1
|
Li C, Zeng L, Li M, Deng K, Zhou D, Liang R, Zhang X, Hu Z, Luo A, Chen C, Chen Q, Wei W, Li W, Hu Z. New sagittal abdominal diameter and transverse abdominal diameter based equations to estimate visceral fat area in type 2 diabetes patients. BMC Public Health 2024; 24:1364. [PMID: 38773444 PMCID: PMC11106903 DOI: 10.1186/s12889-024-18659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/18/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVE Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) are considered gold standards for measuring visceral fat area (VFA). However, their relatively high prices and potential radiation exposure limit their widespread use in clinical practice and everyday life. Therefore, our study aims to develop a VFA estimated equation based on sagittal abdominal diameter (SAD) and transverse abdominal diameter (TAD) using anthropometric indexes. To the best of our knowledge, there have been limited studies investigating this aspect thus far. METHODS This study was designed as a cross-sectional, retrospective cohort survey. A total of 288 patients (167 males and 121 females) aged 18-80 with type 2 diabetes (T2D) were consecutively collected from a multicenter hospital, and VFA was measured by CT. Subsequently, variables highly correlated with VFA were screened through general linear correlation analysis. A stepwise regression analysis was then conducted to develop a VFA estimated equation. Discrepancies between the estimated and actual VFA values were assessed using the Bland-Altman method to validate the accuracy of the equation. RESULTS In the female T2D population, triglyceride (TG), SAD, TAD were found to be independently correlated with VFA; in the male T2D population, BMI, TG, SAD and TAD showed independent correlations with VFA. Among these variables, SAD exhibited the strongest correlation with VFA (r = 0.83 for females, r = 0.88 for males), followed by TAD (r = 0.69 for females, r = 0.79 for males). Based on these findings, a VFA estimated equation was developed for the T2D population: VFA (male) =-364.16 + 15.36*SAD + 0.77*TG + 9.41*TAD - 5.00*BMI (R2 = 0.75, adjusted R2 = 0.74); VFA(female)=-170.87 + 9.72*SAD-24.29*(TG^-1) + 3.93*TAD (R2 = 0.69, adjusted R2 = 0.68). Both models demonstrated a good fit. The Bland-Altman plot indicated a strong agreement between the actual VFA values and the estimated values, the mean differences were close to 0, and the majority of differences fell within the 95% confidence interval. CONCLUSIONS In the T2D population, a VFA estimated equation is developed by incorporating SAD and TAD along with other measurement indices. This equation demonstrates a favorable estimated performance, suggesting to the development of novel and practical VFA estimation models in the future study.
Collapse
Affiliation(s)
- Chao Li
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Liankun Zeng
- Department of Endocrinology, the Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 511300, China
| | - Miaosheng Li
- Department of Joint surgery, Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, 533099, China
- Baise People's Hospital, Baise, 533099, China
| | - Kang Deng
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524002, China
| | - Die Zhou
- Department of Clinical Laboratory, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Rutao Liang
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Xiaoshu Zhang
- Department of Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Zhihui Hu
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524002, China
| | - Ai Luo
- Department of Endocrinology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Chunling Chen
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Qi Chen
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Wenlong Wei
- Guangzhou Red Cross Hospital(Guangzhou Red Cross Hospital of Jinan University), Guangzhou, 510240, China
| | - Wangen Li
- Department of Endocrinology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China.
- Guangzhou Medical University, Guangzhou, 510220, China.
| | - Zhuoqing Hu
- Department of Endocrinology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China.
- Guangzhou Medical University, Guangzhou, 510220, China.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Quintana HK, Moreno Velásquez I, Montenegro Mendoza R, Niño Hall C, Motta J, Roa R. Diabetes mellitus, its prevalence, awareness, and control in Panama: Data from ENSPA 2019, a national cross-sectional study. Medicine (Baltimore) 2023; 102:e34600. [PMID: 37565909 PMCID: PMC10419614 DOI: 10.1097/md.0000000000034600] [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: 03/22/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Diabetes mellitus (DM) represents an important global burden of disease. In Panama, DM was investigated in 1 study utilizing questionnaires and in another using biomarkers, but at subnational level. Using data from a recent cross-sectional country-wide population-based study that included biomarkers, we estimated the prevalence of DM, its awareness, and control; evaluating possible risk factors. We used data from 4400 participants aged 18 years or older from the National Health Study of Panama (ENSPA) study conducted in 2019 at a national level. Weighted prevalence and 95% confidence intervals for DM, awareness, and control were estimated by sociodemographic factors, family history of DM, tobacco and alcohol use, nutritional status, and hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression models to assess the possible risk factors associated with DM prevalence and awareness. We generated OR estimates by pooling ENSPA data with a previous regional study, prevalence of cardiovascular risk factors. The prevalence of DM was estimated to be 12.4% (10.9%-14.05%). In both men and women, age, family history of diabetes (OR in men: 4.0 ([2.4-6.7]; OR in women 3.5 [2.5-4.8]), and obesity (OR in men: 2.6 [1.4-5.1]; OR in women: 2.0 [0.9-4.5]) were associated with DM. Diagnosed and controlled hypertension was associated with DM only in women (OR: 2.1 [1.2-3.6]). DM awareness was estimated to be 62.6% (56.3%-68.9%). In both men and women, DM awareness was associated with age and a family history of diabetes (OR in men: 6.6 [2.4-18.4]; OR in women 1.9 ([1.1-3.6]). In women, having secondary education (OR: 1.9 [0.9-3.9]) and being diagnosed with uncontrolled hypertension (OR: 3.3 [1.2-9.5]) was also associated to DM awareness. Men in the ENSPA study were less likely to be aware of DM than those in the prevalence of cardiovascular risk factors (OR: 0.2 [0.0-0.7]). Less than half of the individuals diagnosed with DM had their condition controlled (39.6% [31.4%-47.8%]). This study revealed that the prevalence, awareness, and control of DM were similar to recent estimates reported in other Latin American countries. It also provides a baseline regarding DM and associated risk factors in Panama at a country-level knowledge that is essential for health policy development and useful in clinical practice.
