Is waist circumference more strongly associated with metabolic risk factors than waist-to-height ratio in Asians?

Is Abdominal Obesity a Risk Factor for the Incidence of Vitamin D Insufficiency and Deficiency in Older Adults? Evidence from the ELSA Study

Cross-sectional studies have demonstrated an association between abdominal obesity, determined by waist circumference (WC), and vitamin D (25(OH)D) deficiency in older adults. However, longitudinal evidence is based only on general obesity determined using body mass index (BMI). We investigated whether abdominal obesity is associated with the incidence of 25(OH)D insufficiency (>30 and ≤50 nmol/L) and deficiency (≤30 nmol/L), and whether vitamin D supplementation modifies these associations. We included 2459 participants aged ≥50 years from the English Longitudinal Study of Ageing (ELSA) with 25(OH)D sufficiency (>50 nmol/L) at baseline. Abdominal obesity was defined as >88 cm for women and >102 cm for men. After 4 years, 25(OH)D concentrations were reassessed. Multinomial logistic regression models controlled by covariates were performed. Abdominal obesity increased the risk of the incidence of 25(OH)D insufficiency (RRR = 1.36; 95% CI: 1.01−1.83) and deficiency (RRR = 1.64; 95% CI: 1.05−2.58). These risks were maintained when excluding individuals who took vitamin D supplementation (RRR = 1.38; 95% CI: 1.02−1.88) and (RRR = 1.62; 95% CI: 1.02−2.56). Abdominal obesity is associated with the risk of incidence of low 25(OH)D concentrations. WC seems to be an adequate tool for screening individuals with obesity and at potential risk of developing these conditions.

BMI is dead; long live waist-circumference indices: But which index should we choose to predict cardio-metabolic risk?

BACKGROUND AND AIMS

There is growing evidence that Body Mass Index (BMI) is unfit for purpose. Waist circumference (WC) indices appear to be the preferred alternative, although it is not clear which WC index is optimal at predicting cardio-metabolic risk (CMR) and associated health outcomes.

METHODS AND RESULTS

We obtained a stratified random probability sample of 53,390 participants from the Health Survey for England (HSE), 2008-2018. The four available CMR factors were; high-density lipoproteins (HDL) cholesterol, glycated haemoglobin (HbA1c), systolic (SBP) and diastolic blood pressure (DBP). Strength of association between the four cardio-metabolic risk factors and competing anthropometric indicators of weight status [BMI, Waist-to-height ratio (WHTR), unadjusted WC, and a new WC index independent of height, WHT·5R = WC/height^0.5] was assessed separately, using simple correlations and ANCOVAs, and together (combined) using MANCOVA, controlling for age, sex and ethnicity. Centile curves for the new index WHT·5R = WC/height^0.5were also provided.

CONCLUSIONS

Waist-circumference indices were superior to BMI when explaining/predicting our CMR factors, before and after controlling for age, sex and ethnicity. No single WC index was consistently superior. Results suggest that WHTR is the strongest predictor of HbA1c, confirming that shorter individuals are at great risk of diabetes. The most appropriate WC index associated with blood pressure was WHT·5R for DBP, or unadjusted WC for SBP. Given HDL cholesterol is independent of height, the best predictor of HDL was WHT.5R. Clearly, "no one size fits all!". MANCOVA identified WHT·5R to be the best single WC index associated with a composite of all four CMR factors.

Simulation of 3D Body Shapes for Pregnant and Postpartum Women

Several studies have reported that pre-pregnant women’s body mass index (BMI) affects women’s weight gain with complications during pregnancy and the postpartum weight retention. It is important to control the BMI before, during and after pregnancy. Our objectives are to develop a technique that can compute and visualize 3D body shapes of women during pregnancy and postpartum in various gestational ages, BMI, and postpartum durations. Body changes data from 98 pregnant and 83 postpartum women were collected, tracked for six months, and analyzed to create 3D model shapes. This study allows users to simulate their 3D body shapes in real-time and online, based on weight, height, and gestational age, using multiple linear regression and morphing techniques. To evaluate the results, precision tests were performed on simulated 3D pregnant and postpartum women’s shapes. Additionally, a satisfaction test on the application was conducted on new 149 mothers. The accuracy of the simulation was tested on 75 pregnant and 74 postpartum volunteers in terms of relationships between statistical calculation, simulated 3D models and actual tape measurement of chest, waist, hip, and inseam. Our results can predict accurately the body proportions of pregnant and postpartum women.

