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Luengo-Pérez LM, Fernández-Bueso M, Guzmán-Carmona C, López-Navia A, García-Lobato C. Morphofunctional Assessment beyond Malnutrition: Fat Mass Assessment in Adult Patients with Phenylketonuria-Systematic Review. Nutrients 2024; 16:1833. [PMID: 38931188 PMCID: PMC11206948 DOI: 10.3390/nu16121833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Morphofunctional assessment was developed to evaluate disease-related malnutrition. However, it can also be used to assess cardiometabolic risk, as excess adiposity increases this risk. Phenylketonuria (PKU) is the most prevalent inherited metabolic disease among adults, and obesity in PKU has recently gained interest, although fat mass correlates better with cardiometabolic risk than body mass index. In this systematic review, the objective was to assess whether adult patients with PKU have higher fat mass than healthy controls. Studies of adult PKU patients undergoing dietary treatment in a metabolic clinic reporting fat mass were included. The PubMed and EMBASE databases were searched. Relevance of articles, data collection, and risk of bias were evaluated by two independent reviewers. Ten articles were evaluated, six with a control group, including 310 subjects with PKU, 62 with mild hyperphenylalaninemia, and 157 controls. One study reported a significant and four a tendency towards an increased fat mass in all patients or only females with PKU. Limitations included not having a healthy control group, not reporting sex-specific results and using different techniques to assess fat mass. Evaluation of fat mass should be included in the morphofunctional assessment of cardiometabolic risk in adult patients with PKU.
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Affiliation(s)
- Luis M. Luengo-Pérez
- Medical Sciences Department, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
- Clinical Nutrition and Dietetics Unit, Endocrinology and Nutrition Section, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (C.G.-L.)
| | - Mercedes Fernández-Bueso
- Clinical Nutrition and Dietetics Unit, Endocrinology and Nutrition Section, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (C.G.-L.)
| | - Carlos Guzmán-Carmona
- Endocrinology and Nutrition, Don Benito-Villanueva de la Serena Hospital Complex, 06400 Don Benito, Spain; (C.G.-C.); (A.L.-N.)
| | - Ana López-Navia
- Endocrinology and Nutrition, Don Benito-Villanueva de la Serena Hospital Complex, 06400 Don Benito, Spain; (C.G.-C.); (A.L.-N.)
| | - Claudia García-Lobato
- Clinical Nutrition and Dietetics Unit, Endocrinology and Nutrition Section, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (C.G.-L.)
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Lau DCW, Shaw E, Farris MS, McMullen S, Brar S, Cowling T, Chatterjee S, Quansah K, Kyaw MH, Girard LP. Prevalence of Adult Type 2 Diabetes Mellitus and Related Complications in Alberta, Canada: A Retrospective, Observational Study Using Administrative Data. Can J Diabetes 2024; 48:155-162.e8. [PMID: 38135113 DOI: 10.1016/j.jcjd.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/28/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease and a leading cause of morbidity/mortality in Canada. We evaluated the burden of T2DM in Alberta, Canada, by estimating the 5-year period prevalence of T2DM and rates of comorbidities and complications/conditions after T2DM. METHODS We conducted a population-based, retrospective study linking administrative health databases. Individuals with T2DM (≥18 years of age) were identified between 2008-2009 and 2018-2019 using a published algorithm, with follow-up data to March 2020. The 5-year period prevalence was estimated for 2014-2015 to 2018-2019. Individuals with newly identified T2DM, ascertained between 2010-2011 and 2017-2018 with a lookback period between 2008-2009 and 2009-2010 and a minimum 1 year of follow-up data, were evaluated for subsequent cardiovascular, diabetic, renal, and other complication/condition frequencies (%) and rates (per 100 person-years). Complications/conditions were stratified by atherosclerotic cardiovascular disease (ASCVD) status at index and age. RESULTS The 5-year period prevalence of T2DM was 11,051 per 100,000 persons, with the highest prevalence in men 65 to <75 years of age. There were 195,102 individuals included in the cohort (mean age 56.7±14.7 years). The most frequently reported complications/conditions (rates per 100 person-years) were acute infection (23.10, 95% confidence interval [CI] 23.00 to 23.30), hypertension (17.30, 95% CI 16.80 to 17.70), and dyslipidemia (12.20, 95% CI 11.90 to 12.40). Individuals who had an ASCVD event/procedure and those ≥75 years of age had higher rates of complications/conditions. CONCLUSIONS We found that over half of the individuals had hypertension or infection after T2DM. Also, those with ASCVD had higher rates of complications/conditions. Strategies to mitigate complications/conditions after T2DM are required to reduce the burden of this disease on individuals and health-care systems.
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Affiliation(s)
- David C W Lau
- Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
| | - Eileen Shaw
- Medlior Health Outcomes Research, Ltd, Calgary, Alberta, Canada
| | - Megan S Farris
- Medlior Health Outcomes Research, Ltd, Calgary, Alberta, Canada
| | | | - Saman Brar
- Medlior Health Outcomes Research, Ltd, Calgary, Alberta, Canada
| | - Tara Cowling
- Medlior Health Outcomes Research, Ltd, Calgary, Alberta, Canada
| | - Satabdi Chatterjee
- Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, United States
| | - Kobina Quansah
- Boehringer Ingelheim (Canada), Ltd, Burlington, Ontario, Canada
| | - Moe H Kyaw
- Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, United States
| | - Louis P Girard
- Division of Nephrology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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Zhang M, Bai Y, Wang Y, Cui H, Zhang W, Zhang L, Yan P, Tang M, Liu Y, Jiang X, Zhang B. Independent association of general and central adiposity with risk of gallstone disease: observational and genetic analyses. Front Endocrinol (Lausanne) 2024; 15:1367229. [PMID: 38529389 PMCID: PMC10961427 DOI: 10.3389/fendo.2024.1367229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
Background General obesity is a well-established risk factor for gallstone disease (GSD), but whether central obesity contributes additional independent risk remains controversial. We aimed to comprehensively clarify the effect of body fat distribution on GSD. Methods We first investigated the observational association of central adiposity, characterized by waist-to-hip ratio (WHR), with GSD risk using data from UK Biobank (N=472,050). We then explored the genetic relationship using summary statistics from the largest genome-wide association study of GSD (ncase=43,639, ncontrol=506,798) as well as WHR, with and without adjusting for body mass index (BMI) (WHR: n=697,734; WHRadjBMI: n=694,649). Results Observational analysis demonstrated an increased risk of GSD with one unit increase in WHR (HR=1.18, 95%CI=1.14-1.21). A positive WHR-GSD genetic correlation (r g =0.41, P=1.42×10-52) was observed, driven by yet independent of BMI (WHRadjBMI: r g =0.19, P=6.89×10-16). Cross-trait meta-analysis identified four novel pleiotropic loci underlying WHR and GSD with biological mechanisms outside of BMI. Mendelian randomization confirmed a robust WHR-GSD causal relationship (OR=1.50, 95%CI=1.35-1.65) which attenuated yet remained significant after adjusting for BMI (OR=1.17, 95%CI=1.09-1.26). Furthermore, observational analysis confirmed a positive association between general obesity and GSD, corroborated by a shared genetic basis (r g =0.40, P=2.16×10-43), multiple novel pleiotropic loci (N=11) and a causal relationship (OR=1.67, 95%CI=1.56-1.78). Conclusion Both observational and genetic analyses consistently provide evidence on an association of central obesity with an increased risk of GSD, independent of general obesity. Our work highlights the need of considering both general and central obesity in the clinical management of GSD.
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Affiliation(s)
- Min Zhang
- Clinical and Public Health Research Center, Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ye Bai
- Gene Diagnosis Center, the First Affiliated Hospital of Jilin University, Jilin, China
| | - Yutong Wang
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huijie Cui
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wenqiang Zhang
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Zhang
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peijing Yan
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingshuang Tang
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunjie Liu
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xia Jiang
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ben Zhang
- Department of Epidemiology and Health Statistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Thapa S, Selvaraj BS, Davis PN, Smith B, Givan AH, Perez-Rivera JA, Woodard P, Klingensmith JD, Fernandez-del-Valle M. Vigorous-intensity exercise as a modulator of cardiac adipose tissue in women with obesity: a cross-sectional and randomized pilot study. Front Endocrinol (Lausanne) 2023; 14:1104441. [PMID: 37223011 PMCID: PMC10200876 DOI: 10.3389/fendo.2023.1104441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/28/2023] [Indexed: 05/25/2023] Open
Abstract
Cardiac adipose tissue (CAT) has become an important target for the reduction of disease risk. Supervised exercise programs have shown potential to "significantly" reduce CAT; however, the impact of different exercise modalities is not clear, and the relationships between CAT, physical activity (PA) levels and fitness (PFit) remain unknown. Therefore, the purpose of this study was to analyze the relationships between CAT, PA and PFit, and to explore the effects of different exercise modalities in a group of women with obesity. A total of 26 women (age: 23.41 ± 5.78 years-old) were enrolled in the cross-sectional study. PA, cardiorespiratory fitness, muscular strength, body composition and CAT were evaluated. The pilot intervention included 16 women randomized to a control (CON, n=5), high intensity interval training (HIIT, n = 5) and high-intensity circuit training (HICT, n=6) groups. Statistical analysis showed negative correlations between CAT and vigorous PA (VPA) (r s=-0.41, p=0.037); and between percent body fat (%BF), fat mass (FM), and all PA levels (r s=-0.41- -0.68, p<0.05); while muscle mass was positively associated with moderate-to-vigorous PA, and upper-body lean mass with all PA levels (r s =0.40-0.53, p<0.05). The HICT intervention showed significant improvements (p<0.05) in %BF, FM, fat free mass, and whole-body and lower extremities lean mass and strength after three weeks; however, only leg strength and upper extremities' FM improved significantly compared to CON and HICT. In conclusion, although all types of PA showed a positive influence on body fat content, only VPA significantly impacted on CAT volume. Moreover, three weeks of HICT induced positive changes in PFit in women with obesity. Further research is needed to explore VPA levels and high-intensity exercise interventions for short- and long-term CAT management.
