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Agius R, Pace NP, Fava S. Anthropometric and Biochemical Correlations of Insulin Resistance in a Middle-Aged Maltese Caucasian Population. J Nutr Metab 2024; 2024:5528250. [PMID: 38420511 PMCID: PMC10901578 DOI: 10.1155/2024/5528250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/20/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Background Insulin resistance (IR) is associated with increased cardiovascular disease risk, and with increased all-cause, cardiovascular, and cancer mortality. A number of surrogate markers are used in clinical practice to diagnose IR. The aim of this study was to investigate the discriminatory power of a number of routinely available anthropometric and biochemical variables in predicting IR and to determine their optimal cutoffs. Methods We performed a cross-sectional study in a cohort of middle-aged individuals. We used receiver operator characteristics (ROC) analyses in order to determine the discriminatory power of parameters of interest in detecting IR, which was defined as homeostatic model assessment-insulin resistance ≥2.5. Results Both the lipid accumulation product (LAP) and visceral adiposity index (VAI) exhibited good discriminatory power to detect IR in both males and females. The optimal cutoffs were 42.5 and 1.44, respectively, in males and 36.2 and 1.41, respectively, in females. Serum triglycerides (TG) and waist circumference (WC) similarly demonstrated good discriminatory power in detecting IR in both sexes. The optimal cutoffs for serum TG and WC were 1.35 mmol/L and 96.5 cm, respectively, in men and 1.33 mmol/L and 82 cm, respectively, in women. On the other hand, systolic and diastolic blood pressure, liver transaminases, high-density lipoprotein cholesterol, serum uric acid, ferritin, waist-hip ratio, "A" body shape, thigh circumference, and weight-adjusted thigh circumference all had poor discriminatory power. Conclusions Our data show that LAP, VAI, TG, and WC all have good discriminatory power in detecting IR in both men and women. The optimal cutoffs for TG and WC were lower than those currently recommended in both sexes. Replication studies are required in different subpopulations and different ethnicities in order to be able to update the current cut points to ones which reflect the contemporary population as well as to evaluate their longitudinal relationship with longer-term cardiometabolic outcomes.
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Affiliation(s)
- Rachel Agius
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida MSD2090, Malta
| | - Nikolai Paul Pace
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
| | - Stephen Fava
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida MSD2090, Malta
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Ramezankhani A, Mehrabi Y, Azizi F, Hosseinpanah F, Dehghan P, Hadaegh F. Cumulative burden and trajectories of body mass index and blood pressure from childhood and carotid intima-media thickness in young adulthood. Prev Med 2023; 177:107747. [PMID: 37898182 DOI: 10.1016/j.ypmed.2023.107747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/25/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
There are significant gaps in understanding of the association between levels and rate of change of body mass index (BMI) and blood pressure (BP) at different ages during childhood and carotid intima-media thickness (CIMT) in adulthood. We investigated the association between trajectories of BMI and BP from childhood to adulthood and adult CIMT among Iranian participants in the Tehran Lipid and Glucose Study (TLGS) cohort. A total of 1334 participants (692 men), from the TLGS cohort (1999-2018) with repeated measurements of BMI and BP (2-6 times) from childhood (3-18 years) to young adulthood (20-40 years) were selected. Trajectory parameters included levels and linear slopes of BMI and BP growth curve models, and cumulative burden defined as the area under those curves (AUC). After adjusting for confounders, AUC of BMI and diastolic blood pressure (DBP) were significantly associated with high CIMT in adulthood, with the standardized odds ratios (OR) and 95% confidence interval (95% CI) of 1.35 (1.12-1.62) and 1.27 (1.01-1.60), respectively. Associations between level-independent slopes of BMI and adult CIMT were significantly positive (ORs: 1.27 to 1.26) during childhood ages (3-18 years). Further, levels of BMI (ORs: 1.23 to 1.29) and DBP (ORs: 1.25 to 1.33) during the ages of 13-18 and 11-17 years, respectively, were significantly associated with CIMT in adulthood (all P < 0.05). The cumulative burden of BMI and DBP was associated with CIMT in adulthood. Adolescence is a crucial period for high CIMT, which has implications for early prevention of atherosclerosis.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pooneh Dehghan
- Imaging Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Ferigollo A, Chemello D, Pavão TP, Saffi MAL, Dos Santos Stein C, Moresco RN, de Souza LS, Moreira CHC, Signori LU, Chagas P. Anthropometric measurements and their association with endothelial function and arterial stiffness of eutrophic individuals and with overweight. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000617. [PMID: 37249452 PMCID: PMC10665052 DOI: 10.20945/2359-3997000000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/14/2022] [Indexed: 05/31/2023]
Abstract
Objective The objective of the study was to assess the association of anthropometric measurements with endothelial function and arterial stiffness of eutrophic individuals and with overweight. Subjects and methods A cross-sectional study was carried out with individuals with body mass index (BMI) between 18.5 kg/m2 and < 30 kg/m2, low to intermediate global cardiovascular risk scores, and aged ≥ 18 and < 60 years. We assessed the sociodemographic data, anthropometric variables (body weight, height, circumferences of the waist [WC], neck [NC], hip [HC], sagittal abdominal diameter [SAD], [BMI], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]), biochemical parameters (lipid profile and nitric oxide), endothelial function (flow-mediated dilation [FMD], by ultrasound), and arterial stiffness (pulse wave velocity [PWV] and the amplification index [AIx@75] by oscillometry). Thirty-six individuals were included, 18 eutrophic and 18 with overweight, with a mean age of 37.5 ± 10.2 years, mostly at low cardiovascular risk (86.1%), female (80.6%), single (52.8%), employed with formal contracts (44.4%), and with over twelve years of education (88.9%). Results The PWV presented positive and moderate correlation with the WC (r = 0.584; P = 0.001), WHR (r = 0.513; P = 0.001), and WHtR (r = 0.590; P = 0.001), and positive and low correlation with the NC (r = 0.372; P = 0.013) and SAD (r = 0.356; P = 0.033). Moreover, no anthropometric parameter presented a correlation with the AIx@75 or the FMD percentage in the total sample. Conclusion Our findings show that in eutrophic individuals and with overweight the WC, WHR, WHtR, SAD, and NC were positively correlated with the PWV but not to the endothelial function in the overall sample. These are hypothesis-generating findings and they should be replicated in other studies.
