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Gómez Salas G, Arriola Aguirre R, Vindas Meza L, Pinto Tomás A, Cordero Solís JJ, Barrientos Calvo I, Pérez Carvajal AM. [Dietary diversity, anthropometric status and biochemical profile of centenarians of the Nicoya Peninsula, Costa Rica, and their offspring]. Rev Esp Geriatr Gerontol 2024; 59:101513. [PMID: 38964265 DOI: 10.1016/j.regg.2024.101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/09/2024] [Accepted: 05/15/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND AND OBJECTIVE Social relationships, physical activity and diet have been proposed as responsible for longevity; however, many of these conditions have changed in modern societies. The objective of this study was to identify if the anthropometric status, biochemical profile and diet of Nicoyan centenarians is different from that of their decency and if the quality and diversity of the diet of these Costa Ricans differs from that of adults from urban areas of the same country. MATERIALS AND METHODS Anthropometric, biochemical and dietary assessments were carried out on 120 adults residing in the Nicoya Peninsula, including centenarians, their children and grandchildren. The data were analyzed using descriptive and inferential statistics. RESULTS There is a significantly lower percentage of excess weight, central adiposity and blood lipids in Nicoyan centenarians compared to their children and grandchildren. The consumption of «Dairy» and «Other fruits» is higher in centenarians than in their descendants. Centenarians showed a higher dietary diversity index (DDI) compared to other age categories, and they also showed a higher DDI and a significantly more diverse diet than the urban population of Costa Rica. CONCLUSION Nicoyan centenarians presented a better lipid and glycemic profile than their offspring, they have lower weight and a better quality and diversity of diet than their relatives and than adults from the urban area of Costa Rica.
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Affiliation(s)
- Georgina Gómez Salas
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | | | | | - Adrián Pinto Tomás
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica; Centro de Investigación en Estructuras Microscópicas, Universidad de Costa Rica, San José, Costa Rica
| | - Juan José Cordero Solís
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Isabel Barrientos Calvo
- Hospital Nacional de Geriatría y Gerontología Dr. Raúl Blanco Cervantes, San José, Costa Rica
| | - Ana M Pérez Carvajal
- Centro de Investigación en Tecnología de Alimentos, Universidad de Costa Rica, San José, Costa Rica
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Zhang Y, Wang H, Yang J, Wang S, Tong W, Teng B. Obstructive Sleep Apnea Syndrome and Obesity Indicators, Circulating Blood Lipid Levels, and Adipokines Levels: A Bidirectional Two-Sample Mendelian Randomization Study. Nat Sci Sleep 2024; 16:573-583. [PMID: 38827393 PMCID: PMC11143989 DOI: 10.2147/nss.s460989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose This investigation sought to elucidate the genetic underpinnings that connect obesity indicators, circulating blood lipid levels, adipokines levels and obstructive sleep apnea syndrome (OSAS), employing a bidirectional two-sample Mendelian randomization (MR) analysis that utilizes data derived from extensive genome-wide association studies (GWAS). Methods We harnessed genetic datasets of OSAS available from the FinnGen consortium and summary data of four obesity indices (including neck circumference), seven blood lipid (including triglycerides) and eleven adipokines (including leptin) from the IEU OpenGWAS database. We primarily utilized inverse variance weighted (IVW), weighted median, and MR-Egger methods, alongside MR-PRESSO and Cochran's Q tests, to validate and assess the diversity and heterogeneity of our findings. Results After applying the Bonferroni correction, we identified significant correlations between OSAS and increased neck circumference (Odds Ratio [OR]: 3.472, 95% Confidence Interval [CI]: 1.954-6.169, P= 2.201E-05) and decreased high-density lipoprotein (HDL) cholesterol levels (OR: 0.904, 95% CI: 0.858-0.952, P= 1.251E-04). Concurrently, OSAS was linked to lower leptin levels (OR: 1.355, 95% CI: 1.069-1.718, P= 0.012) and leptin receptor levels (OR: 0.722, 95% CI: 0.530-0.996, P= 0.047). Sensitivity analyses revealed heterogeneity in HDL cholesterol and leptin indicators, but further multiplicative random effects IVW method analysis confirmed these correlations as significant (P< 0.05) without notable heterogeneity or horizontal pleiotropy in other instrumental variables. Conclusion This investigation compellingly supports the hypothesis that OSAS could be a genetic predisposition for elevated neck circumference, dyslipidemia, and adipokine imbalance. These findings unveil potential genetic interactions between OSAS and metabolic syndrome, providing new pathways for research in this domain. Future investigations should aim to delineate the specific biological pathways by which OSAS impacts metabolic syndrome. Understanding these mechanisms is critical for developing targeted prevention and therapeutic strategies.
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Affiliation(s)
- Yating Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Hongyan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Jie Yang
- Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Sanchun Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Weifang Tong
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Bo Teng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
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Haradwala MB, Sivaraman M. Largest Neck Circumference Associated With Obstructive Sleep Apnea: A Case Report. Cureus 2024; 16:e54761. [PMID: 38524094 PMCID: PMC10961093 DOI: 10.7759/cureus.54761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder associated with obesity markers such as neck circumference (NC), waist circumference (WC), and body mass index (BMI). A greater NC has been linked to a higher risk of OSA. To date, the largest reported NC has been 20.5 inches. We present a case of a patient who came to our clinic for OSA management and was found to have an NC of 25 inches, the largest reported to date. The primary objective of this case is to stimulate discussion and research on the specific limits of NC that indicate a higher risk of OSA, the impact of extreme obesity on the severity of the condition and its treatment challenges, and the importance of basic physical measurements of NC in assessing a patient's level of risk and providing appropriate care. This case highlights an extreme clinical observation of a common medical problem. It illustrates the importance of physical examination findings and their relevance in OSA.
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Xu Y, Li X, Hu T, Shen Y, Xiao Y, Wang Y, Bao Y, Ma X. Neck circumference as a potential indicator of pre-sarcopenic obesity in a cohort of community-based individuals. Clin Nutr 2024; 43:11-17. [PMID: 37992633 DOI: 10.1016/j.clnu.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/25/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND & AIMS ESPEN/EASO advocates screening for sarcopenic obesity based on the concomitant presence of an elevated body mass index (BMI) or waist circumference. Neck circumference (NC) is another simple and reliable anthropometric measurement for estimating obesity; however, its ability to detect sarcopenic obesity has not yet been established. The aim of the present study was to explore the association between NC and sarcopenic obesity in a Shanghai community population. METHODS The study included 1542 participants (622 men and 920 women) with a mean age of 58 years who underwent an examination for the detection of obesity at baseline in 2013-2014 and received a re-examination in 2015-2016. An automatic bioelectric impedance analyzer was used to estimate body composition, and magnetic resonance imaging was used to measure abdominal fat distribution. The definition of pre-sarcopenic obesity combined low skeletal muscle mass adjusted by weight (SMM/W) with obesity which defined according to overall adiposity or fat distribution as BMI ≥25 kg/m2, fat percentage (fat%) ≥ 25% in men and 30% in women, or visceral fat area (VFA) ≥ 80 cm2, respectively. RESULTS In both men and women, subjects with low SMM/W had a higher level of NC than those without (both P < 0.01). In turn, participants with elevated NC had a higher proportion of pre-sarcopenic obesity in both men and women, regardless of adiposity status assessed by BMI, fat%, or VFA (all P < 0.01). During an average follow up of 2.1 years, for each 1 cm increase in NC, multivariable-adjusted hazard ratios of pre-sarcopenic obesity in which adiposity status assessed by high BMI were 1.40 (1.11-1.76) in men and 1.32 (1.13-1.56) in women; in addition, such association remained between NC and pre-sarcopenic obesity assessed by high fat% or high VFA. CONCLUSION NC is closely associated with the incidence of sarcopenic obesity, suggesting that it could be helpful for screening sarcopenic obesity in a community-based population.
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Affiliation(s)
- Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaoya Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yunfeng Xiao
- Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
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Yoon Y, Kim YM, Lee S, Shin BC, Kim HL, Chung JH, Son M. Association between Neck Circumference and Chronic Kidney Disease in Korean Adults in the 2019-2021 Korea National Health and Nutrition Examination Survey. Nutrients 2023; 15:5039. [PMID: 38140298 PMCID: PMC10745966 DOI: 10.3390/nu15245039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Chronic kidney disease (CKD) is a major public health problem and a leading cause of cardiovascular disease and death. Early recognition and management of CKD risk factors are necessary to prevent its onset and progression. Neck circumference (NC) is a non-invasive and easily accessible anthropometric measure associated with central obesity and subcutaneous fat accumulation in the upper body. Our study aimed to explore the relationship between NC and the prevalence of CKD using data from the nationally representative Korea National Health and Nutrition Examination Survey (2019-2021). We analyzed data from 10,219 subjects (age > 19 years, no missing values). CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Logistic regression analysis was performed, which revealed a significant association between NC and CKD prevalence even after adjusting for confounding factors, both when NC was considered a continuous variable (OR [95% CI], 1.11 [1.03-1.19]) and in quartiles (Q1 as reference; Q2 OR [95% CI], 1.23 [0.91-1.67]; Q3 OR [95% CI], 1.59 [1.16-2.18]; Q4 OR [95% CI], 1.70 [1.16-2.50]). Our findings suggest that NC could be a simple and effective anthropometric measurement for identifying individuals at risk for CKD.
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Affiliation(s)
- Youngmin Yoon
- Division of Nephrology, Department of Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea; (Y.Y.); (S.L.); (B.-C.S.); (H.-L.K.); (J.-H.C.)
| | - Yoo-min Kim
- Department of Obstetrics and Gynecology, Chung-Ang University Gwang-myung Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si 14353, Republic of Korea;
| | - Somin Lee
- Division of Nephrology, Department of Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea; (Y.Y.); (S.L.); (B.-C.S.); (H.-L.K.); (J.-H.C.)
| | - Byung-Chul Shin
- Division of Nephrology, Department of Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea; (Y.Y.); (S.L.); (B.-C.S.); (H.-L.K.); (J.-H.C.)
| | - Hyun-Lee Kim
- Division of Nephrology, Department of Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea; (Y.Y.); (S.L.); (B.-C.S.); (H.-L.K.); (J.-H.C.)
| | - Jong-Hoon Chung
- Division of Nephrology, Department of Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea; (Y.Y.); (S.L.); (B.-C.S.); (H.-L.K.); (J.-H.C.)
| | - Minkook Son
- Department of Physiology, Dong-A University College of Medicine, Busan 49201, Republic of Korea
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Abdi Dezfouli R, Mohammadian Khonsari N, Hosseinpour A, Asadi S, Ejtahed HS, Qorbani M. Waist to height ratio as a simple tool for predicting mortality: a systematic review and meta-analysis. Int J Obes (Lond) 2023; 47:1286-1301. [PMID: 37770574 DOI: 10.1038/s41366-023-01388-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/06/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The association of central obesity with higher rates of mortality is not well studied. This study evaluates the association between waist-to-height ratio (WHtR), as a measure of central obesity, with mortality. METHODS Documents were retrieved from PubMed, Web of Science, Scopus, and Google Scholar databases until May 2022. Data were extracted from cohort studies reporting effect size (hazard ratio (HR)) regarding the association between WHtR as a continuous (per 1 SD increment) or categorical (highest/lowest) measure and all-cause and cause-specific mortality. Screening of included studies was performed independently by two authors. Moreover, the quality assessment of included studies was performed based on the Newcastle-Ottawa assessment scale. Finally, random effect meta-analysis was performed to pool the data, and the outcomes' certainty level was assess based on the GRADE criteria. RESULTS Of the 815 initial studies, 20 were included in the meta-analysis. Random effect meta-analysis showed that in the general population, the all-cause mortality HRs for categorical and continuous measurements of WHtR increased significantly by 23% (HR:1.23; 95% CI: 1.04-1.41) and 16% (HR:1.16; 95% CI: 1.07-1.25), respectively. Moreover, the hazard of cardiovascular (CVD) mortality increased significantly for categorical and continuous measurements of WHtR by 39% (HR:1.39; 95% CI: 1.18-1.59) and 19% (HR:1.19; 95% CI: 1.07-1.31). The quality assessment score of all included studies was high. CONCLUSIONS Higher levels of WHtR, indicating central obesity, were associated with an increased hazard of CVD and all-cause mortality. This measure can be used in the clinical setting as a simple tool for predicting mortality.
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Affiliation(s)
- Ramin Abdi Dezfouli
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Hosseinpour
- Non-communicable Diseases Research Center, Alborz University of Medicl Sciences, Karaj, Iran
| | - Sasan Asadi
- Social Determinants of Health Research Center, Alborz University of Medicl Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Qorbani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Non-communicable Diseases Research Center, Alborz University of Medicl Sciences, Karaj, Iran.
