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Stefan N, Schiborn C, Machann J, Birkenfeld AL, Schulze MB. Impact of higher BMI on cardiometabolic risk: does height matter? Lancet Diabetes Endocrinol 2024; 12:514-515. [PMID: 38968941 DOI: 10.1016/s2213-8587(24)00164-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 07/07/2024]
Affiliation(s)
- Norbert Stefan
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen 72076, Germany; Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany.
| | - Catarina Schiborn
- German Center for Diabetes Research, Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Jürgen Machann
- Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Andreas L Birkenfeld
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen 72076, Germany; Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Matthias B Schulze
- German Center for Diabetes Research, Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
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Aduse-Poku L, Karanth SD, Wheeler M, Yang D, Washington C, Hong YR, Manini TM, Fabregas JC, Cheng TYD, Braithwaite D. Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors. Cancers (Basel) 2023; 15:1081. [PMID: 36831420 PMCID: PMC9953880 DOI: 10.3390/cancers15041081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Purpose: The importance of body composition on cancer outcomes is of great clinical interest. Measures of body composition that differentiate fat mass from skeletal muscle mass can help redefine our understanding of body composition for cancer survival. We investigated whether the risk of all-cause and cancer-specific mortality differ by levels of total fat mass and sarcopenia status in cancer survivors. Our secondary aim was a subgroup analysis assessing the role of race within these associations. Methods: Participants included 1682 adult cancer survivors who had undergone a dual-energy X-ray absorptiometry (DXA) examination to measure body composition, from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Survey (NHANES). Total fat mass was categorized into tertiles (we assessed high vs. low tertiles), and sarcopenia was considered as having an appendicular skeletal muscle mass index less than 7.26 kg/m2 for males and less than 5.45 kg/m2 for females. Multivariable Cox proportional hazard models estimated the adjusted hazard ratio (aHR) and 95% confidence interval (CI). Results: The mean age of study participants was 61.9 years, and they were followed up for an average of 9.67 years. The prevalence of sarcopenia was 25.0% (N = 304), and 33.4% (N = 561) had a high total fat mass. Participants with a higher fat mass (aHR = 1.30, 95% CI = 1.06-1.61) and with sarcopenia (aHR = 1.51, 95% CI = 1.22-1.88) had a 30% and 51% increased risk of all-cause mortality compared to participants with a low fat mass and with no sarcopenia, respectively. Further, sarcopenia (aHR = 1.74, 95% CI = 1.23-2.29) was associated with a higher risk of cancer-specific mortality in cancer survivors. The association between sarcopenia and all-cause mortality was twice as strong in Black people (aHR = 2.99, 95% CI = 1.39-6.06) compared to White people (aHR = 1.53, 95% CI = 1.19-1.95). Conclusions: Our findings show the opposing relations of fat mass and appendicular skeletal muscle mass index with mortality in a national sample of cancer survivors, and that the relationships may differ by race. These results emphasize the importance of maintaining a healthy body composition among cancer survivors.
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Affiliation(s)
- Livingstone Aduse-Poku
- Department of Epidemiology, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
| | - Shama D. Karanth
- University of Florida Health Cancer Center, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
- Aging & Geriatric Research, Institute on Aging, 2004 Mowry Rd., Gainesville, FL 32610, USA
| | - Meghann Wheeler
- Department of Epidemiology, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
| | - Danting Yang
- Department of Epidemiology, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
| | - Caretia Washington
- Department of Epidemiology, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management, & Policy, 1225 Center Dr., Gainesville, FL 32610, USA
| | - Todd M. Manini
- Department Health Outcomes & Biomedical Informatics, Institute on Aging, 2004 Mowry Rd., Gainesville, FL 32611, USA
| | - Jesus C. Fabregas
- Division of Hematology & Oncology, College of Medicine, University of Florida, 2000 SW Archer Rd., Gainesville, FL 32608, USA
| | - Ting-Yuan David Cheng
- Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Dejana Braithwaite
- Department of Epidemiology, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
- University of Florida Health Cancer Center, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA
- Department of Surgery, University of Florida, 1600 SW Archer Rd., Gainesville, FL 32608, USA
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Wang X, Ma J, Huang S, Dong B, Dong Y, Yang Z, Hu J, Liang W. Use of Tri-Ponderal Mass Index in Predicting Late Adolescent Overweight and Obesity in Children Aged 7–18. Front Nutr 2022; 9:785863. [PMID: 35387193 PMCID: PMC8978718 DOI: 10.3389/fnut.2022.785863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/21/2022] [Indexed: 12/19/2022] Open
Abstract
Background Current reference systems using body mass index (BMI) or BMI z-scores to estimate overweight and obesity risk in adolescents are complex to use. An easy and effective measure and cutoffs such as the tri-ponderal mass index (TMI) are in need for parents and grassroots health workers. Objective The aim of this study was to test whether cohort-derived TMI could be efficient for obesity prediction and to find out whether simplified TMI cutoffs could be used in the prediction. Methods Data were obtained from a 12-year retrospective growth cohort generated in Guangdong, China. A total of 17,815 children (53.9% were boys) with 151,879 follow-ups conducted annually between 2005 and 2016 were involved. Late adolescent overweight and obesity were defined based on the BMI z-score (WHO 2007 growth reference) of the last measurement, which happened at the mean age of 17.2 (SD: 0.7) for both sexes. Analysis of the area under the curve (AUC) of the receiver operating characteristic curves was used to find the most appropriate cutoff. Results In total, 9,604 boys and 8,211 girls were included in the final analysis. TMI cutoffs performed better than WHO BMI cutoffs in the prediction of late adolescent overweight and obesity, with all corresponding AUCs <0.7. The simplified TMI cutoffs used to predict late adolescent overweight and obesity were 13.1 and 14.1 kg/m3 for children aged 7 to 15 years, respectively, with the corresponding AUCs ranging from 0.7315 (standard error, SE: 0.0132) to 0.9367 (SE: 0.0052). The cutoffs for predicting late adolescent overweight and obesity for children aged 16 to 18 years were 14.0 and 15.8 kg/m3, respectively, with the corresponding AUCs ranging from 0.9189 (SE: 0.0048) to 0.9841 (95% CI: 0.0027). Conclusion Tri-ponderal mass index with the ease of administration in practice could be a promising alternative screening tool to BMI for the prediction of late adolescent overweight and obesity.
