BMI, waist circumference, and clustering of cardiovascular risk factors in Japanese adults

Increased Waist Circumference after One-Year Is Associated with Poor Chewing Status

BACKGROUND

This study aimed to investigate the relationship between an increase in waist circumference (WC) after 1 year and self-reported chewing status in 10,870 Japanese adults who had received health checkups. Subsequently, 8068 participants were included in the final analysis.

METHODS

We defined an increase in WC ≥ 5 cm after 1 year as an unhealthy increase; in total, 613 (7.5%) respondents met this criterion. Chewing status was evaluated using a self-reported questionnaire at baseline; 1080 (13%) respondents were diagnosed with poor chewing status.

RESULTS

After adjusting for age, gender, WC, body mass index (BMI), and chewing status, an increase in WC ≥ 5 cm was found to be positively associated with gender (females: odds ratios [ORs]: 1.206; 95% confidence intervals [CIs]: 1.008-1.443), WC (ORs: 0.967; 95% CIs: 0.954-0.981), BMI (≥25 kg/m2; ORs: 2.194; 95% CIs: 1.715-2.808), and chewing status (poor; ORs: 1.356; 95% CIs: 1.084-1.697).

CONCLUSIONS

These findings suggest that increased WC after 1 year was associated with self-reported poor chewing status in Japanese adults.

Insights into pelvic insufficiency fracture following pelvic radiotherapy for cervical cancer: a comparative review

BACKGROUND

Radiotherapy (RT)-induced pelvic insufficiency fractures (PIF) are prevalent in patients with cervical cancer. Inconclusive studies on PIF after cervical irradiation create uncertainty. This review examined PIF after RT in cervical patients, including its pathobiology, likely locations of fractures, incidence, clinical symptoms, and predisposing factors. We further discussed study limitations and therapeutic possibilities of PIF.

METHODS

The following online resources were searched for relevant articles: Google Scholar and PubMed. The keywords 'pelvic insufficiency fractures', 'cervical carcinoma' and 'cervical cancer', as well as 'chemoradiotherapy', 'chemoradiation', and 'radiotherapy', were some of the terms that were used during the search.

RESULTS

Patients with PIF report pelvic pain after radiation treatment for cervical cancer; the incidence of PIF ranges from 1.7 to 45.2%. Evidence also supports that among all patients treated with pelvic radiation, those who experienced pelvic insufficiency fractures invariably had at least one sacral fracture, making it the most frequently fractured bone in the body. Menopausal status, weight, BMI, age, and treatments and diagnosis modalities can influence PIF during radiotherapy.

CONCLUSIONS

In conclusion, our comparative review of the literature highlights significant heterogeneity in various aspects of PIF following radiation for patients with cervical cancer. This diversity encompasses prevalence rates, associated risk factors, symptoms, severity, diagnosis methods, preventive interventions, and follow-up periods. Such diversity underscores the complexity of PIF in this population and emphasizes the critical need for further research to elucidate optimal management strategies and improve patient outcomes.

Comparison of Body Mass Index and Waist Circumference in the Prediction of Diabetes: A Retrospective Longitudinal Study

INTRODUCTION

Both body mass index (BMI) and waist circumference (WC) are associated with diabetes risk, and the difference between them in predictive ability for diabetes is still contentious. We conducted a population-based study to investigate and compare the association of them with diabetes by sex.

METHODS

This study included a total of 4754 subjects aged 40-80 years with no diabetes at baseline between 2008 and 2017. Using multivariate Cox proportional hazards models, we calculated hazard ratios for diabetes according to tertiles of BMI or WC. Harrell's C statistics was applied to assess and compare the predictive ability of the models using BMI and WC.

RESULTS

Both BMI and WC showed the significant positive trends with diabetes risk. In men, the extreme tertiles (BMI > 25.1 kg/m² and WC > 88.0 cm) provided 1.58-fold or 2.04-fold higher risk compared with the first tertiles (< 22.6 kg/m² and < 81.2 cm). In women, BMI > 24.4 kg/m² showed 3.28-fold higher risk than the first tertile (< 21.6 kg/m²), whereas WC ≥ 78.2 cm was more than twice as likely to suffer from diabetes as WC < 78.2 cm. BMI and WC showed a comparative performance in predicting diabetes in both sexes (P value 0.447 in men, and 0.337 in women).