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Affiliation(s)
- Sumsen Thapa
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
| | - Bharath S. Selvaraj
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Iowa Digestive Disease Center, Heartland Medical Research, Inc., Clive, IA, United States
| | - Paige N. Davis
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Department of Cardiopulmonary Rehabilitation, Charleston Area Medical Center (CAMC) Memorial Hospital at West Virginia, Charleston, WV, United States
| | - Bryan Smith
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
| | - Amy H. Givan
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Division of Rehabilitation Sciences, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Jose A. Perez-Rivera
- Department of Cardiology, University Hospital of Burgos, Burgos, Spain
- Facultad de Ciencias de la Salud, Universidad Isabel I, Isabel, Spain
| | - Pamela K. Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jon D. Klingensmith
- Department of Electrical and Computer Engineering, Southern Illinois University Edwardsville, Edwardsville, IL, United States
| | - Maria Fernandez-del-Valle
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
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Joseph LP, Joseph EA, Prasad R. Explainable diabetes classification using hybrid Bayesian-optimized TabNet architecture. Comput Biol Med 2022; 151:106178. [PMID: 36306578 DOI: 10.1016/j.compbiomed.2022.106178] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 12/27/2022]
Abstract
Diabetes is a deadly chronic disease that occurs when the pancreas is not able to produce ample insulin or when the body cannot use insulin effectively. If undetected, it may lead to a host of health complications. Hence, accurate and explainable early-stage detection of diabetes is essential for the proper administration of treatment options in leading a healthy and productive life. For this, we developed an interpretable TabNet model tuned via Bayesian optimization (BO). To achieve model-specific interpretability, the attention mechanism of TabNet architecture was used, which offered the local and global model explanations on the influence of the attributes on the outcomes. The model was further explained locally and globally using more robust model-agnostic LIME and SHAP eXplainable Artificial Intelligence (XAI) tools. The proposed model outperformed all benchmarked models by obtaining high accuracy of 92.2% and 99.4% using the Pima Indians diabetes dataset (PIDD) and the early-stage diabetes risk prediction dataset (ESDRPD), respectively. Based on the XAI results, it was clear that the most influential attribute for diabetes classification using PIDD and ESDRPD were Insulin and Polyuria, respectively. The feature importance values registered for insulin was 0.301 (PIDD) and for polyuria 0.206 was registered (ESDRPD). The high accuracy and ancillary interpretability of our objective model is expected to increase end-users trust and confidence in early-stage detection of diabetes.
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Affiliation(s)
- Lionel P Joseph
- School of Mathematics, Physics, and Computing, University of Southern Queensland, Springfield, QLD, 4300, Australia
| | - Erica A Joseph
- Umanand Prasad School of Medicine and Health Sciences, The University of Fiji, Saweni, Lautoka, Fiji
| | - Ramendra Prasad
- Department of Science, School of Science and Technology, The University of Fiji, Saweni, Lautoka, Fiji.
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Metabolic Score for Visceral Fat: a novel predictor for the risk of type 2 diabetes mellitus. Br J Nutr 2022; 128:1029-1036. [PMID: 34632975 DOI: 10.1017/s0007114521004116] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To investigate the association between the Metabolic Score for Visceral Fat (METS-VF) and risk of type 2 diabetes mellitus (T2DM) and compare the predictive value of the METS-VF for T2DM incidence with other obesity indices in Chinese people. A total of 12 237 non-T2DM participants aged over 18 years from the Rural Chinese Cohort Study of 2007-2008 were included at baseline and followed up during 2013-2014. The cox proportional hazards regression was used to calculate hazard ratios (HR) and 95 % CI for the association between baseline METS-VF and T2DM risk. Restricted cubic splines were used to model the association between METS-VF and T2DM risk. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the ability of METS-VF to predict T2DM incidence. During a median follow-up of 6·01 (95 % CI 5·09, 6·06) years, 837 cases developed T2DM. After adjusting for potential confounding factors, the adjusted HR for the highest v. lowest METS-VF quartile was 5·97 (95 % CI 4·28, 8·32), with a per 1-sd increase in METS-VF positively associated with T2DM risk. Positive associations were also found in the sensitivity and subgroup analyses, respectively. A significant nonlinear dose-response association was observed between METS-VF and T2DM risk for all participants (Pnonlinearity = 0·0347). Finally, the AUC value of METS-VF for predicting T2DM was largest among six indices. The METS-VF may be a reliable and applicable predictor of T2DM incidence in Chinese people regardless of sex, age or BMI.
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Cichosz SL, Rasmussen NH, Vestergaard P, Hejlesen O. Is predicted body-composition and relative fat mass an alternative to body-mass index and waist circumference for disease risk estimation? Diabetes Metab Syndr 2022; 16:102590. [PMID: 35986982 DOI: 10.1016/j.dsx.2022.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS New methods to estimate body-composition have recently been proposed, but their relation to diseases, such as diabetes and coronary heart disease, needs further investigation. The purpose of this study was to investigate the association between proposed prediction of body-composition (PBC); Relative Fat Mass (RFM), Body Mass Index (BMI), Waist Circumference (WC) and disease. METHODS In a cross-sectional cohort (NHANES) the association between the four body measures and diabetes, high blood pressure, coronary heart disease, cancer, arthritis, and hospitalization were assessed. A total of 13,348 people was included in this study. Receiver operating characteristic (ROC), Area Under Curve (AUC) and statistical testing were used to evaluate the differences. RESULTS PBC/RFM had significant higher AUC than BMI or WC for diabetes, high blood pressure, hospitalization, and arthritis. PBC had a significant higher AUC than RFM, BMI, WC for Cancer and coronary heart disease. CONCLUSIONS RFM and PBC could be a better indicator to distinguish amongst people with a risk of diseases compared to traditional measures such as BMI and WC. However, future studies need to investigate the longitudinal association between RFM, PBC and the risk of disease development to assess if these measures are better suited for risk-stratification.
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Affiliation(s)
| | - Nicklas H Rasmussen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Vestergaard
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Ole Hejlesen
- Department of Health Science and Technology, Aalborg University, Denmark
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Dwivedi AK. How to write statistical analysis section in medical research. J Investig Med 2022; 70:1759-1770. [PMID: 35710142 DOI: 10.1136/jim-2022-002479] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 12/15/2022]
Abstract
Reporting of statistical analysis is essential in any clinical and translational research study. However, medical research studies sometimes report statistical analysis that is either inappropriate or insufficient to attest to the accuracy and validity of findings and conclusions. Published works involving inaccurate statistical analyses and insufficient reporting influence the conduct of future scientific studies, including meta-analyses and medical decisions. Although the biostatistical practice has been improved over the years due to the involvement of statistical reviewers and collaborators in research studies, there remain areas of improvement for transparent reporting of the statistical analysis section in a study. Evidence-based biostatistics practice throughout the research is useful for generating reliable data and translating meaningful data to meaningful interpretation and decisions in medical research. Most existing research reporting guidelines do not provide guidance for reporting methods in the statistical analysis section that helps in evaluating the quality of findings and data interpretation. In this report, we highlight the global and critical steps to be reported in the statistical analysis of grants and research articles. We provide clarity and the importance of understanding study objective types, data generation process, effect size use, evidence-based biostatistical methods use, and development of statistical models through several thematic frameworks. We also provide published examples of adherence or non-adherence to methodological standards related to each step in the statistical analysis and their implications. We believe the suggestions provided in this report can have far-reaching implications for education and strengthening the quality of statistical reporting and biostatistical practice in medical research.
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Affiliation(s)
- Alok Kumar Dwivedi
- Department of Molecular and Translational Medicine, Division of Biostatistics and Epidemiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
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van Drünick C, de Waard L, Muller CJB, Theron G. Association between gynaecological disorders and body mass index in a South African cohort: a retrospective observational study. J OBSTET GYNAECOL 2022; 42:2420-2425. [PMID: 35653780 DOI: 10.1080/01443615.2022.2069483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A retrospective observational study of new patients who visited the gynaecology outpatient clinic at Tygerberg Hospital, South Africa, between February and June 2019 was conducted to determine the association between body mass index (BMI) and gynaecological disorders. BMI was calculated and analysed concerning the presenting complaint and final diagnosis. From the sample of 651 patients, 18.4% had a normal BMI and 47.3% were classified as overweight or obese class 1. Older age was associated with a higher BMI (p = .013). Hypertension was most prevalent (26.7%) and associated with excess weight (p < .001). Disorders significantly associated with obesity were infertility (odds ratio [OR] 1.013, 95% confidence interval [CI] 0.992-1.033, p = .001), polycystic ovarian syndrome (OR 1.058, 95% CI 1.028-1.089, p = .006), pelvic organ prolapse (OR 1.027, 95% CI 0.995-1.060, p = .0291) and postmenopausal bleeding (OR 1.038, 95% CI 1.009-1.068, p = .048). Chronic pelvic pain and endometriosis were associated with a low BMI. IMPACT STATEMENTWhat is already known on this subject? It is well known that obesity has multiple negative effects on health. It affects women's health on many levels including their endocrine balance as well as pressure effects on the pelvic floor. The association between gynaecological disorders and excess weight has been described mainly in the context of separate gynaecological conditions.What the results of study add? This study described the large numbers of women with obesity in the South African context. It adds to the body of knowledge by looking at the association of BMI, not only obesity, and a large range of the most seen gynaecological conditions in the study setting.What the implications are of these findings for clinical practice and/or further research? This study highlights the importance of lifestyle and nutritional implications on women's health. For clinical practice, this knowledge needs to be applied with every opportunity to counsel women on how their weight can affect their gynaecological health. The focus of further research should focus on the most effective strategies to combat obesity in a holistic patient-centered approach.
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Affiliation(s)
- Celesté van Drünick
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Liesl de Waard
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Gerhard Theron
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Husted KLS, Brink-Kjær A, Fogelstrøm M, Hulst P, Bleibach A, Henneberg KÅ, Sørensen HBD, Dela F, Jacobsen JCB, Helge JW. A Model for Estimating Biological Age From Physiological Biomarkers of Healthy Aging: Cross-sectional Study. JMIR Aging 2022; 5:e35696. [PMID: 35536617 PMCID: PMC9131142 DOI: 10.2196/35696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/21/2022] [Accepted: 04/06/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Individual differences in the rate of aging and susceptibility to disease are not accounted for by chronological age alone. These individual differences are better explained by biological age, which may be estimated by biomarker prediction models. In the light of the aging demographics of the global population and the increase in lifestyle-related morbidities, it is interesting to invent a new biological age model to be used for health promotion. OBJECTIVE This study aims to develop a model that estimates biological age based on physiological biomarkers of healthy aging. METHODS Carefully selected physiological variables from a healthy study population of 100 women and men were used as biomarkers to establish an estimate of biological age. Principal component analysis was applied to the biomarkers and the first principal component was used to define the algorithm estimating biological age. RESULTS The first principal component accounted for 31% in women and 25% in men of the total variance in the biological age model combining mean arterial pressure, glycated hemoglobin, waist circumference, forced expiratory volume in 1 second, maximal oxygen consumption, adiponectin, high-density lipoprotein, total cholesterol, and soluble urokinase-type plasminogen activator receptor. The correlation between the corrected biological age and chronological age was r=0.86 (P<.001) and r=0.81 (P<.001) for women and men, respectively, and the agreement was high and unbiased. No difference was found between mean chronological age and mean biological age, and the slope of the regression line was near 1 for both sexes. CONCLUSIONS Estimating biological age from these 9 biomarkers of aging can be used to assess general health compared with the healthy aging trajectory. This may be useful to evaluate health interventions and as an aid to enhance awareness of individual health risks and behavior when deviating from this trajectory. TRIAL REGISTRATION ClinicalTrials.gov NCT03680768; https://clinicaltrials.gov/ct2/show/NCT03680768. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19209.