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Affiliation(s)
- Ariélen Ferigollo
- Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Diego Chemello
- Departamento de Clínica Médica, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Tábata Pereira Pavão
- Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | | | - Carolina Dos Santos Stein
- Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Rafael Noal Moresco
- Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Lucas Silva de Souza
- Graduação em Medicina, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - Carlos Heitor Cunha Moreira
- Departamento de Estomatologia, Divisão de Periodontologia, Faculdade de Odontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Luis Ulisses Signori
- Departamento de Fisioterapia e Reabilitação, Programa de Pós-graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Patrícia Chagas
- Departamento de Alimentação e Nutrição, Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil,
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Munusamy G, Shanmugam R. Effectiveness of structured interventional strategy for middle-aged adolescence (SISMA-PA) for preventing atherosclerotic risk factors—A study protocol. PLoS One 2022; 17:e0271599. [PMID: 35853088 PMCID: PMC9295980 DOI: 10.1371/journal.pone.0271599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Atherosclerotic risk starts at an early stage in adolescents and interventions on adolescents’ lifestyles are most important. The pandemic of obesity-related morbidities like atherosclerosis among young adults and atherosclerotic risk factors for middle-aged adolescents in India is known. Yet, there is a lack of cost-effective and integrated intervention programs to treat this important health problem. Objective The main objective of this study is to evaluate the effect of a 12-week structured interventional strategy program, containing integrated education and supervised physical activity interventions for middle-aged adolescents. Methods/design This will be a school-based pre-experimental one-group pre-post time-series research design. The sample size is estimated to include 154 adolescents of 10th to 12th grade; aged 15–17 years will be grouped as a single arm. Data will be collected from July 2021 to January 2022. The intervention duration will be 3 months. The following measures will be evaluated before, during, and after intervention: knowledge, body mass index, level of physical activity, dietary habits, and sedentary activity. Discussion We believe that the structured interventional strategy approach which includes education related to atherosclerosis, physical activity, dietary habits, and sedentary activity, and cost-effective physical activity training will be more effective in preventing atherosclerotic-related changes among middle-aged adolescents. Further, this kind of approach may be applied in similar study areas elsewhere in India. Trial registration Clinical Trials Registry—India (Registered Number: CTRI/2021/03/032271).
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Affiliation(s)
- Gomathi Munusamy
- Department of Community Heal Nursing, Centre of Postgraduate Studies, Faculty of Nursing, Lincoln University College, Selangor, Malaysia
- * E-mail:
| | - Ramesh Shanmugam
- Department of Medical Surgical Nursing, Centre of Postgraduate Studies, Faculty of Nursing, Lincoln University College, Selangor, Malaysia
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Hayajneh AA, Alhusban IM, Rababa M, Al-Rawashdeh S, Al-Sabbah S, Bani-Hamad D. Differences in the number of stented coronary arteries based on the seven traditional obesity parameters among patients with coronary artery diseases undergoing cardiac catheterization. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agius R, Pace NP, Fava S. Sex differences in cardiometabolic abnormalities in a middle-aged Maltese population. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:484-500. [PMID: 35006592 PMCID: PMC9043060 DOI: 10.17269/s41997-021-00592-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/25/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES There are sex differences in distribution of fat and in the prevalence of overweight and obesity. We therefore sought to explore sex differences in the prevalence of adiposity-metabolic health phenotypes, in anthropometric and cardio-metabolic parameters, and in the relationship between body mass index (BMI) categories and metabolic health. METHODS We conducted a cross-sectional study carried out between January 2018 and June 2019, of a nationally representative sample of the Maltese Caucasian population aged 41 ± 5 years. Metabolic health was defined as presence of ≤ 1 parameter of the metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria. RESULTS Males exhibited the unhealthy metabolic phenotype more frequently than women (41.3% vs 27.8%). In total, 10.3% of normal weight men and 6.3% of normal weight women were metabolically unhealthy. Males had a higher median BMI, but a lower proportion of males exhibited an abnormally high waist circumference as compared with females. A significant difference in sex distribution was noted for each body composition phenotype. CONCLUSION In a contemporary sample of middle-aged individuals, males were more metabolically unhealthy and more insulin resistant than their female counterparts in spite of exhibiting an abnormal waist circumference less frequently and having similar waist index. This suggests that the currently used cut-offs for normal waist circumference should be revised downwards in men. Since even normal weight men were more often metabolically unhealthy than normal weight women, BMI cut-offs may also need to be lowered in men.
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Affiliation(s)
- Rachel Agius
- University of Malta Medical School, Msida, Malta ,Mater Dei Hospital, Msida, Malta
| | | | - Stephen Fava
- University of Malta Medical School, Msida, Malta ,Mater Dei Hospital, Msida, Malta
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Agius R, Pace NP, Fava S. Characterisation of body size phenotypes in a middle-aged Maltese population. J Nutr Sci 2021; 10:e81. [PMID: 34616552 PMCID: PMC8477348 DOI: 10.1017/jns.2021.74] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/03/2021] [Accepted: 08/19/2021] [Indexed: 12/23/2022] Open
Abstract
Obesity is increasingly recognised as being a heterogeneous disease. Some obese individuals may present a metabolically healthy profile (metabolically healthy obese (MHO)), while some normal weight individuals exhibit an adverse cardiometabolic phenotype (metabolically unhealthy normal weight individuals (MUHNW)). The objectives of the present study were to examine the prevalence and associated characteristics of the different body composition phenotypes within a Maltese cohort. This was a cross-sectional analysis involving 521 individuals aged 41 ± 5 years. The metabolically unhealthy state was defined as the presence of ≥2 metabolic syndrome components (NCEP-ATPIII parameters), while individuals with ≤1 cardiometabolic abnormalities were classified as metabolically healthy. Overall, 70 % of the studied population was overweight or obese and 30⋅7 % had ≥2 cardiometabolic abnormalities. The prevalence of MHO and MUHNW was 10⋅7 and 2⋅1 %, respectively. Individuals with the healthy phenotype were more likely to consume alcohol, participate in regular physical activity and less likely to be smokers. While the MHO phenotype had similar values for waist, hip and neck circumferences, waist-hip ratio and insulin resistance when compared with MUHNW individuals, there was a lower proportion of MHO subjects having a high fasting plasma glucose, hypertriglyceridaemia or low HDL-C when compared with the unhealthy lean individuals. A high prevalence of the metabolically unhealthy phenotype was observed in this relatively young population which may result in significant future cardiovascular disease burden if timely assessment and management of modifiable risk factors are not implemented. Furthermore, the present study suggests that the MHO phenotype is not totally benign as previously thought.
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Affiliation(s)
- Rachel Agius
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida, MSD 2090, Malta
| | - Nikolai Paul Pace
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
| | - Stephen Fava
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida, MSD 2090, Malta
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Ma X, Chen L, Hu W, He L. Association Between a Body Shape Index and Subclinical Carotid Atherosclerosis in Population Free of Cardiovascular and Cerebrovascular Diseases. J Atheroscler Thromb 2021; 29:1140-1152. [PMID: 34483222 PMCID: PMC9371761 DOI: 10.5551/jat.62988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM We used a dataset from a cross-sectional survey conducted in China to determine which of the anthropometric indices of obesity are important in terms of carotid atherosclerosis free of cardiovascular and cerebrovascular diseases. METHODS A total of 5,245 participants who were volunteering for carotid ultrasound unit in this cross-sectional survey were included in the present analysis. All subjects were free of angina, myocardial infarction, heart failure and stroke, and cancer. A low-risk subgroup was defined as people free of hypertension, diabetes, and hyperlipidemia. All analyses based on logistic regression were gender-specific. RESULTS The present study consisted of 2,501 males and 2,744 females, with 776 (31.03%) diagnosed as carotid artery plaque in males and 550 (20.04%) in females. Univariable analyses in unadjusted logistic model showed significant associations between disease presence and all central obesity indices. After adjusting for more variables, only a body shape index (ABSI) was associated with the presence of disease in both males and females. Moreover, stepwise regression approaches revealed that ABSI was always an independent determinant of the presence of subclinical carotid plaque. Multiple regression shows a linear and significant increase in the prevalence of atherosclerosis in males and females as ABSI decile levels increased. Similar results were obtained when the association between ABSI and carotid plaque was studied in this low-risk subgroup. CONCLUSIONS ABSI, as a novel anthropometric indicator compared with traditional indices, was found to have a closer relationship with subclinical carotid atherosclerosis, even in populations free of hypertension, diabetes, and hyperlipidemia.
