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Wei L, Wang B, Wang Y. Low handgrip strength with asymmetry is associated with elevated all-cause mortality risk in older Chinese adults with abdominal obesity. PLoS One 2024; 19:e0306982. [PMID: 39137193 PMCID: PMC11321545 DOI: 10.1371/journal.pone.0306982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/26/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Low handgrip strength (HGS) and abdominal obesity (AO) have been reported to be linked to an increased all-cause mortality risk in older adults. However, the combined impact of AO with low HGS and/or HGS asymmetry on mortality risk remains unclear. Therefore, this study aimed to investigate the synergistic effects of AO and abnormal HGS on mortality risk among Chinese older adults. METHODS Baseline data of the China Health and Retirement Longitudinal Study in 2011, along with mortality outcomes obtained in 2018 were used for the analysis. Low HGS was identified as HGS <18 kg in women or <28 kg in men, while HGS asymmetry is defined as an HGS of either hand > 10% stronger than the other. AO was characterized by a waist circumference ≥90 cm in men and ≥85 cm in women. Logistic regression analysis was used to evaluate the relationship between AO, abnormal HGS and mortality risk. RESULTS A total of 5186 subjects aged 60 years or older were enrolled, 50.6% of whom were male. The proportions of participants with only AO, only low HGS, only HGS asymmetry, low HGS with asymmetry, both AO and low HGS, both AO and asymmetric HGS, and AO with both low HGS and asymmetry were 20.0%, 6.1%, 16.6%, 8.3%, 3.2%, 13.4%, and 3.9%, respectively. Over the course of a 7-year follow-up interval, 970 of these individuals died, with 13.4%, 12.4%, 13.6%, 15.5%, 4.1%, 10.1% and 6.9% of deaths in the above groups, respectively. The adjusted logistic regression analysis model confirmed that only low HGS (OR = 1.897, 95%CI: 1.386-2.596, p<0.001), low HGS with asymmetry (OR = 1.680, 95%CI: 1.265-2.231, p<0.001), and AO combined with both low HGS and asymmetry (OR = 2.029, 95%CI: 1.381-2.981, p<0.001) were associated with a higher risk of mortality. CONCLUSIONS Low HGS, with or without asymmetry, is associated with increased mortality risk in older Chinese adults without AO, and the combination of low HGS and HGS asymmetry further elevates mortality risk in those with AO.
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Affiliation(s)
- Ling Wei
- Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Binyou Wang
- Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
| | - Yilin Wang
- Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
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Musazadeh V, Tandorost A, Zarezadeh M, Jafarzadeh J, Ghavami Z, Jamilian P, Ostadrahimi A. Can omega-3 fatty acids and vitamin E co-supplementation affect obesity indices? INT J VITAM NUTR RES 2023; 93:471-480. [PMID: 35796416 DOI: 10.1024/0300-9831/a000757] [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] [Indexed: 11/19/2022]
Abstract
Background: Studies have shown that vitamin E as an antioxidant protects omega-3 fatty acids (FAs) from oxidation. Several studies have evaluated the effect of omega-3 FAs and vitamin E co-supplementation on obesity indices; however, the results are inconsistent. The present systematic review and meta-analysis was conducted to address the role of omega-3 FAs plus vitamin E on obesity indices. Methods: Cochrane Library, PubMed, Scopus, Embase, and Web of Science databases were searched up to February 2022. Among all of the qualified studies, 10 articles were selected. The effect size was presented as weighted mean difference (WMD) and 95% confidence interval (CI). Fixed-effects model was employed to perform meta-analysis. Subgroup analysis and publication bias assessment were carried out. Results: Ten eligible randomized controlled trials comprising 558 participants were included. The average dose of omega-3 FAs and vitamin E co-supplementation in studies was 1000-4000 mg/day and 400 IU, respectively. Intervention duration varied from 6 to 16 weeks. There was no significant effect of omega-3 and vitamin E co-supplementation on body weight (BW) (WMD=0.14 kg; 95% CI: -0.13 to 0.42; p=0.297), and body mass index (BMI) (WMD=0.08, 95% CI: -0.01 to 0.16, p=0.073). However, subgroup analysis showed that it might increase BMI in women over 50 years and if the intervention lasted more than 8 weeks. Conclusion: There was no significant impact of combined omega-3 FAs and vitamin E supplementation on BW and BMI; however, it should be noted that the intervention has an increasing impact when supplementation duration was >8 weeks and in individuals with type 2 diabetes mellitus, >50 years old, and BMI>25 kg/m2.
