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Sewak A, Hothorn T. Estimating transformations for evaluating diagnostic tests with covariate adjustment. Stat Methods Med Res 2023; 32:1403-1419. [PMID: 37278185 PMCID: PMC10500951 DOI: 10.1177/09622802231176030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Receiver operating characteristic analysis is one of the most popular approaches for evaluating and comparing the accuracy of medical diagnostic tests. Although various methodologies have been developed for estimating receiver operating characteristic curves and their associated summary indices, there is no consensus on a single framework that can provide consistent statistical inference while handling the complexities associated with medical data. Such complexities might include non-normal data, covariates that influence the diagnostic potential of a test, ordinal biomarkers or censored data due to instrument detection limits. We propose a regression model for the transformed test results which exploits the invariance of receiver operating characteristic curves to monotonic transformations and accommodates these features. Simulation studies show that the estimates based on transformation models are unbiased and yield coverage at nominal levels. The methodology is applied to a cross-sectional study of metabolic syndrome where we investigate the covariate-specific performance of weight-to-height ratio as a non-invasive diagnostic test. Software implementations for all the methods described in the article are provided in the tram add-on package to the R system for statistical computing and graphics.
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Affiliation(s)
- Ainesh Sewak
- Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Zürich, Switzerland
| | - Torsten Hothorn
- Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Zürich, Switzerland
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Liu T, Lu W, Zhao X, Yao T, Song B, Fan H, Gao G, Liu C. Relationship between lipid accumulation product and new-onset diabetes in the Japanese population: a retrospective cohort study. Front Endocrinol (Lausanne) 2023; 14:1181941. [PMID: 37265697 PMCID: PMC10230034 DOI: 10.3389/fendo.2023.1181941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/04/2023] [Indexed: 06/03/2023] Open
Abstract
Background Diabetes has become a global public health problem. Obesity has been established as a risk factor for diabetes. However, it remains unclear which of the obesity indicators (BMI, WC, WhtR, ABSI, BRI, LAP, VAI) is more appropriate for monitoring diabetes. Therefore, the objective of this investigation is to compare the strength of the association of these indicators and diabetes and reveal the relationship between LAP and diabetes. Methods 15,252 people took part in this research. LAP was quartered and COX proportional risk model was applied to explore the relationship between LAP and new-onset diabetes. Smooth curve fitting was employed to investigate the non-linear link between LAP and diabetes mellitus. Finally, the receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the aforementioned indicators for diabetes. Results After adjusting for confounding factors, multiple linear regression analysis showed that each unit increase in LAP was associated with a 76.8% increase in the risk of developing diabetes (HR=1.768, 95% CI: 1.139 to 2.746, P=0.011). In addition, LAP predicted new-onset diabetes better than other indicators, and the AUC was the largest [HR: 0.713, 95% CI: 0.6806-0.7454, P<0.001, in women; HR: 0.7922, 95% CI: 0.7396-0.8447; P<0.001, in men]. When LAP was used as a lone predictor, its AUC area was largest both men and women. However, after adding classical predictors (FPG, HbA1c, SBP, exercise, age) to the model, the LAP is better than the ABSI, but not better than the other indicators when compared in pairs. Conclusions High levels of LAP correlate very strongly with diabetes and are an important risk factor for diabetes, especially in women, those with fatty liver and current smokers. LAP was superior to other indicators when screening for diabetes susceptibility using a single indicator of obesity, both in men and in women. However, when obesity indicators were added to the model together with classical predictors, LAP did not show a significant advantage over other indicators, except ABSI.
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Affiliation(s)
| | | | | | | | | | | | | | - Chengyun Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Guo H, An Z, Wang N, Ge S, Cai J, Yu S, Zhou Y, Ying R, Zha K, Gu T, Zhao Y, Lu Y. Diabetes Mellitus Type 2 Patients with Abdominal Obesity Are Prone to Osteodysfunction: A Cross-Sectional Study. J Diabetes Res 2023; 2023:3872126. [PMID: 37102159 PMCID: PMC10125752 DOI: 10.1155/2023/3872126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/31/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
Introduction The interaction between diabetes, obesity, and bone metabolism was drawing increasing public attention. However, the osteometabolic changes in diabetes mellitus type 2 (T2DM) patients with abdominal obesity have not been fully revealed. This study is aimed at investigating the association between abdominal obesity indices and bone turnover markers among T2DM participants. Methods 4351 subjects were involved in the METAL study. Abdominal obesity indices included neck, waist, and hip circumference, visceral adiposity index (VAI), lipid accumulation product (LAP), waist-to-hip ratio (WHR), and Chinese visceral adiposity index (CVAI). They were applied to elucidate the nexus between β-C-terminal telopeptide (β-CTX), osteocalcin (OC), and intact N-terminal propeptide of type I collagen (P1NP). Results Abdominal obesity indices were strongly negatively associated with β-CTX and OC. Among males, five indices were negatively correlated with β-CTX (BMI, WC, LAP, WHR, and CVAI) and OC (BMI, NC, WC, WHR, and CVAI). There were no significant associations with P1NP. Among females, all eight indices were negatively associated with β-CTX. Seven indices were negatively related to OC (BMI, NC, WC, HC, LAP, WHR, and CVAI). The VAI was negatively correlated with P1NP. Conclusions The present study demonstrated that in T2DM, abdominal obesity had an obviously negative correlation with bone metabolism. Abdominal obesity indices were significantly negatively associated with skeletal destruction (β-CTX) and formation (OC). In routine clinical practice, these easily obtained indices could be used as a preliminary screening method and relevant factors for osteodysfunction incidence risk at no additional cost and may be of particular value for postmenopausal women in T2DM populations.
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Affiliation(s)
- Hui Guo
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Zengmei An
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaohong Ge
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Jian Cai
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Shiyan Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhou
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Rong Ying
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Kexi Zha
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Tao Gu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yan Zhao
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ma YL, Jin CH, Zhao CC, Ke JF, Wang JW, Wang YJ, Lu JX, Huang GZ, Li LX. Waist-to-height ratio is a simple and practical alternative to waist circumference to diagnose metabolic syndrome in type 2 diabetes. Front Nutr 2022; 9:986090. [PMID: 36419559 PMCID: PMC9676651 DOI: 10.3389/fnut.2022.986090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/20/2022] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND As an indicator of abdominal obesity, waist circumference (WC) varied with race and gender in diagnosing metabolic syndrome (MetS). Therefore, it is clinically important to find an alternative indicator of abdominal obesity independent of these factors to diagnose MetS. Our aims were to evaluate the association between waist-to-height ratio (WHtR) and MetS and further determine whether WHtR could be used as a simple and practical alternative to WC to diagnose MetS in patients with type 2 diabetes mellitus (T2DM). METHODS This cross-sectional, real-world study recruited 8488 hospitalized T2DM patients including 3719 women (43.8%) aged from 18 to 94 years and 4769 men (56.2%) aged from 18 to 91 years. A WHtR cut-off of 0.52 was used to diagnose MetS in both men and women T2DM patients based on our previous study. The association of WHtR with MetS in T2DM patients was analyzed by binary logistic regression. The consistency of two diagnostic criteria for MetS according to WC and WHtR was determined by Kappa test. RESULTS The prevalence of MetS according to WHtR was 79.4% in women and 68.6% in men T2DM patients, which was very close to the prevalence of MetS according to WC in both women (82.6%) and men (68.3%). The prevalence of MetS diagnosed by WC in both men and women with WHtR ≥ 0.52 was significantly higher than in those with WHtR < 0.52 after adjustment for age and duration of diabetes (89.2 vs. 38.7% for men; 92.8 vs. 57.4% for women; respectively, all p < 0.001). Binary logistic regression analysis displayed that after adjusting for confounding factors, WHtR was significantly associated with the presence of MetS in both men and women (men: OR = 4.821, 95% CI: 3.949-5.885; women: OR = 3.096, 95% CI: 2.484-3.860; respectively, all p < 0.001). Kappa test revealed that there was an excellent consistency between the diagnosis of MetS based on WC and on WHtR in T2DM patients (men: kappa value = 0.929, 95% CI: 0.918-0.940; women: kappa value = 0.874, 95% CI: 0.854-0.894; total: kappa value = 0.911, 95% CI: 0.901-0.921; respectively, all p < 0.001). CONCLUSION WHtR is independently associated with the presence of MetS and can be used as a simple and practical alternative to WC to diagnose MetS regardless of gender in T2DM patients.
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Affiliation(s)
- Yi-Lin Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Chun-Hua Jin
- Department of Endocrinology and Metabolism, Shanghai Songjiang District Central Hospital, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Preparatory Stage), Shanghai, China
| | - Cui-Chun Zhao
- Department of VIP, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang-Feng Ke
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jun-Wei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yu-Jie Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jun-Xi Lu
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Gao-Zhong Huang
- Department of VIP, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian-Xi Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
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Anthropometric Cut-Off Values for Detecting the Presence of Metabolic Syndrome and Its Multiple Components among Adults in Vietnam: The Role of Novel Indices. Nutrients 2022; 14:nu14194024. [PMID: 36235677 PMCID: PMC9571833 DOI: 10.3390/nu14194024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
Recent studies have shown that using international guidelines to diagnose metabolic syndrome (MetS) may underestimate its prevalence in different Asian populations. This study aims to determine the validity of anthropometric indicators and appropriate cut-off values to predict MetS for Vietnamese adults. We analyzed data on 4701 adults across four regions of Vietnam. Four conventional and five novel anthropometric indexes were calculated. The area under a receiver operating characteristic (ROC) curve (AUC) and Youden’s J statistic were applied to evaluate the diagnostic ability and optimal cut-off values. Regardless of diagnostic criteria and gender, Abdominal volume index (AVI), Body roundness index (BRI), and Waist-height ratio (WHtR) had the highest AUC values, followed by Body mass index (BMI) and Waist-hip ratio (WHR). However, it was seen that differences among the AUC values of most indices were minor. In men, using International Diabetes Federation (IDF) criteria, the threshold of indices was 3.86 for BRI, 16.20 for AVI, 0.53 for WHtR, 22.40 for BMI, and 0.90 for WHR. In women, the threshold for these figures were 3.60, 12.80, 0.51, 23.58, and 0.85, respectively. It is recommended that health personnel in Vietnam should apply appropriate thresholds of anthropometry, which are lower than current international guidelines, for MetS screening to avoid under-diagnosis.
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Sun B, Yao X, Yin C. An N-Shaped Association between Population Density and Abdominal Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9577. [PMID: 35954934 PMCID: PMC9368206 DOI: 10.3390/ijerph19159577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022]
Abstract
Abdominal obesity is a threat to public health and healthy cities. Densification may reduce abdominal obesity, but current evidence of the relationship between population density and abdominal obesity is not conclusive. The aim of this study was to disentangle the nonlinear association between population density and abdominal obesity. Data came from the 2004-2015 China Health and Nutrition Survey, which included 36,422 adults aged between 18 and 65 years. Generalized additive models (GAMs) were applied to explore how population density was associated with objectively measured waist circumference (WC) and waist-to-height ratio (WHtR), after controlling for other built environmental attributes, socioeconomic characteristics, and regional and year fixed effects. We found that population density had N-shaped associations with both WC and WHtR, and the two turning points were 12,000 and 50,000 people/km2. In particular, population density was positively correlated with abdominal obesity when it was below 12,000 people/km2. Population density was negatively associated with abdominal obesity when it was between 12,000 and 50,000 people/km2. Population density was also positively related to abdominal obesity when it was greater than 50,000 people/km2. Therefore, densification is not always useful to reduce abdominal obesity. Policy-makers need to pay more attention to local density contexts before adopting densification strategies.