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Affiliation(s)
- Xijie Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Sizhe Huang
- Zhongshan Health Care Center for Primary and Secondary Schools, Guangdong, China
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- *Correspondence: Bin Dong
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- Yanhui Dong
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Measuring body fat—How accurate is the extrapolation of predictive models in epidemiology? PLoS One 2022; 17:e0263590. [PMID: 35143559 PMCID: PMC8830724 DOI: 10.1371/journal.pone.0263590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/23/2022] [Indexed: 11/19/2022] Open
Abstract
Excess fat is a risk factor for many chronic diseases which can lead to premature mortality. Many studies have proposed predictive equations for body fat mass and body fat mass percentage based on anthropometric measures in relation to age and sex. However, the use of these predictive equations on other subject samples may not be relevant. Our objective is to assess whether the predictive equations proposed in the literature are generalizable to any population. We obtained fat mass and fat percentage on a reference population using Absorptiometry DXA. The predictive equations were applied to our population and the mean and individual differences between actual and estimated values were obtained. Predictive equations obtained from a reduced number of subjects have a very high Standard Error of Estimate (>3) and therefore their accuracy is not acceptable. Only the formulae established from a large number of individuals allow the estimation of values whose Standard Error of Estimate is less than 3. These equations, thanks to the large sample size, include a sufficiently large variability in anthropometric measurements covering the diversity of anthropometric values for the same fat value. However, predictive equations based on a large sample size, while exhibiting no current difference in variances, can show a shift in mean values. This mean-shift is the result of differences in DXA devices and needs to be corrected. It means that DXA values from a few individuals in the population under study must be obtained to calculate a corrective factor.
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Brown JC, Heymsfield SB, Caan BJ. Scaling of computed tomography body composition to height: relevance of height-normalized indices in patients with colorectal cancer. J Cachexia Sarcopenia Muscle 2022; 13:203-209. [PMID: 34741439 PMCID: PMC8818649 DOI: 10.1002/jcsm.12847] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/13/2021] [Accepted: 10/01/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Body weight scales to height with a power of ≈2 (weight/height2 ), forming the basis of body mass index (BMI). The corresponding scaling of body composition measured by abdominal computed tomography (CT) to height has not been established. The objective of this analysis was to quantify the scaling of body composition measured by a single-slice axial abdominal CT image (skeletal muscle, and visceral, subcutaneous, and total adipose tissue) to height in patients with colorectal cancer (CRC). METHODS This cross-sectional study included non-Hispanic white males and females, aged 18-80 years, who were diagnosed with stage I-III CRC at an integrated health care system in North America between January 2006 and December 2011. Body composition was measured by a single-slice axial CT image of the third lumbar vertebra and analysed with a semi-automated threshold segmentation procedure. Allometric regression models were used to quantify height scaling powers (β ± standard error) for each body composition measure, adjusted for age, for males and females. An interaction test was used to determine if height scaling powers were statistically significantly different between males and females. RESULTS Among 2036 subjects, the mean (standard deviation) age was 64 ± 11 years, 1008 (49.5%) were female, and the mean (standard deviation) BMI was 27.9 ± 5.4 kg/m2 . Powers for skeletal muscle area were 1.06 ± 0.12 for males and 0.80 ± 0.12 for females (P = 0.049). Powers for visceral adipose tissue area were 1.81 ± 0.64 for males and 0.57 ± 0.79 for females (P = 0.16). Powers for subcutaneous adipose tissue area were 2.04 ± 0.42 for males and 0.81 ± 0.45 for females (P = 0.056). Powers for total abdominal adipose tissue area were 1.80 ± 0.46 for males and 0.76 ± 0.50 for females (P = 0.20). CONCLUSIONS Body composition measured by single-slice axial abdominal CT, particularly muscle area, scales to height with age-adjusted powers that are different than 2 and are distinct between males and females. These observations may have implications for the development of height-adjusted body composition indices in patients with cancer.
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Affiliation(s)
- Justin C Brown
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.,LSU Health Sciences Center New Orleans School of Medicine, New Orleans, LA, USA.,Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | - Bette J Caan
- Kaiser Permanente Northern California, Oakland, CA, USA
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Anthropometrics by Three-Dimensional Photonic Scanner in Patients with Obesity Before and After Bariatric Surgery. Obes Surg 2020; 31:53-61. [PMID: 32794078 DOI: 10.1007/s11695-020-04905-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND We studied body composition by three-dimensional photonic scanning (3DPS) and metabolic biomarkers in a large ethnically diverse cohort of individuals with severe obesity before and after weight loss by Roux-en-Y gastric bypass (RYGB) or adjustable gastric banding (AGB) surgery. MATERIALS AND METHODS Male and female participants (n = 95) underwent 3DPS testing in the weeks preceding bariatric surgery (baseline), and 1 year after either RYGB (n = 34) or AGB (n = 9). RESULTS Principal component analysis showed that A1C and HDL cholesterol clustered with waist-to-hip ratio (WHR). Both RYGB and AGB surgeries led to similar improvements in A1C and lipids after 1 year. RYGB led to greater decreases in body weight, and in most anthropometric measures, compared with AGB at 1 year. However, after accounting for weight loss differences, RYGB and AGB groups did not differ in regional decreases in circumferences or volumes; the exception was a greater reduction in lean mass in RYGB compared with AGB. CONCLUSION Distribution of weight loss, assessed by 3DPS, did not differ between RYGB and AGB, but surgery type predicted change in lean mass at 1 year.
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Environmental Exposures during Puberty: Window of Breast Cancer Risk and Epigenetic Damage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020493. [PMID: 31941024 PMCID: PMC7013753 DOI: 10.3390/ijerph17020493] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022]
Abstract
During puberty, a woman’s breasts are vulnerable to environmental damage (“window of vulnerability”). Early exposure to environmental carcinogens, endocrine disruptors, and unhealthy foods (refined sugar, processed fats, food additives) are hypothesized to promote molecular damage that increases breast cancer risk. However, prospective human studies are difficult to perform and effective interventions to prevent these early exposures are lacking. It is difficult to prevent environmental exposures during puberty. Specifically, young women are repeatedly exposed to media messaging that promotes unhealthy foods. Young women living in disadvantaged neighborhoods experience additional challenges including a lack of access to healthy food and exposure to contaminated air, water, and soil. The purpose of this review is to gather information on potential exposures during puberty. In future directions, this information will be used to help elementary/middle-school girls to identify and quantitate environmental exposures and develop cost-effective strategies to reduce exposures.
