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Hoteit M, Dagher M, Tzenios N, Al Kaaki N, Rkein G, Chahine AR, Sacre Y, Hotayt S, Matar R, Hallal M, Maitar M, Hotayt B. Influence of Sugar-Sweetened Beverages Intake on Sarcopenic Obesity, Visceral Obesity, and Sarcopenia in Lebanese Patients with MASLD: A Case-Control Study. Healthcare (Basel) 2024; 12:591. [PMID: 38470703 PMCID: PMC10931226 DOI: 10.3390/healthcare12050591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic liver diseases are a major global health concern. AIMS this study investigated the links between medical, clinical, anthropometric, and dietary factors with dysfunction-associated steatotic liver disease (MASLD) in the Lebanese population using a case-control approach to uncover factors influencing visceral obesity, sarcopenia, and sarcopenic obesity. METHODS AND MATERIALS a total of 120 participants (20-70 years old) were divided into case and control groups based on liver disease diagnosis. Patient information was gathered through a questionnaire encompassing demographics, medical history, and beverage consumption. Anthropometric and body composition data were collected in a clinical setting. RESULTS our findings indicated a clear association between the presence of MASLD and obesity, hypertension, and diabetes. The positive association with higher body mass index and all three conditions remained consistent even when data was stratified by case and control groups. A greater proportion of MASLD patients exhibited sarcopenic obesity. Furthermore, MASLD cases showed higher consumption of sugary beverages and a reduced intake of milk and water in their diets. CONCLUSIONS this study shed light on the health attributes and diets of the Lebanese population with liver diseases and suggested more research in this area and in a more ethnically diverse population.
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Affiliation(s)
- Maha Hoteit
- Food Science Unit, National Council for Scientific Research-Lebanon (CNRS-Lebanon), Beirut P.O. Box 11-8281, Lebanon
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 14-6573, Lebanon; (N.A.K.); (G.R.)
| | - Myriam Dagher
- Faculty of Health Sciences, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon;
| | - Nikolaos Tzenios
- Faculty of Public Health, Charisma University, London EC1V 7QE, UK;
| | - Najat Al Kaaki
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 14-6573, Lebanon; (N.A.K.); (G.R.)
| | - Ghadir Rkein
- Faculty of Public Health, Lebanese University, Beirut P.O. Box 14-6573, Lebanon; (N.A.K.); (G.R.)
| | | | - Yonna Sacre
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Samer Hotayt
- Anesthesia Department, Saint Joseph Hospital, 75014 Paris, France;
| | - Rami Matar
- School of Medicine, St. George’s University, West Indies FZ818, Grenada;
| | - Mahmoud Hallal
- Gastroenterology Department, Faculty of Medical Science, Lebanese University, Beirut P.O. Box 14-6573, Lebanon;
- Gastroenterology and Hepatology Department, Zahraa University Medical Center (ZHUMC), Beirut P.O. Box 90-361, Lebanon
| | - Micheal Maitar
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Southern Illinois University, Springfield, IL 62901, USA;
| | - Bilal Hotayt
- Gastroenterology Department, Sahel General Hospital, Beirut P.O. Box 90-1603, Lebanon
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Skouloudi M, Bonou MS, Adamantou M, Parastatidou D, Kapelios C, Masoura K, Efstathopoulos E, Aggeli C, Papatheodoridis GV, Barbetseas J, Cholongitas E. Left atrial strain and ventricular global longitudinal strain in cirrhotic patients using the new criteria of Cirrhotic Cardiomyopathy Consortium. Liver Int 2023; 43:2727-2742. [PMID: 37641813 DOI: 10.1111/liv.15714] [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: 05/09/2023] [Revised: 07/13/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The new criteria of Cirrhotic Cardiomyopathy Consortium (CCC) propose the use of left ventricular global longitudinal strain (LV-GLS) for evaluation of systolic function in patients with cirrhosis. The aim of this study was to evaluate LV-GLS and left atrial (LA) strain in association with the severity of liver disease and to assess the characteristics of cirrhotic cardiomyopathy (CCM). METHODS One hundred and thirty-five cirrhotic patients were included. Standard echocardiography and speckle tracking echocardiography (2D-STE) were performed, and dual X-ray absorptiometry was used to quantify the total and regional fat mass. CCM was defined, based on the criteria of CCC, as having advanced diastolic dysfunction, left ventricular ejection fraction ≤50% and/or a GLS <18%. RESULTS LV-GLS lower or higher than the absolute mean value (22.7%) was not associated with mortality (logrank, p = 0.96). LV-GLS was higher in patients with Model for end stage liver disease (MELD) score ≥15 compared to MELD score <15 (p = 0.004). MELD score was the only factor independently associated with systolic function (LV-GLS <22.7% vs. ≥22.7%) (Odds Ratio:1.141, p = 0.032). Patients with CCM (n = 11) had higher values of estimated volume of visceral adipose tissue compared with patients without CCM (median: 735 vs. 641 cm3 , p = 0.039). On multivariable Cox regression analysis, MELD score [Hazard Ratio (HR):1.26, p < 0.001] and LA reservoir strain (HR:0.96, p = 0.017) were the only factors independently associated with the outcome. CONCLUSION In our study, absolute LV-GLS was higher in more severe liver disease, and LA reservoir strain was significantly associated with the outcome in patients with end-stage liver disease.
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Affiliation(s)
- Marina Skouloudi
- Department of Cardiology, General Hospital of Athens "Laiko", Athens, Greece
| | - Maria S Bonou
- Department of Cardiology, General Hospital of Athens "Laiko", Athens, Greece
| | - Magdalini Adamantou
- First Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | - Despoina Parastatidou
- Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | - Christos Kapelios
- Department of Cardiology, General Hospital of Athens "Laiko", Athens, Greece
| | - Konstantina Masoura
- Department of Cardiology, General Hospital of Athens "Laiko", Athens, Greece
| | - Efstathios Efstathopoulos
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantina Aggeli
- First Department of Cardiology, General Hospital of Athens "Hippokration", National and Kapodistrian University Athens School of Medicine, Athens, Greece
| | - George V Papatheodoridis
- Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | - John Barbetseas
- Department of Cardiology, General Hospital of Athens "Laiko", Athens, Greece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
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Staiano AE, Katzmarzyk PT. Visceral, subcutaneous, and total fat mass accumulation in a prospective cohort of adolescents. Am J Clin Nutr 2022; 116:780-785. [PMID: 35544287 PMCID: PMC9437989 DOI: 10.1093/ajcn/nqac129] [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] [Received: 11/03/2021] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Race and sex differences in adolescents' body fat are demonstrated in cross-sectional cohorts, yet a longitudinal design would better identify patterns of fat distribution over time. OBJECTIVES The aim was to examine race and sex differences in adiposity between black and white adolescents over 2 y. METHODS A cohort of adolescents aged 10-16 y (38% black; 52% girls; 15% overweight, 34% with obesity) underwent body composition measurements at baseline (n = 309) and 2 y later (n = 236), using DXA to quantify whole-body fat mass (FM) and MRI for abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) volumes. General linear models were used to examine race and sex differences in log-transformed FM, SAT, and VAT, adjusting for age, sexual maturation, extended BMI percentile, and race-by-sex interaction. SAT and VAT models in addition controlled for baseline FM and change in FM (for change models). RESULTS Mean (95% CI) baseline FM (kg) was higher among white [18.5 (17.9, 19.2) than among black adolescents [17.4 (16.6, 18.2), P = 0.03] and girls [19.5 (18.8, 20.3) than boys [16.5 (15.8, 17.2), P < 0.0001]. Mean (95% CI) baseline SAT (L) was higher among girls [4.4 (4.2, 4.6)] than among boys [3.9 (3.7, 4.1), P < 0.0001]. Mean (95% CI) baseline VAT (L) was higher among white [0.5 (0.5, 0.6)] than among black [0.3 (0.3, 0.4)] adolescents (P < 0.0001) and boys [0.5 (0.4, 0.5)] than girls [0.4 (0.4, 0.4), P = 0.04]. Over 2 y mean (95% CI) FM change (kg) was higher among white [3.7 (2.9, 4.5)] than among black adolescents [2.3 (1.3, 3.3), P = 0.04] and girls [4.0 (3.0, 4.9)] than boys [2.0 (1.1, 3.0), P = 0.007], but SAT change (L) did not differ by race or sex. VAT change (L) was higher among white [0.1 (0.1, 0.1)] than among black adolescents [0.0 (0.0, 0.1), P = 0.003] and boys [0.1 (0.1, 0.1)] than girls [0.0 (0.0, 0.1), P = 0.034]. CONCLUSIONS Sex and race differences in the deposition and accumulation of excess fat are important considerations for understanding obesity prevalence and obesity-related disease risk among adolescents.This trial was registered at clinicaltrials.gov as NCT02784509.