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Affiliation(s)
- Xiaotian Ma
- Department of Medical Experiment Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University
| | - Lihong Chen
- Department of Emergency, Qingdao Eighth People's Hospital
| | - Wenchao Hu
- Department of Endocrinology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University
| | - Lanjie He
- Department of Endocrinology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University.,Department of Endocrinology, General Hospital of Ningxia Medical University
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Soltani D, Fakhrzadeh H, Sharifi F, Mahmoudi MJ, Mahmoudi E, Vasheghani-Farahani A. Surrogate Markers of Subclinical Atherosclerosis and Its Associated Factors in Patients with β-Thalassemia Major. Hemoglobin 2021; 45:107-111. [PMID: 33829939 DOI: 10.1080/03630269.2021.1907405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
β-Thalassemia major (β-TM) is a severe genetic hemoglobin (Hb) disorder with cardiovascular complications such as atherosclerosis due to transfusion-dependent iron overload. We aimed to determine the associated factors with surrogate markers of subclinical atherosclerosis in these patients. Sixty subjects with β-TM referred to the Thalassemia Clinic of the Iranian Blood Transfusion Organization (IBTO) were included in our study. The blood samples were collected for laboratory measurements. The carotid intima-media thickness (CIMT), was measured by ultrasonography, and ankle-brachial index (ABI) was calculated. The multivariate linear analysis was performed to determine the appropriate indicators of subclinical atherosclerosis in β-TM. There was no significant difference in baseline characteristics between the study groups. In multivariate linear analysis, age and systolic blood pressure (SBP) were negatively associated with inverse-transformed CIMT [unstandardized β coefficient (B): -0.024, 95% confidence interval (95% CI): -0.032- -0.010, p < 0.001; B: -0.009, 95% CI: -0.017- -0.001, p 0.031, respectively]. There was also a significant correlation between the serum level of high-density lipoprotein cholesterol (HDL-C) and insulin with higher ABI, after adjustment for confounding variables (B: 0.003; 95% CI: 0.000-0.005; p = 0.030, and B: 0.004, 95% CI: 0.000-0.009, p = 0.037, respectively). Our results show that advancing age and increased SBP, HDL-C and insulin, associated with higher CIMT or ABI, are appropriate indicators of subclinical atherosclerosis in β-TM patients.
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Affiliation(s)
- Danesh Soltani
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Mahmoudi
- Department of Medicine, Amir-Alam Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mahmoudi
- Department of Medicine, Amir-Alam Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Rao HA, Harischandra P, Yadav S. Correlation of Waist to Calf Circumference Ratio and Carotid Intima-Media Thickness in Diabetes Mellitus. Curr Diabetes Rev 2021; 17:387-393. [PMID: 32729422 DOI: 10.2174/1573399816999200729124903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/04/2020] [Accepted: 07/19/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Diabetes mellitus is a well-known risk factor for cardiovascular disease because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with the occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in the event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. AIMS & OBJECTIVES To ascertain if waist to calf circumference ratio (WCR) is a marker of carotid atherosclerosis in patients with type 2 diabetes mellitus, and the correlation between waist to calf circumference ratio and carotid intima-media thickness (CIMT ) in patients with Type 2 diabetes. MATERIALS AND METHODS A cross-sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018. Patients with type 2 DM as per ADA criteria, age >18years, are recruited for the study. RESULTS AND DISCUSSION In our study, with 150 population, 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07, and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p-value of <0.05. In our study, it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly, calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. CONCLUSION To conclude, in our population-based study of 150 subjects, we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful, and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima-media thickness and carotid plaques using better measures than ultrasound, such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.
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Affiliation(s)
- Harish A Rao
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Prakash Harischandra
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Srikanth Yadav
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
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Raele R, Lotufo PA, Bittencourt MS, de Jesus M Fonseca M, Goulart AC, Santos IS, Bensenor IM. The association of waist-to-height ratio and other anthropometric measurements with subclinical atherosclerosis: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Nutr Metab Cardiovasc Dis 2020; 30:1989-1998. [PMID: 32624345 DOI: 10.1016/j.numecd.2020.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS To compare the performance of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and Body-mass index (BMI) with subclinical atherosclerosis. METHODS AND RESULTS The association of quintiles of anthropometric variables (1st as reference) - Odds ratio (OR); 95% Confidence Interval (95% CI) - with Coronary Artery Calcium (CAC: 0 vs. >0; <100 vs. ≥100), Carotid Intima-Media Thickness (CIMT: <75th vs. ≥P75%) and as continuous variables in linear regression models in 4216 participants of ELSA-Brasil baseline. WHtR was associated with CAC >0 (OR, 1.84; 95% CI, 1.16-2.93) and ≥100 after multivariate adjustment including BMI. WHR was associated with CAC >0 OR, 1.81 (95% CI, 1.25-2.82) and ≥100. BMI was not associated with CAC after further adjustment for WHtR, but was associated with CAC >0 after adjustment for WHR (OR, 1.42; 95% CI, 1.02-1.94) or WC (1.63; 95% CI, 1.03-2.59). WHtR was not associated with CIMT after further adjustment for BMI. WHR was associated with CIMT ≥P75% (OR, 1.44; 95% CI, 1.02-2.02) and in linear models (p < 0.0001). WC was associated with CIMT in linear models (p < 0.0001). BMI was associated to CIMT ≥P75% (OR, 2.25; 95% CI, 1.53-2.54); and in linear models (P < 0.0001) after further adjustment for WHtR. After adjustment for WHR and WC the association of BMI with CIMT ≥P75% was respectively (OR 2.31; 95% CI, 1.70-3.13; and OR 2.39; 95% CI, 1.55-3.70); and in both linear models (p < 0.0001). CONCLUSIONS WHtR was a good biomarker for subclinical atherosclerosis measured by CAC while BMI was a good biomarker for CIMT. WHR presented the best performance being associated with both biomarkers of subclinical atherosclerosis.