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Yee LD, Mortimer JE, Natarajan R, Dietze EC, Seewaldt VL. Metabolic Health, Insulin, and Breast Cancer: Why Oncologists Should Care About Insulin. Front Endocrinol (Lausanne) 2020; 11:58. [PMID: 32153503 PMCID: PMC7045050 DOI: 10.3389/fendo.2020.00058] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 01/29/2020] [Indexed: 12/13/2022] Open
Abstract
Studies investigating the potential link between adult pre-menopausal obesity [as measured by body mass index (BMI)] and triple-negative breast cancer have been inconsistent. Recent studies show that BMI is not an exact measure of metabolic health; individuals can be obese (BMI > 30 kg/m2) and metabolically healthy or lean (BMI < 25 kg/m2) and metabolically unhealthy. Consequently, there is a need to better understand the molecular signaling pathways that might be activated in individuals that are metabolically unhealthy and how these signaling pathways may drive biologically aggressive breast cancer. One key driver of both type-2 diabetes and cancer is insulin. Insulin is a potent hormone that activates many pathways that drive aggressive breast cancer biology. Here, we review (1) the controversial relationship between obesity and breast cancer, (2) the impact of insulin on organs, subcellular components, and cancer processes, (3) the potential link between insulin-signaling and cancer, and (4) consider time points during breast cancer prevention and treatment where insulin-signaling could be better controlled, with the ultimate goal of improving overall health, optimizing breast cancer prevention, and improving breast cancer survival.
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Hwaung P, Heo M, Kennedy S, Hong S, Thomas DM, Shepherd J, Heymsfield SB. Optimum waist circumference-height indices for evaluating adult adiposity: An analytic review. Obes Rev 2020; 21:e12947. [PMID: 31507076 DOI: 10.1111/obr.12947] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 12/17/2022]
Abstract
Phenotyping adults for excess adiposity and related health risks usually include three body size measurements: height, weight and waist circumference (WC). Height and weight are now widely used as components of the body shape measure, body mass index (BMI, weight/height2 ), with the height power referred to as the scaling factor, α. At present, WC is usually not adjusted for height or is expressed as WC/height in which α = 1. Although other α values have been proposed, a critical review of these shape measures is lacking. Here, we examine classical pathways by which the scaling exponent for height used in BMI was developed and then apply this strategy to identify the optimum WC index characteristic of adult shape. Our analyses explored anthropometric, body composition and clinically-relevant data from US and Korean National Health and Nutrition Surveys. Our findings provide further support for the WC index of WC/height0.5 as having the strongest associations with adiposity while having the weakest correlations with height across non-Hispanic white and black, Mexican American and Korean men and women. The WC index, defined as WC/height0.5 , when combined with BMI, can play an important role when phenotyping adults for excess adiposity and associated health risks in research and clinical settings.
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Affiliation(s)
- Phoenix Hwaung
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, South Carolina, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
| | - Sangmo Hong
- Department of Internal Medicine, Hallym University, Seoul, Republic of Korea
| | - Diana M Thomas
- United States Military Academy, West Point, New York, USA
| | - John Shepherd
- Cancer Epidemiology, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
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Watts K, Hwaung P, Grymes J, Cottam SH, Heymsfield SB, Thomas DM. Allometric models of adult regional body lengths and circumferences to height: Insights from a three‐dimensional body image scanner. Am J Hum Biol 2019; 32:e23349. [PMID: 31654539 DOI: 10.1002/ajhb.23349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/07/2019] [Accepted: 10/11/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Krista Watts
- Department of Mathematical SciencesUnited States Military Academy West Point New York
| | - Phoenix Hwaung
- Metabolism and Body CompositionPennington Biomedical Research Center Baton Rouge Louisiana
| | - James Grymes
- Department of Mathematical SciencesUnited States Military Academy West Point New York
| | | | - Steven B. Heymsfield
- Metabolism and Body CompositionPennington Biomedical Research Center Baton Rouge Louisiana
| | - Diana M. Thomas
- Department of Mathematical SciencesUnited States Military Academy West Point New York
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Hood K, Ashcraft J, Watts K, Hong S, Choi W, Heymsfield SB, Gautam RK, Thomas D. Allometric scaling of weight to height and resulting body mass index thresholds in two Asian populations. Nutr Diabetes 2019; 9:2. [PMID: 30683839 PMCID: PMC6347591 DOI: 10.1038/s41387-018-0068-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/14/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Body mass index (BMI) represents a normalization of weight to height and is used to classify adiposity. While the capacity of BMI as an adiposity index has been experimentally validated in Caucasians, but there has been little testing Asian populations. METHODS To determine whether weight scales to height squared in Asian Indians across the general population and in Asian Indian tribes an allometric analysis on the power law model, W = αHβ, where W is weight (kg) and H is height (m) was performed on cross-sectional weight and height data from India (N = 43,880) collected through the Anthropological Survey of India. The database contained males 18-84 years of age spanning 161 districts of 14 states and including 33 different tribes (N = 5,549). Models were developed that were unadjusted and adjusted for tribe membership. The Korean National Health and Nutrition Examination Survey (KNHANES) was used to compare to height-weight data from the Anthropological Survey of India and to calculate BMI thresholds for obesity status using a receiver operating characteristic. RESULTS The unadjusted power was β = 2.08 (s = 0.02). The power for the general population (non-tribal) was β = 2.11 (s = 0.02). Powers when adjusted for tribe ranged from 1.87 to 2.35 with 24 of the 33 tribes resulting in statistically significant (p < 0.05) differences in powers from the general population. The coefficients of the adjusted terms ranged from -0.22 to 0.26 and therefore the scaling exponent does not deviate far from 2. Thresholds for BMI classification of overweight in the KNHANES database were BMI = 21 kg/m2 (AUC = 0.89) for males 18 kg/m2 (AUC = 0.97) for females. Obesity classification was calculated as BMI = 26 kg/m2 (AUC = 0.81) and 23 kg/m2 (AUC = 0.83) for females. CONCLUSIONS Our study confirms that weight scales to height squared in Asian Indian males even after adjusting for tribe membership. We also demonstrate that optimal BMI thresholds are lower in a Korean population in comparison to currently used BMI thresholds. These results support the application of BMI in Asian populations with potentially lower thresholds.
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Affiliation(s)
- Karoline Hood
- United States Military Academy, West Point, NY, United States
| | - Jacob Ashcraft
- United States Military Academy, West Point, NY, United States
| | - Krista Watts
- United States Military Academy, West Point, NY, United States
| | - Sangmo Hong
- Hanyang University, Seoul, Republic of Korea
| | - Woong Choi
- Hanyang University, Seoul, Republic of Korea
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, United States
| | - Rajesh K Gautam
- Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ, United States
| | - Diana Thomas
- United States Military Academy, West Point, NY, United States.