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Kahaer M, Zhang B, Chen W, Liang M, He Y, Chen M, Li R, Tian T, Hu C, Sun Y. Triglyceride Glucose Index Is More Closely Related to Hyperuricemia Than Obesity Indices in the Medical Checkup Population in Xinjiang, China. Front Endocrinol (Lausanne) 2022; 13:861760. [PMID: 35311243 PMCID: PMC8924289 DOI: 10.3389/fendo.2022.861760] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/09/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Hyperuricemia (HUA) is a metabolic anomaly with an increased incidence rate, causing a global medical burden. Several studies have confirmed that obesity and insulin resistance (IR) are the risk factors for HUA. Reports on the predictive power of different obesity indices for HUA are limited. This study aimed to compare the association between different general, abdominal, and visceral obesity indices and markers of the IR-triglyceride glucose (TyG) index with serum uric acid (SUA) and to assess the ability of these indices to predict HUA. METHODS A total of 2243 participants were recruited from Barkol County Hospital and surrounding township hospitals in Xinjiang. Obesity indices, including the atherogenic index of plasma, cardiometabolic index, visceral adiposity index, lipid accumulation product index, a body shape index, body roundness index, waist circumference, waist-to-height ratio, body mass index, and TyG index, were divided into four quartiles. Moreover, partial correlations and logistic regression were used to analyze the association between these indices and SUA. The area under the curve (AUC) and receiver operating characteristic curves were used to analyze the predictive value of these indices for HUA. RESULTS After controlling for confounding variables, the association between the TyG index and HUA was stronger than that between the obesity indices in both males and females. The odds ratios (ORs) for HUA in the highest quartile of the TyG index were 2.098 (95% confidence interval, 1.555-2.831) in males and 7.788 (95% CI, 3.581-16.937) in females. For males, the AIP, CMI, VAI, LAP index, and TyG index were able to discriminate HUA, and the TyG index showed the highest AUC value of 0.586 (95% CI, 0.557-0.614; P < 0.001). For females, all indices, except BMI, can discriminate HUA. Moreover, the visceral obesity index CMI showed the highest AUC value of 0.737 (95% CI, 0.691-0.782; P < 0.001). Meanwhile, the TyG index had a relatively high AUC value of 0.728 (95% CI, 0.682-0.773; P < 0.001). CONCLUSION The TyG index was significantly related to HUA and was superior to obesity indices in identifying HUA in the medical checkup population in Xinjiang, China.
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Affiliation(s)
- Mayina Kahaer
- School of Public Health, Xinjiang Medical University, Urumqi, China
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Bei Zhang
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Wujin Chen
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Meiting Liang
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Yi He
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Miao Chen
- Department of Rheumatology and Immunology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Rui Li
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Tingting Tian
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Cheng Hu
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Department of Endocrinology and Metabolism, Fengxian Central Hospital Affiliated to the Southern Medical University, Shanghai, China
- *Correspondence: Yuping Sun, ; Cheng Hu,
| | - Yuping Sun
- Department of Microbiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
- *Correspondence: Yuping Sun, ; Cheng Hu,
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Sex differences in white adipose tissue expansion: emerging molecular mechanisms. Clin Sci (Lond) 2021; 135:2691-2708. [PMID: 34908104 DOI: 10.1042/cs20210086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022]
Abstract
The escalating prevalence of individuals becoming overweight and obese is a rapidly rising global health problem, placing an enormous burden on health and economic systems worldwide. Whilst obesity has well described lifestyle drivers, there is also a significant and poorly understood component that is regulated by genetics. Furthermore, there is clear evidence for sexual dimorphism in obesity, where overall risk, degree, subtype and potential complications arising from obesity all differ between males and females. The molecular mechanisms that dictate these sex differences remain mostly uncharacterised. Many studies have demonstrated that this dimorphism is unable to be solely explained by changes in hormones and their nuclear receptors alone, and instead manifests from coordinated and highly regulated gene networks, both during development and throughout life. As we acquire more knowledge in this area from approaches such as large-scale genomic association studies, the more we appreciate the true complexity and heterogeneity of obesity. Nevertheless, over the past two decades, researchers have made enormous progress in this field, and some consistent and robust mechanisms continue to be established. In this review, we will discuss some of the proposed mechanisms underlying sexual dimorphism in obesity, and discuss some of the key regulators that influence this phenomenon.
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Kim C, Harrall KK, Glueck DH, Dabelea D. Sex steroids and adiposity in a prospective observational cohort of youth. Obes Sci Pract 2021; 7:432-440. [PMID: 34401201 PMCID: PMC8346372 DOI: 10.1002/osp4.510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Adiposity, particularly visceral adipose tissue (VAT), predicts adverse cardiovascular risk factor profiles in children as well as adults. Although endogenous sex steroids likely influence VAT in adults, such an association has not been established in youth. The association between childhood and adolescent sex steroids with adiposity, specifically VAT, was examined before and after adjustment for other hormone changes. METHODS These analyses examined longitudinal associations between sex steroids (testosterone, estradiol, dehydroepiandrosterone [DHEA]) and magnetic resonance imaging assessments of VAT in 418 children, 49% of whom were non-White, at approximately 10 years old at Visit 1 (V1) and 17 years old at Visit 2 (V2). Linear mixed effects models adjusted for maternal education, household income, child caloric intake, physical activity, fasting insulin and leptin, and hepatic fat fraction. Differences in associations by race and pubertal stage were also assessed. RESULTS At V1, mean body mass index (BMI) for boys was 19.1 (4.7) kg/m2 and for girls was 18.5 (4.1) kg/m2. At V2, mean BMI for boys was 23.7 (5.5) kg/m2 and for girls was 23.6 (5.7) kg/m2. For each ng/dl (0.035 nmol/L) increase in testosterone at V1, there was a 0.25 cm2 increase in concurrent and future VAT in non-White (p = 0.04) but not White girls (p = 0.78). Higher levels of testosterone and DHEA at V1 were associated with greater concurrent and future VAT at V2. These associations were consistent regardless of pubertal stage. In boys, higher testosterone predicted higher future VAT but lower concurrent VAT. Estradiol and DHEA did not predict future VAT in boys. In girls, DHEA predicted future subcutaneous adipose tissue (SAT), and no sex steroids predicted future SAT in boys. CONCLUSIONS Testosterone levels predict VAT in boys and girls, and DHEA predicts VAT in girls, even after adjustment for other hormone changes.
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Affiliation(s)
- Catherine Kim
- Departments of Medicine, Obstetrics & Gynecology, and EpidemiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Kylie K. Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) CenterUniversity of Colorado DenverAuroraColoradoUSA
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) CenterUniversity of Colorado DenverAuroraColoradoUSA
- Department of PediatricsUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) CenterUniversity of Colorado DenverAuroraColoradoUSA
- Department of PediatricsUniversity of Colorado School of MedicineAuroraColoradoUSA
- Department of EpidemiologyUniversity of ColoradoAuroraColoradoUSA
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Ahadi M, Molooghi K, Masoudifar N, Namdar AB, Vossoughinia H, Farzanehfar M. A review of non-alcoholic fatty liver disease in non-obese and lean individuals. J Gastroenterol Hepatol 2021; 36:1497-1507. [PMID: 33217052 DOI: 10.1111/jgh.15353] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of hepatic disorders. It represents a wide range of chronic liver diseases in patients with no history of significant alcohol consumption, starting with simple steatosis and progressing towards non-alcoholic steatohepatitis, cirrhosis, and ultimately hepatocellular carcinoma. NAFLD is usually associated with type 2 diabetes mellitus, dyslipidemia, metabolic syndrome, and obesity. This disease has mostly been studied in obese individuals; however, it has been widely reported and studied among the lean/non-obese population in recent years. The pathogenesis of NAFLD in non-obese patients is associated with various genetic predispositions, particularly a patatin-like phospholipase domain-containing protein 3 G allele polymorphism, which results in the accumulation of triglyceride in the liver and resistance to insulin. Additionally, dietary factors such as high fructose consumption seem to play a substantial role in the pathology of non-obese NAFLD. Although there is not enough evidence on the treatment of NAFLD in non-obese patients, the standard approach is to advise altering one's lifestyle in order to diminish visceral adiposity. Dietary modification, weight loss, and increased physical activity are highly recommended. We aimed to review and summarize the existing information on the prevalence, pathogenesis, genetic predispositions, diagnosis, and treatment of NAFLD in non-obese patients according to the latest literature.