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Canyolu BA, Şen N, Sadıç BÖ. Anthropometric indexes for predicting high blood pressure in Turkish adults. J Family Med Prim Care 2023; 12:2848-2854. [PMID: 38186827 PMCID: PMC10771201 DOI: 10.4103/jfmpc.jfmpc_460_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/21/2023] [Accepted: 08/23/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose It is controversial which anthropometric indexes are the best in predicting the risk of hypertension and how anthropometric measurements are related to blood pressure (BP). This study aimed to evaluate the relationship between BP and anthropometric indexes and to determine the best predictors for hypertension risk. Methods This cross-sectional study was conducted with 415 consecutive participants (161 men, mean age: 33.4 years) aged 18-88 years in Istanbul, Turkey. Weight, height, waist circumference (WC), and neck circumference (NC) and BP were measured by well-trained personnel. Waist-to-height ratio (WHtR) and body mass index (BMI) were calculated. Pearson correlation, linear regression, and multivariate analyses were used to assess the relationship between anthropometric measurements and SBP, DBP, using the Statistical Package for the Social Sciences version 23.0. Results The systolic BP (SBP) and diastolic BP (DBP) were related to weight, WC, NC, BMI, and WHtR (P < 0.05). Linear regression analyses showed BMI and WC as independent risk factors for SBP with an increase by 1.11 mmHg in men (P = 0.036) and 1.59 mmHg in women (P = 0.001) in SBP when BMI increased 1 unit, while SBP increases by 0.2 mmHg when WC increases by 1 unit regardless of gender (P = 0.013). Conclusion Our results showed that BMI and WC are related to BP and important predictors of hypertension risk. Therefore, the uses of BMI and WC are recommended as screening tools for the prediction of hypertension risk among Turkish adults.
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Affiliation(s)
- Burcu Aksoy Canyolu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nilüfer Şen
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Beste Özben Sadıç
- Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey
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Oliveira IKF, Teixeira NDSCCDA, Rêgo BDMP, Aires IO, Torres Rodrigues RR, Araújo REDS, Lima CHR, Sousa RRD, Carvalho CMRGD, Costa DL, Santos MMD, Paz SMRSD, Paiva ADA. Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV. NUTR HOSP 2023; 40:1000-1008. [PMID: 37334822 DOI: 10.20960/nh.04402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Introduction Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.
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Alirezaei T, Soori H, Irilouzadian R, Najafimehr H. Novel Anthropometric Indices as Screening Tools for Obesity: A Study on Healthy Iranians. J Nutr Metab 2023; 2023:6612411. [PMID: 37822568 PMCID: PMC10564568 DOI: 10.1155/2023/6612411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/09/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
Background and Aims Upper body fat distribution is more related to cardiometabolic diseases than central obesity. Neck circumference (NC) and neck-to-height ratio (NHtR) are two indicators of upper body obesity that are affordable, easy to obtain, highly reproducible, and more practical in the crowded health centers than the classic anthropometric indices. Methods 18-65-year-old individuals with no past medical history were included. After obtaining written informed consent, they were screened for hypertension, high blood glucose, and other abnormal laboratory results. Data were analyzed using SPSS and Mann-Whitney U test, Chi square test, Spearman's correlation coefficient, and ROC curve. Results In our 2,812 participants, NC had the lowest area under the curve (AUC) in both male and female obese and overweight subjects. NHtR and hip circumference (HC) had the highest AUC in men and women with obesity, respectively. The highest sensitivity for overweight men and women belonged to waist circumference (WC) and waist-to-height ratio (WHtR), respectively, and for both males and females with obesity, NHtR had the highest sensitivity. The cutoff point of NHtR had the same value for males and females. HC and NHtR had the highest positive likelihood ratio (PLR) for obesity in men. In addition, HC and WC had the highest PLR for obesity in women. Conclusion In this study, we revealed that NC had the lowest and NHtR and HC had the highest predictive value for obesity. Furthermore, for both males and females with obesity, NHtR had the highest sensitivity. HC had the highest PLR for obesity in both genders. Our results warrant prospective studies to evaluate the role of NHtR and other novel anthropometric indices in the risk of cardiometabolic diseases.
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Affiliation(s)
- Toktam Alirezaei
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention of Research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rana Irilouzadian
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Najafimehr
- Safety Promotion and Injury Prevention of Research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Deng H, Duan X, Huang J, Zheng M, Lao M, Weng F, Su QY, Zheng ZF, Mei Y, Huang L, Yang WH, Xing X, Ma X, Zhao W, Liu X. Association of adiposity with risk of obstructive sleep apnea: a population-based study. BMC Public Health 2023; 23:1835. [PMID: 37735660 PMCID: PMC10512644 DOI: 10.1186/s12889-023-16695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Obesity is a crucial risk factor for obstructive sleep apnea (OSA), but the association between adiposity deposition and OSA risk has not reached a consistent conclusion. This study sought to reveal the association of multiple adiposity indicators with OSA risk. METHODS This cross-sectional study included 9,733 participants aged 35-74 years, recruited from an ongoing population-based cohort. OSA was assessed by the Berlin Questionnaire. Six adiposity indicators, including neck circumference (NC), body fat percentage (BF%), waist-to-hip ratio (WHR), visceral adiposity index (VAI), lipid accumulation product (LAP), and resting metabolic rate (RMR), were selected. Multivariate logistic regression models were used to examine the association of adiposity indicators with OSA risk. RESULTS One thousand six hundred twenty-six participants (16.71%) were classified into the OSA group. NC, BF%, WHR, VAI, LAP, and RMR were all positively associated with the risk of OSA after adjusting for confounders, regardless of age, sex, and history of dyslipidemia. Every 1-unit increment of NC, BF%, and VAI was associated with a 13%, 9%, and 14% increased risk of OSA, respectively; every 0.01-unit increment of WHR was associated with a 3% increased risk of OSA; every 10-unit increment of LAP and RMR was associated with 2% and 4% increased risk of OSA, respectively. CONCLUSIONS NC, BF%, WHR, VAI, LAP, and RMR were all independently and positively associated with OSA risk, regardless of age, sex, history of dyslipidemia, and menopausal status. Application of these new indicators could help to more comprehensively reflect and predict the risk of OSA in the general population.
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Affiliation(s)
- Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Jun Huang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Murui Zheng
- Faculty of Health Sciences, University of Macau, Macau SAR, 999078, China
| | - Miaochan Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Fan Weng
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, 510080, China
| | - Qi-Ying Su
- Dadong Street Community Health Service Center, Guangzhou, 510080, China
| | - Zhen-Feng Zheng
- Nancun Community Health Service Center, Guangzhou, 511442, China
| | - Yunting Mei
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Li Huang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Wen-Han Yang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Xiaohui Xing
- Guangdong Provincial Engineering Technology Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Xiaofeng Ma
- Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, 7 Zhuanchang Road, Xining, 810012, China.
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Nanshan District, 1088 Xueyuan Avenue, Shenzhen, 518055, China.
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China.
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11
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Duksal F, Eren F. Evaluation of thyroid functions and obesity in obstructive sleep apnea syndrome. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230376. [PMID: 37729367 PMCID: PMC10508951 DOI: 10.1590/1806-9282.20230376] [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: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Obstructive sleep apnea syndrome is associated with many chronic diseases. METHODS Obesity and thyroid function tests were evaluated retrospectively and cross-sectionally for 782 obstructive sleep apnea syndrome patients. RESULTS The mean patient age was 49.3±11.5 years, and the majority were obese (67.9%) or overweight (26.6%). The mean age of the patients in Group 2 (moderate/severe obstructive sleep apnea syndrome) was higher than that of Group 1 (simple snoring/mild obstructive sleep apnea syndrome). The rate of severe obstructive sleep apnea syndrome among obese patients (35.2%) was significantly higher than that of normal-weight (11.6%) and overweight (18.3%) patients (p=0.001). The oxygen desaturation index/apnea-hypopnea index and levels of leukocytes and C-reactive protein were significantly higher, while mean/minimum saturation values and hemoglobin, hematocrit, and free triiodothyronine levels were significantly lower among obese patients compared with overweight and normal-weight patients (p=0.001). Leukocytes, C-reactive protein, and apnea-hypopnea index/oxygen desaturation index values were higher, and mean/minimum saturation values were lower in Group 2 than in Group 1. CONCLUSION There were relationships between obstructive sleep apnea syndrome severity and body mass index. Obesity could be a critical predisposing factor for sleep disturbances. The prevention and control of obesity is important while being treated for obstructive sleep apnea syndrome.
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Affiliation(s)
- Faysal Duksal
- Konya Beyhekim Research and Training Hospital, Department of Chest Diseases – Konya, Turkey
| | - Fettah Eren
- Selcuk University, Faculty of Medicine, Department of Neurology – Konya, Turkey
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12
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de Victo ER, Fisberg M, Solé D, Kovalskys I, Gómez G, Rigotti A, Cortes LY, Yépez-Garcia MC, Pareja R, Herrera-Cuenca M, Drenowatz C, Christofaro D, Araujo T, Silva D, Ferrari G. Joint Association between Sedentary Time and Moderate-to-Vigorous Physical Activity with Obesity Risk in Adults from Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085562. [PMID: 37107844 PMCID: PMC10138536 DOI: 10.3390/ijerph20085562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
Recent studies have shown various relationships between physical activity and the incidence of obesity, but this study critically explored the association of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with obesity risk in adults from eight Latin American countries. ST and MVPA were assessed with accelerometers and stratified into 16 joint categories. Multivariate logistic regression models were used. The obesity risk indicators evaluated were body mass index (BMI), waist circumference (WC), and neck circumference (NC). Quartile 4 of ST and ≥300 min/week of MVPA was associated with lower odds of BMI compared to quartile 1 of ST and ≥300 min/week of MVPA. Quartile 1 of ST and 150-299 min/week of MVPA, quartile 1 of ST and 76-149 min/week MVPA, quartile 3 of ST and 76-149 min/week MVPA, and quartiles 1, 2, and 3 of ST with 0-74 min/week MVPA were associated with higher odds of high WC compared to quartile 1 of ST and ≥300 min/week of MVPA. Quartile 3 of ST and 150-299 min/week of MVPA, quartiles 1 and 3 of ST and 76-149 min/week of MVPA, and quartile 1 of ST and 0-74 min/week MVPA were associated with higher NC compared to quartile 1 of ST and ≥300 min/week of MVPA. This study suggests that achieving the MVPA recommendations will likely protect against obesity, regardless of ST.
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Affiliation(s)
- Eduardo Rossato de Victo
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo 04023-062, Brazil
| | - Mauro Fisberg
- Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Dirceu Solé
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo 04023-062, Brazil
| | - Irina Kovalskys
- Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires C1107, Argentina
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José 11501-2060, Costa Rica
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 8330024, Chile
| | - Lilia Yadira Cortes
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | | | - Rossina Pareja
- Instituto de Investigación Nutricional, Lima 15026, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
| | - Diego Christofaro
- Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, Presidente Prudente 01049-010, Brazil
| | - Timoteo Araujo
- Faculdades Metropolitanas Unidas, São Paulo 03021-000, Brazil
| | - Danilo Silva
- Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
| | - Gerson Ferrari
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia 7500912, Chile
- Correspondence:
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13
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Razmpour F, Daryabeygi-Khotbehsara R, Soleimani D, Asgharnezhad H, Shamsi A, Bajestani GS, Nematy M, Pour MR, Maddison R, Islam SMS. Application of machine learning in predicting non-alcoholic fatty liver disease using anthropometric and body composition indices. Sci Rep 2023; 13:4942. [PMID: 36973382 PMCID: PMC10043285 DOI: 10.1038/s41598-023-32129-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, which can progress from simple steatosis to advanced cirrhosis and hepatocellular carcinoma. Clinical diagnosis of NAFLD is crucial in the early stages of the disease. The main aim of this study was to apply machine learning (ML) methods to identify significant classifiers of NAFLD using body composition and anthropometric variables. A cross-sectional study was carried out among 513 individuals aged 13 years old or above in Iran. Anthropometric and body composition measurements were performed manually using body composition analyzer InBody 270. Hepatic steatosis and fibrosis were determined using a Fibroscan. ML methods including k-Nearest Neighbor (kNN), Support Vector Machine (SVM), Radial Basis Function (RBF) SVM, Gaussian Process (GP), Random Forest (RF), Neural Network (NN), Adaboost and Naïve Bayes were examined for model performance and to identify anthropometric and body composition predictors of fatty liver disease. RF generated the most accurate model for fatty liver (presence of any stage), steatosis stages and fibrosis stages with 82%, 52% and 57% accuracy, respectively. Abdomen circumference, waist circumference, chest circumference, trunk fat and body mass index were among the most important variables contributing to fatty liver disease. ML-based prediction of NAFLD using anthropometric and body composition data can assist clinicians in decision making. ML-based systems provide opportunities for NAFLD screening and early diagnosis, especially in population-level and remote areas.
