hands for males and females using a paired t-test and analysed the correlation between grip strength and weight, height, and BMI using Pearson's correlation coefficient.

Results

The mean HGS for right-hand dominant (RHD) male participants was 35.62 kg (± 7.36) for the right hand compared with 32.84 kg (± 7.36) for the left hand. For females RHD the mean HGS in the right hand was 24.60 kg (± 6.42) compared to 22.12 kg (± 5.37) in the left hand. The mean weight, height and BMI of participants were 62.86 kg (± 10.30), 1.67 m (± 0.09) and 22.9 kg/m2 (± 4.9), respectively. A significant relationship existed between HGS and height (r = 0.492; p < 0.01) as well as HGS and BMI (r = 0.290; p < 0.01). However, no notable connection was found between HGS and weight (r = 0.001; p = 0.982).

Conclusion

Hand grip strength was significantly stronger in the dominant hand of both males and females.

Clinical implications

Physiotherapists should test HGS objectively and quantitatively for use in disease evaluation, diagnosis, and therapy.

A pilot study: handgrip as a predictor in the disease progression of SCA3

BACKGROUND

Spinocerebellar ataxia type 3 (SCA3) is an inherited, autosomal, and rare neurodegenerative disease. Serum/plasma biomarkers or functional magnetic resonance imaging used to assess progression, except for neurological examinations, is either inconvenient or expensive. Handgrip strength (HGS) may be considered as a biomarker to predict the progress of SCA3 and align with the alteration of plasma neurofilament light chain (NfL) and Scale for the Assessment and Rating of Ataxia (SARA).

METHODS

Patients with SCA3 and healthy subjects were recruited from Changhua Christian Hospital. SARA, body mass index (BMI), and NfL were obtained for both groups. HGS was measured using a Jamar Plus + hand dynamometer.

RESULTS

This study recruited 31 patients and 36 controls. HGS in the SCA3 group revealed a profound decrease (P < 0.001) compared with normal subjects. HGS also had a negative correlation with SARA (r =  - 0.548, P = 0.001), NfL (r =  - 0.359, P = 0.048), and a positive correlation with BMI (r = 0.680, P < 0.001). Moreover, HGS/BMI ratio correlated with SARA (r =  - 0.441, P = 0.013). Controlling for gender and age, HGS still correlated with the above clinical items. The initial hypothesis was also proved in SCA3 84Q transgenic mice, showing grip strength weakness compared to normal mice.

CONCLUSIONS

HGS can be an alternative tool to assess the clinical severity of SCA3. Further research is needed to investigate the underlying mechanisms.

Exploring the Relationship Between the Indices of Body Composition With Grip Strength Performance and Peak VO2