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Affiliation(s)
- Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Iran
| | | | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Iran
| | - Jaber Jafarzadeh
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Iran
| | - Zoha Ghavami
- Student Research Committee, Tabriz University of Medical Sciences, Iran
| | | | - Alireza Ostadrahimi
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Iran
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Damato TM, Tebar WR, Oliveira CBS, Saraiva BTC, Morelhao PK, Ritti-Dias RM, Christofaro DGD. Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents — the moderating effect of body mass index. Sleep Breath 2022; 26:1809-1816. [DOI: 10.1007/s11325-021-02519-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 12/09/2022]
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Sbaraini M, Cureau FV, Ritter JDA, Schuh DS, Madalosso MM, Zanin G, Goulart MR, Pellanda LC, Schaan BD. Prevalence of overweight and obesity among Brazilian adolescents over time: a systematic review and meta-analysis. Public Health Nutr 2021; 24:6415-6426. [PMID: 33821783 PMCID: PMC11148597 DOI: 10.1017/s1368980021001464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To estimate the burden of excess weight in Brazilian adolescents. DESIGN Systematic review with meta-analysis. SETTING We searched the literature in four databases (MEDLINE/PubMed, EMBASE, SciELO and LILACS). Studies were included if they had cross-sectional or cohort design and enrolled Brazilian adolescents. Studies based on self-reported measures were excluded. Random effect models were used to calculate prevalence estimates and their 95 % CI. PARTICIPANTS Brazilian adolescents (10 to 19 years old). RESULTS One hundred and fifty-one studies were included. Trend analyses showed a significant increase in the prevalence of excess weight in the last decades: 8·2 % (95 % CI 7·7, 8·7) until year 2000, 18·9 (95 % CI 14·7, 23·2) from 2000 to 2009, and 25·1 % (95 % CI 23·4, 26·8) in 2010 and after. A similar temporal pattern was observed in the prevalence of overweight and obesity separately. In sensitivity analyses, lower prevalence of excess weight was found in older adolescents and those defined using International Obesity Task Force cut-off points. The Southeast and South regions had the highest prevalence of excess weight, overweight and obesity. No significant difference in prevalence by sex was found, except for studies before the year 2000. CONCLUSIONS The prevalence of overweight and obesity in Brazilian adolescents is high and continues to rise. Public policies on an individual level and targeting modifications in the obesogenic environment are necessary.
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Affiliation(s)
- Mariana Sbaraini
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil
| | - Felipe Vogt Cureau
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Julianna do Amaral Ritter
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Daniela Schneid Schuh
- Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariana Migliavacca Madalosso
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Gabriella Zanin
- Universidade Luterana do Brasil (ULBRA), Porto Alegre, RS, Brazil
| | - Maíra Ribas Goulart
- Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucia Campos Pellanda
- Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Health and Wellbeing Benefits from Nature Experiences in Tropical Settings Depend on Strength of Connection to Nature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910149. [PMID: 34639451 PMCID: PMC8507985 DOI: 10.3390/ijerph181910149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 12/21/2022]
Abstract
A growing number of policies and programmes in cities aim to increase the time people spend in nature for the health and wellbeing benefits delivered by such interactions. Yet, there is little research investigating the extent to which, and for whom, nature experiences deliver such benefits outside Europe, North America, and Australia. Here, we assessed the relationships between nature dose (frequency, duration, and intensity) and three mental wellbeing (depression, stress, and anxiety) and two physical health (high blood pressure, diabetes) outcomes in Singapore, an intensely urbanised tropical city. Our analyses accounted for individual factors, including socio-economic status, nature connection (nature relatedness), and whether people with poor health are prevented by their condition from visiting green spaces. Our results show that the association between nature dose (specifically duration) and mental wellbeing is moderated by a nature connection. Specifically, people with a stronger nature connection were less likely to be depressed, stressed, and anxious, regardless of the duration of their nature dose. For those with a weaker connection to nature, spending longer in nature was associated with being more depressed, stressed, and anxious. We did not find a relationship between nature dose and high blood pressure or diabetes. Our results highlight that the relationship between nature dose and wellbeing might vary substantially among cities.