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Pleuss JD, Talty K, Morse S, Kuiper P, Scioletti M, Heymsfield SB, Thomas DM. A machine learning approach relating 3D body scans to body composition in humans. Eur J Clin Nutr 2018; 73:200-208. [PMID: 30315314 DOI: 10.1038/s41430-018-0337-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/05/2018] [Indexed: 11/09/2022]
Abstract
A long-standing question in nutrition and obesity research involves quantifying the relationship between body fat and anthropometry. To date, the mathematical formulation of these relationships has relied on pairing easily obtained anthropometric measurements such as the body mass index (BMI), waist circumference, or hip circumference to body fat. Recent advances in 3D body shape imaging technology provides a new opportunity for quickly and accurately obtaining hundreds of anthropometric measurements within seconds, however, there does not yet exist a large diverse database that pairs these measurements to body fat. Herein, we leverage 3D scanned anthropometry obtained from a population of United States Army basic training recruits to derive four subpopulations of homogenous body shape archetypes using a combined principal components and cluster analysis. While the Army database was large and diverse, it did not have body composition measurements. Therefore, these body shape archetypes were paired to an alternate smaller sample of participants from the Pennington Biomedical Research Center in Baton Rouge, LA that were not only similarly imaged by the same 3D scanning machine, but also had concomitant measures of body composition by dual-energy X-ray absorptiometry body composition. With this enhanced ability to obtain anthropometry through 3D scanning quickly of large populations, our machine learning approach for pairing body shapes from large datasets to smaller datasets that also contain state-of-the-art body composition measurements can be extended to pair other health outcomes to 3D body shape anthropometry.
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Affiliation(s)
- James D Pleuss
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - Kevin Talty
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - Steven Morse
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - Patrick Kuiper
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - Michael Scioletti
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | | | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA.
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14
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Mei L, He L, Song Y, Lv Y, Zhang L, Hao F, Xu M. Association between obesity with disease-free survival and overall survival in triple-negative breast cancer: A meta-analysis. Medicine (Baltimore) 2018; 97:e0719. [PMID: 29742734 PMCID: PMC5959383 DOI: 10.1097/md.0000000000010719] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To investigate the relationship between obesity and disease-free survival (DFS) and overall survival (OS) of triple-negative breast cancer. METHODS Citations were searched in PubMed, Cochrane Library, and Web of Science. Random effect model meta-analysis was conducted by using Revman software version 5.0, and publication bias was evaluated by creating Egger regression with STATA software version 12. RESULTS Nine studies (4412 patients) were included for DFS meta-analysis, 8 studies (4392 patients) include for OS meta-analysis. There were no statistical significances between obesity with DFS (P = .60) and OS (P = .71) in triple-negative breast cancer (TNBC) patients. CONCLUSION Obesity has no impact on DFS and OS in patients with TNBC.
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Affiliation(s)
- Lin Mei
- Department of Oncology, The PLA Navy Anqing Hospital, Anqing, Anhui Province. Breast Center B Ward, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province Department of Gastroenterology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province Department of Anesthesiology Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
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15
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Dietze EC, Chavez TA, Seewaldt VL. Obesity and Triple-Negative Breast Cancer: Disparities, Controversies, and Biology. THE AMERICAN JOURNAL OF PATHOLOGY 2017. [PMID: 29128565 DOI: 10.1016/j.ajpath.2017.09.018"] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Once considered a problem of Western nations, obesity (body mass index ≥30 kg/m2) has rapidly increased since the 1970s to become a major threat to world health. Since 1970, the face of obesity has changed from a disease of affluence and abundance to a disease of poverty. During the last 10 years, studies have mechanistically linked obesity and an obese tumor microenvironment with signaling pathways that predict aggressive breast cancer biology. For example, in the United States, African American women are more likely than non-Hispanic European American women to be obese and to be diagnosed with triple-negative breast cancer (TNBC). In 2008, the Carolina Breast Study found that obesity (increased waist/hip ratio) was linked to an increased incidence of TNBC in premenopausal and postmenopausal African American women. Subsequently, several groups have investigated the potential link between obesity and TNBC in African American women. To date, the data are complex and sometimes contradictory. We review epidemiologic studies that investigated the potential association among obesity, metabolic syndrome, and TNBC in African American women and mechanistic studies that link insulin signaling to the obese breast microenvironment, tissue inflammation, and aggressive TNBC biology.
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Affiliation(s)
- Eric C Dietze
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Tanya A Chavez
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Victoria L Seewaldt
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California.
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16
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Dietze EC, Chavez TA, Seewaldt VL. Obesity and Triple-Negative Breast Cancer: Disparities, Controversies, and Biology. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 188:280-290. [PMID: 29128565 DOI: 10.1016/j.ajpath.2017.09.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/07/2017] [Accepted: 09/26/2017] [Indexed: 12/13/2022]
Abstract
Once considered a problem of Western nations, obesity (body mass index ≥30 kg/m2) has rapidly increased since the 1970s to become a major threat to world health. Since 1970, the face of obesity has changed from a disease of affluence and abundance to a disease of poverty. During the last 10 years, studies have mechanistically linked obesity and an obese tumor microenvironment with signaling pathways that predict aggressive breast cancer biology. For example, in the United States, African American women are more likely than non-Hispanic European American women to be obese and to be diagnosed with triple-negative breast cancer (TNBC). In 2008, the Carolina Breast Study found that obesity (increased waist/hip ratio) was linked to an increased incidence of TNBC in premenopausal and postmenopausal African American women. Subsequently, several groups have investigated the potential link between obesity and TNBC in African American women. To date, the data are complex and sometimes contradictory. We review epidemiologic studies that investigated the potential association among obesity, metabolic syndrome, and TNBC in African American women and mechanistic studies that link insulin signaling to the obese breast microenvironment, tissue inflammation, and aggressive TNBC biology.
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Affiliation(s)
- Eric C Dietze
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Tanya A Chavez
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Victoria L Seewaldt
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California.