Background The importance of measurements of body composition in terms of various indices including Body Mass Index (BMI), Body Surface Area (BSA), Body Size Index (BSI), and Waist to Height ratio (WtHR) in the diagnosis of health risks and mortality outcome analysis has largely been limited to their use relating to determining abdominal obesity. The understanding of the extent of implications of the newer, underutilized indices of body composition is deficient. Peak VO₂ (maximal oxygen uptake) majorly serves for the evaluation of the measure of aerobic capacity. Grip strength performance is a simple, primary, objective predictor of overall physical status and muscular and cardiovascular fitness. This study aimed to derive the relationship between a gamut of parameters such as BMI, BSA, WtHR, BSI, grip strength performance and peak VO₂ investigated using the latest scientific methodology in a cross-section of the population in a rural tertiary care center. Methodology This study was a descriptive, cross-sectional study carried out in a rural medical college in central India. Sixty participants from the healthcare setting were considered eligible for the study within the age group of 18 to 45 years. Anthropometric assessments like height (in cm), weight (in kg), waist circumference (in cm), and BMI were carried out. BSA, WtHR, and BSI were calculated using the respective formulae. VO₂ max (maximal oxygen uptake) recordings were done using the treadmill/ergometer and metabolic module of LabChart software (Bella Vista, New South Wales, Australia). Grip Strength Performance was quantified by measuring the amount of static force with which the hand is able to squeeze a transducer. It was measured using Grip Force Transducer (MLT004 / ST) from AD Instruments (Bella Vista, New South Wales, Australia). Results Upon analysis, a significant negative correlation was obtained between BSI and BMI (r= -0.51, p<0.0001) whereas a significant positive correlation was found between BSA and BMI (r= 0.71, p< 0.0001). A significant correlation was also seen between WtHR and BMI (r= 0.71, p< 0.0001) while a negative significant correlation between peak VO₂ and BMI (r= -024,p=0.0425) was deduced. Similarly, a negative correlation was evident between BSA and BMI (r= -0.46, p=0.0002) with a positive correlation between WtHR and BSA (r= 0.30,p=0.0188). Grip strength performance positively correlated with BSA (r= 0.58, p< 0.0001) whereas peak VO₂ showed a significant negative correlation with WtHR (r= -026,p=0.043). There was also a positive significant correlation between grip strength performance and peak VO₂ (r= 0.37, p=0.0033) Conclusion The study determined the relationships of grip strength performance and peak VO₂, with the body composition indices in order to provide an overview of the mortal risks of an individual which might mediate the prognosis. Based on the relative independence of BSI with peak VO₂ and grip strength performance, the unification of these parameters can help assess the overall health of an individual.

Central obesity as assessed by conicity index and a-body shape index associates with cardiovascular risk factors and mortality in kidney failure patients

Background

Anthropometric indices of central obesity, waist circumference (WC), conicity index (CI), and a-body shape index (ABSI), are prognostic indicators of cardiovascular (CV) risk. The association of CI and ABSI with other CV risk indices, markers of nutritional status and inflammation, and clinical outcomes in chronic kidney disease (CKD) stage 5 (CKD5) patients was investigated.

Methods

In a cross-sectional study with longitudinal follow up of 203 clinically stable patients with CKD5 (median age 56 years; 68% males, 17% diabetics, 22% with CV disease, and 39% malnourished), we investigated CI and ABSI and their associations with atherogenic index of plasma (AIP), Framingham CV risk score (FRS), Agatston scoring of coronary artery calcium (CAC) and aortic valve calcium (AVC), handgrip strength (HGS), high sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6). CV events (CVE) and all-cause mortality during up to 10-years follow up were analyzed by multivariate survival analysis of restricted mean survival time (RMST).

Results

Chronic kidney disease patients with middle and highest CI and ABSI tertiles (indicating greater abdominal fat deposition), compared to those with the lowest CI and ABSI tertiles, tended to be older, more often men and diabetic, had significantly higher levels of hsCRP, IL-6, AIP, FRS, CAC and AVC scores. CI and ABSI were positively correlated with CAC, FRS, AIP, hsCRP and IL-6. Both CI and ABSI were negatively correlated with HGS. In age-weighted survival analysis, higher CI and ABSI were associated with higher risk of CVE (Wald test = 4.92, p = 0.027; Wald test = 4.95, p = 0.026, respectively) and all-cause mortality (Wald test = 5.24, p = 0.022; Wald test = 5.19, p = 0.023, respectively). In RMST analysis, low vs. high and middle tertiles of CI and ABSI associated with prolonged CVE-free time and death-free time, and these differences between groups increased over time.

Conclusion

Abdominal fat deposit indices, CI and ABSI, predicted CV outcomes and all-cause mortality, and were significantly associated with the inflammatory status in CKD patients.

[Using Quantitative Computed Tomography to Study the Correlation Between Physical Composition and Grip Strength in Young People]

Objective

To study with quantitative computed tomography (QCT) the correlation between grip strength and physical composition and waist and hip circumferences in young people with different body mass indexes (BMIs).