Analysis of Blood Pressure and Ventilation Efficiency in Different Types of Obesity Aged 40-60 Years by Cardiopulmonary Exercise Test

PURPOSE

This study investigated blood pressure and ventilation efficiency by cardiopulmonary exercise test (CPX) in different types of obesity aged 40-60 years.

MATERIAL AND METHODS

The inclusion criteria of this cross-sectional study were adults aged 40-60 years underwent health checks. CPX was measured according to the relevant standards. According to different body mass index (BMI), there were 3 groups, BMI<24 (kg/m²), 24≤BMI<28 (kg/m²) and BMI≥28 (kg/m²). There were two groups in male, waist circumference≥90 (cm) and waist circumference<90 (cm). Similarly, there were two groups in female, waist circumference≥85 (cm) and waist circumference<85 (cm).

RESULTS

There were 543 individuals (64.6% male and 35.4% female) aged 40-60 years in this study. The resting blood pressure (BP) and peak BP have the significant differences in different BMI groups (p < 0.001) and male or female groups (p < 0.001). However, the resting DBP (77.70±9.45 vs 81.16±8.80, p < 0.001) and peak DBP (85.67±10.21 vs 89.03±9.94, p = 0.002) have the significant differences in different male waist circumference groups, and the resting BP (SBP 113.76±14.29 vs 121.86±15.54, p = 0.001, DBP 71.95±10.83 vs 77.27±11.42, p = 0.005) has the significant differences in different female waist circumference groups. Carbon dioxide Ventilation equivalent (VE/VCO₂) has the significant differences in different male waist circumference groups (26.84±3.10 vs 27.68±2.93, p = 0.009), but it has not the significant differences in different BMI groups and different female waist circumference groups. The oxygen pulse (VO₂/HR) is slightly higher in female group than male group (0.93±0.15 vs 0.89±0.15, p = 0.001). Breathing reserve has the statistical significance in BMI ≥28 group compared with the BMI <24 group (0.52±0.13 vs 0.46±0.17, ηp²=0.021).

CONCLUSION

We found that the blood pressure and ventilation efficiency of CPX were different between the obesity and normal. This will provide a basis for accurate cardiopulmonary assessment of obesity.

Indirect Predictors of Visceral Adipose Tissue in Women with Polycystic Ovary Syndrome: A Comparison of Methods

Visceral adipose tissue (VAT) accumulation, is a part of a polycystic ovary syndrome (PCOS) phenotype. Dual-energy x-ray absorptiometry (DXA) provides a gold standard measurement of VAT. This study aimed to compare ten different indirect methods of VAT estimation in PCOS women. The study included 154 PCOS and 68 age- and BMI-matched control women. Subjects were divided into age groups: 18-30 y.o. and 30-40 y.o. Analysis included: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist/height 0.5 (WHT.5R), visceral adipose index (VAI), lipid accumulation product (LAP), and fat mass index (FMI). VAT accumulation, android-to-gynoid ratio (A/G), and total body fat (TBF) was measured by DXA. ROC analysis revealed that WHtR, WHT.5R, WC, BMI, and LAP demonstrated the highest predictive value in identifying VAT in the PCOS group. Lower cut-off values of BMI (23.43 kg/m2) and WHtR (0.45) were determined in the younger PCOS group and higher thresholds of WHtR (0.52) in the older PCOS group than commonly used. Measuring either: WHtR, WHT.5R, WC, BMI, or LAP, could help identify a subgroup of PCOS patients at high cardiometabolic risk. The current observations reinforce the importance of using special cut-offs to identify VAT, dependent on age and PCOS presence.