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17
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Pintér Z, Pósa A, Varga C, Horváth I, Palkó A, Just Z, Pálfi G. Anthropometric dimensions provide reliable estimates of abdominal adiposity: A validation study. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2017; 68:398-409. [PMID: 29066093 DOI: 10.1016/j.jchb.2017.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 06/18/2017] [Indexed: 12/31/2022]
Abstract
Abdominal fat accumulation is a major risk factor for cardiometabolic morbidity and mortality. The purpose of the study is to assess the possibility of developing accurate estimation equations based on body measurements to determine total abdominal (TFA), subcutaneous (SFA) and visceral fat area (VFA). Hungarian volunteers (n=198) aged between 20 and 81 years were enrolled in the study, which was conducted between July and November 2014. All persons underwent anthropometric measurements and computer tomographic (CT) scanning. Sex-specific multiple linear regression analyses were conducted in a subgroup of 98 participants to generate estimation models, then Bland-Altman's analyses were applied in the cross-validation group to compare their predictive efficiency. The variables best predicting VFA were hip circumference, calf circumference and waist-to-hip ratio (WHR) for males (R2=0.713; SEE=5602.1mm2) and sagittal abdominal diameter (SAD), WHR, thigh circumference and triceps skinfold for females (R2=0.845; SEE=3835.6mm2). The SFA prediction equation included SAD, thigh circumference and abdominal skinfold for males (R2=0.848; SEE=4124.1mm2), body mass index and thigh circumference for females (R2=0.861; SEE=5049.7mm2). Prediction accuracy was the highest in the case of TFA: hip circumference and WHR for males (R2=0.910; SEE=5637.2mm2), SAD, thigh circumference and abdominal skinfold for females (R2=0.915; SEE=6197.5mm2) were used in the equations. The results suggested that deviations in the predictions were independent of the amount of adipose tissue. Estimation of abdominal fat depots based on anthropometric traits could provide a cheap, reliable method in epidemiologic research and public health screening to evaluate the risk of cardiometabolic events.
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Affiliation(s)
- Z Pintér
- Department of Biological Anthropology, University of Szeged, Közép fasor 52, Szeged 6726, Hungary.
| | - A Pósa
- Department of Physiology, Anatomy and Neuroscience, University of Szeged, Közép fasor 52, Szeged 6726, Hungary
| | - C Varga
- Department of Physiology, Anatomy and Neuroscience, University of Szeged, Közép fasor 52, Szeged 6726, Hungary
| | - I Horváth
- Affidea Diagnostics Szeged Center / Affidea Diagnostics Ltd. - Szeged, Semmelweis u. 6, Szeged 6725, Hungary
| | - A Palkó
- Department of Radiology, University of Szeged, Semmelweis u. 6, Szeged 6725, Hungary
| | - Z Just
- Department of Biological Anthropology, University of Szeged, Közép fasor 52, Szeged 6726, Hungary
| | - G Pálfi
- Department of Biological Anthropology, University of Szeged, Közép fasor 52, Szeged 6726, Hungary
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18
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Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables. PLoS One 2017; 12:e0177175. [PMID: 28493988 PMCID: PMC5426673 DOI: 10.1371/journal.pone.0177175] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/24/2017] [Indexed: 02/06/2023] Open
Abstract
Background The conventional measurement of obesity utilises the body mass index (BMI) criterion. Although there are benefits to this method, there is concern that not all individuals at risk of obesity-associated medical conditions are being identified. Whole-body fat percentage (%FM), and specifically visceral adipose tissue (VAT) mass, are correlated with and potentially implicated in disease trajectories, but are not fully accounted for through BMI evaluation. The aims of this study were (a) to compare five anthropometric predictors of %FM and VAT mass, and (b) to explore new cut-points for the best of these predictors to improve the characterisation of obesity. Methods BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist/height0.5 (WHT.5R) were measured and calculated for 81 adults (40 women, 41 men; mean (SD) age: 38.4 (17.5) years; 94% Caucasian). Total body dual energy X-ray absorptiometry with Corescan (GE Lunar iDXA, Encore version 15.0) was also performed to quantify %FM and VAT mass. Linear regression analysis, stratified by sex, was applied to predict both %FM and VAT mass for each anthropometric variable. Within each sex, we used information theoretic methods (Akaike Information Criterion; AIC) to compare models. For the best anthropometric predictor, we derived tentative cut-points for classifying individuals as obese (>25% FM for men or >35% FM for women, or > highest tertile for VAT mass). Results The best predictor of both %FM and VAT mass in men and women was WHtR. Derived cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting visceral obesity was 0.59 in both sexes. Conclusions In the absence of more objective measures of central obesity and adiposity, WHtR is a suitable proxy measure in both women and men. The proposed DXA-%FM and VAT mass cut-offs require validation in larger studies, but offer potential for improvement of obesity characterisation and the identification of individuals who would most benefit from therapeutic intervention.
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19
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Smith AD, Hardy R, Heron J, Joinson CJ, Lawlor DA, Macdonald-Wallis C, Tilling K. A structured approach to hypotheses involving continuous exposures over the life course. Int J Epidemiol 2016; 45:1271-1279. [PMID: 27371628 PMCID: PMC5841633 DOI: 10.1093/ije/dyw164] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/22/2022] Open
Abstract
Background: Epidemiologists are often interested in examining different hypotheses for how exposures measured repeatedly over the life course relate to later-life outcomes. A structured approach for selecting the hypotheses most supported by theory and observed data has been developed for binary exposures. The aim of this paper is to extend this to include continuous exposures and allow for confounding and missing data. Methods: We studied two examples, the association between: (i) maternal weight during pregnancy and birthweight; and (ii) stressful family events throughout childhood and depression in adolescence. In each example we considered several plausible hypotheses including accumulation, critical periods, sensitive periods, change and effect modification. We used least angle regression to select the hypothesis that explained the most variation in the outcome, demonstrating appropriate methods for adjusting for confounders and dealing with missing data. Results: The structured approach identified a combination of sensitive periods: pre-pregnancy weight, and gestational weight gain 0-20 weeks and 20-40 weeks, as the best explanation for variation in birthweight after adjusting for maternal height. A sensitive period hypothesis best explained variation in adolescent depression, with the association strengthening with the proximity of stressful family events. For each example, these models have theoretical support at least as strong as any competing hypothesis. Conclusions: We have extended the structured approach to incorporate continuous exposures, confounding and missing data. This approach can be used in either an exploratory or a confirmatory setting. The interpretation, plausibility and consistency with causal assumptions should all be considered when proposing and choosing life course hypotheses.