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Affiliation(s)
- Rosana Raele
- School of Medicine, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Maria de Jesus M Fonseca
- Department of Epidemiology and Quantitative Methods, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
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Hou Y, Jia X, Xuan L, Zhu W, Deng C, Wang L, Zhao Z, Li M, Lu J, Xu Y, Chen Y, Wang W, Bi Y, Xu M, Wang T. Association between mid-upper arm circumference and cardiometabolic risk in Chinese population: a cross-sectional study. BMJ Open 2019; 9:e028904. [PMID: 31501106 PMCID: PMC6738736 DOI: 10.1136/bmjopen-2019-028904] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Upper body fat has been associated with an unfavourable cardiometabolic risk. We aimed to investigate the associations between mid-upper arm circumference (MUAC), a novel indicator of upper body fat, and a wide spectrum of cardiometabolic risk profiles in Chinese population. DESIGN AND SETTING Cross-sectional analyses were performed using data from a well-defined community in 2014, Shanghai, China. PARTICIPANTS A total of 6287 Chinese adults (2310 men and 3977 women) aged 40 years or older. OUTCOME MEASURES Multivariable logistic regression model was used to examine the associations of MUAC with cardiometabolic disorders including central obesity, diabetes, hypertension, hypertriglyceridaemia, low high-density lipoprotein (HDL) cholesterol and subclinical atherosclerosis. RESULTS In the overall participants, after multivariable adjustment, each 1 SD (3.13 cm) increment in MUAC was positively associated with central obesity (OR 2.05; 95% CI 1.85 to 2.28), hypertension (OR 1.10; 95% CI 1.03 to 1.19) and low HDL cholesterol (OR 1.10; 95% CI 1.01 to 1.22). Multivariable-adjusted ORs for subclinical atherosclerosis were gradually increased across increasing quartiles of MUAC with the lowest quartile as reference (quartile 2: OR 1.31; 95% CI 1.09 to 1.58; quartile 3: OR 1.33; 95% CI 1.10 to 1.62; quartile 4: OR 1.45; 95% CI 1.16 to 1.80; p for trend=0.005). Similar but more prominent associations were observed among women than men. In addition, MUAC was significantly interacted with diabetes (p for interaction=0.04) and insulin resistance (p for interaction=0.01) on subclinical atherosclerosis. CONCLUSION A greater MUAC was positively associated with higher risks of several cardiometabolic disorders and subclinical atherosclerosis in Chinese adults.
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Affiliation(s)
- Yanan Hou
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xu Jia
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liping Xuan
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Zhu
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chanjuan Deng
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Long Wang
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mian Li
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Xu
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Min Xu
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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13
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Muñoz-Torres FJ, Andriankaja OM, Ruiz JI, Joshipura KJ. Longitudinal association between adiposity and inter-arm blood pressure difference. J Clin Hypertens (Greenwich) 2019; 21:1519-1526. [PMID: 31490614 DOI: 10.1111/jch.13678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 12/23/2022]
Abstract
This is the first longitudinal study evaluating whether adiposity is associated with inter-arm blood pressure difference. We evaluated 714 overweight/obese individuals aged 40-65 years over a 3-year follow-up. Systolic and diastolic blood pressures were measured in both arms simultaneously using an automated machine. Linear regression assessed the associations of body mass index, fat %, waist, neck, thigh, and arm circumferences (cm), with absolute inter-arm differences in systolic (IAS) and diastolic (IAD) blood pressure (mm Hg). Poisson regression was used for binary outcomes (IAS and IAD ≥ 10 mm Hg). All models were adjusted for age, gender, smoking, physical activity, and HOMA-IR. Adiposity measures were associated with increased IAS and IAD (β range: 0.09-0.20 and 0.09-0.30). Neck circumference showed the strongest association with IAS (β = 0.20, 95% CI: 0.03, 0.37) and IAD (β = 0.30, 95% CI: 0.12, 0.47); arm circumference showed a similar association with IAS, but lower with IAD. Highest quartiles of BMI, thigh, and arm showed significant associations with IAS (IRR: 2.21, 2.46 and 2.70). Highest quartiles of BMI, waist, neck, and arm circumferences were significantly associated with IAD (IRR: 2.38, 2.68, 4.50 and 2.24). If the associations are corroborated in other populations, adiposity may be an important modifiable risk factor for inter-arm blood pressure difference with a large potential public health impact.
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Affiliation(s)
- Francisco J Muñoz-Torres
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Oelisoa M Andriankaja
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - José I Ruiz
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Ruderman A, Pérez LO, Adhikari K, Navarro P, Ramallo V, Gallo C, Poletti G, Bedoya G, Bortolini MC, Acuña-Alonzo V, Canizales-Quinteros S, Rothhammer F, Ruiz-Linares A, González-José R. Obesity, genomic ancestry, and socioeconomic variables in Latin American mestizos. Am J Hum Biol 2019; 31:e23278. [PMID: 31237064 DOI: 10.1002/ajhb.23278] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/29/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES This article aims to assess the contribution of genomic ancestry and socioeconomic status to obesity in a sample of admixed Latin Americans. METHODS The study comprised 6776 adult volunteers from Brazil, Chile, Colombia, Mexico, and Peru. Each volunteer completed a questionnaire about socioeconomic variables. Anthropometric variables such as weight, height, waist, and hip circumference were measured to calculate body indices: body mass index, waist-to-hip ratio and waist-to-height ratio (WHtR). Genetic data were extracted from blood samples, and ancestry was estimated using chip genotypes. Multiple linear regression was used to evaluate the relationship between the indices and ancestry, educational level, and economic well-being. The body indices were dichotomized to obesity indices by using appropriate thresholds. Odds ratios were calculated for each obesity index. RESULTS The sample showed high percentages of obesity by all measurements. However, indices did not overlap consistently when classifying obesity. WHtR resulted in the highest prevalence of obesity. Overall, women with low education level and men with high economic wellness were more likely to be obese. American ancestry was statistically associated with obesity indices, although to a lesser extent than socioeconomic variables. CONCLUSIONS The proportion of obesity was heavily dependent on the index and the population. Genomic ancestry has a significant influence on the anthropometric measurements, especially on central adiposity. As a whole, we detected a large interpopulation variation that suggests that better approaches to overweight and obesity phenotypes are needed in order to obtain more precise reference values.
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Affiliation(s)
- Anahí Ruderman
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Luis O Pérez
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Kaustubh Adhikari
- School of Mathematics and Statistics, Faculty of Science, Technology, Engineering and Mathematics, The Open University, Milton Keynes, UK.,Department of Genetics, Evolution and Environment, and UCL Genetics Institute, University College London, London, UK
| | - Pablo Navarro
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Virginia Ramallo
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
| | - Carla Gallo
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Giovanni Poletti
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gabriel Bedoya
- Grupo de Genética Molecular (GENMOL), Universidad de Antioquia, Medellín, Colombia
| | - Maria C Bortolini
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Samuel Canizales-Quinteros
- Unidad de Genomica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM-Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Francisco Rothhammer
- Instituto de Alta Investigación Universidad de Tarapacá, Programa de Genética Humana, ICBM Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andres Ruiz-Linares
- Department of Genetics, Evolution and Environment, and UCL Genetics Institute, University College London, London, UK.,Ministry of Education Key Laboratory of Contemporary Anthropology and Collaborative Innovation Center of Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.,Laboratory of Biocultural Anthropology, Law, Ethics, and Health (Centre National de la Recherche Scientifique and Etablissement Français du Sang, UMR-7268), Aix-Marseille University, Marseille, France
| | - Rolando González-José
- Instituto Patagónico de Ciencias Sociales y Humanas-CONICET, Puerto Madryn, Chubut, Argentina
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15
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Osborne G, Wu F, Yang L, Kelly D, Hu J, Li H, Jasmine F, Kibriya MG, Parvez F, Shaheen I, Sarwar G, Ahmed A, Eunus M, Islam T, Pei Z, Ahsan H, Chen Y. The association between gut microbiome and anthropometric measurements in Bangladesh. Gut Microbes 2019; 11:63-76. [PMID: 31138061 PMCID: PMC6973329 DOI: 10.1080/19490976.2019.1614394] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 02/06/2023] Open
Abstract
Our objective was to investigate the relationship between the gut microbiota and anthropometric measurements among 248 participants from the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh. Our cohort represents a unique population that allows for the investigation of the gut microbiota and anthropometric measurements in lean individuals. We measured height, weight, arm, thigh, hip, and waist circumferences, and collected fecal samples. Microbial DNA was extracted from the stool samples and sequenced by 16S rRNA gene sequencing. We examined associations between relative abundance of individual bacterial taxa from phylum to genus levels and anthropometric measurements. We found that higher BMI, mid-upper arm circumference, waist circumference, and waist-to-hip ratio were associated with a lower alpha diversity of fecal bacteria. Relative abundance of the genus Oscillospira and the family S24-7 were inversely related to all measurements after correction for multiple testing. Relative abundance of genus Acidaminococcus and family Ruminococcaceae were also associated with several measurements. The positive associations of the genus Acidaminococcus with BMI, as well as waist and hip circumferences, were stronger in women than in men. Our data in this lean Bangladeshi population found a correlation between Oscillospira and leanness, as measured using multiple anthropometric measures.