CONCLUSION

Both BMI and WC showed a positive association with diabetes and offered a comparative predictive performance for diabetes in both sexes. The cut-off points, BMI 25.1 kg/m² and WC 88.0 cm in men and BMI 24.4 kg/m² and WC 78.2 cm in women, might contribute to the effective prevention strategies for diabetes.

Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis

INTRODUCTION

Obesity is one of the main risk factors for cardiovascular disease (CVD) and cardiometabolic disease (CMD). Many studies have developed cutoff points of anthropometric indices for predicting these diseases. The aim of this systematic review was to differentiate the screening potential of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for adult CVD risk.

METHODS

We used relevant key words to search electronic databases to identify studies published up to 2019 that used receiver operating characteristic (ROC) curves for assessing the cut-off points of anthropometric indices. We used a random-effects model to pool study results and assessed between-study heterogeneity by using the I² statistic and Cochran's Q test.

RESULTS

This meta-analysis included 38 cross-sectional and 2 cohort studies with 105 to 137,256 participants aged 18 or older. The pooled area under the ROC curve (AUC) value for BMI was 0.66 (95% CI, 0.63-0.69) in both men and women. The pooled AUC values for WC were 0.69 (95% CI, 0.67-0.70) in men and 0.69 (95% CI, 0.64-0.74) in women, and the pooled AUC values for WHR were 0.69 (95% CI, 0.66-0.73) in men and 0.71 (95% CI, 0.68-0.73) in women.

CONCLUSION

Our findings indicated a slight difference between AUC values of these anthropometric indices. However, indices of abdominal obesity, especially WHR, can better predict CVD occurrence.

Clustering of cardio metabolic risk factors in Iranian adult population: A growing problem in the north of Iran

INTRODUCTION

The clustering of components of metabolic syndrome (MetS) is a major concern in a transition population because of dramatic changing toward modern life styles. The objective of this study was to determine the prevalence of clustering of various combinations of MetS and its association with obesity.

METHODS AND SUBJECTS

In a population- based cross-sectional study, a representative samples of 1000 adults were recruited in Babol, the north of Iran. The demographic data, blood pressure, body mass index and waist circumference (WC) were measured with standard method. Fasting blood sugar, serum levels of triglycerides, high density lipoprotein were measured with enzymatic method.

RESULTS

A quarter of population had only one component of MetS. The prevalence of just two components was 30.7% and 26.2% in men and women respectively and about 67.1% of men and 73.3% of women had ≥2 risk factors (P=0.001). While the joint prevalence of three and four components was 22.0% and 12.0% in male and 27.3% and 16.5% in female respectively. The combination of high WC with any of other four components of MetS were significantly higher compared with any other joint combinations in particularly among women (P=0.001). The adjusted odds ratio for having clustering (≥2 risk factors) increased 5.6 times (95%CI: 2.15, 6.04) in obese subjects and remained at significant level after adjustment for age, sex, level of education.

CONCLUSION

An emerging high rate of clustering of joint combination of cardio metabolic risk factors highlights an urgent intervention for life style modification in public health management.

Prevalence of stroke and associated risk factors among middle-aged and older farmers in western China

Objectives

China has the world’s largest population and the stroke has become the leading cause of death in recent years. The purpose of this study was to explore the associations between hypertension, family history of stroke, diabetes mellitus, obesity and stroke among middle-aged and older farmers of western China. A population-based study was conducted from June 2014 to April 2015 in Shaanxi and Sichuan provinces.

Methods

Twenty thousand five hundred twenty-five Chinese middle-aged and older farmers (≥40 years) were recruited to the Qinling-Daba Mountains Region Stroke Study. A structured-questionnaire was used to collect data through face-to-face interviews. Demographic characteristics, risk factors, medical history, and other clinical characteristics were recorded for all participants. The association between hypertension, family history of stroke, diabetes mellitus, obesity and stroke were analyzed by using univariate and multivariate logistic regression analysis.

Results

The stoke prevalence rate was 1380/100,000 in middle-aged and older farmers of western China. The difference in hypertension, diabetes mellitus, obesity and family history between different age groups had statistical significance (p < 0.05). The prevalence rate of hypertension and family history of stroke were higher in male population than in the female population. The difference was statistically significant (p < 0.05). Univariate logistic regression analysis demonstrated age, gender, hypertension, obesity and family history of stroke were stroke risk factors (p < 0.05). Multivariate logistic regression analysis revealed that the odds ratios of family history of stroke, obesity and hypertension were 7.177, 4.389 and 3.647 respectively.

