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Chen ZT, Wang XM, Zhong YS, Zhong WF, Song WQ, Wu XB. Association of changes in waist circumference, waist-to-height ratio and weight-adjusted-waist index with multimorbidity among older Chinese adults: results from the Chinese longitudinal healthy longevity survey (CLHLS). BMC Public Health 2024; 24:318. [PMID: 38287292 PMCID: PMC10825986 DOI: 10.1186/s12889-024-17846-x] [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: 10/12/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The association of changes in waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted-waist index (WWI) with subsequent risk of multimorbidity remains unclear among older Chinese adults. Therefore, we aimed to assess this association by utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS Our study was based on the 2011/2012 wave of the CLHLS whose follow-up surveys were conducted in 2014 and 2017/2018. A total of 2900 participants aged 65 and above at baseline were enrolled. WC, WHtR, and WWI were calculated from measured height, weight, and waist circumference. Multimorbidity refers to the coexistence of two or more of 18 chronic diseases. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) to evaluate the effect of three-year changes in WC, WHtR, and WWI on the risk of multimorbidity. RESULTS During a mean follow-up time of 4.2 (2.0) years, 906 multimorbidity cases were identified. Compared to participants in the persistently low WC group, those in the WC gain group and the persistently high WC group had a higher multimorbidity risk with adjusted HRs (95%CI) of 1.23 (1.01-1.50) and 1.34(1.14-1.58), respectively. Participants in the WHtR gain group and the persistently high WHtR group also had higher risks of multimorbidity with HRs (95%CI) of 1.35 (1.08-1.67) and 1.27 (1.05-1.53), respectively, relative to the persistently low WHtR group. Compared to the persistently low WWI group, those in the WWI loss group had a lower risk of multimorbidity with HRs (95%CI) of 0.80 (0.66-0.98). For every standard deviation increase in WC, WHtR, and WWI over three years, the risk of multimorbidity was higher by 12% (95%CI: 1.05-1.19), 13% (95%CI: 1.06-1.20), and 12% (95%CI: 1.05-1.20), respectively. CONCLUSIONS Associations of changes in WC, WHtR and WWI with multimorbidity are significant among older Chinese adults. The findings highlight the importance of evaluating changes in WC, WHtR, and WWI in screening and prevention of multimorbidity in older adults.
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Affiliation(s)
- Zi-Ting Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Yi-Shi Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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de Souza ÂMN, Griep RH, Hermsdorff HHM, da Fonseca MDJM, Juvanhol LL. Are ambulatory blood pressure parameters associated more with central adiposity than with total adiposity? Results of the ELSA-Brasil study. Front Cardiovasc Med 2023; 10:1286726. [PMID: 38155992 PMCID: PMC10752922 DOI: 10.3389/fcvm.2023.1286726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Worldwide obesity has a high prevalence, as well as carries a high risk of several chronic diseases, including hypertension. Studies of the association between obesity and ambulatory blood pressure (BP) are scarce and most use only body mass index (BMI) as indicator of adiposity. Thus, we aimed to examine for associations between total and central adiposity and ambulatory BP parameters (BP means and variability, nocturnal dipping and morning surge) among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This cross-sectional study (2012-2014) used a subsample of participants (n = 812) of ELSA-Brasil who underwent 24-hour ambulatory BP monitoring to assess systolic and diastolic BP (SBP and DBP, respectively) over 24-hour periods and sub-periods. Indicators for total adiposity were BMI and body fat (BF) and, for central adiposity, waist circumference (WC) and waist-to-height ratio (WHR). Associations were tested using crude and adjusted gamma and logistic regression. Results Overweight (BMI) and abdominal obesity (WC and WHR) associated positively with mean 24-hour (Coef = 2.71, 3.09 and 4.00, respectively), waking (Coef = 2.87, 3.26 and 4.16, respectively), and sleeping (Coef = 2.30, 2.74 and 3.50, respectively) SBP; mean DBP associated with high WHR in these three periods (Coef = 2.00, 2.10 and 1.68, respectively) and with WC in the waking period (Coef = 1.44). Overweight and abdominal obesity (WC and WHR) were positively associated with SBP variability over 24 h (Coef = 0.53, 0.45 and 0.49, respectively) and in sleep (Coef = 0.80, 0.74 and 0.59, respectively), and with DBP variability in 24 h (Coef = 0.64, 0.73 and 0.58, respectively), wakefulness (Coef = 0.50, 0.52 and 0.52, respectively) and sleep (Coef = 0.53, 0.45 and 0.49); excess BF associated positively with DBP variability over 24 h (Coef = 0.43) and in wakefulness (Coef = 0.38). Lastly, high WHR and excess BF were associated with higher odds of extreme dipping (OR = 1.03 for both), while high WC and WHR associated with higher odds of exacerbated diastolic morning surge (OR = 3.18 and 3.66, respectively). Conclusion Indicators of adiposity were associated with the BP means and variability, nocturnal dipping and morning surge, with more substantial results for indicators of central adiposity that the others.