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Affiliation(s)
- Bindong Sun
- The Center for Modern Chinese City Studies, East China Normal University, Shanghai 200241, China
- Research Center for China Administrative Division, East China Normal University, Shanghai 200241, China
- Institute of Eco-Chongming, 20 Cuiniao Rd., Chenjia Zhen, Chongming, Shanghai 202162, China
- School of Urban and Regional Science, East China Normal University, Shanghai 200241, China
- Future City Laboratory, East China Normal University, Shanghai 200241, China
| | - Xiajie Yao
- Research Center for China Administrative Division, East China Normal University, Shanghai 200241, China
- Institute of Eco-Chongming, 20 Cuiniao Rd., Chenjia Zhen, Chongming, Shanghai 202162, China
- School of Urban and Regional Science, East China Normal University, Shanghai 200241, China
- Future City Laboratory, East China Normal University, Shanghai 200241, China
| | - Chun Yin
- Research Center for China Administrative Division, East China Normal University, Shanghai 200241, China
- Institute of Eco-Chongming, 20 Cuiniao Rd., Chenjia Zhen, Chongming, Shanghai 202162, China
- School of Urban and Regional Science, East China Normal University, Shanghai 200241, China
- Future City Laboratory, East China Normal University, Shanghai 200241, China
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Wu W, Wu Y, Yang J, Sun D, Wang Y, Ni Z, Yang F, Xie Y, Tan X, Li L, Li L. Relationship between obesity indicators and hypertension-diabetes comorbidity among adults: a population study from Central China. BMJ Open 2022; 12:e052674. [PMID: 35858720 PMCID: PMC9305822 DOI: 10.1136/bmjopen-2021-052674] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the relationship between obesity indicators and hypertension-diabetes comorbidity (HDC) among adults in central China. DESIGN AND SETTING A cross-sectional study was conducted from 1 June 2015 to 30 September 2018 in 11 districts of Hubei Province, China. PARTICIPANTS A total of 29 396 participants aged 18 years or above were enrolled in the study. 2083 subjects with missing data were excluded. Eventually, 25 356 participants were available for the present analysis. MAIN OUTCOME MEASURES Data were subjected to univariable and multivariable logistic regression to examine the association between obesity indicators (body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR)) and HDC prevalence. Crude odds ratio and adjusted OR (AOR) with associated 95% CI were calculated. RESULTS Overall, 2.8% of the respondents had HDC. The odds of HDC prevalence increased with the BMI of the participants (18.5≤BMI (kg/m2)≤23.9-1; 24≤BMI (kg/m2)≤26.9-AOR: 5.66, 95% CI: 4.25 to 7.55; BMI (kg/m2)≥27-AOR: 7.96, 95% CI: 5.83 to 10.87). The risk of HDC also increased with the WHtR of participants (WHtR≤P25-1; P25≤WHtR≤P50-AOR: 1.73, 95% CI: 1.10 to 2.71; P50 ≤WHtR≤P75-AOR: 2.51, 95% CI: 1.60 to 3.92; WHtR≥P75-AOR: 3.22, 95% CI: 2.01 to 5.16). Stratified analysis by gender showed that high BMI and WHtR were risk factors of HDC in males and females. However, the odds of HDC prevalence increased only when WHtR≥P75 in males, whereas the probability of HDC increased when WHtR≥ P25 in females. CONCLUSION High BMI and WHtR can increase the risk of HDC among Chinese adults. Reasonable control of BMI and WHtR may be beneficial in preventing HDC. Females should focus on maintaining an optimal WHtR earlier.
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Affiliation(s)
- Wenwen Wu
- Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- School of Public Health, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yifan Wu
- Department of Traditional Chinese Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jinru Yang
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Donghan Sun
- Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Ying Wang
- Department of Nosocomial Infection Management, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Ziling Ni
- School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Fen Yang
- Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Yaofei Xie
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Ling Li
- Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li Li
- Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Suarez J, Makridis M, Anesiadou A, Komnos D, Ciuffo B, Fontaras G. Benchmarking the driver acceleration impact on vehicle energy consumption and CO 2 emissions. TRANSPORTATION RESEARCH. PART D, TRANSPORT AND ENVIRONMENT 2022. [PMID: 35784495 DOI: 10.1016/j.trd.2022.103228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The study proposes a methodology for quantifying the impact of real-world heterogeneous driving behavior on vehicle energy consumption, linking instantaneous acceleration heterogeneity and CO2 emissions. Data recorded from 20 different drivers under real driving are benchmarked against the Worldwide Harmonized Light Vehicle Test Cycle (WLTC), first by correlating the speed cycle with individual driver behavior and then by quantifying the CO2 emissions and consumption. The vehicle-Independent Driving Style metric (IDS) is used to quantify acceleration dynamicity, introducing driving style stochasticity by means of probability distribution functions. Results show that the WLTC cycle assumes a relatively smooth acceleration style compared to the observed ones. The method successfully associates acceleration dynamicity to CO2 emissions. We observe a 5% difference in the CO2 emissions between the most favourable and the least favourable case. The intra-driver variance reached 3%, while the inter-driver variance is below 2%. The approach can be used for quantifying the driving style induced emissions divergence.
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Affiliation(s)
- Jaime Suarez
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Michail Makridis
- ETH Zürich, Institute for Transport Planning and Systems (IVT), Zürich, Switzerland
| | | | | | - Biagio Ciuffo
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Tang Z, Yang C, Zheng H, Jing J, Li X, Zhu Y. Adiposity measures in screening for metabolic syndrome among Chinese children and adolescents. J Pediatr Endocrinol Metab 2022; 35:617-625. [PMID: 35316596 DOI: 10.1515/jpem-2021-0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/01/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Existing various and complicated metabolic syndrome (MetS) definitions have contributed to the difficulty in assessing MetS in children and adolescents, and therefore it is urgently needed to develop a convenient and effective screening tool for pediatric MetS. This study aimed to identify the optimal adiposity measure to screen for pediatric MetS. METHODS The cross-sectional data was collected from 8,150 children and adolescents aged 7-17 y living in southern China. Anthropometric indices, blood lipids, and serum glucose were determined. Results of two commonly used MetS definitions were compared: International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP) modified by Cook. Receiver operating characteristic curve analyses were performed and areas under the curve (AUCs) were calculated to determine the optimal index for MetS screening. RESULTS MetS prevalence assessed by NCEP-ATP was significantly higher than that by IDF (6.2% vs. 1.5%, p<0.001). Waist-to-height ratio (WHtR) showed the highest screening power for MetS defined by both IDF and NCEP-ATP (AUC 0.932 and 0.900, respectively), and its optimal cut-off point was 0.48 by both IDF and NCEP-ATP definition (sensitivity 0.944 and 0.847, specificity 0.800 and 0.830, respectively), regardless of age or sex. When taking sex diversity into account, the optimal WHtR cut-off point was 0.49 (IDF) or 0.50 (NCEP-ATP) in boys, and 0.46 (both definitions) in girls. CONCLUSIONS Among children and adolescents aged 7-17 y in southern China, a WHtR greater than 0.48 can be a simple but effective screening tool for MetS.
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Affiliation(s)
- Zhaoxie Tang
- Department of Maternal and Child Health and Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Chen Yang
- Physical Examination Center, The Eastern Hospital of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao Zheng
- Department of Maternal and Child Health and Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Jiajia Jing
- Department of Maternal and Child Health and Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Xiuhong Li
- Department of Maternal and Child Health and Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yanna Zhu
- Department of Maternal and Child Health and Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
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Pouragha H, Amiri M, Saraei M, Pouryaghoub G, Mehrdad R. Body impedance analyzer and anthropometric indicators; predictors of metabolic syndrome. J Diabetes Metab Disord 2021; 20:1169-1178. [PMID: 34277496 PMCID: PMC8275900 DOI: 10.1007/s40200-021-00836-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022]
Abstract
Aim Metabolic syndrome is one of the outcomes of a sedentary lifestyle in the modern world. In this study, we want to introduce the predictors of metabolic syndrome using anthropometric indices and Bio-Electrical Impedance Analysis (BIA) test values. Method This cross-sectional study was performed on 2284 employees of Tehran University of Medical Sciences in different job categories. Metabolic syndrome was determined according to IDF criteria. Anthropometric dimensions, para-clinical tests, basic information were collected from the participants. Also, the body analysis of the participants was performed using a BIA method. Result The prevalence of metabolic syndrome in this study was 23.2% based on IDF criteria, which was 21% and 26.6% in men and women, respectively. The most important factor among the components of IDF criteria was HDL deficiency. In this study, neck circumference, fat mass, visceral fat, muscle mass percentage and waist to height ratio were observed as predictors of metabolic syndrome. Conclusion This study realized that there is association between fat mass, fat-free mass, visceral fat and muscle mass which all are some elements of body composition analysis and metabolic syndrome as a major health issue.
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Affiliation(s)
- Hamidreza Pouragha
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Amiri
- Occupational Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Department of Occupational Medicine, School of Medicine Baharlou Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Pouryaghoub
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
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Rabiei N, Heshmat R, Gharibzadeh S, Ostovar A, Maleki V, Sadeghian M, Birjandi SM, Nabipour I, Shafiee G, Larijani B. Comparison of anthro-metabolic indicators for predicting the risk of metabolic syndrome in the elderly population: Bushehr Elderly Health (BEH) program. J Diabetes Metab Disord 2021; 20:1439-1447. [PMID: 34900795 PMCID: PMC8630247 DOI: 10.1007/s40200-021-00882-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/15/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster metabolic disorder that includes central obesity, insulin resistance, hypertension, and dyslipidemia, and is highly associated with an increased risk of developing non-communicable diseases (NCDs). This study aimed to compare the reliability of anthro-metabolic indices [visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (BSI), body adiposity index (BAI), lipid accumulation product (LAP), waist to hip ratio, and waist to height ratio] in predicting MetS in Iranian older people. METHODS This cross-sectional study was conducted based on the data of 2426 adults aged ≥60 years that participated in the second stage of the Bushehr Elderly Health (BEH) program, a population-based prospective cohort study being conducted in Bushehr, Iran. MetS was defined based on the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive performance of anthro-metabolic indices and determine optimal cutoff values. Logistic regression analysis was applied to determine the associations between MetS and indices. RESULTS 2426 subjects (48.1% men) with mean ± SD age of 69.34 ± 6.40 years were included in the study. According to ATP III criteria, 34.8% of men and 65.2% of women had MetS (P < 0.001). Of the seven examined indices, the AUCs of VAI and LAP in both genders were higher than AUCs of other anthro-metabolic indices. Also, in general population, VAI and LAP had the greatest predictive power for MetS with AUC 0.87(0.86-0.89) and 0.87(0.85-0.88), respectively. The lowest AUC in total population belonged to BSI with the area under the curve of 0.60(0.58-0.62). After adjusting for potential confounders (e.g. age, sex, education, physical activity, current smoking) in the logistic regression model, the highest OR in the total population was observed for VAI and LAP, which was 16.63 (13.31-20.79) and 12.56 (10.23-15.43) respectively. The lowest OR for MetS was 1.93(1.61-2.30) for BSI. CONCLUSION This study indicated that both VAI and LAP are the most valuable indices among the anthro-metabolic indices to identify MetS among the elderly in both genders. So, they could be used as proper assessment tools for MetS in clinical practice. However, the cost-benefit of these indices compared to the ATP III criteria need further studies.
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Affiliation(s)
- Neda Rabiei
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Maleki
- Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran
- Knee and Sport Medicine Research Center, Milad Hospital, Tehran, Iran
| | - Mehdi Sadeghian
- Shafa Nuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Saba Maleki Birjandi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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12
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Dorsey AF, Penny ME, Thompson AL. Adiposity and pathogen exposure: An investigation of response to iron supplementation and hypothesized predictors in anemic pre-school-aged children living in a dual burden environment. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 176:54-65. [PMID: 33852740 PMCID: PMC8376780 DOI: 10.1002/ajpa.24287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Peruvians are experiencing rapid dietary and lifestyle changes, resulting in a phenomenon known as the "dual burden of disease." A common manifestation of the dual burden in individuals is the co-occurrence of overweight and anemia. Despite recent initiatives introduced to address these concerns, rates continue to be public health concerns. This study investigates the relationship between immune activation and lack of response to iron supplementation after 1 month of treatment and explores variation in body fat stores as a potential moderator between immune function and response to treatment. METHODS Data come from children, aged 2-5 years (n = 50) from a peri-urban community in Lima, Peru. Multivariate logistic regression models were used to explore the associations between response to treatment (Hb > =11.0 g/dl) after 1 month of treatment), markers of immune activation (C-reactive protein [CRP] and reported morbidity symptoms), and measures of body fat (waist-to-height ratio, triceps skinfold thickness, and body mass index [BMI]). RESULTS We found that high CRP is associated with a lack of response to iron supplementation after 1 month of treatment and that BMI z-score may moderate this association. Generally, larger body size is associated with response to iron supplementation whether or not the children in this sample have high immune activation. However, the probability of anemic children responding to iron supplementation treatment differed across adiposity measures. CONCLUSIONS Our finding suggesting that adiposity and CRP influence response to iron supplementation, furthers our understanding of the relationship between inflammation and anemia treatment in children and has both theoretical and public health implications.