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Affiliation(s)
- Farkhondeh Razmpour
- Department of Nutrition, Faculty of Medicine, Hormozgan University of Medical Sciences, Shahid Chamran Boulevard, Bandar Abbas, Iran.
| | | | - Davood Soleimani
- Department of Nutrition, School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamzeh Asgharnezhad
- Institute for Intelligent Systems Research and Innovation (IISRI), Geelong Waurn Ponds Victoria, Australia
| | - Afshar Shamsi
- Biomedical Machine Learning Lab, University of New South Whales, Sydney, Australia
- Concordia Institute for Information Systems Engineering, Concordia University, Montreal, Canada
| | - Ghasem Sadeghi Bajestani
- Department of Biomedical Engineering, Faculty of Engineering, Imam Reza International University, Mashhad, Iran
| | - Mohsen Nematy
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ralph Maddison
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong Victoria, Australia
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14
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Are the different cut-off points for sitting time associated with excess weight in adults? A population based study in Latin America. BMC Public Health 2023; 23:110. [PMID: 36647028 PMCID: PMC9841640 DOI: 10.1186/s12889-023-15029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Excess weight is increasing worldwide, and in Latin America more than half of the population is excess weight. One of the reasons for this increase has been excessive sitting time. Still, it remains to be seen whether there is an excessive amount of that time in Latin American adults. This study aimed to associate different sitting time cut-off points with the excess weight. METHODS Data from the Latin American Study of Nutrition and Health (ELANS), a cross-sectional population-based survey conducted in eight Latin American countries, were used. The excess weight indicators used were body mass index, and waist and neck circumferences. Sitting time was obtained using questionnaires and categorized at different cut-off points. Differences between sitting time categories (< 4 or ≥ 4; < 6 or ≥ 6; and < 8 or ≥ 8 hours/day) and excess weight were obtained by Student's t test for independent samples and the association between sitting time categories and different indicators of excess weight were obtained by logistic regression. RESULTS The median of the sitting time was 420 min/day (IQR: 240-600). There were no significant differences between body mass index (kg/m2) and waist circumference (cm) with categories of sitting time. The mean values of neck circumference (cm) were significantly higher in ≥4, ≥6 and ≥ 8 hours/day than < 4, < 6, and < 8 hours/day of sitting time in the pooled sample. Some distinct differences by country were observed. There were significant differences among excess weight by body mass index (63.2% versus 60.8) with < 8 vs ≥8 hours/day of sitting time. The proportion of excess weight by neck circumference was higher in participants who reported ≥4, ≥6, and ≥ 8 hours/day compared to < 4, < 6, and < 8 hours/day of sitting time. Considering ≥8 hours/day of sitting time, higher odds of excess weight were found evaluated by body mass index (OR: 1.10; 95% CI: 1.01, 1.20) and neck circumference (OR: 1.13; CI 95%: 1.03, 1.24) overall. CONCLUSIONS Sitting time above 8 hours/day was associated with higher odds of excess weight, even though there were no differences in waist circumference between sitting time categories. TRIAL REGISTRATION Clinical Trials NCT02226627. (27/08/2014).
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15
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Guo H, An Z, Wang N, Ge S, Cai J, Yu S, Zhou Y, Ying R, Zha K, Gu T, Zhao Y, Lu Y. Diabetes Mellitus Type 2 Patients with Abdominal Obesity Are Prone to Osteodysfunction: A Cross-Sectional Study. J Diabetes Res 2023; 2023:3872126. [PMID: 37102159 PMCID: PMC10125752 DOI: 10.1155/2023/3872126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/31/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
Introduction The interaction between diabetes, obesity, and bone metabolism was drawing increasing public attention. However, the osteometabolic changes in diabetes mellitus type 2 (T2DM) patients with abdominal obesity have not been fully revealed. This study is aimed at investigating the association between abdominal obesity indices and bone turnover markers among T2DM participants. Methods 4351 subjects were involved in the METAL study. Abdominal obesity indices included neck, waist, and hip circumference, visceral adiposity index (VAI), lipid accumulation product (LAP), waist-to-hip ratio (WHR), and Chinese visceral adiposity index (CVAI). They were applied to elucidate the nexus between β-C-terminal telopeptide (β-CTX), osteocalcin (OC), and intact N-terminal propeptide of type I collagen (P1NP). Results Abdominal obesity indices were strongly negatively associated with β-CTX and OC. Among males, five indices were negatively correlated with β-CTX (BMI, WC, LAP, WHR, and CVAI) and OC (BMI, NC, WC, WHR, and CVAI). There were no significant associations with P1NP. Among females, all eight indices were negatively associated with β-CTX. Seven indices were negatively related to OC (BMI, NC, WC, HC, LAP, WHR, and CVAI). The VAI was negatively correlated with P1NP. Conclusions The present study demonstrated that in T2DM, abdominal obesity had an obviously negative correlation with bone metabolism. Abdominal obesity indices were significantly negatively associated with skeletal destruction (β-CTX) and formation (OC). In routine clinical practice, these easily obtained indices could be used as a preliminary screening method and relevant factors for osteodysfunction incidence risk at no additional cost and may be of particular value for postmenopausal women in T2DM populations.
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Affiliation(s)
- Hui Guo
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Zengmei An
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaohong Ge
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Jian Cai
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Shiyan Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhou
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Rong Ying
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Kexi Zha
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Tao Gu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yan Zhao
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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16
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Zhang K, Bao Y, Han X, Zhai W, Yang Y, Luo M, Gao F. Effects of opioid-free propofol or remimazolam balanced anesthesia on hypoxemia incidence in patients with obesity during gastrointestinal endoscopy: A prospective, randomized clinical trial. Front Med (Lausanne) 2023; 10:1124743. [PMID: 37035337 PMCID: PMC10073760 DOI: 10.3389/fmed.2023.1124743] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
There are presently no consensuses on the optimal sedation strategy for obese patients during gastrointestinal endoscopy. This study aim to explore the effects of opioid-free propofol or remimazolam balanced anesthesia on hypoxemia incidence in patients with obesity. A total of 264 patients were randomized to remimazolam + esketamine group (group R) or propofol + esketamine group (group P). Anesthesia in group P was administrated by propofol, esketamine and in group R by remimazolam, esketamine. The primary outcome was incidence of hypoxemia. Secondary outcomes were the time to loss of consciousness (LoC) and to recovery and the incidence of intraoperative and postoperative adverse reactions. We found the incidence of mild hypoxemia in group R was similar to that in group P (14.2% vs. 11.5%, p = 0.396). The incidence of severe hypoxemia in group R was significantly lower than Group P (4.2% vs. 9.2%, p = 0.019). The time to LoC in group R was longer than group P [Median (interquartile range, IQR): 53 s (45 to 61) vs. 50 s (42 to 54), p = 0.001]. The time to recovery from anesthesia in group R was less than group P [Median (IQR): 48 min (41 to 58) vs. 55.5 min (46 to 67), p<0.001]. There was no significant difference in the incidence of adverse events (p > 0.05 for all). We concluded that compared with propofol combined with esketamine, remimazolam combined with esketamine can reduce the incidence of severe hypoxemia during gastrointestinal endoscopy in obese patients. Clinical Trial Registration: www.chictr.org.cn, Identifier: ChiCTR2200065575.
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Affiliation(s)
- Keyao Zhang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yuan Bao
- Department of Gaoxin Operating Room, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xue Han
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wenshan Zhai
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yi Yang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Meng Luo
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Fang Gao
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Anesthesiology, Suining County People’s Hospital, Xuzhou, Jiangsu, China
- *Correspondence: Fang Gao,
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17
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Zanuncio VV, Sediyama CMNO, Dias MM, Nascimento GM, Pessoa MC, Pereira PF, Silva MRI, Segheto KJ, Longo GZ. Neck circumference and the burden of metabolic syndrome disease: a population-based sample. J Public Health (Oxf) 2022; 44:753-760. [PMID: 34156087 DOI: 10.1093/pubmed/fdab197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND This study aims to verify the association between neck circumference (NC) and metabolic syndrome and establish NC cut-off points to predict metabolic syndrome. METHODS Weight, height, NC, waist circumference, body mass index, fasting plasma glucose, HDL cholesterol, triglycerides and blood pressure were measured in a cross-sectional and population-based study with 966 adults. The association between NC and the burden of metabolic syndrome disease was evaluated by multinomial logistic regression. Receiver operating characteristic curves were used to acquire gender-specific cut-off values and predict metabolic syndrome. The NC is a simple anthropometric measurement, has low evaluation costs, can estimate the subcutaneous fat in the upper body and is related to cardiometabolic risks. RESULTS NC is an independent predictor of metabolic syndrome burden with high association to women. The syndrome components stratification indicated that the NC of individuals with one component was lower than those with three or more (P = 0.001). Metabolic syndrome prediction cut-off point was a NC of 39.5 cm for men and 33.3 cm for women. CONCLUSIONS Increased NC was associated with higher metabolic syndrome risks. This anthropometric parameter can be used as an additional marker for screening cardiovascular risk diseases.
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Affiliation(s)
- V V Zanuncio
- Department of Nursing and Medicine, Universidade Federal de Viçosa, Viçosa 36570-900, Brazil
| | - C M N O Sediyama
- Department of Nursing and Medicine, Universidade Federal de Viçosa, Viçosa 36570-900, Brazil
| | - M M Dias
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa 36570-900, Brazil
| | - G M Nascimento
- Department of Nutrition, Universidade Federal de Santa Catarina, Santa Catarina 88040-900, Brazil
| | - M C Pessoa
- Department of Nutrition-School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - P F Pereira
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa 36570-900, Brazil
| | - M R I Silva
- Department of Physical Education, Universidade Federal de Juiz de Fora, Governador Valadares 35010-177, Brazil
| | - K J Segheto
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa 36570-900, Brazil
| | - G Z Longo
- Department of Nutrition, Universidade Federal de Santa Catarina, Santa Catarina 88040-900, Brazil
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18
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Ferrari G, Alberico C, Marques A, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Pareja RG, Herrera-Cuenca M, Drenowatz C, Leme ACB, Cristi-Montero C, da Costa RF, Farías‑Valenzuela C, Fisberg M. Perceived urban environment attributes and obesity indices in adults: an 8-Nation study from Latin America. Sci Rep 2022; 12:19598. [PMID: 36380054 PMCID: PMC9666441 DOI: 10.1038/s41598-022-24209-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
This study examines the associations between perceived urban environment attributes and obesity indices by country using data from an eight-nation study from Latin America. The data were collected from 8185 adults. The Neighbourhood Environment Walkability-abbreviated scale was used to assess perceived urban environment attributes. Obesity indices considered were body mass index, waist circumference, neck circumference, a body shape index and waist-to-height ratio. The perception of a more and better land use mix-diversity (β - 0.44; 95% CI - 0.59, - 0.28), traffic safety (- 0.39; - 0.66, - 0.12), and safety from crime (- 0.36; - 0.57, - 0.15) was associated with lower body mass index across the entire sample. Land use mix-diversity (- 1.21; - 1.60, - 0.82), street connectivity (- 0.26; - 0.37, - 0.15), and traffic safety (- 0.79; - 1.47, - 0.12) were negatively associated with waist circumference. Land use mix-diversity (- 0.11; - 0.20, - 0.03), land use mix-access (- 0.23; - 0.34, 0.12), walking/cycling facilities (- 0.22; - 0.37, - 0.08), and safety from crime (- 0.27; - 0.42, - 0.12) were negatively associated with neck circumference. No associations between perceived urban environment attributes and a body shape index were found. Land use mix-diversity (- 0.01; - 0.02, - 0.01), aesthetics (- 0.02; - 0.03, - 0.01), and safety from crime (- 0.02; - 0.04, - 0.01) were associated with waist-to-height ratio. Environmental interventions involving urban environment attributes are associated with obesity indices and, therefore, may help decrease the prevalence of overweight and obesity.
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Affiliation(s)
- Gerson Ferrari
- grid.441837.d0000 0001 0765 9762Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Dirección: Av. Pedro de Valdivia 425, Santiago, Providencia Chile
| | - Claudia Alberico
- grid.261038.e0000000122955703North Carolina Central University (NCCU), Julius L. Chambers Biomedical and Biotechnology Research Institute (JLC-BBRI), Durham, NC USA
| | - Adilson Marques
- grid.9983.b0000 0001 2181 4263CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal ,grid.9983.b0000 0001 2181 4263Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Irina Kovalskys
- grid.412525.50000 0001 2097 3932Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- grid.412889.e0000 0004 1937 0706Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- grid.7870.80000 0001 2157 0406Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes Y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- grid.41312.350000 0001 1033 6040Departamento de Nutrición Y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martha Yépez García
- grid.412251.10000 0000 9008 4711Colégio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Rossina G. Pareja
- grid.419080.40000 0001 2236 6140Instituto de Investigación Nutricional, La Molina, Lima Peru
| | - Marianella Herrera-Cuenca
- grid.8171.f0000 0001 2155 0982Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Clemens Drenowatz
- grid.508763.f0000 0004 0412 684XDivision of Physical Education, University of Education Upper Austria, 4020 Linz, Austria
| | - Ana Carolina B. Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
| | - Carlos Cristi-Montero
- grid.8170.e0000 0001 1537 5962IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Roberto Fernandes da Costa
- grid.411233.60000 0000 9687 399XPhysical Education Department, Research Group in Physical Activity and Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Claudio Farías‑Valenzuela
- grid.441811.90000 0004 0487 6309Instituto del Deporte, Universidad de las Americas, 9170022 Santiago, Chile
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil ,grid.411249.b0000 0001 0514 7202Departamento de Pediatria da, Universidade Federal de São Paulo, São Paulo, Brazil
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Zou H, Jia Q, Yang W, Zhang Z, Miao J. Clinical and Polysomnographic Characteristics of Nonobese and Obese Chinese Patients With Obstructive Sleep Apnea. J Clin Neurophysiol 2022; 39:631-636. [PMID: 33587387 DOI: 10.1097/wnp.0000000000000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Obesity is a risk factor associated with the onset and exacerbation of obstructive sleep apnea (OSA). However, the majority of OSA patients in Asian populations are nonobese. To date, there have been insufficient large-scale studies of the differences in the clinical and polysomnographic features of obese and nonobese OSA patients in this population, and few studies have sought to identify predictors of OSA severity in affected obese and nonobese patients. METHODS We conducted a case-matched retrospective study, including 652 consecutive Chinese OSA patients (326 nonobese and 326 obese) to assess differences in demographic, clinical, and polysomnographic data between these two groups. Independent predictors of OSA severity were identified through multivariate linear regression analysis. RESULTS The age and gender distributions of our obese and nonobese OSA patient cohorts did not differ significantly ( P > 0.05), and rates of comorbidities were comparable in these two patient groups ( P > 0.05). Nonobese patients were more likely to report atypical symptoms of OSA, including insomnia ( P < 0.001), irritability ( P < 0.05), and depressive symptoms ( P < 0.01), whereas obese patients were more likely to report typical symptoms of OSA, such as habitual snoring ( P < 0.001), witnessed apnea ( P < 0.05), and daytime sleepiness ( P < 0.001). Relative to nonobese patients, those who were obese exhibited significantly higher apnea-hypopnea index during total sleep time ( P < 0.001), apnea-hypopnea index during nonrapid eye movement sleep ( P < 0.001), and apnea-hypopnea index during rapid eye movement sleep ( P < 0.001), in addition to lower average oxygen saturation ( P < 0.001), minimal oxygen saturation ( P < 0.001), and a higher oxygen desaturation index ( P < 0.001) and arousal index ( P < 0.001). Total sleep time was, on average, shorter for nonobese patients ( P < 0.05), who also exhibited decreased sleep efficiency and more frequent awakening relative to obese patients ( P < 0.05). A multivariate linear regression analysis revealed that neck circumference and waist circumference were independent predictors of OSA severity in obese patients ( P < 0.05). CONCLUSIONS On average, OSA was typically less severe in nonobese patients, who were also more likely to experience atypical OSA symptoms relative to obese patients. These results also suggest that the differential contributions of body fat accumulation and distribution to OSA severity may offer insights into the pathogenesis, clinical manifestations, and optimal management of this condition in nonobese and obese patient populations. It is vital that clinicians consider these differences to properly diagnose and treat this debilitating condition.
