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Agius R, Pace NP, Fava S. Anthropometric and Biochemical Correlations of Insulin Resistance in a Middle-Aged Maltese Caucasian Population. J Nutr Metab 2024; 2024:5528250. [PMID: 38420511 PMCID: PMC10901578 DOI: 10.1155/2024/5528250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/20/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Background Insulin resistance (IR) is associated with increased cardiovascular disease risk, and with increased all-cause, cardiovascular, and cancer mortality. A number of surrogate markers are used in clinical practice to diagnose IR. The aim of this study was to investigate the discriminatory power of a number of routinely available anthropometric and biochemical variables in predicting IR and to determine their optimal cutoffs. Methods We performed a cross-sectional study in a cohort of middle-aged individuals. We used receiver operator characteristics (ROC) analyses in order to determine the discriminatory power of parameters of interest in detecting IR, which was defined as homeostatic model assessment-insulin resistance ≥2.5. Results Both the lipid accumulation product (LAP) and visceral adiposity index (VAI) exhibited good discriminatory power to detect IR in both males and females. The optimal cutoffs were 42.5 and 1.44, respectively, in males and 36.2 and 1.41, respectively, in females. Serum triglycerides (TG) and waist circumference (WC) similarly demonstrated good discriminatory power in detecting IR in both sexes. The optimal cutoffs for serum TG and WC were 1.35 mmol/L and 96.5 cm, respectively, in men and 1.33 mmol/L and 82 cm, respectively, in women. On the other hand, systolic and diastolic blood pressure, liver transaminases, high-density lipoprotein cholesterol, serum uric acid, ferritin, waist-hip ratio, "A" body shape, thigh circumference, and weight-adjusted thigh circumference all had poor discriminatory power. Conclusions Our data show that LAP, VAI, TG, and WC all have good discriminatory power in detecting IR in both men and women. The optimal cutoffs for TG and WC were lower than those currently recommended in both sexes. Replication studies are required in different subpopulations and different ethnicities in order to be able to update the current cut points to ones which reflect the contemporary population as well as to evaluate their longitudinal relationship with longer-term cardiometabolic outcomes.
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Affiliation(s)
- Rachel Agius
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida MSD2090, Malta
| | - Nikolai Paul Pace
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
| | - Stephen Fava
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida MSD2090, Malta
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Magri CJ, Xuereb S, Xuereb RA, Fava S. Metabolic Health and Carotid Intima-Media Thickness: Association of Different Definitions in Women. Am J Cardiol 2023; 206:35-39. [PMID: 37677881 DOI: 10.1016/j.amjcard.2023.08.003] [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: 06/22/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023]
Abstract
The concept of metabolic health and the metabolic syndrome is to identify subjects at a higher cardiovascular risk. However, many definitions are currently in use, and it is uncertain which is the best in identifying at-risk subjects. We performed a cross-sectional study whereby women were invited to participate and were assessed for several anthropometric and biochemical parameters. Carotid intima-media thickness (CIMT) was measured in both common carotid arteries in each participant. The study cohort consisted of 203 white premenopausal women with a mean age of 38.3 ± 5.4 years. The prevalence of the metabolically unhealthy varied from 7.3% to 61.6%, according to the definition used. The prevalence of the metabolic syndrome, as defined by the International Diabetes Federation, was 20.7%. Women with a metabolically unhealthy phenotype had a higher referent CIMT for all definitions of metabolic health. Defining metabolically unhealthy phenotype as having <2 abnormalities using the National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (NCEP-ATPIII) cutoffs had the highest odds ratio for an abnormal CIMT. In conclusion, we found that in a contemporary cohort of middle-aged women, the NCEP-ATPIII definition of the metabolic syndrome was more strongly associated with atherosclerosis as determined by the CIMT than the International Diabetes Federation definition or other definitions of metabolic health; it was also more strongly associated than body mass index or waist circumference. Our results need to be validated by other investigators in other populations.
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Affiliation(s)
- Caroline Jane Magri
- University of Malta Medical School, Msida, Malta; Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | - Sara Xuereb
- Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | - Rachel-Anne Xuereb
- University of Malta Medical School, Msida, Malta; Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | - Stephen Fava
- University of Malta Medical School, Msida, Malta; Department of Medicine, Mater Dei Hospital, Msida, Malta.