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Affiliation(s)
- Gwendolyn Osborne
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Fen Wu
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Liying Yang
- Departments of Pathology and Medicine, New York University School of Medicine, New York, NY, USA
- The Department of Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Dervla Kelly
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Jiyuan Hu
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Huilin Li
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Farzana Jasmine
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, IL, USA
| | - Muhammad G Kibriya
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, IL, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, NY, USA
| | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Ltd, Dhaka, Bangladesh
| | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Ltd, Dhaka, Bangladesh
| | - Tariqul Islam
- U-Chicago Research Bangladesh, Ltd, Dhaka, Bangladesh
| | - Zhiheng Pei
- Departments of Pathology and Medicine, New York University School of Medicine, New York, NY, USA
- The Department of Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, IL, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
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Asaleye AA, Braimoh KT, Oyinloye OI, Asaleye CM, Omisore AD. Variation of Carotid Intima Media Thickness With Body Mass Index in Healthy Adults of Black African Descent. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:123-130. [PMID: 29761548 DOI: 10.1002/jum.14673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/21/2018] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Studies have shown that common carotid intima media thickness (CIMT) measured by B-mode sonography increases with body mass index (BMI) among subjects with cardiovascular diseases in different populations. However, association of body fat and subclinical atherosclerosis in the absence of these cardiovascular diseases is understudied. We aimed to evaluate the correlation between BMI and CIMT in a healthy adult population of black African ancestry. METHODS This is a cross-sectional prospective study in 300 consecutive apparently healthy subjects aged 18 to 70 years without history of hypertension, dyslipidemia, diabetes mellitus, and renal disease. Subjects' common carotid artery intima media thickness was measured with a 7.5-MHz linear ultrasound transducer at a point 10 mm proximal to the carotid bulb. All subjects' biodata, medical history, anthropometric (weight and height from which BMI was calculated), laboratory (fasting lipid profile and blood glucose), and CIMT values were recorded on a pro forma. Data were analysed using SPSS version 21, and significant P was set at less than .05. RESULTS The right, left, and average CIMT of both sides in our study subjects are 0.52 ± 0.11 mm, 0.51 ± 0.11 mm and 0.52 ± 0.11 mm respectively, with no significant difference between the right and left sides (P > .05). The right, left, and average CIMT increased with increasing age and BMI category (all P < .01) but were not significantly different between men and women (all P > .05). Age (r = .824, .825, and .827; P < .01) and BMI (r = .503, .504, .507; P < .01) had strong positive correlations with right, left, and average CIMT. CONCLUSIONS Increasing age and BMI category, but not sex, significantly influenced CIMT values in our apparently healthy black African population.
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Affiliation(s)
- Adesola Abiodun Asaleye
- Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Kolawole Thomas Braimoh
- Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | | | - Christianah Mopelola Asaleye
- Department of Radiology, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Adeleye Dorcas Omisore
- Department of Radiology, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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Chat V, Wu F, Demmer RT, Parvez F, Ahmed A, Eunus M, Hasan R, Nahar J, Shaheen I, Sarwar G, Desvarieux M, Ahsan H, Chen Y. Association between number of children and carotid intima-media thickness in Bangladesh. PLoS One 2018; 13:e0208148. [PMID: 30481229 PMCID: PMC6258552 DOI: 10.1371/journal.pone.0208148] [Citation(s) in RCA: 6] [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: 07/16/2018] [Accepted: 11/11/2018] [Indexed: 12/19/2022] Open
Abstract
Previous studies on the association between number of children and carotid intima-media thickness (cIMT) were limited to Western populations. Pregnancy in women is associated with physiologic changes that may influence the risk of cardiovascular disease. Comparing the association between number of children and cIMT in men and women can provide insights on whether the association may be due to pregnancy. We investigated the association between number of children and cIMT among 718 female (mean age 37.5 years) and 417 male participants (mean age 41.3 years), randomly selected from the Health Effect of Arsenic Longitudinal Study (HEALS), a population-based cohort study in Bangladesh. Multivariate linear regression was used to assess the association and to control for education attainment, history of diabetes, age, smoking, betel use, BMI, systolic blood pressure, and diastolic blood pressure. The average number of children was 4.43 for women and 3.74 for men. There were no nulliparous women. We observed a positive association between number of children and cIMT in women. Mean cIMT increased by 4.5 μm (95% CI, 0.8–8.1) per increment of one birth (P = 0.02). Compared to women with two children, cIMT in women with 4 children and ≥5 children was 23.6μm (95%CI, 2.6–44.7; P = 0.03) and 25.1 μm (95%CI, 3.5–46.6; P = 0.02) greater, respectively. The association was not modified by BMI, SBP, betel use or age. Data in men showed no evidence of association (P = 0.4). The finding suggests a role of high parity in atherosclerosis in women of a low-income, high parity population.
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Affiliation(s)
- Vylyny Chat
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Fen Wu
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Ryan T. Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Rabiul Hasan
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Jabun Nahar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- INSERM UMR 1153, Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Core, Paris France
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, Chicago, Illinois, United States of America
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, United States of America
- * E-mail:
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18
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Association between Obesity and Carotid Intima-Media Thickness in Korean Office Workers: The Mediating Effect of Physical Activity. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4285038. [PMID: 30155478 PMCID: PMC6093045 DOI: 10.1155/2018/4285038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/02/2018] [Accepted: 07/16/2018] [Indexed: 12/29/2022]
Abstract
Background Obesity and physical inactivity are associated with higher prevalence of cardiovascular disease (CVD). Objective This study investigated the association between obesity and carotid intima-media thickness (CIMT) stratified by physical activity (PA) in Korean office workers. Methods Data obtained from 914 office workers aged 21-60 years (347 women) were used. Resting blood pressures, body mass index (BMI), and waist-to-height ratio (WHtR) were measured. PA was assessed using the international physical activity questionnaire. CIMT was assessed with a carotid artery ultrasonography. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of obesity stratified by weekly PA for an abnormally increased CIMT. Results Logistic regression analyses showed that those who were overall obese (OR=2.50, 95% CI=1.60-3.91, P<0.001) or central obese (OR=2.08, 95% CI=1.29-3.40, P=0.003) had significantly higher estimated risks of having an abnormally increased CIMT even after adjustments for age, sex, smoking, alcohol consumption, resting blood pressures, and history of hypertension, diabetes, and hyperlipidemia, as compared with those who were not overall or central obese (OR=1). A multivariate linear regression suggested that age (P<0.001), sex (P=0.002), hypertension (P=0.014), smoking (P=0.054), BMI (P<0.001), and physical activity (P=0.011) were important determinants of abnormally elevated CIMT in this study population. Conclusion The current findings suggest that the risk of obesity for an abnormally increased CIMT is significantly modulated by demographics as well as lifestyle-related risk factors including smoking and physical inactivity in Korean office workers.
