The association of wrist circumference with hypertension in northeastern Chinese residents in comparison with other anthropometric obesity indices

Childhood Obesity, Diabetes. and Cardiovascular Disease Risk

This mini-review aims to briefly summarize the pathophysiology of childhood obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) risk in children and adolescents. Recent data on efficacy of lifestyle interventions, medications, and metabolic surgery for obesity, T2DM, and CVD risk factors are also reviewed. We conducted a PubMed search of English-language original and review articles relevant to childhood obesity, T2DM, and CVD risk factors, and biomarkers in children with an emphasis on recent publications. Childhood obesity arises from an intricate interaction between genetic, physiologic, environmental, and socioeconomic factors. The rise in the prevalence of childhood obesity is associated with the development of comorbidities including T2DM and CVD at an early age. A multipronged approach is central to the detection, monitoring, and management of childhood obesity and associated adverse metabolic consequences.

Comparison of conventional and unconventional obesity indices associated with new-onset hypertension in different sex and age populations

We aimed to compare the relationship between hypertension and obesity-related anthropometric indices (waist circumference [WC], waist-height ratio, waist-hip ratio [WHR], and body mass index; unconventional: new body shape index [ABSI] and body roundness index [BRI]) to identify best predictors of new-onset hypertension. The study included 4123 adult participants (2377 women). Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined using a Cox regression model to estimate the risk of new-onset hypertension with respect to each obesity index. In addition, we assessed the predictive value of each obesity index for new-onset hypertension using area under the receiver operating characteristic curve (AUC) after adjusting for common risk factors. During the median follow-up of 2.59 years, 818 (19.8%) new hypertension cases were diagnosed. The non-traditional obesity indices BRI and ABSI had predictive value for new-onset hypertension; however, they were not better than the traditional indexes. WHR was the best predictor of new-onset hypertension in women aged ≤ 60 and > 60 years, with HRs of 2.38 and 2.51 and AUCs of 0.793 and 0.716. However, WHR (HR 2.28, AUC = 0.759) and WC (HR 3.24, AUC = 0.788) were the best indexes for predicting new-onset hypertension in men aged ≤ 60 and > 60 years, respectively.

Emergent Anthropometric Indices in Differential Prediction of Prehypertension and Hypertension in Mexican Population: Results according to Age and Sex

Background

Hypertension (HTN) is recognized as a significant public health problem in the world. The objective of this study is to evaluate emergent anthropometric indices as predictors of preHTN and HTN according to age and sex in a sample of Mexican adults.

Methods

A cross-sectional study was conducted in 1,150 participants aged 18-80 years old. Anthropometric data and blood pressure measurements were analyzed. Comparisons between men and women were carried out by independent analysis. Cutoff points for each emergent anthropometric index were obtained using the values' upper second and third tertiles. Logistic regression models and receiver operating characteristics curve analyses were used to assess the association and the predictive value of several emergent anthropometric indices with the presence of preHTN and HTN.

Results

The prevalence of preHTN and HTN was 29.74% and 14.35%, respectively. In a logistic regression analysis adjusted by age and sex, the body roundness index (BRI) (OR = 2.08, p < 0.001) and conicity index (CI) (OR = 1.37, p=0.044) were associated with preHTN, while CI (OR = 2.47, p < 0.001) and waist to height squared (W/Ht2) (OR = 2.19, p < 0.001) were associated with HTN. Furthermore, in both sexes, BRI was the main predictor of preHTN (AUC: 0.634 and 0.656, respectively). Particularly, according to sex and age range, the predictive emergent anthropometric indices in men were the body shape index (ABSI) and waist to height cubic (W/Ht3) (AUC = 0.777 and 0.771, respectively), whereas in women, the predictors were CI and ABSI (AUC = 0.737 and 0.729, respectively). In men ≤40 years old, central body fat indices were predictors of preHTN and HTN, but in men >40 years old, the predictor indices were W/Ht3 and W/Ht2. In women ≤40 years, the pulse mass index (PMI) was the best main predictor (AUC = 0.909) of HTN.

Conclusion

CI, PMI, W/Ht3, W/Ht2, and ABSI could represent differential predictors of preHTN and HTN between men and women according to age range.

Wrist circumference as a novel predictor of transition from metabolically healthy to unhealthy phenotype in overweight/obese adults: a gender-stratified 15.5-year follow-up

BACKGROUND

Individuals with transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) phenotype are significantly predisposed to greater risks of cardiovascular events compared to those with a persistent MHO phenotype. The aim of this study was to evaluate the predictive performance of wrist circumference for this transition in adults over a 15.5-year follow-up.

METHODS

We included 309 males and 821 females with the age of ≥18 years old, body mass index ≥25 kg/m², and metabolically healthy status according to the criteria of the Joint Interim Statement. The incidence of MUO phenotype was evaluated for each gender, across tertiles wrist circumference, using Cox-proportional hazard models.