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Affiliation(s)
- Karina Louise Skov Husted
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Andreas Brink-Kjær
- Digital Health, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Mathilde Fogelstrøm
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hulst
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Akita Bleibach
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kaj-Åge Henneberg
- Biomedical Engineering, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | | | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Geriatrics, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jens Christian Brings Jacobsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jørn Wulff Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Nuhu JM, Yakasai AM, Danazumi MS, Nazeef F, Zakari UU, Usman Z, Mohammed J. Effect of aerobic exercise and burst-modulated biphasic pulsed current on glycemic control, central obesity and body image in individuals with type 2 diabetes mellitus: study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Obesity as a Risk Factor for Hypertension and Diabetes among Truck Drivers in a Logistics Company, South Africa. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Despite the occupational nature of truckers predisposing them to cardiovascular diseases and risk factors, data is scarce on their prevalence of obesity and its association with developing hypertension (HBP) and diabetes in South Africa. Extracted from the original cross-sectional study of a sample of 312 employees in a logistics company, a census of 96 male truckers was used to determine the prevalence of obesity and its association with HBP and diabetes. WHO STEPwise approach was used to collect data, including systolic (SBP) and diastolic (DBP) blood pressure and anthropometry measurements. HBP is defined as SBP/DBP ≥ 140/90 mmHg, overweight/obesity as BMI ≥ 25 kg/m2, abdominal obesity by waist circumference as WC ≥ 90cm, waist-to-hip-ratio as WHR ≥ 0.90, and waist-to-height ratio as WHtR ≥ 0.5. Data were analysed using SPSS 22. The mean age of truckers was 46 years, 29% were smokers, and 57% alcohol users, while 26% were physically inactive. The prevalence of overweight (44%) and obesity (30%) were observed, while abdominal obesity was high; WC (59%), WHR (65%), and WHtR (80%). HBP (57%) was prevalent and diabetes was 14%. The odds of developing HBP were high for obese truckers by WC [AOR = 4.68; CI = 1.92–11.34)] and by WHtR [AOR = 5.49 CI = 1.74–17.27), while diabetes was associated with WHR (AOR = 1.19; CI = 1.19–31.21). This study showed an associative link between obesity, HBP, and diabetes among the truckers, which is informative for a relevant prevention programme tailored to their needs.
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13
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Perna S, Faragli A, Spadaccini D, Peroni G, Gasparri C, Al-Mannai MA, Casali PM, La Porta E, Kelle S, Alogna A, Rondanelli M. Predicting Visceral Adipose Tissue in older adults: A pilot clinical study. Clin Nutr 2022; 41:810-816. [DOI: 10.1016/j.clnu.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 01/19/2022] [Accepted: 02/14/2022] [Indexed: 11/26/2022]
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14
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DeLacey S, Josefson JL. A Mini-Review of Pediatric Anthropometrics as Predictors of Future Insulin Resistance. Front Endocrinol (Lausanne) 2022; 13:826430. [PMID: 35185801 PMCID: PMC8848350 DOI: 10.3389/fendo.2022.826430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/07/2022] [Indexed: 12/16/2022] Open
Abstract
The impact of rising rates of childhood obesity is far reaching. Metabolic syndrome in children is increasing, yet for most children the consequences of excess adiposity will manifest in adulthood. Excess early fat accrual is a risk factor for future insulin resistance. However, certain types of fat and patterns of fat distribution are more relevant than others to metabolic risk. Therefore, adiposity measures are important. The link between childhood obesity and future insulin resistance was initially established with body mass index (BMI), but BMI is an in imperfect measure of adiposity. It is worthwhile to evaluate other anthropometrics as they may more accurately capture metabolic risk. While measures such as waist to height ratio are established as superior screening measures in adulthood - the findings are not as robust in pediatrics. Emerging evidence suggests that alternative anthropometrics may be slightly superior to BMI in identifying those youth most at risk of developing insulin resistance, but the clinical significance of that superiority appears limited. Increasing study is needed in longitudinal and varied cohorts to identify which pediatric anthropometric best predicts adult insulin resistance. We review alternative anthropometrics as predictors of future insulin resistance and identify current gaps in knowledge and potential future directions of inquiry.
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Affiliation(s)
- Sean DeLacey
- Department of Pediatrics, Division of Endocrinology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- *Correspondence: Sean DeLacey,
| | - Jami L. Josefson
- Department of Pediatrics, Division of Endocrinology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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15
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de Alencar AKN, Wang H, de Oliveira GMM, Sun X, Zapata-Sudo G, Groban L. Crossroads between Estrogen Loss, Obesity, and Heart Failure with Preserved Ejection Fraction. Arq Bras Cardiol 2021; 117:1191-1201. [PMID: 34644788 PMCID: PMC8757160 DOI: 10.36660/abc.20200855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/16/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
The prevalence of obesity and heart failure with preserved ejection fraction (HFpEF) increases significantly in postmenopausal women. Although obesity is a risk factor for left ventricular diastolic dysfunction (LVDD), the mechanisms that link the cessation of ovarian hormone production, and particularly estrogens, to the development of obesity, LVDD, and HFpEF in aging females are unclear. Clinical, and epidemiologic studies show that postmenopausal women with abdominal obesity (defined by waist circumference) are at greater risk for developing HFpEF than men or women without abdominal obesity. The study presents a review of clinical data that support a mechanistic link between estrogen loss plus obesity and left ventricular remodeling with LVDD. It also seeks to discuss potential cell and molecular mechanisms for estrogen-mediated protection against adverse adipocyte cell types, tissue depots, function, and metabolism that may contribute to LVDD and HFpEF.
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Affiliation(s)
| | - Hao Wang
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
- Wake Forest School of MedicineWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gláucia Maria Moraes de Oliveira
- Universidade Federal do Rio de JaneiroDepartamento de Clínica MédicaFaculdade de MedicinaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Departamento de Clínica Médica, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Xuming Sun
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gisele Zapata-Sudo
- Universidade Federal do Rio de JaneiroInstituto de Ciências BiomédicasRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Instituto de Ciências Biomédicas, Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de JaneiroInstituto de Cardiologia Edson SaadFaculdade de MedicinaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Instituto de Cardiologia Edson Saad, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Leanne Groban
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
- Wake Forest School of MedicineWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
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16
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Shea B, Bakre S, Carano K, Scharen J, Langheier J, Hu EA. Changes in Glycemic Control Among Individuals With Diabetes Who Used a Personalized Digital Nutrition Platform: Longitudinal Study. JMIR Diabetes 2021; 6:e32298. [PMID: 34661545 PMCID: PMC8561409 DOI: 10.2196/32298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diabetes-related costs are the highest across all chronic conditions in the United States, with type 2 diabetes accounting for up to 95% of all cases of diabetes. A healthy diet is strongly associated with lowering glycated hemoglobin A1c (HbA1c) levels among individuals with diabetes, which can help curtail other health complications. Digital health platforms can offer critical support for improving diet and glycemic control among individuals with diabetes. Less is known about the characteristics of people with diabetes who use digital health platforms (specifically, a platform that integrates personalized healthy meal plans and food ordering) and changes in their HbA1c levels. OBJECTIVE The aim of this study is to characterize Foodsmart users with diabetes and evaluate the longitudinal impact of Foodsmart-a personalized digital nutrition platform with meal planning, food ordering, and nutrition education features-on changes in HbA1c levels. METHODS We retrospectively analyzed data collected from 643 adults with at least two self-reported HbA1c entries in the Foodsmart platform between January 2016 and June 2021. Participants self-reported their HbA1c levels, height, weight, health conditions, and diet in a 53-item food frequency questionnaire. Diabetes was defined as HbA1c ≥6.5%. We analyzed distributions of characteristics by baseline diabetes status and examined the association of characteristics with the likelihood of having diabetes at baseline. To evaluate the change in HbA1c levels among Foodsmart users, we calculated mean changes (absolute and percent) in HbA1c among participants with diabetes and by length of follow-up. We also compared changes in HbA1c and weight between participants with diabetes at baseline who achieved a normal HbA1c level and those who did not. RESULTS We found that 43.5% (280/643) of the participants with at least two HbA1c level entries had diabetes at baseline. Participants with diabetes at baseline were more likely to be male, have a higher weight and BMI, report high blood pressure, and have a poorer diet in comparison to participants without diabetes. Using a multivariable logistic regression model, we found that being male and obese were statistically significantly associated with baseline diabetes. Among participants with diabetes at baseline, HbA1c was reduced, on average, by 0.46%. In addition, 21.4% (60/280) of participants with diabetes achieved a normal HbA1c level (<6.5%) in their last HbA1c level entry; this percentage increased with longer follow-up time (39% [7/18] at >24 months). In a sensitivity analysis, users with an HbA1c ≥7.0% at baseline had an average absolute change of -0.62% and 31.2% (62/199) of these participants achieved HbA1c levels of less than 7.0%. CONCLUSIONS This study assessed characteristics of individuals enrolled on the Foodsmart platform with HbA1c levels and found that users with diabetes had lower HbA1c levels over time and a sizable percentage of participants were successful in achieving normal levels.
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Affiliation(s)
- Benjamin Shea
- Foodsmart, San Francisco, CA, United States.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Shivani Bakre
- Foodsmart, San Francisco, CA, United States.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | | | | | - Emily A Hu
- Foodsmart, San Francisco, CA, United States
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17
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Dorsey AF, Penny ME, Thompson AL. Adiposity and pathogen exposure: An investigation of response to iron supplementation and hypothesized predictors in anemic pre-school-aged children living in a dual burden environment. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 176:54-65. [PMID: 33852740 PMCID: PMC8376780 DOI: 10.1002/ajpa.24287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Peruvians are experiencing rapid dietary and lifestyle changes, resulting in a phenomenon known as the "dual burden of disease." A common manifestation of the dual burden in individuals is the co-occurrence of overweight and anemia. Despite recent initiatives introduced to address these concerns, rates continue to be public health concerns. This study investigates the relationship between immune activation and lack of response to iron supplementation after 1 month of treatment and explores variation in body fat stores as a potential moderator between immune function and response to treatment. METHODS Data come from children, aged 2-5 years (n = 50) from a peri-urban community in Lima, Peru. Multivariate logistic regression models were used to explore the associations between response to treatment (Hb > =11.0 g/dl) after 1 month of treatment), markers of immune activation (C-reactive protein [CRP] and reported morbidity symptoms), and measures of body fat (waist-to-height ratio, triceps skinfold thickness, and body mass index [BMI]). RESULTS We found that high CRP is associated with a lack of response to iron supplementation after 1 month of treatment and that BMI z-score may moderate this association. Generally, larger body size is associated with response to iron supplementation whether or not the children in this sample have high immune activation. However, the probability of anemic children responding to iron supplementation treatment differed across adiposity measures. CONCLUSIONS Our finding suggesting that adiposity and CRP influence response to iron supplementation, furthers our understanding of the relationship between inflammation and anemia treatment in children and has both theoretical and public health implications.