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Affiliation(s)
- Andrew Dac Smith
- School of Social and Community Medicine .,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK and
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jon Heron
- School of Social and Community Medicine
| | | | - Debbie A Lawlor
- School of Social and Community Medicine.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK and
| | - Corrie Macdonald-Wallis
- School of Social and Community Medicine.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK and
| | - Kate Tilling
- School of Social and Community Medicine.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK and
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20
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Stefan N, Häring HU, Hu FB, Schulze MB. Divergent associations of height with cardiometabolic disease and cancer: epidemiology, pathophysiology, and global implications. Lancet Diabetes Endocrinol 2016; 4:457-67. [PMID: 26827112 DOI: 10.1016/s2213-8587(15)00474-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 11/16/2015] [Accepted: 11/26/2015] [Indexed: 12/22/2022]
Abstract
Among chronic non-communicable diseases, cardiometabolic diseases and cancer are the most important causes of morbidity and mortality worldwide. Although high BMI and waist circumference, as estimates of total and abdominal fat mass, are now accepted as predictors of the increasing incidence of these diseases, adult height, which also predicts mortality, has been neglected. Interestingly, increasing evidence suggests that height is associated with lower cardiometabolic risk, but higher cancer risk, associations supported by mendelian randomisation studies. Understanding the complex epidemiology, biology, and pathophysiology related to height, and its association with cardiometabolic diseases and cancer, is becoming even more important because average adult height has increased substantially in many countries during recent generations. Among the mechanisms driving the increase in height and linking height with cardiometabolic diseases and cancer are insulin and insulin-like growth factor signalling pathways. These pathways are thought to be activated by overnutrition, especially increased intake of milk, dairy products, and other animal proteins during different stages of child development. Limiting overnutrition during pregnancy, early childhood, and puberty would avoid not only obesity, but also accelerated growth in children-and thus might reduce risk of cancer in adulthood.
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Affiliation(s)
- Norbert Stefan
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases (IDM), Helmholtz Centre Munich at the Unversity of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Hans-Ulrich Häring
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases (IDM), Helmholtz Centre Munich at the Unversity of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Matthias B Schulze
- German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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21
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Heymsfield SB, Peterson CM, Thomas DM, Heo M, Schuna JM. Why are there race/ethnic differences in adult body mass index-adiposity relationships? A quantitative critical review. Obes Rev 2016; 17:262-75. [PMID: 26663309 PMCID: PMC4968570 DOI: 10.1111/obr.12358] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/16/2015] [Accepted: 10/19/2015] [Indexed: 12/25/2022]
Abstract
Body mass index (BMI) is now the most widely used measure of adiposity on a global scale. Nevertheless, intense discussion centers on the appropriateness of BMI as a phenotypic marker of adiposity across populations differing in race and ethnicity. BMI-adiposity relations appear to vary significantly across race/ethnic groups, but a collective critical analysis of these effects establishing their magnitude and underlying body shape/composition basis is lacking. Accordingly, we systematically review the magnitude of these race-ethnic differences across non-Hispanic (NH) white, NH black and Mexican American adults, their anatomic body composition basis and potential biologically linked mechanisms, using both earlier publications and new analyses from the US National Health and Nutrition Examination Survey. Our collective observations provide a new framework for critically evaluating the quantitative relations between BMI and adiposity across groups differing in race and ethnicity; reveal new insights into BMI as a measure of adiposity across the adult age-span; identify knowledge gaps that can form the basis of future research and create a quantitative foundation for developing BMI-related public health recommendations.
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Affiliation(s)
- S B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - C M Peterson
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - D M Thomas
- Montclair State University, Montclair, NJ, USA
| | - M Heo
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - J M Schuna
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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22
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Corsi DJ, Subramanian SV, Ackerson LK, Davey Smith G. Is there a greater maternal than paternal influence on offspring adiposity in India? Arch Dis Child 2015; 100:973-9. [PMID: 26044138 DOI: 10.1136/archdischild-2014-307690] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/09/2015] [Indexed: 11/03/2022]
Abstract
Previous research has provided conflicting evidence regarding fetal roots of adiposity in India. To compare the strength of association between maternal and paternal body mass indexes (BMIs) corrected for height with offspring BMI in India to examine the potential for intrauterine mechanisms to influence offspring adiposity in India, we analysed a sample of 16,528 mother-father-offspring trios from the 2005 to 2006 Indian National Family Health Survey. Children were aged 0-59 months with parents aged 15-49 years (mothers) and 15-54 years (fathers). Linear and logistic regression models, specified in multiple ways, were used to estimate associations between parental BMI* (BMI redefined by power term x (kg/m(x)) to be independent from height), and child BMI/top decile of child BMI. Higher values of maternal BMI and paternal BMI were associated with higher values of offspring BMI. In comparing the effects of maternal BMI and paternal BMI, however, no consistent differences were found in the strength of these parental influences on offspring BMI. In the fully adjusted linear model, the standardised coefficient was 0.131 (95% CI 0.110 to 0.154) for maternal BMI* and 0.079 (95% CI 0.056 to 0.103) for paternal BMI*; with evidence of heterogeneity between maternal-offspring and paternal-offspring associations (p=0.005). This was not robust in the unstandardised regression (β=0.056, 95% CI 0.044 to 0.067 for maternal BMI and β=0.039, 95% CI 0.025 to 0.053 for paternal BMI, p=0.093). Mixed results indicate that compared with paternal BMI, maternal BMI did not have a consistently stronger influence on offspring BMI in India.
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Affiliation(s)
- Daniel J Corsi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA Harvard Center for Population & Development Studies, Cambridge, Massachusetts, USA
| | - Leland K Ackerson
- Department of Community Health and Sustainability, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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23
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Krishna A, Razak F, Lebel A, Smith GD, Subramanian SV. Trends in group inequalities and interindividual inequalities in BMI in the United States, 1993-2012. Am J Clin Nutr 2015; 101:598-605. [PMID: 25733645 DOI: 10.3945/ajcn.114.100073] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Marked increases in mean body mass index (BMI) and prevalence of obesity and overweight in the United States are well known. However, whether these average increases were accompanied by changing dispersion (or SD) remains understudied. OBJECTIVE We investigated population-level changes in the BMI distribution over time to understand how changes in dispersion reflect between-group compared with within-group inequalities in weight gain in the United States. DESIGN Using data from the Behavioral Risk Factor Surveillance System survey (1993-2012), we analyzed associations between mean, SD, and median BMI and BMI at the 5th and 95th percentiles for 3,050,992 non-Hispanic white, non-Hispanic black, and Hispanic men and women aged 25-64 y. RESULTS Overall, an increase of 1.0 in mean BMI (in kg/m²) was associated with an increase of 0.70 (95% CI: 0.67, 0.73) in the SD of BMI. A change of 1.0 in median BMI was associated with a change of 0.18 (95% CI: 0.14, 0.21) in the BMI value at the 5th percentile compared with a change of 2.94 (95% CI: 2.81, 3.07) at the 95th percentile. Quantile-quantile plots showed unequal changes in the BMI distribution, with pronounced changes at higher percentiles. Similar patterns were observed in subgroups stratified by sex, race-ethnicity, and education with non-Hispanic black women and women with less than a high school education having highest mean BMI, SD of BMI, and BMI values at the 5th and 95th percentiles. CONCLUSIONS Mean BMI and the percentage of overweight and obese individuals do not fully describe population changes in BMI. Increases in within-group inequality in BMI represent an underrecognized characteristic of population-level weight gain. Crucially, similar increases in dispersion within groups suggest that growing inequalities in BMI at the population level are not driven by these socioeconomic and demographic factors. Future research should focus on understanding factors driving inequalities in weight gain between individuals.