Methods

A total of 1310 young people who came to West China Hospital, Sichuan University for physical checkups and underwent chest QCT at our hospital from April to July 2021 were included in the study. Their data were collected and their BMIs were calculated. The subjects were divided according to their BMIs into 4 groups, underweight group (BMI<18.5 kg/m 2), normal-weight group (18.5 kg/m 2≤BMI<24 kg/m 2), overweight group (24 kg/m 2≤BMI<28 kg/m 2), and obesity group (BMI≥28 kg/m 2). The raw data were uploaded to QCT Mindways Pro 6.1 software to be processed for measurement of the fat content (area) of the physical components of the L2 vertebral body, including total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and abdominal fat ratio, or VAT/SAT. Grip strength was measured with CAMRY EH101 digital grip dynamometer. Statistical analysis of the data was performed, and the correlations between grip strength and various physical components, waist circumference, and hip circumference in subjects of different BMIs were examined. In addition, stratified analysis of normal-weight and overweight subjects of different age groups was conducted.

Results

In the normal-weight group, height, body mass, hip circumference and grip strength were positively correlated with grip strength in males aged 21-40 years, SAT was negatively correlated with grip strength in males aged 36-40 years, and VAT/SAT was positively correlated with grip strength in males aged 36-40 years. In normal-weight females aged 21-25 years, SAT was negatively correlated with grip strength, while VAT and VAT/SAT were positively correlated with grip strength. In normal-weight females aged 26-40 years, height, body mass, and hip circumference were positively correlated with grip strength. In normal-weight females aged 36-40 years, VAT/SAT was positively correlated with grip strength. In overweight males aged 21-25 years, hip circumference and body mass were positively correlated with grip strength. In overweight males aged 26-30 years, TAT, waist-to-hip ratio, and waist-to-height ratio were negatively correlated with grip strength. In overweight males aged 31-40 years, height and body mass were positively correlated with grip strength, while waist-to-hip ratio and waist-to-height ratio were negatively correlated with grip strength. In addition, hip circumference was positively correlated with grip strength in overweight males aged 31-35 years. In overweight females aged 21-25 years, waist circumference, hip circumference, and waist-to-height ratio were positively correlated with grip strength. In overweight females aged 26-30 years, height and body mass were positively correlated with grip strength. In overweight females aged 31-35 years, TAT, SAT, waist circumference, waist-to-hip ratio, and waist-to-height ratio were negatively correlated with grip strength. In overweight females aged 36-40 years, SAT and waist-to-height ratio were negatively correlated with grip strength, while VAT, VAT/SAT, height and body mass were positively correlated with grip strength. The height and body mass of males and females in the underweight group were positively correlated with grip strength, and the hip circumference of females in the underweight group was also positively correlated with grip strength. In the obesity group, TAT, VAT, and waist-to-height ratio were negatively correlated with grip strength in males, but no such correlation was observed in females.

Conclusion

There is a close association between abdominal fat content and grip strength in young people with different BMIs, indicating that young people should control abdominal fat content and hip fat content in order to maintain the strength of corresponding muscles.

The Applicability of the ESPEN and EASO-Defined Diagnostic Criteria for Sarcopenic Obesity in Japanese Patients after Stroke: Prevalence and Association with Outcomes

