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Hu L, Han X, Chen M, Zhang T. Association of waist circumference and BMI with premature death in young and middle-aged population. Front Public Health 2024; 12:1389766. [PMID: 38873315 PMCID: PMC11169795 DOI: 10.3389/fpubh.2024.1389766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Premature death is a global health indicator, significantly impacted by obesity, especially in young and middle-aged population. Both body mass index (BMI) and waist circumference (WC) assess obesity, with WC specifically indicating central obesity and showing a stronger relationship with mortality. However, despite known associations between BMI and premature death, as well as the well-recognized correlation between WC and adverse health outcomes, the specific relationship between WC and premature death remains unclear. Therefore, focusing on young and middle-aged individuals, this study aimed to reliably estimate independent and combined associations between WC, BMI and premature death, thereby providing causal evidence to support strategies for obesity management. Methods This study involved 49,217 subjects aged 18-50 years in the United States from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Independent and combined associations between WC and BMI with premature death across sex and age stratum were examined by Cox regression. Survey weighting and inverse probability weighting (IPW) were further considered to control selection and confounding bias. Robustness assessment has been conducted on both NHANES and China Health and Retirement Longitudinal Study (CHARLS) data. Results A linear and positive relationship between WC and all-cause premature death was found in both males and females, with adjusted HRs of 1.019 (95%CI = 1.004-1.034) and 1.065 (95%CI = 1.039-1.091), respectively. Nonlinear relationships were found with respect to BMI and all-cause premature death. For females aged 36-50 with a BMI below 28.6 kg/m2, the risk of premature death decreased as BMI increased, indicated by adjusted HRs of 0.856 (95%CI = 0.790-0.927). Joint analysis showed among people living with obesity, a larger WC increased premature death risk (HR = 1.924, 95%CI = 1.444-2.564). Discussion WC and BMI exhibited prominent associations with premature death in young and middle-aged population. Maintaining an appropriate WC and BMI bears significant implications for preventing premature death.
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Affiliation(s)
| | | | | | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Kim WJ, Lim HJ, Moon JY, Kim SH, Sung JH, Kim IJ, Lim SW, Cha DH, Kang SH. Sex differences in the impact of body mass index on outcomes of coronary artery disease in Koreans. Coron Artery Dis 2024; 35:193-200. [PMID: 38411167 DOI: 10.1097/mca.0000000000001346] [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] [Indexed: 02/28/2024]
Abstract
BACKGROUND Obesity is often considered a risk factor for cardiovascular disease, but recent studies have shown conflicting results regarding the effect of BMI on the prognosis of coronary artery disease (CAD). This study aimed to evaluate the relationship between BMI and clinical outcomes of CAD according to sex in a Korean population. METHODS A total of 3476 patients with a significant CAD who underwent percutaneous coronary intervention (PCI) were enrolled. Patients were classified as follows according to BMI using the Asia-Pacific cutoff points: underweight (<18.5 kg/m 2 ), normal weight (18.5-22.9 kg/m 2 ), overweight (23.0-24.9 kg/m 2 ) and obese (≥25 kg/m 2 ) patients. Underweight and normal weight patients were further categorized into the lower BMI group, whereas overweight and obese patients were categorized into the higher BMI group. The primary endpoint was all-cause mortality. RESULTS Among women, the higher BMI group showed poor clinical features in the prevalence of hypertension and chest pain presentation, and among men, the higher BMI group had a significantly lower rate of chronic renal failure. At the end of the follow-up period (median 53.5 months), the all-cause mortality rate was lower in the higher BMI group in men, and cardiovascular death and stroke rates were significantly lower in the higher BMI group in women. CONCLUSION In Korean CAD patients treated with PCI, inverse correlations were observed between the clinical outcomes and BMI, but there were differences between men and women.
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Affiliation(s)
- Won-Jang Kim
- Department of Cardiology, CHA Ilsan Medical Center, CHA University, Goyang-si
| | - Ha Jeong Lim
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jae Youn Moon
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang-Hoon Kim
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jung-Hoon Sung
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - In Jai Kim
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang-Wook Lim
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dong-Hun Cha
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Se Hun Kang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Pebole MM, Iverson KM, Fortier CB, Werner KB, Fonda JR, Currao A, Whitworth JW, McGlinchey RE, Galovski TE. Associations Between Head Injury, Strangulation, Cardiometabolic Health, and Functional Disability Among Female Survivors of Intimate Partner Violence. Womens Health Issues 2024; 34:208-216. [PMID: 38102057 DOI: 10.1016/j.whi.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Head injury and strangulation are highly prevalent in intimate partner violence (IPV) contexts, but there is little research examining the potential implications of these injuries on physical health and functional status. This pilot study explored the extent to which injury type (head injury, strangulation) and severity (no injury, subconcussive head injury, traumatic brain injury; no strangulation, strangulation, strangulation with loss of consciousness) were associated with biomarkers of cardiometabolic health and self-reported functioning among female survivors of IPV. METHODS Participants were 51 individuals assigned female at birth who experienced IPV during their lifetime and screened positive for probable posttraumatic stress disorder (PTSD) on the PTSD Checklist for DSM-5 (average age = 32.6 years, SD = 7.1). RESULTS Head injury was associated with statistically significant increases in blood glucose levels (p = .01, d = 1.10). Shifts toward more high-risk values with moderate-strong effect sizes were also found in high-density lipoprotein, low-density lipoprotein, and waist-to-hip ratio (ps: .06-.13; ds: 0.51-1.30). Strangulation was associated with increased cholesterol levels, with a moderate effect size (p = .20, d = 0.59). Regression models accounting for age, education, PTSD symptoms, childhood trauma, strangulation, and head injuries predicted functional disability status (R2 = 0.37, p < .01) and several of its associated domains: cognition (R2 = 0.34, F(8,42) = 2.73, p = .01), mobility (R2 = 0.47, F(8,42) = 4.82, p < .001), and participation in society (R2 = 0.33, F(8,42) = 2.59, p = .02). CONCLUSIONS Findings suggest the need to develop integrated treatments that address physical health comorbidities among female survivors of IPV with a history of head injury to improve daily function and quality of life.
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Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts.
| | - Katherine M Iverson
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Catherine B Fortier
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Kimberly B Werner
- College of Nursing, University of Missouri-St. Louis, St. Louis, Missouri
| | - Jennifer R Fonda
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alyssa Currao
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts
| | - James W Whitworth
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; National Center for PTSD Behavioral Health Science Division at VA Boston Healthcare System, Boston, Massachusetts
| | - Regina E McGlinchey
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Tara E Galovski
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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Xie Y, Yu C, Zhou W, Zhu L, Wang T, Bao H, Cheng X. Relationship between normal weight central obesity and arterial stiffness in Chinese adults with hypertension. Nutr Metab Cardiovasc Dis 2024; 34:343-352. [PMID: 38145917 DOI: 10.1016/j.numecd.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND AND AIMS Normal weight central obesity (NWCO) is a category of obesity that is characterized by having a normal BMI and presence of abdominal obesity. Recently, studies have reported that NWCO was associated with the cardiovascular diseases. The researches exploring the relationship between NWCO and arterial stiffness are limited. So this study intended to investigate the relationship between NWCO and arterial stiffness in Chinese adults with hypertension. METHODS AND RESULTS This study is a sub-study of the China H-type Hypertension Registry Study. We included 8580 Chinese hypertensive patients with normal weight (18.5 kg/m2 ≤BMI <24 kg/m2). Central obesity was defined as waist-height ratio ≥0.5, and participants were categorized into two groups: NWCO and normal weight and no central obesity (NWNO). Using the brachial-ankle pulse wave conduction velocity (baPWV) assessed the arterial stiffness. Multiple linear regression analysis was used to evaluate relationship between NWCO and baPWV. Multiple logistic regression analysis was used to evaluate relationship between NWCO and arterial stiffness. Of 8580 participants, 4327 (50.4 %) were NWCO. The multiple linear regression analysis demonstrated that people with NWCO had higher baPWV value (total people: β = 38.33, 95%CI 22.82-53.84; men: β = 39.87, 95%CI 18.43-61.32; women: β = 29.65, 95%CI 7.20-52.09) compared with NWNO. The baPWV ≥1800 cm/s was defined as arterial stiffness, and the multiple logistic regression analysis showed that people with NWCO associated higher arterial stiffness risk (total people: OR = 1.25, 95%CI 1.12-1.39; men: OR = 1.29, 95%CI 1.11-1.50; women: OR = 1.18, 95%CI 1.01-1.38). CONCLUSION NWCO is significantly related to increased risk of arterial stiffness in Chinese adults with hypertension.
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Affiliation(s)
- Yanyou Xie
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Chao Yu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China.
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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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Lee H, Chung HS, Kim YJ, Choi MK, Roh YK, Yu JM, Oh CM, Kim J, Moon S. Association between body composition and the risk of mortality in the obese population in the United States. Front Endocrinol (Lausanne) 2023; 14:1257902. [PMID: 38089609 PMCID: PMC10711108 DOI: 10.3389/fendo.2023.1257902] [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: 07/13/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Background Recent studies have presented the concept of the obesity paradox, suggesting that individuals with obesity have a lower risk of death than those without obesity. This paradox may arise because body mass index (BMI) alone is insufficient to understand body composition accurately. This study investigated the relationship between fat and muscle mass and the risk of mortality in individuals with overweight/obesity. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006 and 2011 to 2018, which were linked to mortality information obtained from the National Death Index. Multiple Cox regression analyses were performed to estimate mortality risk. Subgroup analysis was conducted using propensity score-matched (PSM) data for age, sex, and race/ethnicity. Results This study included 16,555 participants who were overweight/obese (BMI≥25 kg/m2). An increase in appendicular skeletal muscle mass index was associated with a lower mortality risk (hazard ratio [HR]: 0.856; 95% confidence interval [CI]: 0.802-0.915). This finding was consistent with the subgroup analysis of the PSM data. Contrastingly, a high fat mass index was associated with an increased risk of mortality. Sarcopenic overweight/obesity was significantly associated with high mortality compared to obesity without sarcopenia (HR: 1.612, 95%CI: 1.328-1.957). This elevated risk was significant in both age- and sex-based subgroups. This finding was consistent with the subgroup analysis using PSM data. Conclusion In contrast to the obesity paradox, a simple increase in BMI does not protect against mortality. Instead, low body fat and high muscle mass reduce mortality risk.
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Affiliation(s)
- Heeso Lee
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Min Kyu Choi
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Chang-Myung Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Joon Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Jiang Y, Xu B, Zhang K, Zhu W, Lian X, Xu Y, Chen Z, Liu L, Guo Z. The association of lipid metabolism and sarcopenia among older patients: a cross-sectional study. Sci Rep 2023; 13:17538. [PMID: 37845303 PMCID: PMC10579328 DOI: 10.1038/s41598-023-44704-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023] Open
Abstract
Sarcopenia has become a heavy disease burden among the elderly. Lipid metabolism was reported to be involved in many degenerative diseases. This study aims to investigate the association between dysregulated lipid metabolism and sarcopenia in geriatric inpatients. This cross-sectional study included 303 patients aged ≥ 60, of which 151 were diagnosed with sarcopenia. The level of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), homocysteine (HCY), BMI, and fat percentage, were compared between sarcopenia and non-sarcopenia patients. The Spearman correlation coefficient was used to estimate the association between sarcopenia and the level of lipid metabolism. To determine risk factors related to sarcopenia, a multivariate logistic regression analysis was carried out. Risk prediction models were constructed based on all possible data through principal component analysis (PCA), Logistic Regression (LR), Support Vector Machine (SVM), k-Nearest Neighbor (KNN), and eXtreme Gradient Boosting (XGboost). We observed rising prevalence of sarcopenia with increasing age, decreasing BMI, and fat percentage (p < 0.001, Cochran Armitage test). Multivariate logistic regression analysis revealed sarcopenia's risk factors, including older age, male sex, lower levels of BMI, TC, and TG, and higher levels of LDL and HCY (p < 0.05). The sarcopenia risk prediction model showed the risk prediction value of sarcopenia, with the highest area under the receiver operating curve (AUC) of 0.775. Our study provided thorough insight into the risk factors associated with sarcopenia. It demonstrated that an increase in lipid metabolism-related parameters (BMI, TG, TC), within normal reference ranges, may be protective against sarcopenia. The present study can illuminate the direction and significance of lipid metabolism-related factors in preventing sarcopenia.