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Alvarez C, Flores-Opazo M, Mancilla R, Martínez-Salazar C, Mangiamarchi P, Sade-Calles F, Ramírez-Campillo R. Gender differences in blood pressure and body composition in schoolchildren ascendants from Amerindian and European. ETHNICITY & HEALTH 2021; 26:936-947. [PMID: 30681013 DOI: 10.1080/13557858.2018.1557119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
Background: In spite of there are a wide knowledge of the prevalence of hypertension in adult, there is poor information on schoolchildren of different ethnicity and gender.Aim: To compare the levels of blood pressure and other cardiometabolic risk factors for hypertension between schoolchildren of different gender and ethnicity.Material and methods: In a cross-sectional study, 540 schoolchildren (6-13 years) ascendants from a Chilean public school population were analysed by ethnicity and gender in four groups (Mapuches N = 55; European boys N = 199, and Mapuches N = 64, and European girls N = 222). The study included the measurement of cardiovascular (systolic and diastolic blood pressure) as main outcomes, as well as other cardiovascular (resting heart rate), body composition (body mass, BMI, waist circumference, fat mass, muscle mass), muscle strength (handgrip strength of dominant, non-dominant, and mean handgrip strength) as additional cardiometabolic outcomes.Results: The systolic blood pressure was significantly higher in Mapuches girls 126 ± 4 vs. their European counterparts 119 ± 3 mmHg, P < .002, as well as diastolic blood pressure, was higher in Mapuches girls 82 ± 5 vs. European girls 74 ± 3 mmHg, P < .0001. There were more 'prehypertensive' Mapuches girls 10 (15.6%) vs. European peers 22 (9.9%) at P < .0001, and the 'hypertension' was significantly more prevalent in Mapuches boys 19 (34.5%) vs. European peers 39 (19.4%) at P < .0001, as well as in Mapuches girls 16 (25%) vs. European peers 33 (14.9%) at P < .0001. The 'obesity' was less prevalent in Mapuches 10 (18.2%) vs. European boys 55 (27.4%) at P < .0001. The waist circumference was high in European 74 ± 4 vs. Mapuches 67 ± 6 cm, P < .012 in boys, although, waist circumference was high in Mapuches girls 75 ± 5 vs. European peers 71 ± 3 cm, P < .021. There were higher levels of muscle mass in Mapuches boys 19.5 ± 12 vs. European peers 17.1 ± 4 kg, P < .0001.Conclusion: Mapuches girls show higher levels of systolic and diastolic BP than European girls, Mapuches boys and girls are more hypertensive than European peers, but are less obese than European schoolchildren peers. These cardiometabolic differences that are more detrimental for endemic ethnic Latinoamerican groups are in need to be explored further.
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Affiliation(s)
- Cristian Alvarez
- Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile
| | - Marcelo Flores-Opazo
- Laboratorio de Ciencias del Ejercicio y La Actividad Física, Universidad Finis Terrae, Santiago, Chile
| | - Rodrigo Mancilla
- Department of Nutrition and Movement Sciences, University of Maastricht, Maastricht, Netherlands
| | - Cristian Martínez-Salazar
- Faculty of Education, Social Sciences and Humanities, Department of Physical Education and Recreation, Universidad de la Frontera, Temuco, Chile
| | - Pedro Mangiamarchi
- Centre of Physical Exercise, Cardiovascular Health Program, Padre las Casas, Chile
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Beltran-Valls MR, Santos R, Mota J, Moreira C, Lopes L, Agostinis-Sobrinho C. The mediating role of adiposity in the longitudinal association between cardiorespiratory fitness and blood pressure in adolescents: LabMed cohort study. Eur J Clin Invest 2021; 51:e13430. [PMID: 33047322 DOI: 10.1111/eci.13430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this prospective cohort study was to examine whether the association between the cardiorespiratory fitness (CRF) at baseline and blood pressure (BP) at follow-up is mediated by adiposity in adolescents. MATERIALS AND METHODS The sample comprised 734 adolescents (349 girls) aged 12-18 years from the LabMed Physical Activity Cohort Study. The variables of interest were measured in 2011 (baseline) and in 2013 (2-year follow-up). CRF was assessed by the 20-m shuttle run test. Body mass index, waist circumference, body fat percentage, pubertal status and resting BP were assessed according to standard procedures. Boot-strapped mediation procedures were performed, and indirect effects (IE) with confidence intervals (CI) not including zero were considered statistically significant. RESULTS After adjusting for potential confounders, body mass index acted as a mediator of the relationship between CRF and systolic BP (IE = -0. 023; CI = -0.039; -0.009), pulse pressure (IE = -0.023; CI = -0.034; -0.012) and rate product pressure (IE = -2.839; CI = -5.329; -0.340). Similar results were obtained for waist circumference as mediator for systolic BP (IE = -0.019; CI = -0.033; -0.005), pulse pressure (IE = -0.017; CI = -0.028; -0.007) and rate product pressure (IE = -3.793; CI = -6.097; -1.689). Likewise, body fat percentage mediated the association for: systolic BP (IE = -0.029; CI = -0.048; -0.010), pulse pressure (IE = -0.027; CI = -0.041; -0.013) and rate product pressure (IE = -4.280; CI = -7.488; -1.264). CONCLUSIONS Adiposity mediated the association between CRF and BP in adolescents. Therefore, both optimal CRF and adiposity levels are important to maintain normal BP ranges throughout adolescence.