Sarcopenic obesity is of growing research and clinical interest; however, validated diagnostic criteria are lacking. We therefore aimed to examine the prevalence of sarcopenic obesity as diagnosed by the criteria recently proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO), and its association with outcomes among patients after stroke. This study was based on a cohort of 760 Japanese patients after stroke admitted to a post-acute rehabilitation hospital. Sarcopenic obesity was diagnosed at admission according to the ESPEN and EASO criteria using reference values specific to Asians. Outcomes included the motor domain of the functional independence measure (FIM-motor) and the food intake level scale (FILS) at discharge. Multivariate linear regression models were used to assess the associations between sarcopenic obesity and outcomes. Among 760 patients (median age, 73 years; 352 women and 408 men), sarcopenic obesity was diagnosed in 34 patients (4.5%; 5.4% of women and 4.1% of men). In multivariate analyses, sarcopenic obesity was independently and negatively associated with FIM-motor (β = −0.048, p = 0.031) and FILS at discharge (β = −0.095, p = 0.046) in women. In contrast, in men, sarcopenic obesity showed an independent negative association with FIM-motor at discharge (β = −0.117, p < 0.001) but no statistically significant association with FILS at discharge (β = −0.004, p = 0.323). In conclusion, the prevalence of sarcopenic obesity diagnosed by the ESPEN and EASO-defined criteria was as low as 4.5% among Japanese patients after stroke. Furthermore, sarcopenic obesity was negatively associated with improvements in activities of daily living and dysphagia.

Handgrip weakness, systemic inflammation indicators, and overall survival in lung cancer patients with well performance status: A large multicenter observational study

BACKGROUND

Systemic inflammation and handgrip weakness have been used to predict mortality in many cancers. The purpose of current study was to evaluate the association of co-occurrence of inflammation indicators and handgrip weakness with overall survival (OS) of lung cancer (LC) patients with good performance status.

METHODS

The cutoff points for handgrip strength (HGS) and the four inflammation indicators were calculated using Maxstat. The time-dependent receiver operating characteristic curve and C-index were used to select optimal inflammation indicator for predicting OS of LC patients. The Cox proportional hazard regression model was used to calculate the hazard ratio (HR) of mortality. Kaplan-Meier curves were constructed to evaluate the association of indicators and the OS of LC patients.

RESULTS

Among the 1951 patients, the mean ± standard deviation (SD) age was 60.6 ± 9.9 years, and 1300 (66.6%) patients were male. In patients with good performance status (PS), handgrip weakness (HR, 1.49; 95% confidence interval [95% CI], 1.30-1.70, p < 0.001) and low advanced lung cancer inflammation index (ALI) (HR, 2.05; 95%CI, 1.79-2.34, p < 0.001), high systemic immune-inflammation index (SII) (HR, 1.91; 95%CI, 1.66-2.19, p < 0.001), high platelet: lymphocyte ratio (PLR) (HR, 1.60; 95%CI, 1.40-1.82, p < 0.001), or high neutrophil: lymphocyte ratio (NLR) (HR, 2.01; 95%CI, 1.76-2.30, p < 0.001) were associated with increased mortality risk of LC patients. ALI had better C-index (0.624) and time-AUC in the prediction of OS in LC patients with good PS than other three combinations. The co-occurrence of handgrip weakness and low ALI more than doubled the risk of death in LC with good PS (HR, 2.44; 95% CI, 2.06-2.89, p < 0.001).

CONCLUSION

In LC patients who have good PS, patients with combined handgrip weakness and low ALI have the worst prognosis.

THE TRIAL REGISTRATION NUMBER

ChiCTR1800020329.

Association between body shape index and risk of mortality in the United States

The body mass index (BMI) neither differentiates fat from lean mass nor does it consider adipose tissue distribution. In contrast, the recently introduced z-score of the log-transformed A Body Shape Index (LBSIZ) can be applied to measure obesity using waist circumference (WC), height, and weight. We aimed to investigate the association between LBSIZ and mortality. We used data from the National Health and Nutrition Examination Survey 1999–2014 and linked the primary dataset to death certificate data from the National Death Index with mortality follow-up through December 31, 2015. A multiple Cox regression analysis was performed to evaluate the hazard ratio (HR) of all-cause and cardiovascular disease (CVD) mortalities with adjustment for baseline characteristics. LBSIZ, WC, and BMI showed positive association with total fat percentage (P < 0.001); however, only WC and BMI were positively associated with appendicular skeletal mass index (ASMI) (P < 0.001). In the multiple Cox regression analysis, only LBSIZ showed a significant HR for all-cause and CVD mortalities. Under restricted cubic spline regression, mortality risk increased with LBSIZ. However, BMI and WC showed a U-shape association. In conclusion, LBSIZ is strongly associated with all-cause and CVD mortalities. Since LBSIZ is independent of BMI, LBSIZ complements BMI to identify high-risk groups for mortality even in individuals with low or normal BMI.