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Affiliation(s)
- Yiwen Jiang
- Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100006, China
| | - Bingqing Xu
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China
| | - Kaiyu Zhang
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China
| | - Wenyu Zhu
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China
| | - Xiaoyi Lian
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China
| | - Yihui Xu
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China
| | - Zhe Chen
- Laboratory of Cough, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, 215000, Jiangsu, China
| | - Lei Liu
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China.
| | - Zhengli Guo
- Department of Gerontology, Affiliated Kunshan Hospital of Jiangsu University, 566 Qiannjin East Road, Kunshan, Suzhou, 215300, Jiangsu, China.
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Ohara K, Nakamura H, Kouda K, Fujita Y, Mase T, Momoi K, Nishiyama T. Similarities and discrepancies between commercially available bioelectrical impedance analysis system and dual-energy X-ray absorptiometry for body composition assessment in 10-14-year-old children. Sci Rep 2023; 13:17420. [PMID: 37833453 PMCID: PMC10576075 DOI: 10.1038/s41598-023-44217-0] [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: 02/02/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
A variety of easy-to-use commercial bioelectrical impedance appliances are available. The aim of this study was to examine the usefulness of a commercially available body composition meter using bioelectrical impedance analysis (BIA) by comparing its measurement results with those obtained from dual-energy X-ray absorptiometry (DXA). The participants were 443 children aged from 10 to 14 years (226 boys and 217 girls). Fat mass, fat-free mass, lean body mass, percentage of body fat, and bone mineral contents were evaluated for all participants using BIA and DXA. The agreement in the anthropometric data obtained from both devices was analyzed using correlation analysis, intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC), Bland-Altman plots, and ordinary least products regression analysis. Equivalence between both devices was tested by two one-sided t-test. All measured indicators showed strong linear correlations between the two measurement systems (r, 0.853-1.000). Fat mass, fat-free mass, and lean body mass showed absolute concordance (ICC, 0.902-0.972; Lin's CCC, 0.902-0.972). BIA overestimated bone mineral content (62.7-66.5%) and underestimated percentage of body fat (- 8.9 to - 0.8%), lean body mass (- 3.5 to - 1.8%), and body mass (- 0.8 to - 0.5%). For fat mass and fat-free mass, the overestimate or underestimate varied according to the sex and statistical analysis test. Bland-Altman analysis and ordinary least products analysis showed fixed bias and proportional bias in all indicators. Results according to quartiles of body mass index showed poor agreement for fat mass and percentage of body fat in both boys and girls in the lowest body mass index quartile. The present results revealed strong linear correlations between BIA and DXA, which confirmed the validity of the present single-frequency BIA-derived parameters. Our results suggest that BIA cannot provide the exact same values as DXA for some body composition parameters, but that performance is sufficient for longitudinal use within an individual for daily health management and monitoring.
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Affiliation(s)
- Kumiko Ohara
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan
| | - Harunobu Nakamura
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan.
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
| | - Yuki Fujita
- Center for Medical Education, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Tomoki Mase
- Faculty of Human Development and Education, Kyoto Women's University, 35 Imagumanokitahiyoshi-cho, Higashiyama, Kyoto, Kyoto, 605-8501, Japan
| | - Katsumasa Momoi
- Faculty of Human Development and Education, Kyoto Women's University, 35 Imagumanokitahiyoshi-cho, Higashiyama, Kyoto, Kyoto, 605-8501, Japan
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
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Das S, Goswami V, Chandel S. Normal weight central obesity and hypertension in India: Cross-sectional finding from LASI, 2017-19. Nutr Metab Cardiovasc Dis 2023; 33:1888-1898. [PMID: 37544873 DOI: 10.1016/j.numecd.2023.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIM The current public health guidelines for preventing and managing obesity still emphasize the importance of maintaining a normal Body Mass Index, while paying little attention to central obesity, which is common among the general population. Normal Weight Central Obesity (NWCO) is a less explored risk factor for hypertension in India. Therefore, this study aims to investigate the prevalence of NWCO and its association with hypertension in India. METHODS AND RESULTS The cross-sectional study used data from the Longitudinal Aging Study in India (LASI), 2017-19, which included 54,016 participants (22,438 men and 31,578 women). Hypertension was evaluated following the JNC-VIII guidelines for the detection, evaluation, and treatment of hypertension. Anthropometric measurements were taken to identify NWCO. The study found that NWCO was more prevalent among women (33.9%) than men (17.8%), while men had a higher prevalence of hypertension (47.6%) than women (43.8%). In India, the state of Haryana had the highest proportion of NWCO among men (26.4%), while Kerala had the highest proportion among women (39.1%). Binary logistic regression analysis showed that NWCO was significantly associated with an increased risk of hypertension. The odds ratio (aOR) was 1.57 (95% CI 1.45-1.67, p < 0.001) in men and 1.53 (95% CI 1.43-1.63, p < 0.001) in women, compared to normal-weight study participants. CONCLUSIONS The study emphasizes the importance of considering central obesity in individuals with a normal BMI when assessing cardiovascular risk, particularly for hypertension. State-specific data can help identify high-risk areas and facilitate targeted prevention and treatment strategies.
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Affiliation(s)
- Sayani Das
- Department of Health Research, International Institute of Health Management Research, New Delhi 110075, India.
| | - Vaidehi Goswami
- Department of Anthropology, University of Delhi, Delhi 110007, India
| | - Shivani Chandel
- Department of Anthropology, University of Delhi, Delhi 110007, India
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10
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Yuan Y, Liao J, Luo Z, Li D, Hou L. A cross-sectional study from NHANES found a positive association between obesity with bone mineral density among postmenopausal women. BMC Endocr Disord 2023; 23:196. [PMID: 37705039 PMCID: PMC10498604 DOI: 10.1186/s12902-023-01444-w] [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: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
PURPOSE Obesity has been demonstrated to improve bone mineral density (BMD), according to previous research. Nevertheless, there is a dearth of clarity regarding the optimal body mass index (BMI) and waist circumference (WC) for achieving the highest beneficial BMD in postmenopausal women. The objective of this study was to establish the correlation between obesity and BMD. METHODS The relationship between BMI, WC, and BMD was examined by using multivariate logistic regression models, fitting smoothing curves and utilizing the latest data from the National Health and Nutrition Examination Survey (NHANES) survey conducted between 2007 and 2018. Furthermore, the analysis of saturation effects was employed to examine the association of nonlinear connections among BMI, WC, and BMD. RESULTS The research examined information from a combination of 564 participants. A significant correlation between BMD and BMI as well as WC was observed in our findings. The enduring correlation between BMI and WC with BMD was demonstrated across subgroup analyses categorized by age and race, except among other Hispanic and other race. Furthermore, the smoothing curve fitting indicated that there existed not just a linear correlation among BMI, WC, and BMD, but also a saturation threshold in the association of these three factors. CONCLUSIONS Based on our study, we have found a strong and positive relationship between obesity and BMD. According to the results of this research, maintaining obesity at a moderate level in postmenopausal women would result in achieving an optimal equilibrium between obesity and BMD.
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Affiliation(s)
- Yu Yuan
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Jiaxin Liao
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Zhiyuan Luo
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Dingshuang Li
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
| | - Lei Hou
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China.
- Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China.
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11
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Azizad O, Joshi GP. Day-surgery adult patients with obesity and obstructive sleep apnea: Current controversies and concerns. Best Pract Res Clin Anaesthesiol 2023; 37:317-330. [PMID: 37938079 DOI: 10.1016/j.bpa.2022.11.004] [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: 10/13/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Obesity and obstructive sleep apnea are considered independent risk factors that can adversely affect perioperative outcomes. A combination of these two conditions in the ambulatory surgery patient can pose significant challenges for the anesthesiologist. Nevertheless, these patients should not routinely be denied access to ambulatory surgery. Instead, patients should be appropriately optimized. Anesthesiologists and surgeons must work together to implement fast-track anesthetic and surgical techniques that will ensure successful ambulatory outcomes.
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Affiliation(s)
- Omaira Azizad
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Girish P Joshi
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA
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12
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Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, Hess B, Johnson HM, Kazi DS, Kolte D, Kumbhani DJ, LoFaso J, Mahtta D, Mark DB, Minissian M, Navar AM, Patel AR, Piano MR, Rodriguez F, Talbot AW, Taqueti VR, Thomas RJ, van Diepen S, Wiggins B, Williams MS. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2023; 82:833-955. [PMID: 37480922 DOI: 10.1016/j.jacc.2023.04.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
AIM The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease." METHODS A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. STRUCTURE This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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13
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Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, Hess B, Johnson HM, Kazi DS, Kolte D, Kumbhani DJ, LoFaso J, Mahtta D, Mark DB, Minissian M, Navar AM, Patel AR, Piano MR, Rodriguez F, Talbot AW, Taqueti VR, Thomas RJ, van Diepen S, Wiggins B, Williams MS. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation 2023; 148:e9-e119. [PMID: 37471501 DOI: 10.1161/cir.0000000000001168] [Citation(s) in RCA: 126] [Impact Index Per Article: 126.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
AIM The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease." METHODS A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. STRUCTURE This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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Affiliation(s)
| | | | | | | | | | | | - Dave L Dixon
- Former Joint Committee on Clinical Practice Guideline member; current member during the writing effort
| | - William F Fearon
- Society for Cardiovascular Angiography and Interventions representative
| | | | | | | | - Dhaval Kolte
- AHA/ACC Joint Committee on Clinical Data Standards
| | | | | | | | - Daniel B Mark
- Former Joint Committee on Clinical Practice Guideline member; current member during the writing effort
| | | | | | | | - Mariann R Piano
- Former Joint Committee on Clinical Practice Guideline member; current member during the writing effort
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14
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Bottino R, Carbone A, Formisano T, D'Elia S, Orlandi M, Sperlongano S, Molinari D, Castaldo P, Palladino A, Barbareschi C, Tolone S, Docimo L, Cimmino G. Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver? Life (Basel) 2023; 13:1552. [PMID: 37511927 PMCID: PMC10381712 DOI: 10.3390/life13071552] [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: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Obesity is an increasingly widespread disease worldwide because of lifestyle changes. It is associated with an increased risk of cardiovascular disease, primarily type 2 diabetes mellitus, with an increase in major cardiovascular adverse events. Bariatric surgery has been shown to be able to reduce the incidence of obesity-related cardiovascular disease and thus overall mortality. This result has been shown to be the result of hormonal and metabolic effects induced by post-surgical anatomical changes, with important effects on multiple hormonal and molecular axes that make this treatment more effective than conservative therapy in determining a marked improvement in the patient's cardiovascular risk profile. This review, therefore, aimed to examine the surgical techniques currently available and how these might be responsible not only for weight loss but also for metabolic improvement and cardiovascular benefits in patients undergoing such procedures.