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Affiliation(s)
| | - Rosane Harter Griep
- Environment and Health Education Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Qin X, Chen C, Wang J, Cai A, Feng X, Jiang X, Feng Y. Association of adiposity indices with cardiometabolic multimorbidity among 101,973 chinese adults: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:514. [PMID: 37865773 PMCID: PMC10590510 DOI: 10.1186/s12872-023-03543-x] [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: 05/19/2023] [Accepted: 10/03/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CMM) and obesity represent two major health problems. The relationship between adiposity indices and CMM, however, remains understudied. This study aimed to investigate the associations of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) with CMM among Chinese adults. METHODS Data of 101,973 participants were collected from a population-based screening project in Southern China. CMM was defined as having two or more of the following diseases: coronary heart disease, stroke, hypertension, and diabetes. The relationship between the six adiposity indices and CMM was investigated by multivariate logistic regression and restricted cubic splines. Receiver operator characteristic curve, C-statistic and net reclassification index were used to estimate the discriminative and incremental values of adiposity indices on CMM. RESULTS Logistic regression models showed the six adiposity indices were all significantly associated with the odds of CMM with non-linear relationships. For per SD increment, WC (Odds ratio [OR]: 1.66; 95% confidence interval (CI): 1.62-1.70) and WHtR (OR, 1.61; 95% CI, 1.58-1.65) were more significantly associated with a higher prevalence of CMM than BMI (OR, 1.55; 95% CI, 1.52-1.58) (all P < 0.05). In addition, WC, WHtR, and BRI displayed significantly better performance in detecting CMM compared with BMI (all P < 0.05). Their respective area under the curve (AUC) values were 0.675 (95% CI: 0.670-0.680), 0.679 (95% CI: 0.675-0.684), and 0.679 (95% CI: 0.675-0.684), while BMI yielded an AUC of 0.637 (95% CI: 0.632-0.643). These findings hold true across all subgroups based on sex and age. When Adding WC, WHtR, or BRI to a base model, they all provided larger incremental values for the discrimination of CMM compared with BMI (all P < 0.05). CONCLUSIONS Adiposity indices were closely associated with the odds of CMM, with WC and WHtR demonstrating stronger associations than BMI. WC, WHtR, and BRI were superior to BMI in discriminative ability for CMM. Avoidance of obesity (especially abdominal obesity) may be the preferred primary prevention strategy for CMM while controlling for other major CMM risk factors.
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Affiliation(s)
- Xiaoru Qin
- Department of Cardiology, Zhuhai hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
- Department of cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Chaolei Chen
- Department of cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jiabin Wang
- Global Health Research Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Anping Cai
- Department of cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xiaoxuan Feng
- Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xiaofei Jiang
- Department of Cardiology, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Yingqing Feng
- Department of Cardiology, Zhuhai hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China.
- Department of cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
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Fontenelle LC, de Paiva Sousa M, Dos Santos LR, Cardoso BEP, de Sousa TGV, da Cunha Soares T, de Sousa Melo SR, Morais JBS, da Silva Dias TM, de Oliveira FE, Braz DC, de Castro E Sousa JM, Torres-Leal FL, Henriques GS, do Nascimento Marreiro D. RELATIONSHIP BETWEEN SELENIUM NUTRITIONAL STATUS AND MARKERS OF LOW-GRADE CHRONIC INFLAMMATION IN OBESE WOMEN. Biol Trace Elem Res 2023; 201:663-676. [PMID: 35381948 DOI: 10.1007/s12011-022-03209-3] [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: 12/07/2021] [Accepted: 03/15/2022] [Indexed: 02/07/2023]
Abstract
Low-grade chronic inflammation is one of the main disorders that characterize adipose tissue dysfunction in obesity and is an important element in the pathogenesis of several comorbidities. In this context, selenium is an essential micronutrient that exerts important anti-inflammatory functions, and the role of selenium in controlling inflammation associated with obesity is not well defined. Thus, this study aimed to evaluate the relationship between markers of the nutritional status of selenium and low-grade chronic inflammation in obese women. This cross-sectional study included 81 women aged between 18 and 50 years, who were divided into two groups according to body mass index (BMI): the obesity group (n = 38) and normal weight group (n = 43). Selenium intake was assessed by 3-day diet records. The plasma, erythrocyte, and urinary selenium concentrations were determined using inductively coupled plasma optical emission spectrometry. The analysis of serum cytokines interleukin (IL)-8, IL-1β, IL-6, IL-10, and tumor necrosis factor alpha (TNFα) was performed using flow cytometry. The results of this study revealed that the obese women had higher dietary intake of selenium than eutrophic women. However, obese participants showed decreased selenium concentrations in plasma and erythrocytes, in parallel with increased concentrations of selenium in the urine. Regarding the inflammatory parameters, obese women exhibited higher concentrations of IL-6 and lower concentrations of the cytokines IL-8, IL-1β, and TNFα than eutrophic women. In the binary logistic regression analysis, erythrocyte selenium was considered an independent predictor of the serum concentrations of cytokine IL-8 in obese women, reflecting the anti-inflammatory action of this micronutrient.