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Affiliation(s)
- Huili Zou
- Department of Neurology, Xi'an Daxing Hospital, Xi'an City, Shaanxi Province, China
- Sleep Disorders Center, Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an City, Shaanxi Province, China; and
| | - Qingge Jia
- Xi'an International Medical Center, Northwest University, Xi'an City, Shaanxi Province, China
| | - Weiyi Yang
- Department of Neurology, Xi'an Daxing Hospital, Xi'an City, Shaanxi Province, China
- Sleep Disorders Center, Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an City, Shaanxi Province, China; and
| | - Zhuo Zhang
- Sleep Disorders Center, Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an City, Shaanxi Province, China; and
| | - Jianting Miao
- Department of Neurology, Xi'an Daxing Hospital, Xi'an City, Shaanxi Province, China
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Hu Z, Li Y, Ma B, Lei S, Wang X. Iron metabolism mediates the relationship between Vitamin C and hepatic steatosis and fibrosis in NAFLD. Front Nutr 2022; 9:952056. [PMID: 36159474 PMCID: PMC9494736 DOI: 10.3389/fnut.2022.952056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Vitamin C (Vit C) and iron metabolism are closely related to metabolic disorders. However, the relation between iron storage protein ferritin and Vit C has not been elucidated. We aimed to investigate the crosstalk between Vit C and ferritin and its implications on non-alcoholic fatty liver disease (NAFLD). Clinical information of 3,614 subjects was obtained from the NHANES Public Data 2017–2018. FibroScan data, which estimates liver steatosis and fibrosis and Vit C, were selected to assess factors influencing NAFLD in this cross-sectional study. Ferritin and Vit C among different categories of liver steatosis and fibrosis were assessed by CAP and E value. Logistic regression and RCS models were used to analyze the correlations. In vitro study in hepG2 were conducted to validate the regulations. Ferritin increased while Vit C decreased with more severe hepatic steatosis and hepatic fibrosis (all P < 0.001). Logistic regression models indicated that increased serum ferritin was a risk factor for NAFLD while increased Vit C was a protective factor for NAFLD and hepatic fibrosis after adjusting the continuous and categorical variables. Vitamin C was negatively associated with ferritin. Further mediation analysis identified that ferritin mediates the impact of Vit C on NAFLD (P < 0.05) and cirrhosis (P < 0.001). The experiments on cellular level suggested Vit C alleviated PA/OA induced steatosis and maintains iron homeostasis through inhibiting PA/OA induced upregulation of iron bound protein ferritin and labile iron pool (LIP) induction in hepG2 cells. In conclusion, Vit C was a protective factor, whereas ferritin was a risk factor for hepatic steatosis and fibrosis. Vitamin C alleviated NAFLD and maintained iron homeostasis via ferritin suppression and LIP induction.
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Affiliation(s)
- Zhengyu Hu
- Department of General Surgery, Shanghai Tenth People's Hospital, Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Gastroenterology, Shanghai Tenth People's Hospital, Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Bingwei Ma
- Department of General Surgery, Shanghai Tenth People's Hospital, Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Saifei Lei
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Xingchun Wang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
- *Correspondence: Xingchun Wang
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A Prediction Nomogram Combining Epworth Sleepiness Scale and Other Clinical Parameters to Predict Obstructive Sleep Apnea in Patients with Hypertension. Int J Hypertens 2022; 2022:3861905. [PMID: 36034887 PMCID: PMC9411005 DOI: 10.1155/2022/3861905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/25/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Obstructive sleep apnea (OSA) is common in patients with hypertension. Nonetheless, OSA is underdiagnosed despite considerable evidence of the association between OSA and adverse health outcomes. This study developed and validated a clinical nomogram to predict OSA in patients with hypertension based on the Epworth Sleepiness Scale (ESS) score and OSA-related parameters. Methods A total of 347 hypertensive patients with suspected OSA were retrospectively enrolled and randomly assigned to a training set and a validation set at 70 : 30 (N = 242/N = 105) ratio. OSA was diagnosed through sleep monitoring and was defined as an apnea-hypopnea index ≥5 events/h. Using the least absolute shrinkage and selection operator regression model, we identified potential predictors of OSA and constructed a nomogram model in the training set. The predictive performance of the nomogram was assessed and validated by discrimination and calibration. The nomogram was also compared with ESS scores according to decision curve analysis (DCA), integrated discrimination index (IDI), and net reclassification index (NRI). Results ESS scores, body mass index, neck circumference, snoring, and observed apnea predicted OSA are considered. The nomogram showed similar discrimination between the training set (AUC: 0.799, 95% CI: 0.743–0.847) and validation set (AUC: 0.766, 95% CI: 0.673–0.843) and good calibration in the training (P=0.925 > 0.05) and validation (P=0.906 > 0.05) sets. Compared with the predictive value of the ESS, the nomogram was clinically useful and significantly improved reclassification accuracy (NRI: 0.552, 95% CI: 0.282–0.822, P < 0.001; IDI: 0.088, 95% CI: 0.045–0.133, P < 0.001) at a probability threshold of >42%. Conclusions We developed a novel OSA prediction nomogram based on ESS scores and OSA-related parameters. This nomogram may help improve clinical decision-making, especially in communities and primary clinics, where polysomnography is unavailable.
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Duarte RLDM, Togeiro SMGP, Palombini LDO, Rizzatti FPG, Fagondes SC, Magalhães-da-Silveira FJ, Cabral MM, Genta PR, Lorenzi-Filho G, Clímaco DCS, Drager LF, Codeço VM, Viegas CADA, Rabahi MF. Brazilian Thoracic Association Consensus on Sleep-disordered Breathing. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2022; 48:e20220106. [PMID: 35830079 PMCID: PMC9262434 DOI: 10.36416/1806-3756/e20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022]
Abstract
Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea. Obstructive sleep apnea is an extremely prevalent but often underdiagnosed disease. It is often accompanied by comorbidities, notably cardiovascular, metabolic, and neurocognitive disorders, which have a significant impact on quality of life and mortality rates. Therefore, to create this consensus, the Sleep-Disordered Breathing Department of the Brazilian Thoracic Association brought together 14 experts with recognized, proven experience in sleep-disordered breathing.
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Affiliation(s)
| | - Sonia Maria Guimarães Pereira Togeiro
- . Disciplina de Clínica Médica, Escola Paulista de Medicina - EPM - Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil.,. Instituto do Sono, São Paulo (SP) Brasil
| | | | | | - Simone Chaves Fagondes
- . Serviço de Pneumologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | | | | | - Pedro Rodrigues Genta
- . Laboratório de Investigação Médica 63 - LIM 63 (Laboratório do Sono) - Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | - Geraldo Lorenzi-Filho
- . Laboratório de Investigação Médica 63 - LIM 63 (Laboratório do Sono) - Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | | | - Luciano Ferreira Drager
- . Unidade de Hipertensão, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | - Vitor Martins Codeço
- . Hospital Regional da Asa Norte, Secretaria de Estado de Saúde do Distrito Federal, Brasília (DF) Brasil
| | | | - Marcelo Fouad Rabahi
- . Faculdade de Medicina, Universidade Federal de Goiás - UFG - Goiânia (GO) Brasil
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Do JY, Kim AY, Kang SH. Clinical usefulness of neck circumference for predicting sarcopenia in patients undergoing peritoneal dialysis. Nutr Clin Pract 2022; 37:1366-1375. [PMID: 35780314 DOI: 10.1002/ncp.10886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/03/2022] [Accepted: 05/15/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Neck circumference (NC), per se, includes muscle mass beyond simple fat mass and mainly subcutaneous fat. We aimed to investigate the clinical usefulness of NC for predicting muscle mass, strength, or sarcopenia in patients undergoing peritoneal dialysis (PD). METHODS We retrospectively analyzed the data of patients undergoing PD (n = 199). NC, body compositions, and handgrip strength (HGS) were measured in all patients. Appendicular lean mass (ALM) was evaluated using dual-energy x-ray absorptiometry at the time of dry abdomen. Sarcopenia and metabolic syndrome were diagnosed using the definitions from previous guidelines. We analyzed the data divided by sex. RESULTS In male patients, the discrimination performance of BMI or NC for sarcopenia was similar, but BMI was more closely associated with the prediction of metabolic syndrome than NC. Linear and logistic regression analyses showed that, in males, BMI was associated with the ALM index and metabolic syndrome, but NC was associated with sarcopenia and HGS. In addition, the addition of NC in the multivariate model was associated with better predictability of sarcopenia in men. In female patients, the discrimination performance of BMI or NC for sarcopenia or metabolic syndrome was similar. CONCLUSION The present study demonstrated that NC is associated with HGS and sarcopenia in male patients undergoing PD. NC may be a useful option for screening for sarcopenia beyond simple BMI and may be helpful in identifying whether further evaluation for a diagnosis of sarcopenia is required.
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Affiliation(s)
- Jun Young Do
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - A Young Kim
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Haidar SA, de Vries N, Poulia KA, Hassan H, Rached M, Karavetian M. Neck Circumference as a Screening Tool for Metabolic Syndrome among Lebanese College Students. Diseases 2022; 10:diseases10020031. [PMID: 35735631 PMCID: PMC9221764 DOI: 10.3390/diseases10020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 12/04/2022] Open
Abstract
Metabolic syndrome (MetS) is a cluster of symptoms that, when present, increase the risk for cardiovascular disease. There is a need for reliable screening tools that are ethnically sensitive. Two hundred and sixty-six college students were assessed anthropometrically. They had a fasting blood sample drawn, and blood pressure measured. They then completed a demographic questionnaire and The International Physical Activity Questionnaire (IPAQ). The prevalence of MetS was found to be 10.1% in males and 4.5% in females. Neck circumference (NC) was positively associated with BMI in males (r = 0.55, p < 0.001) and females (r = 0.53, p < 0.001) and was positively associated with hip circumference in both males (r = 0.47, p < 0.001) and females (r = 0.50, p < 0.001) and with waist circumference in males (r = 0.46, p < 0.001) and females (r = 0.49, p < 0.001.) An area under the curve (AUC) was calculated using receiver operating characteristics (ROC), and NC > 38 cm in males and NC> 36 cm in females were found to be appropriate cut-offs for diagnosing MetS. NC is a reliable and non-invasive screening tool that can be used to screen for MetS in males. NC could also serve as an anthropometric instrument to assess abdominal obesity and could be valuable for college students.
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Affiliation(s)
- Suzan A. Haidar
- Department of Nutrition and Food Sciences, School of Arts and Sciences, Lebanese International University, Beirut P.O. Box 146404, Lebanon;
| | - Nanne de Vries
- Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 6166200, 6211 LK Maastricht, The Netherlands;
| | - Kalliopi-Anna Poulia
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece;
| | - Hussein Hassan
- Nutrition Program, Department of Natural Sciences, Lebanese American University, Beirut P.O. Box 135053, Lebanon;
| | - Mohammad Rached
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut P.O. Box 146404, Lebanon;
| | - Mirey Karavetian
- School of Nutrition, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON M1L2A6, Canada
- Correspondence:
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Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome in Women: Effects of Lifestyle Modifications. J Clin Med 2022; 11:jcm11102759. [PMID: 35628889 PMCID: PMC9146022 DOI: 10.3390/jcm11102759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most widespread liver disease, characterized by fatty acids liver accumulation and subsequent fibrosis. NAFLD prevalence ranges from 80% to 90% in obese subjects and is estimated to be around 50% in patients with metabolic syndrome. In this clinical scenario, diet and lifestyle modifications can play an important role. There are several imaging techniques that can accurately diagnose fatty liver. Recently, ultrasound has acquired a leading role in the diagnosis and follow-up of fatty liver disease. Furthermore, elastosonography represents a valid alternative to liver biopsy. Shear wave elastosonography evaluates the elastic and mechanical properties of liver tissue. The aim is to evaluate the effects of lifestyle and nutritional interventions and a loss of body weight during hepatic steatosis through ultrasonographic and elastosonographic techniques. Thirty-two female subjects with metabolic syndrome were subjected to clinical, anthropometric, and laboratory assessments, as well as abdominal ultrasonographic/elastosonographic measurements taken from enrollment time (T0) and after 3 months (T1) of lifestyle modifications. After 3 months of lifestyle changes, significant weight loss was observed, with a marked improvement in all adiposity indices. The laboratory parameters at T1 showed significant decreases in total and LDL cholesterol, triglycerides, basal blood glucose, 120 min glycaemia, basal insulin and HOMA Index (p < 0.001). A similar improvement was observed at T1 for steatosis degree (p < 0.01) and elastosonographic measurements (Kpa p < 0.001). The linear regression analysis of the baseline conditions documented that the size of the liver positively correlated with body weight, BMI, neck and waist circumferences, waist to height ratio (WhtR), insulin and HOMA Index, fat mass and visceral fat, and steatosis grade. After 3 months, the liver size showed improvement with positive correlations to all previous variables. Hepatic stiffness (Kpa) positively correlated with neck circumference, visceral fat, and ALT, with basal insulin, gamma-GT, and AST, and with waist circumference, WhtR, and fat mass. The degree of steatosis was positively correlated with more variables and with greater statistical significance at T1 with respect to T0. Particularly, the positive correlations between the degree of steatosis and neck circumference (p < 0.001), HOMA Index, and triglycerides (p < 0.001) appeared to be very significant. NAFLD management in women with metabolic syndrome should be focused on lifestyle modifications. Moreover, liver involvement and improvement at follow-up could be evaluated in a non-invasive manner through ultrasonographic and elastosonographic techniques.