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Kryst Ł, Żegleń M, Badzińska J, Woronkowicz A, Kowal M. Intergenerational Changes in the Waist Circumference and Selected Associated Indicators among Children and Adolescents from Kraków (Poland), between 1983 and 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5344. [PMID: 37047960 PMCID: PMC10094173 DOI: 10.3390/ijerph20075344] [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: 02/17/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
The aim of the study was to examine the direction of the secular changes in the waist and hips circumferences, as well as selected associated body proportions, among children and adolescents from Kraków, Poland. The study group included 8-18-year-olds examined in three cross-sectional studies (1983, 2010, and 2020). The analyzed characteristics included body height, circumferences of the waist and hips, which were used to calculate Waist-to-Hip Ratio (WHR), and Waist-to-Height Ratio (WHtR). There was a secular increase regarding the majority of the analyzed features, particularly for the younger children (i.e., prepubertal/early pubertal age). The trends were also especially evident when comparing the results of the 1983 series to the results of their peers examined in 2020. An opposite trend was noted in adolescent girls. The observed changes reflect the secular trend resulting from changes in body composition and fat distribution happening due to alterations in the lifestyle and socio-economic environment of the population over the years. It should also be stressed that the increase in the studied characteristics occurred mainly in younger children. This suggests that the observed changes may have resulted from a shift in the age of maturation and also from the personal and social motivators characteristic for late adolescence.
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Affiliation(s)
- Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
| | - Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 30-060 Kraków, Poland
| | - Julia Badzińska
- Pain Research Group, Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 30-060 Kraków, Poland
- Doctoral School in the Social Sciences, Jagiellonian University, 30-060 Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
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Żegleń M, Kryst Ł, Kowal M, Woronkowicz A. Associations of anthropometric cardiometabolic risk factors and leg fat accumulation in children and adolescents from Poland. Am J Hum Biol 2022; 34:e23795. [PMID: 36066007 DOI: 10.1002/ajhb.23795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/06/2022] [Accepted: 08/21/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To analyze the correlation between anthropometric cardiometabolic risk factors with calf adiposity in 4-16-year-olds from Poland. METHODS Three thousand seventy-six persons (1568 girls and 1508 boys) were examined. Analyzed characteristics included body height, waist, hips and neck circumferences, body weight, six skinfolds. The following were calculated: body mass index (BMI), waist-to-hips ratio (WHR), the sum of all skinfolds, and the sum of skinfolds on the waist area. RESULTS The relationship between the calf skinfold and the rest of the characteristics was estimated using multiple regression. There was a negative relationship between calf adiposity and fat tissue accumulated around the waist and the BMI (in some groups). This suggests that participants with greater calf adiposity had lower waist adiposity and BMI than those with less fat tissue on the lower limb. CONCLUSION Persons with higher calf adiposity may have a lower cardiometabolic risk. This observation is significant because cardiovascular risk factors can persist from childhood into adulthood. Additionally, cardiovascular issues have numerous medical consequences but also socio-economic ones, thus they can affect individuals and be a burden on public health.
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Affiliation(s)
- Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
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Kryst Ł, Żegleń M, Woronkowicz A, Kowal M. Body height, weight, and Body Mass Index - magnitude and pace of secular changes in children and adolescents from Kraków (Poland) between 1983 and 2020. Am J Hum Biol 2022; 34:e23779. [PMID: 35779045 DOI: 10.1002/ajhb.23779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/29/2022] [Accepted: 06/22/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim of this study was to analyze the occurrence and pace of secular trends regarding body height, weight, and Body Mass Index (BMI) among children and adolescents from Kraków (Poland) examined in 1983, 2000, 2010, and 2020. METHODS The study group consisted of 17 407 individuals (8650 girls and 8757 boys) aged 3-18 included in four cross-sectional studies conducted in 1983, 2000, 2010, and 2020.Analyzed anthropometric characteristics included body height (measured according to Martin's technique, with an anthropometer) and body weight. BMI was calculated as follows: body weight (kg)/body height2 (m). RESULTS Results of the current study suggest that there was a cessation of previously observed secular increase of the body height in the examined population in the recent decade. Additionally, secular changes regarding body height, body mass, and BMI occurred noticeably slower in the recent decade compared to the previous years. CONCLUSIONS In conclusion, the rapid increase of body height in the years 1983-2000 and later secular increase of the body mass and BMI in 2000-2010 were probably associated mainly with significant socio-economic progress of the country. On the other hand, deceleration of those trends in 2010-2020, especially in regards to body height, may be associated with reaching the maximum genetically attainable body height in the examined population.