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Geng S, Chen X, Shi Z, Bai K, Shi S. Association of anthropometric indices with the development of multimorbidity in middle-aged and older adults: A retrospective cohort study. PLoS One 2022; 17:e0276216. [PMID: 36240163 PMCID: PMC9565419 DOI: 10.1371/journal.pone.0276216] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies have explored the relationship between body mass index (BMI) and multimorbidity. However, the relationship between other obesity indicators and their dynamic changes and multimorbidity has not been systematically estimated. Therefore, we aimed to investigate the association of BMI and other obesity indicators, including waist circumference (WC), waist-to-height ratio (WHtR), waist divided by height0.5 (WHT.5R), and body roundness index (BRI) and their changes and the risk of multimorbidity in middle-aged and older adults through a retrospective cohort study. METHODS Data collected from annual health examination dataset in the Jinshui during 2017 and 2021. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the effect of baseline and dynamic changes in the anthropometric indices on the risk of multimorbidity. RESULTS A total of 75,028 individuals were included in the study, and 5,886 participants developed multimorbidity during the follow-up. Multivariate Cox regression analysis revealed a progressive increase in the risk of multimorbidity with increasing anthropometric indicators (BMI, WC, WHtR, WHT.5R, and BRI) (all P<0.001). Regardless of general obesity status at baseline, increased WC was associated with a high risk of multimorbidity. Compared to the subjects with baseline BMI<24 kg/m2 and WC<90 (men)/80 (women), the HRs (95% CI) of the baseline BMI<24 kg/m2 and WC≥90 (men)/80 (women) group and BMI≥24 kg/m2 and WC≥90 (men)/80 (women) group were 1.31 (1.08, 1.61) and 1.82 (1.68, 1.97), respectively. In addition, the dynamics of WC could reflect the risk of multimorbidity. When subjects with baseline WC<90 (men)/80 (women) progressed to WC≥90 (men)/80 (women) during follow-up, the risk of multimorbidity significantly increased (HR = 1.78; 95% CI, 1.64, 1.95), while the risk of multimorbidity tended to decrease when people with abnormal WC at baseline reversed to normal at follow-up (HR = 1.40; 95% CI, 1.26, 1.54) compared to those who still exhibited abnormal WC at follow-up (HR = 2.00; 95% CI, 1.82, 2.18). CONCLUSIONS Central obesity is an independent and alterable risk factor for the occurrence of multimorbidity in middle-aged and elderly populations. In addition to the clinical measurement of BMI, the measurement of the central obesity index WC may provide additional benefits for the identification of multimorbidity in the Chinese middle-aged and elderly populations.
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Affiliation(s)
- Shuoji Geng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Xuejiao Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Zhan Shi
- Department of pharmacy, Zhengzhou people’s hospital, Zhengzhou, Henan, People’s Republic of China
| | - Kaizhi Bai
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
- * E-mail:
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Pereira SGS, Silva Junior RFD, Ribeiro CDAL, Barbosa HA, Torres JDPRV, Silva CSDOE. Factors associated with prehypertension and hypertension among healthcare workers working in high-complexity services. CIENCIA & SAUDE COLETIVA 2021; 26:6059-6068. [PMID: 34909998 DOI: 10.1590/1413-812320212612.14952021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/22/2021] [Indexed: 11/22/2022] Open
Abstract
The objective was to estimate the prevalence and factors associated with prehypertension and hypertension among health workers who work in high-complexity services for critically-ill and chronic patients. An epidemiological, cross-sectional study was carried out with 490 health workers in the macroregional region of Northern Minas Gerais, Brazil. The dependent variable blood pressure (BP) was categorized as normal BP, prehypertension and hypertension. Multinomial Logistic Regression was used for the multiple analysis. The prevalence of arterial hypertension was 21.8% and that of prehypertension was 25.9%. The chances of developing arterial hypertension and prehypertension were higher in male professionals, aged ≥40 years, in civil servant workers and those who were obese or overweight. The use of continuous medication and night shift work were associated with hypertension and prehypertension, respectively. The prevalence of arterial hypertension in the group of workers was lower than that of the Brazilian population. It is necessary to carry out studies with workers from this group and investments are required in preventive measures that encourage a change to a healthy lifestyle.