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Affiliation(s)
- Maria Reyes Beltran-Valls
- LIFE Research Group, University Jaume I, Castellon, Spain.,Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,National Physical Activity Promotion Program, Directorate-General of Health, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Hou J, Gu J, Liu X, Tu R, Dong X, Li R, Mao Z, Huo W, Chen G, Pan M, Guo Y, Li S, Wang C. Long-term exposure to air pollutants enhanced associations of obesity with blood pressure and hypertension. Clin Nutr 2021; 40:1442-1450. [PMID: 33740513 DOI: 10.1016/j.clnu.2021.02.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 01/26/2021] [Accepted: 02/18/2021] [Indexed: 11/24/2022]
Abstract
Although obesity reflected by BMI can enhance the association of air pollution with increase blood pressures (BP) and prevalent hypertension in susceptible population, there remains lack evidence on interactive effects of different obesity indices and air pollutants on BP and prevalent hypertension in rural adults. 39,259 individuals were recruited from the Henan Rural Cohort. Concentrations of air pollutants (PM1, PM2.5, PM10 and NO2) were evaluated by a spatio-temporal model based on satellites data. Independent associations of air pollutants and obesity reflected by BMI, WC, WHR, WHtR, BFP and VFI on BP indicators (SBP, DBP, MAP and PP) and prevalent hypertension were analyzed by linear regression and logistic regression models, respectively. Furthermore, their additive effects were quantified by RERI, AP and S. Six obesity indices enhanced the associations of four air pollutants and BP indicators. Individuals with high PM1 concentrations plus obesity classified by BMI, WC, WHR, WHtR, BFP and VFI had a 4.18-fold (95% CI: 3.86, 4.53), 3.58-fold (95% CI: 3.34, 3.84), 3.53-fold (95% CI: 3.28, 3.81), 4.02-fold (95% CI: 3.72, 4.35), 3.89-fold (95% CI: 3.59, 4.23), 3.87-fold (95% CI: 3.62, 4.14) increase in prevalent hypertension, respectively, compared to non-obese individuals with low PM1 concentrations; similar results were observed for combined effect of PM2.5, PM10 or NO2 and obesity indices on prevalent hypertension. The significant values of RERI, AP and S indicated additive effects of air pollutants and obesity indices on hypertension. Obesity amplified the effects of exposure to high levels of air pollutants on increased BP values and prevalent hypertension, implying that obese individuals may be susceptible to elevate BP and prevalent hypertension in relation to air pollution exposure. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375).
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Affiliation(s)
- Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jianjun Gu
- Department of Neurosurgery, Henan Provincial People's Hospital, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Mingming Pan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Çam HH, Ustuner Top F. Prevalence of Hypertension and Its Association with Body Mass Index and Waist Circumference Among Adolescents in Turkey: A Cross-Sectional Study. J Pediatr Nurs 2021; 57:e29-e33. [PMID: 33010984 DOI: 10.1016/j.pedn.2020.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE This study examined the prevalence of hypertension in adolescents, with the aim of determining a link between blood pressure and body composition measurements. DESIGN AND METHODS This cross-sectional study included adolescents aged 14-19 years attending schools. Their body mass index (BMI) and waist circumference (WC) measurements were recorded. Blood pressure (BP) was taken three or more times, with an average systolic BP and/or diastolic BP ≥ the 95th percentile was regarded as hypertension. RESULTS The prevalence rates of pre-hypertension and hypertension were 11.2% and 14.8%, respectively. Obese and overweight adolescents had a higher prevalence of hypertension compared with those of normal weight (41.6% and 15.5% versus 6.2%, respectively). Following adjustment for BMI status and WC, significant correlations were observed between overweight/obesity and hypertension. After adjusting for BMI status and WC, abdominal obesity was not associated with hypertension. CONCLUSIONS A comparatively high prevalence of hypertension was found among the adolescents. Obesity and overweight were highly correlated with hypertension. PRACTICE IMPLICATIONS School nurses and doctors must describe and address high or raised blood pressure levels in children and adolescents. Because of the high prevalence of hypertension in the obese and overweight adolescents, this study emphasizes the need for the early prevention and control of obesity and hypertension among children.
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Affiliation(s)
- Hasan Hüseyin Çam
- Yusuf Şerefoğlu Faculty of Health Sciences, Department of Public Health Nursing, Kilis 7 Aralık University, Turkey
| | - Fadime Ustuner Top
- Faculty of Health Sciences, Department of Child Health and Disease Nursing, Giresun University, Turkey.