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Affiliation(s)
- Achsah F Dorsey
- Department of Anthropology, University of Massachusetts, Amherst, Massachusetts, USA
| | - Mary E Penny
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - Amanda L Thompson
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
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18
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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19
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Safari S, Abdoli M, Amini M, Aminorroaya A, Feizi A. A 16-year prospective cohort study to evaluate effects of long-term fluctuations in obesity indices of prediabetics on the incidence of future diabetes. Sci Rep 2021; 11:11635. [PMID: 34079024 PMCID: PMC8172923 DOI: 10.1038/s41598-021-91229-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/24/2021] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.
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Affiliation(s)
- Shahla Safari
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Abdoli
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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20
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Calcaterra V, Verduci E, Schneider L, Cena H, De Silvestri A, Vizzuso S, Vinci F, Mameli C, Zuccotti G. Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity. CHILDREN-BASEL 2021; 8:children8060449. [PMID: 34073195 PMCID: PMC8226600 DOI: 10.3390/children8060449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/12/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
New indexes of adiposity have been introduced to evaluate body-fat distribution and cardiometabolic risk. However, data on the correlation between Insulin Resistance (IR) and these new indexes are limited. We therefore evaluated the relationship between IR and adiposity indexes in children and adolescents with obesity, focusing on gender differences. We retrospectively enrolled 586 patients with obesity (10.80 ± 2.63; 306F/279M). As adiposity indexes we considered body mass index (BMI), BMI-z score, WC, waist-to-height ratio (WHtR), a body shape index (ABSI), triponderal mass index (TMI), visceral adiposity index (VAI) and conicity index (ConI). The homeostasis model assessment for insulin resistance (HOMA-IR), HOMA of percentage β-cell function (HOMA-β), quantitative insulin sensitivity check index (QUICKI), and triglyceride and glucose index (TyG-index) were measured and recorded as IR surrogates. In both sexes, WC and VAI significantly correlated with all IR measurements (p < 0.001). BMI significantly correlated (p < 0.001) with all IR parameters except for the TyG-index in females. Fat mass and TMI correlated with IR parameters only in females, BMI-z score with IR markers except for HOMA-β in males, WHtR with HOMA-β in both sexes (p < 0.05), free fat mass with HOMA-IR and QUICKI only in females (p < 0.01), ConI correlated with the TyG index in females (p = 0.01). Tryglicerides and SBP were correlated with all IR measurements (p < 0.001), in both sexes. Correlations between different sex parameters were significantly more evident in middle puberty. The relationship between IR surrogates and obesity indexes is influenced by gender in pediatrics. Sex-specific differences in obesity-related complications should be considered in preventive intervention decision-making.
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Affiliation(s)
- Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (L.S.); (S.V.); (C.M.); (G.Z.)
- Correspondence:
| | - Elvira Verduci
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (L.S.); (S.V.); (C.M.); (G.Z.)
- Department of Health Sciences, University of Milan, 20146 Milan, Italy
| | - Laura Schneider
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (L.S.); (S.V.); (C.M.); (G.Z.)
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy
| | - Annalisa De Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Sara Vizzuso
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (L.S.); (S.V.); (C.M.); (G.Z.)
| | - Federica Vinci
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
- Pediatric Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Chiara Mameli
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (L.S.); (S.V.); (C.M.); (G.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (L.S.); (S.V.); (C.M.); (G.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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21
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SAINI SIMMI, WALIA GAGANDEEPKAUR, SACHDEVA MOHINDERPAL, GUPTA VIPIN. Genomics of body fat distribution. J Genet 2021. [DOI: 10.1007/s12041-021-01281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Waduud MA, Sucharitkul PP, Giannoudi M, Bailey MA, Scott DJ. The abdominal waist circumference and 4-year outcomes following peripheral bypass grafting. INT ANGIOL 2021; 40:213-221. [PMID: 33739076 DOI: 10.23736/s0392-9590.21.04642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Current literature evaluating the relationship between obesity, utilizing measures other than the Body Mass Index (BMI), and postoperative outcomes following vascular surgery are sparse. This study aimed to investigate any association between abdominal waist circumference (AWC) and waist-hip ratio (WHR) in relation to postoperative morbidity and mortality following peripheral artery bypass graft (PABG) surgery. METHODS AWC and hip circumference (HC) were measured from pre-intervention magnetic resonance (MR) and computed tomography (CT) scans of patients undergoing elective and nonelective PABG. The AWC and WHR were assessed in relation to: the need for higher level care (i.e. level 2/3), the duration of higher level care, postoperative limb ischemia, postoperative hospital stay, graft patency on discharge and 30 day readmission, using logistic and linear regression analysis. Mortality was assessed using cox-regression analysis with calculation of hazard ratios at 30 days and 4 years. RESULTS In total, 177 patient images performed between January 2014 to January 2017 were analyzed. There were no significant intra-observer and interobserver differences in measurements of AWC and HC. Pre-intervention AWC was predictive of the need for higher level care following non-elective PABG (adjusted OR 1.1 [95% CI: 1.0-1.1, P=0.026]). An inverse relationship between AWC and mortality at 4 years was also observed (adjusted HR=0.9, 95% CI: 0.9-1.0, P=0.028). However, pre-intervention WHR failed to predict mortality and morbidity. CONCLUSIONS AWC may potentially be a suitable risk stratification tool in patients undergoing non-elective PABG. The association of AWC with long-term mortality outcomes require further investigation so that suitable cut-off values may be determined.
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Affiliation(s)
- Mohammed A Waduud
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK -
| | - Penelope P Sucharitkul
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Marilena Giannoudi
- Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Marc A Bailey
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - David J Scott
- Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Li T, Quan H, Zhang H, Lin L, Lin L, Ou Q, Chen K. Type 2 diabetes is more predictable in women than men by multiple anthropometric and biochemical measures. Sci Rep 2021; 11:6062. [PMID: 33723361 PMCID: PMC7960723 DOI: 10.1038/s41598-021-85581-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/03/2021] [Indexed: 12/14/2022] Open
Abstract
Men and women are sexually dimorphic but whether common anthropometric and biochemical parameters predict type 2 diabetes (T2D) in different ways has not been well studied. Here we recruit 1579 participants in Hainan Province, China, and group them by sex. We compared the prediction power of common parameters of T2D in two sexes by association, regression, and Receiver Operating Characteristic (ROC) analysis. HbA1c is associated with FPG stronger in women than in men and the regression coefficient is higher, consistent with higher prediction power for T2D. Age, waist circumference, BMI, systolic and diastolic blood pressure, triglyceride levels, total cholesterol, LDL, HDL, fasting insulin, and proinsulin levels all predict T2D better in women. Except for diastolic blood pressure, all parameters associate or tend to associate with FPG stronger in women than in men. Except for diastolic blood pressure and fasting proinsulin, all parameters associate or tend to associate with HbA1c stronger in women than in men. Except for fasting proinsulin and HDL, the regression coefficients of all parameters with FPG and HbA1c were higher in women than in men. Together, by the above anthropometric and biochemical measures, T2D is more readily predicted in women than men, suggesting the importance of sex-based subgroup analysis in T2D research.
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Affiliation(s)
- Tangying Li
- Department of Health Care Centre, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road, Haikou, 570311, Hainan, China.
| | - Huachuan Zhang
- Department of Endocrinology Laboratory, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan, China
| | - Leweihua Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road, Haikou, 570311, Hainan, China
| | - Lu Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road, Haikou, 570311, Hainan, China
| | - Qianying Ou
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road, Haikou, 570311, Hainan, China
| | - Kaining Chen
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road, Haikou, 570311, Hainan, China
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Datta Banik S, Pacheco-Pantoja E, Lugo R, Gómez-de-Regil L, Chim Aké R, Méndez González RM, Gutiérrez Solis AL. Evaluation of Anthropometric Indices and Lipid Parameters to Predict Metabolic Syndrome Among Adults in Mexico. Diabetes Metab Syndr Obes 2021; 14:691-701. [PMID: 33623404 PMCID: PMC7896767 DOI: 10.2147/dmso.s281894] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/20/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster of conditions that increases the risk of cardiovascular disease (CVD) and is related to genetic background, dietary habits, and lifestyle. Anthropometric indices and lipid parameters have been shown to be simple and useful tools in clinical practice for predicting MetS. The aim of the present study was to evaluate the differential magnitudes of anthropometric characteristics (waist circumference and body mass index [BMI]) and lipid parameters, namely, lipid accumulation product (LAP), cardiometabolic index (CMI), and Castelli Risk Index (CRI-I), to estimate MetS, usingappropriate cut-off values, among adults from a public hospital in Yucatan, Mexico. METHODS A cross-sectional study among 250 adults (77 men, 173 women) was carried out in the Regional High Speciality Hospital of the Yucatan Peninsula (HRAEPY) in Merida, Yucatan. MetS was diagnosed using standard criteria (central obesity, arterial hypertension, hyperglycemia, and dyslipidemia), and derived parameters (LAP, CMI, and CRI-I) were calculated. Binary logistic regression analysis-based receiver operating characteristics (ROC) curves were used to predict MetS. RESULTS Of the 250 participants, 48% had MetS. High prevalences of overweight (35.2%) and obesity (48.8%) were found in the sample. The CMI and LAP were found to be the best parameters in the prediction of MetS in men and women. The optimal cut-off values of the parameters were higher in men and decreased with advancing age. CONCLUSION The CMI and LAP were shown to be the most effective indicators to diagnose MetS among adults from Yucatan, Mexico.
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Affiliation(s)
- Sudip Datta Banik
- Center for Research and Advanced Studies (Cinvestav-IPN), Merida, Yucatan, Mexico
| | - Elda Pacheco-Pantoja
- School of Medicine, Health Sciences Division, Universidad Anáhuac Mayab, Merida, Yucatan, Mexico
| | - Roberto Lugo
- Regional High Speciality Hospital of the Yucatan Peninsula (HRAEPY), Merida, Yucatan, Mexico
| | - Lizzette Gómez-de-Regil
- Regional High Speciality Hospital of the Yucatan Peninsula (HRAEPY), Merida, Yucatan, Mexico
| | - Rodolfo Chim Aké
- Regional High Speciality Hospital of the Yucatan Peninsula (HRAEPY), Merida, Yucatan, Mexico
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Chen MQ, Shi WR, Wang HY, Li Z, Guo XF, Sun YX. Interaction of General or Central Obesity and Hypertension on Diabetes: Sex-Specific Differences in a Rural Population in Northeast China. Diabetes Metab Syndr Obes 2021; 14:1061-1072. [PMID: 33727839 PMCID: PMC7955680 DOI: 10.2147/dmso.s295960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/26/2021] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Some studies have established an association between hypertension or obesity and the risk of diabetes. This study aimed to examine the interaction of hypertension and obesity on diabetes. PARTICIPANTS AND METHODS The data of 11,731 Chinese men and women were analyzed from the 2012-2013 Northeast China Rural Cardiovascular Health Study. The interaction was examined by both additive and multiplicative scales. General obesity was measured by body mass index (BMI); central obesity was defined by waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR). RESULTS After controlling for potential confounders, the odds ratios for diabetes were 3.864 (3.205-4.660), 4.500 (3.673-5.514), 4.932 (3.888-6.255) and 4.701 (3.817-5.788) for the combinations of hypertension and BMI, WC, WHtR or WHpR, respectively, which had the highest risk of diabetes among the four combinations. Notwithstanding the multiplicative interactions showed statistically significant in all analyses, the results of additive interactions were not consistent, suggesting the diabetes risk from female BMI (relative excess risk due to interaction (RERI): 1.136, 95% CI: 0.127-2.146, attributable proportion due to interaction (AP): 0.267, 95% CI: 0.057-0.477, synergy index (S):1.536, 95% CI: 1.017-2.321) or female WHpR (RERI: 1.076, 95% CI: 0.150-2.002, AP:0.205, 95% CI: 0.037-0.374, S:1.340, 95% CI: 1.012-1.775) was additive to the risk from hypertension. CONCLUSION The findings suggest that high BMI and high WHpR have synergistic interactions with hypertension on the risk of diabetes for females. The results of this study also suggest that BMI and WHpR, rather than WC, should be used for the diagnosis of metabolic syndrome in Chinese population.