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Affiliation(s)
- Mitra Ahadi
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kasra Molooghi
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Masoudifar
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Beheshti Namdar
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Vossoughinia
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadreza Farzanehfar
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
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Chen Y, Wang N, Dong X, Wang X, Zhu J, Chen Y, Jiang Q, Fu C. Underweight rather than adiposity is an important predictor of death in rural Chinese adults: a cohort study. J Epidemiol Community Health 2021; 75:1123-1128. [PMID: 33879539 DOI: 10.1136/jech-2020-214821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 02/23/2021] [Accepted: 04/06/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND To assess the associations of body mass index (BMI) with all-cause and cause-specific mortalities among rural Chinese. METHODS A prospective study of 28 895 individuals was conducted from 2006 to 2014 in rural Deqing, China. Height and weight were measured. The association of BMI with mortality was assessed by using Cox proportional hazards model and restricted cubic spline regression. RESULTS There were a total of 2062 deaths during an average follow-up of 7 years. As compared with those with BMI of 22.0-24.9 kg/m2, an increased risk of all-cause mortality was found for both underweight men (BMI <18.5 kg/m2) (adjusted HR (aHR): 1.45, 95% CI: 1.18 to 1.79) and low normal weight men (BMI of 18.5-21.9 kg/m2) (aHR: 1.20, 95% CI: 1.03 to 1.38). A J-shaped association was observed between BMI and all-cause mortality in men. Underweight also had an increased risk of cardiovascular disease and cancer mortalities in men. The association of underweight with all-cause mortality was more pronounced in ever smokers and older men (60+ years). The results remained after excluding participants who were followed up less than 1 year. CONCLUSION The present study suggests that underweight is an important predictor of mortality, especially for elderly men in the rural community of China.
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Affiliation(s)
- Yun Chen
- School of Public Health,NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Na Wang
- School of Public Health,NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Xiaolian Dong
- Department of Office, Deqing County Center for Disease Control and Prevention, Deqing, China
| | - Xuecai Wang
- Department of Office, Deqing County Center for Disease Control and Prevention, Deqing, China
| | - Jianfu Zhu
- Department of Office, Deqing County Center for Disease Control and Prevention, Deqing, China
| | - Yue Chen
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Qingwu Jiang
- School of Public Health,NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Chaowei Fu
- School of Public Health,NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
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Wong WK, Chan WK. Nonalcoholic Fatty Liver Disease: A Global Perspective. Clin Ther 2021; 43:473-499. [PMID: 33526312 DOI: 10.1016/j.clinthera.2021.01.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022]
Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing over the years and is now as high in Asia as in the Western world, so much so that it should no longer be considered a Western disease. In fact, China is expected to have the largest increase in the number of NAFLD cases in the coming years. The increase in prevalence of NAFLD in Asia lags behind that of the Western world; thus, there will be a lag in more severe liver disease in Asia despite a similar prevalence of the disease. NAFLD is more prevalent among patients with diabetes mellitus, which is also an important risk factor for more severe liver disease. Patients with diabetes mellitus thus represent an important target for screening for NAFLD and more severe liver disease. Although the PNPLA3 gene polymorphism is the most studied in NAFLD, it is increasingly clear that the cumulative effect of multiple genes likely predisposes to NAFLD and more severe liver disease in the different ethnic groups, and polygenic risk scores are emerging. Lean NAFLD has been largely reported in Asia but is increasingly recognized worldwide. Multiple risk factors have been identified for the disease that manifests in metabolically unhealthy normal weight individuals; however, it responds to lifestyle intervention, similar to the disease in obese individuals. Lastly, the newer term "metabolic dysfunction-associated fatty liver disease" provides a more accurate reflection of the disease, giving more focus to clinicians and researchers in tackling this increasingly common and challenging disease.
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Affiliation(s)
- Wei-Kei Wong
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Zhang X, Ding Y, Shao Y, He J, Ma J, Guo H, Keerman M, Liu J, Si H, Guo S, Ma R. Visceral Obesity-Related Indices in the Identification of Individuals with Metabolic Syndrome Among Different Ethnicities in Xinjiang, China. Diabetes Metab Syndr Obes 2021; 14:1609-1620. [PMID: 33889002 PMCID: PMC8055644 DOI: 10.2147/dmso.s306908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/20/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Few studies have focused on the predictive ability of visceral obesity-related indices for metabolic syndrome (MetS), especially in different ethnic groups. This study aimed to evaluate the applicability of visceral obesity-related indices for MetS screening among three major ethnic groups living in remote rural areas of Xinjiang. METHODS Based on multistage stratified cluster random sampling method, 3,192 Uyghurs, 3,054 Kazakhs, and 3,658 Hans were recruited from Xinjiang, China. The Joint Interim Statement (JIS) criteria were used to define MetS. The receiver operating characteristic curve (ROC), area under the ROC curve (AUC), and predictive value of each visceral obesity-related index were used to evaluate the predictive ability of MetS. RESULTS After adjusting for potential confounding factors, the lipid accumulation product (LAP), Chinese visceral adiposity index (CVAI), waist-to-height ratio (WHtR), and atherogenic index of plasma (AIP) were significantly correlated with MetS for each ethnic group, and the odds ratios (ORs) for MetS increased across quartiles. LAP was best able to identify MetS status in Kazakhs (AUC=0.853) and Uyghurs (AUC=0.851), with optimal cut-offs being 36.3 and 28.2, respectively. Both LAP (AUC=0.798) and CVAI (AUC=0.791) most accurately identified MetS status in Hans, with the optimal cut-offs being 27.3 and 85.0, respectively. Moreover, the AUC of the combination of these visceral obesity-related indices is higher for each ethnic group. However, compared with LAP, the improved value of combined screening was not significant. CONCLUSION LAP had the best discriminative capability for the screening of MetS among Kazakhs, Uyghurs, and Hans. The screening ability of CVAI for MetS was similar to that of LAP in Hans. Thus, LAP may be a complementary indicator for assessing MetS in various ethnic groups.
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Affiliation(s)
- Xianghui Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Yusong Ding
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Yinbao Shao
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Jiaolong Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Heng Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Mulatibieke Keerman
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Jiaming Liu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Huili Si
- Department of Neurology, Shihezi People’s Hospital, Shihezi, Xinjiang, People’s Republic of China
| | - Shuxia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
- Department of Pathology and Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
- Correspondence: Shuxia Guo Department of Public Health, Shihezi University School of Medicine, Suite 721, Building No. 1, Beier Road, Shihezi, 832000, Xinjiang, People’s Republic of ChinaTel +86 1800-9932-625Fax +86 993-2057-153 Email
| | - Rulin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
- Rulin Ma Department of Public Health, Shihezi University School of Medicine, Suite 816, Building No. 1, Beier Road, Shihezi, 832000, Xinjiang, People’s Republic of ChinaTel +86 1330-9930-561Fax +86 993-2057-153Email
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Increase in visceral adipose tissue and subcutaneous adipose tissue thickness in children with acute pancreatitis. A case-control study. Arch Pediatr 2020; 28:29-32. [PMID: 33309120 DOI: 10.1016/j.arcped.2020.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/18/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
AIM The aim of this study was to investigate the relationship between the development of acute pancreatitis in children and their body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) thickness. METHOD This was a case-control study carried out in a tertiary hospital between October and November 2019. The diagnosis of acute pancreatitis was based on the presence of at least two of three criteria of the International Study Group of Pediatric Pancreatitis (INSPPIRE) guidelines. AC, VAT, and SAT measurements of patients and controls were performed by using a three-dimensional workstation (Aquarius 3D Workstation, TeraRecon Inc., San Mateo, Calif., USA) through cross sections of the L2 vertebra level after examining previous abdominal computerized tomography (CT) records. RESULTS A total of 25 patients diagnosed with acute and acute recurrent pancreatitis who underwent abdominal CT were included in the study and 38 healthy, sex- and age-matched children formed the control group. There were no differences between the patients and healthy children in terms of age, sex and BMI-for-age z-scores. Besides, measurements of WC, SAT, and VAT thickness were found to be higher in the patient group (P=0.007, P=0.021, P=0.016, respectively). CONCLUSION In this study, WC, VAT, and SAT were found to be thicker in children with acute pancreatitis compared with healthy children without any difference in BMI. Further studies are needed to clarify whether adipose tissue thickness is an etiological cause or a secondary finding in patients with acute pancreatitis.
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Chrysavgis L, Ztriva E, Protopapas A, Tziomalos K, Cholongitas E. Nonalcoholic fatty liver disease in lean subjects: Prognosis, outcomes and management. World J Gastroenterol 2020; 26:6514-6528. [PMID: 33268944 PMCID: PMC7673972 DOI: 10.3748/wjg.v26.i42.6514] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/24/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) accounts for most cases of chronic liver disease worldwide, with an estimated global prevalence of approximately 25% and ranges from simple steatosis to nonalcoholic steatohepatitis and cirrhosis. NAFLD is strongly connected to metabolic syndrome, and for many years, fatty liver was considered to be an exclusive feature of obese patients. However, recent studies have highlighted the presence of NAFLD in non-obese subjects, with or without increased visceral fat or even in lean subjects without increased waist circumference. “Lean NAFLD” is a relatively new concept and there is significant scientific interest in understanding the differences in pathophysiology, prognosis and management compared with NAFLD in overweight/obese patients. In the present editorial, we discuss the clinical and metabolic profiles and outcomes of lean NAFLD compared with both obese NAFLD and lean healthy individuals from Asian and Western countries. Moreover, we shed light to the challenging topic of management of NAFLD in lean subjects since there are no specific guidelines for this population. Finally, we discuss open questions and issues to be addressed in the future in order to categorize NAFLD patients into lean and non-lean cohorts.
