Indices of body composition and chronic morbidity: a cross-sectional study of a rural population in central Russia

High Obesity Indices Are Associated with Gastroesophageal Reflux Disease, but Low Obesity Indices Are Associated with Peptic Ulcer Disease in a Large Taiwanese Population Study

INTRODUCTION

Gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB).

METHODS

A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD.

RESULTS

The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p = 0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001), and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001) and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the values of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not.

CONCLUSION

This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.

Effects of obesity on the pharmacology of proton pump inhibitors: current understanding and future implications for patient care and research

INTRODUCTION

In the United States, obesity affects approximately ⅖ adults and ⅕ children, leading to increased risk for comorbidities, like gastroesophageal reflux disease (GERD), treated increasingly with proton pump inhibitors (PPIs). Currently, there are no clinical guidelines to inform PPI dose selection for obesity, with sparse data regarding whether dose augmentation is necessary.

AREAS COVERED

We provide a review of available literature regarding the pharmacokinetics (PK), pharmacodynamics (PD), and/or metabolism of PPIs in children and adults with obesity, as a step toward informing PPI dose selection.

EXPERT OPINION

Published PK data in adults and children are limited to first-generation PPIs and point toward reduced apparent oral drug clearance in obesity, with equipoise regarding obesity impact on drug absorption. Available PD data are sparse, conflicting, and limited to adults. No studies are available to inform the PPI PK→PD relationship in obesity and if/how it differs compared to individuals without obesity. In the absence of data, best practice may be to dose PPIs based on CYP2C19 genotype and lean body weight, so as to avoid systemic overexposure and potential toxicities, while monitoring closely for efficacy.

Heritability estimation of 2D:4D finger ratio in a Chuvashian population-based sample

OBJECTIVES

The purpose of this study was to evaluate the familial correlations and heritability of 2D:4D ratio traits using a large population-based sample of ethnically homogeneous pedigrees from Chuvasha and Bashkortostan Autonomies of the Russian Federation.

METHODS

We calculated the familial correlations and performed a heritability analysis of 2D:4D ratio traits in a sample of 1541 subjects (803 men and 738 women, mean age 47.78 ± 16.89 years, range 18-90 years).

RESULTS

Familial correlations of 2D:4D ratio traits showed no significant correlation for spouses; however, parent-offspring (0.15-0.28, P < .001) and sibling correlations (0.13-0.38, P < .009) were found to be significant. Heritability (H² ) of visual classification of 2D:4D ratio was 0.36 for the left and 0.28 for the right hand; finger ratio was 0.55 and 0.66, respectively; the ray ratio was 0.49 and 0.59, respectively, thus indicating the existence of a clear familial aggregation of 2D:4D ratio variation in the Chuvashian pedigrees, which cannot be explained only by common environmental effects.

DISCUSSION

Results of our study suggest familial aggregations of finger ratio variation (for all traits) in Chuvashian pedigrees. No evidence of assortative mating was found.

Association of gastric and duodenal ulcers with anthropometry and nutrients: Korean National Health and Nutrition Examination Survey (KNHANES II-IV) 2001-2009

Objectives

The objective of this study was to examine the association of peptic ulcer disease (PUD), including gastric ulcer and duodenal ulcer, with obesity-related indices, nutrients, and blood parameters in Korean adults.

Methods

Data were obtained from the Second-Fourth Korean National Health and Nutrition Examination Survey (KNHANES II-IV). Binary logistic regression was carried out to analyze the association between PUD and all variables in the crude analysis; in a subsequent analysis, adjustments were made for age, region, house type, number of snacks per day, and number of household members.