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Azevêdo LM, Santos LS, Pardono E, Almeida JA, Menezes AS. Physical Activity Level, Anthropometric and Cardiovascular Profile Among Students in Sergipe State Attending Public Schools. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20200050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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11
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Tebar WR, Ritti Dias RM, Scarabottolo CC, Gil FCS, Saraiva BTC, Delfino LD, Zanuto EF, Vanderlei LCM, Christofaro DGD. Sedentary behavior is more related with cardiovascular parameters in normal weight than overweight adolescents. J Public Health (Oxf) 2020; 42:e215-e222. [PMID: 31340011 DOI: 10.1093/pubmed/fdz082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/17/2019] [Accepted: 06/26/2019] [Indexed: 11/12/2022] Open
Abstract
This study analyzed the relationship between sedentary behavior and cardiovascular parameters in normal weight and overweight adolescents. The sample included 449 boys and 555 girls with mean age of 13 years from public schools, which were divided into five geographical regions, with data collections performed in one selected school from each region. Sedentary behavior was assessed by screen time on TV, computer, videogame and cell phone/tablet, with good reliability in adolescents. Physical activity was assessed by Baecke's questionnaire, validated for adolescents. Measures of body weight, height and waist circumference were collected. Adolescents were classified as overweight or normal weight by cut-off points of body mass index for age and sex. Cardiovascular parameters were evaluated by oscillometric device and heart rate by specific monitor. Computer use was positively related to systolic blood pressure (SBP) (β = 0.35; 95%CI = 0.07-0.62) and diastolic blood pressure (DBP) (β = 0.25; 95%CI = 0.05-0.44) in normal weight but not in overweight adolescents. Similar results were observed for cell phone/tablet in SBP (β = 0.46; 95%CI = 0.20-0.72) and DBP (β = 0.36; 95%CI = 0.18-0.54), only for normal weight. The cluster of screen time was related to SBP in normal weight (β = 0.44; 95%CI = 0.03-0.84) and overweight (β = 0.60; 95%CI = 0.01-1.19). Screen time in computer and cell phone/tablet was more related to cardiovascular parameters in normal weight than overweight adolescents.
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Affiliation(s)
- William R Tebar
- Movement Sciences Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physical Education. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Raphael M Ritti Dias
- Rehabilitation Sciences Post Graduation Program-Universidade Nove de Julho, Department of Physical Education. Vergueiro Street, Number 235-249, Postal Code 01504-001, Sao Paulo, Brazil
| | - Catarina C Scarabottolo
- Movement Sciences Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physical Education. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Fernanda C S Gil
- Physiotherapy Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physiotherapy. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Bruna T C Saraiva
- Movement Sciences Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physical Education. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Leandro D Delfino
- Physiotherapy Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physiotherapy. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Edner F Zanuto
- Physiotherapy Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physiotherapy. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Luiz Carlos M Vanderlei
- Physiotherapy Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physiotherapy. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
| | - Diego G D Christofaro
- Movement Sciences Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physical Education. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil.,Physiotherapy Post Graduation Program-Sao Paulo State University (Unesp), School of Technology and Sciences, Department of Physiotherapy. Roberto Simonsen Street, Number 305, Postal Code 19.060-900, Presidente Prudente, Brazil
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12
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Hormonal Blood Pressure Regulationduring General Anesthesia Usinga Standardized Propofol Dosagein Children and Adolescents SeemsNot to Be Affected by Body Weight. J Clin Med 2020; 9:jcm9072129. [PMID: 32640705 PMCID: PMC7408938 DOI: 10.3390/jcm9072129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity in pediatric surgical patients is a challenge for the anesthesiologist. Despite potentially beneficial properties, propofol might also induce hypotension. This study examined whether a dose adjustment in overweight children could avoid hypotension and if there would be differences regarding hormonal regulation in children under anesthesia. Fifty-nine children undergoing surgery under general anesthesia were enrolled in this prospective observational trial. Participants were allocated into two groups according to their BMI. The induction of anesthesia was conducted using propofol (“overweight”: 2 mg/kgBW, “regular”: 3.2 mg/kgBW). The maintenance of anesthesia was conducted as total intravenous anesthesia. Hormone levels of renin, angiotensin II, aldosterone, copeptin, norepinephrine and epinephrine were assessed at different timepoints. Blood pressure dropped after the administration of propofol in both groups, with a nadir 2 min after administration—but without a significant difference in the strength of reduction between the two groups. As a reaction, an increase in the plasma levels of renin, angiotensin and aldosterone was observed, while levels of epinephrine, norepinephrine and copeptin dropped. By adjusting the propofol dosage in overweight children, the rate of preincision hypotension could be reduced to the level of normal-weight patients with a non-modified propofol dose. The hormonal counter regulation was comparable in both groups. The release of catecholamines and copeptin as an indicator of arginine vasopressin seemed to be inhibited by propofol.