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Al- Ahmadi J, Enani S, Bahijri S, Al-Raddadi R, Jambi H, Eldakhakhny B, Borai A, Ajabnoor G, Tuomilehto J. Association between anthropometric indices and non-anthropometric components of the metabolic syndrome in Saudi adults. J Endocr Soc 2022; 6:bvac055. [PMID: 35592514 PMCID: PMC9113350 DOI: 10.1210/jendso/bvac055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Context Waist circumference (WC) is used in screening for metabolic syndrome (MetS) based on its association with cardiometabolic risk. This might apply differently in ethnically different populations. Associations with other measures are also unclear. Objective This work aimed to investigate the association between neck circumference (NC), WC, WC:hip circumference, WC:height (WC:Ht), NC:Ht, fat percentage, body mass index (BMI), conicity index, abdominal volume index, and weight-adjusted waist index with nonanthropometric components of MetS in nondiabetic Saudi adults. Methods This cross-sectional study took place in public health centers in Jeddah, comprising 1365 Saudi adults (772 men and 593 women) aged 18 years or older not previously diagnosed with diabetes. Main outcome measures included the presence of 2 or more nonanthropometric components of the MetS were used to define clinical metabolic abnormality (CMA). The predictive ability of studied anthropometric indices for CMA was determined using the area under receiver operating characteristics (AUC) curve and binary logistic regression. Results A total of 157 men and 83 women had CMA. NC and NC:Ht had the highest predictive ability for CMA in men (odds ratio [OR]NC = 1.79, P < .001 and ORNC:Ht = 1.68, P < .001; AUCNC = 0.69 [95% CI, 0.64-0.74] and AUCNC:Ht = 0.69 [95% CI, 0.64-0.73]). In women, WC had the highest predictive ability ORWC = 1.81, P < .001; AUCWC = 0.75 [95% CI, 0.69-0.80]). Conclusion Upper-body anthropometric indicators that were associated with subcutaneous fat had the highest predictive ability for CMA in men whereas abdominal obesity indictors had the best predictive ability in women, suggesting that fat distribution might contribute to CMA in a sex-specific manner.
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Affiliation(s)
- Jawaher Al- Ahmadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Sumia Enani
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Suhad Bahijri
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Rajaa Al-Raddadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hanan Jambi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Basmah Eldakhakhny
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Anwar Borai
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), College of Medicine, King Saud Bin Abdulaziz, University for Health Sciences (KSAU-HS), Jeddah 22384, Saudi Arabia
| | - Ghada Ajabnoor
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Jaakko Tuomilehto
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Department of Public Health, University of Helsinki, FI-00014 Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland
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Ji Y, Liang Y, Mak JC, Ip MS. Obstructive sleep apnea, intermittent hypoxia and non-alcoholic fatty liver disease. Sleep Med 2022; 95:16-28. [DOI: 10.1016/j.sleep.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022]
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Impact of Hyoid Position, Mandible Body Length and Anthropometric Measurements on Sleep Indices in Patients with Snoring in North Indian Population. J Maxillofac Oral Surg 2022; 21:253-259. [PMID: 35400929 PMCID: PMC8934888 DOI: 10.1007/s12663-020-01505-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022] Open
Abstract
Introduction In Indian population, the estimated prevalence of OSA is 7.5% to 13.5%. Craniofacial anatomical variations and obesity are the major risk factors for OSA. Among the craniofacial anatomy, the neck circumference and abnormal craniofacial morphology play an important role in the pathogenesis of OSA. Obesity is the major risk factor for which waist and hip circumference and BMI are considered. Aim The aim of this paper was to evaluate the impact of hyoid position, mandible body length (MBL) and anthropometric measurements on sleep indices in patients with snoring in North Indian population. Methods In this cross-sectional study, we analyzed the position of the hyoid, mandible body length and anthropometric measurements, of 104 patients attending ENT OPD with the complaint of snoring and excessive daytime sleepiness. All subjects underwent a full overnight polysomnography. The position of the hyoid, MBL and the anthropometric measurements were compared with the sleep architecture of the subjects, and a p value < 0.05 was considered significant. Results A strong positive correlation is seen between the position of the hyoid, MBL and anthropometric measurements on the sleep indices in this study. Pearson 2-tailed correlation was evaluated, and upon analysis, it was found that at significance level of 0.01, obesity (BMI) is strongly correlated with overall AHI with correlation coefficient of 0.926, whereas AHI in supine position was having coefficient of 0.837 and AHI on right side and left side was almost same 0.597 and 0.575, respectively. Similarly WC is strongly correlated with AHI and RDI, having coefficient of 0.930 with both. NC and HC also showed strong positive correlation with overall AHI and RDI having correlation coefficient of 0.893, 0.926 with AHI and 0.893, 0.926 with RDI, respectively. The MBL also showed a strong positive correlation with AHI and RDI with correlation coefficient of 0.994 in both. The position of the hyoid also showed a strong positive correlation with AHI and RDI. Conclusion Results indicated that significant positive correlation was found between position of the hyoid, MBL and anthropometric measurements on the sleep indices in patients with snoring in North Indian population.
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Kornej J, Lin H, Trinquart L, Jackson CR, Ko D, Benjamin EJ, Preis SR. Neck Circumference and Risk of Incident Atrial Fibrillation in the Framingham Heart Study. J Am Heart Assoc 2022; 11:e022340. [PMID: 35156385 PMCID: PMC9245798 DOI: 10.1161/jaha.121.022340] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Increased neck circumference, a proxy for upper‐body subcutaneous fat, is associated with cardiovascular risk and metabolic risk factors, accounting for body mass index (BMI) and waist circumference. The association between neck circumference and incident atrial fibrillation (AF) is unclear. The aim of current study was to evaluate the association between neck circumference and incident AF. Methods and Results We selected participants from the Framingham Heart Study aged ≥55 years without diagnosed AF and with available neck circumference, BMI, and waist circumference measurements. We defined high neck circumference as ≥14 inches in women and ≥17 inches in men on the basis of the Contal and O’Quigley changepoint method. We used Fine‐Gray models to estimate subdistribution hazards ratios (sHRs) for the association between neck circumference and incident AF accounting for the competing risk of death. We adjusted models for clinical risk factors. We then additionally adjusted separately for BMI, waist circumference, and height/weight. The study sample included 4093 participants (mean age 64±7 years, 55% female). During 11.2±5.7 mean years of follow‐up, incident AF occurred in 571 participants. High neck circumference was associated with incident AF (sHR for high versus low: 1.58; 95% CI, 1.32–1.90, P<0.0001). The association remained significant after adjustment for BMI (sHR, 1.51; 95% CI, 1.21–1.89; P=0.0003), waist circumference (sHR, 1.47; 95% CI, 1.18–1.83; P<0.0001), and height/weight (sHR, 1.37; 95% CI, 1.09–1.72; P=0.007). Conclusions High neck circumference was associated with incident AF adjusting for traditional adiposity measures such as BMI and waist circumference.
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Affiliation(s)
- Jelena Kornej
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Section of Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA
| | - Honghuang Lin
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Section of Computational Biomedicine Department of Medicine Boston University School of Medicine Boston MA
| | - Ludovic Trinquart
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Department of Biostatistics Boston University School of Public Health Boston MA
| | | | - Darae Ko
- Section of Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA
| | - Emelia J. Benjamin
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Section of Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA
- Department of Epidemiology Boston University School of Public Health Boston MA
| | - Sarah R. Preis
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Department of Biostatistics Boston University School of Public Health Boston MA
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He ZY, Gu X, Du LJ, Hu X, Zhang XX, Yang LJ, Li YQ, Li J, Pan LY, Yang B, Gu XJ, Lin XL. Neck-to-height ratio is positively associated with diabetic kidney disease in Chinese patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:1100354. [PMID: 36704030 PMCID: PMC9871585 DOI: 10.3389/fendo.2022.1100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The aim of this study was to investigate the associations of neck circumference (NC) and neck-to-height (NHR) with diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS A total of 2,615 patients with prevalent T2DM were enrolled. NHR was calculated through NC (cm) divided by height (cm), and prevalent DKD was defined as the urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g or the estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2 in the absence of other primary kidney diseases. RESULTS The levels of NC and NHR were higher in DKD patients compared with non-DKD patients (38.22 vs. 37.71, P = 0.003; 0.232 vs. 0.227, P < 0.001, respectively). After full adjustments, individuals at the highest tertile of NHR had higher odds of DKD than those at the lowest tertile (multivariate-adjusted OR = 1.63, 95% CI: 1.22, 2.18), but this association was not pronounced with NC (multivariate-adjusted OR = 1.24, 95% CI: 0.87, 1.76). Individuals at the highest tertile of NHR had lower eGFR (β = -4.64, 95% CI: -6.55, -2.74) and higher UACR levels (β = 0.27, 95% CI: 0.10, 0.45) than those at the lowest tertile. The adverse association between NHR and prevalent DKD remained statistically significant among most of the subgroups analyzed and no interaction effects were observed. CONCLUSION The increase in NHR was adversely and independently associated with DKD in this Chinese T2DM population.
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Affiliation(s)
- Zhi-Ying He
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao Gu
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lin-Jia Du
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiang Hu
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xing-Xing Zhang
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li-Juan Yang
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ying-Qian Li
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Li
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lin-Yu Pan
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bo Yang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China
| | - Xue-Jiang Gu
- Department of Endocrine and Metabolic Disease, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Xiu-Li Lin, ; Xue-Jiang Gu,
| | - Xiu-Li Lin
- Department of Infection, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- *Correspondence: Xiu-Li Lin, ; Xue-Jiang Gu,
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Tsai CY, Liu WT, Lin YT, Lin SY, Houghton R, Hsu WH, Wu D, Lee HC, Wu CJ, Li LYJ, Hsu SM, Lo CC, Lo K, Chen YR, Lin FC, Majumdar A. Machine learning approaches for screening the risk of obstructive sleep apnea in the Taiwan population based on body profile. Inform Health Soc Care 2021; 47:373-388. [PMID: 34886766 DOI: 10.1080/17538157.2021.2007930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
(a) Objective: Obstructive sleep apnea syndrome (OSAS) is typically diagnosed through polysomnography (PSG). However, PSG incurs high medical costs. This study developed new models for screening the risk of moderate-to-severe OSAS (apnea-hypopnea index, AHI ≥15) and severe OSAS (AHI ≥30) in various age groups and sexes by using anthropometric features in the Taiwan population.(b) Participants: Data were derived from 10,391 northern Taiwan patients who underwent PSG.(c) Methods: Patients' characteristics - namely age, sex, body mass index (BMI), neck circumference, and waist circumference - was obtained. To develop an age- and sex-independent model, various approaches - namely logistic regression, k-nearest neighbor, naive Bayes, random forest (RF), and support vector machine - were trained for four groups based on sex and age (men or women; aged <50 or ≥50 years). Dataset was separated independently (training:70%; validation: 10%; testing: 20%) and Cross-validated grid search was applied for model optimization. Models demonstrating the highest overall accuracy in validation outcomes for the four groups were used to predict the testing dataset.(d) Results: The RF models showed the highest overall accuracy. BMI was the most influential parameter in both types of OSAS severity screening models.(e) Conclusion: The established models can be applied to screen OSAS risk in the Taiwan population and those with similar craniofacial features.
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Affiliation(s)
- Cheng-Yu Tsai
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Wen-Te Liu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Engineering Science, National Cheng Kung University, Tainan, Taiwan
| | - Yin-Tzu Lin
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shang-Yang Lin
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Robert Houghton
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Biomedical Science and Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Lok Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Shin-Mei Hsu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chen-Chen Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kang Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - You-Rong Chen
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Feng-Ching Lin
- Division of Integrated Diagnostic and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.,Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Taipei, Taiwan
| | - Arnab Majumdar
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, UK
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Pouragha H, Amiri M, Saraei M, Pouryaghoub G, Mehrdad R. Body impedance analyzer and anthropometric indicators; predictors of metabolic syndrome. J Diabetes Metab Disord 2021; 20:1169-1178. [PMID: 34277496 PMCID: PMC8275900 DOI: 10.1007/s40200-021-00836-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022]
Abstract
Aim Metabolic syndrome is one of the outcomes of a sedentary lifestyle in the modern world. In this study, we want to introduce the predictors of metabolic syndrome using anthropometric indices and Bio-Electrical Impedance Analysis (BIA) test values. Method This cross-sectional study was performed on 2284 employees of Tehran University of Medical Sciences in different job categories. Metabolic syndrome was determined according to IDF criteria. Anthropometric dimensions, para-clinical tests, basic information were collected from the participants. Also, the body analysis of the participants was performed using a BIA method. Result The prevalence of metabolic syndrome in this study was 23.2% based on IDF criteria, which was 21% and 26.6% in men and women, respectively. The most important factor among the components of IDF criteria was HDL deficiency. In this study, neck circumference, fat mass, visceral fat, muscle mass percentage and waist to height ratio were observed as predictors of metabolic syndrome. Conclusion This study realized that there is association between fat mass, fat-free mass, visceral fat and muscle mass which all are some elements of body composition analysis and metabolic syndrome as a major health issue.