Results

PUD exhibited the highest association with age in both men and women among all variables used in this study. In men, only body mass index was associated with PUD in both the crude and adjusted analyses. PUD was associated with weight, height, and fat in the crude analysis, but these associations disappeared after adjustment for confounders. Vitamin B2, hemoglobin, and glucose were related to PUD, but these associations became nonsignificant in the adjusted analysis. Water, vitamin C, and potassium were not associated with PUD in the crude analysis but were associated with PUD after adjustment for confounders. In women, systolic blood pressure and height were associated with PUD. PUD was also related to waist circumference, the waist-to-height ratio, fat, and cholesterol, but these associations became nonsignificant after adjustment for confounders. Vitamin C, protein, niacin, sodium, energy, vitamin B2, vitamin B1, and aspartate aminotransferases were associated with PUD in only the crude analysis. PUD was not associated with diastolic blood pressure, water, vitamin A, or glucose, but these factors were associated with the disease in the adjusted analysis.

Conclusion

Older age was a risk factor for PUD in Korean adults, and the association of PUD with most nutrients and anthropometric indices may differ according to gender.

2D:4D finger length ratio and radiographic hand osteoarthritis

To evaluate the association between the index and ring finger's (2D:4D) length ratio with the prevalence and severity of radiographic hand osteoarthritis (OA). A population-based sample included 802 males (mean age 46.98 ± 17.10 years) and 738 females (mean age 48.65 ± 16.62 years) who had participated in a Chuvashian skeletal aging study. Age, sex, basic demographics, anthropometric data and X-rays of both hands were acquired. Each hand was visually classified on X-ray as either type 1-index finger longer than the ring finger; type 2-index and ring finger equal in length; or type 3-index finger shorter than the ring finger. Hand OA was defined by the number of affected joints (Kellgren-Lawrence score ≥ 2) in both hands and the sum total of Kellgren-Lawrence scores (total OA score). After comparing the OA variables of individuals with different finger length ratio types (after adjustment for age and BMI) significant differences were found only in females between finger ratio types of the right hand in a number of affected joints (F = 3.153, p = 0.043) and finger ratio types of the left (F = 3.330, p = 0.036) and right (F = 2.397, p = 0.047) hands of the total OA score. Females with type 3 ratios had the highest adjusted values of hand OA parameters. We found that finger length ratios are associated with hand OA parameters. Females with a type 3 finger length pattern showed significantly higher hand OA values than those with types 1 and 2.

Association of peptic ulcer disease with obesity, nutritional components, and blood parameters in the Korean population

Objectives

Peptic ulcer disease (PUD) is a common disorder, but whether an association exists between PUD and anthropometric indicators remains controversial. Furthermore, no studies on the association of PUD with anthropometric indices, blood parameters, and nutritional components have been reported. The aim of this study was to assess associations of anthropometrics, blood parameters, nutritional components, and lifestyle factors with PUD in the Korean population.

Methods

Data were collected from a nationally representative sample of the South Korean population using the Korea National Health and Nutrition Examination Survey. Logistic regression was used to examine associations of anthropometrics, blood parameters and nutritional components among patients with PUD.

Results

Age was the factor most strongly associated with PUD in women (p = <0.0001, odds ratio (OR) = 0.770 [0.683–0.869]) and men (p = <0.0001, OR = 0.715 [0.616–0.831]). In both crude and adjusted analyses, PUD was highly associated with weight (adjusted p = 0.0008, adjusted OR = 1.251 [95%CI: 1.098–1.426]), hip circumference (adjusted p = 0.005, adjusted OR = 1.198 [1.056–1.360]), and body mass index (adjusted p = 0.0001, adjusted OR = 1.303 [1.139–1.490]) in women and hip circumference (adjusted p = 0.0199, adjusted OR = 1.217 [1.031–1.435]) in men. PUD was significantly associated with intake of fiber (adjusted p = 0.0386, adjusted OR = 1.157 [1.008–1.328], vitamin B2 (adjusted p = 0.0477, adjusted OR = 1.155 [1.001–1.333]), sodium (adjusted p = 0.0154, adjusted OR = 1.191 [1.034–1.372]), calcium (adjusted p = 0.0079, adjusted OR = 1.243 [1.059–1.459]), and ash (adjusted p = 0.0468, adjusted OR = 1.152 [1.002–1.325] in women but not in men. None of the assessed blood parameters were associated with PUD in women, and only triglyceride level was associated with PUD in men (adjusted p = 0.0169, adjusted OR = 1.227 [1.037–1.451]).

