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Kapoor N, Jiwanmall SA, Nandyal MB, Kattula D, Paravathareddy S, Paul TV, Furler J, Oldenburg B, Thomas N. Metabolic Score for Visceral Fat (METS-VF) Estimation - A Novel Cost-Effective Obesity Indicator for Visceral Adipose Tissue Estimation. Diabetes Metab Syndr Obes 2020; 13:3261-3267. [PMID: 32982356 PMCID: PMC7507406 DOI: 10.2147/dmso.s266277] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/19/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) assessment is limited in clinical practice due to expensive, time consuming and limited availability of MRI and DXA machines. We explored the utility of a recently developed Metabolic Score for Visceral Fat (METS-VF) to assess VAT in south Asian individuals with morbid obesity. PATIENTS AND METHODS Individuals with BMI ≥35 kg/m2 aged between 30 and 60 years were randomly selected from a database of individuals with morbid obesity, attending a multi-disciplinary bariatric clinic in a tertiary care teaching hospital in southern India. Body composition was assessed by using a Hologic Discovery A dual-energy X-ray absorptiometry (DXA) machine. METS-VF was used to estimate VAT by using a previously published algorithm. RESULTS The mean age and body mass index of the study subjects (N=350) were 38.2 years and 40.1 kg/m2. The MET-VF score performed satisfactorily (AUC of 0.78 (95% CI 0.72-0.85)) for predicting an increased visceral adipose tissue (VAT area ≥ 163 cm2) as detected by DXA. A METS-VF value of 7.3 was found to have a good sensitivity and reasonable specificity in predicting elevated VAT in this population. CONCLUSION This is the first study to validate the utility of METS-VF as a surrogate measure of visceral adiposity in south Indian individuals with morbid obesity. Given the simplicity, easy availability, reliability and inexpensive nature of this obesity indicator, it may find its widespread use in lower middle-income countries.
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Affiliation(s)
- Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
- Non-Communicable Disease Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Stephen A Jiwanmall
- Department of Psychiatry, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Munaf B Nandyal
- Department of Psychiatry, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Dheeraj Kattula
- Department of Psychiatry, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Sandhiya Paravathareddy
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Thomas V Paul
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - John Furler
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Brian Oldenburg
- Non-Communicable Disease Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
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Kalra S, Kapoor N, Kota S, Das S. Person-centred Obesity Care - Techniques, Thresholds, Tools and Targets. EUROPEAN ENDOCRINOLOGY 2020; 16:11-13. [PMID: 32595763 DOI: 10.17925/ee.2020.16.1.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/05/2019] [Indexed: 12/29/2022]
Abstract
Obesity is a complex syndrome with multifactorial etiopathogenesis, multifaceted clinical presentations, multidimensional therapeutic approaches, and multipronged treatment strategies. These create the need for a person-centred approach to the management of obesity. This opinion piece explores the spectrum of person-centred obesity care. The authors describe the person-centred nature of techniques used to detect obesity, the thresholds used to diagnose it, the tools (treatment strategies) used to manage it, and the therapeutic outcomes aimed for. The discussion highlights the vast spectrum of obesity and its impact on health, and underscores the need for healthcare professionals to take a person-centred approach to its evaluation and management.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - Nitin Kapoor
- Department of Endocrinology, Christian Medical College, Vellore, India
| | - Sunil Kota
- Department of Endocrinology, Diabetes and Endocare Clinic, Berhampur, India
| | - Sambit Das
- Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India
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Taberna DJ, Navas-Carretero S, Martinez JA. Current nutritional status assessment tools for metabolic care and clinical nutrition. Curr Opin Clin Nutr Metab Care 2019; 22:323-328. [PMID: 31246586 DOI: 10.1097/mco.0000000000000581] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The aim of this report is to critically review existing questionnaires and tools to assess nutritional status in different populations and pathological conditions. RECENT FINDINGS A total of 16 instruments to evaluate nutritional status were recorded, which were based on anthropometrical determinations, biochemical markers, clinical examinations and subjective questionnaires, depending on the nutritional assessment focus, involving different concepts: screening of the risk, diagnosis and severity of malnutrition, as well as the consequences of undernutrition or overnutrition. SUMMARY A variety of questionnaires, equations and tools were found with ability to assess nutritional status for metabolic care or clinical nutrition purposes, but apparently there is no optimal, universal and reliable nutritional status screening system for all metabolic conditions. Novel assessment instruments should provide high sensibility and specificity, be precise and reliable as well as inexpensive and simple, in order to avoid the additional burden of excessive loads of costs, work and time while dynamically overcoming the influence of disease diversity.