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Affiliation(s)
| | | | | | - Henrique Andrade Barbosa
- Universidade Estadual de Montes Claros. Av. Prof. Rui Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
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Lu Y, Liu S, Qiao Y, Li G, Wu Y, Ke C. Waist-to-height ratio, waist circumference, body mass index, waist divided by height 0.5 and the risk of cardiometabolic multimorbidity: A national longitudinal cohort study. Nutr Metab Cardiovasc Dis 2021; 31:2644-2651. [PMID: 34226121 DOI: 10.1016/j.numecd.2021.05.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Cardiometabolic multimorbidity (CM) is an increasing public health burden. This study aimed to evaluate the association of waist-to-height ratio (WHtR), waist circumference (WC), waist divided by height0.5 (WHT.5R) and body mass index (BMI) with the risk of CM. METHODS AND RESULTS We used data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10,521 participants aged 45 years and over were recruited, including 8807 individuals with 0 cardiometabolic diseases at baseline (stage I) and 1714 individuals with 1 cardiometabolic disease at baseline (stage II). CM was defined as self-reporting of two or more of the following conditions: stroke, diabetes and heart disease. Logistic regression was conducted to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the incremental predictive value beyond conventional factors. In stage I, an increased risk of CM was observed among participants with WHtR ≥0.5 (OR: 1.76, 95% CI: 1.05-2.97), WC ≥ 90 cm (men) + WC ≥ 80 cm (women) (OR: 2.06, 95% CI: 1.29-3.27), WHT.5R ≥ 6.54 cm0.5 (OR: 1.81, 95% CI: 1.16-2.83) or BMI ≥24 kg/m2 (OR: 1.48, 95% CI: 0.98-2.24). Furthermore, the NRI and IDI of WHtR, WC and WHT.5R were all higher than those of BMI. In stage II, the adjusted ORs (95% CIs) of WHtR, WC, WHT.5R and BMI were 2.04 (1.24-3.35), 1.89 (1.29-2.77), 1.86 (1.24-2.78) and 1.47 (1.06-2.04), respectively. In addition, WC exhibited the highest NRI and IDI. CONCLUSION WHtR, WC, WHT.5R and BMI are independent predictors of CM in the middle-aged and older Chinese population. WHtR, WC and WHT.5R show better abilities in predicting CM than BMI.
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Affiliation(s)
- Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Ying Wu
- Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China.
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Abdominal obesity and risk of CVD: a dose-response meta-analysis of thirty-one prospective studies. Br J Nutr 2021; 126:1420-1430. [PMID: 33431092 DOI: 10.1017/s0007114521000064] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This meta-analysis aimed to study the relationship between abdominal obesity and the risk of CVD by waist circumference (WC), waist:hip ratio (WHR) and waist:height ratio (WHtR). We systematically searched PubMed, Embase and Web of Science. Prospective studies that estimated cardiovascular events by WC, WHR and WHtR were included in this study. Pooled relative risks with 95 % CI were calculated using random effects models. A total of thirty-one studies were included in the meta-analysis, including 669 560 participants and 25 214 cases. Compared the highest with the lowest category of WC, WHR and WHtR, the summary risk ratios were 1·43 (95 % CI, 1·30, 1·56, P < 0·001), 1·43 (95 % CI, 1·33, 1·54, P < 0·001) and 1·57 (95 % CI, 1·37, 1·79, P < 0·001), respectively. The linear dose-response analysis revealed that the risk of CVD increased by 3·4 % for each 10 cm increase of WC, and by 3·5 and 6·0 % for each 0·1 unit increase of WHR and WHtR in women, respectively. In men, the risk of CVD increased by 4·0 % for each 10 cm increase of WC, and by 4·0 and 8·6 % for each 0·1 unit increase of WHR and WHtR, respectively. Collectively, abdominal obesity is associated with an increased risk of CVD. WC, WHR and WHtR are good indicators for the prediction of CVD.
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Raele R, Lotufo PA, Bittencourt MS, de Jesus M Fonseca M, Goulart AC, Santos IS, Bensenor IM. The association of waist-to-height ratio and other anthropometric measurements with subclinical atherosclerosis: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Nutr Metab Cardiovasc Dis 2020; 30:1989-1998. [PMID: 32624345 DOI: 10.1016/j.numecd.2020.05.025] [Citation(s) in RCA: 4] [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: 10/10/2019] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS To compare the performance of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and Body-mass index (BMI) with subclinical atherosclerosis. METHODS AND RESULTS The association of quintiles of anthropometric variables (1st as reference) - Odds ratio (OR); 95% Confidence Interval (95% CI) - with Coronary Artery Calcium (CAC: 0 vs. >0; <100 vs. ≥100), Carotid Intima-Media Thickness (CIMT: <75th vs. ≥P75%) and as continuous variables in linear regression models in 4216 participants of ELSA-Brasil baseline. WHtR was associated with CAC >0 (OR, 1.84; 95% CI, 1.16-2.93) and ≥100 after multivariate adjustment including BMI. WHR was associated with CAC >0 OR, 1.81 (95% CI, 1.25-2.82) and ≥100. BMI was not associated with CAC after further adjustment for WHtR, but was associated with CAC >0 after adjustment for WHR (OR, 1.42; 95% CI, 1.02-1.94) or WC (1.63; 95% CI, 1.03-2.59). WHtR was not associated with CIMT after further adjustment for BMI. WHR was associated with CIMT ≥P75% (OR, 1.44; 95% CI, 1.02-2.02) and in linear models (p < 0.0001). WC was associated with CIMT in linear models (p < 0.0001). BMI was associated to CIMT ≥P75% (OR, 2.25; 95% CI, 1.53-2.54); and in linear models (P < 0.0001) after further adjustment for WHtR. After adjustment for WHR and WC the association of BMI with CIMT ≥P75% was respectively (OR 2.31; 95% CI, 1.70-3.13; and OR 2.39; 95% CI, 1.55-3.70); and in both linear models (p < 0.0001). CONCLUSIONS WHtR was a good biomarker for subclinical atherosclerosis measured by CAC while BMI was a good biomarker for CIMT. WHR presented the best performance being associated with both biomarkers of subclinical atherosclerosis.