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Affiliation(s)
- Aditi Krishna
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - Fahad Razak
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - Alexandre Lebel
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - George Davey Smith
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - S V Subramanian
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
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24
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Heo M, Kabat GC, Strickler HD, Lin J, Hou L, Stefanick ML, Anderson GL, Rohan TE. Optimal cutoffs of obesity measures in relation to cancer risk in postmenopausal women in the Women's Health Initiative Study. J Womens Health (Larchmt) 2015; 24:218-27. [PMID: 25587642 DOI: 10.1089/jwh.2014.4977] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obesity is a risk factor for several cancers in postmenopausal women. We attempted to determine cutoffs of adiposity measures in relation to risk of obesity-related cancers among postmenopausal women and to examine the effects of hormone therapy (HT) use on the cutoffs, neither of which has been broadly studied. METHODS We used data from the Women's Health Initiative cohort (n=144,701) and applied Cox-proportional hazards regressions to each combination of 17 cancer types and 6 anthropometric measures (weight, body mass index [BMI], weight to height ratio, waist circumference, waist to hip ratio [WHR], and waist to height ratio). Interactions between the anthropometric measures and HT use were also examined. Cutoffs were determined by applying a grid search followed by a two-fold cross validation method. Survival ROC analysis of 5- and 10-year incidence followed. RESULTS Breast, colorectal, colon, endometrium, kidney, and all cancers combined were significantly positively associated with all six anthropometric measures, whereas lung cancer among ever smokers was significantly inversely associated with all measures except WHR. The derived cutoffs of each obesity measure varied across cancers (e.g., BMI cutoffs for breast and endometrium cancers were 30 kg/m(2) and 34 kg/m(2), respectively), and also depended on HT use. The Youden indices of the cutoffs for predicting 5- and 10-year cancer incidence were higher among HT never users. CONCLUSION Using a panel of different anthropometric measures, we derived optimal cut-offs categorizing populations into high- and low-risk groups, which differed by cancer type and HT use. Although the discrimination abilities of these risk categories were generally poor, the results of this study could serve as a starting point from which to determine adiposity cutoffs for inclusion in risk prediction models for specific cancer types.
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Affiliation(s)
- Moonseong Heo
- 1 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, New York
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Heymsfield SB, Peterson CM, Thomas DM, Heo M, Schuna JM, Hong S, Choi W. Scaling of adult body weight to height across sex and race/ethnic groups: relevance to BMI. Am J Clin Nutr 2014; 100:1455-61. [PMID: 25411280 PMCID: PMC4232013 DOI: 10.3945/ajcn.114.088831] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 09/09/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Body mass index (BMI) is formulated on the assumption that body weight (BW) scales to height with a power of 2 (BW∝height(2)), independent of sex and race-ethnicity. Powers differing from 2 are observed in studies of selected samples, thus raising the question if BMI is a generalizable metric that makes BW independent of height across populations. OBJECTIVES The objectives were to test the hypothesis that adult BW scales to height with a power of 2 independent of sex and race-ethnicity and to advance an understanding of BMI as a measure of shape by extending allometric analyses to waist circumference (WC). DESIGN We conducted cross-sectional subject evaluations, including body composition, from the NHANES and the Korean NHANES (KNHANES). Variations of the allometric model (Y = αX(β)) were used to establish height scaling powers (β ± SE) across non-Hispanic white and black, Mexican American, and Korean men and women. RESULTS Exploratory analyses in population samples established age and adiposity as important independent determinants of height scaling powers (i.e., β). After age and adiposity in the next series of analyses were controlled for, BW scaling powers were nonsignificantly different between race/ethnic groups within each sex group; WC findings were similar in women, whereas small but significant between-race differences were observed in the men. Sex differences in β values were nonsignificant except for BW in non-Hispanic blacks and WC in Koreans (P < 0.05). Nationally representative powers for BW were (NHANES/KNHANES) 2.12 ± 0.05/2.11 ± 0.06 for men and 2.02 ± 0.04/1.99 ± 0.06 for women and for WC were 0.66 ± 0.03/0.67 ± 0.05 for men and 0.61 ± 0.04/0.56 ± 0.05 for women. CONCLUSIONS Adult BW scales to height with a power of ∼2 across the 8 sex and race/ethnic groups, an observation that makes BMI a generalizable height-independent measure of shape across most populations. WC also follows generalizable scaling rules, a finding that has implications for defining body shape in populations who differ in stature.