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Affiliation(s)
- Hamidreza Pouragha
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Amiri
- Occupational Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Department of Occupational Medicine, School of Medicine Baharlou Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Pouryaghoub
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
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Herrera-Cuenca M, Kovalskys I, Gerardi A, Hernandez P, Sifontes Y, Gómez G, Yépez García MC, Méndez-Pérez B, Landaeta-Jimenez M, Pareja R, Cortés LY, Rigotti A, Fisberg M, Zimberg IZ. Anthropometric Profile of Latin American Population: Results From the ELANS Study. Front Nutr 2021; 8:740361. [PMID: 34820411 PMCID: PMC8606788 DOI: 10.3389/fnut.2021.740361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/05/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Latin America has experienced changes in lifestyle since 1960. Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity. Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status. Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%). Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.
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Affiliation(s)
- Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV), Caracas, Venezuela
- Fundación Bengoa para la Alimentación y Nutrición, Caracas, Venezuela
| | - Irina Kovalskys
- Facultad de Medicina, Pontificia Universidad Católica de Argentina, Buenos Aires, Argentina
| | - Alejandro Gerardi
- Facultad de Medicina, Pontificia Universidad Católica de Argentina, Buenos Aires, Argentina
| | - Pablo Hernandez
- Escuela de Nutrición y Dietética, Universidad Central de Venezuela, Caracas, Venezuela
| | - Yaritza Sifontes
- Fundación Bengoa para la Alimentación y Nutrición, Caracas, Venezuela
- Escuela de Nutrición y Dietética, Universidad Central de Venezuela, Caracas, Venezuela
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | | | - Betty Méndez-Pérez
- Unidad de Investigación en Bioantropología, Actividad Física y Salud, Instituto de Investigaciones Económicas y Sociales Rodolfo Quintero, Universidad Central de Venezuela, Caracas, Venezuela
| | | | | | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Egydio Setubal, Sabará Hospital Infantil, São Paulo, Brazil
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Iona Zalcman Zimberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Ulander M, Rångtell F, Theorell-Haglöw J. Sleep Measurements in Women. Sleep Med Clin 2021; 16:635-648. [PMID: 34711387 DOI: 10.1016/j.jsmc.2021.07.004] [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: 11/25/2022]
Abstract
Sleep in women and men have been studied in several studies with higher prevalence of sleep complaints in women compared with men. Several factors can affect sleep and could be argued to contribute to sex and gender differences in general sleep. There are no differences in guidelines when measuring sleep in women but several sleep assessment tools have been validated or compared between sexes. Because there is still a lack of knowledge on sleep measurements in women, the present review aimed to produce an overview of the current knowledge of objective and subjective sleep measurements in women.
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Affiliation(s)
- Martin Ulander
- Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linkoping University, Sjukhusvägen, 581 83 Linkoping, Sweden; Department of Clinical Neurophysiology, Linköping University Hospital, Linköping S-581 85, Sweden
| | - Frida Rångtell
- Slumra of Sweden AB, Tiundagatan 41, Uppsala 75230, Sweden
| | - Jenny Theorell-Haglöw
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Box 256, Uppsala 751 05, Sweden.
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Asil S, Murat E, Taşkan H, Barış VÖ, Görmel S, Yaşar S, Çelik M, Yüksel UÇ, Kabul HK, Barçın C. Relationship between Cardiovascular Disease Risk and Neck Circumference Shown in the Systematic Coronary Risk Estimation (SCORE) Risk Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10763. [PMID: 34682509 PMCID: PMC8535320 DOI: 10.3390/ijerph182010763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The most important way to reduce CVD-related mortality is to apply appropriate treatment according to the risk status of the patients. For this purpose, the SCORE risk model is used in Europe. In addition to these risk models, some anthropometric measurements are known to be associated with CVD risk and risk factors. OBJECTIVES This study aimed to investigate the association of these anthropometric measurements, especially neck circumference (NC), with the SCORE risk chart. METHODS This was planned as a cross-sectional study. The study population were classified according to their SCORE risk values. The relationship of NC and other anthropometric measurements with the total cardiovascular risk indicated by the SCORE risk was investigated. RESULTS A total of 232 patients were included in the study. The patients participating in the study were analysed in four groups according to the SCORE ten-year total cardiovascular mortality risk. As a result, the NC was statistically significantly lower among the SCORE low and moderate risk group than all other SCORE risk groups (low-high and very high 36(3)-38(4) (IQR) p: 0.026, 36(3)-39(4) (IQR) p < 0.001, 36(3)-40(4) (IQR) p < 0.001), (moderate-high and very high 38(4) vs. 39(4) (IQR) p: 0.02, 38(4) vs. 40(4) (IQR) p < 0.001, 39(4) vs. 40(4) (IQR) p > 0.05). NC was found to have the strongest correlation with SCORE than the other anthropometric measurements. CONCLUSIONS Neck circumference correlates strongly with the SCORE risk model which shows the ten-year cardiovascular mortality risk and can be used in clinical practice to predict CVD risk.
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Affiliation(s)
- Serkan Asil
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Ender Murat
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Hatice Taşkan
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Veysel Özgür Barış
- Department of Cardiology, Gaziantep Dr. Ersin Arslan Training and Research Hospital, 27010 Gaziantep, Turkey;
| | - Suat Görmel
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Salim Yaşar
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Murat Çelik
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Uygar Çağdaş Yüksel
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Hasan Kutsi Kabul
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
| | - Cem Barçın
- Department of Cardiology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey; (E.M.); (H.T.); (S.G.); (S.Y.); (M.Ç.); (U.Ç.Y.); (H.K.K.); (C.B.)
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Wang H. Analyzing Neck Circumference as a Tool for Evaluating Overweight and Obesity in Chinese Adolescents. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1274627. [PMID: 34659678 PMCID: PMC8514922 DOI: 10.1155/2021/1274627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
Overweight and obesity at an early age are important criteria for predicting chronic diseases. Each anthropometric method available to assess obesity has its limitations. Recently, neck circumference (NC) has received greater attention as a new evaluation index. This study aimed to investigate the relationship between NC and overweight in Chinese Yi adolescents. A total of 647 Chinese Yi male and female students, aged 13-18 years, were randomly selected from a junior high school and a senior middle school in Leshan, Sichuan Province of China. The measurement indexes included height, weight, waist circumference (WC), and NC, and clinical information was collected by trained physicians. The neck cutoff values were determined through the receiver operating characteristic (ROC) curve and the area under the curve (AUC). The correlation among NC, body mass index (BMI), and WC was determined by Pearson's correlation coefficient. The ROC analysis revealed that the AUC values were 0.79-0.95 for boys and 0.83-0.91 for girls. The correlation among NC, BMI, and WC in obese boys and girls was higher than 0.70 in both genders. In addition, the NC cutoff values of high BMI ranged from 31.0 cm to 36.1 cm for boys and 31.2 cm to 34.5 cm for girls, respectively. There was a significant positive correlation between NC and obesity in Chinese Yi adolescents. The NC can be used as an additional index to predict the obesity of Chinese Yi adolescents.
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Affiliation(s)
- Hui Wang
- Department of Physical Education, Xiamen University TKK College, Zhangzhou 363105, China
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Chen B, Drager LF, Peker Y, Vgontzas AN, Phillips CL, Hoyos CM, Salles GF, Guo M, Li Y. Effect of Continuous Positive Airway Pressure on Weight and Local Adiposity in Adults with Obstructive Sleep Apnea: A Meta-Analysis. Ann Am Thorac Soc 2021; 18:1717-1727. [PMID: 33740390 DOI: 10.1513/annalsats.202101-060oc] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Rationale: Evidence suggests that continuous positive airway pressure (CPAP) treatment promotes weight gain in patients with obstructive sleep apnea (OSA). It is unclear whether weight gain is influenced by CPAP adherence or comorbid disorders. Objectives: To examine the CPAP effects on body mass index (BMI) and local adiposity and the potential moderators of CPAP effects on BMI in patients with OSA. Methods: We searched PubMed/Medline, Embase, and Cochrane through December 2019. Randomized controlled trials of CPAP versus control treatment with ⩾4 weeks' treatment were included. Results: A total of 39 randomized controlled trials with 6,954 subjects were included. In intention-to-treat analysis, the BMI increased significantly after CPAP treatment compared with control treatment (weighted mean difference [WMD], 0.148 kg/m2; 95% confidence interval, 0.04-0.26; P = 0.001). In studies demonstrating an increase in the BMI, waist and neck circumferences were also significantly increased. Subgroup analyses revealed that an increased BMI was attributable to CPAP use of ⩽5 h/night (WMD, 0.231) but was not attributable to CPAP use of >5 h/night (WMD, 0.001; between-group P value = 0.049). Furthermore, the BMI increased significantly in patients without cardiovascular disease (CVD; WMD, 0.200), whereas it decreased significantly in those with CVD at baseline (WMD, -0.188; between-group P value < 0.001). Moreover, the BMI increased significantly in patients with dysglycemia (WMD, 0.499) but did not increase in those without dysglycemia at baseline (WMD, 0.100; between-group P value = 0.032). Meta-regression confirmed the subgroup findings. Conclusions: The BMI increased significantly in patients with OSA after CPAP treatment, especially in those with CPAP use of ⩽5 h/night, without CVD and/or with dysglycemia at baseline. CPAP use of at least 5 h/night seems to be necessary in mitigating the risk for weight gain in patients with OSA.
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Affiliation(s)
- Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, and
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Luciano F Drager
- Unidade de Hipertensao, Instituto do Coração e Unidade de Hipertensao, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Yüksel Peker
- Research Center for Translational Medicine, Koc University, Istanbul, Turkey
- Department of Pulmonary Medicine, Koc University Hospital, Istanbul, Turkey
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Faculty of Medicine, Lund University, Lund, Sweden
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania
| | - Craig L Phillips
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, and
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia; and
| | - Gil F Salles
- Department of Internal Medicine, Clementino Fraga Filho University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Miaolan Guo
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, and
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
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Morinigo R, Quraishi SA, Ewing S, Azocar RJ, Schumann R. The B-APNEIC score: distilling the STOP-Bang questionnaire to identify patients at high risk for severe obstructive sleep apnoea. Anaesthesia 2021; 77:286-292. [PMID: 34473837 DOI: 10.1111/anae.15571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 12/16/2022]
Abstract
The STOP-Bang questionnaire is an established clinical screening tool to identify the risk of having mild, moderate or severe obstructive sleep apnoea using eight variables. It is unclear whether all eight variables contribute equally to the risk of clinically significant obstructive sleep apnoea. We analysed each variable for its contribution to detecting obstructive sleep apnoea; based on the results, we investigated whether the STOP-Bang questionnaire could be abbreviated to identify patients at high risk for severe obstructive sleep apnoea. We recruited patients with suspected obstructive sleep apnoea who were referred for overnight polysomnography. We used multivariable logistic regression to investigate the association of STOP-Bang parameters with severe obstructive sleep apnoea based on clinical and polysomnography data. Regression estimates were used to select variables to create the novel B-APNEIC score. We constructed receiver operating characteristic curves for the STOP-Bang questionnaire and B-APNEIC scores to identify patients with severe obstructive sleep apnoea and compared the areas under the curve using the DeLong method. Of the 275 patients enrolled, 32% (n = 88) had severe obstructive sleep apnoea. Logistic regression demonstrated that neck circumference (OR 2.20; 95%CI 1.10-4.40, p = 0.03) was the only variable independently associated with severe obstructive sleep apnoea. Observed apnoea during sleep, blood pressure and body mass index were the three next most closely trending predictors of severe obstructive sleep apnoea and were included along with neck circumference in the B-APNEIC score. Receiver operating curves demonstrated that the areas under the curve for STOP-Bang vs. B-APNEIC were comparable for identifying patients with severe obstructive sleep apnoea (OR 0.75; 95%CI 0.68-0.81 vs. OR 0.75; 95%CI 0.68-0.81: p = 0.99, respectively). Our results suggest that the B-APNEIC score is a simplified adaptation of the STOP-Bang questionnaire with equivalent effectiveness in identifying patients with severe obstructive sleep apnoea. Further studies are needed to validate and build on our findings.