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Affiliation(s)
- Achsah F Dorsey
- Department of Anthropology, University of Massachusetts, Amherst, Massachusetts, USA
| | - Mary E Penny
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - Amanda L Thompson
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
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Kim H, Lee CW, Nam MJ, Choi YJ, Han K, Jung JH, Kim DH, Park JH. Association between body composite indices and vertebral fractures in pre and postmenopausal women in Korea. PLoS One 2021; 16:e0254755. [PMID: 34347809 PMCID: PMC8336842 DOI: 10.1371/journal.pone.0254755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/05/2021] [Indexed: 11/18/2022] Open
Abstract
The association between obesity and vertebral fracture remains controversial. This study aimed to investigate the association between obesity/abdominal obesity and vertebral fracture according to menopausal status. This nationwide population-based epidemiologic study collected data from the Korean National Health Insurance Services to investigate the association between obesity/abdominal obesity and vertebral fracture in pre and postmenopausal women who underwent national cancer screening in 2009. We used three body composite indices of obesity, body mass index, waist circumference and waist-to-height ratio, to classify participants into obesity and abdominal obesity groups. In both pre and postmenopausal groups, participants with obesity showed a higher risk of vertebral fracture and the association was stronger in those with abdominal obesity (p < 0.001). Participants with obesity showed a high risk of vertebral fracture, and the association was stronger in participants with abdominal obesity (p < 0.001). In both pre and postmenopausal groups, participants with obesity showed a higher risk of vertebral fracture (adjusted HR, 1.24; 95% CI, 1.19–1.30), (adjusted HR, 1.04; 95% CI, 1.03–1.05, and those with abdominal obesity showed even higher risk of vertebral fractures (adjusted HR, 1.35; 95% CI, 1.27–1.43), (adjusted HR, 1.13; 95% CI, 1.11–1.14). Vertebral fracture risk is higher in pre and postmenopausal women with obesity and even higher in those with abdominal obesity. Therefore, weight management can prevent vertebral fractures.
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Affiliation(s)
- HyunJin Kim
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan-si, Republic of Korea
| | - Chung-woo Lee
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan-si, Republic of Korea
| | - Myung Ji Nam
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan-si, Republic of Korea
| | - Yeon Joo Choi
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan-si, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jin-Hyung Jung
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan-si, Republic of Korea
- * E-mail: (DHK); (JHP)
| | - Joo-Hyun Park
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan-si, Republic of Korea
- * E-mail: (DHK); (JHP)
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Naghshband Z, Kumar L, Mandappa S, Niranjana Murthy AS, Malini SS. Visceral Adiposity Index and Lipid Accumulation Product as diagnostic markers of Metabolic Syndrome in South Indians with Polycystic Ovary Syndrome. J Hum Reprod Sci 2021; 14:234-243. [PMID: 34759612 PMCID: PMC8527071 DOI: 10.4103/jhrs.jhrs_12_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/28/2021] [Accepted: 05/17/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is one of the debilitating consequences of polycystic ovary syndrome (PCOS). Early diagnosis of metabolic syndrome (MetS) with a simple but accurate method can reduce the risk of progression to CVD in PCOS. AIMS This study aimed to determine the accuracy of various anthropometric indices and lipid accumulation product (LAP), in assessing the risk of MetS in PCOS. SETTINGS AND DESIGN This is a cross-sectional study including 150 PCOS women and 100 control subjects. MATERIALS AND METHODS Anthropometric parameters were measured and calculated. Lipid profile, fasting plasma glucose (FPG), and insulin were estimated. MetS was detected according to the International Diabetes Federation criteria. STATISTICAL ANALYSIS Logistic regression and receiver operating characteristic curve analysis were applied to determine the potential association of anthropometric indices such as body mass index, waist circumference (WC), waist-to-hip ratio, waist-to-height ratio, conicity index (CI), visceral adiposity index (VAI), abdominal volume index (AVI), body adiposity index (BAI), and a body shape index (ABSI) and LAP with MetS. RESULTS In our study of PCOS women of the south Indian population, the prevalence of MetS was 59.3%, which was higher than other populations and the cutoff values of VAI and LAP were 6.05 and 53, respectively. VAI showed the strongest association with MetS, followed by diastolic blood pressure BP, FPG, and LAP. CONCLUSIONS We recommend VAI and LAP as new indices for MetS diagnosis. As these indices exhibit population specificity, it is imperative that independent cutoffs are determined for every demographic population.
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Affiliation(s)
- Zeinab Naghshband
- Department of Studies in Zoology, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
| | - Lakshmi Kumar
- Department of Studies in Zoology, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
| | - Sonia Mandappa
- Mother's Care Clinic and Ashwini Hospital, Manasagangotri, Mysuru, Karnataka, India
| | - Ashitha S. Niranjana Murthy
- Department of Studies in Genetics and Genomics, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
| | - Suttur S. Malini
- Department of Studies in Zoology, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
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Chen J, Li M, Hao B, Cai Y, Li H, Zhou W, Song Y, Wang S, Liu H. Waist to height ratio is associated with an increased risk of mortality in Chinese patients with heart failure with preserved ejection fraction. BMC Cardiovasc Disord 2021; 21:263. [PMID: 34049494 PMCID: PMC8164240 DOI: 10.1186/s12872-021-02080-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022] Open
Abstract
Background Abdominal obesity as a predominant comorbidity has played a key role in the incidence and worsening of heart failure with preserved ejection fraction (HFpEF), and waist-to-height ratio (WHtR) behaves better than waist circumference or body mass index in evaluating abdominal obesity. While the association between WHtR and all-cause death in Chinese patients with HFpEF remains unclear. Methods Patients with stable HFpEF (N = 2041) who presented to our hospital from January 2008 to July 2019 were divided into low-WHtR (< 0.5, N = 378) and high-WHtR (≥ 0.5, N = 1663). Multivariable Cox proportional-hazard models were used to examine the association of WHtR with all-cause death. Results The average age was 76.63 ± 11.44 years, and the mean follow-up was 4.53 years. During follow-up, 185 patients (9.06%) reached the primary outcome of all-cause death. As for the secondary outcome, 79 patients (3.87%) experienced cardiovascular death, 106 (5.19%) had non-cardiovascular death, and 94 (4.61%) had heart failure rehospitalization. After multivariable adjustment, a higher WHtR was significantly associated with the increased risks of all-cause death [adjusted hazard ratios (HR) 1.91, 95% confidence interval (CI) 1.06–3.45, p = 0.032], cardiovascular death (adjusted HR 2.58; 95% CI 1.01–6.67, p = 0.048), and HF rehospitalization (adjusted HR 3.04; 95% CI 1.26–7.31, p = 0.013). Conclusions Higher WHtR is an independent risk factor for all-cause death in Chinese patients with HFpEF. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02080-9.
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Affiliation(s)
- Jianqiao Chen
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Man Li
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Benchuan Hao
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Yulun Cai
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Huiying Li
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Wenli Zhou
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Yujian Song
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China
| | - Shiqi Wang
- General Department of Zhengzhou First People's Hospital, #56 Dong Dajie, Guancheng Hui District, Zhengzhou City, 450000, Henan Province, China
| | - Hongbin Liu
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China.
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Cho S, Shin A, Choi JY, Park SM, Kang D, Lee JK. Optimal cutoff values for anthropometric indices of obesity as discriminators of metabolic abnormalities in Korea: results from a Health Examinees study. BMC Public Health 2021; 21:459. [PMID: 33676466 PMCID: PMC7937287 DOI: 10.1186/s12889-021-10490-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/23/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cutoff values for obesity indices to discriminate the presence of metabolic abnormalities as a primary risk factor for cardiovascular diseases in a Health Examinees study (HEXA). METHODS The current study analyzed 134,195 participants with complete anthropometric and laboratory information in a Health Examinees study, consisting of the Korean population aged 40 to 69 years. The presence of metabolic abnormality was defined as having at least one of the following: hypertension, hyperglycemia, or dyslipidemia. The area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs) were calculated for body mass index, waist to hip ratio, waist to height ratio, waist circumference, and conicity index. RESULTS The AUC of metabolic abnormalities was the highest for waist-to-height ratio (AUC [95% CIs], 0.677 [0.672-0.683] among men; 0.691 [0.687-0.694] among women), and the lowest for the C index (0.616 [0.611-0.622] among men; 0.645 [0.641-0.649] among women) among both men and women. The optimal cutoff values were 24.3 kg/m2 for the body mass index, 0.887 for the waist-to-hip ratio, 0.499 for the waist-to-height ratio, 84.4 cm for waist circumference and 1.20 m3/2/kg1/2 for the conicity index among men, and 23.4 kg/m2 for the body mass index, 0.832 for the waist-to-hip ratio, 0.496 for the waist-to-height ratio, 77.0 cm for the waist circumference and 1.18 m3/2/kg1/2 for the conicity index among women. CONCLUSION The waist-to-height ratio is the best index to discriminate metabolic abnormalities among middle-aged Koreans. The optimal cutoff of obesity indices is lower than the international guidelines for obesity. It would be appropriate to use the indices for abdominal obesity rather than general obesity and to consider a lower level of body mass index and waist circumference than the current guidelines to determine obesity-related health problems in Koreans.
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Affiliation(s)
- Sooyoung Cho
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Ji-Yeob Choi
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Sang Min Park
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Jong-Koo Lee
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Seoul Center for Infectious Disease Control, Seoul, Republic of Korea
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Wuhib Shumye M, Tegegne B, Ademe S, Workneh M, Abera M, Nemera G, Balcha F. The Magnitude of Diabetes Mellitus in Adult Hypertensive Patients in Northeast Ethiopia. Diabetes Metab Syndr Obes 2021; 14:37-45. [PMID: 33442280 PMCID: PMC7797297 DOI: 10.2147/dmso.s283158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/24/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hypertension and diabetes mellitus are the most common comorbid non-communicable chronic diseases that threaten human beings worldwide. Hypertension is associated with an increased risk of diabetes mellitus and vis-a-vis. However, there is limited information on the magnitude of diabetes mellitus in hypertensive patients in sub-Saharan countries. Hence, this study assessed the magnitude of diabetes mellitus and its associated factors among adult hypertensive patients attending a hypertension clinic in Northeast Ethiopia. METHODS Institution-based cross-sectional study conducted on 407 participants from April to June 2019. The participants were included in the study using systematic random sampling. Data were collected using the WHO STEPwise method. We run descriptive statistics to determine the magnitude of diabetes mellitus in hypertensive patients and logistic regression to identify factors associated with diabetes, and statistically significant associations were declared at a P-value of less than 0.05. RESULTS The magnitude of diabetes mellitus among hypertensive patients was 29.1%, of whom 24% were newly diagnosed. Respondents with a family history of diabetes mellitus (AOR: 4.6, CI: 2.2, 9.48), increased waist-to-height ratio (AOR: 21.5, CI: 5.62,43.67), increased waist circumference (AOR: 3.2, CI: 1.58, 6.53) and primary school educational status (AOR: 3.2, CI: 1.41, 7.25) were more likely to have diabetes. Similarly, respondents with longer hypertension duration (AOR: 4.09, CI: 1.22, 13.64), past daily smoking history (AOR: 10.46, CI: 1.59,6.8), increased diastolic blood pressure (AOR: 4.15, CI: 1.51, 11.37), and increased waist circumference (AOR: 7.5, CI: 4.47,14.95) were more likely to be diagnosed newly for diabetes. CONCLUSION Our study indicated around one-third of hypertensive patients had diabetes. Family history of diabetes mellitus, primary educational status and increased waist-to-height ratio and waist circumference were significant predictors of diabetes among hypertensive patients. The finding suggests the need for regular diabetic screening among hypertensive patients.
