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Martinez-Amezcua P, Simonsick EM, Wanigatunga AA, Urbanek JK, Shaffer NC, Ferrucci L, Schrack JA. Association Between Adiposity and Perceived Physical Fatigability in Mid- to Late Life. Obesity (Silver Spring) 2019; 27:1177-1183. [PMID: 31127707 PMCID: PMC6591054 DOI: 10.1002/oby.22500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/19/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to compare and contrast the associations between measures of adiposity and fat distribution and perceived fatigability among well-functioning individuals in mid- to late life. METHODS In 1,054 adults (70.4 ± 12.4 years, 52% female), adiposity was measured as BMI, percent fat (dual-energy x-ray absorptiometry), waist and hip circumferences, and waist to height ratio. In a subset of 383 participants, visceral fat was measured. Perceived fatigability was evaluated after a 5-minute treadmill walk (1.5 mph) using the Borg rating of perceived exertion (range, 6-20). Associations between adiposity measures and perceived fatigability were assessed using regression models adjusting for age, sex, race, smoking, and comorbidities. RESULTS All adiposity measures, except subcutaneous fat, were positively associated with perceived fatigability after adjustment (P < 0.05 for all). Standardized coefficients indicated that BMI, hip circumference, and visceral fat had the strongest associations with fatigability. Associations between BMI and fatigability were present only among those above the threshold for overweight and strongest in those aged ≥ 65 years. Moreover, BMI was associated with fatigability only among participants with higher waist circumference. CONCLUSIONS Measures of adiposity, particularly central adiposity, are strongly associated with fatigability, suggesting that weight management may be an effective target for curbing fatigability and maintaining quality of life with aging.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Eleanor M. Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
| | - Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jacek K. Urbanek
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Geriatrics & Gerontology, Johns Hopkins School of Medicine, Baltimore Maryland, USA
| | - Nancy Chiles Shaffer
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
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52
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Wan J, Zhou P, Wang D, Liu S, Yang Y, Hou J, Li W, Wang P. Impact of Normal Weight Central Obesity on Clinical Outcomes in Male Patients With Premature Acute Coronary Syndrome. Angiology 2019; 70:960-968. [PMID: 30871333 DOI: 10.1177/0003319719835637] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is a lack of studies that evaluate the association between normal weight central obesity and subsequent outcomes in patients with premature acute coronary syndrome (ACS). We evaluated 338 consecutive male patients (aged ≤ 55 years) with premature ACS. The primary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE). We compared the hazard ratios (HRs) in patients with and without normal weight central obesity using multivariable Cox proportional hazard models. All-cause mortality (16.8%) of patients with normal weight central obesity was much higher than those (7.1%) without normal weight central obesity (P = .008). The incidence of MACCE in patients with and without normal weight central obesity were 40.7 and 23.6% (P = .001), respectively. After multivariable adjustment, the risks of all-cause mortality and MACCE were significantly higher in patients with normal weight central obesity than those without normal weight central obesity (adjusted HR: 1.83; 95% confidence interval [CI]: 1.04-3.31; P = .004 and adjusted HR: 1.62; 95% CI: 1.18-2.27; P = .017, respectively). In conclusion, the risks of all-cause mortality and MACCE were significantly higher in male patients with premature ACS with normal weight central obesity than in those without normal weight central obesity.
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Affiliation(s)
- Jindong Wan
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Peng Zhou
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Dan Wang
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Sen Liu
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Yi Yang
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Jixin Hou
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Wenzhang Li
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Peijian Wang
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
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53
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Vyas V, Lambiase P. Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities. Arrhythm Electrophysiol Rev 2019; 8:28-36. [PMID: 30918664 PMCID: PMC6434511 DOI: 10.15420/aer.2018.76.2] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Obesity is already a major global public health issue, implicated in a vast array of conditions affecting multiple body systems. It is now also firmly established as an independent risk factor in the incidence and progression of AF. The rapidly rising morbidity, mortality and healthcare costs associated with AF despite implementation of the three pillars of AF management — anticoagulation, rate control and rhythm control — suggest other strategies need to be considered. Compelling data has unveiled novel insights into adipose tissue biology and its effect on arrhythmogenesis while secondary prevention strategies targeting obesity as part of a comprehensive risk factor management programme have been demonstrated to be highly effective. Here, the authors review the epidemiological basis of the obesity—AF relationship, consider its underlying pathophysiology and discuss new therapeutic opportunities on the horizon.