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Affiliation(s)
- Roberta Bottino
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Andreina Carbone
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Tiziana Formisano
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Saverio D'Elia
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Massimiliano Orlandi
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Simona Sperlongano
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Daniele Molinari
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Pasquale Castaldo
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Alberto Palladino
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Consiglia Barbareschi
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Salvatore Tolone
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mini-Invasive and Obesity Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Ludovico Docimo
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mini-Invasive and Obesity Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Giovanni Cimmino
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, 80138 Napoli, Italy
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
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15
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Valenzuela PL, Carrera-Bastos P, Castillo-García A, Lieberman DE, Santos-Lozano A, Lucia A. Obesity and the risk of cardiometabolic diseases. Nat Rev Cardiol 2023; 20:475-494. [PMID: 36927772 DOI: 10.1038/s41569-023-00847-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 03/18/2023]
Abstract
The prevalence of obesity has reached pandemic proportions, and now approximately 25% of adults in Westernized countries have obesity. Recognized as a major health concern, obesity is associated with multiple comorbidities, particularly cardiometabolic disorders. In this Review, we present obesity as an evolutionarily novel condition, summarize the epidemiological evidence on its detrimental cardiometabolic consequences and discuss the major mechanisms involved in the association between obesity and the risk of cardiometabolic diseases. We also examine the role of potential moderators of this association, with evidence for and against the so-called 'metabolically healthy obesity phenotype', the 'fatness but fitness' paradox or the 'obesity paradox'. Although maintenance of optimal cardiometabolic status should be a primary goal in individuals with obesity, losing body weight and, particularly, excess visceral adiposity seems to be necessary to minimize the risk of cardiometabolic diseases.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ("i + 12"), Madrid, Spain.
- Department of Systems Biology, University of Alcalá, Alcalá de Henares, Spain.
| | - Pedro Carrera-Bastos
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ("i + 12"), Madrid, Spain
- Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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16
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Zheng J, Hu Y, Xu H, Lei Y, Zhang J, Zheng Q, Li L, Tu W, Chen R, Guo Q, Zang X, You Q, Xu Z, Zhou Q, Wu X. Normal-weight visceral obesity promotes a higher 10-year atherosclerotic cardiovascular disease risk in patients with type 2 diabetes mellitus-a multicenter study in China. Cardiovasc Diabetol 2023; 22:137. [PMID: 37308932 DOI: 10.1186/s12933-023-01876-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Visceral obesity is associated with high cardiovascular events risk in type 2 diabetes mellitus (T2DM). Whether normal-weight visceral obesity will pose a higher atherosclerotic cardiovascular disease (ASCVD) risk than body mass index (BMI)-defined overweight or obese counterparts with or without visceral obesity remains unclear. We aimed to explore the relationship between general obesity and visceral obesity and 10-year ASCVD risk in patients with T2DM. METHODS Patients with T2DM (6997) who satisfied the requirements for inclusion were enrolled. Patients were considered to have normal weight when 18.5 kg/m2 ≤ BMI < 24 kg/m2; overweight when 24 kg/m2 ≤ BMI < 28 kg/m2; and obesity when BMI ≥ 28 kg/m2. Visceral obesity was defined as a visceral fat area (VFA) ≥ 100 cm2. Patients were separated into six groups based on BMI and VFA. The odd ratios (OR) for a high 10-year ASCVD risk for different combinations of BMI and VFA were analysed using stepwise logistic regression. Receiver operating characteristic (ROC) curves for diagnosing the high 10-year ASCVD risk were constructed, and areas under the ROC curves were estimated. Potential non-linear relationships between VFA levels and high 10-year ASCVD risk were examined using restricted cubic splines (knot = 4). Multilinear regression was used to identify factors affecting VFA in patients with T2DM. RESULTS In patients with T2DM, subjects with normal-weight visceral obesity had the highest 10-year ASCVD risk among the six groups, which had more than a 2-fold or 3-fold higher OR than those who were overweight or obese according to BMI but did not have visceral obesity (all P < 0.05). The VFA threshold for high 10-year ASCVD risk was 90 cm2. Multilinear regression showed significant differences in the effect of age, hypertension, drinking, fasting serum insulin, fasting plasma glucose, 2 h postprandial C-peptide, triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol on VFA in patients with T2DM (all P < 0.05). CONCLUSIONS T2DM patients with normal-weight visceral obesity had a higher 10-year ASCVD risk than BMI-defined overweight or obese counterparts with or without visceral obesity, which should initiate standardised management for ASCVD primary prevention.
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Affiliation(s)
- Jia Zheng
- Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Ye Hu
- Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Hanwen Xu
- Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Yu Lei
- Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Jieji Zhang
- Department of Endocrinology, Fenghua District Traditional Chinese Medicine Hospital of Ningbo, Ningbo, 315500, China
| | - Qidong Zheng
- Department of Endocrinology, Yuhuan Second People's Hospital, Taizhou, 317605, China
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, 315000, China
| | - Weiping Tu
- Department of Endocrinology, Shaoxing Shangyu People's Hospital, Shaoxing, 312300, China
| | - Riqiu Chen
- Department of Endocrinology, Lishui People's Hospital, Lishui, 323000, China
| | - Qiongyao Guo
- Department of Endocrinology, The People's Hospital of Putuo Zhoushan, Zhoushan, 316100, China
| | - Xunxiong Zang
- Department of Endocrinology, Yueqing People's Hospital, Wenzhou, 325600, China
| | - Qiaoying You
- Department of Endocrine and Metabolism, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Zhiyong Xu
- Department of Endocrinology, Xianju people's hospital, Taizhou, 317300, China
| | - Qiang Zhou
- Department of Endocrinology, The First Hospital of Jiaxing, Jiaxing, 314000, China
| | - Xiaohong Wu
- Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China.
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17
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Ren H, Guo Y, Wang D, Kang X, Yuan G. Association of normal-weight central obesity with hypertension: a cross-sectional study from the China health and nutrition survey. BMC Cardiovasc Disord 2023; 23:120. [PMID: 36890477 PMCID: PMC9996911 DOI: 10.1186/s12872-023-03126-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/16/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Central obesity is associated with an increased risk of hypertension in the general population. However, little is known regarding the potential relationship between central obesity and the risk of hypertension among adults with a normal body mass index (BMI). Our aim was to assess the risk of hypertension among individuals with normal weight central obesity (NWCO) in a large Chinese population. METHODS We identified 10 719 individuals aged 18 years or older from the China Health and Nutrition Survey 2015. Hypertension was defined by blood pressure measurements, physician diagnosis, or the use of antihypertensive treatment. Multivariable logistic regression was used to assess the association of obesity patterns, defined by BMI, waist circumference (WC) and waist hip ratio (WHR), with hypertension after adjusting for confounding factors. RESULTS The patients' mean age was 53.6 ± 14.5 years, and 54.2% were women. Compared with individuals with a normal BMI but no central obesity, subjects with NWCO had a greater risk of hypertension (WC: OR, 1.49, 95% CI 1.14-1.95; WHR: OR, 1.33, 95% CI 1.08-1.65). Overweight-obese subjects with central obesity demonstrated the highest risk of hypertension after adjustment for potential confounders (WC: OR, 3.01, 95% CI 2.59-3.49; WHR: OR, 3.08, CI 2.6-3.65). Subgroup analyses showed that the combination of BMI with WC had similar findings to the overall population except for female and nonsmoking persons; when BMI was combined with WHR, a significant association of NWCO with hypertension was observed only in younger persons and nondrinkers. CONCLUSIONS Central obesity, as defined by WC or WHR, is associated with an increased risk of hypertension in Chinese adults with normal BMI, highlighting the need to combine measures in obesity-related risk assessment.
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Affiliation(s)
- Huihui Ren
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
- Branch of National Clinical Research Center for Metabolic Disease, Hubei, People's Republic of China
| | - Yaoyao Guo
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Dan Wang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Xiaonan Kang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Gang Yuan
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China.
- Branch of National Clinical Research Center for Metabolic Disease, Hubei, People's Republic of China.
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18
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Association of obesity and cardiovascular disease and progress in pharmacotherapy: what is next for obesity? Int J Rehabil Res 2023; 46:14-25. [PMID: 36727942 DOI: 10.1097/mrr.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Obesity has recently emerged as one of the most severe health concerns. Obesity is a key autonomous risk factor for heart failure and contributes to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and metabolic abnormalities. Obesity is caused by a metabolic imbalance, which occurs when calories burnt are fewer than the number of calories consumed. There are several pathways accountable for the adverse impacts of obesity on the cardiovascular system. Inflammatory cell infiltration develops in the adipose tissue, the pancreas, and other issues similar to the progression of obesity. Inflammation is triggered by immune cells that invade dysfunctional adipose tissue. The atherosclerotic inflammation phase, related to obesity, induces coronary calcification. Obesity is linked to elevated levels of leptin and high blood pressure. Leptin causes systemic vasoconstriction, sodium retention, and increased blood pressure by influencing the synthesis of nitric oxide and activating the sympathetic nervous system. Obesity is a well-known risk factor for CVD and is one of the leading causes of the greater risk of diseases, including dyslipidemia, hypertension, depression, metabolic syndrome, atrial fibrillation, and heart failure in adults and children. When used with dietary improvements, antiobesity drugs improve the probability of experiencing clinically healthy (5%) weight loss. This review aimed to address the consequences of obesity on cardiac structure and function, risk factors, the impact of the obesity paradox, pharmacological treatment strategies for managing and recommended exercise and diet.
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19
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Duangjai A, Phanthurat N, Sajjapong W, Ontawong A, Pengnet S, Yosboonruang A, Jongsomchai K, Thatsanasuwan N. Association of abdominal obesity and systolic blood pressure indices with cardiovascular disease risk prediction among community-dwelling older adults. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
<b>Background:</b> Excess adiposity is an established risk factor for cardiovascular disease (CVD), therefore the early screening indies with predicted CVD risk is more useful for older adults. The current study evaluated the associations between anthropometric, body composition and dietary indices and elevated 10-year CVD risk in older people.<br />
<b>Methods:</b> This research, which involved 55 to 94-year-olds living in the community. Standard techniques were used to determine anthropometric factors and body composition indicators. The risk prediction chart created by World Health Organization and International Society of Hypertension was used to calculate the CVD risk score. Odds ratio (OR) and 95% confidence interval (CI) were determined.<br />
<b>Results:</b> CVD risk prediction was positively correlated with the anthropometric and body composition parameters. After controlling for confounding variables, the logistic regression analysis revealed that waist circumference (OR=16.34; 95% CI: 7.22, 36.98; <i>p</i><0.001), systolic blood pressure (BP) (OR=9.53; 95% CI: 4.52, 20.07; <i>p</i><0.001), and visceral adipose tissue percentage (OR=5.47; 95% CI: 2.98, 10.01; <i>p</i><0.001) were correlated with cardiovascular risk prediction.<br />
<b>Conclusions:</b> Abdominal obesity and increase of systolic BP were associated to increased risk for CVD. Additionally, a positive association between the risk factors for CVD (%visceral adipose tissue) and diet (cholesterol consumption) was established.
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Affiliation(s)
- Acharaporn Duangjai
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Naritsara Phanthurat
- Division of Nutrition and Dietetics, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Wittawas Sajjapong
- Division of Nutrition and Dietetics, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Atcharaporn Ontawong
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Sirinat Pengnet
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Atchariya Yosboonruang
- Division of Microbiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Kamonwan Jongsomchai
- Division of Anatomy, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Natthaphon Thatsanasuwan
- Division of Nutrition and Dietetics, School of Medical Sciences, University of Phayao, Phayao, THAILAND
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Choi MK, Park YMM, Shivappa N, Hong OK, Han K, Steck SE, Hebert JR, Merchant AT, Sandler DP, Lee SS. Inflammatory potential of diet and risk of mortality in normal-weight adults with central obesity. Clin Nutr 2023; 42:208-215. [PMID: 36603461 PMCID: PMC10284332 DOI: 10.1016/j.clnu.2022.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Inflammatory potential of diet may contribute to poor health outcomes in individuals with metabolic disorders. In a representative sample of the U.S. population, we investigated the association between consuming a pro-inflammatory diet and mortality risk in adults with normal range of body mass index (BMI) but with central obesity. METHODS This prospective cohort study included 3521 adults 20-90 years of age with normal BMI who participated in the National Health and Nutrition Examination Survey III, 1988-1994 and did not have a history of cardiovascular disease (CVD) or cancer and did not change their dietary intake in the year preceding baseline measurements. Mortality from all causes, CVD, and cancer was ascertained from the National Death Index. Normal-weight central obesity (NWCO, n = 1777) was defined as those with BMI 18.5 to <25 kg/m2 and waist-to-hip ratio (WHR) ≥0.85 in women and ≥0.90 in men. Severe central obesity was defined as WHR ≥0.92 in women and ≥1.00 in men. The dietary inflammatory index (DII®) was computed based on baseline dietary intake using 24-h dietary recalls, and associations with mortality were estimated using multivariable Cox proportional hazards regression. RESULTS In individuals with NWCO, DII score (i.e., more pro-inflammatory diet) was associated with increased risk of CVD mortality (HRT3 vs T1, 1.89 [95% CI, 1.01-3.53], P trend = 0.04; HR 1 SD increase 1.29 [95% CI, 1.06-1.57]). This association was stronger with more severe central obesity (HRT3 vs T1, 2.79 [95% CI, 1.10-7.03], P trend = 0.03; HR 1 SD increase 1.52 [95% CI, 1.05-2.21]). DII score was not associated with increased risk of mortality in normal-weight individuals without central obesity or with risk of cancer mortality in either group. CONCLUSION Among individuals in the normal-weight range of BMI, a pro-inflammatory diet assessed by high DII scores was associated with increased risk of CVD mortality in those with central obesity.