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Zheng J, Zhou Y, Zhang K, Qi Y, An S, Wang S, Zhao X, Tang YD. Association between nonalcoholic fatty liver disease and subclinical atherosclerosis: a cross-sectional study on population over 40 years old. BMC Cardiovasc Disord 2018; 18:147. [PMID: 30012085 PMCID: PMC6048911 DOI: 10.1186/s12872-018-0877-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) refers to fatty infiltration of liver in the absence of excessive alcohol abuse. However, the problem that whether NAFLD is correlated with subclinical atherosclerosis assessed by carotid intima-media thickness (CIMT) and brachial-ankle pulse wave velocity (ba-PWV) remains a source of controversy. This can be attributed to the differences in diagnosis methods, population ethnicity, sampling size and bias. This study aimed to further investigate the association of NAFLD with subclinical atherosclerosis. METHODS A cross-sectional study was carried out in the current study on population aged over 40 years derived from Kailuan community-based prospective study among Chinese adults from June 2010 to June 2011. NAFLD was evaluated through ultrasonography and histories of alcohol consumption. Clinical parameters and medical histories of patients were collected in the manner of interview performed by trained investigators using the standardized questionnaires. The biochemical parameters were analyzed at the central laboratory. CIMT and ba-PWV of each patient were measured. Multivariate logistic regression was used to analyze the associations of NAFLD with subclinical atherosclerosis assessed by CIMT or ba-PWV. RESULTS A total of 4112 participants aged over 40 years were enrolled from Kailuan cohort, including 2229 men and 1883 women. The overall prevalence of NAFLD was 38.2% in the total population. Statistically significant differences were found in CIMT (P < 0.0001) and ba-PWV (P = 0.0007) according to the presence of NAFLD. It is notably that the multivariate logistic regression revealed NAFLD was independently associated with elevated CIMT after adjusting the conventional cardiovascular and metabolic risk factors (OR = 1.663, 95% CI = 1.391-1.989, P < 0.0001). In addition, NAFLD was also found to be positively associated with elevated ba-PWV after adjusting age, gender, BMI, current smoking and regular exercising (OR = 1.319, 95% CI = 1.072-1.624, P = 0.0089). CONCLUSIONS Our findings suggest that NAFLD is remarkably correlated with subclinical atherosclerosis, which should be strongly advised to engage in the preventive strategies for cardiovascular diseases (CVDs).
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Affiliation(s)
- Jilin Zheng
- Department of Internal Medicine, Coronary Heart Disease Center State, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, China
| | - Yong Zhou
- Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Kuo Zhang
- Department of Internal Medicine, Coronary Heart Disease Center State, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, China
| | - Yu Qi
- Department of Internal Medicine, Coronary Heart Disease Center State, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, China
| | - Shimin An
- Department of Internal Medicine, Coronary Heart Disease Center State, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, China
| | - Siyuan Wang
- Department of Internal Medicine, Coronary Heart Disease Center State, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
| | - Yi-Da Tang
- Department of Internal Medicine, Coronary Heart Disease Center State, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, China.
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The contribution of obesity to carotid atherosclerotic plaque burden in a general population sample in Norway: The Tromsø Study. Atherosclerosis 2018; 273:15-20. [PMID: 29665456 DOI: 10.1016/j.atherosclerosis.2018.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/16/2018] [Accepted: 04/11/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Few studies have investigated the association of different measures of adiposity with carotid plaque. We aimed to investigate and compare the associations of four measures of adiposity: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) with the presence of carotid plaque and total plaque area (TPA) in the right carotid artery. METHODS We included 4906 individuals aged 31-88 years who participated in a population-based study with ultrasonography of the right carotid artery. Adiposity measures were converted to sex-specific SD units to allow comparison of effect sizes. TPA was log transformed due to its skewed distribution. Logistic and linear regression models were used respectively to investigate the association of each adiposity measure with the presence of plaque and with log-transformed TPA. Estimates were adjusted for potential confounders and mediators such as blood pressure and lipids. RESULTS After adjustment for age, sex, smoking, and education level, there was strong evidence of an association between all adiposity measures and log-transformed TPA, whereas only WHR was weakly associated with presence of plaque. WHR showed the largest adjusted effect size for both log-transformed TPA (beta 0.055, 95%CI 0.028-0.081) and the presence of plaque (OR 1.07, 95%CI 1.01-1.15). Adjustment for mediators led to appreciable attenuation of observed effects. CONCLUSIONS Adiposity is more consistently associated with extent of plaque burden than with whether an individual does or does not have any plaque. There was evidence that established biomarkers mediate much of this association. Abdominal adiposity appears to show the strongest effect.
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Dabas A, Thomas T, Gahlot M, Gupta N, Devasenathipathy K, Khadgawat R. Carotid Intima-medial Thickness and Glucose Homeostasis in Indian Obese Children and Adolescents. Indian J Endocrinol Metab 2017; 21:859-863. [PMID: 29285449 PMCID: PMC5729674 DOI: 10.4103/ijem.ijem_112_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate for subclinical atherosclerosis and its risk factors in Indian obese children. MATERIALS AND METHODS A cross-sectional, case-control study was conducted to recruit 80 children aged 6-17 years with constitutional obesity as cases and 23 age- and gender-matched controls with normal body mass index (BMI). Anthropometric and clinical evaluation was followed by biochemical analysis and body fat estimation by dual-energy X-ray absorptiometry in cases. Similar evaluation was performed for controls except laboratory parameters. Carotid intima-media thickness (CIMT) was measured with B-mode ultrasonography in both cases and controls to evaluate subclinical atherosclerosis. RESULTS The mean age of cases was 12.8 ± 3 years, with mean BMI of 29.2 ± 4.8 kg/m2. The mean CIMT was significantly higher in cases than controls (0.54 ± 0.13 vs. 0.42 ± 0.08; P < 0.001 across all ages). CIMT was significantly higher in participants who were hypertensive than nonhypertensive (0.6 ± 0.11 vs. 0.53 ± 0.11 mm; P = 0.04). CIMT showed a positive correlation with BMI (r = 0.23, P = 0.02), percentage body fat and fat mass index (r = 0.28 and 0.3 respectively; P < 0.001), but not with waist: hip ratio. CIMT showed significant positive correlation with blood glucose at 60 min (r = 0.22; P = 0.04), serum insulin at 60 min (r = 0.28; P = 0.01) while negative correlation with whole body insulin sensitivity (r = -0.27; P = 0.01). CONCLUSION CIMT correlated significantly to blood pressure, insulin sensitivity, and body fat in Indian obese children.