The A Body Shape Index Might Be a Stronger Predictor of Chronic Kidney Disease Than BMI in a Senior Population

The A Body Shape Index (ABSI) was recently introduced to quantify abdominal adiposity relative to the body mass index (BMI) and height. This cross-sectional study was performed to explore whether the ABSI is linked to chronic kidney disease (CKD) in older adults and compare the predictive capacity of the ABSI versus BMI for CKD. In total, 7053 people aged ≥ 60 years were divided into normal, mild, and moderate-to-severe CKD groups based on their estimated glomerular filtration rate (eGFR). The correlation of the ABSI with the eGFR and the differences and trends in the ABSI and BMI among the groups were analyzed, and the cutoff points for moderate-to-severe CKD were calculated. The association between the ABSI and CKD was stronger than that between the BMI and CKD. The ABSI had a better capacity to discriminate the CKD stage than did the BMI. The capacity of the ABSI to predict moderate-to-severe CKD was higher than that of the BMI and was more substantial in women than men. The ABSI cutoff points for CKD were ≥0.0822 and 0.0795 in men and women, respectively. In conclusion, the ABSI serves as a better index than the BMI for screening and detecting high-risk individuals with CKD.

The association between muscle indicators and bone mass density and related risk factors in the diabetic elderly population: Bushehr Elderly Health (BEH) Program

BACKGROUND

Loss of muscle mass and strength and bone mass density are complications of the aging process. Studies show that the prevalence of sarcopenia and osteoporosis may be higher in patients with diabetes. Therefore, this study was aimed to investigate the relationship between muscle mass and strength indices and bone mass density in diabetic elderly.

MATERIALS AND METHODS

This cross-sectional study was conducted based on the data collected during the Bushehr Elderly Health (BEH) Program, stage II. Diabetes was defined as FPG ≥ 126 mg/dl or HbA1C ≥ 6.5 or taking anti-diabetic medication. Dual x-ray absorptiometry (DXA, Discovery WI, Hologic Inc, USA) was used to measure bone mineral density, fat mass, trabecular bone score (TBS) and muscle mass. Muscle strength was measured by grip strength.Osteoporosis was defined as the bone mineral density of ≥ 2.5 standard deviations (SD) below the average value of young normal adults (T-score of ≤ -2.5 SD) in the femoral neck, or lumbar spine (L1-L4) or total hip. To determine the relationship between skeletal muscle index (SMI) and muscle strength on bone status in a continuous scale was used from linear regression. To estimate the effect of SMI and muscle strength on osteoporosis was used from modified Poisson regression for analysis.

RESULTS

This study included 759 diabetic elderly with a mean age of 68.6 years and 56.9% of them were women. Skeletal muscle index (SMI) was related to all sites of BMDs and TBS L1-L4 after adjusted in full models (P-value < 0.001). The largest coefficients were observed for BMD L1-L4 in all models (β: 0.043 g/cm2; 95% CI: 0.030-0.057 in full model). Muscle strength was also associated with BMDs and TBS. Only, in model 2 (adjustments for age and sex effect), there was no significant relationship between muscle strength and BMD L1-L4 and TBS L1-L4. The strongest associations were observed for the total hip BMD and muscle strength (β: 0.034 g/cm2; 95% CI: 0.022- 0.046 in full model). Also, increased SMI and muscle strength was associated with decreased osteoporosis in crude and adjusted models (P < 0.001).