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Affiliation(s)
- R Morinigo
- Department of Anesthesiology and Peri-operative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - S A Quraishi
- Department of Anesthesiology and Peri-operative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - S Ewing
- Department of Anesthesiology and Peri-operative Medicine, Tufts Medical Center, Boston, MA, USA
| | - R J Azocar
- Department of Anesthesiology and Peri-operative Medicine, Tufts Medical Center, Boston, MA, USA
| | - R Schumann
- Veterans Affairs Health Care System, Boston, MA, USA
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Shokri-Mashhadi N, Moradi S, Mohammadi H, Ghavami A, Rouhani MH. Association between neck circumference and lipid profile: a systematic review and meta-analysis of observational studies. Eur J Cardiovasc Nurs 2021; 20:588-603. [PMID: 33580771 DOI: 10.1093/eurjcn/zvaa018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/07/2020] [Accepted: 11/04/2020] [Indexed: 12/29/2022]
Abstract
AIMS Previous studies suggested that neck circumference (NC) as a new, simple, and valuable tool for the measuring obesity. However, the results of studies regarding the relationship between blood lipids and neck circumference were inconsistent. Therefore, we aimed to perform a systematic review and meta-analysis to summarize the association between NC and lipid profiles in adults. METHODS AND RESULTS PubMed and Scopus electronic databases were searched until 30 June 2018 to find articles that reported the association between NC and blood lipids. Mean serum lipids and variables contributed to heterogeneity were extracted. Sources of inter-study heterogeneity were determined by subgroup analysis. Of 2490 publications identified, 33 studies were included in the qualitative and quantitative synthesis. We found an inverse correlation between NC and high-density lipoprotein cholesterol [HDL-C; overall Fisher's Z = -0.18; 95% confidence interval (CI): -0.21, -0.15]. Furthermore, we found positive associations between NC and total cholesterol (TC; overall Fisher's Z = 0.11; 95% CI = 0.06, 0.16), low-density lipoprotein cholesterol (LDL-C; overall Fisher's Z = 0.1; 95% CI = -0.04, 0.16), and triglyceride (TG; overall Fisher's Z = 0.21; 95% CI = 0.17, 0.25) in men. Neck circumference was directly correlated to TC (overall Fisher's Z = 0.1; 95% CI = 0.01, 0.19) and LDL-C (overall Fisher's Z = 0.16; 95% CI = 0.12, 0.20) in healthy and unhealthy women, respectively. There was no correlation between NC and serum concentration of TC (overall Fisher's Z = 0.01; 95% CI = -0.02, 0.03) and LDL-C (overall Fisher's Z = 0.09; 95% CI = 0.02, 0.16) in unhealthy and healthy women, respectively. CONCLUSION Higher NC in unhealthy men was strongly indirectly associated with HDL-C, and directly related to LDL-C, TG, and TC. In unhealthy women, higher NC was inversely associated with HDL and directly related to LDL-C.
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Affiliation(s)
- Nafiseh Shokri-Mashhadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, 2348569, Iran
| | - Sajjad Moradi
- Student Research Committee, School of Nutrition and Food Science, Department of Clinical Nutrition, Isfahan University of Medical Sciences, Isfahan, 2348569, Iran
| | - Hamed Mohammadi
- Student Research Committee, School of Nutrition and Food Science, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, 2348569, Iran
| | - Abed Ghavami
- Student Research Committee, School of Nutrition and Food Science, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, 2348569, Iran
| | - Mohammad Hossein Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, 2348569, Iran
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Hussain WG, Shehzad F, Ahmad R, Akbar A. Establishing growth charts for proposed body shape and size index of the Pakistani population, using quantile regression approach. SAGE Open Med 2021; 9:20503121211036135. [PMID: 34394930 PMCID: PMC8351037 DOI: 10.1177/20503121211036135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 07/12/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Obesity leads to other fatal diseases like diabetes, cardiovascular diseases, depression, and some forms of cancer. Still, the well-known tool to measure obesity is the body mass index. But it usually failed in the measurement of adipose tissues. So, we present a novel anthropometric measure, called body shape and size index which is developed by the combination of major anthropometric determinants: body surface area, body mass index, weight, and height. Methods: This study is based on cross-sectional data consisting of 7224 individuals that were taken from the city Multan, Punjab, Pakistan. All the individuals, both males, and females, of age 2 years and above were included in the study except the pregnant women. The variables included in this study are gender, area (urban and rural), age (years), weight (kg), and height (meters). Growth charts of quantile regression are used for the inferential analysis of data. Comparison of proposed body shape and size index at different obesity levels has also been made to access the relationship of proposed body shape and size index with obesity. Results: The results show that the proposed body shape and size index has a great association with body surface area, body mass index, weight, height, and age. The proposed body shape and size index has a high negative association with body surface area, moderate negative association with body mass index and weight, and low negative association with height and age. According to growth charts of body shape and size index, after the age of 25 years, body shape and size index curves go upward while it smoothly goes downward at the age of 50 years but decreases in earlier ages. Body shape and size index showed a significant association with body shape and body size (body development) at the same time. Conclusion: Body shape and size index is found, generally linear with age, and increased with decreasing body mass index and body surface area. The proposed index has an indirect relationship with obesity. Body shape and size index with low values indicates a high risk of obesity. While, however, body shape and size index with high values indicates a low risk of obesity. Applications of the proposed body shape and size index are also presented in statistical modeling.
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Affiliation(s)
- Waqas Ghulam Hussain
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Farrukh Shehzad
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Rashid Ahmad
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Atif Akbar
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
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Shin C, Baik I. Evaluation of a Modified STOP-BANG Questionnaire for Sleep Apnea in Adults from the Korean General Population. SLEEP MEDICINE RESEARCH 2021. [DOI: 10.17241/smr.2020.00808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Reis SS, Callejas GH, Marques RA, Gestic MA, Utrini MP, Chaim FDM, Ramos AC, Chaim EA, Cazzo E. Correlation Between Anthropometric Measurements and Non-alcoholic Fatty Liver Disease in Individuals With Obesity Undergoing Bariatric Surgery: Cross-Sectional Study. Obes Surg 2021; 31:3675-3685. [PMID: 33982243 DOI: 10.1007/s11695-021-05470-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND We hypothesize that non-alcoholic fatty liver disease (NAFLD) may be significantly associated with waist circumference (WC), neck circumference (NC), hip circumference (HC), and waist-to-hip ratio (WHR). OBJECTIVES To analyze correlations between anthropometric parameters and the occurrence and intensity of NAFLD aspects assessed by histopathological examination in individuals undergoing bariatric surgery. METHODS This is a cross-sectional study carried out in a tertiary university hospital. Demographic, clinical, anthropometric, laboratory, and histopathological variables were analyzed; uni- and multivariate analyses were performed. Histopathological variables analyzed were findings of liver biopsies collected during surgical procedures. RESULTS Of 119 individuals, 105 (88.2%) were female. The mean age was 38.8 ± 9.3 years and the mean BMI was 37.6 ± 3.1 kg/m2. The prevalence of NAFLD histopathological aspects was: steatosis (76.5%), steatohepatitis (49.6%), and fibrosis (51.3%). WC was significantly higher in individuals with steatosis (103.5 ± 9.9 vs. 99.4 ± 8.4; p = 0.03). Individuals with steatohepatitis presented significantly higher BMI (38.2 ± 3.2 vs. 36.7 ± 2.8; p = 0.01), WC (105.3 ± 10.4 vs. 99.6 ± 8.8; p = 0.002), and WHR (1 ± 0.1 vs. 0.9 ± 0.1; p = 0.02). Age (40.6 ± 9.7 vs. 37 ± 8.5; p = 0.03) and hemoglobin A1c (6.5 ± 0.5 vs. 5.6 ± 0.5; p = 0.004) were significantly higher among individuals with fibrosis. A positive correlation was observed between the steatosis intensity and WHR (R = 0.2; p = 0.04). BMI (R = 0.2; p = 0.02) and glucose (R = 0.2; p = 0.009) were independently correlated with the steatohepatitis intensity. Age (R = 0.3; p = 0.04) was independently correlated with the fibrosis intensity. CONCLUSION There were significant associations between anthropometric parameters and NAFLD aspects. WC and WHR were associated with steatosis; BMI, WC, and WHR were associated with steatohepatitis. WHR independently correlated with steatosis intensity.
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Affiliation(s)
- Silênio Souza Reis
- Special Academic Unit of Health Sciences (UAE-CISAU), Federal University of Jataí (UFJ), Jataí, Brazil
| | - Guilherme Hoverter Callejas
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Rodolfo Araújo Marques
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Martinho A Gestic
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Murillo P Utrini
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Felipe D M Chaim
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Almino C Ramos
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Elinton A Chaim
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil
| | - Everton Cazzo
- Department of Surgery-Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Alexander Fleming, s/nº, Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
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Wang H, Goodman MO, Sofer T, Redline S. Cutting the fat: advances and challenges in sleep apnoea genetics. Eur Respir J 2021; 57:57/5/2004644. [PMID: 33958377 DOI: 10.1183/13993003.04644-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/10/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Heming Wang
- Division of Sleep and Circadian Disorders, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew O Goodman
- Division of Sleep and Circadian Disorders, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Bioelectrical Impedance Analysis and Manual Measurements of Neck Circumference Are Interchangeable, and Declining Neck Circumference Is Related to Presarcopenia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6622398. [PMID: 33860044 PMCID: PMC8024069 DOI: 10.1155/2021/6622398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/26/2021] [Accepted: 03/20/2021] [Indexed: 02/07/2023]
Abstract
Purpose Preventive medicine is important in an aging society. Presarcopenia is the preliminary stage of sarcopenia. Recent advances in bioelectrical impedance analysis (BIA) devices have enabled automatic estimation of neck circumference (NC). However, the agreement between and interchangeability of NC measured manually and that calculated with BIA have not been evaluated. We performed these analyses in the context of health checkups and investigated their associations with presarcopenia. Methods We enrolled 318 participants who underwent anthropometric measurements, including NC measured manually and by BIA; assessment of physical function; and blood testing. We used Bland-Altman analysis to calculate the agreement between and interchangeability of NC measurements by BIA and by the manual method. We then statistically compared normal participants and those with presarcopenia. Using multivariable analysis, we subsequently investigated significant risk factors for presarcopenia. We defined presarcopenia according to the appendicular skeletal muscle index (aSMI; the ratio of arm and leg skeletal muscle mass to height2). Results Bland-Altman analysis showed that bias (BIA-manual) was negative overall (−1.07), for male participants (−1.23), and for female participants (−0.96). This finding suggests that BIA measurement is an underestimate in comparison with manual measurement. NC measurement by BIA was found to be interchangeable with that by manual methods, inasmuch as the percentage error was less than 5% overall (4.38%), for male participants (3.81%), and for female participants (4.58%). Univariable analysis revealed that NC was significantly smaller in the participants with presarcopenia than in those without. Multivariable analysis, adjusted for confounding factors, revealed that a decrease in NC was significantly correlated with presarcopenia. Conclusions BIA measurements of NC are interchangeable within about 95% with manual measurements. The decrease in NC measured by BIA was significantly associated with presarcopenia in both genders. NC measurement can be used for early detection of presarcopenia.
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Purnell JQ, Dewey EN, Laferrère B, Selzer F, Flum DR, Mitchell JE, Pomp A, Pories WJ, Inge T, Courcoulas A, Wolfe BM. Diabetes Remission Status During Seven-year Follow-up of the Longitudinal Assessment of Bariatric Surgery Study. J Clin Endocrinol Metab 2021; 106:774-788. [PMID: 33270130 PMCID: PMC7947785 DOI: 10.1210/clinem/dgaa849] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Indexed: 12/13/2022]
Abstract
CONTEXT Few studies have examined the clinical characteristics that predict durable, long-term diabetes remission after bariatric surgery. OBJECTIVE To compare diabetes prevalence and remission rates during 7-year follow-up after Roux-en-Y gastric bypass (RYGB) and laparoscopic gastric banding (LAGB). DESIGN An observational cohort of adults with severe obesity recruited between 2006 and 2009 who completed annual research assessments for up to 7 years after RYGB or LAGB. SETTING Ten US hospitals. PARTICIPANTS A total sample of 2256 participants, 827 with known diabetes status at both baseline and at least 1 follow-up visit. INTERVENTIONS Roux-en-Y gastric bypass or LAGB. MAIN OUTCOME MEASURES Diabetes rates and associations of patient characteristics with remission status. RESULTS Diabetes remission occurred in 57% (46% complete, 11% partial) after RYGB and 22.5% (16.9% complete, 5.6% partial) after LAGB. Following both procedures, remission was greater in younger participants and those with shorter diabetes duration, higher C-peptide levels, higher homeostatic model assessment of β-cell function (HOMA %B), and lower insulin usage at baseline, and with greater postsurgical weight loss. After LAGB, reduced HOMA insulin resistance (IR) was associated with a greater likelihood of diabetes remission, whereas increased HOMA-%B predicted remission after RYGB. Controlling for weight lost, diabetes remission remained nearly 4-fold higher compared with LAGB. CONCLUSIONS Durable, long-term diabetes remission following bariatric surgery is more likely when performed soon after diagnosis when diabetes medication burden is low and beta-cell function is preserved. A greater weight-independent likelihood of diabetes remission after RYGB than LAGB suggests mechanisms beyond weight loss contribute to improved beta-cell function after RYGB.Trial Registration clinicaltrials.gov Identifier: NCT00465829.