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Affiliation(s)
- Meng-Qi Chen
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Wen-Rui Shi
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Hao-Yu Wang
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, People’s Republic of China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xiao-Fan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Ying-Xian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
- Correspondence: Ying-Xian Sun Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing, North Street, Heping District, Shenyang, 110001, People’s Republic of China Email
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Qi J, Hu H, Yaghjyan L, An L, Kalim HA, Cooke EO, Cheng TYD. Association of Adipose Tissue Distribution With Type 2 Diabetes in Breast Cancer Patients. Breast Cancer (Auckl) 2020; 14:1178223420972369. [PMID: 33281450 PMCID: PMC7691945 DOI: 10.1177/1178223420972369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/12/2020] [Indexed: 01/02/2023] Open
Abstract
PURPOSE We examined the association of adipose tissue distribution with type 2 diabetes (T2D) in breast cancer patients. METHODS Participants (N = 238) diagnosed with breast cancer at 20-75 years old who received breast cancer treatment at a major hospital from January 1, 2012, to December 31, 2017, with at least one completed and identifiable abdominal or pelvic computed tomography (CT) scan and data regarding race and ethnicity were included. Thirty-two breast cancer patients were identified as T2D patients after their breast cancer diagnoses. The adipose tissue distribution (visceral fat area [VFA], subcutaneous fat area [SFA], and the ratio of VFA to SFA [VFA/SFA]) was quantified on CT images of the third lumbar vertebra. T2D status was retrieved from patients' electronic medical records. The association of adipose tissue distribution with T2D in women with breast cancer was examined using multivariable logistic regression. RESULTS Participants with T2D had significantly smaller SFA compared to those without T2D (odds ratio [OR] = 0.88, 95% confidence interval [95% CI] = 0.81-0.96, per 10 cm2 SFA). A positive association of VFA/SFA ratio with T2D was observed (OR = 19.57, 95% CI = 3.26-117.42, per unit VFA/SFA), although the estimate was imprecise. CONCLUSIONS The amount of subcutaneous adipose tissue was inversely associated with T2D, and the ratio of the amount of visceral adipose tissue to the amount of subcutaneous adipose tissue was positively associated with T2D in breast cancer patients.
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Affiliation(s)
- Jia Qi
- School of Population and Public Health,
The University of British Columbia, Vancouver, BC, Canada
| | - Hui Hu
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| | - Lusine Yaghjyan
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| | - Lejun An
- Department of Hypertension, Chinese
Medicine Hospital of the Xinjiang University of Medicine, Urumqi, China
| | - Harris A Kalim
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| | - Erinn O Cooke
- Department of Radiology, College of
Medicine, University of Florida, Gainesville, FL, USA
| | - Ting-Yuan David Cheng
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
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Husted KLS, Fogelstrøm M, Hulst P, Brink-Kjær A, Henneberg KÅ, Sorensen HBD, Dela F, Helge JW. A Biological Age Model Designed for Health Promotion Interventions: Protocol for an Interdisciplinary Study for Model Development. JMIR Res Protoc 2020; 9:e19209. [PMID: 33104001 PMCID: PMC7652682 DOI: 10.2196/19209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/16/2020] [Accepted: 09/30/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Actions to improve healthy aging and delay morbidity are crucial, given the global aging population. We believe that biological age estimation can help promote the health of the general population. Biological age reflects the heterogeneity in functional status and vulnerability to disease that chronological age cannot. Thus, biological age assessment is a tool that provides an intuitively meaningful outcome for the general population, and as such, facilitates our understanding of the extent to which lifestyle can increase health span. OBJECTIVE This interdisciplinary study intends to develop a biological age model and explore its usefulness. METHODS The model development comprised three consecutive phases: (1) conducting a cross-sectional study to gather candidate biomarkers from 100 individuals representing normal healthy aging people (the derivation cohort); (2) estimating the biological age using principal component analysis; and (3) testing the clinical use of the model in a validation cohort of overweight adults attending a lifestyle intervention course. RESULTS We completed the data collection and analysis of the cross-sectional study, and the initial results of the principal component analysis are ready. Interpretation and refinement of the model is ongoing. Recruitment to the validation cohort is forthcoming. We expect the results to be published by December 2021. CONCLUSIONS We expect the biological age model to be a useful indicator of disease risk and metabolic risk, and further research should focus on validating the model on a larger scale. TRIAL REGISTRATION ClinicalTrials.gov NCT03680768, https://clinicaltrials.gov/ct2/show/NCT03680768 (Phase 1 study); NCT04279366 https://clinicaltrials.gov/ct2/show/NCT04279366 (Phase 3 study). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19209.
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Affiliation(s)
- Karina Louise Skov Husted
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Physiotherapy and Occupational therapy, University College Copenhagen, Copenhagen, Denmark
| | - Mathilde Fogelstrøm
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hulst
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Brink-Kjær
- Digital Health, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Kaj-Åge Henneberg
- Biomedical Engineering, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Geriatrics, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jørn Wulff Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
The waist-hip ratio, namely waist circumference (WC) divided by hip circumference (HC), has been referred to in thousands of articles, generally as a correlate and predictor either of health conditions such as cardiovascular disease and diabetes, or of amounts of visceral and subcutaneous abdominal fat. It has been argued that combining WC and HC as a ratio is inappropriate, and yet their individual roles can only be fully elucidated if considered jointly. Whereas WC is positively associated with cardiovascular disease, diabetes and premature mortality, the opposite is true of HC. With health-related measures taken as dependent variables, the present novel approach establishes that WC and HC are far better treated as separate independent variables in multiple regression equations than as their ratio. This necessarily produces closer fits to data. One should then allow for variations in height, or some other such measure of general body size, by including this in the regression equations. The widespread concern with the ratio seems to have distracted attention from HC, for this is discussed notably less often than WC. Given that other body parts, such as the thighs, may share relevant properties with the hips, measurements of these could perhaps replace HC.
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Affiliation(s)
- Richard Francis Burton
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Jang BN, Nari F, Kim S, Park EC. Association between relative handgrip strength and prediabetes among South Korean adults. PLoS One 2020; 15:e0240027. [PMID: 33002067 PMCID: PMC7529255 DOI: 10.1371/journal.pone.0240027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/18/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Diabetes is a progressive disease, and thus, it is important to prevent diabetes at the prediabetes stage. Although the loss of muscle strength and prediabetes are associated, few studies have examined relative handgrip strength (RHGS), which can be an indicator of both muscle strength and adiposity. Therefore, our study aimed to examine the association between RHGS and prediabetes (HbA1c level >5.7%) stratified by sex due to sex differences in strength. METHODS We analyzed data from the 2016-2018 Korean National Health and Nutrition Examination Survey. Prediabetes was defined using the HbA1c cut-off level of 5.7-6.4%, identified by the American Diabetes Association. RHGS was calculated as the maximal absolute handgrip strength of both hands divided by body mass index and was divided into sex-specific quartiles. Multiple logistic regression analysis was performed to determine the association between sex-specific RHGS and prediabetes. RESULTS Among the total participants, 13,384 did not have diabetes. In men, the low and mid-low RHGS groups had increased odds of prediabetes (low group, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.10-1.82; mid-low group, OR: 1.32, 95% CI: 1.04-1.67). However, no significant differences were observed between the corresponding female groups. Moreover, central obesity and lower RHGS were strongly associated with prediabetes in men (low group, OR: 2.40, 95% CI: 1.52-3.80; mid-low group, OR: 2.00, 95% CI: 1.26-3.17; mid-high group, OR: 1.76, 95% CI: 1.11-2.81), and a trend was observed (p = 0.0026). CONCLUSION RHGS could be a practical and inexpensive tool for predicting diabetes in men. Programs aimed at preventing diabetes need to include exercise routines for improving muscle strength, and further research through longitudinal studies is required to investigate the causality of RHGS on the risk of prediabetes.
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Affiliation(s)
- Bich Na Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Fatima Nari
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Selin Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Palmeiro-Silva YK, Aravena RI, Ossio L, Parro Fluxa J. Effects of Daily Consumption of an Aqueous Dispersion of Free-Phytosterols Nanoparticles on Individuals with Metabolic Syndrome: A Randomised, Double-Blind, Placebo-Controlled Clinical Trial. Nutrients 2020; 12:nu12082392. [PMID: 32785036 PMCID: PMC7468816 DOI: 10.3390/nu12082392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/16/2022] Open
Abstract
Metabolic syndrome (MS) affects up to 40% of the population and is associated with heart failure, stroke and diabetes. Phytosterols (PS) could help to manage one or more MS criteria. The purpose of this study was to evaluate the therapeutic effect of daily supplementation of an aqueous dispersion of 2 g of free-phytosterols nanoparticles in individuals with MS over six months of intervention, compared with placebo. This double-blind study included 202 participants with MS randomly assigned into phytosterol (n = 102) and placebo (n = 100) groups. Participants were assessed at baseline, 4, 12 and 24 weeks. General health questions, anthropometric measurements and blood parameters were analysed. At week 24, the proportion of participants with high triglycerides (≥150 mg/dL) in the phytosterol group was 15.65% lower than in the placebo group (p-value = 0.023). Similarly, half of the participants in the phytosterol group decreased their waist circumference up to 4 cm compared with 0 cm in the placebo group (p-value = 0.0001). We reported no adverse effects (diarrhoea or vitamin D reduction); nonetheless, almost 70% of participants in the phytosterol group self-reported an improvement in bowel habits. Daily intake of free-PS nanoparticles improved some MS criteria; therefore, it might be a promising adjuvant therapy for individuals with MS (NCT02969720).
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Affiliation(s)
- Yasna K. Palmeiro-Silva
- School of Nursing, Universidad de los Andes, Las Condes 7550000, Chile; (L.O.); (J.P.F.)
- Correspondence: ; Tel./Fax: +56-2-226181332
| | - Raúl I. Aravena
- Department of Chemical Engineering, Imperial College London, London SW7 2BX, UK;
| | - Lisette Ossio
- School of Nursing, Universidad de los Andes, Las Condes 7550000, Chile; (L.O.); (J.P.F.)
| | - Javiera Parro Fluxa
- School of Nursing, Universidad de los Andes, Las Condes 7550000, Chile; (L.O.); (J.P.F.)