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Affiliation(s)
- Vishal Vyas
- Barts and The London School of Medicine and Dentistry London, UK.,Queen Mary University of London London, UK.,Barts Heart Centre, St Bartholomew's Hospital London, UK
| | - Pier Lambiase
- Barts Heart Centre, St Bartholomew's Hospital London, UK.,Institute of Cardiovascular Science, University College London London, UK
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54
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Puzianowska-Kuznicka M, Kuryłowicz A, Walkiewicz D, Borkowska J, Owczarz M, Olszanecka-Glinianowicz M, Wieczorowska-Tobis K, Skalska A, Szybalska A, Mossakowska M. Obesity Paradox in Caucasian Seniors: Results of the PolSenior Study. J Nutr Health Aging 2019; 23:796-804. [PMID: 31641728 PMCID: PMC6800404 DOI: 10.1007/s12603-019-1257-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/19/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To investigate the influence of overweight and obesity on general performance and mortality in seniors. DESIGN Cross-sectional multidisciplinary study on ageing of the Polish population. SETTING Community-dwelling individuals aged 65 years or older, selected using three-stage stratified, proportional draw. PARTICIPANTS 4944 Polish Caucasian seniors, aged 65 years or older recruited between October 2007 and October 2010. MEASUREMENTS All study subjects underwent measurement of body mass index (BMI), waist circumference (WC), and arm circumference (AC). The physical and cognitive performance was evaluated using the Katz Activities of Daily Living (ADL) score and Mini-Mental State Examination (MMSE), respectively. Morbidity data were obtained from a medical questionnaire. Mortality data were obtained from the Population Register of Poland between October 2015 and October 2018. RESULTS Increasing age was associated with a decreased prevalence of obesity (all p<0.001). Higher BMI, WC and AC values were associated with higher ADL and MMSE scores (all p<0.001). On multivariate analysis, all three body measurements in women remained independent predictors of the ADL score (BMI p=0.002, WC p=0.005, AC p<0.001) and MMSE score (p<0.001, p=0.003, p<0.001). In men, physical functioning was associated with AC (p=0.003), and cognitive status was associated with AC (p<0.001) and BMI (p=0.013). There was no association between general obesity, abdominal obesity, or AC with several aging-related adverse conditions. Kaplan-Meier survival curves showed that overweight and obesity were associated with the lowest mortality. On multivariate analysis, BMI and AC values remained independent predictors of mortality. In successfully aging individuals, neither BMI, WC, nor AC remained such predictors. CONCLUSIONS Overweight and obesity in Caucasian seniors are not associated with deterioration of physical and cognitive function or with increased mortality.