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Affiliation(s)
- Jonathan Q Purnell
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
- Correspondence and Reprint Requests: Jonathan Q Purnell, MD, Knight Cardiovascular Institute, HRC5N, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239. E-mail:
| | - Elizabeth N Dewey
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Blandine Laferrère
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Faith Selzer
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - David R Flum
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - James E Mitchell
- Department of Clinical Neuroscience, University of North Dakota, Fargo, ND, USA
| | - Alfons Pomp
- Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Walter J Pories
- Department of Surgery, East Carolina University, Greenville, NC, USA
| | - Thomas Inge
- Department of Surgery, University of Colorado, Denver, CO, USA
| | - Anita Courcoulas
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bruce M Wolfe
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA
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Liu Y, Zhang X, Lee J, Smelser D, Cade B, Chen H, Zhou H, Kirchner HL, Lin X, Mukherjee S, Hillman D, Liu CT, Redline S, Sofer T. Genome-wide association study of neck circumference identifies sex-specific loci independent of generalized adiposity. Int J Obes (Lond) 2021; 45:1532-1541. [PMID: 33907307 PMCID: PMC8236408 DOI: 10.1038/s41366-021-00817-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/06/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND/OBJECTIVES Neck circumference, an index of upper airway fat, has been suggested to be an important measure of body-fat distribution with unique associations with health outcomes such as obstructive sleep apnea and metabolic disease. This study aims to study the genetic bases of neck circumference. METHODS We conducted a multi-ethnic genome-wide association study of neck circumference, adjusted and unadjusted for BMI, in up to 15,090 European Ancestry (EA) and African American (AA) individuals. Because sexually dimorphic associations have been observed for anthropometric traits, we conducted both sex-combined and sex-specific analysis. RESULTS We identified rs227724 near the Noggin (NOG) gene as a possible quantitative locus for neck circumference in men (N = 8831, P = 1.74 × 10-9) but not in women (P = 0.08). The association was replicated in men (N = 1554, P = 0.045) in an independent dataset. This locus was previously reported to be associated with human height and with self-reported snoring. We also identified rs13087058 on chromosome 3 as a suggestive locus in sex-combined analysis (N = 15090, P = 2.94 × 10-7; replication P =0.049). This locus was also associated with electrocardiogram-assessed PR interval and is a cis-expression quantitative locus for the PDZ Domain-containing ring finger 2 (PDZRN3) gene. Both NOG and PDZRN3 interact with members of transforming growth factor-beta superfamily signaling proteins. CONCLUSIONS Our study suggests that neck circumference may have unique genetic basis independent of BMI.
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Affiliation(s)
- Yaowu Liu
- grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Xiaoyu Zhang
- grid.189504.10000 0004 1936 7558Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Jiwon Lee
- grid.62560.370000 0004 0378 8294Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA USA
| | - Diane Smelser
- grid.415341.60000 0004 0433 4040Department of Molecular and Functional Genomics, Geisinger Clinic, Danville, PA USA
| | - Brian Cade
- grid.62560.370000 0004 0378 8294Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Medicine, Harvard Medical School, Boston, MA USA
| | - Han Chen
- grid.267308.80000 0000 9206 2401Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX USA ,grid.267308.80000 0000 9206 2401Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Hufeng Zhou
- grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - H. Lester Kirchner
- grid.415341.60000 0004 0433 4040Department of Population Health Sciences, Geisinger Clinic, Danville, PA USA
| | - Xihong Lin
- grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Statistics, Harvard University, Cambridge, MA USA
| | - Sutapa Mukherjee
- Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, SA Australia ,grid.1014.40000 0004 0367 2697Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA Australia
| | - David Hillman
- grid.1012.20000 0004 1936 7910School of Human Sciences, The University of Western Australia, Perth, WA Australia
| | - Ching-Ti Liu
- grid.189504.10000 0004 1936 7558Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Susan Redline
- grid.62560.370000 0004 0378 8294Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Medicine, Harvard Medical School, Boston, MA USA
| | - Tamar Sofer
- grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.62560.370000 0004 0378 8294Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Medicine, Harvard Medical School, Boston, MA USA
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Yan Q, Sun D, Li X, Zheng Q, Long H, Feng B. Neck Circumference and Incidence of Type 2 Diabetes in Chinese Elderly Individuals: A Community-Based Cohort Study. Obes Facts 2021; 14:450-455. [PMID: 34428761 PMCID: PMC8546435 DOI: 10.1159/000514219] [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: 06/26/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This study aimed to investigate whether neck circumference (NC) was associated with the incidence of type 2 diabetes in Chinese elderly individuals. METHODS A community-based cohort study was conducted on elderly inhabitants in Shanghai with a mean age of 71.0 ± 5.8 years (n = 2,646). Binary logistic regression analysis was performed to evaluate the association between NC and the prevalence of type 2 diabetes, while a Cox regression model was used to determine the association between NC and the incidence of type 2 diabetes after a follow-up of 2 years. RESULTS Logistic regression analysis showed that a larger NC was significantly associated with an increased risk for type 2 diabetes in men (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.07-1.31; p = 0.001) and women (OR 1.25, 95% CI 1.13-1.38; p < 0.001). Cox regression analysis revealed that NC was independently associated with the incidence of type 2 diabetes in both men (hazard ratio [HR] 1.14, 95% CI 1.05-1.23; p = 0.002) and women (HR 1.18, 95% CI 1.10-1.27; p < 0.001). CONCLUSIONS A larger NC was associated with a higher risk of developing type 2 diabetes in Chinese elderly individuals. However, studies with larger sample sizes and longer follow-up durations are needed to definitively determine the relationship between NC and the risk of developing type 2 diabetes.
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Affiliation(s)
- Qun Yan
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dongmei Sun
- Shanghai Puxing Community Health-Care Center, Shanghai, China
| | - Xu Li
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - QingHu Zheng
- Shanghai Puxing Community Health-Care Center, Shanghai, China
| | - HaiNing Long
- Shanghai Puxing Community Health-Care Center, Shanghai, China
| | - Bo Feng
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- *Bo Feng,
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Herrera-Cuenca M, Previdelli AN, Koletzko B, Hernandez P, Landaeta-Jimenez M, Sifontes Y, Gómez G, Kovalskys I, García MCY, Pareja R, Cortés LY, Rigotti A, Fisberg M. Childbearing Age Women Characteristics in Latin America. Building Evidence Bases for Early Prevention. Results from the ELANS Study. Nutrients 2020; 13:E45. [PMID: 33375712 PMCID: PMC7824015 DOI: 10.3390/nu13010045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
Latin American (LA) women have been exposed to demographic and epidemiologic changes that have transformed their lifestyle, with increasing sedentary and unhealthy eating behaviors. We aimed to identify characteristics of LA women to inform public policies that would benefit these women and their future children. The Latin American Study of Nutrition and Health (ELANS) is a multicenter cross-sectional study of representative samples in eight Latin American countries (n = 9218) with a standardized protocol to investigate dietary intake, anthropometric variables, physical activity, and socioeconomic characteristics. Here we included the subsample of all 3254 women of childbearing age (15 to <45 years). The majority of ELANS women had a low socioeconomic status (53.5%), had a basic education level (56.4%), had a mostly sedentary lifestyle (61.1%), and were overweight or obese (58.7%). According to the logistic multiple regression model, living in Peru and Ecuador predicts twice the risk of being obese, and an increased neck circumference is associated with a 12-fold increased obesity risk. An increased obesity risk was also predicted by age <19 years (Relative Risk (RR) 19.8) and adequate consumption of vitamin D (RR 2.12) and iron (RR 1.3). In conclusion, the identification of these risk predictors of obesity among Latin American women may facilitate targeted prevention strategies focusing on high-risk groups to promote the long-term health of women and their children.
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Affiliation(s)
- Marianella Herrera-Cuenca
- Center for Development Studies, Central University of Venezuela (CENDES-UCV), Caracas 1050, Venezuela
- Bengoa Foundation for Food and Nutrition, Caracas 1071, Venezuela; (M.L.-J.); (Y.S.)
| | | | - Berthold Koletzko
- Departamento Paediatrics, Division Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University of Munich, D-80377 Munich, Germany;
| | - Pablo Hernandez
- School of Nutrition and Dietetics, Faculty of Medicine, Central University of Venezuela, Caracas 1041-A, Venezuela;
| | | | - Yaritza Sifontes
- Bengoa Foundation for Food and Nutrition, Caracas 1071, Venezuela; (M.L.-J.); (Y.S.)
- School of Nutrition and Dietetics, Faculty of Medicine, Central University of Venezuela, Caracas 1041-A, Venezuela;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, University of Costa Rica, San José 11501-2060, Costa Rica;
| | - Irina Kovalskys
- Faculty of Medicine, The Pontifical Catholic University of Argentina, Buenos Aires C1107AAZ, Argentina;
| | | | - Rossina Pareja
- Nutrition Research Institute, La Molina, Lima 15026, Peru;
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110111, Colombia;
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 833-0024, Chile;
| | - Mauro Fisberg
- Instituto Pensi, José Egydio Setubal Foundation, Sabará Children’s Hospital, São Paulo 01239-040, Brazil
- Department of Pediatrics, Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-062, Brazil
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Association between Neck Circumference and the Risk of Decreased Estimated Glomerular Filtration Rate in the General Population of China: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3496328. [PMID: 33299866 PMCID: PMC7707937 DOI: 10.1155/2020/3496328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/05/2020] [Accepted: 11/07/2020] [Indexed: 12/16/2022]
Abstract
Background The burden of chronic kidney disease is increasing substantially worldwide. Neck circumference (NC), an anthropometric index for upper-body adiposity, has been recognized as an indicator of cardiometabolic diseases. However, the association between NC and renal dysfunction has not been fully disclosed. Objectives The aim of this study was to investigate the association between NC and estimated glomerular filtration rate (eGFR) in the general population in China. Methods A total of 8805 participants (3322 men and 5483 women) were enrolled in this study. Logistic regression analysis was conducted to examine the association between NC and eGFR. The male and female subjects were divided into four groups according to the NC quartiles. The primary outcome was defined as an eGFR ≤ 90 mL/min/1.73 m2. Results Logistic regression analysis revealed that in both sexes, higher NC was significantly associated with a higher risk of decreased eGFR even after fully adjusting for age, other anthropometric indexes, traditional risk factors for chronic kidney diseases, and sociologic risk factors (quartile 1 as a reference; the odds ratios [95% confidence intervals] were as follows: quartile 2, 1.26 [0.99-1.59]; quartile 3, 1.40 [1.07-1.83]; and quartile 4, 1.71 [1.22-2.38], in men; quartile 2, 1.14 [0.95-1.37]; quartile 3, 1.31 [1.03-1.66]; and quartile 4, 1.32 [1.04-1.68], in women). Stratified analyses suggested that the association was significant among subjects with prediabetes or normal serum uric acid levels and those without cardiovascular diseases (CVD). Among subjects with CVD, the association persisted only in males. When the subjects were stratified according to blood pressure or BMI, the association persisted among male subjects with abnormal blood pressure and was strengthened among male subjects who were overweight/obese, while the association disappeared among female subjects. Conclusions NC is independently associated with the risk of decreased eGFR in the general population in China, indicating that NC could contribute to renal dysfunction risk assessment.
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Lampignano L, Zupo R, Donghia R, Guerra V, Castellana F, Murro I, Di Noia C, Sardone R, Giannelli G, De Pergola G. Cross-sectional relationship among different anthropometric parameters and cardio-metabolic risk factors in a cohort of patients with overweight or obesity. PLoS One 2020; 15:e0241841. [PMID: 33152746 PMCID: PMC7644056 DOI: 10.1371/journal.pone.0241841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Body fat distribution influences the risk of cardio-metabolic disease in people with overweight. This study was aimed at identifying the anthropometric parameters more strongly associated with the majority of cardio-metabolic risk factors. METHODS This study included 1214 subjects (840 women), with a body-mass-index (BMI) ≥ 25 Kg/m2, aged 39.2 ± 13 years. Fasting blood glucose (FBG), triglycerides (TG), total, HDL- and LDL-cholesterol, uric acid, vitamin D, high-sensitive C-reactive protein (hs-CRP), white blood cells (WBC), platelets, insulin and insulin resistance (HOMA-IR), systolic (SBP) and diastolic blood pressure (DBP), smoking habit and snoring were evaluated as cardio-metabolic risk factors.We also included the Systematic COronary Risk Evaluation (SCORE) to estimate cardiovascular risk in our study population. BMI, waist circumference (WC), waist-to-height-ratio (WHtR) and neck circumference (NC) were evaluated as anthropometric parameters. RESULTS All four anthropometric parameters were positively associated to SBP, DBP, TG, FBG, insulin, HOMA-IR, WBC, and snoring (p<0.001), and negatively associated with HDL-cholesterol (p<0.001). NC showed a positive association with LDL-cholesterol (β = 0.76; p = 0.01; 95% C.I. 0.19 to 1.32), while vitamin D was negatively associated to WC (β = -0.16; p<0.001; 95% C.I. -0.24 to -0.09), BMI (β = 0.42); p<0.001; 95% C.I. -0.56 to -0.28) and WHtR (β = -24.46; p<0.001; 95% C.I. -37 to -11.9). Hs-CRP was positively correlated with WC (β = 0.003; p = 0.003; 95% C.I. 0.001 to 0.006), BMI (β = 0.01; p = 0.02; 95% C.I. 0.001 to 0.012) and WHtR (β = 0.55; p = 0.01; 95% C.I. 0.14 to 0.96). SCORE was associated to NC (β = 0.15; 95% CI 0.12 to 0.18; p<0.001), BMI (β = -0.18; 95% CI -0.22 to 0.14; p<0.001) and WHtR (β = 7.56; 95% CI 5.30 to 9.82; p<0.001). CONCLUSIONS NC, combined with BMI and WC or WHtR could represent an essential tool for use in clinical practice to define the cardio-metabolic risk in individuals with excess body weight.
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Affiliation(s)
- Luisa Lampignano
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Rossella Donghia
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Vito Guerra
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Isanna Murro
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Carmen Di Noia
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Rodolfo Sardone
- Population Health Unit—"Salus in Apulia Study” National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
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