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Affiliation(s)
- Lampros Chrysavgis
- First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens 11527, Greece
| | - Eleftheria Ztriva
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece
| | - Adonis Protopapas
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens 11527, Greece
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13
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Relative fat mass at baseline and its early change may be a predictor of incident nonalcoholic fatty liver disease. Sci Rep 2020; 10:17491. [PMID: 33060775 PMCID: PMC7567080 DOI: 10.1038/s41598-020-74659-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023] Open
Abstract
The relationship between changes in body components and the risk of nonalcoholic fatty liver disease (NAFLD) is not fully understood. We investigated the effects of body components and subsequent changes on incident NAFLD at follow-up ultrasound scanning in a longitudinal cohort. We included 9967 participants without NAFLD at baseline who underwent serial health examinations. Sex-specific, weight-adjusted skeletal muscle index (SMI_Wt) was used. Mean follow-up duration was 48.5 ± 33.5 months. NAFLD developed in 2395 participants (24.0%). Body composition was measured using bioelectrical impedance analysis. The following baseline body components were significantly associated with incident NAFLD: the lowest and middle SMI_Wt tertiles in the normal-weight group (adjusted hazard ratio [aHR] = 2.20 and 1.54, respectively), and fat percentage in the normal-weight (aHR = 1.12), overweight (aHR = 1.05), and obese groups (aHR = 1.03) (all P < 0.05). Among 5,033 participants who underwent ≥ 3 health examinations, SMI_Wt increase between the first and second examinations was an independent protective factor against incident NAFLD in non-obese groups (P < 0.05). Increased fat percentage was an independent risk factor for incident NAFLD in all weight categories (P < 0.05). High fat mass at baseline may be a better predictor of incident NAFLD than muscle mass. Reciprocal changes in fat and muscle mass during the first year of follow-up predicted incident NAFLD in non-obese groups.
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14
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Leskinen T, Eloranta AM, Tompuri T, Saari A, Ollila H, Mäkelä J, Niinikoski H, Lagström H. Changes in body composition by age and obesity status in preschool-aged children: the STEPS study. Eur J Clin Nutr 2020; 75:57-65. [PMID: 32647366 DOI: 10.1038/s41430-020-0678-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/02/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Obesity in early childhood is associated with increased risk of chronic diseases, but studies of body composition at preschool ages are sparse. Therefore, we examined differences in body composition by sex and obesity status in Finnish preschool-aged children and within-individual changes in body composition in normal and overweight children. SUBJECT/METHODS Body composition was measured using segmental multifrequency bioimpedance analysis (BIA) in 476 children and in 781 children at age 3 and 5 years, respectively. Of those, 308 had repeated BIA measurements at both ages. BMI-SDS was used for classification of normal weight and overweight children. RESULTS Sex difference in the amount of lean mass (LM) was already seen at 3 years of age (boys 11.7 kg, girls 11.3 kg; p < 0.001). At 5 years of age, boys had lower fat mass (FM; 3.6 kg vs. 3.9 kg, p < 0.001), lower percent fat mass (%FM; 17.2% vs. 19.1%; p < 0.001), and higher LM (16.0 kg vs. 15.2 kg; p < 0.001) than girls. Overweight children had higher values in FM, %FM, and LM compared with normal weight peers at both ages. Among normal weight children, the increase of LM by age was associated with only minor changes in FM, whereas children who were or became overweight both LM and FM was substantially increased between 3 and 5 years of age. CONCLUSIONS BIA-assessed body composition differs by sex and obesity status already at age of 3 years. For children who are or become overweight at very young age, the patterns for the changes in LM and FM by age are different than for normal weight children.
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Affiliation(s)
- Tuija Leskinen
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Aino-Maija Eloranta
- Institute on Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Tompuri
- Institute on Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Antti Saari
- Department of Pediatrics, Kuopio University Hospital, and University of Eastern Finland, Kuopio, Finland
| | - Helena Ollila
- Department of Biostatistics, Faculty of Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Johanna Mäkelä
- Finnish Clinical Biobank Tampere, Pirkanmaa Hospital District and Tampere University Hospital, Tampere, Finland
| | - Harri Niinikoski
- Department of Pediatrics and Physiology, University of Turku, Turku, Finland
| | - Hanna Lagström
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland. .,Centre for Population Health Research, University of Turku, Turku, Finland.
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15
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Young S, Tariq R, Provenza J, Satapathy SK, Faisal K, Choudhry A, Friedman SL, Singal AK. Prevalence and Profile of Nonalcoholic Fatty Liver Disease in Lean Adults: Systematic Review and Meta-Analysis. Hepatol Commun 2020; 4:953-972. [PMID: 32626829 PMCID: PMC7327210 DOI: 10.1002/hep4.1519] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 12/14/2022] Open
Abstract
Data on prevalence and profile of nonalcoholic fatty liver disease (NAFLD) among individuals who are lean (normal body mass index) is unclear. Published data from studies comparing lean with obese NAFLD or with healthy subjects on prevalence, comorbidities, liver chemistry and histology, and metabolic/inflammatory markers were analyzed. Data were reported as odds ratio and 95% confidence interval for categorical variables and difference of means for continuous variables. Analysis of 53 studies on 65,029 subjects with NAFLD (38,084 lean) and 249,544 healthy subjects showed a prevalence of lean NAFLD at 11.2% in the general population. Among individuals with NAFLD, the prevalence of lean NAFLD was 25.3%. Lean NAFLD versus healthy subjects had higher odds for abnormalities on metabolic profile, including metabolic syndrome and its components, renal and liver function, and patatin‐like phospholipase domain‐containing protein 3 (PNPLA3) G allele; and inflammatory profile, including uric acid and C‐reactive protein. The abnormalities were less severe among lean versus obese NAFLD on metabolic syndrome with its components, renal and liver chemistry, liver stiffness measurement, PNPLA3 and transmembrane 6 superfamily member 2 polymorphisms, and uric acid levels as markers of inflammation. Lean NAFLD had less severe histologic findings, including hepatocyte ballooning, lobular inflammation, NAFLD activity score, and fibrosis stage. Limited data also showed worse outcomes between obese versus lean NAFLD. Conclusion: Lean NAFLD is a distinct entity with metabolic, biochemical, and inflammatory abnormalities compared to healthy subjects and a more favorable profile, including liver histology of steatohepatitis and fibrosis stage, compared to obese NAFLD. We suggest that prospective multicenter studies examine long‐term hepatic and extrahepatic outcomes in individuals with lean NAFLD.