The effect of extra virgin olive oil on anthropometric indices, lipid profile, and markers of oxidative stress and inflammation in patients with depression, a double-blind randomised controlled trial

BACKGROUND

Epidemiological evidence suggests a mutual association between depression and obesity and also an anti-obesity effect for olive oil. We examined the effect of extra virgin olive oil (EVOO) on weight, waist circumference, and a number of cardiovascular risk factors in patients with depression.

METHODS

The randomised double-blind controlled trial was conducted on 62 patients with depression. Patients were randomly allocated to EVOO and sunflower oil groups (n = 31 for each) that consumed 25 mL/day of the corresponding oils for 52 days. An isocaloric diet was prescribed to each patient according to his/her previous energy intake with considering the energy provided by the administered oils. Weight, body mass index (BMI), waist circumference, blood lipids, malondialdehyde, and hs-C reactive protein (CRP) analysis were performed using the intention-to-treat approach.

RESULTS

BMI was significantly decreased in sunflower oil group (-0.20 ± 0.53 kg/m² , P = .047) and waist circumference was significantly decreased in EVOO group (-2.15 ± 2.09 cm, P < .001); however, only reduction of waist circumference was significantly different between groups (P < .001). High-density lipoprotein (HDL) cholesterol was significantly increased in EVOO group (3.02 ± 6.79 mg/dL, P = .03), without showing a significant between-group difference. Other lipids, malondialdehyde, and hs-CRP did not change.

CONCLUSION

Overall, the results suggest that both EVOO and sunflower oil may benefit overweight patients with depression, as they respectively decreased waist circumference and BMI without need for administration of a low-calorie diet.

Influence of uric acid on the correlation between waist circumference and triglyceride glucose index: an analysis from CHARLS

Background

Waist circumference (WC) and uric acid (UA) are significantly related. Still, their temporal sequence and how the sequence works on future risk of triglyceride glucose (TyG) are unknown, especially in the Chinese population.

Methods

Cross-lagged panel model was used to analyze the reciprocal, longitudinal relationships among a set of interrelated variables. The mediation model was constructed to test the effect of the relationship between WC and UA on TyG.

Results

A total of 5727 subjects were enrolled in our study population, of which 53.5% were women, and the mean age was 59.0 (standard deviation, 8.62) years. After adjusting for traditional confounding factors, the results showed that a higher level of baseline WC was significantly associated with a higher level of follow-up UA (β = 0.003, P = 0.031) and follow-up TyG (β = 0.003, P < 0.001);. Simultaneously, there was no statistical association between the level of baseline UA and the level of follow-up WC (β = − 0.009, P = 0.951). The mediation effects of UA on WC-TyG were estimated to be 18.1% in adults, and 36.2% in women.

Conclusions

The current study demonstrated that higher baseline level of WC probably preceded UA’ level in general population. In addition, UA mediated the relationship of WC to TyG, especially in females. And the possible mechanism would require further clarification.

Health risks associated with high waist circumference: A systematic review

Obesity is a health disorder characterized by an increase in body weight, measured by waist circumference. High waist circumference is linked to potential development of non-communicable diseases. A systematic review study was used to explore health risks of high waist circumference through Google Scholar, Science Direct, Pubmed, and Proquest. Findings show that high waist circumference increased the risks of developing hypertension, type 2 diabetes mellitus, hypercholesterolemia, joint pain, low back pain, and hyperuricemia. It is recommended that government increase their role in raising public awareness to maintain healthy lifestyle.

Beyond Asian-Specific Cutoffs: Gender Effects on the Predictability of Body Mass Index, Waist Circumference, and Waist Circumference to Height Ratio on Hemoglobin A1c

OBJECTIVES

This study examines the gender effect on the associations between body mass index (BMI), waist circumference (WC), and waist circumference to height ratio (WHtR) with hemoglobin A1c (HbA1c) when Asian-specific cutoffs are applied among Asians living in the USA.