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Affiliation(s)
- Rosana Raele
- School of Medicine, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Maria de Jesus M Fonseca
- Department of Epidemiology and Quantitative Methods, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo, SP, Brazil.
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Petermann-Rocha F, Ulloa N, Martínez-Sanguinetti MA, Leiva AM, Martorell M, Villagrán M, Troncoso-Pantoja C, Ho FK, Celis-Morales C, Pizarro A. Is waist-to-height ratio a better predictor of hypertension and type 2 diabetes than body mass index and waist circumference in the Chilean population? Nutrition 2020; 79-80:110932. [PMID: 32847773 DOI: 10.1016/j.nut.2020.110932] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The aim of this study was to identify which anthropometric measurement (body mass index [BMI], waist circumference [WC], or waist-to-height ratio [WHtR]) is a better predictor of type 2 diabetes and hypertension in the Chilean population. METHODS The study included 13 044 participants (59.7% women) from the Chilean National Health Surveys conducted in 2003, 2009-2010, and 2016-2017. BMI, WC, and WHtR were the anthropometric measurements evaluated. Hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥90 mm Hg or on medication for hypertension. Diabetes was defined as fasting glucose ≥7 mmol/L or on medication for diabetes. The receiver operating characteristics (ROC) curve and the area under curve (AUC) were computed to derive the specificity and sensitivity using a bootstrapping approach. RESULTS Compared with BMI and WC, WHtR was the anthropometric measurement with the highest AUC curve in both sexes for hypertension (AUC for women: 0.70; 95% confidence interval [CI], 0.67-0.73; AUC for men: 0.71; 95% CI, 0.69-0.74) and diabetes (AUC for women: 0.71; 95% CI, 0.66-0.77; AUC for men: 0.71; 95% CI, 0.67-0.76). The sex-specific cutoff points of WHtR to predict hypertension were 0.59 and 0.55 for women and men, respectively. Those used to predict diabetes were 0.60 and 0.58 for women and men, respectively. CONCLUSION WHtR was a better predictor of hypertension and diabetes than BMI and WC in Chile. The definition of cutoff points specific for the Chilean population could be implemented in future screening programs aiming to identify high-risk individuals.
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Affiliation(s)
- Fanny Petermann-Rocha
- Institute of Health and Wellbeing, On behalf of ELHOC-Chile Research Consortium, Glasgow, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
| | - Natalia Ulloa
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile; Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | | | - Ana María Leiva
- Instituto de Anatomía, Histología y Patología, Facultad de Farmacia, Universidad Austral de Chile, Valdivia, Chile
| | - Miquel Martorell
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile; Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción, Chile
| | - Marcelo Villagrán
- Department of Basic Science, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Claudia Troncoso-Pantoja
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Departamento de Salud Pública, Facultad de Medciina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Frederick K Ho
- Institute of Health and Wellbeing, On behalf of ELHOC-Chile Research Consortium, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, On behalf of ELHOC-Chile Research Consortium, Glasgow, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Centre of Exercise Physiology Research (CIFE), Universidad Mayor, Chile; Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
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11
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Fernandes Gomes AP, da Costa ACC, Massae Yokoo E, de Matos Fonseca V. Impact of Bean Consumption on Nutritional Outcomes amongst Adolescents. Nutrients 2020; 12:nu12041083. [PMID: 32295142 PMCID: PMC7230442 DOI: 10.3390/nu12041083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/31/2022] Open
Abstract
Brazilian adolescents have undergone a noteworthy nutritional epidemiological transition. There is an increase in the prevalence of overweight and high consumption of ultra-processed foods in parallel with patterns of traditional meals that include beans. This study analyzed associations between bean consumption in the diet of adolescents and nutrition outcomes. Multiple regression analysis showed a significant reduction in body mass index (BMI), body fat percentage (%BF) and LDL-cholesterol (LDL-c) values among those with bean consumption equal to or greater than five times a week. Adolescents who had lunch outside the home and those who did not have the habit of having lunch showed a significantly higher BMI. There was an increase in the %BF among married adolescents and those who did not have lunch. There was a reduction of LDL-c among those with intermediate per capita income and those who consumed processed juice less than 5 times a week, and an increase among those who did not have breakfast. There were significant interactions between sexual maturation, energy consumption, physical activity and energy consumption. Thus, in the context of this study, the presence of beans in the diet, at frequencies equal to or greater than five times a week, can be considered a proxy for healthy eating.