Collapse
Affiliation(s)
| | | | | | | | - Jorge Motta
- Gorgas Memorial Institute for Health Studies, Panama, Panama
| | - Reina Roa
- Gorgas Memorial Institute for Health Studies, Panama, Panama
- Ministerio de Salud de Panamá, Panama, Panama
| |
Collapse
|
4
|
Montenegro Mendoza R, Roa R, Fontes F, Moreno Velásquez I, Quintana H. Physical Inactivity and Sedentary Behaviour among Panamanian Adults: Results from the National Health Survey of Panama (ENSPA) 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085554. [PMID: 37107836 PMCID: PMC10138807 DOI: 10.3390/ijerph20085554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 05/07/2023]
Abstract
Physical inactivity (PI) has been described as an independent risk factor for a large number of major non-communicable diseases and is associated with an increased risk of premature death. Additionally, sedentary behaviour has been associated with increased overall mortality. We estimated the national prevalence of PI and sedentary behaviour using the Global Physical Activity Questionnaire version 2. Using unconditional logistic regressions, the possible risk factors for PI were assessed. Over half of the people included in this study (54.9%; 95% CI: 54.1-57.3%) were physically inactive, with the median time spent engaged in sedentary behaviour being 120 min per day. Statistically significant associations with PI were observed with regard to sex, living area, and alcohol consumption. PI prevalence in Panama was elevated and showed a sex difference (women: 64.7%, 95% CI: 63.7-66.7%; men: 43.4%, 95% CI: 41.5-47.5%). According to our analysis of three-domain-related physical activities, the main contribution to the total estimated energy expenditure of physical activity/week came from the transport domain, followed by the work/household domain, and the least significant contributor was consistently the domain of exercise- and sports-related physical activities.
Collapse
Affiliation(s)
- Roger Montenegro Mendoza
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
- Correspondence: ; Tel.: +507-527-4961
| | - Reina Roa
- Planning Directorate, Ministry of Health, Panama City 4444, Panama
| | - Flavia Fontes
- Dietetic and Nutrition Department, Faculty of Medicine, University of Panama, Panama City 3366, Panama
| | - Ilais Moreno Velásquez
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
| | - Hedley Quintana
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Guerra C, Conte E, Del Rio AI, Motta J, Moreno Velásquez I, Quintana HK. Medication Adherence in Hypertensive Individuals in Panama 2019: A National Cross-Sectional Study. Healthcare (Basel) 2022; 10:2244. [PMID: 36360586 PMCID: PMC9690778 DOI: 10.3390/healthcare10112244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 09/08/2024] Open
Abstract
Poor medication adherence is a public health concern leading to a large burden of cardiovascular disease among persons with hypertension. Using data from 3281 persons with diagnosed hypertension (N = 622,581) from the Panamanian National Health Survey (ENSPA) collected in 2019, we assessed the national prevalence of low-moderate medication adherence in hypertensive individuals using the 4-scale Morisky Medication Adherence Scale (4-MMAS) and identifying gender-specific associated factors. Multivariate logistic regression models were used to estimate the association between possible risk factors and low-moderate medication adherence with odds ratios (OR) and 95% confidence intervals (95% CI) stratified by gender. The national prevalence of low-moderate medication adherence was 78.2% (95% CI: 74.7-81.0%); in men it was 74.4% (95% CI: 67.5-80.3%) and in women it was 81.4% (78.4-84.0%). In women, low-moderate medication adherence was associated with living in indigenous area (OR: 5.15; 95% CI: 1.40-18.98), educational level (OR no formal education: 0.77, 95% CI 0.28-2.14; OR for primary education: 0.76, 95% CI 0.38-1.56; OR for secondary education: 0.90, 95% CI 0.48-1.70; Higher education as reference), increased BMI (normal as reference, OR for overweight: 1.35, 95% CI: 0.73-2.50, OR for obesity: 1.65, 95% CI: 0.90-3.03) and medical diagnosis of anxiety/depression (OR: 4.89, 95% CI: 1.36-17.49). However, in men, it was associated with having secondary education (OR: 2.94; 95% CI: 1.03-8.36), currently smoking (OR: 16.74, 95% CI: 1.83-152.70), taking antihypertensive medication with denial of hypertension diagnosis (OR: 4.35, 95% CI: 1.11-17.11) and having less than three annual check-ups (OR for no health check-ups: 2.97, 95% CI: 0.63-13.88; OR for 1-2 check-ups: 1.61, 95% CI: 0.78-3.32: three or more health check-ups: reference). Time since diagnosis was inversely associated with low-moderate adherence. This study assesses for the first time the national prevalence of low-moderate medication adherence among hypertensive individuals in Panama. Low-moderate medication adherence is an important public health issue that should be addressed to achieve blood pressure control in patients diagnosed with hypertension, taking into account gender-specific factors.
Collapse
Affiliation(s)
- Carlos Guerra
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
- Ministry of Health, Panama City 0843-03441, Panama
| | - Eric Conte
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
| | - Angela Isabel Del Rio
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
- Ministry of Health, Panama City 0843-03441, Panama
| | - Jorge Motta
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
| | - Ilais Moreno Velásquez
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
| | - Hedley Knewjen Quintana
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City 0816-02593, Panama
| |
Collapse
|