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Affiliation(s)
- Aashima Dabas
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Thushanth Thomas
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Monita Gahlot
- Department of Dietetics, All India Institute of Medical Sciences, New Delhi, India
| | - Nandita Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - K. Devasenathipathy
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Khadgawat
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Garshick M, Wu F, Demmer R, Parvez F, Ahmed A, Eunus M, Hasan R, Nahar J, Shaheen I, Sarwar G, Desvarieux M, Ahsan H, Chen Y. The association between socioeconomic status and subclinical atherosclerosis in a rural Bangladesh population. Prev Med 2017; 102. [PMID: 28645628 PMCID: PMC7605117 DOI: 10.1016/j.ypmed.2017.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND In Bangladesh, CVD accounts for the majority of non-communicable mortality. The purpose of this study was to determine the role of socioeconomic status (SES) on subclinical atherosclerosis measured as carotid intima-media thickness (IMT) in a rural Bangladesh population. METHODS Carotid IMT was measured between 2010 and 2011 in 1022 participants (average age 46, 40% male) randomly selected from the Health Effects of Arsenic Longitudinal Study (HEALS), a population-based prospective cohort study based in rural Bangladesh. SES was measured as occupation type, land ownership, educational attainment, and television ownership. RESULTS Half of the participants received formal education (53%) and under half owned land (48%) and a television (44%). Women were primarily homemakers (95%) and men worked as factory workers (24%), laborers (18%), or in business (55%). In univariate analysis, those owning greater than one acre of land (p=0.03), owning a television (p=0.02), or laborers and business owners compared to factory workers had higher levels of carotid IMT (p<0.01). In multivariate analysis after adjustment for confounders, only men employed in the business sector had elevated carotid IMT compared to factory workers. The association was strongest in older men (58.7μm, 95% CI 17.2-100.0, ≥50years old) compared to younger men (13.7μm, 95% CI -7.8-35.2, <50years old). CONCLUSION Business sector employment was positively associated with subclinical atherosclerosis after adjustment for confounders. This finding is consistent with evidence from other developing nations suggesting that certain SES factors are independent predictors of CVD.
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Affiliation(s)
- Michael Garshick
- Leon H. Charney Division of Cardiology, New York University Langone Medical Center, New York City, NY, USA.
| | - Fen Wu
- Department of Population Health and Environmental Health, New York University School of Medicine, New York, NY, USA.
| | - Ryan Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Faruque Parvez
- Department of Environrmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
| | - Rabiul Hasan
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Jabun Nahar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
| | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, Chicago, IL, USA.
| | - Yu Chen
- Department of Population Health and Environmental Health, New York University School of Medicine, New York, NY, USA.
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Mărginean C, Mărginean CO, Iancu M, Szabo B, Cucerea M, Melit LE, Crauciuc A, Bănescu C. The role of TGF-β1 869 T > C and PPAR γ2 34 C > G polymorphisms, fat mass, and anthropometric characteristics in predicting childhood obesity at birth: A cross-sectional study according the parental characteristics and newborn's risk for child obesity (the newborns obesity's risk) NOR study. Medicine (Baltimore) 2016; 95:e4265. [PMID: 27442659 PMCID: PMC5265776 DOI: 10.1097/md.0000000000004265] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This study proposed to establish a correlation between the risk score for child obesity and anthropometric, genetic, and bioimpedance characteristics in mothers and newborns, and to assess the discriminant ability for anthropometric parameters to classify over-fatness (defined by bioimpedance body fatness %) in pregnant women.We performed a cross-sectional study on 388 couples (mother and father) and their newborns admitted in a Tertiary Hospital from Romania. The measured parameters for mothers and their newborns were risk percentage for child obesity, anthropometric characteristics (mid-upper arm circumference [MUAC], tricipital skinfold thickness [TST] of mother and newborn), genetic polymorphisms (human peroxisome proliferator-activated receptor γ [PPARγ2] 34 C > G and transforming growth factor-beta 1 [TGF-β1] 869 T > C gene polymorphisms in both mothers and newborns), and mother's bioimpedance characteristics (fat mass [FM] %).The obesity risk score according to standard predictable Northern Finland Birth Cohort equation was in our study 4.07%. We found a monotone positive significant correlation between the newborn's risk of childhood obesity and the mother's TST (P = 0.01), as well as a tendency toward statistical significance concerning correlation with mother's MUAC (P = 0.053), without any correlations with the mothers' bioimpedance parameters and also a positive correlation between the newborn's risk of childhood obesity and the newborn's anthropometrical characteristics like body mass index (BMI), MUAC, and TST (P < 0.001). We observed that the calculated newborn's risk percentage for child obesity was greater for the variant allele of the TGF-β1 869 T > C polymorphism and also for the wild-type C allele of the PPARγ2 34 C > G gene polymorphism. Our study indicated that the best predictors for over-fatness are BMI and MUAC (P = 0.01 < 0.02 and P = 0.019 < 0.02, respectively).
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Affiliation(s)
- Claudiu Mărginean
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Tîrgu Mureş
| | - Cristina Oana Mărginean
- Department of Pediatrics, University of Medicine and Pharmacy, Tîrgu Mureş
- Correspondence: Cristina Oana Mărginean, Department of Pediatrics, University of Medicine and Pharmacy, 38 Gh. Marinescu St., 540139 Tîrgu Mureş, Romania (e-mail: )
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj Napoca
| | - Bela Szabo
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Tîrgu Mureş
| | - Manuela Cucerea
- Department of Neonatology, University of Medicine and Pharmacy, Tîrgu Mureş
| | - Lorena Elena Melit
- Department of Pediatrics, University of Medicine and Pharmacy, Tîrgu Mureş
| | - Andrei Crauciuc
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
| | - Claudia Bănescu
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
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Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese. Sci Rep 2016; 6:21521. [PMID: 26882876 PMCID: PMC4756331 DOI: 10.1038/srep21521] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/26/2016] [Indexed: 12/17/2022] Open
Abstract
Obesity is usually considered to predispose to atherosclerotic cardiovascular disease (ASCVD) but milder degrees of obesity or overweight may be protective in some elderly populations. We examined the relationships between general and abdominal obesity indices with ASCVD and its risk factors in elderly (aged ≥65 years) Shanghai community residents Among the 3950 participants, 21.5% had ASCVD, 56.2% had body mass index (BMI) ≥24 kg/m2, 50.1% had high waist circumference (WC) and 77.1% had waist-to-height ratio (WHtR) ≥0.50. WHtR increased with age in both men and women whereas WC increased with age only in women and BMI decreased with age only in men. The optimal WHtR cut-off value to predict the risk of ASCVD determined by receiver operating characteristic analysis was WHtR ≥0.53 with a prevalence of 55.8%. Having abdominal obesity was significantly associated with prevalent ASCVD with WHtR ≥0.53 having a higher value for the odds ratio than high WC, whereas high BMI was not associated. All three indices predicted high glucose, triglycerides and hsCRP levels but only the WHtR ≥0.53 showed a significant association with physical activity. Abdominal obesity indices, but not BMI, predicted prevalent ASCVD and its risk factors in this elderly Chinese population.