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Affiliation(s)
- Ana Paula Fernandes Gomes
- Postgraduate Program in Child and Women’s Health, National Institute of Women’s, Child and Adolescent Health Fernandes Figueira, Oswaldo Cruz Foundation, 20021-140 Rio de Janeiro, Brazil
- Department of Fundamental Nutrition, Federal University of the State of Rio de Janeiro, 22290-240 Rio de Janeiro, Brazil
- Correspondence:
| | - Ana Carolina Carioca da Costa
- National Institute of Women’s, Child and Adolescent Health Fernandes Figueira, Oswaldo Cruz Foundation, 20021-140 Rio de Janeiro, Brazil; (A.C.C.d.C.); (V.d.M.F.)
| | - Edna Massae Yokoo
- Department of Epidemiology and Biostatistics, Fluminense Federal University, 24220-000 Niterói, Brazil;
| | - Vania de Matos Fonseca
- National Institute of Women’s, Child and Adolescent Health Fernandes Figueira, Oswaldo Cruz Foundation, 20021-140 Rio de Janeiro, Brazil; (A.C.C.d.C.); (V.d.M.F.)
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12
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Suliga E, Ciesla E, Głuszek-Osuch M, Rogula T, Głuszek S, Kozieł D. The Usefulness of Anthropometric Indices to Identify the Risk of Metabolic Syndrome. Nutrients 2019; 11:nu11112598. [PMID: 31671800 PMCID: PMC6893758 DOI: 10.3390/nu11112598] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/16/2022] Open
Abstract
Despite several papers having been published on the association between adiposity and the risk of metabolic syndrome (MetS), it is still difficult to determine unambiguously which of the indices of nutritional status is the best to identify MetS. The aim of this study was to analyze the ability of six anthropometric indices to identify MetS in the Polish population. The highest odds ratios for the occurrence of MetS, according to International Diabetes Federation (IDF), were noted for the following indices: waist-to-height ratio (WHtR, OR = 24.87) and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE, OR = 17.47) in men and WHtR (OR = 25.61) and body roundness index (BRI, OR = 16.44) in women. The highest odds ratios for the modified definition of MetS (without waist circumference) were found for the following indices: WHtR (OR = 7.32), BRI (OR = 6.57), and CUN-BAE (OR = 6.12) in women and CUN-BAE (OR = 5.83), WHtR (OR = 5.70), and body mass index (BMI, OR = 5.65) in men (p < 0.001 for all). According to the Receiver Operating Characteristic (ROC) analyses conducted for the identification of MetS, defined in accordance with IDF, the largest areas under the curve (AUCs) in men were observed for WHtR and CUN-BAE indices, whereas in women, they were observed for WHtR and BRI. In the analysis carried out for the identification of MetS (according to modified definition, without waist circumference), the AUCs were larger for WHtR and BRI in women, while in men, they were larger for CUN-BAE, BMI, and WHtR. BMI was also characterized by a relatively strong discriminatory power in identifying individuals with MetS. An optimal cut-off point for MetS, in accordance with the conventional definition, for both sexes was the value of BMI = 27.2 kg/m2. The weakest predictor of the syndrome was the ABSI (a body shape index) indicator. The most useful anthropometric indicator for the identification of MetS, both in men and in women in the Polish population, was WHtR. The optimal cut-off points for WHtR equaled 0.56 in men and 0.54 in women.
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Affiliation(s)
- Edyta Suliga
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland.
| | - Elzbieta Ciesla
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland.
| | - Martyna Głuszek-Osuch
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland.
| | - Tomasz Rogula
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland.
| | - Stanisław Głuszek
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland.
| | - Dorota Kozieł
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland.
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13
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Tavares ÓM, Duarte JP, Werneck AO, Costa DC, Sousa-E-Silva P, Martinho D, Luz LGO, Morouço P, Valente-Dos-Santos J, Soles-Gonçalves R, Conde J, Casanova JM, Coelho-E-Silva MJ. Body composition, strength static and isokinetic, and bone health: comparative study between active adults and amateur soccer players. EINSTEIN-SAO PAULO 2019; 17:eAO4419. [PMID: 31166483 PMCID: PMC6533075 DOI: 10.31744/einstein_journal/2019ao4419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/24/2018] [Indexed: 11/15/2022] Open
Abstract
Objective: To compare tissue composition, total and regional bone mineral content and bone mineral density, static hand grip and knee joint isokinetic strength between amateur soccer players and Control Group. Methods: Cross-sectional study. Air displacement plethysmography was used to estimate body volume and, in turn, density. Body composition, bone mineral content and bone mineral density were assessed for the whole body and at standardized regions using dual energy X-ray absorptiometry. Static grip strength was assessed with an adjustable dynamometer, and peak torque derived from isokinetic strength dynamometer (concentric muscular knee actions at 60°/s). Magnitude of the differences between groups was examined using d-Cohen. Results: Compared to healthy active adults, soccer players showed larger values of whole body bone mineral content (+651g; d=1.60; p<0.01). In addition, differences between groups were large for whole body bone mineral density (d=1.20 to 1.90; p<0.01): lumbar spine, i.e. L1-L4 (+19.4%), upper limbs (+8.6%) and lower limbs (+16.8%). Soccer players attained larger mean values in strength test given by static hand grip protocol (+5.6kg, d=0.99; p<0.01). Conclusion: Soccer adequately regulates body composition and is associated better bone health parameters (bone mineral content and density at whole-body and at particular sites exposed to mechanical loadings).