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Affiliation(s)
- Moon Kyung Choi
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, CA, USA
| | - Yong-Moon Mark Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, AR, USA; Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Oak-Kee Hong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Susan E Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Ribeiro Rosa K, Fruschein Annichino R, de Azevedo E Souza Munhoz M, Gomes Machado E, Marchi E, Castano-Betancourt MC. Role of central obesity on pain onset and its association with cardiovascular disease: a retrospective study of a hospital cohort of patients with osteoarthritis. BMJ Open 2022; 12:e066453. [PMID: 36564108 PMCID: PMC9791386 DOI: 10.1136/bmjopen-2022-066453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To determine the role of central obesity (CO) in the onset and severity of joint pain and in predicting cardiovascular disease (CVD) in subjects affected with osteoarthritis (OA). DESIGN Retrospective analysis on the onset of OA joint pain and CO. Waist circumference (WC), Waist-to-height ratio andwaist-to-hip ratio (WHR) were measured at the interview and defined according to the WHO criteria. Cross-sectional analyses on the association of comorbidities, including CVD, pain severity (number of joints and pain score) and CO. SETTINGS AND PARTICIPANTS Medical records and interviews of a hospital cohort study of 609 patients with OA. Analyses included analysis of variance, mean differences (MDs), SE and logistic regression. Areas under the receiver operating characteristic curve (AUROC) compared the predictive value of the sex-specific CVD models. OUTCOME MEASURES Onset of OA joint pain (years) and severity according to body mass index (BMI) and WC categories. Predictive value of WC for CVD by sex. Education level, disability, smoking and alcohol use were used to adjust the analysis. RESULTS Subjects with OA and CO by WHR started 2 years earlier with pain symptoms and had more joints affected than those without CO (MD=1.96 years, SE=0.95, p=0.04 and MD=0.32, SE=0.15 and p=0.04, respectively). Age and hypertension were associated with CVD in both genders, and NSAIDs use only in males. In addition, respiratory disease, hypercholesterolaemia, stairs difficulty, a wider WC and obesity were significant risk factors in females, improving 12.7% in the prediction of CVD cases, compared with only age and BMI (AUROCC=0.793 and 0.666, respectively, p=0.03 for the difference between AUROCs). CONCLUSION CO is associated with the onset of joint pain, and all pain analysed variables. CO has a role in CVD in women affected with OA and might help predict CVD cases.
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Affiliation(s)
- Karoline Ribeiro Rosa
- Postgraduate Department, Faculty of Medicine of Jundiaí (FMJ), Jundiaí, São Paulo, Brazil
| | - Ricardo Fruschein Annichino
- Bone Reconstruction and Elongation Group, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, Brazil
- Orthopedics Department, Hospital de Caridade São Vicente de Paulo, Jundiaí, Brazil
| | - Marcelo de Azevedo E Souza Munhoz
- Postgraduate Department, Faculty of Medicine of Jundiaí (FMJ), Jundiaí, São Paulo, Brazil
- Ortopedia, Instituto Jundiaiense de Ortopedia de Traumatologia, Jundiaí, São Paulo, Brazil
| | - Eduardo Gomes Machado
- Postgraduate Department, Faculty of Medicine of Jundiaí (FMJ), Jundiaí, São Paulo, Brazil
- Ortopedia, Instituto Jundiaiense de Ortopedia de Traumatologia, Jundiaí, São Paulo, Brazil
| | - Evaldo Marchi
- Postgraduate Department, Faculty of Medicine of Jundiaí (FMJ), Jundiaí, São Paulo, Brazil
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Xu Z, Zhao Y, Sun J, Luo L, Ling Y. Association between dietary knowledge and overweight and obesity in Chinese children and adolescents: Evidence from the China Health and Nutrition Survey in 2004-2015. PLoS One 2022; 17:e0278945. [PMID: 36490274 PMCID: PMC9733866 DOI: 10.1371/journal.pone.0278945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To assess whether dietary knowledge of Chinese children and adolescents and their mothers was associated with childhood and adolescent overweight and obesity. METHODS This cross-sectional study obtained data from the China Health and Nutrition Survey (CHNS) between 2004 and 2015. Dietary knowledge of children and adolescents and their mothers was assessed by asking questions and statements on diets, and clustered by K-means clustering. Body mass index (BMI) and waist circumference (WC) were used to evaluate overweight and obesity among children and adolescents. The association of dietary knowledge with childhood and adolescent overweight and obesity was evaluated by multivariate regression analysis, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. RESULTS A total of 2,338 children and adolescents were included. Children and adolescents with low dietary knowledge were demonstrated to have significantly higher risks of BMI-defined overweight or obesity (OR = 1.66, 95%CI = 1.21-2.28, P = 0.002), and WC-defined obesity (OR = 1.52, 95%CI = 1.12-2.06, P = 0.007) than those with high dietary knowledge. Compared with high dietary knowledge in mothers, low dietary knowledge was associated with significantly elevated risks of BMI-defined overweight or obesity (OR = 1.48, 95%CI = 1.08-2.02, P = 0.014), and WC-defined obesity (OR = 1.59, 95%CI = 1.18-2.16, P = 0.003). Furthermore, significantly increased odds of BMI-defined overweight or obesity and WC-defined non-obesity in children and adolescents were related to low dietary knowledge versus high dietary knowledge of children and adolescents (OR = 1.72, 95%CI = 1.08-2.74, P = 0.023), while there was no association of BMI-defined non-overweight and non-obesity and WC-defined obesity with dietary knowledge among children and adolescents (OR = 1.35, 95%CI = 0.89-2.04, P = 0.161). Additionally, no association was found between dietary knowledge of mothers and BMI-defined overweight or obesity and WC-defined non-obesity among children and adolescents (OR = 1.39, 95%CI = 0.89-2.17, P = 0.155), while low dietary knowledge of mothers was associated with increased odds of BMI-defined non-overweight and non-obesity and WC-defined obesity in children and adolescents (OR = 1.58, 95%CI = 1.03-2.43, P = 0.036). CONCLUSION Dietary knowledge of children and adolescents and their mothers was associated with childhood and adolescent overweight and obesity. Dietary knowledge of children and adolescents negatively related to the risk of BMI-defined overweight or obesity, and dietary knowledge of mothers to odds of WC-defined obesity.
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Affiliation(s)
- Zhen Xu
- Department of Child healthcare, Kunming Children’s Hospital, Kunming, Yunnan, China
| | - Yibin Zhao
- Department of Child Rehabilitation, Kunming Children’s Hospital, Kunming, Yunnan, China
| | - Jingjing Sun
- Department of Child healthcare, Kunming Children’s Hospital, Kunming, Yunnan, China
| | - Lisi Luo
- Department of Child healthcare, Kunming Children’s Hospital, Kunming, Yunnan, China
| | - Yu Ling
- Department of Child healthcare, Kunming Children’s Hospital, Kunming, Yunnan, China
- * E-mail:
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Tutor AW, Lavie CJ, Kachur S, Milani RV, Ventura HO. Updates on obesity and the obesity paradox in cardiovascular diseases. Prog Cardiovasc Dis 2022:S0033-0620(22)00134-7. [PMID: 36481212 DOI: 10.1016/j.pcad.2022.11.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/10/2022]
Abstract
The prevalence of obesity has reached pandemic proportions worldwide and certainly in the United States. Obesity is a well-established independent risk factor for development of many cardiovascular diseases (CVD), including heart failure, coronary heart disease, atrial fibrillation, and hypertension. Therefore, it is logical to expect obesity would have a strong correlation with CVD mortality. However, a substantial body of literature demonstrates a paradox with improved prognosis of overweight and obese patients with established CVD compared to lean patients with the identical CVD. Surprisingly, similar data has also shown that cardiovascular fitness, rather than weight loss alone, influences the relationship between obesity and mortality in those with established CVD. The impact of fitness, exercise, physical activity (PA), and weight loss and their relationship to the obesity paradox are all reviewed here.
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Affiliation(s)
- Austin W Tutor
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA.
| | - Sergey Kachur
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA; Ascension Sacred Heart Regional Heart and Vascular Institute, Pensacola, FL, USA; Department of Medicine, University of Central Florida School of Medicine, Orlando, FL, USA
| | - Richard V Milani
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
| | - Hector O Ventura
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
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Ren Z, Sun W, Wang S, Ying J, Liu W, Fan L, Zhao Y, Wu C, Song P. Status and transition of normal-weight central obesity and the risk of cardiovascular diseases: A population-based cohort study in China. Nutr Metab Cardiovasc Dis 2022; 32:2794-2802. [PMID: 36319576 DOI: 10.1016/j.numecd.2022.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) has become a growing public health concern. Normal weight central obesity (NWCO) has emerged as a potential risk factor for cardiometabolic dysregulation. To date, the association between NWCO and new-onset CVDs remains unclear. We aimed to evaluate the associations of NWCO and its longitudinal transitions with cardiovascular risks in middle-aged and older Chinese. METHODS AND RESULTS Data were from the China Health and Retirement Longitudinal Study 2011-2018. NWCO was defined as the combination of a body mass index (BMI) of <24.0 kg/m2 and a waist circumference (WC) of >85 cm in males or >80 cm in females. CVDs included heart diseases and stroke. Cause-specific hazard models and subdistribution hazard models with all-cause death as the competing event were applied. In 2011, 9856 participants without prior CVDs were included, of whom 1814 developed CVDs during a 7-year follow-up. Compared to normal weight and non-central obesity (NWNCO), NWCO was significantly associated with new-onset CVDs, with cause-specific hazard ratios (cHRs) and 95% confidence intervals (CIs) of 1.21 (1.04-1.41) for heart diseases and 1.40 (1.11-1.76) for stroke. From 2011 to 2013, 571 NWNCO participants developed NWCO who subsequently demonstrated a 45% higher risk of CVDs than those with maintained NWNCO. CONCLUSION NWCO and transition from NWNCO to NWCO are associated with higher risks of CVDs. Identification and prevention of NWCO may be useful in the management of CVDs.