RESULTS

The overall rate of transition from MHO to MUO phenotype was 87.1% in males and 77.5% in females. The hazard ratios (HRs) with 95% CI across second and third tertiles of wrist circumference were 0.89 (0.64-1.24) and 1.31 (0.99-1.73) in men (P for trend =0.027); and 1.34 (1.09-1.66) and 1.61 (1.30-2.00) in women (P for trend <0.001), respectively. After multivariable adjustment, HRs across second and third tertiles of wrist circumference were 0.92 (0.64-1.32) and 1.18 (0.83-1.67) in males (p for trend =0.352), and 1.32 (1.05-1.65) and 1.34 (1.06-1.96) in females (p for trend =0.025), respectively.

CONCLUSIONS

Wrist circumference significantly predicts the transition from MHO to MUO phenotype in adults of both genders. However, it is an independent predictor of the transition only in females. Future studies are warranted to clarify the role of wrist circumference mechanisms on metabolic risk deterioration.

Neck and Wrist Circumferences as Indicators of Metabolic Alterations in the Pediatric Population: A Scoping Review

Neck circumference (NC) and wrist circumference (WrC) have been proposed as practical and inexpensive tools with the capacity to indicate metabolic alterations to some extent. Nevertheless, their application in the pediatric population is relatively recent. Thus, the aim of this scoping review was to review and analyze the reported evidence regarding the correlation of NC and WrC with metabolic alterations in the pediatric stage. The literature search was performed in January 2021 in seven indexes and databases. A total of 26 articles published between 2011 and 2020 were included. Most significant results were grouped into three categories: serum lipid profile, glucose homeostasis, and blood pressure. The parameter that showed the most significant results regardless of the anthropometric indicator analyzed for association was blood pressure. In contrast, total cholesterol and LDL-cholesterol showed non-significant associations along with conflicting results. We conclude that the use of NC and WrC, in addition to other well-established indicators, could facilitate the identification of metabolic alterations, specifically in plasma insulin and blood pressure. In fact, further studies are required to address the potential use of NC and WrC as predictors of early metabolic alterations, especially in countries with a fast-growing prevalence in obesity.

The correlation between neck circumference and risk factors in patients with hypertension: What matters

It is necessary to identify the relationship between neck circumference and cardiovascular risk factors in patients with hypertension.Patients with hypertension treated in our hospital were included. The height, weight, neck circumference, waist circumference, fasting blood glucose, 2 h blood glucose (2hPPG), density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and glycated hemoglobin (HbA1c) were analyzed and compared.A total of 2860 patients with hypertension were included. There were significant differences between male and female patients in the neck circumference, waist circumference, fasting blood glucose, Total cholesterol, triacylglycerol, HDL-C, LDL-C, diabetes, metabolic syndrome, dyslipidemia, drinking and smoking (all P < .05); the neck circumference was positively correlated with waist circumference, body mass index (BMI), fasting blood glucose, 2hPPG, HbA1c, triacylglycerol and LDL-C (all P < .05), and negatively correlated with HDL-C (P = .014); as the neck circumference increases, the risk of hypertension, diabetes, metabolic syndrome, abdominal obesity, and dyslipidemia increases accordingly (all P < .05); the area under curve (AUC) was 0.827 and 0.812, and the neck circumference of 37.8 and 33.9 cm was the best cut-off point for male and female patients, respectively.Neck circumference is closely related to cardiovascular risk factors in patients with hypertension, which should be promoted in the screening of cardiovascular diseases.

Predictive value of relative fat mass algorithm for incident hypertension: a 6-year prospective study in Chinese population

OBJECTIVES

Individuals with obesity especially excessive visceral adiposity have high risk for incident hypertension. Recently, a new algorithm named relative fat mass (RFM) was introduced to define obesity. Our aim was to investigate whether it can predict hypertension in Chinese population and to compare its predictive power with traditional indices including body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR).

DESIGN

A 6-year prospective study.

SETTING

Nine provinces (Hei Long Jiang, Liao Ning, Jiang Su, Shan Dong, He Nan, Hu Bei, Hu Nan, Guang Xi and Gui Zhou) in China.

PARTICIPANTS

Those without hypertension in 2009 survey and respond in 2015 survey.

INTERVENTION

Logistic regression were performed to investigate the association between RFM and incident hypertension. Receiver operating characteristic (ROC) analysis was performed to compare the predictive ability of these indices and define their optimal cut-off values.

MAIN OUTCOME MEASURES

Incident hypertension in 2015.

RESULTS

The prevalence of incident hypertension in 2015 based on RFM quartiles were 14.8%, 21.2%, 26.8% and 35.2%, respectively (p for trend <0.001). In overall population, the OR for the highest quartile compared with the lowest quartile for RFM was 2.032 (1.567-2.634) in the fully adjusted model. In ROC analysis, RFM and WHtR had the highest area under the curve (AUC) value in both sexes but did not show statistical significance when compared with AUC value of BMI and WC in men and AUC value of WC in women. The performance of the prediction model based on RFM was comparable to that of BMI, WC or WHtR.

CONCLUSIONS

RFM can be a powerful indictor for predicting incident hypertension in Chinese population, but it does not show superiority over BMI, WC and WHtR in predictive power.