CONCLUSIONS

In this study, it was revealed that the reduction of SMI in elderly patients with diabetes was significantly associated with decreased BMD and TBS. The muscle strength was also associated with BMD and TBS. So, muscle strength and muscle mass should be measured separately ever since both are independently associated with BMD and TBS. Muscle strength and muscle mass were negatively associated with osteoporosis in older people with diabetes. Thus, we should pay more attention to muscle strength training in older people with diabetes, particularly in osteoporotic patients.

Association of body-shape phenotypes with imaging measures of body composition in the UK Biobank cohort: relevance to colon cancer risk

Background

Body mass index (BMI), waist and hip circumference are strongly correlated and do not reflect body composition. A Body Shape Index (ABSI) and Hip Index (HI) define waist and hip size among individuals with the same weight and height and would thus reflect body density. We examined differences in body composition between body-shape phenotypes defined with ABSI and HI and used this information to propose explanations for associations between body-shape phenotypes and colon cancer risk.

Methods

We used data from the UK Biobank Resource for 15,520 men, 16,548 women with dual-emission X-ray absorptiometry (DXA) measurements; 3997 men, 4402 women with magnetic resonance imaging (MRI) measurements; 200,289 men, 230,326 women followed-up for colon cancer. We defined body-shape phenotypes as: large-ABSI-small-HI (“apple”), small-ABSI-large-HI (“pear”), small-ABSI-small-HI (“slim”), large-ABSI-large-HI (“wide”). We evaluated differences in body composition in linear models and associations with colon cancer risk in Cox proportional hazards models adjusted for confounders and explored heterogeneity by BMI.

Results

Among individuals with the same height and weight, visceral adipose tissue (VAT) was lowest for “pear” and highest for “apple”, while abdominal subcutaneous adipose tissue (ASAT) was lowest for “slim” and highest for “wide” phenotype. In the gynoid region, differences between “apple” and “pear” phenotypes were accounted for mainly by fat mass in women but by lean mass in men. In men, lean mass was inversely associated with waist size, while the pattern of gynoid fat resembled ASAT in women. Lean and fat mass were higher for higher BMI, but not hand grip strength. Compared to normal weight “pear”, the risk of colon cancer in men (1029 cases) was higher for “apple” phenotype for normal weight (hazard ratio HR = 1.77; 95% confidence interval: 1.16–2.69) and comparably for overweight and obese, higher for “wide” phenotype for overweight (HR = 1.60; 1.14–2.24) and comparably for obese, but higher for “slim” phenotype only for obese (HR = 1.98; 1.35–2.88). Associations with colon cancer risk in women (889 cases) were weaker.

Conclusions

ABSI-by-HI body-shape phenotypes provide information for body composition. Colon cancer risk in men appears related to ASAT quantity for “slim” and “wide” but to factors determining VAT accumulation for “apple” phenotype.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-021-08820-6.

Healthy Eating Index-2015 Is Associated with Grip Strength among the US Adult Population

The Healthy Eating Index-2015 (HEI-2015) was designed to reflect adherence to the 2015-2020 Dietary Guidelines for Americans (DGA). The study aims to examine the association between HEI-2015 and grip strength in a nationally representative sample of the U.S. adult population. This cross-sectional study used data from the National Health and Nutrition Examination Surveys of 2011-2014. Low grip strength was defined as <35.5 kg for men and <20 kg for women. HEI-2015 was computed from two days of 24-h dietary recalls and comprised 13 components. Each component was scored on the density out of 1000 calories and summed to a total score divided into quartiles. Weighted logistic regressions examined the study aim while controlling for associated covariates. The sample included 9006 eligible participants, of those, 14.4% (aged 20+ years), and 24.8% (aged ≥50 years) had low grip strength. Mean (±SD) HEI-2015 total score was 54.2 ± 13.6 and in the lowest and highest quartiles 37.3 ± 5.1 and 72.0 ± 6.5, respectively. In the multivariable model, participants in the highest vs. lowest HEI-2015 quartile had 24% lower odds of having low grip strength (Odds Ratio (OR) = 0.76; 95% CI: 0.60-0.96). Specifically, participants who met the DGA for protein intakes, whole grains, greens and beans, vegetables, or whole fruits had 20-35% lower odds of having low grip strength than those who did not. Higher compliance to the DGA might reduce the risk for low grip strength as a proxy measure for sarcopenia among U.S. adults, particularly adequate intakes of proteins, whole grains, greens and beans, vegetables, and whole fruits.