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Goodarzi G, Keshavarz SA, Hosseini-Esfahani F, Ataie-Jafari A. Associations between Dietary Diversity Scores and Obesity Phenotypes in Women. NUTRITION AND FOOD SCIENCES RESEARCH 2020. [DOI: 10.29252/nfsr.7.4.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Yu EA, Finkelstein JL, Brannon PM, Bonam W, Russell DG, Glesby MJ, Mehta S. Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. PLoS One 2020; 15:e0233306. [PMID: 32442216 PMCID: PMC7244113 DOI: 10.1371/journal.pone.0233306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/01/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Our study goal was to evaluate a set of nutritional indicators among adults with confirmed or suspected active tuberculosis disease in southern India, given the limited literature on this topic. Study objectives were to assess the: I) double burden of malnutrition at individual and population levels; II) relative performance of anthropometric indicators (body mass index, waist circumference) in diabetes screening; and III) associations between vitamin D and metabolic abnormalities. DESIGN Cross-sectional study. SETTING Hospital in rural southern India. PARTICIPANTS Among adult patients (n = 834), we measured anthropometry, body composition, and biomarkers (vitamin D, glycated hemoglobin, hemoglobin) of nutritional status. Subsets of participants provided blood and sputum samples. RESULTS Among participants, 91.7% had ≥ 1 malnutrition indicator; 34.6% had both undernutrition and overnutrition indicators. Despite the fact that >80% of participants would be considered low-risk in diabetes screening based on low body mass index and waist circumference, approximately one-third had elevated glycated hemoglobin (≥ 5.7%). The lowest quintile of serum 25-hydroxyvitamin D was associated with an increased risk of glycated hemoglobin ≥ 5.7% (adjusted risk ratio 1.61 [95% CI 1.02, 2.56]) compared to the other quintiles, adjusting for age and trunk fat. CONCLUSIONS Malnutrition and diabetes were prevalent in this patient population; since both can predict poor prognosis of active tuberculosis disease, including treatment outcomes and drug resistance, this emphasizes the importance of dual screening and management of under- and overnutrition-related indicators among patients with suspected or active tuberculosis disease. Further studies are needed to determine clinical implications of vitamin D as a potential modifiable risk factor in metabolic abnormalities, and whether population-specific body mass index and waist circumference cut-offs improve diabetes screening.
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Affiliation(s)
- Elaine A. Yu
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
| | - Julia L. Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
| | - Patsy M. Brannon
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
| | - Wesley Bonam
- Arogyavaram Medical Centre, Madanapalle, Andhra Pradesh, India
| | - David G. Russell
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Marshall J. Glesby
- Weill Cornell Medical College, New York, New York, United States of America
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
- Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, New York, United States of America
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Epicardial Adipose Tissue: Clinical Biomarker of Cardio-Metabolic Risk. Int J Mol Sci 2019; 20:ijms20235989. [PMID: 31795098 PMCID: PMC6929015 DOI: 10.3390/ijms20235989] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023] Open
Abstract
Epicardial adipose tissue (EAT) is part of the visceral adipose tissue (VAT) that surrounds the heart and it is a quantifiable, modifiable, and multifaceted tissue that has both local and systemic effects. When EAT is enlarged, EAT contributes to atherosclerotic cardiovascular disease (ASCVD) risk and plays a role in the development of metabolic syndrome (MetS). In this review, we will discuss the role of EAT in various facets of MetS, including type 2 diabetes mellitus (T2DM) and insulin resistance. We examine the association between EAT and liver steatosis. We also address the correlations of EAT with HIV therapy and with psoriasis. We discuss racial differences in baseline EAT thickness. We conclude that EAT measurement serves as a powerful potential diagnostic tool in assessing cardiovascular and metabolic risk. Measurement of EAT is made less costly, more convenient, and yet accurate and reliable by transthoracic echocardiography. Furthermore, modification of EAT thickness has therapeutic implications for ASCVD, T2DM, and MetS.
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Eghan BA, Agyemang-Yeboah F, Togbe E, Annani-Akollor ME, Donkor S, Afranie BO. Waist circumference and hip circumference as potential predictors of visceral fat estimate among type 2 diabetic patients at the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1080/20905068.2019.1658340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Benjamin Ackon Eghan
- Medicine Department, KNUST School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Francis Agyemang-Yeboah
- Department of Molecular Medicine, KNUST School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Eliezer Togbe
- Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, KNUST School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Sampson Donkor
- Department of Molecular Medicine, KNUST School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Bright Oppong Afranie
- Department of Molecular Medicine, KNUST School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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Sebati B, Monyeki K, Kemper HCG, Sekgala MD, Mphekgwana P. Anthropometric indices for predicting cardiovascular risk factors: Ellisras longitudinal study. Am J Hum Biol 2019; 31:e23293. [PMID: 31298782 DOI: 10.1002/ajhb.23293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/14/2019] [Accepted: 06/15/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The aim of the study was to determine which anthropometric indices can best predict the presence of common cardiovascular risk factors among young adults in the rural village of Ellisras in the Limpopo Province, South Africa. METHODS A total of 624 young adults (306 males and 318 females) aged 18 to 29 years took part in this cross-sectional study. Anthropometrics were measured according to the standard procedures. Blood pressure and blood parameters were collected and measured. The stepwise logistic regression was used to determine anthropometric indices that can predict the presence of common cardiovascular risk factors and a receiver-operating characteristic (ROC) curve was plotted to assess discrimination abilities of anthropometric indices for cardiovascular risk factors. RESULTS The waist-to-hip ratio (WHR) in multivariable adjusted models was not found to be associated with cardiovascular risk factors compared to body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). The area below the ROC curve for the abovementioned indices was above 0.62. CONCLUSIONS The central obesity indices, WC and WHtR, are better predictors of dyslipedemia and hypercholesterolemia, whereas BMI was a better predictor of hypertension among young adults living in rural South Africa between the ages of 18 and 29 years.
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Affiliation(s)
- Betty Sebati
- Department of Physiology and Environmental Health, University of Limpopo, South Africa
| | - Kotsedi Monyeki
- Department of Physiology and Environmental Health, University of Limpopo, South Africa
| | | | - Machoene Derrick Sekgala
- Department of Physiology and Environmental Health, University of Limpopo, South Africa.,Social Aspects of Public Health, Human Sciences Research Council, Cape Town, South Africa
| | - Peter Mphekgwana
- Department of Statistics and Operations Research, University of Limpopo, South Africa
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Shahwan MJ, Khattab MH, Jairoun AA. Association of Serum Calcium Level with Waist Circumference and Other Biochemical Health-care Predictors among Patients with Type 2 Diabetes. J Pharm Bioallied Sci 2019; 11:292-298. [PMID: 31555037 PMCID: PMC6662041 DOI: 10.4103/jpbs.jpbs_137_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION This study aimed to find the association of serum calcium level with abdominal obesity according to the waist circumference (WC) and the associated factors. MATERIALS AND METHODS A cross-sectional study was carried out at private health-care center. A total of 291 patients, aged 18 years and above, with type 2 diabetes mellitus who attended the clinic from May 2017 through March 2018 were included. Sociodemographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for the Social Sciences software (SPSS, version 23). Abdominal obesity was defined by WC ≥ 80cm in women and ≥94cm in men. RESULTS A total number of 291 participants participated in the study. Among these participants, 42.6% (n = 124) were male and 57.4% (n = 167) were female. The average age of respondents was 55.99 ± 9.81 years. Among the male participants, 90 (72.6%) (95% confidence interval [CI]: 64.6%-80.5%) were abdominally obese as were 154 participants (92.2%) (95% CI: 88.1%-96.3%) among females. Overall, 244 participants (83.8%) (95% CI: 79.6%-88.1%) were abdominally obese. The results of statistical modeling showed that gender, smoking status, physical activity, and serum calcium are strong determinants of abdominal obesity. CONCLUSION This study revealed a significant association of abdominal obesity and serum calcium level among patients with diabetes.
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Affiliation(s)
- Moyad J Shahwan
- Department of Clinical Sciences, College of Pharmacy, Ajman University, Ajman, United Arab Emirates
| | - Mohammed H Khattab
- Department of Clinical Sciences, College of Pharmacy, Ajman University, Ajman, United Arab Emirates
| | - Ammar A Jairoun
- Consumer Product Safety Section, Public Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
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Wang Y, Shirore RM, Ramakrishnan C, Tan NC, Jafar TH. Adiposity measures and pre‐diabetes or diabetes in adults with hypertension in Singapore polyclinics. J Clin Hypertens (Greenwich) 2019; 21:953-962. [DOI: 10.1111/jch.13587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/25/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Yeli Wang
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
| | - Rupesh M. Shirore
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
| | - Chandrika Ramakrishnan
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
| | - Ngiap Chuan Tan
- Health Services Research Centre SingHealth Singapore Singapore
- SingHealth Polyclinics Singapore Singapore
- SingHealth‐Duke NUS Family Academic Clinical Program Singapore Singapore
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
- Health Services Research Centre SingHealth Singapore Singapore
- Department of Renal Medicine Singapore General Hospital Singapore Singapore
- Duke Global Health Institute Duke University Durham North Carolina
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Luo J, Hendryx M, Laddu D, Phillips LS, Chlebowski R, LeBlanc ES, Allison DB, Nelson DA, Li Y, Rosal MC, Stefanick ML, Manson JE. Racial and Ethnic Differences in Anthropometric Measures as Risk Factors for Diabetes. Diabetes Care 2019; 42:126-133. [PMID: 30352893 PMCID: PMC6463546 DOI: 10.2337/dc18-1413] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/25/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The study objective was to examine the impact of race/ethnicity on associations between anthropometric measures and diabetes risk. RESEARCH DESIGN AND METHODS A total of 136,112 postmenopausal women aged 50-79 years participating in the Women's Health Initiative without baseline cancer or diabetes were followed for 14.6 years. BMI, waist circumference (WC), and waist-to-hip ratio (WHR) were measured in all participants, and a subset of 9,695 had assessment of whole-body fat mass, whole-body percent fat, trunk fat mass, and leg fat mass by DXA. Incident diabetes was assessed via self-report. Multivariate Cox proportional hazards regression models were used to assess associations between anthropometrics and diabetes incidence. RESULTS During follow-up, 18,706 cases of incident diabetes were identified. BMI, WC, and WHR were all positively associated with diabetes risk in each racial and ethnic group. WC had the strongest association with risk of diabetes across all racial and ethnic groups. Compared with non-Hispanic whites, associations with WC were weaker in black women (P < 0.0001) and stronger in Asian women (P < 0.0001). Among women with DXA determinations, black women had a weaker association with whole-body fat (P = 0.02) but a stronger association with trunk-to-leg fat ratio (P = 0.03) compared with white women. CONCLUSIONS In postmenopausal women across all racial/ethnic groups, WC was a better predictor of diabetes risk, especially for Asian women. Better anthropometric measures that reflect trunk-to-leg fat ratio may improve diabetes risk assessment for black women.