Discussion

We found that obesity was associated with PUD in the Korean population; additionally, the association between nutritional components and PUD was greater in women than in men.

Dermatological aspects influencing the practice of physical activities by obese individuals

Abstract Objective : The aim of this study was to perform a systematic review of the major skin diseases affecting obese individuals and their influence on physical activity. Methods : Relevant articles were identified by systematically searching PubMed from 2000 to 2014, using the descriptors "skin diseases" and "obesity", "skin disease" and "obesity", "skin diseases" and "physical activity", "skin disease" and "physical activity". The PEDro Scale (in Brazilian Portuguese) was used to rate the methodological quality of the studies. Results : A total of 320 articles were examined in the first phase. In the end, 11 articles met the proposed criteria and were included for analysis in the systematic review. We investigated cutaneous manifestations of diseases and classified them according to their effects under 5 categories: metabolic (n = 10), aesthetic (n = 7), inflammatory (n = 6), mechanical (n = 5) and infectious (n = 3). The most frequent dermatoses among obese were acanthosis nigricans, acrochordon (skin tags), stretch marks, plantar keratodermia, intertrigo, bacterial and fungal infections. Acanthosis nigricans was found to be the most important metabolic implication of obesity. Conclusion : Although neglected, skin lesions are common in obesity and have implications for physical activity because they cause pain, discomfort, friction, infection, inflammation, embarrassment, limitation or difficulty of movement. Strategies to promote skin health may result in a better integration of physical activity into routine therapy and improve the quality of life of obese individuals.

Utility of anthropometric measures in a multiethnic population: their association with prevalent diabetes, hypertension and other chronic disease comorbidities

Body mass index (BMI) and waist circumference (WC) are two common anthropometric measures of obesity in clinical and public health practice. Consensus, however, remains elusive regarding their utility for predicting cardiovascular disease risk in multiethnic populations. We address this gap in the literature by analyzing cross-sectional data from the first round of the Los Angeles County Health and Nutrition Examination Survey, 2011. We characterized the relationships between BMI, WC, waist-to-hip ratios, waist-to-height ratios, and chronic disease extent, as confirmed by the presence of hypertension, diabetes, and/or two or more other chronic conditions as defined by a composite indicator 'comorbidity'. To account for race/ethnicity, age, gender, and cigarette smoking frequency, adjusted odds ratios (aOR) were generated and reported for each of the regression analyses. Whereas being overweight was associated with hypertension alone (aOR 2.10; 95% CI 1.12-3.94), obesity was associated with hypertension (aOR 5.04; 95% CI 2.80-9.06) as well as diabetes (aOR 5.28; 95% CI 2.25-12.3) and comorbidity (aOR 3.69; 95% CI 2.02-6.77). In whites and African-Americans, BMI and WC were positively related to diabetes, hypertension and comorbidity. In Hispanics, BMI and WC were also positively related to diabetes and comorbidity, but only the former measure was associated with hypertension (p < 0.050). In Asians, BMI was not a significant predictor of diabetes, hypertension and/or comorbidity. Collectively, the findings suggest that BMI is not universally informative and waist circumference and its derivatives may represent a viable, more racially/ethnically appropriate alternative for use with selected minority groups.

Association between obesity and selected morbidities: a study of BRICS countries

Objective

Over the past few decades, obesity has reached epidemic proportions, and is a major contributor to the global burden of chronic diseases and disability. There is little evidence on obesity related co-morbidities in BRICS countries. The first objective is to examine the factors associated with overweight and obesity in four of the five BRICS countries (China, India, Russia and South Africa). The second is to examine the linkage of obesity with selected morbidities.

Methods

We used data from the Study on Global Ageing and Adult Health (SAGE) survey conducted by the World Health Organization (WHO) in China, India, Russia and South Africa during 2007–10. The morbidities included in the analysis are Hypertension, Diabetes, Angina, Stroke, Arthritis and Depression.