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Affiliation(s)
- Óscar M Tavares
- Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal
| | - João P Duarte
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Coimbra, Portugal.,Centro de Investigação do Desporto e da Actividade Física, Universidade de Coimbra, Coimbra, Portugal.,Fundação para a Ciência e a Tecnologia, Lisboa, Portugal
| | - André O Werneck
- Grupo de Investigação Científica Relacionada à Atividade Física, Laboratório de Investigação em Exercício, Departamento de Educação Física, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
| | - Daniela C Costa
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Coimbra, Portugal.,Centro de Investigação do Desporto e da Actividade Física, Universidade de Coimbra, Coimbra, Portugal.,Fundação para a Ciência e a Tecnologia, Lisboa, Portugal
| | - Paulo Sousa-E-Silva
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Coimbra, Portugal.,Centro de Investigação do Desporto e da Actividade Física, Universidade de Coimbra, Coimbra, Portugal.,Fundação para a Ciência e a Tecnologia, Lisboa, Portugal
| | - Diogo Martinho
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Coimbra, Portugal.,Centro de Investigação do Desporto e da Actividade Física, Universidade de Coimbra, Coimbra, Portugal.,Fundação para a Ciência e a Tecnologia, Lisboa, Portugal
| | - Leonardo G O Luz
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Coimbra, Portugal.,Laboratório de Cineantropometria, Atividade Física e Promoção da Saúde, Universidade Federal de Alagoas, Arapiraca, AL, Brazil
| | - Pedro Morouço
- Instituto Politécnico de Leiria, Leiria, Portugal.,Centro para o Desenvolvimento Rápido e Sustentado do Produto, Marinha Grande, Portugal
| | - João Valente-Dos-Santos
- Centro de Investigação do Desporto e da Actividade Física, Universidade de Coimbra, Coimbra, Portugal.,Fundação para a Ciência e a Tecnologia, Lisboa, Portugal.,Faculdade de Educação Física e Desporto, Universidade Lusófona de Humanidades e Tecnologia, Lisboa, Portugal
| | - Rui Soles-Gonçalves
- Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal.,Centro de Estudos e Investigação em Saúde, Universidade de Coimbra, Coimbra, Portugal
| | - Jorge Conde
- Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal
| | - José M Casanova
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Manuel J Coelho-E-Silva
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Coimbra, Portugal.,Centro de Investigação do Desporto e da Actividade Física, Universidade de Coimbra, Coimbra, Portugal
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14
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Deng G, Yin L, Liu W, Liu X, Xiang Q, Qian Z, Ma J, Chen H, Wang Y, Hu B, Li W, Jiang Y. Associations of anthropometric adiposity indexes with hypertension risk: A systematic review and meta-analysis including PURE-China. Medicine (Baltimore) 2018; 97:e13262. [PMID: 30508913 PMCID: PMC6283208 DOI: 10.1097/md.0000000000013262] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The association between hypertension and obesity has been confirmed, while no agreement has been reached about which anthropometric adiposity index is the best. This meta-analysis aimed to perform a systematic review and meta-analysis on the associations of hypertension risk with body mass index (BMI), waist circumstance (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), and a prospective urban and rural epidemiology study from China (PURE-China) was added into this meta-analysis as an individual study. METHODS Systematic literature searching was conducted to identify relevant articles published up to September 2018 in CNKI, WANFANG Data, Web of Science, SinoMed, PubMed, MEDLINE, EMBASE, Cochrane Library and cross-referencing. Literature reporting the association of hypertension risk with BMI, WC, WHR, and WHtR were defined as eligible. PURE-China data were analyzed and included as 1 eligible study into meta-analyses. Summary odds ratio (OR) and area under receiver operating characteristic curve (AUC) were pooled using meta-analysis methods. Heterogeneity and publication bias were evaluated. Subgroups based on gender, country and study design were conducted as well. RESULTS Thirty-eight original articles including PURE-China were included into meta-analyses, involving 309,585 subjects. WHtR had the strongest association with hypertension risk (OR, 1.68; 95% confidence interval, [CI]:1.29-2.19) and prediction ability (AUC, 70.9%; 95% CI: 67.8%-74.2%), which were also confirmed in subgroup analyses based on gender and country. However, BMI was found to have the highest prediction ability in adjusted models of PURE-China and followed WC, both of which were superior to WHtR (73.7% and 73.4% vs 73.2%). CONCLUSIONS Our overall meta-analysis further confirmed WHtR as a good indicator at discriminating those individuals at increased risk of hypertension, and in some cases, it is better than BMI, WC, and WHR.