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Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Science, University of Illinois at Chicago, Chicago, IL
| | - Lawrence S Phillips
- Atlanta VA Health Care System, Decatur, GA.,Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | | | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Dorothy A Nelson
- Department of Sociology, Anthropology, Social Work, and Criminal Justice, Oakland University, Rochester, MI
| | - Yueyao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Milagros C Rosal
- Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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González-Salinas S, Cruz-Sánchez R, Ferrer-Juárez L, Reyes-Garduño M, Gil-Trejo M, Sánchez-Moguel S. Short-term changes in the mental health of recently enrolled university students. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2019. [DOI: 10.4103/jmhhb.jmhhb_42_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Elsaied MA, Masallat D, Abdel-Hamid IA. Correlation of Adiponectin With Testosterone in Patients With and Without Type 2 Diabetes and Erectile Dysfunction. Am J Mens Health 2019; 13:1557988318807049. [PMID: 30339037 PMCID: PMC6771219 DOI: 10.1177/1557988318807049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the levels of adiponectin in diabetic patients with and without erectile dysfunction (ED). In addition, the correlations of adiponectin with the scores of international index of erectile function (IIEF) and total testosterone levels were explored in diabetic and nondiabetic patients with ED. The study included three groups: Type 2 Diabetic patients (T2DM) with and without ED and a third nondiabetics with ED group, each of 29 patients. Fasting blood glucose (FBG), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR index), testosterone and adiponectin levels were evaluated. IIEF was applied to diabetic and nondiabetic patients with ED. The results showed that adiponectin was lower in diabetic patients with ED than in both nondiabetics with ED and diabetics without ED groups (5.23 ± 1.05 vs. 11.38 ± 10.08 and 6.5 ± 2.13; p = .003 and .006 respectively). Testosterone was lower in diabetic patients with ED than in diabetics without ED group (2.52 ± 1.15 vs. 4.1 ± 1.46; p = .024). Testosterone had a direct correlation with adiponectin ( r = .371; p = .001). Both adiponectin and testosterone levels did not correlate with IIEF. In conclusion, the decreased adiponectin and testosterone are associated with ED in T2DM. Testosterone has a direct correlation with circulating adiponectin while both have no correlation with IIEF.
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Affiliation(s)
- Moustafa A. Elsaied
- Division of Andrology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Doaa Masallat
- Department of Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Salehinia F, Abdi H, Hadaegh F, Serahati S, Valizadeh M, Azizi F, Hosseinpanah F. Abdominal obesity phenotypes and incident diabetes over 12 years of follow-up: The Tehran Lipid and glucose study. Diabetes Res Clin Pract 2018; 144:17-24. [PMID: 30036611 DOI: 10.1016/j.diabres.2018.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/14/2018] [Accepted: 07/17/2018] [Indexed: 12/14/2022]
Abstract
AIMS To investigate future diabetes in different abdominal obesity phenotypes during 12 years of follow-up. METHODS For this population-based cohort, 7982 adults without diabetes including 3533 men and 4449 women, aged ≥20 years were selected from the Tehran Lipid and Glucose Study. Abdominal obesity was defined according to the national cutoffs for waist circumference (WC). Metabolic health was defined as having ≤1 metabolic abnormality based on Joint Interim Statement (JIS) criteria other than WC. Participants were classified into 4 groups of abdominal obesity phenotypes: Metabolically healthy non-abdominal obese (MHNAO), metabolically healthy abdominal obese (MHAO), metabolically unhealthy non-abdominal Obese (MUNAO), and metabolically unhealthy abdominal obese (MUAO). RESULTS In total, 1018 cases of incident diabetes occurred. Compared to the MHNAO phenotype, based on multivariate Cox regression models, diabetes risk was increased in all unhealthy phenotypes except the MUNAO phenotype in men. Regarding the association of the MHAO phenotype with incident diabetes, borderline statistical significance in men [HR 1.5 (95% CI: 1.0-2.36), p-value: 0.07] and statistical significance in women [HR 1.68 (95% CI: 1.08-2.6)] were detected. CONCLUSIONS In addition to unhealthy phenotypes except the MUNAO phenotype in men, the MHAO phenotype is also associated with incident diabetes, highlighting the importance of preventive strategies in this subgroup of abdominally obese subjects.
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Affiliation(s)
- Farahnaz Salehinia
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Devision of Endocrinology, Department of Internal Medicine, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hengameh Abdi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Serahati
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Jafari-Koshki T, Arsang-Jang S, Aminorroaya A, Mansourian M, Amini M. Risk modeling in prospective diabetes studies: Association and predictive value of anthropometrics. Diabetes Metab Syndr 2018; 12:563-567. [PMID: 29650347 DOI: 10.1016/j.dsx.2018.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/26/2018] [Indexed: 11/21/2022]
Abstract
AIMS This study aimed to introduce and apply modern statistical techniques for assessing association and predictive value of risk factors in first-degree relatives (FDR) of patients with diabetes from repeatedly measured diabetes data. METHODS We used data from 1319 FDR's of patients with diabetes followed for 8 years. Association and predictive performance of weight (Wt), body mass index (BMI), waist and hip circumferences (WC and HC) and their ratio (WHR), waist-height ratio (WHtR) and a body shape index (ABSI) in relation to future diabetes were evaluated by using Cox regression and joint longitudinal-survival modeling. RESULTS According to Cox regression, in total sample, WC, HC, Wt, WHtR and BMI had significant direct association with diabetes (all p < 0.01) with the best predictive ability for WHtR (concordance probability estimate = 0.575). Joint modeling suggested direct associations between diabetes and WC, WHR, Wt, WHtR and BMI in total sample (all p < 0.05). According to LPML criterion, WHtR was the best predictor in both total sample and females with LPML of -2666.27 and -2185.67, respectively. However, according to AUC criteria, BMI had the best predictive performance with AUC-JM = 0.7629 and dAUC-JM = 0.5883 in total sample. In females, both AUC criteria indicated that WC was the best predictor followed by WHtR. CONCLUSION WC, WHR, Wt, WHtR and BMI are among candidate anthropometric measures to be monitored in diabetes prevention programs. Larger multi-ethnic and multivariate research are warranted to assess interactions and identify the best predictors in subgroups.
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Affiliation(s)
- Tohid Jafari-Koshki
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahram Arsang-Jang
- Department of Epidemiology and Biostatistics, School of Health, Qom University of Medical Sciences, Qom, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Zafari N, Lotfaliany M, Mansournia MA, Khalili D, Azizi F, Hadaegh F. Optimal cut-points of different anthropometric indices and their joint effect in prediction of type 2 diabetes: results of a cohort study. BMC Public Health 2018; 18:691. [PMID: 29866083 PMCID: PMC5987476 DOI: 10.1186/s12889-018-5611-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 05/25/2018] [Indexed: 01/02/2023] Open
Abstract
Background To determine the anthropometric indices that would predict type 2 diabetes (T2D) and delineate their optimal cut-points. Methods In a cohort study, 7017 Iranian adults, aged 20–60 years, free of T2D at baseline were investigated. Using Cox proportional hazard models, hazard ratios (HRs) for incident T2D per 1 SD change in body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), and hip circumference (HC) were calculated. The area under the receiver operating characteristics (ROC) curves (AUC) was calculated to compare the discriminative power of anthropometric variables for incident T2D. Cut-points of each index were estimated by the maximum value of Youden’s index and fixing the sensitivity at 75%. Using the derived cut-points, joint effects of BMI and other obesity indices on T2D hazard were assessed. Results During a median follow-up of 12 years, 354 men, and 490 women developed T2D. In both sexes, 1 SD increase in anthropometric variables showed significant association with incident T2D, except for HC in multivariate adjusted model in men. In both sexes, WHtR had the highest discriminatory power while HC had the lowest. The derived cut-points for BMI, WC, WHtR, WHR, and HC were 25.56 kg/m2, 89 cm, 0.52, 0.91, and 96 cm in men and 27.12 kg/m2, 87 cm, 0.56, 0.83, and 103 cm in women, respectively. Assessing joint effects of BMI and each of the obesity measures in the prediction of incident T2D showed that among both sexes, combined high values of obesity indices increase the specificity for the price of reduced sensitivity and positive predictive value. Conclusions Our derived cut-points differ between both sexes and are different from other ethnicities. Electronic supplementary material The online version of this article (10.1186/s12889-018-5611-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Neda Zafari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojtaba Lotfaliany
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Non-Communicable Disease Control, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Nazari M, Hashemi Nazari S, Zayeri F, Gholampour Dehaki M, Akbarzadeh Baghban A. Estimating transition probability of different states of type 2 diabetes and its associated factors using Markov model. Prim Care Diabetes 2018; 12:245-253. [PMID: 29396206 DOI: 10.1016/j.pcd.2018.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/30/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022]
Abstract
AIMS Type 2 diabetes is a chronic metabolic disorder and one of the most common non-contagious diseases which is on the rise all over the world. The present study aims to assess the trend of change in fasting blood sugar (FBS) and factors associated with the progression and regression of type 2 diabetes. Moreover, this study estimates transition intensities and transition probabilities among various states using the multi-state Markov model. METHODS In this study Multi-Ethnic Study of Atherosclerosis (MESA) dataset, from a longitudinal study, was used. The study, at the beginning, included 6814 individuals who were followed during the five phases of the study. FBS, serving as the criterion to assess the progression of diabetes, was classified into four states including (a) normal (FBS<100mg/dl), (b) impaired fasting glucose I (IFG I) (100mg/dl<FBS<110mg/dl), (c) impaired fasting glucose II (IFG II) (110mg/dl<FBS<126mg/dl), and (d) diabetes status (FBS>126mg/dl). A continuous-time Markov process was used to describe the evaluation of disease changes over the four states. The model estimated the mean sojourn time for each state. RESULTS Based on the results obtained from fitting the Markov model, the transition probability for a normal individual to remain in the same status over a 10-year period was 0.63, while the probability for a person in the diabetes state was 0.40. The mean sojourn time for the normal and diabetic individuals aged 45-84 years was 6.26 and 5.20 respectively. The covariates of age, race, body mass index (BMI), physical activity, waist-to-hip ratio (WHR) and blood pressure, significantly affected the progression and regression of diabetes. CONCLUSION An increase in physical activity could be the most important factor in the regression of diabetes, while an increase in WHR and BMI could be the most significant factors in progression of the disease.