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Affiliation(s)
- Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
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Kryst Ł, Żegleń M, Kowal M, Woronkowicz A. Secular changes in the waist, hips circumferences and selected associated indicators, among preschool children from Kraków (Poland), between 1983 and 2018. Am J Hum Biol 2022; 34:e23748. [PMID: 35333429 DOI: 10.1002/ajhb.23748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Waist circumference and derived indicators are great for measuring the risk of abdominal obesity. The main aim of the study was to assess the changes in the waist, hips circumferences and selected associated indicators, among preschool children (3-7 years of age) from Kraków, Poland, between 1983, 2008 and 2018. METHODS The research was conducted in randomly selected kindergarten in Krakow (Poland). The 1983 cohort consisted of 1414 children and the 2008 and 2018 series included 1050 preschoolers each. Analyzed characteristics included waist and hip circumferences, body height, waist-to-hips ratio (WHR) and waist-to-height ratio (WHtR). RESULTS There was a negative secular trend regarding circumferences of the hips and waist, as well as WHtR. In girls, WHR was, the greatest in the 2018 cohort, while among boys there was a secular increase in the value of this parameter compared to the 2008 cohort, but not to the 1983 series. CONCLUSIONS The coexistence of currently noted trends with the previously described secular decrease in the prevalence of overweight/obesity and increase in trunk adiposity in the same population, suggests that WHR is preferable to body mass index in assessing the risk associated with excess adiposity in the population examined in the presented study.
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Affiliation(s)
- Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
| | - Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education in Kraków, Kraków, Poland
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Żegleń M, Kryst Ł, Kowal M, Woronkowicz A. Social inequalities in obesity and overweight: secular changes in Poland between 1983 and 2020. Eur J Public Health 2021; 31:1053-1057. [PMID: 34510183 DOI: 10.1093/eurpub/ckab161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human development is strongly influenced by environmental factors, including the socioeconomic status (SES) of the family. The aim of this study is to analyze the prevalence of excess body weight among Polish children and adolescents from families of varying SES examined in 1983 and 2020. METHODS The study group included 3-15-year olds from two cross-sectional surveys (1983 and 2020) conducted in kindergartens and schools. The 1983 cohort consisted of 3394 individuals and the one from 2020-of 1253 children and adolescents. Body height and weight were measured and body mass index was calculated. Inclusion into underweight, normal weight and overweight/obese categories was based on Cole's cutoff points. SES was established based on the place of the parents' birth, parents', education status and the number of children in the family, which were self-reported in a questionary by the parents of the examined individuals. RESULTS The mean overall SES was higher in the 2020 cohort, in comparison to the one examined in 1983. This change was also reflected by the changing prevalence of excess body weight, which, in 1983 was the greatest in the high socioeconomic category. On the other hand, in 2020 overweight/obesity was the most prevalent among individuals from families of low SES. CONCLUSIONS The present results confirm the findings obtained in other countries, which suggest that changing the level of socioeconomic development modifies the changes regarding the prevalence of excess body weight. It is an important observation because a study of this type has not yet been conducted in the Polish population.
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Affiliation(s)
| | - Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
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The impact of lifestyle and socioeconomic parameters on body fat level in early childhood. J Biosoc Sci 2021; 54:643-650. [PMID: 34238397 DOI: 10.1017/s002193202100033x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to examine the differences between selected lifestyle and socioeconomic parameters among preschool (3-7 years of age) children of differing adiposity status. The study was conducted from February to June 2018 in 20 randomly selected kindergartens in Kraków, Poland. Triceps, biceps, subscapular, suprailiac, abdominal and calf skinfold thicknesses were measured. The sum of all six skinfolds was calculated and the children were subsequently characterized by low (≤-1 SD [standard deviation]), normal (-1 to 1 SD) or high body fat (≥1 SD). Socioeconomic and lifestyle characteristics were obtained using a questionnaire filled out by the children's parents or legal guardians. Preschool children in the high adiposity category had, on average, fewer siblings and longer screen time; additionally, their parents had lower education and more often worked in manual jobs, in comparison to the children in the low and average adiposity categories. In conclusion, it was observed that children in different adiposity categories varied in terms of some socioeconomic as well as lifestyle characteristics. Knowledge regarding the influence that those factors can have on the metabolic health of children is essential for children's present as well as future well-being. Moreover, it can help health care professionals and parents decide what intervention and/ or preventive measures should be undertaken to ensure the best possible outcomes, as the development of successful obesity prevention strategies should rely on evidence-based information. Nonetheless, future research examining the issue of factors influencing the metabolic health of children, as well as these outcomes later in life, is crucial. Well-planned studies including a large number of individuals, as well as longitudinal research, will be particularly beneficial in this regard.
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