Conclusions

Family history is the strongest stroke risk factor in middle-aged and older farmers of western China.

Comparison of body mass index, waist circumference, and waist-to-height ratio for predicting the clustering of cardiometabolic risk factors by age in Japanese workers--Japan Epidemiology Collaboration on Occupational Health study

BACKGROUND

Waist-to-height ratio (WHtR) has been suggested as a better screening tool than body mass index (BMI) and waist circumference (WC) for assessing cardiometabolic risk. However, most previous studies did not consider age.

METHODS AND RESULTS

Participants were 45,618 men and 8,092 women aged 15-84 years who received periodic health checkups in 9 companies in Japan. Clustering of cardiometabolic risk factors was defined by the existence of 2 or more of high blood pressure, hyperglycemia, and dyslipidemia. In both men and women, unadjusted area under the curve (AUC) of the receiver-operating characteristic curve for WHtR in detecting the clustering of cardiometabolic risk factors was significantly higher than that for either BMI or WC; the AUCs for WHtR, BMI, and WC, respectively, were 0.734, 0.705, and 0.717 in men and 0.782, 0.762, and 0.755 in women. After adjustment for age, however, such differences were not observed; the corresponding values were 0.702, 0.701, and 0.696 in men. In women, the age-adjusted AUC for BMI was slightly higher than for other indices (WHtR, 0.721; BMI, 0.726; WC, 0.707).

CONCLUSIONS

The screening performance of WHtR for detecting the clustering cardiometabolic risk factors was not superior to that of BMI.

Body mass index compared with abdominal obesity indicators in relation to prehypertension and hypertension in adults: the CHPSNE study

BACKGROUND

Debate ensues regarding the stronger indicator of obesity, body mass index (BMI), or waist circumference (WC), in association with hypertension. Furthermore, little research has been done to compare BMI and WC in their associations with prehypertension.

METHODS

A cross-sectional survey was undertaken in 33 communities randomly selected from 3 cities in Northeastern China during 2009-2010, using a total of 25,196 adults aged 18-74 years with an overall response rate of 87.4%. Diagnoses of prehypertension and hypertension were based on the criteria set by the Seventh Report of the Joint National Committee. Generalized overweight and obesity were defined as BMI 25-29.9 and ≥30 kg/m(2), respectively. Abdominal overweight and obesity were defined as WC 94-102 and >102 cm in men and WC 80-88 and >88 cm in women, respectively.

RESULTS

Both BMI and WC were positively related to the prevalence rate of elevated blood pressure. Among younger individuals, aged 18-44 years, WC seemed to be associated with a higher odds ratio (OR) than BMI for hypertension (e.g., for men, 17.18 (BMI) vs. 23.28 (WC) for obesity), in contrast, BMI seemed to be associated with a higher OR than WC for prehypertension (e.g., for men, 5.99 (BMI) vs. 1.51 (WC) for obesity). Among older individuals, aged ≥45 years, the adjusted OR for hypertension was modestly higher for WC than for BMI in men. In women, the adjusted OR was modestly higher for BMI than for WC.

CONCLUSIONS

In this Chinese population, the association of body fat and abdominal fat with hypertension and prehypertension depends on age and sex.

Are cardiorespiratory fitness and moderate-to-vigorous physical activity independently associated to overweight, obesity, and abdominal obesity in elderly?

OBJECTIVES

This study aimed to examine the independent association of cardiorespiratory fitness (CRF) and physical activity (PA) with overweight and total and abdominal obesity in an elderly population.

METHODS

A total of 112 males and 185 females, 65-103 years, were assessed for PA with accelerometers and results from six-minute walk test were used as a CRF marker. Waist circumference was dichotomized into normal or abdominal obesity and BMI was categorized into normal, overweight, or obesity. Binary logistic regression models were performed.

RESULTS

Binary logistic regressions showed that, moderate-to-vigorous PA (MVPA) predicted OR for abdominal obesity (OR = 1.4%; P = 0.026), obesity (OR = 2.9%; P < 0.001), and both conditions coupled (OR% = 4.0%; P < 0.001). Even adjusting for CRF, MVPA remained a significant predictor. CRF was associated with OR for abdominal obesity (OR = 0.4%; P = 0.001).

CONCLUSION

In conclusion, higher CRF is associated with lower risk for abdominal obesity in elderly. Independently MVPA predicts OR for obesity, abdominal obesity, and the cluster of both conditions.