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Affiliation(s)
- M Puzianowska-Kuznicka
- Monika Puzianowska-Kuznicka, MD, PhD, Department of Human Epigenetics, Mossakowski Medical Research Centre, PAS, Pawinskiego 5, 02-106 Warsaw, Poland; phone/fax: +48 22 6086591;
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Zhou C, Li Y, Shao X, Zou H. Identification of chronic kidney disease risk in relatively lean Southern Chinese: the hypertriglyceridemic waist phenotype vs. anthropometric indexes. Eat Weight Disord 2018; 23:885-892. [PMID: 29372543 PMCID: PMC6244600 DOI: 10.1007/s40519-017-0476-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 12/27/2017] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Assessing and comparing the ability of the hypertriglyceridemic waist (HW) phenotype and anthropometric obesity indexes to identify subjects at high risk of chronic kidney disease (CKD) in a relatively lean population in South China. METHODS Using data from a community-based, cross-sectional study conducted in Zhuhai City, Southern China, we examined associations between the HW phenotype, anthropometric obesity indexes, and incident CKD risk in a relatively lean population. Multiple logistic regression analyses were used to evaluate the associations. RESULTS The HW phenotype associated with CKD significantly in the unadjusted analysis (OR 3.53, 95% CI 1.65-7.52, P = 0.001). Further adjustment for gender, age, and other potential confounding variables had an impact on the odd ratios (OR); the OR decreased but still existed (OR 2.91, 95% 1.23-6.87, P = 0.016). The association of the HW phenotype with CKD remained significant after further adjustment for hypertension and diabetes. No significant association between the anthropometric indexes and incident CKD was found. CONCLUSION The HW phenotype, but not the anthropometric indexes, is associated with an elevated risk of CKD in relatively lean subjects. The HW phenotype appears to be a better predictor of CKD than the anthropometric indexes. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Chaomin Zhou
- Department of Nephrology, The People's Hospital of Guizhou Province, Guiyang, 550002, China
| | - Yongqiang Li
- Department of Nephrology, Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Xiaofei Shao
- Department of Nephrology, Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Hequn Zou
- Department of Nephrology, Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
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56
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Liu XZ, Li HH, Huang S, Zhao DB. Association between hyperuricemia and nontraditional adiposity indices. Clin Rheumatol 2018; 38:1055-1062. [PMID: 30498873 DOI: 10.1007/s10067-018-4374-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 10/18/2018] [Accepted: 11/16/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND The association between several novel adiposity indices and hyperuricemia is inconclusive. Therefore, we aimed to investigate this association so as to provide theoretical support for the management of hyperuricemia in overweight/obese individuals. METHODS A cross-sectional study was carried out among 174,698 adults. The values of body adiposity index (BAI), conicity index (CI), a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), lipid accumulation product (LAP) index, and cardiometabolic index (CMI) were divided into four quartiles, and multivariate logistic analysis was used to analyze the association between them and hyperuricemia. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the power of predictions for hyperuricemia. RESULTS After adjusting for confounding variables, LAP and CMI exhibited stronger association with hyperuricemia than other indices. The odd ratio (OR) for hyperuricemia in the highest quartile of the LAP and CMI was 2.049 (CI 95% = 1.824-2.302) and 4.332(CI 95% = 3.938-4.765). The AUC value of LAP was 0.632 (95% CI = 0.626-0.637), p < 0.001; and the AUC value of CMI was 0.687 (95% CI = 0.682-0.692), p < 0.001. The optimal cutoff values of LAP and CMI were 26.21 and 0.485, respectively. CONCLUSIONS LAP and CMI, combination of WC and lipid parameters and reliable visceral adiposity indices, were strongly associated with hyperuricemia than other indices. So they could be potential monitoring indicators for hyperuricemia management in overweight/obese individuals.
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Affiliation(s)
- Xing Zhen Liu
- Army Convalescence Area, Hangzhou Sanatorium of People's Liberation Army, Hangzhou, China
| | - Hui Hua Li
- Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, China
| | - Shan Huang
- Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, China.
| | - Dong Bao Zhao
- Department of Rheumatology, Changhai Hospital, Naval Military Medical University (The Second Military Medical University), Shanghai, China.
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57
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Obesity in Older Type 2 Diabetic Patients: Does Working Environment Add Vulnerability? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122677. [PMID: 30486498 PMCID: PMC6313713 DOI: 10.3390/ijerph15122677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 12/25/2022]
Abstract
Little is known about how working adults with type 2 diabetes are managing their health. This study aims to analyze the associations between health, behavioral, and sociodemographic characteristics and obesity in older diabetic patients in Europe. Data from the Survey of Health, Ageing, and Retirement in Europe was used to compare 1447 participants that were identified as having type 2 diabetes with 28,047 participants without diabetes. Multilevel logistic models stratified by type 2 diabetes examined the relationships of health, behavioral, and sociodemographic characteristics with obesity. The proportion of physical inactivity was significantly higher among those with type 2 diabetes (15.0% vs. 6.1%). Individuals with diabetes had more chronic diseases, more limitations in activities, higher body mass index, more depression, lower quality of life and well-being, and lower employment rate. Among those with type 2 diabetes, those employed were more likely to be obese (OR = 1.377, 95% CI, 1.023 to 1.853) and women were 52% more likely to be obese than men. The surveillance of weight in working environments should be required within workers with type 2 diabetes. It is concluded that this and other adjustments could be beneficial in people with diabetes.