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Affiliation(s)
- Mekuriaw Wuhib Shumye
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- Correspondence: Mekuriaw Wuhib Shumye Tel +251 92 126 8193 Email
| | - Belachew Tegegne
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Sewunet Ademe
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Moges Workneh
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Million Abera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gugsa Nemera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fikadu Balcha
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Wang K, Pan L, Wang D, Dong F, Yu Y, Wang L, Li L, Liu T, Sun L, Zhu G, Feng K, Xu K, Pang X, Chen T, Pan H, Ma J, Zhong Y, Shan G. Association between obesity indicators and cardiovascular risk factors among adults in low-income Han Chinese from southwest China. Medicine (Baltimore) 2020; 99:e20176. [PMID: 32791656 PMCID: PMC7387039 DOI: 10.1097/md.0000000000020176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There may be differences in optimal anthropometric cut-offs for diagnosing obesity among different regions of China. However, there has been little studies about choosing effective obesity indicators in Han People of low-income Chinese adults in southwest China. The purpose of this study was to compare and evaluate the associations between different obesity indicators and cardiovascular disease risk factors (CVDRF) and choose the optimal cut-off values.A cross-sectional study was carried out in southwest of China, with multi-stage sampling enrolling 2112 subjects aged 20 to 80 years old. Anthropometric measurements included Body mass index (BMI), waist circumference (WC), Hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We measured the percentage of body fat (PBF) by bioelectrical impedance analyzer to assess the body composition. The validity of different obesity indicators in assessing CVDRF risk were assessed through comparison area under curve of different indicators in assessing CVDRF risk in different gender. Logistic regression models were used to evaluate the association between the obesity indicators and CVDRF.When both male and female were considered, the optimal indicators were WHtR and percentage of body fat PBF for hypertension, WHR and WHtR for dyslipidemia. Both WC and WHtR were optimal indicators in assessing metabolic syndrome risk for both genders. When both disease and gender were considered, WHtR was the best associated indicators with various CVDRF. The cut-off of BMI and WC were consistent to the definition of obesity in Working Group of China. The WHtR positively correlated with the CVDRF. The cut-off of WHtR to do what was approximately 0.50 for adults in both genders in southwest of China.WHtR may be the best associated indicators for obesity-related CVDRF among the others (BMI, WC, Hip circumference, PBF, and WHR) in southwest of China. The cut-off of WHtR was approximately 0.50 for adults in both genders in southwest of China.
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Affiliation(s)
- Ke Wang
- National Office for Maternal and Child Health Surveillance of China, Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Dingming Wang
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Fen Dong
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yangwen Yu
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Li Wang
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ling Li
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Tao Liu
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Liangxian Sun
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Guangjin Zhu
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Kui Feng
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ke Xu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinglong Pang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ting Chen
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Pan
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jin Ma
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yong Zhong
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
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Argüello-González AJ, García-Zazueta MA. Prevalence of overweight and obesity in a Mexican prison. ACTA ACUST UNITED AC 2020; 22:58-65. [PMID: 32697275 PMCID: PMC7537363 DOI: 10.18176/resp.00011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/04/2019] [Indexed: 11/20/2022]
Abstract
Objectives Overweight and obesity constitute a public health problem; There are few prevalence studies of inmates. The objectives of this study are to determine the prevalence of overweight and obesity amongst inmates of the Islas Marias Prison Complex and to evaluate the waist-to-hip ratio (WHR) and the waist-to-height ratio (WHtR) as diagnostic measurements for abdominal obesity in this population. Material and method Analytical, retrospective cross-sectional study at Rural Hospital No. 20 Islas Marias Nayarit, Mexico, with 426 cases from January 2016 to March 2017, who were male inmates from 18 to 73 years of age. The following ratios were calculated: BMI, WHR WHtR. A descriptive analysis was carried out for quantitative variables, frequencies and percentages by group, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index, positive and negative likelihood ratios of WHR and WHtR; ANOVA F test, Student's t-test, ROC curve, STROBE statement, SPSS v. 22. Results 51.41% cases presented as overweight, 25.35% were obese, the cut-off point was 0.935 for WHR (s = 0.833; e = 0.717) and 0.545 for WHtR ICA (s = 0.981; e = 0.818). WHtR showed a good performance according to the Youden index. Discussion There was a high prevalence of overweight and obesity in prisoners at the Islas Marias Prison Complex, WHtR showed better performance than WHR for diagnosing abdominal obesity. It is suggested that measurement of WHI should be included in daily medical practice.
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Affiliation(s)
- A J Argüello-González
- Mexican Social Security Institute. Family Medicine Unit No. 186. State of Mexico, Mexico
| | - M A García-Zazueta
- Rural Hospital of the Mexican Social Security Institute. Islas Maria Madre. Mexico
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Lee BJ, Kim JY. Identification of metabolic syndrome using phenotypes consisting of triglyceride levels with anthropometric indices in Korean adults. BMC Endocr Disord 2020; 20:29. [PMID: 32103744 PMCID: PMC7045372 DOI: 10.1186/s12902-020-0510-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 02/19/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The metabolic syndrome (MetS) has shown strong associations with the hypertriglyceridemic waist (HW) phenotype. The best anthropometric indicator of MetS remains controversial. Furthermore, no studies have investigated alternative indices that could replace waist circumference in the HW phenotype. The objectives of this study were to find the best indicator of MetS among anthropometric indices and to examine the predictive power of phenotypes consisting of triglyceride levels with anthropometric indices. METHODS A total of 12,025 subjects participated in this retrospective cross-sectional study. All subjects were recruited between November 2016 and August 2007 from hospitals in 28 urban and rural regions in South Korea. The data analyzed in this study were obtained from the Korean Health and Genome Epidemiology Study database and the Korea Institute of Oriental Medicine. RESULTS The proportion of patients with MetS ranged from 9 to 57% according to age and gender groups. Waist circumference (WC) was best indicator of MetS in men of all age groups. However, in women aged 40-49 years, the waist-to-height ratio (WHtR) was the best indicator of MetS. Rib circumference and chest circumference were the strongest indicators in women aged 50-59 years and 70-79 years, respectively. The combination of WC and triglyceride (TG) was the best indicator of MetS in men and women overall. However, interestingly, the best indicator was TG + WHtR in women aged 40-49 years and TG + forehead-to-waist ratio in women aged 70-79 years. CONCLUSIONS The best indicator of MetS in terms of individual anthropometric indices and the various phenotypes combining a single anthropometric index with TG may differ subtly according to age group in women, but not in men. Our findings provide insight into a simple and inexpensive method that could be used to identify MetS in initial health screening efforts in epidemiology and public health.
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Affiliation(s)
- Bum Ju Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811 Republic of Korea
| | - Jong Yeol Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811 Republic of Korea
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Liu PJ, Lou HP, Zhu YN. Screening for Metabolic Syndrome Using an Integrated Continuous Index Consisting of Waist Circumference and Triglyceride: A Preliminary Cross-sectional Study. Diabetes Metab Syndr Obes 2020; 13:2899-2907. [PMID: 32884316 PMCID: PMC7443454 DOI: 10.2147/dmso.s259770] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/29/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND It has been suggested that hypertriglyceridemic waist (HW) phenotype is strongly associated with metabolic syndrome (MetS); however, there are very limited studies integrating triglyceride (TG) and waist circumference (WC) into a continuous variable to investigate the predictive power of this phenotype. Inspired from the triglyceride glucose index (TyG), we developed an integrated continuous index termed waist-triglyceride index (WTI) which was calculated as Ln [TG (mg/dl) WC (cm)/2]. OBJECTIVE We aimed to examine the potential of WTI in screening for MetS by comparing this quantitative index with the qualitative HW phenotype and other frequently used indices. METHODS A cross-sectional study was conducted in a total of 3460 non-diabetic adults who participated in an annual health checkup. MetS was defined by the update National Cholesterol Education Program/Adult Treatment Panel ш criteria for Asian Americans. Receiving operating characteristic (ROC) curve and areas under the curve (AUC) were employed to evaluate the performance of the involved indices in screening for MetS. Statistical differences among the AUC values of the indices were compared. RESULTS In both genders, the AUC value of WTI, TyG or HW phenotype was markedly larger than that of each anthropometric index alone. In men, there were no statistical differences in the AUC values among WTI, TyG and HW phenotype, whereas in women, the AUC value of WTI was significantly larger than that of HW phenotype [difference between area (DBA): 0.042, 95% CI: 0.0224-0.0617, P < 0.0001] and was nominally and significantly smaller than that of TyG (DBA: 0.00646, 95% CI: 0.000903-0.012, P = 0.0227). CONCLUSION Our results suggest that there are discriminatory performance between the WTI and HW phenotype in the detection of MetS in women rather than in men. Appropriate markers for screening MetS in population study should be considered according to the genders.
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Affiliation(s)
- Peng Ju Liu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Peng Ju Liu Tel +86-10-69155550Fax +86-10-69155551 Email
| | - Hui Ping Lou
- Department of Medical Examination Center, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yan Ning Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
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Sun K, Xie Y, Zhao N, Li Z. A case-control study of the relationship between visceral fat and development of uterine fibroids. Exp Ther Med 2019; 18:404-410. [PMID: 31258679 PMCID: PMC6566109 DOI: 10.3892/etm.2019.7575] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/18/2019] [Indexed: 12/11/2022] Open
Abstract
Relationship between visceral fat and development of uterine fibroids in adult women was investigated. A total of 89 patients with uterine fibroids treated in the First Hospital of Hebei Medical University from April 2016 to April 2018 were enrolled. Another 81 healthy women without uterine fibroids receiving physical examination in the same period were selected as the control group. Self-designed questionnaires were used to investigate the general conditions of the subjects, bioelectrical impedance analysis was employed to analyze obesity-related indicators, and their correlation with the risk of uterine fibroids was explored. Visceral fat area (VFA), body mass index (BMI), body fat percentage, waist circumference, waist-height ratio and waist-hip ratio were positively correlated with the incidence rate of uterine fibroids, and the odds ratio (OR), 95% confidence interval (CI) was 3.910 (2.029, 7.536), 2.716 (1.444, 5.110), 4.335 (1.507, 12.469), 2.881 (1.531, 5.423), 3.837 (1.914, 7.692) and 7.707 (3.501, 16.965), respectively. VFA and body fat percentage were correlated with the size of uterine fibroids, but the correlations were relatively weak. With the increase in the VFA, BMI, waist circumference, waist-height ratio, and waist-hip ratio, the risk of uterine fibroids was elevated. The BMI, VFA and waist circumference of patients with uterine fibroids were gradually increased with increasing age, showing statistically significant differences. Increased body fat (especially abdominal visceral fat) is able to enhance the risk of uterine fibroids. For perimenopausal women, the waist-hip ratio measured can be used as an indicator screening high-risk groups of uterine fibroids. This method is simple, easy and inexpensive. At the same time, providing nutrition guidance and changing diet and exercise habits are important measures to prevent the development of uterine fibroids.
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Affiliation(s)
- Kejuan Sun
- Department of Nursing, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, P.R. China
| | - Ying Xie
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, P.R. China
| | - Na Zhao
- Department of Gynecology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, P.R. China
| | - Zengning Li
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, P.R. China
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Song P, Li X, Bu Y, Ding S, Zhai D, Wang E, Yu Z. Temporal trends in normal weight central obesity and its associations with cardiometabolic risk among Chinese adults. Sci Rep 2019; 9:5411. [PMID: 30931996 PMCID: PMC6443661 DOI: 10.1038/s41598-019-41986-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/18/2019] [Indexed: 02/08/2023] Open
Abstract
Normal weight central obesity (NWCO), a distinct phenotype of obesity that is associated with a higher risk of cardiometabolic dysregulation, has received growing attention in the scientific literature. In this study, we aimed to report the prevalence of NWCO in the general Chinese adults and its secular trend from 1993 to 2011. The comorbid cardiometabolic risk of NWCO was also explored. Data from the China Health and Nutrition Survey (CHNS) 1993-2011 were obtained. NWCO was defined as the combination of a BMI of 18.5-23.9 kg/m2 and 1) a waist circumference (WC) of >85 cm in males or >80 cm in females (NWCO by WC); 2) a waist to height ratio (WHtR) of ≥0.5 (NWCO by WHtR); 3) a waist to hip ratio (WHR) of ≥0.9 in males or ≥0.85 in females (NWCO by WHR). We assessed the trend of NWCO prevalence with the generalized estimating equation method. The demographic, socioeconomic, geographic, behavioural and cardiometabolic predictors of NWCO were explored with multivariable logistic regression. From 1993 to 2011, the age-standardized prevalence of NWCO by WC increased from 6.65% (95% CI: 6.09-7.26) to 13.24% (95% CI: 12.58-13.93), and that of NWCO by WHtR and NWCO by WHR rose from 13.18% (95% CI: 12.41-13.98) to 17.06% (95% CI: 16.35-17.79) and from 16.14% (95% CI: 15.3-17.01) to 19.04% (95% CI: 18.25-19.85) respectively. The associated cardiometabolic factors of NWCO (by WC, WHtR and WHR) were hypertension, diabetes, insulin resistance, decreased insulin sensitivity, low high-density lipoprotein and elevated triglyceride. Moreover, NWCO by WC and NWCO by WHtR were associated with a decreased risk of impaired insulin secretion, and NWCO by WC was additionally linked to elevated total cholesterol. The prevalence of NWCO in the general Chinese adults increased significantly from 1993 to 2011. Effective strategies are needed to combat this epidemic and reduce its deleterious health outcomes.
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Affiliation(s)
- Peige Song
- School of Public Health, Xinxiang Medical University, Xinxiang, China
- Centre for Global Health Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Xue Li
- School of Public Health, Xinxiang Medical University, Xinxiang, China
- Centre for Global Health Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Yongjun Bu
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Erhui Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang, China.
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Wu X, Li B, Lin WQ, Huang LL, Wang XX, Fu LY, Li BB, Wang PX. The association between obesity indices and hypertension: Which index is the most notable indicator of hypertension in different age groups stratified by sex? Clin Exp Hypertens 2018; 41:373-380. [PMID: 30095294 DOI: 10.1080/10641963.2018.1489546] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the most notable obesity index and its optimal cut-off point of hypertension in different age groups stratified by sexes among community residents in southern China. METHODS In this cross-sectional study, 620 men and 631 women aged 18-59 years were enrolled. The independent-samples t-test and chi-square test were conducted to analyze continuous and categorical variables, respectively. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis assessed the association between the obesity indices and hypertension risk. RESULTS Waist-stature ratio (WSR) and waist-hip ratio (WHR) were the most notable risk factors for hypertension in young men and women, respectively. The odds ratios (ORs) of hypertension risk increased with per standard deviation (SD) in WSR and WHR (WSR: OR = 2.877, 95% confidence interval [CI] = 1.602 to 5.167; WHR: OR = 10.683, 95%CI = 2.179 to 52.376). In the middle-aged group of both sexes, body mass index (BMI) was the most distinctive risk factor for hypertension, the ORs of hypertension risk increased with per SD in BMI (men: OR = 2.297, 95%CI = 1.683 to 3.136; women: OR = 1.810, 95%CI = 1.338 to 2.450). ROC curve analysis demonstrated WSR and PI were better indicators than other indices among young men, and WSR was the best marker among young women. However, BMI and WC were the most sensitive markers in middle-aged men and women, respectively. CONCLUSIONS In this Chinese population, the association of obesity indices and hypertension is inconsistent in different age groups and sexes. It is important to choose appropriate indicators for specific groups of people.
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Affiliation(s)
- Xiao Wu
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China.,b General Practice Center, Nanhai Hospital , Southern Medical University , Foshan , China
| | - Bo Li
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Wei-Quan Lin
- c Guangzhou Center for Disease Control and Prevention , Guangzhou , China
| | - Ling-Ling Huang
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Xiao-Xiao Wang
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Li-Ying Fu
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Bing-Bing Li
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Pei-Xi Wang
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China.,b General Practice Center, Nanhai Hospital , Southern Medical University , Foshan , China
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Liu L, Liu Y, Sun X, Yin Z, Li H, Deng K, Chen X, Cheng C, Luo X, Zhang M, Li L, Zhang L, Wang B, Ren Y, Zhao Y, Liu D, Zhou J, Han C, Liu X, Zhang D, Liu F, Wang C, Hu D. Identification of an obesity index for predicting metabolic syndrome by gender: the rural Chinese cohort study. BMC Endocr Disord 2018; 18:54. [PMID: 30081888 PMCID: PMC6090693 DOI: 10.1186/s12902-018-0281-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To compare the accuracy of different obesity indexes, including waist circumference (WC), weight-to-height ratio (WHtR), body mass index (BMI), and lipid accumulation product (LAP), in predicting metabolic syndrome (MetS) and to estimate the optimal cutoffs of these indexes in a rural Chinese adult population. METHODS This prospective cohort involved 8468 participants who were followed up for 6 years. MetS was defined by the International Diabetes Federation, American Heart Association, and National Heart, Lung, and Blood Institute criteria. The power of the 4 indexes for predicting MetS was estimated by receiver operating characteristic (ROC) curve analysis and optimal cutoffs were determined by the maximum of Youden's index. RESULTS As compared with WHtR, BMI, and LAP, WC had the largest area under the ROC curve (AUC) for predicting MetS after adjusting for age, smoking, drinking, physical activity, and education level. The AUCs (95% CIs) for WC, WHtR, BMI, and LAP for men and women were 0.862 (0.851-0.873) and 0.806 (0.794-0.817), 0.832 (0.820-0.843) and 0.789 (0.777-0.801), 0.824 (0.812-0.835) and 0.790 (0.778-0.802), and 0.798 (0.785-0.810) and 0.771 (0.759-0.784), respectively. The optimal cutoffs of WC for men and women were 83.30 and 76.80 cm. Those of WHtR, BMI, and LAP were approximately 0.51 and 0.50, 23.90 and 23.00 kg/m2, and 19.23 and 20.48 cm.mmol/L, respectively. CONCLUSIONS WC as a preferred index over WHtR, BMI, and LAP for predicting MetS in rural Chinese adults of both genders; the optimal cutoffs for men and women were 83.30 and 76.80 cm.
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Affiliation(s)
- Leilei Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Zhaoxia Yin
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Honghui Li
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong People’s Republic of China
| | - Xu Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Chengyi Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Xuejiao Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Dongdong Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
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Inoue Y, Howard AG, Thompson AL, Gordon-Larsen P. Secular change in the association between urbanisation and abdominal adiposity in China (1993-2011). J Epidemiol Community Health 2018; 72:484-490. [PMID: 29514924 PMCID: PMC5948158 DOI: 10.1136/jech-2017-210258] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/06/2018] [Accepted: 02/16/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND Little attention has been paid to how the association between urbanisation and abdominal adiposity changes over the course of economic development in low-income and middle-income countries. METHODS Data came from the China Health and Nutrition Survey waves 1993-2011 (seven waves). A mixed linear model was used to investigate the association between community-level urbanisation with waist-to-height ratio (WHtR; an indicator of abdominal adiposity). We incorporated interaction terms between urbanisation and study waves to understand how the association changed over time. The analyses were stratified by age (children vs adults). RESULTS Adult WHtR was positively associated with urbanisation in earlier waves but became inversely associated over time. More specifically, a 1 SD increase in the urbanisation index was associated with higher WHtR by 0.002 and 0.005 in waves 1993 and 1997, while it was associated with lower WHtR by 0.001 in 2011. Among child participants, the increase in WHtR over time was predominantly observed in more urbanised communities. CONCLUSION Our study suggests a shift in adult abdominal adiposity from more urbanised communities to less urbanised communities over a time of rapid economic development in China. Children living in more urbanised communities had higher increase in abdominal obesity with urbanisation over time relative to children living in less urbanised communities.
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Affiliation(s)
- Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, NC, USA
| | - Annie Green Howard
- Carolina Population Center, The University of North Carolina at Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
| | - Amanda L. Thompson
- Carolina Population Center, The University of North Carolina at Chapel Hill, NC, USA
- Department of Anthropology, The University of North Carolina at Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
| | - Penny Gordon-Larsen
- Carolina Population Center, The University of North Carolina at Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
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Wang Q, Wang Z, Yao W, Wu X, Huang J, Huang L, Sun Y. Anthropometric Indices Predict the Development of Hypertension in Normotensive and Pre-Hypertensive Middle-Aged Women in Tianjin, China: A Prospective Cohort Study. Med Sci Monit 2018; 24:1871-1879. [PMID: 29601569 PMCID: PMC5892460 DOI: 10.12659/msm.908257] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/14/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aims of this study were to investigate the relationship between optimal anthropometric indices and their cut-off values and the incidence of hypertension in a cohort of middle-aged women in China. MATERIAL AND METHODS A cohort of 812 women, aged between 40-70 years were recruited between May 2011 and June 2013. An ideal baseline blood pressure was defined as <120/80 mmHg; pre-hypertension was 120-139/80-89 mmHg; hypertension was ≥140/≥90 mmHg. Anthropometric measurements included waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR). The cohort was divided into an ideal blood pressure group (Group 1) and a pre-hypertensive group (Group 2). Two-year follow-up blood pressure measurements were performed. Receiver-operating characteristic (ROC) curve analysis determined the optimal anthropometric indices and cut-off values for developing hypertension. RESULTS At two-year follow-up, hypertension developed in 9.0% (n=31) in Group 1 and 32.3% (n=121) in Group 2. Logistic regression analysis showed that in both groups, women in the highest quartile for WC, BMI, WHR, and WHtR had a significantly increased risk of developing hypertension compared with the lowest quartile (P<0.05). ROC curve area under the curve (AUC) for these anthropometric indices were greater in Group 1, and for WC in Groups 1 and 2, with the optimal cut-off values greater in Group 1. CONCLUSIONS In a cohort of middle-aged women in China, anthropometric indices of obesity were predictive of the development of hypertension during a two-year follow-up period.
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Park HJ, Hong YH, Cho YJ, Lee JE, Yun JM, Kwon H, Kim SH. Trends and Cut-Point Changes in Obesity Parameters by Age Groups Considering Metabolic Syndrome. J Korean Med Sci 2018; 33:e47. [PMID: 29359535 PMCID: PMC5785623 DOI: 10.3346/jkms.2018.33.e47] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/20/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are an important issue worldwide. Obesity has a close relationship with NCDs. Various age-related changes should be considered when evaluating obesity. METHODS National representative cohort data from the National Health Insurance Service National Sample Cohort from 2012 to 2013 were used. Sex-specific and age group-specific (10-year intervals) means for body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WtHR) were calculated. Optimal cut-points for obesity parameters were defined as the value predicting two or more components of metabolic syndrome (except WC). RESULTS The mean value and optimal cut-point for BMI decreased with age for men. The mean BMI value for women increased with age, but optimal cut-points showed no remarkable difference. The mean WC of men increased with age, but the optimal cut-points were similar for age groups. For women, the mean value and optimal cut-point for WC increased with age. Regarding WtHR, the mean value and optimal cut-point increased with age for men and women. Differences across age groups were larger for women. CONCLUSION The mean values of the obesity indices and the optimal cut-points were changed according to age groups. This study supports the necessity of applying age group-specific cut-points for the various obesity parameters.
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Affiliation(s)
- Hyung Jun Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | | | - Yun Jung Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ji Eun Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Hyuck Kim
- Health Screening and Promotion Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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Zhang K, Zhao Q, Li Y, Zhen Q, Yu Y, Tao Y, Cheng Y, Liu Y. Feasibility of anthropometric indices to identify dyslipidemia among adults in Jilin Province: a cross-sectional study. Lipids Health Dis 2018; 17:16. [PMID: 29357896 PMCID: PMC5778621 DOI: 10.1186/s12944-017-0648-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/21/2017] [Indexed: 12/14/2022] Open
Abstract
Background Dyslipidemia and other cardiovascular disease (CVD) risk factors have a strong association with obesity. Anthropometric indices have been widely used to evaluate obesity in clinical and epidemiological studies. We aim to investigate association between serum lipid levels and different anthropometric indices. Methods Our study included 17,554 participants. We mainly investigated area under the receiver operating characteristic (AUROC) curves and optimal operating points (OOPs) between the anthropometric indices and serum lipid levels or categories of abnormal serum lipid indices. Results For predicting one/two categories of abnormal serum lipid indices among the anthropometric indices, AUROC value of WC was the highest in men (0.718), and AUROC values of BRI and WHtR were the highest in women (0.700 and 0.700) (all P < 0.001); OOP of WC was 82.450 in men; OOPs of BRI and WHtR were 3.435 and 0.504 in women. For predicting three/more categories of abnormal serum lipid indices among the anthropometric indices, AUROC value of WC was the highest in men (0.806), and AUROC values of BRI and WHtR were the highest in women (0.783 and 0.783) (all P < 0.001); OOP of WC was 84.150 in men; OOPs of BRI and WHtR were 3.926 and 0.529 in women. Conclusions WC was a good predictor for one/two or three/more categories of abnormal serum lipid indices in men. However, BRI and WHtR were good predictors for one/two or three/more categories of abnormal serum lipid indices in women. ABSI showed the weakest predictive power. Electronic supplementary material The online version of this article (10.1186/s12944-017-0648-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kaixin Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Qian Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Yong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Qing Zhen
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Yuchun Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Yi Cheng
- The Cardiovascular Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Yawen Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
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Mankowska-Cyl A, Krintus M, Rajewski P, Sypniewska G. Gamma-glutamyltransferase activity as a surrogate biomarker of metabolic health status in young nondiabetic obese women. Biomark Med 2017. [DOI: 10.2217/bmm-2016-0332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim: We investigated the association of gamma-glutamyltransferase (GGT) activity with atherogenic risk factors and metabolic health status in young nondiabetic obese women. Methods & results: In 140 obese women GGT activity was independently associated with BMI, triglyceride to high-density cholesterol ratio and homeostasis model assessment. Metabolically healthy but obese women had significantly lower GGT activity, associated with a normal insulin sensitivity, favorable lipid profile and apolipoprotein B to apolipoprotein AI ratio. GGT activity showed good diagnostic accuracy to distinguish between metabolically healthy but obese and obese women at risk (77.8% sensitivity and 60% specificity). GGT activity >17 U/l can predict atherogenic risk and insulin resistance. Conclusion: GGT activity may serve as a potential surrogate biomarker of atherogenic risk and metabolic health status.
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Affiliation(s)
- Aneta Mankowska-Cyl
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Magdalena Krintus
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Pawel Rajewski
- Department of Internal Diseases, E. Warminski City Hospital, Bydgoszcz, Poland
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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Ramírez-Vélez R, Correa-Bautista JE, Martínez-Torres J, Méneses-Echavez JF, González-Ruiz K, González-Jiménez E, Schmidt-RioValle J, Lobelo F. LMS tables for waist circumference and waist-height ratio in Colombian adults: analysis of nationwide data 2010. Eur J Clin Nutr 2016; 70:1189-1196. [PMID: 27026425 PMCID: PMC5056989 DOI: 10.1038/ejcn.2016.46] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND/OBJECTIVES Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample. SUBJECTS/METHODS We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20-64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions. RESULTS Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained. CONCLUSIONS This study presents first reference values of WC and WHtR for Colombians aged 20-64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications.
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Affiliation(s)
- R Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física 'CEMA', Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC, Colombia
| | - J E Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física 'CEMA', Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC, Colombia
| | - J Martínez-Torres
- Grupo GICAEDS, Programa de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, DC, Colombia
| | - J F Méneses-Echavez
- Grupo GICAEDS, Programa de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, DC, Colombia
| | - K González-Ruiz
- Centro de Estudios para la Medición de la Actividad Física 'CEMA', Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC, Colombia
| | - E González-Jiménez
- Department of Nursing, Faculty of Health Sciences, Universidad de Granada, Granada, Spain
- Grupo CTS-436, Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain
| | - J Schmidt-RioValle
- Department of Nursing, Faculty of Health Sciences, Universidad de Granada, Granada, Spain
- Grupo CTS-436, Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain
| | - F Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Zhang XH, Zhang M, He J, Yan YZ, Ma JL, Wang K, Ma RL, Guo H, Mu LT, Ding YS, Zhang JY, Liu JM, Li SG, Niu Q, Rui DS, Guo SX. Comparison of Anthropometric and Atherogenic Indices as Screening Tools of Metabolic Syndrome in the Kazakh Adult Population in Xinjiang. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:428. [PMID: 27092520 PMCID: PMC4847090 DOI: 10.3390/ijerph13040428] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/01/2016] [Accepted: 04/11/2016] [Indexed: 12/11/2022]
Abstract
Objective: To compare the screening ability of various anthropometric and atherogenic indices for Metabolic syndrome (MetS) using three common criteria and to evaluate the validity of suitable parameters in combination for the screening of MetS among a Kazakh population in Xinjiang. Methods: A total of 3752 individuals were selected using the stratified cluster random sampling method from nomadic Kazakhs (≥18 years old) in Xinyuan county, Xinjiang, China, which is approximately 4407 km away from the capital Beijing. MetS was defined by the International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (ATP III) and Joint Interim Statement (JIS) criteria. The receiver operating characteristic curve (ROC) was used to compare the area under the ROC curve (AUC) of each index. The sensitivity, specificity, Youden’s index and cut-offs of each index for the screening of MetS were calculated. Results: According to the IDF, ATP III and JIS criteria, 18.61%, 10.51%, and 24.83% of males and 23.25%, 14.88%, and 25.33% of females had MetS. According to the IDF criteria, the waist-to-height ratio (WHtR) was the index that most accurately identified individuals with and without MetS both in males (AUC = 0.872) and females (AUC = 0.804), with the optimal cut-offs of 0.53 and 0.52, respectively. According to both the ATP III and JIS criteria, the lipid accumulation product (LAP) was the best index to discriminate between individuals with and without MetS in males (AUC = 0.856 and 0.816, respectively) and females (AUC = 0.832 and 0.788, respectively), with optimal cut-offs of 41.21 and 34.76 in males and 28.16 and 26.49 in females, respectively. On the basis of the IDF standard, Youden’s indices of WHtR and LAP serial tests for the screening of MetS were 0.590 and 0.455 in males and females, respectively, and those of WHtR and LAP parallel tests were 0.608 and 0.479, accordingly. Conclusion: According to the IDF, ATP III and JIS criteria, both the WHtR and LAP were better indices for the screening of MetS. The WHtR and LAP parallel test was the most accurate.
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Affiliation(s)
- Xiang-Hui Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Mei Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Yi-Zhong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Jiao-Long Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Kui Wang
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Ru-Lin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Heng Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - La-Ti Mu
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Yu-Song Ding
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Jing-Yu Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Jia-Ming Liu
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Shu-Gang Li
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Qiang Niu
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Dong-Sheng Rui
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
| | - Shu-Xia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, China.
- Department of Pathology and Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Ministry of Education, Shihezi University School of Medicine, Shihezi 832000, China.
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Prospective Study of Optimal Obesity Index Cut-Off Values for Predicting Incidence of Hypertension in 18-65-Year-Old Chinese Adults. PLoS One 2016; 11:e0148140. [PMID: 26934390 PMCID: PMC4775051 DOI: 10.1371/journal.pone.0148140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 01/13/2016] [Indexed: 02/06/2023] Open
Abstract
Background Overweight and obesity increase the risk of elevated blood pressure; most of the studies that serve as a background for the debates on the optimal obesity index cut-off values used cross-sectional samples. The aim of this study was to determine the cut-off values of anthropometric markers for detecting hypertension in Chinese adults with data from prospective cohort. Methods This study determines the best cut-off values for the obesity indices that represent elevated incidence of hypertension in 18–65-year-old Chinese adults using data from the China Health and Nutrition Survey (CHNS) 2006–2011 prospective cohort. Individual body mass index (BMI), waist circumference (WC), waist:hip ratio (WHR) and waist:stature ratio (WSR) were assessed. ROC curves for these obesity indices were plotted to estimate and compare the usefulness of these obesity indices and the corresponding values for the maximum of the Youden indices were considered the optimal cut-off values. Results Five-year cumulative incidences of hypertension were 21.5% (95% CI: 19.4–23.6) in men and 16.5% (95% CI: 14.7–18.2) in women, and there was a significant trend of increased incidence of hypertension with an increase in BMI, WC, WHR or WSR (P for trend < 0.001) in both men and women. The Youden index indicated that the optimal BMI, WC, WHR, WSR cut-off values were 23.53 kg/m2, 83.7 cm, 0.90, and 0.51 among men. The optimal BMI, WC, WHR, WSR cut-off values were 24.25 kg/m2, 79.9 cm, 0.85 and 0.52 among women. Conclusions Our study supported the hypothesis that the cut-off values for BMI and WC that were recently developed by the Working Group on Obesity in China (WGOC), the cut-off values for WHR that were developed by the World Health Organization (WHO), and a global WSR cut-off value of 0.50 may be the appropriate upper limits for Chinese adults.
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Luo W, Guo Z, Wu M, Hao C, Zhou Z, Yao X. Index of central obesity as a parameter to replace waist circumference for the definition of metabolic syndrome in predicting cardiovascular disease. J Cardiovasc Med (Hagerstown) 2015; 15:738-44. [PMID: 24937473 DOI: 10.2459/jcm.0000000000000039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare the suitability of metabolic syndrome definitions in predicting cardiovascular disease (CVD) risk. METHODS We analyzed data from a population-based prospective cohort of 3598 participants from Jiangsu, China. Waist circumference was replaced with central obesity [index of central obesity (ICO), a ratio of waist circumference and height] in Cholesterol Education Program Adult Treatment Panel III (ICO-replaced ATPIII) and International Diabetes Federation (ICO-replaced IDF), respectively. Cox proportional-hazards regression model and the receiver operating characteristic curve (ROC curve) was used to evaluate the suitability of ATPIII, IDF, ICO-replaced IDF and ICO-replaced ATPIII in predicting CVD risk. RESULTS ICO was a better parameter in predicting CVD risk by ROC curve analysis. The ROC curve analysis also showed that although ICO-replaced IDF and IDF had the higher degree of specificity, lower sensitivity, longer ROC curve distance, less area under the curve to identify CVD than ATPIII and ICO-replaced ATPIII, therefore ICO-replaced IDF and IDF seemed to be undesirable. However, there was no significant difference in area under the curve between ATPIII and ICO-replaced ATPIII in predicting CVD risk. But it seems that odds ratios for abnormal triglyceride and high-density lipoprotein levels increase slightly when using ICO, but decrease for hyperglycemia and hypertension when using ICO. CONCLUSION ICO was a better predictor of abnormal triglyceride and high-density lipoprotein levels than waist circumference, but waist circumference was a better predictor of hyperglycemia and hypertension than ICO. However, we failed to support ICO as a better parameter for metabolic syndrome definition in predicting CVD risk compared with waist circumference.
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Affiliation(s)
- Wenshu Luo
- aChangzhou Center for Disease Control and Prevention, Changzhou bDepartment of Public Health, Soochow University, Suzhou cCenter for Disease Control of Jiangsu Province, Nanjing dCenter for Disease Control of Changshu, Suzhou, Jiangsu, China
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Thompson AL, Adair L, Gordon-Larsen P, Zhang B, Popkin B. Environmental, Dietary, and Behavioral Factors Distinguish Chinese Adults with High Waist-to-Height Ratio with and without Inflammation. J Nutr 2015; 145:1335-44. [PMID: 25948781 PMCID: PMC4442114 DOI: 10.3945/jn.114.206102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 04/07/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The environmental and behavioral risk factors associated with central obesity and/or inflammation in populations exposed to both obesogenic and pathogenic environments remain unclear. OBJECTIVES We tested which of the characteristics distinguished 3 risk groups--high waist-to-height ratio (WHtR; >0.5) without inflammation [high-sensitivity C-reactive protein (hs-CRP) <3 mg/L], normal WHtR (≤ 0.5) with inflammation (hs-CRP: 3-10 mg/L), and high WHtR with inflammation--from the referent group with normal WHtR without inflammation and, secondarily, which factors differed between the groups with high WHtR with and without inflammation. METHODS The analytic sample included 8068 adults participating in the China Health and Nutrition Survey in 2009. Adjusted multinomial and logistic regression models were used to assess the risk of being in one of the "unhealthy" groups compared with the referent group. RESULTS Men with high WHtR with and without inflammation were more likely to live at higher urbanicity (57-63%) and have higher incomes (26-42%) and household sanitation (26-67%) and were >40% less likely to have high physical activity than the healthy referent group. Men with high WHtR with inflammation had higher odds of infectious symptoms than those with high WHtR without inflammation (OR: 1.73; 95% CI: 1.15, 2.61). Women with high WHtR without inflammation were less likely to have high household sanitation (44%) or perform high levels of physical activity (24%) and were 34% more likely to consume more fiber than the healthy referent group. Women with high WHtR and inflammation were more likely than those with high WHtR without inflammation to have infectious symptoms (OR: 1.45; 95% CI: 1.01, 2.07) and less likely to have higher fiber intake (OR: 0.77; 95% CI: 0.60,1.00) or physical activity (OR: 0.55; 95% CI: 0.41, 0.73). CONCLUSION These results document different underlying pathogenic and obesogenic risk factors for visceral adiposity with and without inflammation in Chinese adults, suggesting that context-specific approaches may be needed to prevent and treat inflammation.