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Affiliation(s)
- Ziyang Ren
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Weidi Sun
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuhui Wang
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiayao Ying
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Liu
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijun Fan
- Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, China
| | - Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Sun JY, Huang WJ, Hua Y, Qu Q, Cheng C, Liu HL, Kong XQ, Ma YX, Sun W. Trends in general and abdominal obesity in US adults: Evidence from the National Health and Nutrition Examination Survey (2001-2018). Front Public Health 2022; 10:925293. [PMID: 36276394 PMCID: PMC9582849 DOI: 10.3389/fpubh.2022.925293] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023] Open
Abstract
Aim This study investigates the trend in general obesity and abdominal obesity in US adults from 2001 to 2018. Methods We included 44,184 adults from the nine cycles of the continuous NHANES (2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018). The age-adjusted mean body mass index and waist circumference were calculated, and the sex-specific annual change was estimated by the survey cycle. We used the weighted sex-specific logistic regression models to analyze the prevalence of general obesity and abdominal obesity from 2001 to 2018. The weighted adjusted odds ratio (OR) with a 95% confidence interval (CI) was calculated. Results Our study showed that general obesity and abdominal obesity account for about 35.48 and 53.13% of the US population. From 2001-2002 to 2017-2018, the age-adjusted prevalence of general obesity increased from 33.09 to 41.36% in females and from 26.88 to 42.43% in males. During 2001-2018, the age-adjusted prevalence of abdominal obesity increased from 57.58 to 67.33% in females and from 39.07 to 49.73% in males. A significant time-dependent increase was observed in the prevalence of general obesity (adjusted OR, 1.007; 95% CI 1.005-1.009, P < 0.001) and abdominal obesity (adjusted OR, 1.006; 95% CI, 1.004-1.008; P < 0.001). Conclusion General obesity and abdominal obesity are a heavy health burden among US adults, and the increasing trend remains in both males and females from 2001 to 2018.
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Affiliation(s)
- Jin-Yu Sun
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China,Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen-Jun Huang
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Yang Hua
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Cheng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Heng-Li Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang-Qing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yong-Xiang Ma
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China,*Correspondence: Yong-Xiang Ma
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,Wei Sun
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Wang R, Li X, Huangfu S, Yao Q, Wu P, Wu Z, Li L, Wang Y, Yang M, Hacker M, Zhou H, Yan R, Li S. Combining body mass index with waist circumference to assess coronary microvascular function in patients with non-obstructive coronary artery disease. J Nucl Cardiol 2022; 29:2434-2445. [PMID: 34476781 PMCID: PMC9553765 DOI: 10.1007/s12350-021-02788-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/12/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Coronary microvascular dysfunction (CMD) may precede clinically overt coronary artery disease (CAD). Overall and central obesity (CO) are major risk factors for CAD. This study sought to investigate the subclinical significance of body adiposity patterns based on the CMD risk. METHODS A total of 128 patients with non-obstructive CAD were prospectively enrolled. Patients were categorized into 4 anthropometric groups: normal weight and non-CO (NWNCO, n = 41), normal weight and CO (NWCO, n = 20), excess weight and non-CO (EWNCO, n = 26), and excess weight and CO (EWCO, n = 41). Patients underwent rest/stress electrocardiography-gated 13N-ammonia positron emission tomography to measure absolute myocardial blood flow (MBF), myocardial flow reserve (MFR), hemodynamic parameters, and cardiac function. RESULTS Resting MBF did not differ between groups (P = .36). Compared with the NWNCO group, hyperemic MBF and MFR were significantly lower in the NWCO and EWCO groups. Notably, patients with NWCO presented the lowest hyperemic MBF and MFR and the highest incidence of CMD. Waist circumference was an independent risk factor for CMD (OR 1.05, 95% CI 1.01 to 1.10, P = .02). CONCLUSION In patients with non-obstructive CAD, CO may be associated with an increased risk of CMD to better fit the study findings which did not assess management or monitoring of MBF and MFR.
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Affiliation(s)
- Ruonan Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Xiang Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Shihao Huangfu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Qi Yao
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Ping Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, Shanxi, China
| | - Li Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Minfu Yang
- Department of Nuclear Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Haitao Zhou
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Rui Yan
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China.
- Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, Shanxi, China.
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Ling J, Tang H, Meng H, Wu L, Zhu L, Zhu S. Two-year outcomes of Roux-en-Y gastric bypass vs medical treatment in type 2 diabetes with a body mass index lower than 32.5 kg/m 2: a multicenter propensity score-matched analysis. J Endocrinol Invest 2022; 45:1729-1740. [PMID: 35596918 DOI: 10.1007/s40618-022-01811-9] [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: 12/12/2021] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) has been widely reported to be safe and feasible, and has a powerful effect on improving metabolism and weight loss in patients with a high body mass index (BMI). A few studies have focused on the comparison of RYGB with medical treatment in type 2 diabetes (T2D) patients with a lower BMI. OBJECTIVES To compare the metabolic effects and safety of RYGB versus medical treatment during a 2 years follow-up in T2D patients with a BMI of 25 to 32.5 kg/m2. METHODS This retrospective and multicenter cohort study participants were extracted from the T2D patients with a lower BMI (25-32.5 kg/m2) from three bariatric centers between 2009 and 2018. Propensity score matching (PSM) was used to minimize bias, and each patient in the surgical group was matched 1:2 to the patients in the medical group with the closest propensity score. Finally, 71 patients who received RYGB and 142 patients who underwent medical treatment with a 2 years follow-up were enrolled to compare the effects of RYGB and medical treatment. The primary endpoint was achievement of the triple endpoint (the simultaneous achievement of hemoglobin A1c (HbA1c) < 7.0%, fasting low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL (2.6 mmol/L), and systolic blood pressure (SBP) < 130 mmHg at the year-1 visit). Changes in weight, BMI, medication usage, complications, and adverse events were assessed. RESULTS In total, 213 patients (mean age of 47.4 ± 9.5 years, 70.4% male, mean BMI of 28.6 ± 2.2 kg/m2) were included in this study. At the end of the first year, 17 patients (23.9%) in the surgical group and 10 (7.0%) in the medical group had achieved the composite triple endpoint (OR 4.64; 95% CI 1.82-11.81; p = 0.001). Additionally, 43 patients (60.6%) in the surgical group and 11 patients (19.7%) in the medical group experienced remission of T2D. However, more complications were observed in the surgical group (36 vs. 22, p < 0.01). CONCLUSIONS Among T2D patients with a BMI between 25.0 and 32.5 kg/m2, RYGB was more effective than medical treatment in resolving metabolic disorders and also resulted in more complications. The risk for complications should be considered in the clinical decision-making process for T2D patients with a low BMI.
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Affiliation(s)
- J Ling
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China
| | - H Tang
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China
| | - H Meng
- Department of General Surgery, The China-Japan Friendship Hospital, Beijing, China
| | - L Wu
- Department of Metabolic Surgery, The Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - L Zhu
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China.
| | - S Zhu
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China.
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Tekalegn Y, Solomon D, Sahiledengle B, Assefa T, Negash W, Tahir A, Regassa T, Mamo A, Gezahegn H, Bekele K, Zenbaba D, Tasew A, Desta F, Atlaw D, Regassa Z, Nugusu F, Engida ZT, Tesfaye DG, Kene C, Nigussie WS, Chala D, Abdi AG, Beressa G, Woldeyohannes D, Rogers HL, Mwanri L. Prevalence of central obesity and its associated risk factors among adults in Southeast Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0265107. [PMID: 35930540 PMCID: PMC9355191 DOI: 10.1371/journal.pone.0265107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Obesity and overweight are known public health problems that affect populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, the literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia. Methods From May to July 2021, a community-based cross-sectional survey was conducted on a sample of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage sampling followed by systematic random sampling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) have been reported to estimate the strength of associations. Results The overall prevalence of central obesity using waist circumference was 39.01% [(95% CI: 35.36–42.76; 15.44% for men and 53.12% for women)]. Multi-variable binary logistic regression analysis revealed that female sex (AOR = 12.93, 95% CI: 6.74–24.79), Age groups: 30–39 years old (AOR = 2.8, 95% CI: 1.59–4.94), 40–49 years (AOR = 7.66, 95% CI: 3.87–15.15), 50–59 years (AOR = 4.65, 95% CI: 2.19–9.89), ≥60 years (AOR = 12.67, 95% CI: 5.46–29.39), occupational status like: housewives (AOR = 5.21, 95% CI: 1.85–14.62), self-employed workers (AOR = 4.63, 95% CI: 1.62–13.24), government/private/non-government employees (AOR = 4.68, 95% CI: 1.47–14.88), and skipping breakfast (AOR = 0.46, 95% CI: 0.23–0.9) were significantly associated with central obesity. Conclusions Abdominal obesity has become an epidemic in Bale Zone’s towns in Southeastern Ethiopia. Female sex, age, being employed were positively associated with central obesity, while skipping breakfast was a protective factor.
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Affiliation(s)
- Yohannes Tekalegn
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
- * E-mail:
| | - Damtew Solomon
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Biniyam Sahiledengle
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Tesfaye Assefa
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Wogene Negash
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Anwar Tahir
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Tadele Regassa
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Ayele Mamo
- Pharmacy Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Habtamu Gezahegn
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Kebebe Bekele
- Surgery Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Demisu Zenbaba
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Alelign Tasew
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Fikreab Desta
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Daniel Atlaw
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Zegeye Regassa
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Fikadu Nugusu
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Zinash Teferu Engida
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Degefa Gomora Tesfaye
- Midwifery Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Chala Kene
- Midwifery Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | | | - Dereje Chala
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Adisu Gemechu Abdi
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Girma Beressa
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Demelash Woldeyohannes
- School of Medicine and Health Science, Department of Public health, Wachemo University, Hosana, Ethiopia
| | - Heather L. Rogers
- Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Ikerbasque Basque Foundation for Science Bilbao, Bilbao, Bizkaia, Spain
| | - Lillian Mwanri
- Torrens University Australia, Adelaide, South Australia, Australia
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Morishita T, Uzui H, Mitsuke Y, Tada H. Relationship of body mass index to clinical outcomes after percutaneous coronary intervention. Eur J Clin Invest 2022; 52:e13789. [PMID: 35397173 DOI: 10.1111/eci.13789] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Elevated body mass index (BMI) demonstrates lower all-cause and cardiovascular mortalities compared with normal-weight or lean patients in chronic diseases. This study investigated relationships between BMI and clinical outcomes following percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients, together with the sex-specific impacts of BMI on mortality. METHODS We reviewed 1104 CAD patients who underwent PCI between 2006 and 2015. Patients were divided by BMI into three groups: lean, <18.5 kg/m2 ; normal, 18.5-24.9 kg/m2 ; and overweight/obese, ≥25 kg/m2 . The primary endpoint was all-cause mortality, and the secondary endpoint was 3-point major adverse cardiovascular events (MACE). RESULTS Kaplan-Meier survival analysis demonstrated risks of all-cause death, and 3-point MACE were higher in lean patients compared with normal-weight and overweight/obese subjects (log-rank p < .001). Cox proportional hazard modelling showed overweight/obese was significantly associated with all-cause death (hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.48-0.95; p = .03), and lean was significantly associated with 3-point MACE (HR 2.02, 95% CI 1.15-3.53; p = .01). Cox proportional hazard analysis with restricted cubic spline showed non-linear associations between BMI and both all-cause mortality and 3-point MACE (p for effect = .002 and = .003, respectively). No significant interaction was evident between sex and BMI for all-cause mortality (p for interaction = .104) or 3-point MACE (p for interaction =0.122). CONCLUSIONS Lean category was associated with adverse outcomes among CAD patients. An obesity paradox regarding the independent association of elevated BMI with reduced mortality after PCI is evident in both males and females.