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13
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Liao YY, Ma Q, Chu C, Wang Y, Zheng WL, Hu JW, Yan Y, Wang KK, Yuan Y, Chen C, Mu JJ. The predictive value of repeated blood pressure measurements in childhood for cardiovascular risk in adults: the Hanzhong Adolescent Hypertension Study. Hypertens Res 2020; 43:969-978. [PMID: 32488216 DOI: 10.1038/s41440-020-0480-7] [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: 02/27/2020] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 12/13/2022]
Abstract
There is currently a lack of strong evidence linking childhood elevated blood pressure to long-term cardiovascular risk in adulthood. Repeated observations of abnormal blood pressure in childhood may enhance the prediction of cardiovascular risk in adulthood compared with a single observation. The study included 1738 individuals in rural areas of Hanzhong City, Shaanxi, who had been followed for 30 years since baseline (1987, at which time participants were aged 6-15 years). According to four independent measurements of blood pressure in 1987, 1989, 1992, and 1995, childhood elevated blood pressure was defined as 2 in-person examinations with blood pressure values above the 90th percentile. Arterial stiffness and left ventricular hypertrophy in adulthood were assessed by brachial-ankle pulse wave velocity and the Cornell product index, respectively. Childhood elevated blood pressure was associated with an increased risk of adult hypertension (OR, 2.01; 95% CI, 1.53-2.65), arterial stiffness (OR, 1.69; 95% CI, 1.32-2.16) and left ventricular hypertrophy (OR, 1.86; 95% CI, 1.13-3.05) (all P < 0.05). Cardiovascular risk in adults increased with increasing childhood blood pressure levels. In addition, two abnormal childhood blood pressure observations predicted an increased likelihood of hypertension in adulthood (0.77 for 2 versus 0.70 for 1 observation, P < 0.001). Our study provides strong evidence that elevated blood pressure in childhood predicts cardiovascular risk in adults. The prediction was enhanced by two observations of abnormal blood pressure in childhood compared with a single measurement. We emphasize the importance of childhood blood pressure monitoring and control in the prevention of cardiovascular diseases.
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Affiliation(s)
- Yue-Yuan Liao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Wen-Ling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jia-Wen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Ke-Ke Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yue Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chen Chen
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. .,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
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14
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Li HB, Cheng H, Hou DQ, Gao AY, Zhu ZX, Yu ZC, Wang HJ, Zhao XY, Xiao P, Huang GM, Mi J. [Value of body fat mass measured by bioelectrical impedance analysis in predicting abnormal blood pressure and abnormal glucose metabolism in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:17-23. [PMID: 31948519 PMCID: PMC7389711 DOI: 10.7499/j.issn.1008-8830.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To study the value of body fat mass measured by bioelectrical impedance analysis (BIA) in predicting abnormal blood pressure and abnormal glucose metabolism in children. METHODS Stratified cluster sampling was used to select the students aged 6-16 years, and a questionnaire survey and physical examination were performed. The BIA apparatus was used to measure body fat mass. Body mass index (BMI), body fat mass index (FMI), and fat mass percentage (FMP) were calculated. Fasting blood glucose level were measured. RESULTS A total of 14 293 children were enrolled, among whom boys accounted for 49.89%. In boys and girls, the percentile values (P60, P65, P70, P75, P80, P85, P90, P95) of FMI and FMP fitted by the LMS method were taken as the cut-off values. Based on the receiver operating characteristic curve analysis, the P70 values with a better value in predicting abnormal blood pressure and blood glucose metabolism were selected as the cut-off values for excessive body fat. When FMI or FMP was controlled below P70, the incidence of abnormal blood pressure or abnormal glucose metabolism may be decreased in 8.25%-43.24% of the children. CONCLUSIONS The evaluation of obesity based on FMI and FMP has a certain value in screening for hypertension and hyperglycemia in children, which can be further verified in the future prevention and treatment of obesity and related chronic diseases in children.
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Affiliation(s)
- Hai-Bo Li
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.
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15
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Wang Y, Liu W, Sun L, Zhang Y, Wang B, Yuan Y, Li T, Yao R, Han H, Qian Q, Fu L. A novel indicator, childhood lipid accumulation product, is associated with hypertension in Chinese children and adolescents. Hypertens Res 2019; 43:305-312. [PMID: 31819153 DOI: 10.1038/s41440-019-0366-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/24/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022]
Abstract
Childhood hypertension has become an important public health issue. This study explored a novel indicator, namely, childhood lipid accumulation product (CLAP), which is associated with hypertension among children and adolescents. A total of 683 children and adolescents aged 8-15 years were measured for body weight, height, waist circumference (WC), abdominal skinfold thickness (AST), triacylglycerol (TG), blood pressure, dietary behaviors, and physical activity time. The novel childhood lipid accumulation product (CLAP) was the product of WC, AST, and TG (CLAP = WC (cm) × AST (mm) × TG (mmol/L)). The logarithmic CLAP (LnCLAP), height, weight, WC, WHtR, BMI, AST, and TG were standardized for sex and age using the z-score method (standardized variables: SLnCLAP, Sheight, Sweight, SWC, SWHtR, SBMI, SAST, and STG). The results showed that the overall prevalence of hypertension was 11.6% (13.1% in boys and 9.7% in girls). SLnCLAP ≥ 1, Sweight ≥ 1, SWC ≥ 1, SWHtR ≥ 1, SBMI ≥ 1, SAST ≥ 1, and STG ≥ 1 increased the statistical risk of childhood hypertension (odds ratio values (95% CI) were 3.70 (2.22-6.16), 2.58 (1.50-4.43), 3.08 (1.84-5.15), 2.33 (1.38-3.93), 2.96 (1.72-5.29), 2.38 (1.41-4.70), and 2.40 (1.38-4.19), respectively). The area under the ROC curve (AUC) for CLAP was higher than that for weight, WC, WHtR, BMI, AST, and TG in the prediction of hypertension. In conclusion, this study showed that CLAP is a novel indicator associated with hypertension in children and adolescents and can more effectively predict childhood hypertension than weight, WC, WHtR, BMI, AST, and TG can.