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Jenkins DA, Bowden J, Robinson HA, Sattar N, Loos RJF, Rutter MK, Sperrin M. Adiposity-Mortality Relationships in Type 2 Diabetes, Coronary Heart Disease, and Cancer Subgroups in the UK Biobank, and Their Modification by Smoking. Diabetes Care 2018; 41:1878-1886. [PMID: 29970414 DOI: 10.2337/dc17-2508] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/05/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The obesity paradox in which overweight/obesity is associated with mortality benefits is believed to be explained by confounding and reverse causality rather than by a genuine clinical benefit of excess body weight. We aimed to gain deeper insights into the paradox through analyzing mortality relationships with several adiposity measures; assessing subgroups with type 2 diabetes, with coronary heart disease (CHD), with cancer, and by smoking status; and adjusting for several confounders. RESEARCH DESIGN AND METHODS We studied the general UK Biobank population (N = 502,631) along with three subgroups of people with type 2 diabetes (n = 23,842), CHD (n = 24,268), and cancer (n = 45,790) at baseline. A range of adiposity exposures were considered, including BMI (continuous and categorical), waist circumference, body fat percentage, and waist-to-hip ratio, and the outcome was all-cause mortality. We used Cox regression models adjusted for age, smoking status, deprivation index, education, and disease history. RESULTS For BMI, the obesity paradox was observed among people with type 2 diabetes (adjusted hazard ratio for obese vs. normal BMI 0.78 [95% CI 0.65, 0.95]) but not among those with CHD (1.00 [0.86, 1.17]). The obesity paradox was pronounced in current smokers, absent in never smokers, and more pronounced in men than in women. For other adiposity measures, there was less evidence for an obesity paradox, yet smoking status consistently modified the adiposity-mortality relationship. CONCLUSIONS The obesity paradox was observed in people with type 2 diabetes and is heavily modified by smoking status. The results of subgroup analyses and statistical adjustments are consistent with reverse causality and confounding.
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Affiliation(s)
- David A Jenkins
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K.
| | - Jack Bowden
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, U.K
| | - Heather A Robinson
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, U.K
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Martin K Rutter
- Division of Endocrinology, Diabetes and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K.,Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Matthew Sperrin
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K
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Beberashvili I, Azar A, Abu Hamad R, Sinuani I, Feldman L, Maliar A, Stav K, Efrati S. Abdominal obesity in normal weight versus overweight and obese hemodialysis patients: Associations with nutrition, inflammation, muscle strength, and quality of life. Nutrition 2018; 59:7-13. [PMID: 30415161 DOI: 10.1016/j.nut.2018.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/04/2018] [Accepted: 08/11/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The biological basis of abdominal obesity leading to more severe outcomes in patients with normal body mass index (BMI) on maintenance hemodialysis (MHD) is unclear. The aim of this study was to compare the properties of abdominal obesity in different BMI categories of patients on MHD. METHODS We performed a cross-sectional study of 188 MHD patients (52.7% women; mean age, 69.4 ± 11.5 y) with abdominal obesity in different BMI groups using criteria from the World Health Organization. Appetite and dietary intake, body composition, handgrip strength, malnutrition inflammation score (MIS), inflammatory biomarkers, adipokines, and health-related quality-of-life (QoL) questionnaires were studied. RESULTS According to multivariable analyses, abdominally obese patients with normal BMIs consumed less protein per day (P = 0.04); had lower measurements of surrogates of lean (P < 0.001) and fat mass (P < 0.001); and had higher total cholesterol, tumor necrosis factor-α (P < 0.05), and ratios of adiponectin to leptin (P = 0.003) than overweight and obese patients with abdominal obesity. Multivariable analyses showed no differences in handgrip strength among the study groups.The abdominally obese study participants with normal weight had significantly lower scores in role physical (P = 0.003) and pain (P = 0.04) scales after multivariable adjustments. CONCLUSIONS Normal-weight MHD patients with abdominal obesity exhibited a more proatherogenic profile in terms of inflammatory markers and adipokine expression, lower body composition reserves, and lower physical ability than patients with abdominal obesity with overweight and obesity. This at least partially explains the abdominal obesity paradox in the MHD population in which worse clinical outcomes are seen in abdominally obese patients with normal BMIs, as opposed to overweight and obese patients who are also abdominally obese.