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Affiliation(s)
- Guijuan Deng
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing
| | - Lu Yin
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Weida Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Xiaoyun Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Quanyong Xiang
- Jiangsu Province Center for Disease Control & Prevention
| | - Zhenzhen Qian
- Jiangxinzhou Community Health Service Center, Nanjing
| | - Juntao Ma
- Academy of Military Sciences, People's Liberation Army of China, Beijing, China
| | - Hui Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Yang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Bo Hu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Wei Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Yu Jiang
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing
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15
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Wu X, Li B, Lin WQ, Huang LL, Wang XX, Fu LY, Li BB, Wang PX. The association between obesity indices and hypertension: Which index is the most notable indicator of hypertension in different age groups stratified by sex? Clin Exp Hypertens 2018; 41:373-380. [PMID: 30095294 DOI: 10.1080/10641963.2018.1489546] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the most notable obesity index and its optimal cut-off point of hypertension in different age groups stratified by sexes among community residents in southern China. METHODS In this cross-sectional study, 620 men and 631 women aged 18-59 years were enrolled. The independent-samples t-test and chi-square test were conducted to analyze continuous and categorical variables, respectively. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis assessed the association between the obesity indices and hypertension risk. RESULTS Waist-stature ratio (WSR) and waist-hip ratio (WHR) were the most notable risk factors for hypertension in young men and women, respectively. The odds ratios (ORs) of hypertension risk increased with per standard deviation (SD) in WSR and WHR (WSR: OR = 2.877, 95% confidence interval [CI] = 1.602 to 5.167; WHR: OR = 10.683, 95%CI = 2.179 to 52.376). In the middle-aged group of both sexes, body mass index (BMI) was the most distinctive risk factor for hypertension, the ORs of hypertension risk increased with per SD in BMI (men: OR = 2.297, 95%CI = 1.683 to 3.136; women: OR = 1.810, 95%CI = 1.338 to 2.450). ROC curve analysis demonstrated WSR and PI were better indicators than other indices among young men, and WSR was the best marker among young women. However, BMI and WC were the most sensitive markers in middle-aged men and women, respectively. CONCLUSIONS In this Chinese population, the association of obesity indices and hypertension is inconsistent in different age groups and sexes. It is important to choose appropriate indicators for specific groups of people.
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Affiliation(s)
- Xiao Wu
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China.,b General Practice Center, Nanhai Hospital , Southern Medical University , Foshan , China
| | - Bo Li
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Wei-Quan Lin
- c Guangzhou Center for Disease Control and Prevention , Guangzhou , China
| | - Ling-Ling Huang
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Xiao-Xiao Wang
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Li-Ying Fu
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Bing-Bing Li
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China
| | - Pei-Xi Wang
- a Institute of Chronic Disease Risks Assessment, School of Nursing and Health , Henan University , Kaifeng , China.,b General Practice Center, Nanhai Hospital , Southern Medical University , Foshan , China
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16
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Wang Q, Wang Z, Yao W, Wu X, Huang J, Huang L, Sun Y. Anthropometric Indices Predict the Development of Hypertension in Normotensive and Pre-Hypertensive Middle-Aged Women in Tianjin, China: A Prospective Cohort Study. Med Sci Monit 2018; 24:1871-1879. [PMID: 29601569 PMCID: PMC5892460 DOI: 10.12659/msm.908257] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/14/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aims of this study were to investigate the relationship between optimal anthropometric indices and their cut-off values and the incidence of hypertension in a cohort of middle-aged women in China. MATERIAL AND METHODS A cohort of 812 women, aged between 40-70 years were recruited between May 2011 and June 2013. An ideal baseline blood pressure was defined as <120/80 mmHg; pre-hypertension was 120-139/80-89 mmHg; hypertension was ≥140/≥90 mmHg. Anthropometric measurements included waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR). The cohort was divided into an ideal blood pressure group (Group 1) and a pre-hypertensive group (Group 2). Two-year follow-up blood pressure measurements were performed. Receiver-operating characteristic (ROC) curve analysis determined the optimal anthropometric indices and cut-off values for developing hypertension. RESULTS At two-year follow-up, hypertension developed in 9.0% (n=31) in Group 1 and 32.3% (n=121) in Group 2. Logistic regression analysis showed that in both groups, women in the highest quartile for WC, BMI, WHR, and WHtR had a significantly increased risk of developing hypertension compared with the lowest quartile (P<0.05). ROC curve area under the curve (AUC) for these anthropometric indices were greater in Group 1, and for WC in Groups 1 and 2, with the optimal cut-off values greater in Group 1. CONCLUSIONS In a cohort of middle-aged women in China, anthropometric indices of obesity were predictive of the development of hypertension during a two-year follow-up period.
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