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Affiliation(s)
- Steven Young
- Division of Gastroenterology University of Alabama at Birmingham Birmingham AL
| | - Raseen Tariq
- Department of Internal Medicine University of Rochester Rochester NY
| | - John Provenza
- Department of Internal Medicine University of Alabama at Birmingham Birmingham AL
| | - Sanjaya K Satapathy
- Division of Hepatology Sandra Bass Center for Liver Diseases Northwell Health Manhasset NY
| | - Kamal Faisal
- Division of Gastroenterology Methodist University Hospital University of Tennessee Health Sciences Center Memphis TN
| | - Abhijit Choudhry
- Post Graduate Institute of Medical Education and Research Kolkata India
| | - Scott L Friedman
- Division of Liver Diseases Icahn School of Medicine at Mount Sinai New York NY
| | - Ashwani K Singal
- Department of Medicine University of South Dakota Sanford School of Medicine and Avera Transplant Institute Sioux Falls SD.,Division of Transplant Hepatology Avera Medical Group and Transplant Institute Sioux Falls SD
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16
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Kuciene R, Dulskiene V. Associations between body mass index, waist circumference, waist-to-height ratio, and high blood pressure among adolescents: a cross-sectional study. Sci Rep 2019; 9:9493. [PMID: 31263167 PMCID: PMC6602926 DOI: 10.1038/s41598-019-45956-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Abstract
The purpose of the present study was to examine the associations between body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and high blood pressure (HBP), and to determine which anthropometric parameters can best predict HBP among Lithuanian adolescents aged 12–15 years. Data from the survey of “Prevalence and Risk Factors of HBP in 12–15-Year-Old Lithuanian Children and Adolescents (Study 1, 2010–2012)” were used; a total of 7,457 respondents (3,494 boys and 3,963 girls) were included in this analysis. Adolescents with BP above the 90th percentile were measured on two different occasions. Logistic regression analysis was used to assess the associations and to calculate odds ratios. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of the three anthropometric parameters to predict HBP. The adjusted odds ratios (aOR) in the highest quartiles of BMI, WC, and WHtR were statistically significant for both sexes separately (reference group – the first quartile): in boys, prehypertension – 4.91, 4.09, and 1.59; hypertension – 7.96, 6.44, and 2.81; and prehypertension/hypertension – 6.85, 5.65, and 2.37, respectively; and in girls, prehypertension – 3.42, 2.70, and 1.66; hypertension – 5.71, 3.54, and 2.90; and prehypertension/hypertension – 4.62, 3.17, and 2.31, respectively). According to the analyses of the ROC curve, BMI z-score provided the largest area under the curve (AUC) value, followed by WC z-score, while WHtR z-score showed the lowest AUC value in predicting elevated BP in both sexes separately. Among Lithuanian adolescents aged 12–15 years, both anthropometric indices – BMI and WC (but particularly BMI) – showed stronger associations with HBP and were better for the prediction of HBP, compared to WHtR.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50161, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50161, Kaunas, Lithuania
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Heffernan KS, Columna L, Russo N, Myers BA, Ashby CE, Norris ML, Barreira TV. Brief Report: Physical Activity, Body Mass Index and Arterial Stiffness in Children with Autism Spectrum Disorder: Preliminary Findings. J Autism Dev Disord 2019; 48:625-631. [PMID: 29119519 DOI: 10.1007/s10803-017-3358-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We examined the association between physical activity (PA), body mass index (BMI) and novel measures of subclinical cardiovascular disease (CVD) in 15 children with autism spectrum disorder (ASD) (mean age 7 ± 2 years, 2 girls). PA was objectively assessed using accelerometry as time spent in moderate-vigorous physical activity (MVPA). Arterial stiffness was measured via aortic pulse wave velocity (PWV) and taken as a marker of subclinical CVD risk. MVPA was inversely associated with aortic PWV (r = - 0.46, p < 0.05). BMI percentile was positively associated with aortic PWV (r = 0.61, p < 0.05). Overall findings suggest that reduced PA and higher body mass in children with ASD are associated with increased arterial stiffness which may have a detrimental impact on overall cardiovascular health.
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Affiliation(s)
- Kevin S Heffernan
- Department of Exercise Science, Human Performance Laboratory, Syracuse University, 820 Comstock Ave, Room 201, Syracuse, NY, 13244, USA.
| | - Luis Columna
- Department of Exercise Science, Physical Education, Syracuse University, Syracuse, NY, USA
| | - Natalie Russo
- Department of Psychology, Center for Autism and Electrophysiology Laboratory, Syracuse University, Syracuse, NY, USA
| | - Beth A Myers
- Department of Teaching and Leadership, Taishoff Center for Inclusive Higher Education, Syracuse University, Syracuse, NY, USA
| | - Christine E Ashby
- Department of Teaching and Leadership, Institute on Communication and Inclusion, Syracuse University, Syracuse, NY, USA
| | - Michael L Norris
- Department of Exercise Science, Physical Education, Syracuse University, Syracuse, NY, USA
| | - Tiago V Barreira
- Department of Exercise Science, Human Behavior Measurement Laboratory, Syracuse University, Syracuse, NY, USA
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18
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Body composition and insulin resistance in children. Eur J Clin Nutr 2018; 72:1239-1245. [DOI: 10.1038/s41430-018-0239-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/21/2022]
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19
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Wang AY, Dhaliwal J, Mouzaki M. Lean non-alcoholic fatty liver disease. Clin Nutr 2018; 38:975-981. [PMID: 30466956 DOI: 10.1016/j.clnu.2018.08.008] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/26/2018] [Accepted: 08/09/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD), with its increasing prevalence and association with various co-morbidities, such as diabetes, cardiovascular disease and metabolic syndrome, is a growing concern. Previously thought to predominantly affect obese individuals, NAFLD has been shown to occur in non-obese subjects. This subset of individuals, known to have 'lean NAFLD' or 'non-obese NAFLD', is also growing increasingly prevalent. We summarize the clinical manifestations, pathophysiology and management of lean NAFLD in both adult and pediatric populations. METHODS Two reviewers performed an independent, formal review and analysis of the literature (PubMed and EMBASE search until April 2018). RESULTS AND CONCLUSIONS Patients with lean NAFLD share metabolic features of insulin resistance and dyslipidemia, similar to obese patients with NAFLD. Genetic predisposition, dietary and environmental factors may play a role in the pathogenesis of lean NAFLD. Genetic and metabolic conditions should be considered as well. Currently, there are no formal recommendations for the treatment of adult or pediatric lean NAFLD; however, lifestyle changes aimed at improving overall fitness are likely to have a favorable impact.
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Affiliation(s)
- Alice Yuxin Wang
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jasbir Dhaliwal
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Marialena Mouzaki
- Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA.
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20
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Deeb A, Attia S, Mahmoud S, Elhaj G, Elfatih A. Dyslipidemia and Fatty Liver Disease in Overweight and Obese Children. J Obes 2018; 2018:8626818. [PMID: 30009050 PMCID: PMC6020453 DOI: 10.1155/2018/8626818] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/17/2018] [Accepted: 05/24/2018] [Indexed: 01/21/2023] Open
Abstract
Introduction Obesity is a worldwide concern. It is associated with morbidity such as dyslipidemia and liver disease. Childhood obesity has dramatically increased, particularly in the Gulf region. We aim to assess the prevalence of dyslipidemia and fatty liver disease (FLD) in overweight and obese children and analyze the association between different anthropometric measures with dyslipidemia and fatty liver disease. Methods A descriptive, cross-sectional study conducted on children referred with obesity. BMI percentiles were plotted and standardized waist circumference (WC) was generated. Family history of metabolic syndrome was recorded. Fasting lipid, liver transaminases, and ultrasound scans (US) for those with elevated enzymes were performed. Descriptive statistics were used for quantitative parameters. Results 216 participants were recruited. Mean ± SD age was 10.58 ± 2.996 years. 55.3% had dyslipidemia; 11.7% had high cholesterol, 28.6% high triglyceride, 32.7% high LDL, and 18.0% low HDL. 51 (84%) had either elevated transaminases. All had liver US, and 43 had FLD. WC was strongly associated with dyslipidemia and FLD (P=0.04 and 0.003). Conclusion Dyslipidemia is common in overweight, obese children. FLD is prevalent in those with elevated liver transaminases. WC is an easy tool that can be utilized to screen for dyslipidemia and FLD in overweight and obese children.
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Affiliation(s)
- Asma Deeb
- Pediatric Endocrinology Department, Mafraq Hospital, P.O. Box 2951, Abu Dhabi, UAE
| | - Salima Attia
- Pediatric Endocrinology Department, Mafraq Hospital, P.O. Box 2951, Abu Dhabi, UAE
| | - Samia Mahmoud
- Pediatric Clinic, Police Health Services, Abu Dhabi, UAE
| | - Ghada Elhaj
- Primary Health Care Center, BaniYas, Abu Dhabi, UAE
| | - Abubaker Elfatih
- Biochemistry Department, Shaikh Khalifa Medical City, Abu Dhabi, UAE
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21
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Kliethermes S, Ma M, Purtell C, Balasubramanian N, Gonzalez B, Layden TJ, Cotler SJ. An assessment of racial differences in the upper limits of normal ALT levels in children and the effect of obesity on elevated values. Pediatr Obes 2017; 12:363-372. [PMID: 27237782 DOI: 10.1111/ijpo.12152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 12/29/2015] [Accepted: 04/18/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Childhood obesity is a risk factor for non-alcoholic fatty liver disease and poses important public health issues for children. Racial differences in alanine aminotransferase (ALT) levels among children have not been described. This study aimed to identify racial differences in upper limit normal (ULN) ALT levels and evaluate the effect of obesity on elevated levels in children without other metabolic risk factors. METHODS National Health and Nutrition Examination Surveys and clinical data from the Loyola University Health System were used to determine ULN ALT by race and gender. Quantile regression was used to evaluate the impact of obesity on elevated ALT and to identify potential risk factors for ALT above the ULN. RESULTS Upper limit normal (ULN) ALT was approximately 28.0 and 21.0-24.0 U/L for boys and girls, respectively. No significant difference in ULN ALT across race was observed. Obesity was significantly associated with elevated ALT; obese children with elevated ALT had values 10 U/L higher than normal-weight children. CONCLUSIONS Racial differences in ALT levels among adults are not evident in children. Obesity, in the absence of metabolic risk factors and other causes of liver disease, is associated with elevated ALT, providing evidence against the concept of healthy obesity in children.