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Affiliation(s)
- Ilia Beberashvili
- Nephrology Division, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine Tel Aviv University, Israel.
| | - Ada Azar
- Nutrition Department, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine Tel Aviv University, Israel
| | - Ramzia Abu Hamad
- Nephrology Division, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine Tel Aviv University, Israel
| | - Inna Sinuani
- Pathology Department, Assuta Ashdod University Hospital, Ashdod, Israel
| | - Leonid Feldman
- Nephrology Division, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine Tel Aviv University, Israel
| | - Amit Maliar
- The Kamila Gonczarowski Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine Tel Aviv University, Israel
| | - Kobi Stav
- Urology Department, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Shai Efrati
- Nephrology Division, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine Tel Aviv University, Israel
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Wang S, Ren J. Obesity Paradox in Aging: From Prevalence to Pathophysiology. Prog Cardiovasc Dis 2018; 61:182-189. [PMID: 29990534 DOI: 10.1016/j.pcad.2018.07.011] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/25/2022]
Abstract
Recent advances in medical technology and health care have greatly improved the management for chronic diseases and prolonged human lifespan. Unfortunately, increased lifespan and the aging population impose a major challenge on the ever-rising prevalence of chronic diseases, in particular cardiometabolic stress associated with the pandemic obesity in our modern society. Although overweight and obesity are associated with incident cardiovascular diseases (CVD), including heart failure (HF), it paradoxically leads to a more favorable prognosis in patients with chronic HF, a phenomenon commonly defined as "obesity paradox". Numerous population-based and clinical studies have suggested possible explanations such as better metabolic reserve, smoking and disease-associated weight loss for obesity paradox. Recent evidence noticed a shift in obesity paradox with aging. While some studies have reported a more pronounced "obesity paradox" in the older patients, others have seen diminished cardiac benefits with overweight and obesity in the elderly patients with CVD. These findings suggested that a complex relationship among aging, metabolism, and HF severity/chronicity, which may explain the shift in obesity paradox in the elderly. Aging negatively affects body metabolism and cardiac function although its precise impact on obesity paradox remains elusive. To develop new strategies for cardiovascular health in the elderly, it is imperative to understand the precise role for aging on obesity-related CVD.
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Affiliation(s)
- Shuyi Wang
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai 200032, China; Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA
| | - Jun Ren
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai 200032, China; Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA.
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Pasco JA, Holloway KL, Stuart AL, Williams LJ, Brennan-Olsen SL, Berk M. The subjective wellbeing profile of the ‘pretiree’ demographic: A cross-sectional study. Maturitas 2018; 110:111-117. [DOI: 10.1016/j.maturitas.2018.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/22/2017] [Accepted: 02/08/2018] [Indexed: 01/18/2023]
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62
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Thompson WG. Regarding "Central adiposity and the overweight risk paradox in aging: follow-up of 130,473 UK Biobank participants". Am J Clin Nutr 2017; 106:959. [PMID: 28864590 PMCID: PMC5573031 DOI: 10.3945/ajcn.117.161885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Warren G Thompson
- From the Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN (e-mail: )
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63
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Bowman K, Melzer D. Reply to WG Thompson. Am J Clin Nutr 2017; 106:959. [PMID: 28864591 PMCID: PMC5573032 DOI: 10.3945/ajcn.117.162115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kirsty Bowman
- From the Epidemiology and Public Health Group, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, United Kingdom (KB; DM; e-mail: )
| | - David Melzer
- From the Epidemiology and Public Health Group, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, United Kingdom (KB; DM; e-mail: )
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