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Affiliation(s)
- Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department Cardiovascular Medicine, National Hospital Organization Awara Hospital, Fukui, Japan.,Department of Internal Medicine, Matsunami General Hospital, Gifu, Japan
| | - Hiroyasu Uzui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuhiko Mitsuke
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department Cardiovascular Medicine, National Hospital Organization Awara Hospital, Fukui, Japan
| | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Replacing Sedentary Time with Physically Active Behaviour Predicts Improved Body Composition and Metabolic Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148760. [PMID: 35886612 PMCID: PMC9325190 DOI: 10.3390/ijerph19148760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 02/05/2023]
Abstract
Background: Discretionary leisure time for health-promoting physical activity (PA) is limited. This study aimed to predict body composition and metabolic health marker changes from PA reallocation using isotemporal substitution analysis. Methods: Healthy New Zealand women (n = 175; 16–45 y) with high BMI (≥25 kg/m2) and high body fat percentage (≥30%) were divided into three groups by ethnicity (Māori n = 37, Pacific n = 54, and New Zealand European n = 84). PA, fat mass, lean mass, and metabolic health were assessed. Isotemporal substitution paradigms reallocated 30 min/day of sedentary behaviour to varying PA intensities. Results: Reallocating sedentary behaviour with moderate intensity, PA predicted Māori women would have improved body fat% (14.83%), android fat% (10.74%), and insulin levels (55.27%) while the model predicted Pacific women would have improved waist-to-hip (6.40%) and android-to-gynoid (19.48%) ratios. Replacing sedentary time with moderate-vigorous PA predicted Māori women to have improved BMI (15.33%), waist circumference (9.98%), body fat% (16.16%), android fat% (12.54%), gynoid fat% (10.04%), insulin (55.58%), and leptin (43.86%) levels; for Pacific women, improvement of waist-to-hip-ratio (5.30%) was predicted. Conclusions: Sedentary behaviour must be substituted with PA of at least moderate intensity to reap benefits. Māori women received the greatest benefits when reallocating PA. PA recommendations to improve health should reflect the needs and current activity levels of specific populations.
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Torso Shape Improves the Prediction of Body Fat Magnitude and Distribution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148302. [PMID: 35886153 PMCID: PMC9316251 DOI: 10.3390/ijerph19148302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/25/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022]
Abstract
Background: As obesity increases throughout the developed world, concern for the health of the population rises. Obesity increases the risk of metabolic syndrome, a cluster of conditions associated with type-2 diabetes. Correctly identifying individuals at risk from metabolic syndrome is vital to ensure interventions and treatments can be prescribed as soon as possible. Traditional anthropometrics have some success in this, particularly waist circumference. However, body size is limited when trying to account for a diverse range of ages, body types and ethnicities. We have assessed whether measures of torso shape (from 3D body scans) can improve the performance of models predicting the magnitude and distribution of body fat. Methods: From 93 male participants (age 43.1 ± 7.4) we captured anthropometrics and torso shape using a 3D scanner, body fat volume using an air displacement plethysmography device (BODPOD®) and body fat distribution using bioelectric impedance analysis. Results: Predictive models containing torso shape had an increased adjusted R2 and lower mean square error when predicting body fat magnitude and distribution. Conclusions: Torso shape improves the performance of anthropometric predictive models, an important component of identifying metabolic syndrome risk. Future work must focus on fast, low-cost methods of capturing the shape of the body.
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Lee H, Chung HS, Kim YJ, Choi MK, Roh YK, Chung W, Yu JM, Oh CM, Moon S. Association between body shape index and risk of mortality in the United States. Sci Rep 2022; 12:11254. [PMID: 35788633 PMCID: PMC9253149 DOI: 10.1038/s41598-022-15015-x] [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: 12/16/2021] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
The body mass index (BMI) neither differentiates fat from lean mass nor does it consider adipose tissue distribution. In contrast, the recently introduced z-score of the log-transformed A Body Shape Index (LBSIZ) can be applied to measure obesity using waist circumference (WC), height, and weight. We aimed to investigate the association between LBSIZ and mortality. We used data from the National Health and Nutrition Examination Survey 1999–2014 and linked the primary dataset to death certificate data from the National Death Index with mortality follow-up through December 31, 2015. A multiple Cox regression analysis was performed to evaluate the hazard ratio (HR) of all-cause and cardiovascular disease (CVD) mortalities with adjustment for baseline characteristics. LBSIZ, WC, and BMI showed positive association with total fat percentage (P < 0.001); however, only WC and BMI were positively associated with appendicular skeletal mass index (ASMI) (P < 0.001). In the multiple Cox regression analysis, only LBSIZ showed a significant HR for all-cause and CVD mortalities. Under restricted cubic spline regression, mortality risk increased with LBSIZ. However, BMI and WC showed a U-shape association. In conclusion, LBSIZ is strongly associated with all-cause and CVD mortalities. Since LBSIZ is independent of BMI, LBSIZ complements BMI to identify high-risk groups for mortality even in individuals with low or normal BMI.
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Affiliation(s)
- Heysoo Lee
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea
| | - Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea
| | - Min Kyu Choi
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Wankyo Chung
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea
| | - Chang-Myung Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea.
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea.
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Ewert KR, Semmelweis A, Heistermann J, Schafmeyer L, Schoenau E, Duran I. Body Fat Distribution in Children and Adolescents With Cerebral Palsy. J Clin Densitom 2022; 25:285-292. [PMID: 35710756 DOI: 10.1016/j.jocd.2022.05.002] [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: 02/16/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022]
Abstract
To evaluate the body fat distribution in children with cerebral palsy (CP). The present study focusses on a monocentric retrospective analysis of body fat distribution from children diagnosed with CP. The children participated in a rehabilitation program. Reference centiles were calculated based on data from the National Health and Nutrition Examination Survey (NHANES, 1999-2004). Z-scores for trunk-to-leg fat ratio were calculated. Further, fat mass index (FMI) was evaluated based on percentiles that have already been published. 237 males and 194 females with CP were considered (mean age: 11 years and 11 months [SD 3 years]). These were compared to 1059 males and 796 females from the NHANES (mean age: 14 years and 7 months [SD 3 years and 4 months]). The z-scores for trunk-to-leg fat ratio showed the following values: mean -0.47 (SD 1.50) for males, -0.49 (SD 1.11), for females, -0.48 (SD 1.34) for all. The z-scores for FMI showed the following values: mean -0.29 (SD 0.70) for males, -0.88 (SD 2.0) for females, -0.55 (SD 1.46) for all. The results showed rather a gynoid fat distribution and a lower FMI in children with CP than in the reference population (NHANES 1999-2004).
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Affiliation(s)
- Kim Ramona Ewert
- University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Germany
| | - Alexandra Semmelweis
- University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Germany
| | - Johanna Heistermann
- University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Germany
| | - Leonie Schafmeyer
- University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Germany; Department of Neuropediatrics, University Children's Hospital Klinikum Oldenburg, Oldenburg, Germany
| | - Eckhard Schoenau
- University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Germany; Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
| | - Ibrahim Duran
- University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Germany.
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Wan EYF, Fung WT, Yu EYT, Cheng WHG, Chan KS, Wang Y, Chan EWY, Wong ICK, Lam CLK. Association of genetic variants related to combined exposure to higher BMI and waist-to-hip ratio on lifelong cardiovascular risk in UK Biobank. Public Health Nutr 2022; 26:1-9. [PMID: 35621080 DOI: 10.1017/s1368980022001276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study examines the individual and combined association of BMI and waist-to-hip ratio (WHR) with CVD risk using genetic scores of the obesity measurements as proxies. DESIGN A 2 × 2 factorial analysis approach was applied, with participants divided into four groups of lifetime exposure to low BMI and WHR, high BMI, high WHR, and high BMI and WHR based on weighted genetic risk scores. The difference in CVD risk across groups was evaluated using multivariable logistic regression. SETTING Cohort study. PARTICIPANTS A total of 408 003 participants were included from the prospective observational UK Biobank study. RESULTS A total of 58 429 CVD events were recorded. Compared to the low BMI and WHR genetic scores group, higher BMI or higher WHR genetic scores were associated with an increase in CVD risk (high WHR: OR, 1·07; 95 % CI (1·04, 1·10)); high BMI: OR, 1·12; 95 % CI (1·09, 1·16). A weak additive effect on CVD risk was found between BMI and WHR (high BMI and WHR: OR, 1·16; 95 % CI (1·12, 1·19)). Subgroup analysis showed similar patterns between different sex, age (<65, ≥65 years old), smoking status, Townsend deprivation index, fasting glucose level and medication uses, but lower systolic blood pressure was associated with higher CVD risk in obese participants. CONCLUSIONS High BMI and WHR were associated with increased CVD risk, and their effects are weakly additive. Even though there were overlapping of effect, both BMI and WHR are important in assessing the CVD risk in the general population.
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Affiliation(s)
- Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
| | - Wing Tung Fung
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Will Ho Gi Cheng
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kam Suen Chan
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yuan Wang
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Department of Family Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
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Baba R. How can we evaluate the degree of obesity and cardiorespiratory fitness? They are the great problems we now have! Eur J Prev Cardiol 2022; 29:957-958. [PMID: 35522213 DOI: 10.1093/eurjpc/zwab183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Reizo Baba
- Department of Lifelong Sports and Health Sciences, Chubu University School of Life Science, Matsumoto-cho 1200, Kasugai 487-8501, Japan
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Thelwell M, Bullas A, Kühnapfel A, Hart J, Ahnert P, Wheat J, Loeffler M, Scholz M, Choppin S. Modelling of human torso shape variation inferred by geometric morphometrics. PLoS One 2022; 17:e0265255. [PMID: 35271672 PMCID: PMC8912174 DOI: 10.1371/journal.pone.0265255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 02/26/2022] [Indexed: 02/06/2023] Open
Abstract
Traditional body measurement techniques are commonly used to assess physical health; however, these approaches do not fully represent the complex shape of the human body. Three-dimensional (3D) imaging systems capture rich point cloud data that provides a representation of the surface of 3D objects and have been shown to be a potential anthropometric tool for use within health applications. Previous studies utilising 3D imaging have only assessed body shape based on combinations and relative proportions of traditional body measures, such as lengths, widths and girths. Geometric morphometrics (GM) is an established framework used for the statistical analysis of biological shape variation. These methods quantify biological shape variation after the effects of non-shape variation-location, rotation and scale-have been mathematically held constant, otherwise known as the Procrustes paradigm. The aim of this study was to determine whether shape measures, identified using geometric morphometrics, can provide additional information about the complexity of human morphology and underlying mass distribution compared to traditional body measures. Scale-invariant features of torso shape were extracted from 3D imaging data of 9,209 participants form the LIFE-Adult study. Partial least squares regression (PLSR) models were created to determine the extent to which variations in human torso shape are explained by existing techniques. The results of this investigation suggest that linear combinations of body measures can explain 49.92% and 47.46% of the total variation in male and female body shape features, respectively. However, there are also significant amounts of variation in human morphology which cannot be identified by current methods. These results indicate that Geometric morphometric methods can identify measures of human body shape which provide complementary information about the human body. The aim of future studies will be to investigate the utility of these measures in clinical epidemiology and the assessment of health risk.