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Affiliation(s)
- Yuan Wang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Wenmin Liu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Lili Sun
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Yifei Zhang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Bangxuan Wang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Yongting Yuan
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Ting Li
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Rongying Yao
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Hui Han
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China
| | - Qingwen Qian
- Bengbu Centers for Disease Control and Prevention, Bengbu, 233000, Anhui, PR China
| | - Lianguo Fu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, PR China.
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16
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The combination of obesity and high salt intake are associated with blood pressure elevation among healthy Japanese adolescents. J Hum Hypertens 2019; 34:117-124. [PMID: 31477827 DOI: 10.1038/s41371-019-0239-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/11/2019] [Accepted: 07/03/2019] [Indexed: 11/09/2022]
Abstract
We examined the associations of obesity and high salt intake with blood pressure (BP) in a cross-sectional sample of 1679 healthy Japanese adolescents (827 females and 852 males) aged 12-18 years (mean age: 14.9 years) who had no history of treatment for hypertension, diabetes mellitus, or renal disease. Brachial arterial BP of the subject was measured at the left arm using a digital BP monitor with an appropriate cuff size. The weight status was evaluated by body mass index (BMI), and obesity was determined according to the age- and sex-specific cut-off values for adolescents. All subjects were interviewed by dietitians using a food frequency questionnaire to obtain data on their average daily salt intake. In the study subjects, obesity and high salt intake were associated with a significantly increased BP except for diastolic BP in females. In multiple regression analyses, both BMI (z-score) and salt intake were found to be major determinants of systolic BP and diastolic BP after adjustment for potential confounders, including age, sex, and serum lipid and glucose parameters. The association between salt intake and BP values was more pronounced among individuals with obesity than among those with normal weight. These results suggest that high salt intake is associated with BP elevation in healthy adolescents, and the association may become stronger by the presence or severity of obesity.
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17
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Sousa CM, Santana E, Lopes MV, Lima G, Azoubel L, Carneiro É, Barros AK, Pires N. Development of a Computational Model to Predict Excess Body Fat in Adolescents through Low Cost Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2962. [PMID: 31426509 PMCID: PMC6720279 DOI: 10.3390/ijerph16162962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/14/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Excess body fat has been growing alarmingly among adolescents, especially in low income and middle income countries where access to health services is scarce. Currently, the main method for assessing overweight in adolescents is the body mass index, but its use is criticized for its low sensitivity and high specificity, which may lead to a late diagnosis of comorbidities associated with excess body fat, such as cardiovascular diseases. Thus, the aim of this study was to develop a computational model using linear regression to predict obesity in adolescents and compare it with commonly used anthropometric methods. To improve the performance of our model, we estimated the percentage of fat and then classified the nutritional status of these adolescents. METHODS The model was developed using easily measurable socio-demographic and clinical variables from a database of 772 adolescents of both genders, aged 10-19 years. The predictive performance was evaluated by the following metrics: accuracy, sensitivity, specificity, and area under ROC curve. The performance of the method was compared to the anthropometric parameters: body mass index and waist-to-height ratio. RESULTS Our model showed a high correlation (R = 0.80) with the body fat percentage value obtained through bioimpedance. In addition, regarding discrimination, our model obtained better results compared to BMI and WHtR: AUROC = 0.80, 0.64, and 0.55, respectively. It also presented a high sensitivity of 92% and low false negative rate (6%), while BMI and WHtR showed low sensitivity (27% and 9.9%) and a high false negative rate (65% and 53%), respectively. CONCLUSIONS The computational model of this study obtained a better performance in the evaluation of excess body fat in adolescents, compared to the usual anthropometric indicators presenting itself as a low cost alternative for screening obesity in adolescents living in Brazilian regions where financial resources are scarce.