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Affiliation(s)
- S Kliethermes
- Department of Medicine, Section of Hepatology, Loyola University Chicago, Maywood, IL, USA.,Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - M Ma
- Department of Pediatrics, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - C Purtell
- Department of Pediatrics, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - N Balasubramanian
- Department of Medicine, Section of Hepatology, Loyola University Chicago, Maywood, IL, USA
| | - B Gonzalez
- Department of Medicine, Section of Hepatology, Loyola University Chicago, Maywood, IL, USA
| | - T J Layden
- Department of Medicine, Section of Hepatology, Loyola University Chicago, Maywood, IL, USA
| | - S J Cotler
- Department of Medicine, Section of Hepatology, Loyola University Chicago, Maywood, IL, USA
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22
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Anthropometry, DXA, and leptin reflect subcutaneous but not visceral abdominal adipose tissue on MRI in 197 healthy adolescents. Pediatr Res 2017; 82:620-628. [PMID: 28604756 DOI: 10.1038/pr.2017.138] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 05/23/2017] [Indexed: 12/29/2022]
Abstract
BackgroundAbdominal fat distribution is associated with the development of cardio-metabolic disease independently of body mass index (BMI). We assessed anthropometry, serum adipokines, and DXA as markers of abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) using magnetic resonance imaging (MRI).MethodsWe performed a cross-sectional study that included 197 healthy adolescents (114 boys) aged 10-15 years nested within a longitudinal population-based cohort. Clinical examination, blood sampling, DXA, and abdominal MRI were performed. SAT% and VAT% were adjusted to total abdominal volume.ResultsGirls had a higher SAT% than did boys in early and late puberty (16 vs. 13%, P<0.01 and 20 vs. 15%, P=0.001, respectively), whereas VAT% was comparable (7% in both genders, independently of puberty). DXA android fat% (standard deviation score (SDS)), suprailiac skinfold thickness (SDS), leptin, BMI (SDS), waist-to-height ratio (WHtR), and waist circumference (SDS) correlated strongly with SAT% (descending order: r=0.90-0.55, all P<0.001) but weakly with VAT% (r=0.49-0.06). Suprailiac skinfold was the best anthropometric marker of SAT% (girls: R2=48.6%, boys: R2=65%, P<0.001) and VAT% in boys (R2=16.4%, P<0.001). WHtR was the best marker of VAT% in girls (R2=7.6%, P=0.007).ConclusionsHealthy girls have a higher SAT% than do boys, whereas VAT% is comparable, independently of puberty. Anthropometry and circulating leptin are valid markers of SAT%, but not of VAT%.
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Samouda H, De Beaufort C, Stranges S, Van Nieuwenhuyse JP, Dooms G, Keunen O, Leite S, Vaillant M, Lair ML, Dadoun F. Subtraction of subcutaneous fat to improve the prediction of visceral adiposity: exploring a new anthropometric track in overweight and obese youth. Pediatr Diabetes 2017; 18:399-404. [PMID: 27400675 DOI: 10.1111/pedi.12415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/30/2016] [Accepted: 06/08/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The efficiency of traditional anthropometric measurements such as body mass index (BMI) or waist circumference (Waist C) used to replace biomedical imaging for assessing visceral adipose tissue (VAT) is still highly controversial in youth. HYPOTHESIS AND OBJECTIVES We evaluated the most accurate model predicting VAT in overweight/obese youth, using various anthropometric measurements and their correlation with different body fat compartments, especially by testing, for the first time in youth, the hypothesis that subtracting the anthropometric measurement the most highly correlated with subcutaneous abdominal adipose tissue (SAAT) and less correlated possible with VAT from an anthropometric abdominal measurement highly correlated with visceral and total abdominal adipose tissue (TAAT), predicts VAT with higher accuracy. SUBJECTS AND METHODS VAT and SAAT data resulted from magnetic resonance imaging (MRI) analysis performed on 181 boys and girls (7-17 y) from Diabetes & Endocrinology Care Paediatrics Clinic in Luxembourg. Height, weight, abdominal diameters, waist, hip, and thigh circumferences were measured with a view to developing the anthropometric VAT predictive algorithms. RESULTS In girls, subtracting proximal thigh circumference (Proximal Thigh C), the most closely correlated anthropometric measurement with SAAT, from Waist C, the most closely correlated anthropometric measurement with VAT was instrumental in improving VAT prediction, in comparison with the most accurate single VAT anthropometric surrogate. [Formula: see text] Residual analysis showed a negligible estimation error (5 cm2 ). In boys, Waist C was the best VAT predictor. CONCLUSIONS Subtraction of abdominal subcutaneous fat is important to predict VAT in overweight/obese girls.
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Affiliation(s)
- H Samouda
- Population Health Department, Epidemiology and Public Health Research Unit (EPHRU), Luxembourg Institute of Health, Strassen, Luxembourg
| | - C De Beaufort
- Diabetes & Endocrinology Care Clinique Pédiatrique (DECCP), Centre Hospitalier de Luxembourg, Luxembourg.,Department of Pediatrics, UZ Brussel, Brussel, Belgium
| | - S Stranges
- Population Health Department, Epidemiology and Public Health Research Unit (EPHRU), Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - G Dooms
- Radiology Department, Centre Hospitalier de Luxembourg, Luxembourg
| | - O Keunen
- Norlux Neuro-Oncology Laboratory, Luxembourg Institute of Health, Strassen, Luxembourg
| | - S Leite
- Luxembourg Institute of Health, Centre of Competence for Methodology and Statistics (CCMS), Strassen, Luxembourg.,Epidemiology and Statistics Department, Ministry of Health, Luxembourg
| | - M Vaillant
- Luxembourg Institute of Health, Centre of Competence for Methodology and Statistics (CCMS), Strassen, Luxembourg
| | - M-L Lair
- Population Health Department, Epidemiology and Public Health Research Unit (EPHRU), Luxembourg Institute of Health, Strassen, Luxembourg.,Santé et Prospectives, Sanem, Luxembourg
| | - F Dadoun
- Population Health Department, Epidemiology and Public Health Research Unit (EPHRU), Luxembourg Institute of Health, Strassen, Luxembourg.,Endocrinology and Diabetology Department, Centre Hospitalier de Luxembourg, Luxembourg
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Abstract
OBJECTIVE The present study aimed to evaluate the association of 4-year-old children's dietary patterns with adiposity at 7 years, according to child's sex, using a conceptual model. DESIGN Prospective cohort study. Diet was assessed using an FFQ. Age- and sex-specific BMI standard deviation scores (Z-scores) were defined according to the WHO. Fat mass percentage (FM%), fat mass index (FMI) and waist-to-height ratio (WHtR) were also considered, converted into Z-scores using sex-specific means and standard deviations of the current sample. Dietary patterns were identified by latent class analysis and their association with adiposity was estimated by linear regression models. SETTING Population-based birth cohort Generation XXI (Porto, Portugal, 2005-2006). SUBJECTS Children (n 3473) evaluated at both 4 and 7 years of age. RESULTS Three dietary patterns were identified: high in energy-dense foods (EDF); low in foods typically consumed at main meals and intermediate in snacks (Snacking); and higher in vegetables and fish and lower in EDF (Healthier, reference). The EDF dietary pattern at 4 years of age was positively associated with later BMI only in girls (β=0·075, 95 % CI 0·009, 0·140, P-interaction=0·046). The EDF dietary pattern was also associated with other adiposity indicators only in girls (FMI: β=0·071, 95 % CI 0·000, 0·142; WHtR: β=0·094, 95 % CI 0·023, 0·164). Snacking was not significantly associated with any marker of adiposity in either girls or boys. CONCLUSIONS Although dietary patterns and adiposity persisted across the two ages in both sexes, EDF at 4 years of age increased adiposity at 7 years of age only in girls.