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Affiliation(s)
- Michael Thelwell
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
- * E-mail:
| | - Alice Bullas
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Andreas Kühnapfel
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - John Hart
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Peter Ahnert
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Jon Wheat
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Markus Loeffler
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Markus Scholz
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
- IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
| | - Simon Choppin
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
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Liu W, Li D, Yang M, Wang L, Xu Y, Chen N, Zhang Z, Shi J, Li W, Zhao S, Gao A, Chen Y, Ma Q, Zheng R, Wu S, Zhang Y, Chen Y, Qian S, Bi Y, Gu W, Tang Q, Ning G, Liu R, Wang W, Hong J, Wang J. GREM2 is associated with human central obesity and inhibits visceral preadipocyte browning. EBioMedicine 2022; 78:103969. [PMID: 35349825 PMCID: PMC8965169 DOI: 10.1016/j.ebiom.2022.103969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/06/2022] [Accepted: 03/12/2022] [Indexed: 01/21/2023] Open
Abstract
Background Methods Findings Interpretation Funding
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Affiliation(s)
- Wen Liu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endoceine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danjie Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minglan Yang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Long Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyin Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Shi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaoqian Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aibo Gao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufei Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinyun Ma
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shujing Wu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifei Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuwen Qian
- The Key Laboratory of Metabolism and Molecular Medicine of the Ministry of Education, Department of Biochemistry and Molecular Biology of School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqiong Gu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiqun Tang
- The Key Laboratory of Metabolism and Molecular Medicine of the Ministry of Education, Department of Biochemistry and Molecular Biology of School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endoceine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruixin Liu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Hong
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiqiu Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endoceine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Covassin N, Singh P, McCrady-Spitzer SK, St Louis EK, Calvin AD, Levine JA, Somers VK. Effects of Experimental Sleep Restriction on Energy Intake, Energy Expenditure, and Visceral Obesity. J Am Coll Cardiol 2022; 79:1254-1265. [PMID: 35361348 PMCID: PMC9187217 DOI: 10.1016/j.jacc.2022.01.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although the consequences of sleep deficiency for obesity risk are increasingly apparent, experimental evidence is limited and there are no studies on body fat distribution. OBJECTIVES The purpose of this study was to investigate the effects of experimentally-induced sleep curtailment in the setting of free access to food on energy intake, energy expenditure, and regional body composition. METHODS Twelve healthy, nonobese individuals (9 males, age range 19 to 39 years) completed a randomized, controlled, crossover, 21-day inpatient study comprising 4 days of acclimation, 14 days of experimental sleep restriction (4 hour sleep opportunity) or control sleep (9 hour sleep opportunity), and a 3-day recovery segment. Repeated measures of energy intake, energy expenditure, body weight, body composition, fat distribution and circulating biomarkers were acquired. RESULTS With sleep restriction vs control, participants consumed more calories (P = 0.015), increasing protein (P = 0.050) and fat intake (P = 0.046). Energy expenditure was unchanged (all P > 0.16). Participants gained significantly more weight when exposed to experimental sleep restriction than during control sleep (P = 0.008). While changes in total body fat did not differ between conditions (P = 0.710), total abdominal fat increased only during sleep restriction (P = 0.011), with significant increases evident in both subcutaneous and visceral abdominal fat depots (P = 0.047 and P = 0.042, respectively). CONCLUSIONS Sleep restriction combined with ad libitum food promotes excess energy intake without varying energy expenditure. Weight gain and particularly central accumulation of fat indicate that sleep loss predisposes to abdominal visceral obesity. (Sleep Restriction and Obesity; NCT01580761).
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Zhang RN, Fan JG. Editorial: opposite effects of genetic polymorphisms known to induce NAFLD on hepatic and cardiovascular outcomes in Chinese population. Aliment Pharmacol Ther 2022; 55:876-877. [PMID: 35315107 DOI: 10.1111/apt.16818] [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] [Indexed: 12/12/2022]
Affiliation(s)
- Rui-Nan Zhang
- Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Gao Fan
- Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
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Prevalence of central obesity according to different definitions in normal weight adults of two cross-sectional studies in Panama. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100215. [PMID: 36777687 PMCID: PMC9904116 DOI: 10.1016/j.lana.2022.100215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Central Obesity (CO) might arise among individuals with normal body mass index (BMI). We aim to estimate the prevalence of Normal Weight CO (NWCO), using different definitions, and to compare its association with cardiometabolic risk factors in the adult population of Panama. Methods Data from two population-based studies conducted in Panama in 2010 and 2019 were used. Using standard definitions, normal weight was defined as a BMI between 18·5 and 24·9 while CO was defined as a Waist-to-Height Ratio (WHtR) ≥ 0·5 in both sexes or a Waist Circumference (WC) ≥ 90, ≥94, or ≥102 cm for men, and 80 or 88 cm for women. Unconditional logistic regression models were used to estimate the association between each CO definition and dyslipidemia, high blood pressure (HBP), diabetes, and clusters of cardiovascular risk factors. Findings Recent CO prevalence ranged between 3·9% (WC ≥ 102 cm for men and WC ≥ 88 cm for women) and 43·9% (WHtR ≥ 0·5) among individuals classify as normal weigh according to the BMI. Different cardiovascular risk factors were present in this normal weight population but among men the threshold of WC ≥ 102 cm screened less than 1·0%. Interpretation NWCO was associated with cardiovascular risk factors, particularly with elevated concentration of triglycerides. CO evaluation at the primary health care level may be a useful technique to identify normal weight people with metabolically obese characteristics. Funding Gorgas Memorial Institute for Health studies via Ministry of Economy and Finance of Panama and Inter-American Development Bank.
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Bakhtiyari M, Kazemian E, Kabir K, Hadaegh F, Aghajanian S, Mardi P, Ghahfarokhi NT, Ghanbari A, Mansournia MA, Azizi F. Contribution of obesity and cardiometabolic risk factors in developing cardiovascular disease: a population-based cohort study. Sci Rep 2022; 12:1544. [PMID: 35091663 PMCID: PMC8799723 DOI: 10.1038/s41598-022-05536-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/07/2022] [Indexed: 12/14/2022] Open
Abstract
This study aims to assess the effects of central and general adiposity on development of cardiovascular diseases (CVDs) mediated by cardiometabolic risk factors and to analyze their degree of dependency for mediating their effects. To this end, data from the the Tehran Lipid and Glucose Study cohort with 6280 participants were included in this study. The hazard ratios were calculated using a 2-stage regression model in the context of a survival model. Systolic blood pressure (BP), total serum cholesterol, and fasting plasma glucose were designated as mediators. Assessing the interactions revealed that BP was the most important mediator for general ( (HRNIE: 1.11, 95% CI 1.17–1.24) and central obesity (CO) (HRNIE: 1.11, 95% CI 1.07–1.15) with 60% and 36% proportion of the effects mediated in the total population, respectively. The proportion of mediated risk for all three metabolic risk factors was 46% (95% CI 31–75%) for overweight, 66% (45–100%) for general obesity and 52% (39–87%) for central obesity. BP was the most important mediator for overweight and central obesity in men, comprising 29% and 36% of the risk, respectively. The proportion of the risk mediated through all three metabolic risk factors in women was 23% (95% CI 13–50%) for overweight, 36% (21–64%) for general obesity and 52% (39–87%) for central obesity. Based on the results of this study, cardiometabolic mediators have conciliated more than 60% of the adverse effects of high BMI on CVDs in men. Controlling the metabolic risk factors in women does not efficiently contribute to decreasing CVDs as effectively.
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Affiliation(s)
- Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Elham Kazemian
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kourosh Kabir
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sepehr Aghajanian
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Parham Mardi
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Ali Ghanbari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Pour-Sina Street, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Pour-Sina Street, Tehran, Iran.
| | - Freidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Transgenerational Transcriptomic and DNA Methylome Profiling of Mouse Fetal Testicular Germline and Somatic Cells after Exposure of Pregnant Mothers to Tributyltin, a Potent Obesogen. Metabolites 2022; 12:metabo12020095. [PMID: 35208169 PMCID: PMC8874857 DOI: 10.3390/metabo12020095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/03/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023] Open
Abstract
Obesogens such as tributyltin (TBT) are xenobiotic compounds that promote obesity, in part by distorting the normal balance of lipid metabolism. The obesogenic effects of TBT can be observed in directly exposed (F1 and F2 generations) and also subsequent generations (F3 and beyond) that were never exposed. To address the effects of TBT exposure on germ cells, we exposed pregnant transgenic OG2 mouse dams (F0), which specifically express EGFP in germline cells, to an environmentally relevant dose of TBT or DMSO throughout gestation through drinking water. When fed with a high-fat diet, F3 male offspring of TBT-exposed F0 dams (TBT-F3) accumulated much more body fat than did DMSO-F3 males. TBT-F3 males also lost more body fluid and lean compositions than did DMSO-F3 males. Expression of genes involved in transcriptional regulation or mesenchymal differentiation was up-regulated in somatic cells of TBT-F1 (but not TBT-F3) E18.5 fetal testes, and promoter-associated CpG islands were hyper-methylated in TBT-F1 somatic cells. Global mRNA expression of protein-coding genes in F1 or F3 fetal testicular cells was unaffected by F0 exposure to TBT; however, expression of a subset of endogenous retroviruses was significantly affected in F1 and F3. We infer that TBT may directly target testicular somatic cells in F1 testes to irreversibly affect epigenetic suppression of endogenous retroviruses in both germline and somatic cells.
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The waist-to-body mass index ratio as an anthropometric predictor for cardiovascular outcome in subjects with established atherosclerotic cardiovascular disease. Sci Rep 2022; 12:804. [PMID: 35039542 PMCID: PMC8764082 DOI: 10.1038/s41598-021-04650-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 12/23/2021] [Indexed: 01/01/2023] Open
Abstract
Obesity is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, ‘obesity paradox’ is observed in patients with coronary artery disease while defining obesity by body mass index (BMI). The purpose of this study is to identify a better anthropometric parameter to predict cardiovascular events in patients with ASCVD. The study was conducted using the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry. A total of 6,920 adult patients with stable ASCVD, enrolled from January 2010 to November 2014, were included, with a mean age of 65.9 years, 73.9% males, and a mean BMI of 26.3 kg/m2 at baseline. These patients were followed up for a median of 2.5 years. The study endpoint was the composite major adverse cardiovascular event (MACE), defined as cardiovascular death, nonfatal myocardial infarction or stroke, or cardiac arrest with resuscitation. Multivariable Cox proportional hazards regression showed a significant positive association between waist-to-BMI ratio and MACE (adjusted hazard ratio 1.69 per cm‧m2/kg increase in waist-to-BMI ratio, 95% CI 1.12–2.49, p = 0.01) after adjusting for potential risk factors and confounders. Traditional anthropometric parameters, such as BMI, weight, waist and waist-hip ratio, or newer waist-based indices, such as body roundness index and a body shape index, did not show any significant linear associations (p = 0.09, 0.30, 0.89, 0.54, 0.79 and 0.06, respectively). In the restricted cubic spline regression analysis, the positive dose–response association between waist-to-BMI ratio and MACE persisted across all the range of waist-to-BMI ratio. The positive dose–response association was non-linear with a much steeper increase in the risk of MACE for waist-to-BMI ratio > 3.6 cm‧m2/kg. In conclusion, waist-to-BMI ratio may function as a positive predictor for the risk of MACE in established ASCVD patients.
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Rooprai J, Boodhwani M, Beauchesne L, Chan KL, Dennie C, Wells GA, Coutinho T. Central Hypertension in Patients With Thoracic Aortic Aneurysms: Prevalence and Association With Aneurysm Size and Growth. Am J Hypertens 2022; 35:79-86. [PMID: 33759993 DOI: 10.1093/ajh/hpaa183] [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: 09/22/2020] [Revised: 10/26/2020] [Accepted: 03/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hypertension (HTN) has the greatest population-attributable risk for aortic dissection and is highly prevalent among patients with thoracic aortic aneurysms (TAAs). Although HTN is diagnosed based on brachial blood pressure (bBP), central HTN (central systolic blood pressure [cSBP] ≥130 mm Hg) is of interest as it better reflects blood pressure (BP) in the aorta. We aimed to (i) evaluate the prevalence of central HTN among TAA patients without a diagnosis of HTN, and (ii) assess associations of bBP vs. central blood pressure (cBP) with aneurysm size and growth. METHODS One hundred and five unoperated subjects with TAAs were recruited. With validated methodology, cBP was assessed with applanation tonometry. Aneurysm size was assessed at baseline and follow-up using imaging modalities. Aneurysm growth rate was calculated in mm/year. Multivariable linear regression adjusted for potential confounders assessed associations of bBP and cBP with aneurysm size and growth. RESULTS Seventy-seven percent of participants were men and 49% carried a diagnosis of HTN. Among participants without diagnosis of HTN, 15% had central HTN despite normal bBP ("occult central HTN"). In these patients, higher central systolic BP (cSBP) and central pulse pressure (cPP) were independently associated with larger aneurysm size (β ± SE = 0.28 ± 0.11, P = 0.014 and cPP = 0.30 ± 0.11, P = 0.010, respectively) and future aneurysm growth (β ± SE = 0.022 ± 0.008, P = 0.013 and 0.024 ± 0.009, P = 0.008, respectively) while bBP was not (P > 0.05). CONCLUSIONS In patients with TAAs without a diagnosis of HTN, central HTN is prevalent, and higher cBP is associated with larger aneurysms and faster aneurysm growth.