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25
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Oh HG, Nallamshetty S, Rhee EJ. Increased Risk of Progression of Coronary Artery Calcification in Male Subjects with High Baseline Waist-to-Height Ratio: The Kangbuk Samsung Health Study. Diabetes Metab J 2016; 40:54-61. [PMID: 26912156 PMCID: PMC4768051 DOI: 10.4093/dmj.2016.40.1.54] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of baseline WHtR and progression of coronary artery calcification (CAC) over 4 years of follow-up in apparently healthy Korean men. METHODS A total of 1,048 male participants (mean age, 40.9 years) in a health-screening program in Kangbuk Samsung Hospital, Seoul, Korea who repeated a medical check-up in 2010 and 2014 were recruited. Baseline WHtR was calculated using the value for the waist in 2010 divided by the value for height in 2010. The CAC score (CACS) of each subject was measured by multi-detector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years greater than 0. RESULTS During the follow-up period, progression of CAC occurred in 278 subjects (26.5%). The subjects with CAC progression had slightly higher but significant baseline WHtR compared to those who did not show CAC progression (0.51±0.04 vs. 0.50±0.04, P<0.01). The proportion of subjects with CAC progression significantly increased as the baseline WHtR increased from the 1st quartile to 4th quartile groups (18.3%, 18.7%, 28.8%, and 34.2%; P<0.01). The risk for CAC progression was elevated with an odds ratio of 1.602 in the 4th quartile group of baseline WHtR even after adjustment for confounding variables (95% confidence interval, 1.040 to 2.466). CONCLUSION Increased baseline WHtR was associated with increased risk for CAC progression. WHtR might be a useful screening tool to identify individuals at high risk for subclinical atherosclerosis.
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Affiliation(s)
- Hyung Geun Oh
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Shriram Nallamshetty
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Eun Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Qu B, Qu T. Causes of changes in carotid intima-media thickness: a literature review. Cardiovasc Ultrasound 2015; 13:46. [PMID: 26666335 PMCID: PMC4678459 DOI: 10.1186/s12947-015-0041-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/09/2015] [Indexed: 12/18/2022] Open
Abstract
Atherosclerosis causes significant morbidity and mortality. Carotid intima-media thickness (CIMT) predicts future cardiovascular and ischaemic stroke incidence. CIMT, a measure of atherosclerotic disease, can be reliably determined in vivo by carotid ultrasound. In this review, we determined that CIMT is associated with traditional cardiovascular risk factors such as age, sex, race, smoking, alcohol consumption, habitual endurance exercise, blood pressure, dyslipidemia, dietary patterns, risk-lowering drug therapy, glycemia, hyperuricemia, obesity-related anthropometric parameters, obesity and obesity-related diseases. We also found that CIMT is associated with novel risk factors, including heredity, certain genotypic indices, anthropometric cardiovascular parameters, rheumatoid arthritis, immunological diseases, inflammatory cytokines, lipid peroxidation, anthropometric hemocyte parameters, infectious diseases, vitamin D, matrix metalloproteinases, and other novel factors and diseases. However, the conclusions are inconsonant; the underlying causes of these associations remain to be further explored.
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Affiliation(s)
- Baoge Qu
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong, 271000, P. R. China.
| | - Tao Qu
- Zhuhai Campus of Zunyi Medical College, Zhuhai, Guangdong, 519041, P. R. China
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27
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Kreatsoulas C, Corsi DJ, Subramanian SV. Commentary: The salience of socioeconomic status in assessing cardiovascular disease and risk in low- and middle-income countries. Int J Epidemiol 2015; 44:1636-47. [PMID: 26493737 DOI: 10.1093/ije/dyv182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Daniel J Corsi
- Ottawa Hospital Research Institute, Ottawa, ON, Canada and
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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28
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Fatema K, Zwar NA, Zeba Z, Milton AH, Rahman B, Ali L. Clinical and biochemical characterization of high risk and not high risk for cardiovascular disease adults in a population from peripheral region of Bangladesh. BMC Public Health 2015; 15:559. [PMID: 26084331 PMCID: PMC4471932 DOI: 10.1186/s12889-015-1919-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/09/2015] [Indexed: 12/31/2022] Open
Abstract
Background A group of 63708 Bangladeshi adults from a rural area were screened in 2011–12 for cardiovascular diseases (CVD) risk using a questionnaire based tool developed as part of the ‘WHO CVD-RISK Management Package for low-and medium resource setting’. In the current study participants who were found to be high risk and a sample of the not high risk participants from the screening were further characterized clinically and biochemically to explore the burden and determinants of CVD risk factors in a remote rural Bangladeshi population. Methods The high risk participants comprised all 1170 subjects who screened positive in 2011–12 and the not high risk group comprised 563 randomly sampled participants from the 62538 who screened negative. Socio-demographic, behavioral, anthropometric, clinical and biochemical data (glucose and lipids) were collected by standardized procedures. Body Mass Index (BMI) was classified following Asian BMI criteria. Data was analyzed using univariable and multivariable methods. Results On univariable analysis in high risk and not high risk participants respectively, age in years (M ± SD) was 50 ± 11 for both groups, ratio of male: female was 40:60 and 66:44, current smoking 28.5 % and 50.6 %; smokeless tobacco use 37.1 % and 34.8 %; overweight and obesity measured by body mass index (BMI) was 39.1 % and 20.5 %; high waist circumference (WC) 36.1 % and 11.9 %; high waist to hip ratio (WHR) 53.8 % and 26.3 %; and with high waist to height ratio (WHtR) 56.4 % and 28.4 %, existence of hypertension (HTN) was 15.8 % and 3.6 %, pre-HTN 43.8 % and 12.1 %, diabetes (DM) 14.0 % and 10.5 %, pre-DM 16.9 % and 12.1 % and dyslipidaemia 85.8 % and 89.5 %. In multivariable logistic regression analysis female sex, BMI, WC, WHR and WHtR, HTN and dyslipidaemia remain significantly more common among high risk participants (p < 0.05 and p < 0.001). Conclusions The prevalence of clinical and biochemical risk factors of CVDs are quite high even in this rural population and this may be related to the socioeconomic and cultural transition in Bangladeshi society. Surprisingly more of the high risk group was female and there were fewer smokers. Obesity and hypertension were more frequent in high risk participants.
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Affiliation(s)
- Kaniz Fatema
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka, 1216, Bangladesh. .,The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Nicholas Arnold Zwar
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Zebunnesa Zeba
- Department of Biochemistry, BUHS, 125/1 Darus Salam, Mirpur, Dhaka, 1216, Bangladesh.
| | - Abul Hasnat Milton
- Centre for Clinical Epidemiology and Biostatistics (CCEB), The School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, NSW 2008, Australia.
| | - Bayzidur Rahman
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Liaquat Ali
- Department of Molecular and Cell Biology, BUHS, 125/1 Darus Salam, Mirpur, Dhaka, 1216, Bangladesh.
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