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Cardiorespiratory fitness, waist circumference and liver enzyme levels in European adolescents: The HELENA cross-sectional study. J Sci Med Sport 2017; 20:932-936. [PMID: 28483561 DOI: 10.1016/j.jsams.2017.04.006] [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: 07/19/2016] [Revised: 02/15/2017] [Accepted: 04/16/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVES (1) To examine whether cardiorespiratory fitness (CRF) is related to liver enzyme levels independent of waist circumference (WC), and (2) To test whether having a high CRF is associated with an improved liver enzyme profile with a high WC. DESIGN Cross-sectional. METHODS CRF (20m-shuttle-run test) and WC were assessed in 811 European adolescents (48.5% males) aged 12.5-17.5 years. Fatty liver biomarkers included fasting serum alanine-aminotransferase (ALT), gamma-glutamyl-transpeptidase (GGT) and the aspartate-aminotransferase to ALT (AST/ALT) ratio. Participants were categorized as fit or unfit (CRF below or above 43.8mL/kg/min and 34.6mL/kg/min, for boys and girls, respectively) and as high or non-high WC (sex and age-specific cut-offs). RESULTS CRF was associated with ALT (β=-0.106; p=0.049) and GGT levels (β=-0.225; p<0.001) and AST/ALT ratio (β=0.234; p<0.001), yet these relationships were attenuated after further controlling for WC (all p>0.1). High WC and fit adolescents had lower ALT levels (28±1U/L vs. 23±2U/L, unfit and fit respectively, p=0.018) and higher AST/ALT ratio (0.94±0.04 vs. 1.10±0.06, unfit and fit respectively, p=0.010) than those who were high WC but unfit. CONCLUSIONS The results showed that CRF is not independently associated with liver enzymes, and that WC is a stronger predictor in adolescents. These findings also suggest that high CRF may have specific protective effects on liver enzyme levels in adolescents with high WC. Exercise programs focused on increasing CRF and decreasing abdominal adiposity could be a good alternative in the treatment and prevention of obesity related fatty liver disease in adolescents.
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26
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Mitchell JA, Dowda M, Pate RR, Kordas K, Froberg K, Sardinha LB, Kolle E, Page A. Physical Activity and Pediatric Obesity: A Quantile Regression Analysis. Med Sci Sports Exerc 2017; 49:466-473. [PMID: 27755284 PMCID: PMC5321492 DOI: 10.1249/mss.0000000000001129] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE We aimed to determine whether moderate to vigorous physical activity (MVPA) and sedentary behavior (SB) were independently associated with body mass index (BMI) and waist circumference (WC) in children and adolescents. METHODS Data from the International Children's Accelerometry Database were used to address our objectives (N = 11,115; 6-18 yr; 51% female). We calculated age- and gender-specific BMI and WC z-scores and used accelerometry to estimate MVPA and total SB. Self-reported television viewing was used as a measure of leisure time SB. Quantile regression was used to analyze the data. RESULTS MVPA and total SB were associated with lower and higher BMI and WC z-scores, respectively. These associations were strongest at the higher percentiles of the z-score distributions. After including MVPA and total SB in the same model, the MVPA associations remained, but the SB associations were no longer present. For example, each additional hour per day of MVPA was not associated with BMI z-score at the 10th percentile (b = -0.02, P = 0.170) but was associated with lower BMI z-score at the 50th (b = -0.19, P < 0.001) and 90th percentiles (b = -0.41, P < 0.001). More television viewing was associated with higher BMI and WC, and the associations were strongest at the higher percentiles of the z-score distributions, with adjustment for MVPA and total SB. CONCLUSIONS Our observation of stronger associations at the higher percentiles indicates that increasing MVPA and decreasing television viewing at the population-level could shift the upper tails of the BMI and WC frequency distributions to lower values, thereby lowering the number of children and adolescents classified as obese.
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Affiliation(s)
- Jonathan A Mitchell
- 1Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA; 2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; 3Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, SC; 4School of Social and Community Medicine, University of Bristol, Bristol, UNITED KINGDOM; 5Centre of Research in Childhood Health, University of Southern Denmark, Odense, DENMARK; 6Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, PORTUGAL; 7Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY; and 8Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UNITED KINGDOM
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27
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Martin-Calvo N, Moreno-Galarraga L, Martinez-Gonzalez MA. Association between Body Mass Index, Waist-to-Height Ratio and Adiposity in Children: A Systematic Review and Meta-Analysis. Nutrients 2016; 8:nu8080512. [PMID: 27556485 PMCID: PMC4997425 DOI: 10.3390/nu8080512] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/12/2016] [Accepted: 08/15/2016] [Indexed: 12/16/2022] Open
Abstract
Obesity is defined as an abnormal or excessive fat accumulation that may impair health. Dual-energy X-ray absorptiometry (DEXA) has been suggested as the gold standard to define obesity, but because its use is complex and expensive, anthropometric measures such as body mass index (BMI) or the waist-to-height ratio (WtHr) have been used as alternatives. The aim of this study was to review the published literature and investigate the correlation of BMI and WtHr with body fat (BF) measured by DEXA in pediatric populations. References were sought in PubMed/Medline and Embase datasets. Five original articles, published between 2013 and 2015, were finally included in this review. Their sample size ranged from 83 to 5355, and the age of participants ranged from 4.9 to 19 years old. The most frequently reported association measurements were the coefficients of determination (R²), followed by correlation coefficients and least-squares regression coefficients. BF measured by DEXA was strongly correlated with both BMI (R² ranging from 0.32 to 0.91) and WtHr (R² ranging from 0.49 to 0.73). Thus, either BMI or WtHr may be useful to define obesity when more sophisticated techniques are not available. Our systematic review of the available literature found that neither index demonstrated superiority in assessing obesity in children.
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Affiliation(s)
- Nerea Martin-Calvo
- Department of Preventive Medicine and Public Health, University of Navarre, Pamplona 31009, Spain.
- Navarra Institute for Health Research (IdisNa), Pamplona 31008, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Institute of Health, Madrid 28029, Spain.
| | - Laura Moreno-Galarraga
- Navarra Institute for Health Research (IdisNa), Pamplona 31008, Spain.
- Department of Pediatrics, Complejo Hospital de Navarra, Pamplona 31008, Spain.
| | - Miguel Angel Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, University of Navarre, Pamplona 31009, Spain.
- Navarra Institute for Health Research (IdisNa), Pamplona 31008, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Institute of Health, Madrid 28029, Spain.
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Gillespie SL, Christian LM. Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy. J Womens Health (Larchmt) 2016; 25:1210-1218. [PMID: 27487272 DOI: 10.1089/jwh.2016.5761] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As a measure of obesity, body mass index (BMI; kg/m2) is an imperfect predictor of health outcomes, particularly among African Americans. However, BMI is used to guide prenatal care. We examined racial differences in the predictive value of maternal BMI for physiologic correlates of obesity, serum interleukin (IL)-6 and C-reactive protein (CRP), as well as cesarean section and infant birth weight. METHODS One hundred five pregnant women (40 European American, 65 African American) were assessed during the second trimester. BMI was defined as per prepregnancy weight. Electrochemiluminescence and enzyme-linked immunosorbent assays were used to quantify IL-6 and CRP, respectively. Birth outcomes were determined by medical record review. RESULTS Women of both races classified as obese had higher serum IL-6 and CRP than their normal-weight counterparts (ps ≤ 0.01). However, among women with overweight, elevations in IL-6 (p < 0.01) and CRP (p = 0.06) were observed among European Americans, but not African Americans (ps ≥ 0.61). Maternal obesity was a significantly better predictor of cesarean section among European Americans versus African Americans (p = 0.03) and BMI was associated with infant birth weight among European Americans (p < 0.01), but not African Americans (p = 0.94). Effects remained after controlling for gestational age at delivery, gestational diabetes, and gestational weight gain as appropriate. CONCLUSIONS BMI may be a less valid predictor of correlates of overweight/obesity among African Americans versus European Americans during pregnancy. This should be considered in epidemiological studies of maternal-child health. In addition, studies examining the comparative validity of alternative/complementary measures to define obesity in pregnancy are warranted to inform clinical care.
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Affiliation(s)
| | - Lisa M Christian
- 2 Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center , Columbus, Ohio.,3 Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center , Columbus, Ohio.,4 The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center , Columbus, Ohio.,5 Department of Psychology, The Ohio State University , Columbus, Ohio
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29
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Linder N, Schaudinn A, Garnov N, Blüher M, Dietrich A, Schütz T, Lehmann S, Retschlag U, Karlas T, Kahn T, Busse H. Age and gender specific estimation of visceral adipose tissue amounts from radiological images in morbidly obese patients. Sci Rep 2016; 6:22261. [PMID: 27009353 PMCID: PMC4806365 DOI: 10.1038/srep22261] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/10/2016] [Indexed: 12/21/2022] Open
Abstract
Image-based quantifications of visceral adipose tissue (VAT) volumes from segmented VAT areas are increasingly considered for risk assessment in obese patients. The goal of this study was to determine the power of partial VAT areas to predict total VAT volume in morbidly obese patients (BMI > 40 kg/m2) as a function of gender, age and anatomical landmarks. 130 morbidly obese patients (mean BMI 46.5 kg/m2; 94 females) underwent IRB-approved MRI. Total VAT volumes were predicted from segmented VAT areas (of single or five adjacent slices) at common axial landmark levels and compared with the measured ones (VVAT-T, about 40 slices between diaphragm and pelvic floor). Standard deviations σ1 and σ5 of the respective VAT volume differences served as measures of agreement. Mean VVAT-T was 4.9 L for females and 8.1 L for males. Best predictions were found at intervertebral spaces L3-L4 for females (σ5 = 688 ml, σ1 = 832 ml) and L1-L2 for males (σ5 = 846 ml, σ1 = 992 ml), irrespective of age. In conclusion, VAT volumes in morbidly obese patients can be reliably predicted by multiplying the segmented VAT area at a gender-specific lumbar reference level with a fixed scaling factor and effective slice thickness.