Findings

The prevalence of obesity was highest in South Africa (35%) followed by Russia (22%), China (5%) and India (3%). The prevalence of obesity was significantly higher in females as compared to males in all the countries. While the wealth quintile was associated with overweight in India and China, engaging in work requiring physical activity was associated with obesity in China and South Africa. Overweight/obesity was positively associated with Hypertension and Diabetes in all the four countries. Obesity was also positively associated with Arthritis and Angina in China, Russia and South Africa. In comparison, overweight/obesity was not associated with Stroke and Depression in any of the four countries.

Conclusion

Obesity was statistically associated with Hypertension, Angina, Diabetes and Arthritis in China, Russia and South Africa. In India, obesity was associated only with Hypertension and Diabetes.

2D:4D finger length ratio in the Chuvashian population

In a sample of Chuvashians (803 males and 738 females) we evaluated the mean values of index finger to ring finger (2D:4D) ratio, the contributions of phalanges and metacarpals to the 2D:4D ratio, and the symmetry between right and left 2D:4D ratios. Age, sex, anthropometric data and radiographs of both hands were collected. Each hand was visually classified on a radiograph as either Type 1 - index finger was longer than ring finger; Type 2 - equal; or Type 3 - index shorter than the ring finger. The following measurements (1) from the mid-point of the base of the proximal phalanx to the mid-point of the tip of the distal phalanx; and (2) from the mid-point of the base to the mid-point of the tip of the metacarpal were obtained from the index and ring fingers. Visual classification was significantly associated with the measured 2D:4D length ratio. Women had a higher prevalence of Type 1 and Type 2, but lower prevalence of Type 3 ratio in both hands. Men had smaller measured 2D:4D phalangeal, metacarpal and ray (combined) ratios than women. Symmetry between the right and left hand measured 2D:4D ratios were significant in phalangeal (r=0.657, p<0.001), metacarpal (r=0.638, p<0.001), ray (r=0.682, p<0.001) ratios and visual classification types (contingency coefficient=0.559, p<0.001). No sex dimorphism was found between the right and left hands. Correlations between age and visual classification were significant on both sides before and after adjustment for sex. This result is probably a sign of a secular trend in the Chuvashian sample and the study should be replicated in other samples.

Quantitative digital and palmar dermatoglyphics: sexual dimorphism in the Chuvashian population of Russia

With the aim of determining sex dimorphism among the Chuvashian population of Russia, digital and palmar dermatoglyphics of 547 individuals (293 males, 254 females) were analyzed. The sex differences for PII, TRC, and AFRC are similar to Indian and Jewish populations. Correlation coefficients between individual finger ridge counts are a little lower than in Jews but are almost equal to Indian populations. The Mantel test of matrix correlation between sexes for 22 traits shows a very good similarity. However, sex differences of palmar traits display different levels when compared with other human populations. In light of this, our evidence indicates the possible role of environmental (prenatal) factors in the realization of dermatoglyphic sex differences. The development of palmar dermatoglyphics has had a relatively longer growth period compared with fingers [Cummins, H., 1929. The topographic history of the volar pads (walking pads, tast ballen) in the human embryo. Embryol. 20, 103-126]. The palmar dermatoglyphic pattern of affinities therefore corresponds better than fingers to the ethno historical background of the populations, ascertained by numerous studies.

Age, body composition, and reproductive indices as predictors of radiographic hand osteoarthritis in Chuvashian women

OBJECTIVES

In our observational cross-section population-based study, we evaluated the predictors (age, body composition indices, age at menarche, and age at menopause) of radiographic hand osteoarthritis (OA) from a sample of women of European origin, who were not receiving any medication for prevention or treatment of OA.