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Affiliation(s)
- Carlos Magno Sousa
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Ewaldo Santana
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil.
- Laboratory of Signals Acquisition and Processing, LAPS, State University of Maranhão, Campus Paulo VI, São Luís 65700000, MA, Brazil.
| | - Marcus Vinicius Lopes
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Guilherme Lima
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Luana Azoubel
- Centro de Prevenção de Doenças Renais, University Hospital of Maranhão, São Luís 65080805, MA, Brazil
| | - Érika Carneiro
- Centro de Prevenção de Doenças Renais, University Hospital of Maranhão, São Luís 65080805, MA, Brazil
| | - Allan Kardec Barros
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Nilviane Pires
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
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18
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Kuciene R, Dulskiene V. Associations between body mass index, waist circumference, waist-to-height ratio, and high blood pressure among adolescents: a cross-sectional study. Sci Rep 2019; 9:9493. [PMID: 31263167 PMCID: PMC6602926 DOI: 10.1038/s41598-019-45956-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Abstract
The purpose of the present study was to examine the associations between body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and high blood pressure (HBP), and to determine which anthropometric parameters can best predict HBP among Lithuanian adolescents aged 12–15 years. Data from the survey of “Prevalence and Risk Factors of HBP in 12–15-Year-Old Lithuanian Children and Adolescents (Study 1, 2010–2012)” were used; a total of 7,457 respondents (3,494 boys and 3,963 girls) were included in this analysis. Adolescents with BP above the 90th percentile were measured on two different occasions. Logistic regression analysis was used to assess the associations and to calculate odds ratios. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of the three anthropometric parameters to predict HBP. The adjusted odds ratios (aOR) in the highest quartiles of BMI, WC, and WHtR were statistically significant for both sexes separately (reference group – the first quartile): in boys, prehypertension – 4.91, 4.09, and 1.59; hypertension – 7.96, 6.44, and 2.81; and prehypertension/hypertension – 6.85, 5.65, and 2.37, respectively; and in girls, prehypertension – 3.42, 2.70, and 1.66; hypertension – 5.71, 3.54, and 2.90; and prehypertension/hypertension – 4.62, 3.17, and 2.31, respectively). According to the analyses of the ROC curve, BMI z-score provided the largest area under the curve (AUC) value, followed by WC z-score, while WHtR z-score showed the lowest AUC value in predicting elevated BP in both sexes separately. Among Lithuanian adolescents aged 12–15 years, both anthropometric indices – BMI and WC (but particularly BMI) – showed stronger associations with HBP and were better for the prediction of HBP, compared to WHtR.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50161, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50161, Kaunas, Lithuania
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19
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The association between digit ratio (2D:4D) and blood pressure among children and adolescents. Hypertens Res 2019; 42:876-882. [DOI: 10.1038/s41440-018-0199-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/05/2018] [Accepted: 11/16/2018] [Indexed: 11/08/2022]
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20
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Xu R, Zhang X, Zhou Y, Wan Y, Gao X. Percentage of free fat mass is associated with elevated blood pressure in healthy Chinese children. Hypertens Res 2018; 42:95-104. [PMID: 30393381 DOI: 10.1038/s41440-018-0129-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/05/2018] [Accepted: 06/25/2018] [Indexed: 01/02/2023]
Abstract
Previous studies have reported that a high free fat mass (FFM) was associated with elevated blood pressure in children. However, the observed relationship could be confounded by body weight. Thus, we performed cross-sectional analyses to understand the differences between the percentage of free fat mass (FFM%) and FFM in relation to blood pressure in healthy Chinese children. A total number of 2671 (1264 girls; aged 6-14 years) healthy Chinese children was recruited in 2014 (baseline). We further prospectively examined whether these indices predicted hypertension risk during the 2 years of follow-up (2014-2016) among 2094 participants who were free of hypertension at the baseline. Blood pressure was repeatedly measured in 2014, 2015 and 2016. Hypertension was defined as either high systolic blood pressure and/or high diastolic blood pressure (≥age- and sex-specific 95th percentile for Chinese children). The baseline FFM was assessed by bio-impedance analysis, and FFM% was calculated as FFM divided by the body weight. A high FFM was associated with a high baseline blood pressure and high hypertension risk after adjustment for potential confounders (all p < 0.001). By contrast, a high FFM% was associated with a low baseline blood pressure and low hypertension risk in the fully adjusted model (all p < 0.001). Each one-percent increment of FFM% was associated with a 9% lower risk of developing hypertension (adjusted hazard ratio = 0.91; 95% confidence interval: 0.89, 0.94). A high FFM% was associated with a low blood pressure and low hypertension risk in healthy Chinese children.
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Affiliation(s)
- Renying Xu
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Xiaomin Zhang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiquan Zhou
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanping Wan
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. .,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
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21
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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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