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Affiliation(s)
- Mahsa Nazari
- Department of Biostatistics, Faculty of Paramedical Sciences, Student Research Committee, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Saeed Hashemi Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farid Zayeri
- Department of Biostatistics and Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehrzad Gholampour Dehaki
- Department of Internal Medicine, School of Medicine, Aja University of Medical Science, Tehran, Iran.
| | - Alireza Akbarzadeh Baghban
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Naccashian Z, Hattar-Pollara M, Ho CA, Ayvazian SP. Prevalence and Predictors of Diabetes Mellitus and Hypertension in Armenian Americans in Los Angeles. DIABETES EDUCATOR 2018; 44:130-143. [PMID: 29490579 DOI: 10.1177/0145721718759981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this study was to describe the prevalence of diabetes mellitus (DM) and hypertension (HTN) along with associated risk factors among Armenian Americans living in Los Angeles. Methods After Institutional Review Board approval, a sample of 877 Armenian Americans was collected for 5 consecutive years (2011-2015) at a health fair. Collected data included: sociodemographic variables; cardiometabolic data, including systolic (SBP) and diastolic (DBP) blood pressure, glucose (Glu), and lipids; anthropometric data, including height (Ht), weight (Wt), body mass index (BMI), waist circumference (WC), and hip circumference (HC). Retrospective descriptive correlation, test of significance, and logistic regression analyses were performed. Results Findings showed that about 50% of the participants had abnormal waist/hip ratio and approximately one-quarter of the subjects had glucose levels that were indicative of high risk for DM. Logistic regression analysis revealed that high SBP ( P = .04), above normal WC ( P = .03), and high triglycerides ( P = .04) were significant in predicting DM. Moreover, age ( P =.0001), family history of cardiovascular disease ( P= .01), and above normal WC ( P = .04) were found to be significant predictors of HTN. Conclusion Waist circumference indicated to be a strong predictor for DM and HTN. Early detection and timely interventions are important to prevent DM and HTN and their associated complications. For an underserved population, health fairs become one effective avenue for screening, referral, and evaluation.
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Affiliation(s)
- Zarmine Naccashian
- Department of Nursing, College of Health and Human Development, California State University Northridge, Northridge, California
| | - Marianne Hattar-Pollara
- Department of Nursing, College of Health and Human Development, California State University Northridge, Northridge, California
| | | | - Sareen Pateel Ayvazian
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California
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Olatunbosun ST, Kaufman JS, Bella AF. Central Obesity in Africans: Anthropometric Assessment of Abdominal Adiposity and its Predictors in Urban Nigerians. J Natl Med Assoc 2018; 110:519-527. [PMID: 30129507 DOI: 10.1016/j.jnma.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/21/2017] [Accepted: 01/01/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the occurrence of central obesity and identify its predictors in urban Africans using anthropometric tools. Another objective was to evaluate the anthropometric indices and their interaction with various cardiovascular risk factors. METHODS In an obesity survey in a major Nigerian city, we measured the prevalence of central obesity in 998 randomly selected men and women using the IDF (International Diabetes Federation) criteria. Normalized values of three anthropometric indices, waist circumference (WC), WHR (waist-to-hip ratio) and WHtR (waist-to-height ratio) were also employed in assessing central adiposity and its predictors in the population. RESULTS Most (61%) female participants had central obesity compared with 9% of the males based on the IDF waist criteria. Higher income level and physical inactivity were associated with central obesity (p < 0.001). In multivariate analyses, older participants and women were more likely to have central obesity (p < 0.001), but men had higher WHR than women at the same body mass index. WC was a stronger predictor of glucose intolerance than WHR, whereas WHR was more predictive of hypertension than WC. WHR showed a strong relationship with hypertension but not with glucose intolerance. WHtR was predictive of plasma glucose and diastolic blood pressure. WC showed strongest correlation with other indices. CONCLUSIONS Central obesity was highly prevalent among women in this sample. It was associated with age, gender, socioeconomic status, physical inactivity, and it predicted glucose intolerance and hypertension. WC was a major determinant of both cardiovascular risk factors. It showed best correlation with other anthropometric indices.
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Affiliation(s)
- Samuel T Olatunbosun
- Endocrinology Department, David Grant Medical Center, Travis AFB, CA 94535, USA; Uniformed Services University of the Health Sciences, USA.
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec H3A 1A2, Canada
| | - Andrew F Bella
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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Han Q, Shao P, Leng J, Zhang C, Li W, Liu G, Zhang Y, Li Y, Li Z, Ren Y, Chan JCN, Yang X. Interactions between general and central obesity in predicting gestational diabetes mellitus in Chinese pregnant women: A prospective population-based study in Tianjin, China. J Diabetes 2018; 10:59-67. [PMID: 28383185 DOI: 10.1111/1753-0407.12558] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/14/2017] [Accepted: 04/02/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The aim of the present study was to define cut-off points of body mass index (BMI) and waist circumference (WC) for gestational diabetes mellitus (GDM) and to investigate any interactions between high BMI and high WC on the risk of GDM in pregnant Chinese women. METHODS From 2010 to 2012, 17 803 women in Tianjin, China, who were at 4-12 weeks gestation were recruited to the study. Gestational diabetes mellitus was diagnosed according to the criteria of the International Association of Diabetes and Pregnancy Study Group at 24-28 weeks gestation. Binary logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) while controlling for the confounding effects of traditional risk factors. Restricted cubic spline was used to identify cut-off points of WC and BMI, if any, for GDM. RESULTS Gestational diabetes mellitus developed in 1383 (7.8%) women. The risk of GDM increased steeply with increasing WC from ≥78.5 cm and BMI ≥22.5 kg/m2 . If BMI <22.5 kg/m2 and WC <78.5 cm were used as the reference, BMI between ≥22.5 and <24.0 kg/m2 (multivariable OR 1.76; 95%CI 1.47-2.10) and WC between ≥78.5 and <85.0 cm (multivariable OR 1.53; 95%CI 1.31-1.78) were independently associated with increased risks of GDM. In addition, the presence of both BMI ≥22.5 kg/m2 and WC ≥78.5 cm further increased the OR to 2.83 (95% CI 2.44-3.28), with significant additive interaction. CONCLUSIONS Body mass index ≥22.5 kg/m2 and WC ≥78.5 cm measured up to 12 weeks of gestation were independently and synergistically associated with increased risks of GDM in Chinese pregnant women.
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Affiliation(s)
- Qian Han
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ping Shao
- Department of Women Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Department of Women Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Cuiping Zhang
- Department of Women Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Wei Li
- Department of Women Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Guifeng Liu
- Nankai District Women and Children's Health Center, Tianjin, China
| | - Yuanyuan Zhang
- Heping District Women and Children's Health Center, Tianjin, China
| | - Yi Li
- Department of Women Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Zhe Li
- Department of Women Health, Tianjin Women and Children's Health Center, Tianjin, China
| | - Yanfeng Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Koppad AK, Kaulgud RS, Arun BS. A Study of Correlation of Neck Circumference with Framingham Risk Score as a Predictor of Coronary Artery Disease. J Clin Diagn Res 2017; 11:OC17-OC20. [PMID: 29207753 DOI: 10.7860/jcdr/2017/25710.10609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 06/09/2017] [Indexed: 12/31/2022]
Abstract
Introduction It has been observed that metabolic syndrome is risk factor for Coronary Artery Disease (CAD) and exerts its effects through fat deposition and vascular aging. CAD has been acknowledged as a leading cause of death. In earlier studies, the metabolic risk has been estimated by Framingham risk score. Recent studies have shown that Neck Circumference (NC) has a good correlation with other traditional anthropometric measurements and can be used as marker of obesity. It also correlates with Framingham risk score, which is slightly more sophisticated measure of CAD risk. Aim To assess the risk of CAD in a subject based on NC and to correlate the NC to Framingham risk score. Materials and Methods The present cross-sectional study, done at Karnataka Institute of Medical Sciences, Hubli, Karnataka, India, includes 100 subjects. The study duration was of one year from 1st January 2015 to 31st December 2015. Anthropometric indices Body Mass Index (BMI) and NC were correlated with 10 year CAD risk as calculated by Framingham risk score. The correlation between BMI, NC, vascular age and Framingham risk score was calculated using Karl Pearson's correlation method. Results NC has a strong correlation with 10 year CAD risk (p≤0.001). NC was significantly greater in males as compared to females (p≤0.001). Males had greater risk of cardiovascular disease as reflected by higher 10 year Framingham risk score (p≤0.0035). Conclusion NC gives simple and easy prediction of CAD risk and is more reliable than traditional risk markers like BMI. NC correlates positively with 10 year Framingham risk score.
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Affiliation(s)
- Anand K Koppad
- Assistant Professor, Department of Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - Ram S Kaulgud
- Assistant Professor, Department of Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - B S Arun
- Assistant Professor, Department of Medicine, MVJ Medical College and Research Hospital, Hoskote, Karnataka, India
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Yoo B, Nam H, Hwang IC, Park Y. Correlation of Cardiovascular Risk Factors with Central Obesity and Multiple Body Mass Index in Korea. Korean J Fam Med 2017; 38:338-345. [PMID: 29209473 PMCID: PMC5711652 DOI: 10.4082/kjfm.2017.38.6.338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 11/07/2022] Open
Abstract
Background Body mass index (BMI) and waist circumference (WC) are associated with cardiovascular (CV) risk factors. The aim of this study was to investigate the correlation of CV risk factors by cross-tabulating central obesity with multiple BMI categories in Korea. Methods A total of 328,789 adults aged 30–84 years who completed health assessments for National Health Insurance in 2012–2013 in Korea were examined. The participants were divided into two WC and five BMI groups to investigate CV risk factors, including metabolic syndrome (MetS), hypertension, diabetes, and dyslipidemia. Results The proportions of central obesity and obesity were 24.2% and 39.5% in men and 19.4% and 28.1% in women, respectively, according to the Korean Society for the Study of Obesity and World Health Organization Asia-Pacific Guideline criteria. The odds ratios (ORs) of CV risk factors in all sexes increased with increases in BMI and WC. Compared to the group with a normal WC and BMI, the adjusted ORs (95% confidence intervals) for having MetS and diabetes in the centrally obese and highest BMI group (BMI ≥30.0 kg/m2) were 35.95 (33.75–38.30) and 3.51 (3.26–3.77) in men and 29.22 (27.36–31.20) and 4.35 (4.02–4.70) in women, respectively. Participants who were centrally obese and obese (BMI ≥25.0 kg/m2) had the strongest correlation with all CV risk factors compared with those who were not centrally obese or obese. Conclusion The presence of central obesity in multiple BMI categories may significantly identify individuals at increased risk of CV risk factors.
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Affiliation(s)
- Bora Yoo
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hosuk Nam
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Youngmin Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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Abstract
PURPOSE OF REVIEW The worldwide prevalence of obesity is increasing. Obesity is strongly associated with many chronic health conditions that have been shown to improve with weight loss. However, counseling patients on weight loss can be challenging. Identifying specific aspects of weight management may personalize the conversation about weight loss and better address the individual patient's health goals and perceived barriers to change. RECENT FINDINGS Physical and behavioral phenotypes are being identified to better tailor treatment recommendations, given lack of efficacy of currently available interventions. The current review provides a summary of the evidence behind the management of several recognized clinical phenotypes, to include body fat distribution (e.g., central obesity), muscle mass (e.g., sarcopenic obesity of the elderly), and problematic eating behaviors (e.g., cravings). Identifying specific aspects of weight management may personalize the conversation about weight loss and better address the individual patient's health goals and perceived barriers to change.
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Affiliation(s)
- Meera Shah
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Ryan T Hurt
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA
| | - Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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