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Affiliation(s)
- Nicolas Linder
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Nikita Garnov
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Matthias Blüher
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Internal Medicine, Neurology and Dermatology, Division of Endocrinology and Nephrology, Leipzig University Hospital, Leipzig, Germany
| | - Arne Dietrich
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Division of Bariatric Surgery, Leipzig University Hospital, Leipzig, Germany
| | - Tatjana Schütz
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Division of Bariatric Surgery, Leipzig University Hospital, Leipzig, Germany
| | - Stefanie Lehmann
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Ulf Retschlag
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Thomas Karlas
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Internal Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, Leipzig University Hospital, Leipzig, Germany
| | - Thomas Kahn
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, Leipzig, Germany
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30
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Mota J, Silva Dos Santos S, Santos A, Seabra A, Vale S. Association between sedentary behavior time and waist-to-height ratio in preschool children. Am J Hum Biol 2016; 28:746-8. [DOI: 10.1002/ajhb.22851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/08/2015] [Accepted: 02/15/2016] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jorge Mota
- Faculty of Sport; University of Porto, Research Centre in Physical Activity, Health and Leisure; 4200-450 Porto Portugal
| | - Sandra Silva Dos Santos
- Faculty of Sport; University of Porto, Research Centre in Physical Activity, Health and Leisure; 4200-450 Porto Portugal
| | - Amanda Santos
- Faculty of Sport; University of Porto, Research Centre in Physical Activity, Health and Leisure; 4200-450 Porto Portugal
| | - André Seabra
- Faculty of Sport; University of Porto, Research Centre in Physical Activity, Health and Leisure; 4200-450 Porto Portugal
| | - Susana Vale
- Faculty of Sport; University of Porto, Research Centre in Physical Activity, Health and Leisure; 4200-450 Porto Portugal
- Department of Sport Science; High School of Education, Polytechnic Institute of Porto; Porto Portugal
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Ndombi EM, Budambula V, Webale MK, Musumba FO, Wesongah JO, Mibei E, Ahmed AA, Lihana R, Were T. Serum adiponectin in HIV-1 and hepatitis C virus mono- and co-infected Kenyan injection drug users. Endocr Connect 2015; 4:223-32. [PMID: 26306727 PMCID: PMC4566843 DOI: 10.1530/ec-15-0071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/25/2015] [Indexed: 01/18/2023]
Abstract
Adiponectin is an important marker of anthropometric profiles of adipose tissue. However, association of adiponectin and adiposity in HIV mono- and co-infected and hepatitis (HCV) injection drug users (IDUs) has not been elucidated. Therefore, the relationship of total adiponectin levels with anthropometric indices of adiposity was examined in HIV mono-infected (anti-retroviral treatment, ART-naive, n=16 and -experienced, n=34); HCV mono-infected, n=36; HIV and HCV co-infected (ART-naive, n=5 and -experienced, n=13); uninfected, n=19 IDUs; and healthy controls, n=16 from coastal Kenya. Anthropometric indices of adiposity were recorded and total circulating adiponectin levels were measured in serum samples using enzyme-linked immunosorbent assay. Adiponectin levels differed significantly amongst the study groups (P<0.0001). Post-hoc analyses revealed decreased levels in HIV mono-infected ART-naive IDUs in comparison to uninfected IDUs (P<0.05) and healthy controls (P<0.05). However, adiponectin levels were elevated in HCV mono-infected IDUs relative to HIV mono-infected ART-naive (P<0.001) and -experienced (P<0.001) as well as HIV and HCV co-infected ART-naive (P<0.05) IDUs. Furthermore, adiponectin correlated with weight (ρ=0.687; P=0.003) and BMI (ρ=0.598; P=0.014) in HIV mono-infected ART-naive IDUs; waist circumference (ρ=-0.626; P<0.0001), hip (ρ=-0.561; P=0.001) circumference, and bust-to-waist ratio (ρ=0.561; P=0.001) in HIV mono-infected ART-experienced IDUs; waist girth (ρ=0.375; P=0.024) in HCV mono-infected IDUs; and waist-to-hip ratio (ρ=-0.872; P=0.048) in HIV and HCV co-infected ART-naive IDUs. Altogether, these results suggest suppression of adiponectin production in treatment-naive HIV mono-infected IDUs and that circulating adiponectin is a useful surrogate marker of altered adiposity in treatment-naive and -experienced HIV and HCV mono- and co-infected IDUs.
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Affiliation(s)
- Eric M Ndombi
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Valentine Budambula
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Mark K Webale
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Francis O Musumba
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Jesca O Wesongah
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Erick Mibei
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Aabid A Ahmed
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Raphael Lihana
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Tom Were
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
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Remédios JLD, Cardoso LDO, Gomes FDS, Wahrlich V, Castro IRRD. Percentis para o perímetro de cintura de adolescentes do município do Rio de Janeiro. REV NUTR 2015. [DOI: 10.1590/1415-52732015000300004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Descrever o perímetro da cintura e apresentar estimativas de pontos críticos para classificação de risco e alto risco de excesso de gordura abdominal segundo sexo e faixa etária. MÉTODOS: Foi estudada uma amostra probabilística de adolescentes (n=3 . 175) da rede pública de ensino do Rio de Janeiro. O perímetro da cintura foi aferido no ponto médio entre a borda inferior da costela e a crista ilíaca. Os percentis de perímetro da cintura estudados foram estimados segundo método LMS (Lambda, Mu, Sigma) proposto por Cole em 1990. Os pontos de corte adotados para definição de risco e alto risco de excesso de gordura abdominal foram os propostos por Jolliffe & Janssen em 2007. RESULTADOS: Comparando os valores estimados, meninas apresentaram valores de perímetro da cintura maiores que os de meninos para todos os percentis (exceto para o P90) em todas as idades. Os valores críticos estimados foram menores entre as meninas e aumentaram com a idade em ambos os sexos. Em geral, para ambos os sexos, os valores estimados foram menores do que os propostos pela referência adotada. CONCLUSÃO: Os achados ratificam a importância da aferição dessa medida em adolescentes, sendo apresentados pontos críticos de perímetro da cintura para classificação antropométrica desse grupo populacional segundo essa medida, o que até o momento não havia sido proposto com base em dados de adolescentes brasileiros.
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Okosun IS, Seale JP, Lyn R. Commingling effect of gynoid and android fat patterns on cardiometabolic dysregulation in normal weight American adults. Nutr Diabetes 2015; 5:e155. [PMID: 25985091 PMCID: PMC4450460 DOI: 10.1038/nutd.2015.5] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/06/2015] [Accepted: 03/15/2015] [Indexed: 02/07/2023] Open
Abstract
AIM To determine the independent and commingling effect of android and gynoid percent fat (measured using Dual Energy X-Ray Absorptiometry) on cardiometabolic dysregulation in normal weight American adults. METHODS The 2005-2006 data (n=1802) from the United States National Health and Nutritional Examination Surveys (NHANES) were used in this study. Associations of android percent fat, gynoid percent fat and their joint occurrence with risks of cardiometabolic risk factors were estimated using prevalence odds ratios from logistic regression analyses. RESULTS Android-gynoid percent fat ratio was more highly correlated with cardiometabolic dysregulation than android percent fat, gynoid percent fat or body mass index. Commingling of android and gynoid adiposities was associated with much greater odds of cardiometabolic risk factors than either android or gynoid adiposities. Commingling of android and gynoid adiposities was associated with 1.75 (95% confidence interval (CI)=1.42-2.93), 1.48 (95% CI=1.32-1.91), 1.61 (95% CI=1.50-1.89), 3.56 (95% CI=2.91-4.11) and 1.86 (95% CI=1.49-1.96) increased odds of elevated glucose, elevated blood pressure, elevated low-density lipoprotein-cholesterol, elevated triglyceride and low high-density lipoprotein-cholesterol, respectively. CONCLUSIONS Normal weight subjects who present with both android and gynoid adiposities should be advised of the associated health risks. Both android and gynoid fat accumulations should be considered in developing public health strategies for reducing cardiometabolic disease risk in normal weight subjects.
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Affiliation(s)
- I S Okosun
- Division of Epidemiology & Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
- Division of Epidemiology & Biostatistics, School of Public Health, Georgia State University, Suite 662B/715—One Park Place, PO Box 3984, Atlanta, GA 30302-3984, USA. E-mail:
| | - J P Seale
- Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA, USA
| | - R Lyn
- Division of Health Management & Policy, School of Public Health, Georgia State University, Atlanta, GA, USA
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