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Affiliation(s)
- Jasjit Rooprai
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Munir Boodhwani
- The Department of Surgery, Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Luc Beauchesne
- The Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Kwan-Leung Chan
- The Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Carole Dennie
- The Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
| | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Thais Coutinho
- The Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- The Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Triceps skinfold thickness and body mass index and the risk of gestational diabetes mellitus: Evidence from a multigenerational cohort study. Obes Res Clin Pract 2021; 16:44-49. [PMID: 34973921 DOI: 10.1016/j.orcp.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Pre-pregnancy obesity is a well-recognized risk factor for gestational diabetes mellitus (GDM). There is a continuity of obesity from childhood to adolescence and then adulthood. However, it is unknown whether early childhood obesity predicts GDM. METHODS We investigated the prospective association of childhood triceps skinfold thickness and body mass index (BMI) with GDM risk among women from the Mater-University of Queensland Study of Pregnancy (MUSP), a multigenerational cohort study. A multiple logistic regression model was applied to estimate the odds of experiencing GDM by childhood skinfold thickness and BMI. RESULTS Out of 552 women in the study for whom data were available on triceps skinfold thickness and BMI at average age 5 (range 3-7) years old, 52 (9.42%) developed GDM by average age 30 (range 28-33) years. We found that the risk of developing GDM was greater among women who had greater skinfold thickness but not greater BMI at age 5 years. Women who were classified as overweight or obese based on skinfold thickness at age 5 years had an increased odds ratio of GDM compared to women who had normal skinfold thickness. This association remained significant after adjustment for the potential confounders (OR 2.74; 95% confidence interval=1.28-5.86). CONCLUSION The risk of developing GDM was associated with higher skinfold thickness at age 5 years.
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Association of Obesity and Hypertension: A Cohort Study in China. Int J Hypertens 2021; 2021:1607475. [PMID: 34925914 PMCID: PMC8683188 DOI: 10.1155/2021/1607475] [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: 07/11/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
The prevalence of general and central obesity has increased rapidly in China for decades, while little is known on obesity-normal weight-central obesity (NWCO) in China. In this study, we aim to depict the trend of the three kinds of obesity and to explore their associations with hypertension in a cohort study in China. We used data from eight waves of the China Health and Nutrition Survey (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009, 2011, and 2015 for analysis. The Cochran–Armitage test was used for trend of the three kinds of obesity or hypertension. Mixed logistic regression was used to explore their relationship. In this study, we found the prevalence of general obesity increased from 20.81% in 1993 to 50.57% in 2015 in China, which was from 19.23% to 56.15% for central obesity and from 27.20% to 49.07% for NWCO, respectively. Males had the highest increase among all the subgroups. The RR for hypertension and general obesity was 3.71 (95%CI: 3.26–4.22), 3.62 (95%CI 3.19–4.12) for central obesity, and 1.60 (95%CI 1.23–2.06) for NWCO after adjusted for age, sex, education, smoking, alcohol drinking, marriage status, urbanicity and income. Both prevalence of obesity and hypertension have increased significantly in China for the two decades. The general obesity was most likely to develop hypertension compared to central or NOCWO in this study.
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Gao H, Shen A, Chen H, Li H. Body Mass Index and Long-Term Follow-Up Outcomes in Patients With Acute Myocardial Infarction by the Median of Non-HDL Cholesterol: Results From an Observational Cohort Study in China. Front Cardiovasc Med 2021; 8:750670. [PMID: 34869654 PMCID: PMC8634779 DOI: 10.3389/fcvm.2021.750670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background: The association between obesity, non-HDL cholesterol, and clinical outcomes in subjects with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is incompletely understood. The aim of this investigation was to explore the association between body mass index (BMI), non-high density lipoprotein (non-HDL) cholesterol, and long-term follow-up prognosis. Methods: This present study used data obtained by the Cardiovascular Center of Beijing Friendship Hospital Database Bank. We identified 3,780 consecutive AMI populations aged 25–93 years from 2013 to 2020. Participants were categorized as normal weight (18.5 ≤ BMI <22.9 kg/m2), overweight (23.0 ≤ BMI <24.9 kg/m2), obese class I (25.0 ≤ BMI <29.9 kg/m2), and obese class II (BMI ≥ 30.0 kg/m2). The endpoint of interest was cardiovascular (CV) death, all-cause death, myocardial infarction (MI), stroke, unplanned revascularization, and cardiac hospitalization. Results:Participants with higher BMI were younger and more likely to be males compared with lower BMI groups. Elevated non-HDL cholesterol was present in 8.7, 11.0, 24.3, and 5.9% of the normal, overweight, obese class I, and obese class II groups, respectively. After multivariate adjustment, compared to normal-weight participants with decreased non-HDL cholesterol (reference group), obese participants with and without elevated non-HDL cholesterol had a lower risk of mortality (with obese class I and elevated non-HDL cholesterol: hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.28–0.67; with obese class I and decreased non-HDL cholesterol: HR, 0.68, 95% CI, 0.47–0.98; with obese class II and elevated non-HDL cholesterol: HR, 0.42, 95% CI, 0.20–0.87; with obese class II and decreased non-HDL cholesterol: HR, 0.35, 95% CI, 0.16–0.72). Conclusion: In AMI participants performing with PCI, obesity had a better long-term prognosis which probably unaffected by the level of non-HDL cholesterol.
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Affiliation(s)
- Hui Gao
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Aidong Shen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hui Chen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongwei Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Department of Internal Medical, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China
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Rajan N, Rosero EB, Joshi GP. Patient Selection for Adult Ambulatory Surgery: A Narrative Review. Anesth Analg 2021; 133:1415-1430. [PMID: 34784328 DOI: 10.1213/ane.0000000000005605] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
With migration of medically complex patients undergoing more extensive surgical procedures to the ambulatory setting, selecting the appropriate patient is vital. Patient selection can impact patient safety, efficiency, and reportable outcomes at ambulatory surgery centers (ASCs). Identifying suitability for ambulatory surgery is a dynamic process that depends on a complex interplay between the surgical procedure, patient characteristics, and the expected anesthetic technique (eg, sedation/analgesia, local/regional anesthesia, or general anesthesia). In addition, the type of ambulatory setting (ie, short-stay facilities, hospital-based ambulatory center, freestanding ambulatory center, and office-based surgery) and social factors, such as availability of a responsible individual to take care of the patient at home, can also influence patient selection. The purpose of this review is to present current best evidence that would provide guidance to the ambulatory anesthesiologist in making an informed decision regarding patient selection for surgical procedures in freestanding ambulatory facilities.
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Affiliation(s)
- Niraja Rajan
- From the Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, Pennsylvania
| | - Eric B Rosero
- Department of Anesthesiology and Pain Management, University of Texas Southwestern, Dallas, Texas
| | - Girish P Joshi
- Department of Anesthesiology and Pain Management, University of Texas Southwestern, Dallas, Texas
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Akyea RK, Doehner W, Iyen B, Weng SF, Qureshi N, Ntaios G. Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study. J Cachexia Sarcopenia Muscle 2021; 12:2111-2121. [PMID: 34581015 PMCID: PMC8718037 DOI: 10.1002/jcsm.12818] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/16/2021] [Accepted: 09/05/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The association between obesity, major adverse cardiovascular events (MACE), and mortality in patients with incident stroke is not well established. We assessed the relationship between body mass index (BMI) and MACE in patients with incident stroke. METHODS The population-based cohort study identified 30 702 individuals from the Clinical Practice Research Datalink (CPRD GOLD) and Hospital Episode Statistics (HES) databases from the United Kingdom. Individuals were aged ≥18 years with incident stroke between 1-1-1998 and 31-12-2017, a BMI recorded within 24 months before incident stroke, and no prior history of MACE. BMI was categorized as underweight (<18.5 kg/m2 ), normal (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ), obesity class I (30.0-34.9 kg/m2 ), class II (35.0-39.9 kg/m2 ) and class III (≥40 kg/m2). MACE was defined as a composite of incident coronary heart disease, recurrent stroke, peripheral vascular disease (PVD), heart failure, and cardiovascular-related mortality. Multivariable Cox regression was used to assess differences in MACE risk between BMI categories. RESULTS At baseline, 1217 (4.0%) were underweight, 10 783 (35.1%) had a normal BMI, 10 979 (35.8%) had overweight, 5206 (17.0%) had obesity Class I, 1749 (5.7%) Class II, and 768 (2.5%) Class III. In multivariable analysis, higher BMI were associated with lower risk of subsequent MACE [overweight: HR 0.96, 95% CI 0.93-0.99)]; PVD [overweight: 0.65 (0.49-0.85); obesity Class III: 0.19 (0.50-0.77)]; cardiovascular-related death [overweight: 0.80 (0.74-0.86); obesity Class I: 0.79 (0.71-0.88); Class II: 0.80 (0.67-0.96)]; and all-cause mortality [overweight: 0.75 (0.71-0.79); obesity Class I: 0.75 (0.70-0.81); Class II: 0.77 (0.68-0.86)] when compared to those with normal BMI. The results were similar irrespective of sex, diabetes mellitus, smoking or cancer at time of incident stroke. CONCLUSIONS In patients with incident stroke, overweight or obesity were associated with a more favourable prognosis for subsequent MACE, PVD, and mortality, irrespective of sex, diabetes mellitus, smoking, or cancer at baseline. As with other cohort studies, our study demonstrates an association. Randomized control trials should be considered to robustly evaluate the impact of weight management recommendations on subsequent cardiovascular outcomes in stroke survivors.
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Affiliation(s)
- Ralph K Akyea
- Primary Care Stratified Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Wolfram Doehner
- Berlin Institute of Health, Charité-Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany.,Department of Internal Medicine and Cardiology (Virchow Klinikum), Charité Universitätsmedizin Berlin, and German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Barbara Iyen
- Primary Care Stratified Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Stephen F Weng
- Primary Care Stratified Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nadeem Qureshi
- Primary Care Stratified Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - George Ntaios
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Kesztyüs D, Lampl J, Kesztyüs T. The Weight Problem: Overview of the Most Common Concepts for Body Mass and Fat Distribution and Critical Consideration of Their Usefulness for Risk Assessment and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111070. [PMID: 34769593 PMCID: PMC8583287 DOI: 10.3390/ijerph182111070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
The prevalence of obesity already reached epidemic proportions many years ago and more people may die from this pandemic than from COVID-19. However, the figures depend on which measure of fat mass is used. The determination of the associated health risk also depends on the applied measure. Therefore, we will examine the most common measures for their significance, their contribution to risk assessment and their applicability. The following categories are reported: indices of increased accumulation of body fat; weight indices and mortality; weight indices and risk of disease; normal weight obesity and normal weight abdominal obesity; metabolically healthy obesity; the obesity paradox. It appears that BMI is still the most common measure for determining weight categories, followed by measures of abdominal fat distribution. Newer measures, unlike BMI, take fat distribution into account but often lack validated cut-off values or have limited applicability. Given the high prevalence of obesity and the associated risk of disease and mortality, it is important for a targeted approach to identify risk groups and determine individual risk. Therefore, in addition to BMI, a measure of fat distribution should always be used to ensure that less obvious but risky manifestations such as normal weight obesity are identified.
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Affiliation(s)
- Dorothea Kesztyüs
- Department of Medical Informatics at the University Medical Centre Göttingen, Georg August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
- Correspondence: ; Tel.: +49-731-37873521
| | - Josefine Lampl
- General Practitioner Centre Arnold & Liffers, Albstr. 6, 89081 Jungingen, Germany;
| | - Tibor Kesztyüs
- Department of Medical Informatics at the University Medical Centre Göttingen, Georg August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
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