DESIGN

This study used the pooled 2013-2014 and 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to produce a sample of 900 Asians who were non-pregnant and non-Hispanic aged 20-65. Bivariate and general linear regression analyses were conducted based on gender and age group.

RESULTS

The group variations of BMI, WC, and WHtR all exhibited different patterns between males and females. Among the bivariate correlations with HbA1c, WHtR was the strongest in males and WC was the strongest in females. All three measures performed better in predicting HbA1c among younger Asians. WC predicted more of the variance in HbA1c among females, whereas WHtR predicted more of the variance in HbA1c among males.

CONCLUSIONS

WC and WHtR are two anthropometric measures that serve as appropriate proxy of HbA1c for gauging the risk of developing type 2 diabetes among Asians living in the USA. They can be easily performed at non-clinical settings and should be used by individuals to monitor their health and be a part of disease prevention.

Measurement of Visceral Fat, Abdominal Circumference and Waist-hip Ratio to Predict Health Risk in Males and Females

BACKGROUND AND OBJECTIVE

Obesity is a risk factor for a broad range of diseases. This study aimed to estimate association between selected variables (visceral fat, abdominal circumference and waist-hip ratio) and health risk in between male and female.

MATERIALS AND METHODS

The university student based cross-sectional study was conducted among male and female students. The anthropometric measurements were taken through the auto-calibrated digital scale. Bioelectrical impedance analyzer device was used to determine visceral fat area, abdominal circumference and waist-hip ratio. Independent t-test and Pearson Chi-Square was used for statistical analysis. To see the association among the all three variables, scatter plots were also drawn.

RESULTS

The results showed that 28.3% male and 9.4% female at risk for visceral fat, for the abdominal circumference 16.9% male and 6% female at risk and for waist-hip ratio 27.5% male and 6% female fell under risk category. There was a significant relationship among all variable for male and female.

CONCLUSION

Findings suggested that visceral fat area, abdominal circumference and waist-hip ratio were strong predictors of health risk. Male were more prone to health risk than female participants.

Association between anthropometric indicators of obesity and cardiovascular risk factors among adults in Shanghai, China

Background

To determine the optimal cut-off values and evaluate the associations of body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR) with cardiovascular disease (CVD) risk factors.

Methods

A large-scale cross-sectional survey was conducted among 35,256 adults aged 20–74 years in Shanghai between June 2016 and December 2017. Receiver operating characteristic (ROC) analyses were conducted to assess the optimal cut-off anthropometric indices of CVD risk factors including hypertension, diabetes, dyslipidemia and hyperuricemia. Multivariate Logistic regression models were preformed to evaluate the odds ratio of CVD risk factors.

Results

The area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of hypertension and diabetes, and AUCs were higher in women than men. The optimal cut-off values of WHtR were approximately 0.51 in both sexes, while the cut-off values of BMI and WC were higher for men compared with women. The optimal cutoff values of BMI and WC varied greatly across different age groups, but the difference in WHtR was relatively slight. Among women, the optimal threshold of anthropometric indices appeared to increase with age for hypertension and diabetes. The odds ratio between anthropometric indices and CVD risk factors were attenuated with age. WHtR had the greatest odds ratio for CVD risk factors among adults under 60 years old except for women with hypertension, while among 60–74 years, BMI yielded the greatest odds ratio in terms of all CVD outcomes except for women with diabetes.

Conclusions

WHtR had the best performance for discriminating hypertension and diabetes and potentially be served as a standard screening tool in public health. The associations between three anthropometric indices and CVD risk factors differed by sex and decreased with age. These findings indicated a need to develop age- and gender-specific difference and make effective strategies for primary prevention of CVDs.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7366-0) contains supplementary material, which is available to authorized users.