Association Between a Body Shape Index and Subclinical Carotid Atherosclerosis in Population Free of Cardiovascular and Cerebrovascular Diseases

AIM

We used a dataset from a cross-sectional survey conducted in China to determine which of the anthropometric indices of obesity are important in terms of carotid atherosclerosis free of cardiovascular and cerebrovascular diseases.

METHODS

A total of 5,245 participants who were volunteering for carotid ultrasound unit in this cross-sectional survey were included in the present analysis. All subjects were free of angina, myocardial infarction, heart failure and stroke, and cancer. A low-risk subgroup was defined as people free of hypertension, diabetes, and hyperlipidemia. All analyses based on logistic regression were gender-specific.

RESULTS

The present study consisted of 2,501 males and 2,744 females, with 776 (31.03%) diagnosed as carotid artery plaque in males and 550 (20.04%) in females. Univariable analyses in unadjusted logistic model showed significant associations between disease presence and all central obesity indices. After adjusting for more variables, only a body shape index (ABSI) was associated with the presence of disease in both males and females. Moreover, stepwise regression approaches revealed that ABSI was always an independent determinant of the presence of subclinical carotid plaque. Multiple regression shows a linear and significant increase in the prevalence of atherosclerosis in males and females as ABSI decile levels increased. Similar results were obtained when the association between ABSI and carotid plaque was studied in this low-risk subgroup.

CONCLUSIONS

ABSI, as a novel anthropometric indicator compared with traditional indices, was found to have a closer relationship with subclinical carotid atherosclerosis, even in populations free of hypertension, diabetes, and hyperlipidemia.

Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard

Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999-2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and that adjustment for BMI and ABSI reduced these dependencies. Whole-body composition did not substantially improve mortality prediction compared to basic anthropometrics alone, but regional composition did, with high trunk fat-free mass and low limb fat-free mass both associated with elevated mortality risk. These findings illustrate how DEXA body composition could guide health assessment in conjunction with the more widely employed simple anthropometrics.

Non-linear association of anthropometric measurements and pulmonary function

This study examined the association of anthropometric measurements [body mass index (BMI), waist circumference (WC), percentage body fat (PBF), body roundness index (BRI) and A Body Shape Index (ABSI)] with pulmonary function using a United States national cohort. This cross-sectional study included 7346 participants. The association between anthropometric measurements and pulmonary function was assessed by multivariable linear regression. Where there was evidence of non-linearity, we applied a restricted cubic spline to explore the non-linear association. All analyses were weighted to represent the U.S. population and to account for the intricate survey design. After adjusting for age, race, education, smoking, and physical activity, both underweight and obesity were associated with reduced forced expiratory volume in 1 s (FEV₁) and forced vital capacity (FVC). Furthermore, the associations between BMI and FEV_1, as well as FVC, were reversed U-shape in both males and females. Similar non-linear association shape occurred in WC, PBF, BRI and ABSI. Conclusion: BMI, WC, PBF, BRI, ABSI are non-linearly associated with pulmonary function. Reduced pulmonary function is a risk factor for future all-cause mortality and cardiovascular events; thus, this nonlinearity may explain the U-shape or J-shape association of BMI with overall mortality and cardiovascular events.

Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults

Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82-24.21) and in women (OR = 11.54, 95% (CI) (2.02-65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty.