1
|
Salmón-Gómez L, Catalán V, Frühbeck G, Gómez-Ambrosi J. Relevance of body composition in phenotyping the obesities. Rev Endocr Metab Disord 2023; 24:809-823. [PMID: 36928809 PMCID: PMC10492885 DOI: 10.1007/s11154-023-09796-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Obesity is the most extended metabolic alteration worldwide increasing the risk for the development of cardiometabolic alterations such as type 2 diabetes, hypertension, and dyslipidemia. Body mass index (BMI) remains the most frequently used tool for classifying patients with obesity, but it does not accurately reflect body adiposity. In this document we review classical and new classification systems for phenotyping the obesities. Greater accuracy of and accessibility to body composition techniques at the same time as increased knowledge and use of cardiometabolic risk factors is leading to a more refined phenotyping of patients with obesity. It is time to incorporate these advances into routine clinical practice to better diagnose overweight and obesity, and to optimize the treatment of patients living with obesity.
Collapse
Affiliation(s)
- Laura Salmón-Gómez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain.
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain.
| |
Collapse
|
2
|
Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
Collapse
Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| |
Collapse
|
3
|
Loureiro LM, Cordeiro A, Mendes R, Luna M, Pereira S, Saboya CJ, Ramalho A. Clinic, Anthropometric And Metabolic Changes In Adults With Class III Obesity Classified As Metabolically Healthy And Metabolically Unhealthy. Diabetes Metab Syndr Obes 2019; 12:2419-2431. [PMID: 31819568 PMCID: PMC6885561 DOI: 10.2147/dmso.s210616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 08/30/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To describe clinical, biochemical and anthropometric profiles in adults with class III obesity classified as metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). PATIENTS AND METHODS This is a cross-sectional study with patients classified as MHO and MUHO according to the NCEP-ATP III. Anthropometric, biochemical and clinical variables were analyzed. RESULTS A total of 223 subjects were evaluated and 32.73% were classified as MHO and 67.26% as MUHO, respectively. The insulin resistance homeostasis model (HOMA-IR) showed elevation in the MUHO group (p=0.003) and anthropometric variables were correlated with bone markers [body index mass (BMI) vs phosphorus: r=0.31, p<0.001; BMI vs 25(OH)D: r=-0.31, p=0.041]. Visceral adiposity index was lower in MHO (p=0.001). Negative correlations between inflammatory markers and bone markers were observed in the MHO group (calcium vs C-reactive protein: -0.30, p=0.017; parathyroid hormone vs HOMA-IR: r=-0.28, p=0.017. CONCLUSION MHO individuals showed important metabolic changes, such as those observed in MUHO, despite lower prevalence and severity. Continuous monitoring of these individuals is suggested, given the transient nature of the MHO phenotype.
Collapse
Affiliation(s)
- Ligiane M Loureiro
- Postgraduate Program, Doctorate in Nutritional Sciences, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Health Sciences Institute, Faculty of Nutrition, Federal University of Pará (UFPA), Belém, Brazil
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| | - Adryana Cordeiro
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Biomedicine Department, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rodrigo Mendes
- Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Luna
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| | - Sílvia Pereira
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, Brazil
| | - Carlos J Saboya
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, Brazil
| | - Andrea Ramalho
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Department of Social and Applied Nutrition of the Institute of Nutrition, UFRJ, Rio de Janeiro, Brazil
| |
Collapse
|
4
|
Barbour-Tuck EN, Erlandson MC, Sherar LB, Eisenmann JC, Muhajarine N, Foulds H, Vatanparast H, Nisbet C, Kontulainen S, Baxter-Jones ADG. Relationship Between Trajectories of Trunk Fat Development in Emerging Adulthood and Cardiometabolic Risk at 36 Years of Age. Obesity (Silver Spring) 2019; 27:1652-1660. [PMID: 31436387 DOI: 10.1002/oby.22576] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/07/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study examined trajectories of trunk fat mass (FM) accrual during emerging adulthood of individuals categorized, at 36 years of age, as having higher compared with lower scores of (1) metabolic risk and (2) blood pressure risk. METHODS Fifty-five individuals from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2017) were assessed from adolescence (mean [SD], 11.5 [1.8] years) through emerging adulthood (26.2 [2.2] years) and into early adulthood (35.6 [2.2] years) (median 11 visits per individual). Sex-specific median splits of continuous standardized risk scores at 36 years of age were created. Dual-energy x-ray absorptiometry-assessed trunk FM trajectories were analyzed using multilevel random effects models. RESULTS Higher risk scores of blood pressure risk and metabolic risk had significantly steeper trajectories of fat development (0.45 [0.11] and 0.44 [0.11] log g, respectively) than the lower risk scores. Dietary fat was not related (P > 0.05). Physical activity was negatively related (-0.04 [0.02] physical activity score) to trunk FM development during emerging adulthood. CONCLUSIONS Young adults with higher metabolic risk at 36 years of age had greater trunk FM development during both adolescence and emerging adulthood, supporting the need for intervention at both these critical periods of fat accrual.
Collapse
Affiliation(s)
- Erin N Barbour-Tuck
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lauren B Sherar
- National Centre for Sport and Exercise Medicine School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | | | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Heather Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Christine Nisbet
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Saija Kontulainen
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | |
Collapse
|
5
|
Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study. ACTA ACUST UNITED AC 2019; 55:medicina55070334. [PMID: 31277306 PMCID: PMC6681323 DOI: 10.3390/medicina55070334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/31/2022]
Abstract
Background and objectives: Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. Materials and Methods: This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Results: Neck circumference (in the anthropometric model; R2: 0.889; β: age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; R2: 0.891; β: age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (R2: 0.894; β: age = 0.882, FFMI = 0.126, neck = 0.093). Conclusion: It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.
Collapse
|
6
|
Estrella ML, Pirzada A, Durazo-Arvizu RA, Cai J, Giachello AL, Espinoza Gacinto R, Siega-Riz AM, Daviglus ML. Correlates of and Body Composition Measures Associated with Metabolically Healthy Obesity Phenotype in Hispanic/Latino Women and Men: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Obes 2019; 2019:1251456. [PMID: 30775036 PMCID: PMC6350597 DOI: 10.1155/2019/1251456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022] Open
Abstract
Background Individuals with "metabolically healthy obesity" (MHO) phenotype (i.e., obesity and absence of cardiometabolic abnormalities: favorable levels of blood pressure, lipids, and glucose) experience lower risk of cardiovascular disease compared with those with "metabolically at-risk obesity" (MAO) phenotype (i.e., obesity with concurrent cardiometabolic abnormalities). Among Hispanic/Latino women and men with obesity, limited data exist on the correlates of and body composition measures associated with obesity phenotypes. Methods Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) were used to estimate the age-adjusted distribution of obesity phenotypes among 5,426 women and men (aged 20-74 years) with obesity (BMI ≥ 30 kg/m2) and to compare characteristics between individuals with MHO and MAO phenotypes. Weighted Poisson regression models were used to examine cross-sectional associations between 1-standard deviation (SD) increase in body composition measures (i.e., body fat percentage, waist circumference, and body lean mass) and MHO phenotype prevalence. Results The age-adjusted proportion of the MHO phenotype was low (i.e., 12.5% in women and 6.5% in men). In bivariate analyses, women and men with the MHO phenotype were more likely to be younger, have higher education and acculturation levels, report lower lifetime cigarette use, and have fasting insulin and waist circumference levels than MAO. Adjusting for sociodemographic and lifestyle factors, among women, each 1-SD increase in body fat percentage, waist circumference, and lean body mass was, respectively, associated with a 21%, 33%, and 31% lower prevalence of the MHO phenotype. Among men, each 1-SD increase in waist circumference and lean body mass was, respectively, associated with a 20% and 15% lower prevalence of the MHO phenotype. Conclusions We demonstrated that higher waist circumference and higher lean body mass were independently associated with a lower proportion of the MHO phenotype in Hispanic/Latino women and men. Findings support the need for weight reduction interventions to manage cardiometabolic health among Hispanics/Latinos.
Collapse
Affiliation(s)
- Mayra L. Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| | - Ramon A. Durazo-Arvizu
- Division of Biostatistics, Public Health Sciences, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, USA
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Chapel Hill, NC 27516, USA
| | - Aida L. Giachello
- Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Dr Suite, Chicago, IL 60611, USA
| | - Rebeca Espinoza Gacinto
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Anna Maria Siega-Riz
- School of Nursing and Departments of Public Health Sciences and Obstetrics and Gynecology, School of Medicine, University of Virginia, P.O. Box 800717, Charlottesville, VA 22908, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| |
Collapse
|
7
|
Duarte CK, dos Santos ALT, Kirst C, Nunes GDS, de Franceschi K, de Azevedo MJ, Zelmanovitz T. Dietary source of saturated fat and percentage body fat of patients with type 2 diabetes mellitus: A cross-sectional study. Food Sci Nutr 2019; 7:195-204. [PMID: 30680173 PMCID: PMC6341160 DOI: 10.1002/fsn3.853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/12/2018] [Accepted: 09/21/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The influence of dietary fat on the body fat of patients with diabetes is not well established. This cross-sectional study aimed to analyze the association between percentage body fat (PBF) and dietary sources of fat from the usual diet of patients with type 2 diabetes. METHODS Outpatients were submitted to PBF evaluation estimated by bioelectrical impedance. The patient's usual diet was assessed by a 3-day weighed diet record (WDR), and compliance was analyzed by comparing the protein intake estimated from the WDR and that from 24-hr urinary nitrogen output. RESULTS A total of 188 patients with type 2 diabetes (aged 62.5 ± 8.8 years; 57% female, body mass index [BMI] 29.3 ± 3.8 kg/m²) were analyzed and divided into groups with high and low PBF according to mean PBF (men: 26.6 ± 7.1%; women: 39.8 ± 5.9%). Patients with high PBF consumed an increased proportion of red meat (52.0% of total meat), processed meat (5.4%), and saturated fat from red meat (2.1% of energy) compared to low PBF individuals (42.3% [p = 0.036]; 3.0% [p = 0.010]; 1.5% of energy [p = 0.032], respectively). According to Poisson's regression, the consumption of red meat (PR = 1.008 [95% CI = 1.002-1.013]; p = 0.006) and the reuse of frying oil (PR = 1.670 [95% CI = 1.240-2.249]; p = 0.001) were associated with higher PBF. In the adjusted analysis, the upper tertile of processed meat intake was associated with higher PBF (PR = 1.522 [95% CI = 1.226-1.891]; p = 0.001) compared to the lower tertile. CONCLUSIONS The present study suggested that a higher ingestion of dietary sources of saturated fat was associated with high PBF in patients with type 2 diabetes.
Collapse
Affiliation(s)
- Camila Kümmel Duarte
- Nutrition Departament of Escola de EnfermagemUniversidade Federal de Minas GeraisBelo HorizonteBrasil
- Endocrine Unit of Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | | | - Claudia Kirst
- Endocrine Unit of Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Graziela da S. Nunes
- Endocrine Unit of Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Karine de Franceschi
- Endocrine Unit of Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Mirela Jobim de Azevedo
- Endocrine Unit of Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Themis Zelmanovitz
- Endocrine Unit of Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| |
Collapse
|
8
|
Kim GL, Hwang HR, Kim YJ, Lee SY, Lee JG, Jeong DW, Yi YH, Tak YJ, Lee SH, Park AR. The Association of Body Fat and Arterial Stiffness Using the Brachial-Ankle Pulse Wave Velocity. Korean J Fam Med 2018; 39:347-354. [PMID: 30376701 PMCID: PMC6250948 DOI: 10.4082/kjfm.17.0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/12/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. METHODS This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. RESULTS For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. CONCLUSION Lower pBF in obese men may be associated with improved cardiovascular risk.
Collapse
Affiliation(s)
- Gyu Lee Kim
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
| | - Hye Rim Hwang
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea.,Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Yun Jin Kim
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea.,Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sang Yeoup Lee
- Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea.,Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.,Medical Education Unit and Medical Research Institute, Pusan National University School of Medicine, Yangsan, Korea
| | - Jeong Gyu Lee
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea.,Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Dong Wook Jeong
- Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea.,Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yu Hyeon Yi
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea.,Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Young Jin Tak
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea.,Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Seung Hun Lee
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea.,Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - A Rum Park
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
9
|
Park SK, Ryoo JH, Oh CM, Choi JM, Jung JY. Longitudinally evaluated the relationship between body fat percentage and the risk for type 2 diabetes mellitus: Korean Genome and Epidemiology Study (KoGES). Eur J Endocrinol 2018. [PMID: 29523634 DOI: 10.1530/eje-17-0868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Body fat plays the significant role in maintaining glucose homeostasis. However, it is not fully identified how body fat percentage (BF%) has an impact on the development of type 2 diabetes mellitus (T2DM). Thus, this study was to evaluate the incidental risk for T2DM according to BF% level. METHODS In a community-based Korean cohort, 5972 Korean adults were divided into quintile groups by BF% and followed up for 10 years to monitor the development of T2DM. Cox proportional hazard model was used to evaluate the hazard ratios (HRs) for T2DM according to BF% quintile. Additionally, subgroup analysis was conducted by low and high level of BF% (cut-off: 25 in men and 35 in women) and body mass index (BMI). RESULTS In adjusted model, compared to the BF% quintile 1 group, the risk for T2DM significantly increased over BF% of 22.8% in men and 32.9% in women (≥quintile 4). The level of BF% related to the increased risk for T2DM was lower in non-obese men (22.8%) than obese men (28.4%). In subgroup analysis, men with low BMI (<25) and high BF% (≥25) had the highest risk for T2DM than other subgroups (HRs: 1.83 (1.33-2.52)). However, this association did not show the statistical significance in women (HRs: 1.63 (0.98-2.72)). CONCLUSION The incidental risk for T2DM significantly increased over the specific level of BF%, which was lower in non-obese population than obese population. Gender difference was suggested in the incidental relationship between BF% and T2DM.
Collapse
Affiliation(s)
- Sung Keun Park
- Center for Cohort StudiesTotal Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Ryoo
- Department of Occupational and Environmental MedicineSchool of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang-Mo Oh
- Department of Preventive MedicineSchool of Medicine, Kyung Hee University, Seoul, Korea
| | - Joong-Myung Choi
- Department of Preventive MedicineSchool of Medicine, Kyung Hee University, Seoul, Korea
| | - Ju Young Jung
- Total Healthcare CenterSchool of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|
10
|
Vinknes KJ, Nurk E, Tell GS, Sulo G, Refsum H, Elshorbagy AK. The relation of CUN-BAE index and BMI with body fat, cardiovascular events and diabetes during a 6-year follow-up: the Hordaland Health Study. Clin Epidemiol 2017; 9:555-566. [PMID: 29184445 PMCID: PMC5685095 DOI: 10.2147/clep.s145130] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We compared Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and body mass index (BMI) as correlates of body fat percent (BF%) and the association with future risk of cardiovascular disease (CVD) and type 2 diabetes in a Caucasian population. Methods We used data from 6796 individuals (born 1925–27 and 1950–52) from the Hordaland Health Study, a prospective cohort study in Norway. The study was conducted in 1992–1993 and 1997–1999. Cross-sectional analyses were conducted with data from 1997/99, including BF% measured by dual-energy X-ray absorptiometry. Longitudinal analyses included BMI and CUN-BAE calculated in 1992/93, and self-reported information on CVD events and diabetes in 1997/99. Results The correlation between CUN-BAE and BF% (r=0.88) was stronger than between BMI and BF% (r=0.56). In sex-stratified analyses, CUN-BAE and BMI correlated similarly with BF% in men (r=0.77 and r=0.76, respectively) and women (r=0.82 and r=0.81, respectively). In longitudinal analyses, the odds ratio (per 1 SD increase) of CVD and type 2 diabetes was higher for BMI (ORCVD =1.23 [95% CI: 1.11–1.36]; ORdiabetes =2.11 [1.82–2.45]) than for CUN-BAE (ORCVD =1.15 [1.04–1.27]; ORdiabetes =2.06 [1.72–2.47]) in the total population. In sex-stratified analyses, CUN-BAE showed higher CVD and diabetes risk than BMI: in men BMI ORCVD =1.22 (1.04–1.44), ORdiabetes =2.13 (1.64–2.83); CUN-BAE ORCVD =1.93 (1.54–2.43), ORdiabetes =4.33 (2.80–6.71); and in women BMI ORCVD =1.22 (1.07–1.39), ORdiabetes =2.11 (1.76–2.53); CUN-BAE ORCVD =2.06 (1.69–2.51), ORdiabetes =5.45 (3.87–7.67). Conclusion CUN-BAE is more strongly associated with future risk of type 2 diabetes and CVD compared with BMI in analysis stratified by sex. As a measure of adiposity in men and women separately, CUN-BAE has no advantage over BMI, except when the value of estimated BF% itself is of interest.
Collapse
Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Eha Nurk
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Surveillance and Evaluation, National Institute for Health Development, Tallinn, Estonia
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pharmacology, University of Oxford, Oxford, UK
| | - Amany K Elshorbagy
- Department of Pharmacology, University of Oxford, Oxford, UK.,Department of Physiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| |
Collapse
|
11
|
Lind L, Ärnlöv J, Lampa E. The Interplay Between Fat Mass and Fat Distribution as Determinants of the Metabolic Syndrome Is Sex-Dependent. Metab Syndr Relat Disord 2017; 15:337-343. [PMID: 28586263 DOI: 10.1089/met.2017.0006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fat mass and fat distribution are major determinants of the metabolic syndrome (MetS), but the interplay between them has not been thoroughly investigated. In addition, fat mass and fat distribution are generally different in men than in women. We aimed to determine whether the interplay between fat mass and fat distribution regarding MetS and its components is sex-dependent using data from the large-scale population-based sample EpiHealth. METHODS Occurrence of MetS and its components was determined together with fat mass by bioimpedance in 19,094 participants in the EpiHealth sample [mean age 61 years (SD 8.5), 56% females]. MetS was defined by the NCEP/ATPIII-criteria. RESULTS MetS prevalence was 23.0%. Fat mass (percent of body weight) was more strongly related to MetS (and the number of MetS components) in men than in women (P < 0.0001 for interaction term) and in those with a high compared with those with a low waist/hip ratio (WHR). This modulating effect of WHR on the fat mass versus MetS-relationship was more pronounced in women than in men (P < 0.0001 for interaction term). When analyzing the MetS components one by one, fat mass was more closely related to all the individual MetS criteria in men than in women, except for the glucose criteria. CONCLUSIONS Fat mass is more closely related to prevalent MetS in men than in women, but the modulating effect of an abdominal type of fat distribution on the fat mass versus MetS-relationship is stronger in women.
Collapse
Affiliation(s)
- Lars Lind
- 1 Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University , Uppsala, Sweden
| | - Johan Ärnlöv
- 1 Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University , Uppsala, Sweden
| | - Erik Lampa
- 2 Uppsala Clinical Research Center (UCR), Uppsala University , Uppsala, Sweden
| |
Collapse
|
12
|
Treeprasertsuk S, Romero-Corral A, Somers VK, Sierra-Johnson J, Lindor KD, Angulo P, Lopez-Jimenez F. Association of adiposity, measures of metabolic dysregulation, and elevated alanine aminotransferase in subjects with normal body mass index. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0805.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background: Differences in body fat (BF) distribution in patients with normal body mass index (BMI) with elevated alanine aminotransferase (ALT) remains poorly described.
Objective: To determine the relationship between total BF, waist circumference (WC), insulin resistance (IR), and cardiometabolic risk profile in subjects with elevated ALT and normal BMI.
Methods: We analyzed cross-sectional data from 4,914 US participants in the third National Health and Nutrition Examination Survey database, who were ≥20 years of age, had normal BMI, and had body composition assessed by bioimpedance.
Results: Mean ± SD age was 41.4 ± 0.3 years, and 58% participants were women. BF was 20 ± 0.1% in men and 29.9 ± 0.1% in women. As total BF increased by tertiles, there was a tendency towards a higher prevalence of nonalcoholic fatty liver disease in men (6.1%, 6.5%, 9.5%, P = 0.13), but not in women (8.7%, 8.2%, 10.7%, P = 0.71). As WC increased by tertiles, there was a higher prevalence of elevated ALT in men (2.6%, 8.6%, 6.6%, P < 0.0001), but not in women. As ALT increased, men had significantly higher levels of nonhigh density lipoprotein cholesterol (HDL-C), increased apolipoprotein B, increased IR, and lower levels of C-reactive protein, whereas, women had higher levels of non-HDL-C and increased IR.
Conclusion: In subjects with normal BMI, increased WC is associated with a higher prevalence of elevated ALT in men, but not in women. Higher levels of ALT correlated with a poor cardiometabolic risk profile.
Collapse
Affiliation(s)
- Sombat Treeprasertsuk
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Foundation Rochester, Minnesota 55902, USA Thailand
- Correspondence: MD, PhD, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Abel Romero-Corral
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Mayo Foundation Rochester, MN, Minnesota 55902, USA United States of America
- Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia 19141, United States of America
| | - Virend K. Somers
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Mayo Foundation Rochester, MN, Minnesota 55902, United States of America
| | - Justo Sierra-Johnson
- Department of Medicine, Atherosclerosis Research Unit, Karolinska Institute, SE-171 76 Stockholm, Sweden
| | - Keith D. Lindor
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Foundation Rochester, Minnesota 55902, United States of America
| | - Paul Angulo
- Division of Gastroenterology, University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536-0509, United States of America
| | - Francisco Lopez-Jimenez
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Mayo Foundation Rochester, MN, Minnesota 55902, United States of America
| |
Collapse
|
13
|
Yaacob NM, Yaacob NA, Ismail AA, Che Soh NA, Ismail MS, Mohamed HJ, Hairon SM. Dumbbells and ankle-wrist weight training leads to changes in body composition and anthropometric parameters with potential cardiovascular disease risk reduction. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2016.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
14
|
Breitenbach Z, Raposa B, Szabó Z, Polyák É, Szűcs Z, Kubányi J, Figler M. Examination of Hungarian college students’ eating habits, physical activity and body composition. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Body composition of women 20-49 years old as a predictor for noncommunicable diseases: a community-based study. J Egypt Public Health Assoc 2016; 91:1-7. [PMID: 27110853 DOI: 10.1097/01.epx.0000480718.98448.2f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Obesity increases a person's risk of developing a number of noncommunicable diseases (NCDs), including, type 2 diabetes, coronary heart disease, hypertension, and certain cancers. The bioelectrical impedance analysis (BIA) has been considered as a safe, noninvasive, simple, and least expensive portable method for the evaluation of body composition in clinical practice. However, there is not enough information about its use in community-based surveys to detect the optimal cutoff point for the body fat percent (BF%) that could predict NCDs. OBJECTIVE To identify the cutoff point for the BF%, at which NCD risk could be predicted compared with BMI and waist circumference (WC). METHODS A community-based study was conducted in a randomly selected cluster located within the catchment area of Cairo University Hospitals. All ever-married women 20-49 years old and not currently pregnant (n=373) in the selected cluster were included in the study. A questionnaire was used for recoding data during the household survey. Portable equipment that estimates body composition (water, fat, protein, and bone) through BIA was used. RESULTS Receiver operating characteristic curve analysis showed cutoff point for BF% of 37.5% (P=0.02) at the time of reporting hypertension, with 78% sensitivity and 40% specificity. For diagnosed diabetes, cutoff point for the BF% was 38.5% (P=0.005), with 71% sensitivity and 46% specificity. For diagnosed cardiovascular diseases, cutoff point for BF% was 38.5% (P=0.001) with 86% sensitivity and 47% specificity. For diagnosed joint diseases, cutoff point for BF% was 38.5% (P=0.005), with 67% sensitivity and 48% specificity. CONCLUSION AND RECOMMENDATIONS BIA was effective in predicting and suggesting the cutoff points for the BF% associated with four types of NCDs (hypertension, cardiovascular, diabetes, and joint diseases). The use of BIA for women before the age of 20 years could guide strategies for reducing body fat and its risk of NCDs.
Collapse
|
16
|
Martín V, Dávila-Batista V, Castilla J, Godoy P, Delgado-Rodríguez M, Soldevila N, Molina AJ, Fernandez-Villa T, Astray J, Castro A, González-Candelas F, Mayoral JM, Quintana JM, Domínguez A. Comparison of body mass index (BMI) with the CUN-BAE body adiposity estimator in the prediction of hypertension and type 2 diabetes. BMC Public Health 2016; 16:82. [PMID: 26817835 PMCID: PMC4730622 DOI: 10.1186/s12889-016-2728-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 01/13/2016] [Indexed: 11/29/2022] Open
Abstract
Background Obesity is a world-wide epidemic whose prevalence is underestimated by BMI measurements, but CUN-BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) estimates the percentage of body fat (BF) while incorporating information on sex and age, thus giving a better match. Our aim is to compare the BMI and CUN-BAE in determining the population attributable fraction (AFp) for obesity as a cause of chronic diseases. Methods We calculated the Pearson correlation coefficient between BMI and CUN-BAE, the Kappa index and the internal validity of the BMI. The risks of arterial hypertension (AHT) and diabetes mellitus (DM) and the AFp for obesity were assessed using both the BMI and CUN-BAE. Results 3888 white subjects were investigated. The overall correlation between BMI and CUN-BAE was R2 = 0.48, which improved when sex and age were taken into account (R2 > 0.90). The Kappa coefficient for diagnosis of obesity was low (28.7 %). The AFp was 50 % higher for DM and double for AHT when CUN-BAE was used. Conclusions The overall correlation between BMI and CUN-BAE was not good. The AFp of obesity for AHT and DM may be underestimated if assessed using the BMI, as may the prevalence of obesity when estimated from the percentage of BF.
Collapse
Affiliation(s)
- Vicente Martín
- Grupo de Investigación Interacciones Gen-Ambiente y Salud - Universidad de León (Gigas), León, Spain.,CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Verónica Dávila-Batista
- Grupo de Investigación Interacciones Gen-Ambiente y Salud - Universidad de León (Gigas), León, Spain. .,Facultad de Ciencias de la Salud. Campus de Vegazana. Universidad de León, 24071, León, Spain.
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,División de Medicina Preventiva y Salud Pública, Universidad de Jaén, Jaén, Spain
| | | | - Antonio J Molina
- Grupo de Investigación Interacciones Gen-Ambiente y Salud - Universidad de León (Gigas), León, Spain
| | - Tania Fernandez-Villa
- Grupo de Investigación Interacciones Gen-Ambiente y Salud - Universidad de León (Gigas), León, Spain
| | - Jenaro Astray
- Subdirección de Vigilancia. Comunidad de Madrid, Madrid, Spain
| | - Ady Castro
- CIBER Enfermedades Respiratorias, Madrid, Spain
| | - Fernando González-Candelas
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Unidad Mixta Genómica y Salud CSISP (FISABIO)-Universitat de València, Valencia, Spain
| | | | - José María Quintana
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Fundación Vasca de Innovación e Investigación Sanitarias, Sondika, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | | |
Collapse
|
17
|
Sasaki R, Yano Y, Yasuma T, Onishi Y, Suzuki T, Maruyama-Furuta N, Gabazza EC, Sumida Y, Takei Y. Association of Waist Circumference and Body Fat Weight with Insulin Resistance in Male Subjects with Normal Body Mass Index and Normal Glucose Tolerance. Intern Med 2016; 55:1425-32. [PMID: 27250047 DOI: 10.2169/internalmedicine.55.4100] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective We investigated the relationship of the waist circumference (WC) and body fat weight (BF) with insulin resistance in subjects with normal body mass index (BMI) and normal glucose tolerance (NGT) during a routine medical check-up. Methods We categorized 167 male subjects in three groups as follows: a group with normal BMI but high WC (normal-BMI/high-WC group; 22≤BMI<25 kg/m(2), waist ≥85 cm; n=31), a group with normal BMI and normal WC (normal-BMI/normal-WC group, waist <85 cm; n=68), and a group with low normal BMI and normal WC (low normal-BMI/normal-WC group; 18.5≤BMI<22 kg/m(2) and waist<85 cm; n=68). We measured the plasma glucose and serum insulin levels before glucose loading and after 30 and 120 minutes and calculated several indexes of insulin secretion and sensitivity. Results Subjects from the normal-BMI/high-WC group showed significantly decreased Matsuda index and increased homeostasis model assessment for insulin resistance (HOMA-IR) compared with normal-BMI/normal-WC group. Univariate regression analyses showed significant correlation of HOMA-IR with WC (r=0.39) and BF (r=0.37). Matsuda index was significantly correlated with WC (r=-0.39) and BF (r=-0.47). The multiple regression analysis showed that the BF is significantly correlated with HOMA-IR (p<0.05) and Masuda index (p<0.005) among the clinical variables and with HOMA-IR (p<0.05) and Masuda index (p<0.0001) among the anthropometric variables but not with WC in either analysis. Conclusion Decreased Matsuda index and increased HOMA-IR were observed in subjects from the normal-BMI/high-WC group. Multivariate analysis showed that BF is associated with decreased Matsuda index and increased HOMA-IR and that WC is not associated with either factors.
Collapse
Affiliation(s)
- Ryoma Sasaki
- Department of Diabetes, Metabolism and Endocrinology, Mie University Graduate School of Medicine, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Liao C, Gao W, Cao W, Lv J, Yu C, Wang S, Zhou B, Pang Z, Cong L, Wang H, Wu X, Li L. Associations of Body Composition Measurements with Serum Lipid, Glucose and Insulin Profile: A Chinese Twin Study. PLoS One 2015; 10:e0140595. [PMID: 26556598 PMCID: PMC4640552 DOI: 10.1371/journal.pone.0140595] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/27/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To quantitate and compare the associations of various body composition measurements with serum metabolites and to what degree genetic or environmental factors affect obesity-metabolite relation. METHODS Body mass index (BMI), waist circumference (WC), lean body mass (LBM), percent body fat (PBF), fasting serum high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), glucose, insulin and lifestyle factors were assessed in 903 twins from Chinese National Twin Registry (CNTR). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting serum glucose and insulin. Linear regression models and bivariate structural equation models were used to examine the relation of various body composition measurements with serum metabolite levels and genetic/environmental influences on these associations, respectively. RESULTS At individual level, adiposity measurements (BMI, WC and PBF) showed significant associations with serum metabolite concentrations in both sexes and the associations still existed in male twins when using within-MZ twin pair comparison analyses. Associations of BMI with TG, insulin and HOMA-IR were significantly stronger in male twins compared to female twins (BMI-by-sex interaction p = 0.043, 0.020 and 0.019, respectively). Comparison of various adiposity measurements with levels of serum metabolites revealed that WC explained the largest fraction of variance in serum LDL-C, TG, TC and glucose concentrations while BMI performed best in explaining variance in serum HDL-C, insulin and HOMA-IR levels. Of these phenotypic correlations, 64-81% were attributed to genetic factors, whereas 19-36% were attributed to unique environmental factors. CONCLUSIONS We observed different associations between adiposity and serum metabolite profile and demonstrated that WC and BMI explained the largest fraction of variance in serum lipid profile and insulin resistance, respectively. To a large degree, shared genetic factors contributed to these associations with the remaining explained by twin-specific environmental factors.
Collapse
Affiliation(s)
- Chunxiao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenjing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- * E-mail: (LML); (WJG)
| | - Weihua Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Bin Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zengchang Pang
- Qingdao Center for Diseases Control and Prevention, Qingdao, China
| | - Liming Cong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Hua Wang
- Jiangsu Center for Disease Control and Prevention, Nanjing, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- * E-mail: (LML); (WJG)
| |
Collapse
|
19
|
Díaz M, Bassols J, López-Bermejo A, de Zegher F, Ibáñez L. Metformin treatment to reduce central adiposity after prenatal growth restraint: a placebo-controlled pilot study in prepubertal children. Pediatr Diabetes 2015; 16:538-45. [PMID: 25332100 DOI: 10.1111/pedi.12220] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 08/13/2014] [Accepted: 09/02/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Children born small-for-gestational-age (SGA) who experience rapid postnatal catch-up in weight are at risk for central adiposity and hyperinsulinemia. OBJECTIVES To study the effects of prepubertal metformin intervention over 24 months on the body composition and endocrine-metabolic profile of catch-up SGA children. METHODS Double-blind, placebo-controlled, pilot study including 23 post-catch-up non-obese prepubertal SGA children [age, 7.7 yr; body mass index standard deviation score (BMI SDS) >50th and <97th centile for age] with increased visceral fat [by magnetic resonance imaging (MRI) and insulin-like growth factor-I (IGF-I) both p > 75th for age]. Patients were randomized to receive either placebo or metformin (425 mg/d) for 24 months. Clinical, biochemical [IGF-I, glucose, insulin, lipids, androgens, sex-hormone-binding globulin (SHBG) and high-molecular-weight (HMW)-adiponectin] and imaging [body composition (absorptiometry and MRI; carotid intima-media thickness (ultrasonography)] variables were assessed at baseline, and at 6, 12, and 24 months. RESULTS After 24 months, metformin-treated children were leaner, had higher SHBG levels, and less total and abdominal fat than placebo-treated children (all p ≤ 0.05). Longitudinal analyses showed that metformin had a significant effect on anthropometric (weight, BMI, and waist) and biochemical variables [glucose, homeostasis model assessment-insulin resistance (HOMA-IR), and triglycerides] (all p ≤ 0.05); and in total and abdominal fat (p = 0.01 and p = 0.02). CONCLUSIONS Prepubertal intervention with metformin reduces central adiposity and improves insulin sensitivity in non-obese catch-up SGA children.
Collapse
Affiliation(s)
- Marta Díaz
- Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Judit Bassols
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona Institute for Biomedical Research, Girona, 17007, Spain
| | - Abel López-Bermejo
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona Institute for Biomedical Research, Girona, 17007, Spain
| | - Francis de Zegher
- Pediatric Endocrinology, University Hospital Gasthuisberg, Leuven, 3000, Belgium
| | - Lourdes Ibáñez
- Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| |
Collapse
|
20
|
de Castro Pimentel A, Scorsatto M, Moraes de Oliveira GM, Rosa G, Luiz RR. Characterization of metabolically healthy obese Brazilians and cardiovascular risk prediction. Nutrition 2015; 31:827-33. [DOI: 10.1016/j.nut.2014.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 12/07/2014] [Accepted: 12/08/2014] [Indexed: 12/13/2022]
|
21
|
Zeigler CC, Wondimu B, Marcus C, Modéer T. Pathological periodontal pockets are associated with raised diastolic blood pressure in obese adolescents. BMC Oral Health 2015; 15:41. [PMID: 25884594 PMCID: PMC4373518 DOI: 10.1186/s12903-015-0026-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/10/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Obesity, a well-known risk factor for developing cardiovascular disease (CVD), is associated with chronic periodontitis in adults. This cross-sectional pilot study on obese adolescents was designed to investigate whether periodontal disease in terms of pathological periodontal pockets is associated with raised blood pressure and other risk markers for CVD. METHODS The study included 75 obese subjects between 12 to 18 years of age, mean 14.5. Subjects answered a questionnaire regarding health, oral hygiene habits and sociodemographic factors. A clinical examination included Visible Plaque Index (VPI %), Gingival inflammation (BOP %) and the occurrence of pathological pockets exceeding 4 mm (PD ≥ 4 mm). Blood serum were collected and analyzed. The systolic and diastolic blood pressures were registered. RESULTS Adolescents with pathological periodontal pockets (PD ≥ 4 mm; n = 14) had significantly higher BOP >25% (P = 0.002), higher diastolic blood pressure (P = 0.008), higher levels of Interleukin (IL)-6 (P < 0.001), Leptin (P = 0.018), Macrophage Chemoattractant Protein-1 (MCP-1) (P = 0.049) and thyroid stimulating hormone (TSH) (P = 0.004) in blood serum compared with subjects without pathological periodontal pockets (PD ≥ 4 mm; n = 61). The bivariate linear regression analysis demonstrated that PD ≥ 4 mm (P = 0.008) and systolic blood pressure (P < 0.001) were significantly associated with the dependent variable "diastolic blood pressure". The association between PD ≥ 4 mm and diastolic blood pressure remained significant (P = 0.006) even after adjusting for potential confounders BMI-sds, age, gender, mother's country of birth, BOP >25%, IL-6, IL-8, Leptin, MCP-1, TSH and total cholesterol in the multiple regression analysis. CONCLUSION In conclusion, this study indicates an association between pathological periodontal pockets and diastolic blood pressure in obese adolescents. The association was unaffected by other risk markers for cardiovascular events or periodontal disease. The results call for collaboration between pediatric dentists and medical physicians in preventing obesity development and its associated disorders.
Collapse
Affiliation(s)
- Cecilia C Zeigler
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04, Huddinge, Stockholm, Sweden.
| | - Biniyam Wondimu
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04, Huddinge, Stockholm, Sweden.
| | - Claude Marcus
- National Childhood Obesity Centre, Division of Pediatrics Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | - Thomas Modéer
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04, Huddinge, Stockholm, Sweden.
| |
Collapse
|
22
|
Bohn B, Müller MJ, Simic-Schleicher G, Kiess W, Siegfried W, Oelert M, Tuschy S, Berghem S, Holl RW. BMI or BIA: Is Body Mass Index or Body Fat Mass a Better Predictor of Cardiovascular Risk in Overweight or Obese Children and Adolescents? A German/Austrian/Swiss Multicenter APV Analysis of 3,327 Children and Adolescents. Obes Facts 2015; 8:156-65. [PMID: 26087841 PMCID: PMC5644847 DOI: 10.1159/000381227] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/18/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Body fat (BF) percentiles for German children and adolescents have recently been published. This study aims to evaluate the association between bioelectrical impedance analysis (BIA)-derived BF and cardiovascular risk factors and to investigate whether BF is better suited than BMI in children and adolescents. METHODS Data of 3,327 children and adolescents (BMI > 90th percentile) were included. Spearman's correlation and receiver operating characteristics (ROCs) were applied determining the associations between BMI or BF and cardiovascular risk factors (hypertension, dyslipidemia, elevated liver enzymes, abnormal carbohydrate metabolism). Area under the curve (AUC) was calculated to predict cardiovascular risk factors. RESULTS A significant association between both obesity indices and hypertension was present (all p < 0.0001), but the correlation with BMI was stronger (r = 0.22) compared to BF (r = 0.13). There were no differences between BMI and BF regarding their correlation with other cardiovascular risk factors. BF significantly predicted hypertension (AUC = 0.61), decreased HDL-cholesterol (AUC = 0.58), elevated LDL-cholesterol (AUC = 0.59), elevated liver enzymes (AUC = 0.61) (all p < 0.0001), and elevated triglycerides (AUC = 0.57, p < 0.05), but not abnormal carbohydrate metabolism (AUC = 0.54, p = 0.15). For the prediction of cardiovascular risk factors, no significant differences between BMI and BF were observed. CONCLUSION BIA-derived BF was not superior to BMI to predict cardiovascular risk factors in overweight or obese children and adolescents.
Collapse
Affiliation(s)
- Barbara Bohn
- University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany
- *M.Sc. Public Health Nutrition Barbara Bohn, Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, 89081 Ulm, Germany
| | - Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | | | - Wieland Kiess
- University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | | | - Monika Oelert
- Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Sabine Tuschy
- SANA Clinic Lichtenberg, Department of Pediatric Medicine, SPZ – Adiposity Diseases, Berlin, Germany
| | - Stefan Berghem
- Rehabilitation Clinic ‘Klaus Störtebeker’ for Children and Adolescents, Kölpinsee, Germany
| | - Reinhard W. Holl
- University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany
| | | | | |
Collapse
|
23
|
Lamb MJE, Byrne CD, Wilson JF, Wild SH. Evaluation of bioelectrical impedance analysis for identifying overweight individuals at increased cardiometabolic risk: a cross-sectional study. PLoS One 2014; 9:e106134. [PMID: 25243464 PMCID: PMC4171089 DOI: 10.1371/journal.pone.0106134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 08/03/2014] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To investigate whether bioelectrical impedance analysis could be used to identify overweight individuals at increased cardiometabolic risk, defined as the presence of metabolic syndrome and/or diabetes. DESIGN AND METHODS Cross-sectional study of a Scottish population including 1210 women and 788 men. The diagnostic performance of thresholds of percentage body fat measured by bioelectrical impedance analysis to identify people at increased cardiometabolic risk was assessed using receiver-operating characteristic curves. Odds ratios for increased cardiometabolic risk in body mass index categories associated with values above compared to below sex-specific percentage body fat thresholds with optimal diagnostic performance were calculated using multivariable logistic regression analyses. The validity of bioelectrical impedance analysis to measure percentage body fat in this population was tested by examining agreement between bioelectrical impedance analysis and dual-energy X-ray absorptiometry in a subgroup of individuals. RESULTS Participants were aged 16-91 years and the optimal bioelectrical impedance analysis cut-points for percentage body fat for identifying people at increased cardiometabolic risk were 25.9% for men and 37.1% for women. Stratifying by these percentage body fat cut-points, the prevalence of increased cardiometabolic risk was 48% and 38% above the threshold and 24% and 19% below these thresholds for men and women, respectively. By comparison, stratifying by percentage body fat category had little impact on identifying increased cardiometabolic risk in normal weight and obese individuals. Fully adjusted odds ratios of being at increased cardiometabolic risk among overweight people with percentage body fat ≥ 25.9/37.1% compared with percentage body fat <25.9/37.1% as a reference were 1.93 (95% confidence interval: 1.20-3.10) for men and 1.79 (1.10-2.92) for women. CONCLUSION Percentage body fat measured using bioelectrical impedance analysis above a sex-specific threshold could be used in overweight people to identify individuals at increased cardiometabolic risk, who could benefit from risk factor management.
Collapse
Affiliation(s)
- Maxine J. E. Lamb
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Christopher D. Byrne
- Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
| | - James F. Wilson
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
- MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Sarah H. Wild
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
24
|
Míguez-Burbano MJ, Vargas M, Quiros C, Lewis JE, Espinoza L, Deshratan A. Menthol cigarettes and the cardiovascular risks of people living with HIV. J Assoc Nurses AIDS Care 2014; 25:427-35. [PMID: 24581861 DOI: 10.1016/j.jana.2014.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 01/28/2014] [Indexed: 10/25/2022]
Abstract
The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored cigarettes heightens CVD risk factors. Our study aims to assess traditional (10-year risk using the Framingham Risk Model) and nontraditional CVD risk factors and to contrast the effects of menthol-flavored versus non-menthol-flavored cigarettes on these risk factors. Compared to controls, menthol smokers were twice as likely to have hypertension. Users of menthol-flavored cigarettes had higher body mass index values, and increased risk of abdominal obesity. Multivariate analyses indicated that menthol smokers doubled the odds of having moderate to high CVD risk. This finding is highly significant given the widespread use of menthol-flavored cigarettes, particularly among women, minorities, and PLWH.
Collapse
|
25
|
Wang H, Ni Y, Yang S, Li H, Li X, Feng B. The effects of gliclazide, metformin, and acarbose on body composition in patients with newly diagnosed type 2 diabetes mellitus. Curr Ther Res Clin Exp 2014; 75:88-92. [PMID: 24465050 PMCID: PMC3898190 DOI: 10.1016/j.curtheres.2013.10.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2013] [Indexed: 12/25/2022] Open
Abstract
Background Although numerous clinical trials have evaluated the body weight change achieved using diabetes medications alone or in combinations, the composition of body weight change in these clinical trials has rarely been assessed. Objective We aimed to evaluate the effects of gliclazide, metformin, and acarbose monotherapy on body composition, fat distribution, and other cardiometabolic risk factors in patients with newly diagnosed type 2 diabetes. Methods A total of 86 patients with newly diagnosed type 2 diabetes mellitus were randomly assigned to receive gliclazide, metformin, or acarbose for 6 months. Dual-energy x-ray absorptiometry; abdominal computed tomography scans; and measurements of adiponectin, leptin, and lipid levels were performed before and after 6-month monodrug therapy. Results Blood glucose and glycosylated hemoglobin levels significantly improved after 6 months of monodrug therapy. During the 6 months of use of the 3 antidiabetes medications, the majority of participants experienced fat mass loss and lean mass gain. Metformin monotherapy in patients with newly diagnosed type 2 diabetes led to a significant decrease in percent body fat (P = 0.029) and body fat mass (P = 0.038). Levels of serum total cholesterol (P = 0.004), triglycerides (P = 0.014), and adiponectin (P = 0.001) took a favorable turn after metformin treatment. The 3 antidiabetes medications caused no significant change in abdominal fat distribution, waist circumstance, and blood pressure during the 6 months. Conclusions Our results suggest metformin therapy in patients with newly diagnosed type 2 diabetes can improve cardiometabolic risk markers. Moreover, body composition change induced by gliclazide and acarbose was not likely to be simple fat deposition.
Collapse
Affiliation(s)
- Hua Wang
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yafang Ni
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shuo Yang
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huizhi Li
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xu Li
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Feng
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
- Address correspondence to: Bo Feng, MD, Department of Endocrinology, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Pudong District, Shanghai 200120, China.
| |
Collapse
|
26
|
Hsu CH, Lin JD, Hsieh CH, Lau SC, Chiang WY, Chen YL, Pei D, Chang JB. Adiposity measurements in association with metabolic syndrome in older men have different clinical implications. Nutr Res 2014; 34:219-25. [PMID: 24655488 DOI: 10.1016/j.nutres.2014.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 12/16/2013] [Accepted: 01/16/2014] [Indexed: 02/06/2023]
Abstract
Obesity is a major public health problem, and measuring adiposity accurately and predicting its future comorbidities are important issues. Therefore, we hypothesized that 4 adiposity measurements, body mass index (BMI), waist circumference (WC), waist-to-height ratio, and body fat percentage, have different physiological meanings and distinct associations with adverse health consequences. This study aimed to investigate the relationship of these 4 measurements with metabolic syndrome (MetS) components and identify the most associated factor for MetS occurrence in older, non-medicated men. Cross-sectional data from 3004 men, all 65 years of age and older, were analyzed. The correlation and association between adiposity measurements and MetS components were evaluated by Pearson correlation and multiple linear regression. Based on multivariate logistic regression, BMI and WC were significantly associated with MetS and were selected to build a combined model of receiver operating characteristic curves to increase the diagnosis accuracy for MetS. The results show that BMI is independently associated with systolic and diastolic blood pressure; WC and body fat percentage are associated with fasting plasma glucose and log transformation of triglyceride; BMI and WC are negatively associated with high-density lipoprotein cholesterol (HDL-C); and WC is a better discriminate for MetS than BMI, although the combined model (WC + BMI) is not significantly better than WC alone. Based on these results, we conclude that the 4 adiposity measurements have different clinical implications. Thus, in older men, BMI is an important determinant for blood pressure and HDL-C. Waist circumference is associated with the risk of fasting plasma glucose, HDL-C, triglyceride, and MetS occurrence. The combined model did not increase the diagnosis accuracy.
Collapse
Affiliation(s)
- Chun-Hsien Hsu
- Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Jiunn-Diann Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shu Chuen Lau
- Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Wei-Yong Chiang
- Division of Geriatric Medicine, Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Yen-Lin Chen
- Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Dee Pei
- Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Jin-Biou Chang
- Department of Pathology, National Defense Medical Center, Division of Clinical Pathology, Tri-Service General Hospital, Taipei, Taiwan; Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu, Taiwan.
| |
Collapse
|
27
|
Body fat percentage as a marker of new-onset diabetes mellitus after kidney transplantation. Transplant Proc 2013; 45:1544-7. [PMID: 23726616 DOI: 10.1016/j.transproceed.2012.12.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 12/04/2012] [Indexed: 01/14/2023]
Abstract
BACKGROUND New-onset diabetes after transplantation (NODAT) is a serious metabolic complication that can follow kidney transplantation. Several risk factors, including obesity, have been related to NODAT development. Obesity is defined as an excessive accumulation of body fat, and body fat percentage (BF%) has been commonly measured by different techniques, including bioelectrical impedance analysis. However, the correlation between an increase in BF% and the development of NODAT during outpatient follow-up has not yet been explored. We aimed to elucidate the association between BF% changes and the development of NODAT. METHODS We performed a retrospective study involving 45 patients without diabetes who underwent kidney transplantation in our hospital between March 2008 and December 2010. We compared the BF% and demographic variables of patients who did and did not develop NODAT during follow-up. RESULTS Four patients (8.9%) developed NODAT during a mean follow-up period of 30.3 months. The post-transplantation increase in BF% was much higher in NODAT+ patients than the NODAT- patients. Univariate analysis indicated that the rate of increase in BF% was a risk factor for NODAT (hazard ratio [HR], 1.08 [1.02-1.18]; P < .005). CONCLUSIONS A large increase in BF% may be a risk factor for NODAT. These findings underline the importance of routine BF% measurements in medical practice.
Collapse
|
28
|
Abstract
Obesity is associated with increased risk of developing metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) leading to higher all-cause mortality. However accumulating evidence suggests that not all obese subjects are at increased cardiometabolic risk and that the "metabolically healthy obese" (MHO) phenotype may exist in the absence of metabolic abnormalities. Despite the knowledge of the existence of obese metabolic phenotypes for some time now there is no standard set of criteria to define metabolic health, thus impacting on the accurate estimation of the prevalence of the MHO phenotype and making comparability between studies difficult. Furthermore prospective studies tracking the development of cardiometabolic disease and mortality in MHO have also produced conflicting results. Limited data regards the determinants of the MHO phenotype exist, particularly in relation to dietary and lifestyle behaviours. In light of the current obesity epidemic it is clear that current "one size fits all" approaches to tackle obesity are largely unsuccessful. Whether dietary, lifestyle and/or therapeutic interventions based on stratification of obese individuals according to their metabolic health phenotype are more effective remains to be seen, with limited and conflicting data available so far. This review will present the current state of the art including the epidemiology of MHO and its definitions, what factors may be important in determining metabolic health status and finally, some potential implications of the MHO phenotype in the context of obesity diagnosis, interventions and treatment.
Collapse
Affiliation(s)
- Catherine M Phillips
- HRB Centre for Diet and Health Research, Department of Epidemiology and Public Health, Room 4.033, Western Gateway Building, University College Cork, Cork, Ireland,
| |
Collapse
|
29
|
Faria FR, Faria ER, Cecon RS, Barbosa Júnior DA, Franceschini SDCC, Peluzio MDCG, Ribeiro AQ, Lira PIC, Cecon PR, Priore SE. Body fat equations and electrical bioimpedance values in prediction of cardiovascular risk factors in eutrophic and overweight adolescents. Int J Endocrinol 2013; 2013:501638. [PMID: 23762051 PMCID: PMC3670509 DOI: 10.1155/2013/501638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/25/2013] [Accepted: 01/25/2013] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to analyze body fat anthropometric equations and electrical bioimpedance analysis (BIA) in the prediction of cardiovascular risk factors in eutrophic and overweight adolescents. 210 adolescents were divided into eutrophic group (G1) and overweight group (G2). The percentage of body fat (% BF) was estimated using 10 body fat anthropometric equations and 2 BIA. We measured lipid profiles, uric acid, insulin, fasting glucose, homeostasis model assessment-insulin resistance (HOMA-IR), and blood pressure. We found that 76.7% of the adolescents exhibited inadequacy of at least one biochemical parameter or clinical cardiovascular risk. Higher values of triglycerides (TG) (P = 0.001), insulin, and HOMA-IR (P < 0.001) were observed in the G2 adolescents. In multivariate linear regression analysis, the % BF from equation (5) was associated with TG, diastolic blood pressure, and insulin in G1. Among the G2 adolescents, the % BF estimated by (5) and (9) was associated with LDL, TG, insulin, and the HOMA-IR. Body fat anthropometric equations were associated with cardiovascular risk factors and should be used to assess the nutritional status of adolescents. In this study, equation (5) was associated with a higher number of cardiovascular risk factors independent of the nutritional status of adolescents.
Collapse
Affiliation(s)
- Franciane Rocha Faria
- Department of Nutrition and Health-CCB II, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | - Eliane Rodrigues Faria
- Department of Nutrition and Health-CCB II, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | - Roberta Stofeles Cecon
- Department of Nutrition and Health-CCB II, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | - Djalma Adão Barbosa Júnior
- Department of Rural Economy, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | | | - Maria do Carmo Gouveia Peluzio
- Department of Nutrition and Health-CCB II, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | - Andréia Queiroz Ribeiro
- Department of Nutrition and Health-CCB II, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | - Pedro Israel Cabral Lira
- Department of Nutrition-Center for Health Sciences, Federal University of Pernambuco, Avenida Nelson Chaves s/n°, Cidade Universitária, Recife, PE, Brazil
| | - Paulo Roberto Cecon
- Department of Statistics, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| | - Silvia Eloiza Priore
- Department of Nutrition and Health-CCB II, Federal University of Viçosa, Avenida P.H. Rolfs s/n°, Campus UFV, Viçosa, MG, Brazil
| |
Collapse
|
30
|
Baudrand R, Domínguez JM, Tabilo C, Figueroa D, Jimenez M, Eugenin C, Carvajal C, Moreno M. The estimation of visceral adipose tissue with a body composition monitor predicts the metabolic syndrome. J Hum Nutr Diet 2013; 26 Suppl 1:154-8. [DOI: 10.1111/jhn.12089] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Baudrand
- Department of Endocrinology; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - J. M. Domínguez
- Department of Endocrinology; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - C. Tabilo
- Departments of Diabetes, Nutrition and Metabolism; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - D. Figueroa
- Pontificia Universidad Católica de Chile; Santiago Chile
| | - M. Jimenez
- Pontificia Universidad Católica de Chile; Santiago Chile
| | - C. Eugenin
- Pontificia Universidad Católica de Chile; Santiago Chile
| | - C. Carvajal
- Department of Endocrinology; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - M. Moreno
- Departments of Diabetes, Nutrition and Metabolism; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| |
Collapse
|
31
|
Phillips CM, Tierney AC, Perez-Martinez P, Defoort C, Blaak EE, Gjelstad IMF, Lopez-Miranda J, Kiec-Klimczak M, Malczewska-Malec M, Drevon CA, Hall W, Lovegrove JA, Karlstrom B, Risérus U, Roche HM. Obesity and body fat classification in the metabolic syndrome: impact on cardiometabolic risk metabotype. Obesity (Silver Spring) 2013; 21:E154-61. [PMID: 23505198 DOI: 10.1002/oby.20263] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 05/31/2012] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Obesity is a key factor in the development of the metabolic syndrome (MetS), which is associated with increased cardiometabolic risk. We investigated whether obesity classification by BMI and body fat percentage (BF%) influences cardiometabolic profile and dietary responsiveness in 486 MetS subjects (LIPGENE dietary intervention study). DESIGN AND METHODS Anthropometric measures, markers of inflammation and glucose metabolism, lipid profiles, adhesion molecules, and hemostatic factors were determined at baseline and after 12 weeks of four dietary interventions (high saturated fat (SFA), high monounsaturated fat (MUFA), and two low fat high complex carbohydrate (LFHCC) diets, one supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs)). RESULTS About 39 and 87% of subjects classified as normal and overweight by BMI were obese according to their BF%. Individuals classified as obese by BMI (≥ 30 kg/m(2)) and BF% (≥ 25% (men) and ≥ 35% (women)) (OO, n = 284) had larger waist and hip measurements, higher BMI and were heavier (P < 0.001) than those classified as nonobese by BMI but obese by BF% (NOO, n = 92). OO individuals displayed a more proinflammatory (higher C reactive protein (CRP) and leptin), prothrombotic (higher plasminogen activator inhibitor-1 (PAI-1)), proatherogenic (higher leptin/adiponectin ratio) and more insulin resistant (higher HOMA-IR) metabolic profile relative to the NOO group (P < 0.001). Interestingly, tumor necrosis factor-α (TNF-α) concentrations were lower post-intervention in NOO individuals compared with OO subjects (P < 0.001). CONCLUSIONS In conclusion, assessing BF% and BMI as part of a metabotype may help to identify individuals at greater cardiometabolic risk than BMI alone.
Collapse
Affiliation(s)
- Catherine M Phillips
- Nutrigenomics Research Group, UCD School of Public Health and Population Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
van Dijk SB, Takken T, Prinsen EC, Wittink H. Different anthropometric adiposity measures and their association with cardiovascular disease risk factors: a meta-analysis. Neth Heart J 2012; 20:208-18. [PMID: 22231153 PMCID: PMC3346869 DOI: 10.1007/s12471-011-0237-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives To investigate which anthropometric adiposity measure has the strongest association with cardiovascular disease (CVD) risk factors in Caucasian men and women without a history of CVD. Design Systematic review and meta-analysis. Methods We searched databases for studies reporting correlations between anthropometric adiposity measures and CVD risk factors in Caucasian subjects without a history of CVD. Body mass index (BMI), waist circumference, waist-to-hip ratio, waist-to-height ratio and body fat percentage were considered the anthropometric adiposity measures. Primary CVD risk factors were: systolic blood pressure, diastolic blood pressure, high density lipoprotein (HDL) cholesterol, triglycerides and fasting glucose. Two independent reviewers performed abstract, full text and data selection. Results Twenty articles were included describing 21,618 males and 24,139 females. Waist circumference had the strongest correlation with all CVD risk factors for both men and women, except for HDL and LDL in men. When comparing BMI with waist circumference, the latter showed significantly better correlations to CVD risk factors, except for diastolic blood pressure in women and HDL and total cholesterol in men. Conclusions We recommend the use of waist circumference in clinical and research studies above other anthropometric adiposity measures, especially compared with BMI, when evaluating CVD risk factors.
Collapse
Affiliation(s)
- S B van Dijk
- School of Clinical Health Sciences, Department of Physical Therapy Science, Utrecht University, Utrecht, the Netherlands,
| | | | | | | |
Collapse
|
33
|
Gropper SS, Simmons KP, Connell LJ, Ulrich PV. Changes in body weight, composition, and shape: a 4-year study of college students. Appl Physiol Nutr Metab 2012; 37:1118-23. [PMID: 22978391 DOI: 10.1139/h2012-139] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The objectives of this study were to examine changes in body weight, body mass index (BMI), body composition, and shape in a group of male and female students over the 4-year college period. Anthropometric assessments including height and weight (via standard techniques), body composition (via bioelectrical impedance analysis), and body shape (via 3-dimensional body scanning) were conducted at the beginning of the freshman year and end of the senior year in 131 college students. Four-year changes included significant (p < 0.0001) gains in weight (3.0 kg), BMI (1.0 kg·m(-2)), body fat (3.6%), and absolute fat mass (3.2 kg). Males gained significantly (p < 0.0001) greater amounts of weight, BMI, percent and absolute fat mass, and fat-free mass than females. Weight change ranged from (-)8.7 to (+)16.8 kg. About 70% of the participants gained weight, which averaged 5.3 kg; significant (p < 0.0001) gains in BMI, fat-free mass, absolute fat mass, and percent body fat and significant (p < 0.0005) increases in neck, chest-bust, waist, hips, seat, and biceps circumferences were also observed in this weight gain group. The percentage of participants classified as overweight-obese increased from 18% to 31%. The number of females and males with ≥30% and 20% body fat, respectively, increased from n = 14 to n = 26 (with n = 4 exhibiting normal weight obesity) over the 4-year period. The waist circumference changes were significantly (p < 0.0001) correlated with both weight and percent body fat changes. In conclusion, the increasing prevalence of obesity and normal weight obesity among this college population suggests the need for additional health promotion strategies on college campuses.
Collapse
Affiliation(s)
- Sareen S Gropper
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, AL 36849, USA.
| | | | | | | |
Collapse
|
34
|
Gropper SS, Simmons KP, Connell LJ, Ulrich PV. Weight and Body Composition Changes during the First Three Years of College. J Obes 2012; 2012:634048. [PMID: 23050127 PMCID: PMC3463803 DOI: 10.1155/2012/634048] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 08/26/2012] [Indexed: 11/17/2022] Open
Abstract
Differences in weight, body mass index (BMI), percent and absolute body fat, fat-free mass, and waist circumference were investigated in a group of males and females during the first three years (from 2007 to 2010) of college. Significant three-year gains were observed for weight 2.1 ± 4.7 kg, BMI 0.7 ± 1.6 kg/m(2), percent body fat 2.7 ± 3.3%, and fat mass 2.3 ± 3.5 kg. A significant loss of fat-free mass, -0.5 kg, was observed among females. Absolute gains in weight, BMI, and percent and absolute body fat were highest during the freshman year, followed by the junior year, and lowest during the sophomore year. Among the 70% of students gaining weight over the three years, weight gain averaged 4.3 kg. The numbers of females with over 30% body fat doubled, and the number of males with over 20% body fat increased fivefold. Initially 15% of students were classified as obese/overweight and 79% normal weight; by the end of the junior year, 24% were obese/overweight and 70% were normal weight. Efforts on college campuses to promote healthy lifestyles among its student population are needed throughout the college years.
Collapse
Affiliation(s)
- Sareen S. Gropper
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, 101 Poultry Science Building, AL 36849, USA
- *Sareen S. Gropper:
| | - Karla P. Simmons
- Department of Consumer Affairs, Auburn University, 308 Spidle Hall, AL 36849, USA
| | - Lenda Jo Connell
- Department of Consumer Affairs, Auburn University, 308 Spidle Hall, AL 36849, USA
| | - Pamela V. Ulrich
- Department of Consumer Affairs, Auburn University, 308 Spidle Hall, AL 36849, USA
| |
Collapse
|
35
|
Gómez-Ambrosi J, Silva C, Galofré JC, Escalada J, Santos S, Gil MJ, Valentí V, Rotellar F, Ramírez B, Salvador J, Frühbeck G. Body adiposity and type 2 diabetes: increased risk with a high body fat percentage even having a normal BMI. Obesity (Silver Spring) 2011; 19:1439-44. [PMID: 21394093 DOI: 10.1038/oby.2011.36] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Obesity is the major risk factor for the development of prediabetes and type 2 diabetes. BMI is widely used as a surrogate measure of obesity, but underestimates the prevalence of obesity, defined as an excess of body fat. We assessed the presence of impaired glucose tolerance or impaired fasting glucose (both considered together as prediabetes) or type 2 diabetes in relation to the criteria used for the diagnosis of obesity using BMI as compared to body fat percentage (BF%). We performed a cross-sectional study including 4,828 (587 lean, 1,320 overweight, and 2,921 obese classified according to BMI) white subjects (66% females), aged 18-80 years. BMI, BF% determined by air-displacement plethysmography (ADP) and conventional blood markers of glucose metabolism and lipid profile were measured. We found a higher than expected number of subjects with prediabetes or type 2 diabetes in the obese category according to BF% when the sample was globally analyzed (P < 0.0001) and in the lean BMI-classified subjects (P < 0.0001), but not in the overweight or obese-classified individuals. Importantly, BF% was significantly higher in lean (by BMI) women with prediabetes or type 2 diabetes as compared to those with normoglycemia (NG) (35.5 ± 7.0 vs. 30.3 ± 7.7%, P < 0.0001), whereas no differences were observed for BMI. Similarly, increased BF% was found in lean BMI-classified men with prediabetes or type 2 diabetes (25.2 ± 9.0 vs. 19.9 ± 8.0%, P = 0.008), exhibiting no differences in BMI or waist circumference. In conclusion, assessing BF% may help to diagnose disturbed glucose tolerance beyond information provided by BMI and waist circumference in particular in male subjects with BMI <25 kg/m(2) and over the age of 40.
Collapse
|
36
|
Gómez-Ambrosi J, Silva C, Galofré JC, Escalada J, Santos S, Millán D, Vila N, Ibañez P, Gil MJ, Valentí V, Rotellar F, Ramírez B, Salvador J, Frühbeck G. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. Int J Obes (Lond) 2011; 36:286-94. [PMID: 21587201 DOI: 10.1038/ijo.2011.100] [Citation(s) in RCA: 371] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. OBJECTIVE We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%. DESIGN We performed a cross-sectional study. SUBJECTS A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. METHODS BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. RESULTS We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg l(-1)) as well as in obese BMI-classified individuals (men 4.2 ± 5.5, women 5.1 ± 13.2 mg l(-1)) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 ± 2.6 mg l(-1); P<0.001 for both genders). CONCLUSION Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
Collapse
Affiliation(s)
- J Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
The interaction of lifestyle, socioeconomic status, genetic factors, and treatment with antipsychotic medications likely accounts for the high risk of metabolic syndrome, diabetes, heart disease, and premature mortality in people with serious mental illness. Given the high risk of developing diabetes and cardiovascular disease in persons with serious mental illness, psychiatrists who treat these individuals need to ensure they are familiar with these risks, monitor metabolic parameters in their patients, and educate their patients (and caregivers) about the risks and how to prevent them.
Collapse
Affiliation(s)
- Rohan Ganguli
- Center for Addiction and Mental Health, University of Toronto, 901 King Street West, Toronto, Ontario, Canada.
| | | |
Collapse
|
38
|
Clair C, Chiolero A, Faeh D, Cornuz J, Marques-Vidal P, Paccaud F, Mooser V, Waeber G, Vollenweider P. Dose-dependent positive association between cigarette smoking, abdominal obesity and body fat: cross-sectional data from a population-based survey. BMC Public Health 2011; 11:23. [PMID: 21223575 PMCID: PMC3025841 DOI: 10.1186/1471-2458-11-23] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 01/11/2011] [Indexed: 02/07/2023] Open
Abstract
Background Although smokers tend to have a lower body-mass index than non-smokers, smoking may favour abdominal body fat accumulation. To our knowledge, no population-based studies have assessed the relationship between smoking and body fat composition. We assessed the association between cigarette smoking and waist circumference, body fat, and body-mass index. Methods Height, weight, and waist circumference were measured among 6,123 Caucasians (ages 35-75) from a cross-sectional population-based study in Switzerland. Abdominal obesity was defined as waist circumference ≥102 cm for men and ≥88 cm for women. Body fat (percent total body weight) was measured by electrical bioimpedance. Age- and sex-specific body fat cut-offs were used to define excess body fat. Cigarettes smoked per day were assessed by self-administered questionnaire. Age-adjusted means and odds ratios were calculated using linear and logistic regression. Results Current smokers (29% of men and 24% of women) had lower mean waist circumference, body fat percentage, and body-mass index compared with non-smokers. Age-adjusted mean waist circumference and body fat increased with cigarettes smoked per day among smokers. The association between cigarettes smoked per day and body-mass index was non-significant. Compared with light smokers, the adjusted odds ratio (OR) for abdominal obesity in men was 1.28 (0.78-2.10) for moderate smokers and 1.94 (1.15-3.27) for heavy smokers (P = 0.03 for trend), and 1.07 (0.72-1.58) and 2.15 (1.26-3.64) in female moderate and heavy smokers, respectively (P < 0.01 for trend). Compared with light smokers, the OR for excess body fat in men was 1.05 (95% CI: 0.58-1.92) for moderate smokers and 1.15 (0.60-2.20) for heavy smokers (P = 0.75 for trend) and 1.34 (0.89-2.00) and 2.11 (1.25-3.57), respectively in women (P = 0.07 for trend). Conclusion Among smokers, cigarettes smoked per day were positively associated with central fat accumulation, particularly in women.
Collapse
Affiliation(s)
- Carole Clair
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Falaschetti E, Hingorani AD, Jones A, Charakida M, Finer N, Whincup P, Lawlor DA, Davey Smith G, Sattar N, Deanfield JE. Adiposity and cardiovascular risk factors in a large contemporary population of pre-pubertal children. Eur Heart J 2010; 31:3063-72. [PMID: 20972265 DOI: 10.1093/eurheartj/ehq355] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS to examine the associations of several markers of adiposity and a wide range of cardiovascular risk factors and biomarkers in pre-pubertal children. METHODS AND RESULTS four measures of adiposity,body mass index (BMI), waist circumference, dual-energy X-ray absorptiometry (DXA)-determined fat mass, and leptin concentration, were available in up to 7589 children aged 8.8-11.7 (9.9 mean) years from the Avon Longitudinal Study of Parents and Children (ALSPAC). Thirteen per cent of boys and 18.8% of girls were overweight, and 5.3% of boys and 5% of girls were obese. Body mass index was highly correlated with waist circumference (r = 0.91), DXA fat mass (r = 0.87), and leptin concentration (r = 0.75), and all had similar associations with cardiovascular risk factors. A 1 kg/m(2) greater BMI was associated with 1.4 mmHg (95% CI 1.25-1.44) higher systolic blood pressure (BP). In 5002 children, a 1 kg/m(2) greater BMI was associated with a 0.05 mmol/L (95% CI 0.036-0.055) higher non-high-density lipoprotein (HDL) cholesterol and 0.03 mmol/L (95% CI -0.034 to -0.025) lower HDL cholesterol. There were also graded associations with apolipoproteins A1 and B, interleukin-6, and C-reactive protein. Comparing children who were obese with those who were normal weight, the odds ratio for hypertension was 10.7 (95% CI 7.2-15.9) for boys and 13.5 (95% CI 9.4-19.5) for girls. CONCLUSION in pre-pubertal UK children, overweight/obesity is common and has broadly similar associations with BP, HDL cholesterol, and non-HDL cholesterol to those observed in adults. Future research should evaluate whether effective interventions to maintain healthy weight in childhood could have important benefits for adult cardiovascular risk.
Collapse
Affiliation(s)
- Emanuela Falaschetti
- Vascular Physiology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Ren J, Kelley RO. Cardiac health in women with metabolic syndrome: clinical aspects and pathophysiology. Obesity (Silver Spring) 2009; 17:1114-23. [PMID: 19214173 DOI: 10.1038/oby.2009.8] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Although the classical cardiovascular risk factors (e.g., smoking and hypertension) are becoming more effectively managed, a continuous increase of the so-called "cardiometabolic risk" is noted. Starting from this century, the nomenclature "metabolic syndrome" has become more popular to identify a cluster of disorders including obesity, dyslipidemia, hypertension, and insulin resistance. It is a primary risk factor for diabetes and cardiovascular disease in both genders. Interestingly, the metabolic diseases display a distinct gender disparity with an apparent "female advantage" in the premenopausal women compared with age-matched men. However, women usually lose such "sex protection" following menopause or affliction of metabolic syndrome especially insulin resistance. A controversy exists in the medical literature concerning whether metabolic syndrome is a real syndrome or simply a cluster of risk factors. Several scenarios are speculated to contribute to the gender dimorphism in the cardiovascular sequelae in patients with metabolic syndrome including sex hormones, intrinsic organ function, and the risk factor profile (e.g., hypertension, dyslipidemia, obesity, sedentary lifestyle, and atherogenic diet). With the alarming rise of obesity prevalence, heart problems in metabolic syndrome continue to rise with a distinct gender dimorphism. Although female hearts seem to better tolerate the stress insults compared with the male counterparts, the female sex hormones such as estrogen can interact with certain risk factors to precipitate myopathic changes in the hearts. This synthetic review of recent literature suggests a role of gender disparity in myopathic factors and risk attributable to each metabolic component in the different prevalence of metabolic syndrome.
Collapse
Affiliation(s)
- Jun Ren
- University of Wyoming College of Health Sciences, Laramie, Wyoming, USA.
| | | |
Collapse
|