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Affiliation(s)
| | - Linda Adair
- Carolina Population Center, and,Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Penny Gordon-Larsen
- Carolina Population Center, and,Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Bing Zhang
- Institute of Nutrition and Foods Safety, Chinese Centers for Disease Control, Beijing, China
| | - Barry Popkin
- Carolina Population Center, and,Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
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Exploration of the association between obesity and semen quality in a 7630 male population. PLoS One 2015; 10:e0119458. [PMID: 25822490 PMCID: PMC4379020 DOI: 10.1371/journal.pone.0119458] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 01/26/2015] [Indexed: 12/31/2022] Open
Abstract
This study aimed to explore the association between body mass index (BMI), other anthropometric indexes and semen quality in a general male population in Taiwan. In this cross-sectional cohort study, the study cohort consisted of 7941 healthy male individuals aged 18 years or older who participated in a standard medical screening program run by a private firm from January 2008 to May 2013. Semen parameters including sperm concentration (SC), total sperm motility (TSM), progressive motility (PRM), and normal sperm morphology (NSM) were recorded. Anthropometric indexes including BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body fat percentage were measured. A total of 7630 men were enrolled for the final analysis, of whom 68.5% had a normal weight distribution and 31.4% were overweight or obese. Total sperm motility, progressive motility, normal sperm morphology and sperm concentration showed a statistically linear decline with increasing age (p < 0.001, p < 0.001, p < 0.001 and p = 0.004). Sperm concentration showed a significantly negatively linear association with BMI (p = 0.005), and normal sperm morphology showed an inverse association with BMI and waist-to-height ratio (p < 0.001 and p = 0.004). The prevalence of abnormal total sperm motility, progressive motility, normal sperm morphology and sperm concentration increased with increasing age (p = 0.011, p < 0.001, p < 0.001 and p = 0.002). Lower normal sperm morphology and sperm concentration were associated with increasing body adiposity (p<0.05). No relationship between obesity and sperm motility was identified.
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Ethnic disparities in the association of body mass index with the risk of hypertension and diabetes. J Community Health 2014; 39:437-45. [PMID: 24276618 DOI: 10.1007/s10900-013-9792-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite having lower body mass index (BMI) compared to other ethnic groups, Asians continue to develop significant metabolic diseases such as hypertension and diabetes. To evaluate the disparate association of BMI and risk of hypertension and diabetes in Asians. We retrospectively studied 150,753 adults from the 1985-2011 California Behavioral Risk Factor Survey. Trends in prevalence of obesity, hypertension, and diabetes were stratified by ethnicity. Multivariate logistic regression models evaluated the incremental effect of one unit BMI increase on risk of hypertension and diabetes and the disparate risks of hypertension and diabetes at different BMI thresholds. Asians had the lowest BMI among all groups. However, the impact of increasing BMI on risk of hypertension and diabetes was significantly greater in Asians. For each one unit increase in BMI, Asians were significantly more likely to have hypertension (OR 1.15; 95% CI 1.13-1.18) compared to non-Hispanic whites, blacks, and Hispanics. Similar trends were seen for diabetes (Asians: OR 1.15; 95% CI 1.13-1.18). The risk of hypertension in Asians with BMI ≥ 22 was similar to non-Hispanic whites with BMI ≥ 27 and blacks with BMI ≥ 28. The risk of diabetes in Asians with BMI ≥ 28 was similar to non-Hispanic whites with BMI ≥ 30. Despite lower overall BMI compared to other groups, weight gain in Asians is associated with significantly higher risks of hypertension and diabetes. Compared to other ethnic groups, similar risks of hypertension and diabetes are seen in Asians at much lower BMI.
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Zhu Q, Shen F, Ye T, Zhou Q, Deng H, Gu X. Waist-to-height ratio is an appropriate index for identifying cardiometabolic risk in Chinese individuals with normal body mass index and waist circumference. J Diabetes 2014; 6:527-34. [PMID: 24698481 DOI: 10.1111/1753-0407.12157] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 03/07/2014] [Accepted: 03/29/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The waist-to-height ratio (WHtR), a novel index that has been reported to correlate more strongly than body mass index (BMI) and waist circumference (WC) with cardiometabolic risk factors, has not been studied in Chinese individuals with normal body mass index and waist circumference. The present study compared the predictive power of WHtR with those of BMI and WC for such factors in non-obese Chinese, and to define optimal cutoffs of WHtR in this population. METHODS A total of 2137 subjects aged 40-75 years were recruited. Three anthropometric indices (WHtR, BMI, and WC) were compared and the optimal cutoffs of WHtR were identified by receiver operating characteristic curve (ROC) analysis. WHtR was divided into four quartiles (WHtR-Q), and multiple linear regression analyses were used to calculate the relationship between WHtR-Q and clinical biochemical index. RESULTS Waist-to-height ratio was more efficient than WC to identify cardiometabolic risk factors in both genders, but was only superior to BMI in females. WHtR-Q was positively correlated with fasting plasma glucose, 2-h postprandial blood glucose, and systolic blood pressure, and negatively connected with high density lipoprotein cholesterol in both genders after controlling for age, current smoking and drinking, moderate-intensity physical activity, daily sedentary time, daily screen time and menopause (only for females). The optimal cutoffs of WHtR for detecting cardiometabolic risk factors were 0.47 in males and 0.51 in females. CONCLUSION Waist-to-height ratio might be an effective index to identify cardiometabolic risk factors in Chinese with normal BMI and WC, particularly in females.
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Affiliation(s)
- Qihan Zhu
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China
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Gharipour M, Sadeghi M, Dianatkhah M, Bidmeshgi S, Ahmadi A, Tahri M, Sarrafzadegan N. The cut-off values of anthropometric indices for identifying subjects at risk for metabolic syndrome in Iranian elderly men. J Obes 2014; 2014:907149. [PMID: 24782923 PMCID: PMC3981184 DOI: 10.1155/2014/907149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 01/27/2014] [Indexed: 11/23/2022] Open
Abstract
AIM This study aimed to investigate which anthropometric indices could be a better predictor of metabolic syndrome (MetS) and the cut-off points for these surrogates to appropriately differentiate MetS in the Iranian elderly. METHOD The present cross-sectional study was conducted on a sample of Isfahan Healthy Heart Program (IHHP). MetS was defined according to Third Adult Treatment Panel (ATPIII). In total, 206 elderly subjects with MetS criteria were selected. Anthropometric indices were measured and plotted using receiver operating characteristic (ROC) curves. RESULTS WC followed by WHtR yielded the highest area under the curve (AUC) (0.683; 95% CI 0.606-0.761 and 0.680; 95% CI 0.602-0.758, resp.) for MetS. WC at a cut of 94.5 cm resulted in the highest Youden index with sensitivity 64% and 68% specificity to predict the presence of ≥2 metabolic risk factors. BMI had the lowest sensitivity and specificity for MetS and MetS components. WC has the best ability to detect MetS which followed by WHtR and BMI had a lower discriminating value comparatively. CONCLUSION WC is the best predictor for predicting the presence of ≥2 metabolic risk factors among Iranian elderly population and the best value of WC is 94.5 cm. This cut-off values of WC should be advocated and used in Iranian men until larger cross-sectional studies show different results.
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Affiliation(s)
- Mojgan Gharipour
- Metabolic Syndrome Department, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute (WHO Collaborating Center), Isfahan University of Medical Sciences, Isfahan, Iran
- *Masoumeh Sadeghi:
| | - Minoo Dianatkhah
- Interventional Cardiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Bidmeshgi
- Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ahmadi
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Tahri
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Prevalence of preclinical renal dysfunction in obese Egyptian patients with primary knee osteoarthritis, preliminary data. THE EGYPTIAN RHEUMATOLOGIST 2013. [DOI: 10.1016/j.ejr.2013.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lee OG, Hur YI, Kang JH, Park HA, Kim KW, Cho YG, Choi WY, Park H, Lee HA. The cutoff value of waist circumference for predicting metabolic risks in pre- and post-menopausal korean women: analysis of 2010 korean national health and nutrition examination survey data. Korean J Fam Med 2013; 34:307-18. [PMID: 24106583 PMCID: PMC3791338 DOI: 10.4082/kjfm.2013.34.5.307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 08/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background With metabolic syndrome (MS) being a major risk factor for cardiovascular disease, and central obesity being a major predisposing factor for MS, intensive research is currently being performed on cutoff values according to race and sex. Menopause is an especially significant factor in designating cutoff values for female central obesity, as menopause brings sudden bodily changes that induce central obesity and increased prevalence of MS. Therefore this study aimed to investigate the cutoff values for the obesity index and its validity in predicting the criteria for MS in Korean women according to menstrual status. Methods The study focused on 3,103 women 20 years of age or older participating in the 2007 Korea National Health and Nutrition Examination Survey. Definitions of non-adipose components of MS were defined by the International Diabetes Federation, and menstrual status was judged on the basis of survey results. The sensitivity, specificity, and positive and negative predictive values of the central obesity index (body mass index [BMI], waist circumference [WC], waist-to-height ratio [WHtR]) according to menstrual status for two or more non-adipose components of MS were calculated based on the Youden index. Results Area under the curve (AUC) values predicting the presence of two or more metabolic risk factors were higher in pre-menopausal women, with AUC values for BMI, WC, and WHtR being, in pre- and post-menopausal women, 23.1 kg/m2 vs. 23.9 kg/m2, 76.1 cm vs. 82.5 cm, and 0.49 vs. 0.53, respectively. The WC cut off (76 cm) for pre-menopausal women was found to be more sensitive and more effective at screening for MS risks than the cutoff value given by the Korea Society for the Study of Obesity. Conclusion The central obesity index showed better predictability for MS risk in pre-menopausal women. Because the central obesity index cutoff values are lower in pre-menopausal women, the possibility of metabolic risk can be considered for pre-menopausal women with WC lower than 85 cm. Assessment and control of other risks are needed accordingly for preventing the development of MS.
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Affiliation(s)
- Ok-Gyu Lee
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Zhang ZQ, Deng J, He LP, Ling WH, Su YX, Chen YM. Comparison of various anthropometric and body fat indices in identifying cardiometabolic disturbances in Chinese men and women. PLoS One 2013; 8:e70893. [PMID: 23951031 PMCID: PMC3741370 DOI: 10.1371/journal.pone.0070893] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 06/25/2013] [Indexed: 12/28/2022] Open
Abstract
Background Although many adiposity indices may be used to predict obesity-related health risks, uncertainty remains over which of them performs best. Objective This study compared the predictive capability of direct and indirect adiposity measures in identifying people at higher risk of metabolic abnormalities. Methods This population-based cross-sectional study recruited 2780 women and 1160 men. Body weight and height, waist circumference (WC), and hip circumference (HC) were measured and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were calculated. Body fat (and percentage of fat) over the whole body and the trunk were determined by bioelectrical impedance analysis (BIA). Blood pressure, fasting lipid profiles, and glucose and urine acid levels were assessed. Results In women, the ROC and the multivariate logistic regression analyses both showed that WHtR consistently had the best performance in identifying hypertension, dyslipidemia, hyperuricemia, diabetes/IFG, and metabolic syndrome (MetS). In men, the ROC analysis showed that WHtR was the best predictor of hypertension, WHtR and WC were equally good predictors of dyslipidemia and MetS, and WHtR was the second-best predictor of hyperuricemia and diabetes/IFG. The multivariate logistic regression also found WHtR to be superior in discriminating between MetS, diabetes/IFG, and dyslipidemia while BMI performed better in predicting hypertension and hyperuricemia in men. The BIA-derived indices were the second-worst predictors for all of the endpoints, and HC was the worst. Conclusion WHtR was the best predictor of various metabolic abnormalities. BMI may be used as an alternative measure of obesity for identifying hypertension in both sexes.