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Affiliation(s)
- Steven B Heymsfield
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
| | - Courtney M Peterson
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
| | - Diana M Thomas
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
| | - Moonseong Heo
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
| | - John M Schuna
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
| | - Sangmo Hong
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
| | - Woong Choi
- From the Pennington Biomedical Research Center, LSU System, Baton Rouge, LA (SBH, CMP, and JMS); Montclair State University, Montclair, NJ (DMT); Albert Einstein College of Medicine, Bronx, NY (MH); and Hanyang University, Seoul, Republic of Korea (SH and WC)
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Editorial note on: optimal scaling of weight and waist circumference to height for adiposity and cardiovascular disease risk in individuals with spinal cord injury. Spinal Cord 2014; 53:69. [PMID: 25330939 DOI: 10.1038/sc.2014.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Stergiakouli E, Gaillard R, Tavaré JM, Balthasar N, Loos RJ, Taal HR, Evans DM, Rivadeneira F, St Pourcain B, Uitterlinden AG, Kemp JP, Hofman A, Ring SM, Cole TJ, Jaddoe VWV, Davey Smith G, Timpson NJ. Genome-wide association study of height-adjusted BMI in childhood identifies functional variant in ADCY3. Obesity (Silver Spring) 2014; 22:2252-9. [PMID: 25044758 PMCID: PMC4265207 DOI: 10.1002/oby.20840] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/23/2014] [Accepted: 06/26/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Genome-wide association studies (GWAS) of BMI are mostly undertaken under the assumption that "kg/m(2) " is an index of weight fully adjusted for height, but in general this is not true. The aim here was to assess the contribution of common genetic variation to a adjusted version of that phenotype which appropriately accounts for covariation in height in children. METHODS A GWAS of height-adjusted BMI (BMI[x] = weight/height(x) ), calculated to be uncorrelated with height, in 5809 participants (mean age 9.9 years) from the Avon Longitudinal Study of Parents and Children (ALSPAC) was performed. RESULTS GWAS based on BMI[x] yielded marked differences in genomewide results profile. SNPs in ADCY3 (adenylate cyclase 3) were associated at genome-wide significance level (rs11676272 (0.28 kg/m(3.1) change per allele G (0.19, 0.38), P = 6 × 10(-9) ). In contrast, they showed marginal evidence of association with conventional BMI [rs11676272 (0.25 kg/m(2) (0.15, 0.35), P = 6 × 10(-7) )]. Results were replicated in an independent sample, the Generation R study. CONCLUSIONS Analysis of BMI[x] showed differences to that of conventional BMI. The association signal at ADCY3 appeared to be driven by a missense variant and it was strongly correlated with expression of this gene. Our work highlights the importance of well understood phenotype use (and the danger of convention) in characterising genetic contributions to complex traits.
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Cragg JJ, Ravensbergen HJC, Borisoff JF, Claydon VE. Optimal scaling of weight and waist circumference to height for adiposity and cardiovascular disease risk in individuals with spinal cord injury. Spinal Cord 2014; 53:64-8. [DOI: 10.1038/sc.2014.165] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/01/2014] [Accepted: 08/01/2014] [Indexed: 11/09/2022]
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Forno E, Acosta-Pérez E, Brehm JM, Han YY, Alvarez M, Colón-Semidey A, Canino G, Celedón JC. Obesity and adiposity indicators, asthma, and atopy in Puerto Rican children. J Allergy Clin Immunol 2014; 133:1308-14, 1314.e1-5. [PMID: 24290290 PMCID: PMC4013276 DOI: 10.1016/j.jaci.2013.09.041] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 09/18/2013] [Accepted: 09/20/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Whether adiposity indicators other than body mass index (BMI) should be used in studies of childhood asthma is largely unknown. The role of atopy in "obese asthma" is also unclear. OBJECTIVES To examine the relationship among adiposity indicators, asthma, and atopy in Puerto Rican children, and to assess whether atopy mediates the obesity-asthma association. METHODS In a study of Puerto Rican children with (n = 351) and without (n = 327) asthma, we measured BMI, percent of body fat, waist circumference, and waist-to-hip ratio. The outcomes studied included asthma, lung function, measures of atopy, and, among cases, indicators of asthma severity or control. We performed mediation analysis to assess the contribution of atopy to the relationship between adiposity and asthma. RESULTS BMI, percent of body fat, and waist circumference were associated with increased odds of asthma. Among cases, all 3 measures were generally associated with lung function, asthma severity/control, and atopy; however, there were differences depending on the adiposity indicator analyzed. Atopy considerably mediated the adiposity-asthma association in this population: allergic rhinitis accounted for 22% to 53% of the association with asthma, and sensitization to cockroach mediated 13% to 20% of the association with forced vital capacity and 29% to 42% of the association with emergency department visits for asthma. CONCLUSIONS Adiposity indicators are associated with asthma, asthma severity/control, and atopy in Puerto Rican children. Atopy significantly mediates the effect of adiposity on asthma outcomes. Longitudinal studies are needed to further investigate the causal role, if any, of adiposity distribution and atopy on "obese asthma" in childhood.
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Affiliation(s)
- Erick Forno
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Edna Acosta-Pérez
- Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - John M Brehm
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - María Alvarez
- Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Angel Colón-Semidey
- Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Glorisa Canino
- Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
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Pullinger CR, Goldfine ID, Tanyolaç S, Movsesyan I, Faynboym M, Durlach V, Chiefari E, Foti DP, Frost PH, Malloy MJ, Brunetti A, Kane JP. Evidence that an HMGA1 gene variant associates with type 2 diabetes, body mass index, and high-density lipoprotein cholesterol in a Hispanic-American population. Metab Syndr Relat Disord 2013; 12:25-30. [PMID: 24148075 DOI: 10.1089/met.2013.0086] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND High-mobility group AT-hook 1 (HMGA1) is an important regulator of the insulin receptor gene. We have previously shown in three populations of white European ancestry that the HMGA1 gene variant rs146052672 (also designated IVS5-13insC) is associated with type 2 diabetes mellitus (T2DM). The aim of this study was to measure the frequency of this variant and to determine the degree of the association with T2DM and other features of the metabolic syndrome in a replication cohort of Hispanic Americans. METHODS This was a retrospective cohort study of well-characterized Hispanic-American participants analyzed in the Genomic Resource in Atherosclerosis (GRA) (Cardiovascular Research Institute, University of California, San Francisco). A total of 1144 individuals were studied, 320 of whom had T2DM. We examined associations of the rs146052672 SNP with T2DM, plasma lipids, lipoproteins, and body mass index (BMI). RESULTS In this Hispanic-American cohort, the HMGA1 rs146052672 minor allele (C-insertion) frequency (MAF) was 21.4% with a carrier frequency of 37.4%, considerably higher than we previously observed among GRA white Europeans (MAF 3.1%). The prevalence of the IVS5-13insC variant was significantly higher in those with T2DM compared to controls [42.2% vs. 35.5%; odds ratio (OR) 1.44 95% confidence interval (CI) 1.09-1.90, P=0.011). The variant was also associated with BMI (positively, P=0.045) and plasma high-density lipoprotein cholesterol (HDL-C) (negatively, P=0.047). CONCLUSIONS As we saw previously among white Europeans, a functional HMGA1 variant was associated with T2DM in individuals of Hispanic-American ethnicity and was present at a much higher frequency.
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Affiliation(s)
- Clive R Pullinger
- 1 Cardiovascular Research Institute and Department of Physiological Nursing, University of California , San Francisco, California
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