METHODS

Our population consisted of 745 Chuvashian females with a mean age of 48.65 years (range 18-84 years) residing in peripheral villages of the Russian Federation. OA was evaluated using the Kellgren and Lawrence grading scheme. To evaluate the relationship between age, age at menarche, age at menopause, body composition indices [body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), somatotypes (ectomorphy, mesomorphy, and endomorphy)], and an individual's osteoarthritis score (Tot28) as the dependent variable, we used multiple linear regression analysis (stepwise method).

RESULTS AND CONCLUSIONS

Statistically significant predictors of hand OA in women were found to be the following: age (beta = 0.748, p = 0.000), mesomorphy (beta = 0.120, p = 0.000), WHR (beta = 0.117, p = 0.001), endomorphy (beta = -0.089, p = 0.006), and age at menarche (beta = -0.066, p = 0.012). Age was the most powerful factor in determining hand OA. Mesomorphy, the measure of muscular development was a significant predictor of hand OA. Endomorphy showed a very small, but significant, negative association with hand OA. However, BMI and WC showed no association, leading us to conclude that obesity is a mechanical rather than a systematic risk factor for OA. Age at menarche was negatively associated with hand OA, possibly because early menarche is associated with an increased rate of the general ageing process.

Time-related trends of age at menopause and reproductive period of women in a Chuvashian rural population

OBJECTIVE

The objective of this study was to examine in an observational, cross-sectional, community-based study the secular trend of age at menopause among women in a rural Chuvashian population and to identify factors associated with age at menopause.

DESIGN

The sample included 316 postmenopausal women born between 1920 and 1950 with mean age at menopause of 48.47 +/- 4.63 (34-58) years. Statistical analyses included simple and multiple linear regression and "whiskers" plots.

RESULTS

Significant association was found between year of birth and age at menopause (beta = 0.194, P < 0.001) and reproduction period (P = 0.193, P < 0.001). Mean values of age at menopause increased from 47.0 years (born during 1920-1925) to maximal values of 49.7 years (born during 1940-1945) and 49.3 years (born during 1945-1950). Mean values of their reproductive period increased from 30.7 (born during 1920-1925) to maximal values of 34.1 (born during 1940-1945) and to 33.7 (born during 1945-1950). Multiple linear regression analysis demonstrated that year of birth was the only statistically significant (P = 0.19, P < 0.01) predictor of age at menopause. Age at menarche can also be a possible predictor of age at menopause (beta = -0.12, P = 0.04).

CONCLUSIONS

The study confirmed certain secular trends of age at menopause and reproductive periods in Chuvashian women. The authors also observed a negative association between age at menarche and age at menopause. The number of children and medical abortions as well as body mass index showed no association with age at menopause.

Changes in reproductive indices in Chuvashian women whose maturation was during World War II

OBJECTIVES

The aim of the present study was to evaluate whether Chuvashian women whose maturation was during World War II and the subsequent rehabilitation period were different from women born at other times in terms of age at menarche and age at menopause.

DESIGN

The cohort included 745 Chuvashian females aged 18-90 years; age at menarche (N=653), ranged from 10 to 24 years (mean 15.42+/-2.11). Data regarding menopausal age was obtained from 322 females born between 1915 and 1950 (mean 48.5+/-4.6). We computed descriptive statistics of the age of menopause and the age of menarche for different birth cohorts; we compared the mean values by Student's t-test and the variances by F-test.

RESULTS

The "expected" maturation period of women whose age at menarche >20 and most women whose age at menopause < or =38 was between 1939 and 1950. Women whose age at menarche >20 showed normal parameters regarding age at menopause, and women whose age at menopause was < or =38 showed normal parameters of age at menarche. The variances of age at menopause in women born from 1925 to 1936 was almost two-fold higher than in women born earlier and afterwards (p=0.0003). The difference in the mean ages was significant for both menarche (p=0.005) and menopause (p=0.001).

CONCLUSION

Periods of socioeconomic disasters such as war and famine can influence women's age at menarche and age at menopause. Women, whose maturation occurred during or immediately after World War II, showed a higher mean age at menarche and a wider dispersion of age at menopause than other women.