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Affiliation(s)
- Daniel J Taberna
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, Pamplona
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, Pamplona
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pabellón 11. Planta, Madrid
- Navarra Health Research Institute (IDISNA), Recinto de Complejo Hospitalario de Navarra (Edificio LUNA-Navarrabiomed) C/Irunlarrea, Pamplona
| | - Jose A Martinez
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, Pamplona
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pabellón 11. Planta, Madrid
- Navarra Health Research Institute (IDISNA), Recinto de Complejo Hospitalario de Navarra (Edificio LUNA-Navarrabiomed) C/Irunlarrea, Pamplona
- Program for Precision Nutrition, IMDEA, Carr. de Cantoblanco, Madrid, Spain
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The influence of obesity and weight gain on quality of life according to the SF-36 for individuals of the dynamic follow-up cohort of the University of Navarra. Rev Clin Esp 2018. [DOI: 10.1016/j.rceng.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Grammatikopoulou MG, Chourdakis M, Gkiouras K, Roumeli P, Poulimeneas D, Apostolidou E, Chountalas I, Tirodimos I, Filippou O, Papadakou-Lagogianni S, Dardavessis T. Edmonton obesity staging system among pediatric patients: a validation and obesogenic risk factor analysis. J Endocrinol Invest 2018; 41:947-957. [PMID: 29313283 DOI: 10.1007/s40618-017-0821-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 12/24/2017] [Indexed: 02/08/2023]
Abstract
PURPOSE The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a useful tool, delineating different obesity severity tiers associated with distinct treatment barriers. The aim of the study was to apply the EOSS-P on a Greek pediatric cohort and assess risk factors associated with each stage, compared to normal weight controls. METHODS A total of 361 children (2-14 years old), outpatients of an Athenian hospital, participated in this case-control study by forming two groups: the obese (n = 203) and the normoweight controls (n = 158). Anthropometry, blood pressure, blood and biochemical markers, comorbidities and obesogenic lifestyle parameters were recorded and the EOSS-P was applied. Validation of EOSS-P stages was conducted by juxtaposing them with IOTF-defined weight status. Obesogenic risk factors' analysis was conducted by constructing gender-and-age-adjusted (GA) and multivariate logistic models. RESULTS The majority of obese children were stratified at stage 1 (46.0%), 17.0% were on stage 0, and 37.0% on stage 2. The validation analysis revealed that EOSS-P stages greater than 0 were associated with diastolic blood pressure and levels of glucose, cholesterol, LDL and ALT. Reduced obesity odds were observed among children playing outdoors and increased odds for every screen time hour, both in the GA and in the multivariate analyses (all P < 0.05). Although participation in sports > 2 times/week was associated with reduced obesity odds in the GA analysis (OR = 0.57, 95% CI = 0.33-0.98, P linear = 0.047), it lost its significance in the multivariate analysis (P linear = 0.145). Analogous results were recorded in the analyses of the abovementioned physical activity risk factors for the EOSS-P stages. Linear relationships were observed for fast-food consumption and IOTF-defined obesity and higher than 0 EOSS-P stages. Parental obesity status was associated with all EOSS-P stages and IOTF-defined obesity status. CONCLUSIONS Few outpatients were healthy obese (stage 0), while the majority exhibited several comorbidities. Since each obesity tier entails different impacts to disease management, the study herein highlights modifiable factors facilitating descend to lower stages, and provides insight for designing tailored approaches tackling the high national pediatric obesity rates.
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Affiliation(s)
- M G Grammatikopoulou
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - M Chourdakis
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - K Gkiouras
- Laboratory of Clinical Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Roumeli
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
- Department of Pediatrics, Asklipio General Hospital, Voula, Athens, Greece
| | - D Poulimeneas
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - E Apostolidou
- Laboratory of Clinical Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Chountalas
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - I Tirodimos
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - O Filippou
- Department of Pediatrics, Asklipio General Hospital, Voula, Athens, Greece
| | | | - T Dardavessis
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Barcones-Molero MF, Sánchez-Villegas A, Martínez-González MA, Bes-Rastrollo M, Martínez-Urbistondo M, Santabárbara J, Martínez JA. The influence of obesity and weight gain on quality of life according to the SF-36 for individuals of the dynamic follow-up cohort of the University of Navarra. Rev Clin Esp 2018; 218:408-416. [PMID: 29958652 DOI: 10.1016/j.rce.2018.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/07/2018] [Accepted: 05/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The health-related quality of life is an important element for the comprehensive assessment of overweight and obesity. OBJECTIVE To assess the impact of obesity and weight gain on the health-related quality of life of the dynamic cohort of the Follow-up Program of the University of Navarra. MATERIAL AND METHODS The analysis included 10,033 participants of the prospective dynamic cohort of the Follow-up Project of the University of Navarra, with a response rate of approximately 90%. The quality of life was measured with the Short Form 36 Health Survey (SF-36) (0, worst quality of life; 100, best quality of life). The statistical analysis was performed with generalized lineal models (mean of each SF-36 domain and 95% CI). A difference of 3 points was considered clinically relevant. RESULTS The SF-36 analysis showed that physical function, general health and the physical component summary were inferior in individuals with excess weight and obesity at the start of the study, compared with individuals with normal weight. The study population with unchanged excess weight or obesity after 2 years of follow-up presented lower scores on the SF-36 domains corresponding to physical function, body pain, physical component summary and general health than individuals who maintained the normal weight category according to BMI (kg/m2). CONCLUSIONS Obesity appears to be associated with a negative impact on health-related quality of life, affecting the physical area more significantly than the psychosocial.
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Affiliation(s)
- M F Barcones-Molero
- Instituto de Investigación Sanitaria de Aragón (IIS-IACS Aragón), Hospital Clínico Universitario Lozano Bles», Hospital Universitario Miguel Servet, Centro de Salud Torre Ramona, Zaragoza, España.
| | - A Sánchez-Villegas
- Grupo de Investigación en Nutrición, Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS) , Las Palmas de Gran Canaria, España; Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, España
| | - M A Martínez-González
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdisNA), Pamplona, España
| | - M Bes-Rastrollo
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdisNA), Pamplona, España
| | - M Martínez-Urbistondo
- Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, España
| | - J Santabárbara
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España
| | - J A Martínez
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdisNA), Pamplona, España; Departamento de Nutrición, Ciencias de la Alimentación, Fisiología y Centro de Investigación en Nutrición, Universidad de Navarra, Pamplona, España; IMDEA Food, Campus Cantoblanco, Madrid, España
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