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Affiliation(s)
- Zhe-qing Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Juan Deng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Li-ping He
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangzhou Panyu Central Hospital, Guangzhou, People's Republic of China
| | - Wen-hua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yi-xiang Su
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
- * E-mail: (Y-MC); (Y-XS)
| | - Yu-ming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
- * E-mail: (Y-MC); (Y-XS)
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Yang Q, Cao H, Xie S, Tong Y, Zhu Q, Zhang F, Lü Q, Yang Y, Li D, Chen M, Yu C, Jin W, Yuan Y, Tong N. Associations of the PTEN -9C>G polymorphism with insulin sensitivity and central obesity in Chinese. Gene 2013; 527:545-52. [PMID: 23796801 DOI: 10.1016/j.gene.2013.06.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 04/28/2013] [Accepted: 06/03/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Phosphatase and tensin homolog on chromosome 10 gene (PTEN) is known as a tumor-suppressor gene. Previous studies demonstrated that PTEN dysfunction affects the function of insulin. However, investigations of PTEN single nucleotide polymorphisms (SNPs) and IR-related disease associations are limited. The aim of the present study was to investigate whether its polymorphism could be involved in the risk of metabolic syndrome (MetS). METHODS The genotype frequency of PTEN -9C>G polymorphism was determined by using a Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) method in 530 subjects with MetS and 202 healthy control subjects of the Han Ethnic Chinese population in a case-control analysis. RESULTS The PTEN -9C>G polymorphism was not associated with MetS or its hyperglycemia, hypertension and hypertriglyceridemia components. In the control individuals aged <60 years or ≥60 years, the CG genotype individuals had lower insulin sensitivity than CC individuals (P<0.05). In the <60-year-old MetS group and normal glucose tolerance (NGT) subgroup, the CG individuals had lower insulin sensitivity and higher waist circumference (WC) and waist-height-ratio (WHtR) than CC individuals (P<0.05). Multiple linear regression analysis showed that the PTEN polymorphism (P=0.001) contributed independently to 4.2% (adjusted R(2)) of insulin sensitivity variance (estimated by Matsuda ISI), while age (P=0.004), gender (P=0.000) and the PTEN polymorphism (P=0.032) contributed independently to 5.6% (adjusted R(2)) of WHtR variance. CONCLUSIONS The CG genotype of PTEN -9C>G polymorphism was not associated with MetS and some of its components as well. However, it may not only decrease insulin sensitivity in the healthy control and MetS in pre-elderly or NGT subjects, but may also increase the risk of central obesity among these MetS individuals.
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Affiliation(s)
- Qiu Yang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Huerta JM, Tormo MJ, Chirlaque MD, Gavrila D, Amiano P, Arriola L, Ardanaz E, Rodríguez L, Sánchez MJ, Mendez M, Salmerón D, Barricarte A, Burgui R, Dorronsoro M, Larrañaga N, Molina-Montes E, Moreno-Iribas C, Quirós JR, Toledo E, Travier N, González CA, Navarro C. Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study. BMC Endocr Disord 2013; 13:7. [PMID: 23388074 PMCID: PMC3575248 DOI: 10.1186/1472-6823-13-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 01/30/2013] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Obesity is a major risk factor for type 2 diabetes mellitus (T2DM). A proper anthropometric characterisation of T2DM risk is essential for disease prevention and clinical risk assessement. METHODS Longitudinal study in 37 733 participants (63% women) of the Spanish EPIC (European Prospective Investigation into Cancer and Nutrition) cohort without prevalent diabetes. Detailed questionnaire information was collected at baseline and anthropometric data gathered following standard procedures. A total of 2513 verified incident T2DM cases occurred after 12.1 years of mean follow-up. Multivariable Cox regression was used to calculate hazard ratios of T2DM by levels of anthropometric variables. RESULTS Overall and central obesity were independently associated with T2DM risk. BMI showed the strongest association with T2DM in men whereas waist-related indices were stronger independent predictors in women. Waist-to-height ratio revealed the largest area under the ROC curve in men and women, with optimal cut-offs at 0.60 and 0.58, respectively. The most discriminative waist circumference (WC) cut-off values were 99.4 cm in men and 90.4 cm in women. Absolute risk of T2DM was higher in men than women for any combination of age, BMI and WC categories, and remained low in normal-waist women. The population risk of T2DM attributable to obesity was 17% in men and 31% in women. CONCLUSIONS Diabetes risk was associated with higher overall and central obesity indices even at normal BMI and WC values. The measurement of waist circumference in the clinical setting is strongly recommended for the evaluation of future T2DM risk in women.
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Affiliation(s)
- José María Huerta
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María-José Tormo
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Sociosanitary Sciences, University of Murcia School of Medicine, Murcia, Spain
| | - María-Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Diana Gavrila
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain
| | - Larraitz Arriola
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
| | | | - María-José Sánchez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Michelle Mendez
- Center for Environmental Epidemiology Research, Barcelona, Spain
| | - Diego Salmerón
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Sociosanitary Sciences, University of Murcia School of Medicine, Murcia, Spain
| | - Aurelio Barricarte
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
| | - Rosana Burgui
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
| | - Miren Dorronsoro
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain
| | - Nerea Larrañaga
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain
| | - Esther Molina-Montes
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Conchi Moreno-Iribas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | | | - Estefanía Toledo
- Public Health Institute of Navarra, Pamplona, Spain
- University of Navarra, Pamplona, Spain
| | - Noémie Travier
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Carlos A González
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Carmen Navarro
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Sociosanitary Sciences, University of Murcia School of Medicine, Murcia, Spain
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Kim JY, Oh S, Chang MR, Cho YG, Park KH, Paek YJ, Yoo SH, Cho JJ, Caterson ID, Song HJ. Comparability and utility of body composition measurement vs. anthropometric measurement for assessing obesity related health risks in Korean men. Int J Clin Pract 2013; 67:73-80. [PMID: 23241051 DOI: 10.1111/ijcp.12038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Obesity is commonly assessed by body mass index (BMI) of which limitations come from an inability to distinguish body fat mass from lean mass. Several anthropometric measurements, including BMI, waist circumference, waist-to-height ratio and waist-to-hip ratio have been used to predict metabolic syndrome. The purpose of this study was to evaluate the utility of FMI or BF% combined with previous known anthropometric indices to assess the risk of metabolic syndrome in clinical practice. METHODS In 5534 men visiting a hospital for health check-ups, blood tests, anthropometric measurements and body composition analysis using BIA were performed. Logistic regression analysis was performed to compare the odds ratios for metabolic syndrome and each component of metabolic syndrome among BMI, waist-to-height ratio, waist-to-hip ratio, FMI and BF%. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) for metabolic syndrome was compared between several measurements. The net reclassification improvement with integrated discrimination improvement was used for assessing value of body composition measurement. RESULTS The adjusted odds ratios of metabolic syndrome was 1.80 (95% CI, 1.71-1.89) for FMI and 1.15 (95% CI, 1.13-1.17) for BF%. Odds ratio of each metabolic component was highest for FMI among several anthropometric and body composition measurements. AUCs using the ROC curve for metabolic syndrome was highest for waist-to-height ratio, 0.823 (95% CI, 0.808-0.837) by National Cholesterol Education Program criteria. FMI caused a mild increase in integrated discrimination improvement when combined with waist-to-height ratio. CONCLUSIONS Waist-to-height ratio seems to be the best screening tool for evaluating metabolic syndrome in Korean men, and adding FMI could result in a modest increase in integrated discrimination improvement.
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Affiliation(s)
- J Y Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seoul, Korea
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Silverberg JI, Silverberg NB. Atopic Dermatitis: Update on Pathogenesis and Comorbidities. CURRENT DERMATOLOGY REPORTS 2012. [DOI: 10.1007/s13671-012-0021-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Value of dual-energy X-ray absorptiometry derived parameters vs anthropometric obesity indices in the assessment of early atherosclerosis in abdominally obese men. Obes Res Clin Pract 2012; 6:e263-346. [DOI: 10.1016/j.orcp.2011.08.155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 07/27/2011] [Accepted: 08/23/2011] [Indexed: 12/24/2022]
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Ejike CE, Ijeh II. Obesity in young-adult Nigerians: variations in prevalence determined by anthropometry and bioelectrical impedance analysis, and the development of % body fat prediction equations. Int Arch Med 2012; 5:22. [PMID: 22818201 PMCID: PMC3464790 DOI: 10.1186/1755-7682-5-22] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 07/20/2012] [Indexed: 12/26/2022] Open
Abstract
Background Overweight/obesity is a growing global public health concern. The variations in the prevalence of overweight/obesity, defined by Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Height Ratio (WHtR), Waist-to-Hip Ratio (WHpR) and Bioelectrical Impedance Analysis (BIA), were studied and a prediction equation for % body fat (%BF) developed. Methods A total of 1584 subjects (56.4% males) were recruited for the study. Data on age, gender, height, weight, hip circumference and WC were collected from the subjects using standard protocols. BMI, WHtR and WHpR were derived using standard equations. %BF was measured using a BIA device (Omron BF-400). Appropriate statistical tools were used for the data analysis. Results The prevalence of overweight/obesity in the population was 28.4% (36.3% for males; 22.6% for females) (BIA); 20.7% (17.5% for males; 24.8% for females) (BMI); 7.5% (1.3% for males; 16.1% for females) (WC); 2.9% (4.3% for males; 1.2% for females) (WHpR); and 15.4% (14.8% for males; 16.2% females) (WHtR). Taking BIA as the reference point, WC misclassified overweight/obesity the most for males (35%), while for the females, WHpR misclassified both disorders the most (21.4%). Correlation studies showed that only BMI correlated significantly, albeit weakly, with %BF among the males, whereas all the anthropometric measures, but WHpR correlated significantly with % body fat in females. Two prediction equations for %BF were generated, and %BF predicted with the two equations correlated significantly (P < 0.001) with that measured by BIA. Conclusion The prevalence of overweight/obesity in this population vary widely depending on the definition used. The developed prediction equations could be useful in resource-poor settings, but require validation.
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Affiliation(s)
- Chukwunonso Ecc Ejike
- Department of Biochemistry, College of Natural and Applied Sciences, Michael Okpara University of Agriculture, Umudike, PMB 7267, Umuahia, Abia State, Nigeria.
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Zhan Y, Wang J, Ma Y, Liu Z, Xu H, Lu S, Lu B. Serum insulin-like, growth factor binding protein-related protein 1 (IGFBP-rP1) and endometrial cancer risk in Chinese women. Int J Cancer 2012; 132:411-6. [PMID: 22544761 DOI: 10.1002/ijc.27622] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 03/28/2012] [Indexed: 11/08/2022]
Abstract
Hyperinsulinemia and the metabolic syndrome confer increased risks of endometrial carcinoma. The roles of insulin, and, insulin-like growth factor-binding proteins (IGFBPs) in the etiology of endometrial carcinoma, remain unclear. We recruited 206 patients with endometrial carcinoma and 350 healthy women to a case-control study of fasting insulin and IGFBP-related protein 1 (IGFBP-rP1) in a Chinese tertiary centre. Patients with endometrial carcinoma had higher insulin concentrations (14.8 ± 16.7 vs. 8.1 ± 9.4 μU/mL; p < 0.001) and lower IGFBP-rP1 levels (17.5 ± 17.2 vs. 22.4 ± 22.8 μg/L; p = 0.018) than controls. High insulin and IGFBP-rP1 levels were both positively and negatively associated with endometrial cancer (odds ratio for the highest tertile versus the lowest tertile: insulin: 4.11; 95% CI = 2.61-6.47; IGFBP-rP1: 0.38; 95% CI = 0.24-0.60). Logistic regression analysis confirmed the associations between endometrial carcinoma and fasting insulin or IGFBP-rP1 after adjustments for age, BMI, serum glucose, cholesterol, triglycerides and high-density lipoprotein cholesterol (odds ratio for the highest tertile versus the lowest tertile: insulin: 2.13; 95% CI = 1.30-3.49; IGFBP-rP1: 0.57; 95% CI = 0.34-0.94). Hyperinsulinemia and high IGFBP-rP1 levels confer altered risks for endometrial carcinoma.
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Affiliation(s)
- Yan Zhan
- Department of Clinical Laboratory, The Affiliated Women's Hospital, School of Medicine, Zhejiang University, China
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