1
|
Kholmatova K, Krettek A, Dvoryashina IV, Malyutina S, Kudryavtsev AV. Assessing the prevalence of obesity in a Russian adult population by six indices and their associations with hypertension, diabetes mellitus and hypercholesterolaemia. Int J Circumpolar Health 2024; 83:2386783. [PMID: 39106414 PMCID: PMC11305031 DOI: 10.1080/22423982.2024.2386783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/08/2024] [Accepted: 07/28/2024] [Indexed: 08/09/2024] Open
Abstract
The anthropometric index that best predicts cardiometabolic risk remains inconclusive. This study therefore assessed the prevalence of obesity using six indices and compared their associations with obesity-related cardiometabolic disorders. We determined obesity prevalence according to body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio (WHtR), body fat percentage and fat mass index (FMI) using data from the Know Your Heart study (n = 4495, 35-69 years). The areas under the receiver operating characteristic curves (AUCs) provided predictive values of each index for detecting the presence of hypertension, hypercholesterolaemia and diabetes. Age-standardised obesity prevalence significantly varied according to anthropometric index: from 17.2% (FMI) to 75.8% (WHtR) among men and from 23.6% (FMI) to 65.0% (WHtR) among women. WHtR had the strongest association with hypertension (AUC = 0.784; p < 0.001) and with a combination of disorders (AUC = 0.779; p < 0.001) in women. In women, WHtR also had the largest AUCs for hypercholesterolaemia, in men - for hypertension, diabetes and a combination of disorders, although not all the differences from other obesity indices were significant. WHtR exhibited the closest association between hypertension and a combination of disorders in women and was non-inferior compared to other indices in men.
Collapse
Affiliation(s)
- Kamila Kholmatova
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- International Research Competence Centre, Northern State Medical University, Arkhangelsk, Russia
- Department of Hospital Therapy and Endocrinology, Northern State Medical University, Arkhangelsk, Russia
| | - Alexandra Krettek
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Irina V. Dvoryashina
- Department of Hospital Therapy and Endocrinology, Northern State Medical University, Arkhangelsk, Russia
| | - Sofia Malyutina
- Scientific Research Institute of Internal and Preventive Medicine, Branch of Federal Research Centre Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Novosibirsk, Russia
| | - Alexander V. Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- International Research Competence Centre, Northern State Medical University, Arkhangelsk, Russia
| |
Collapse
|
2
|
Maimaitiyiming M, Yang H, Li H, Xu C, Li S, Zhou L, Zhang X, Wang Y. The association of obesity-related dietary patterns and main food groups derived by reduced-rank regression with cardiovascular diseases incidence and all-cause mortality: findings from 116,711 adults. Eur J Nutr 2023; 62:2605-2619. [PMID: 37219593 DOI: 10.1007/s00394-023-03177-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE Research about using reduced-rank regression (RRR) to simultaneously study the effects of both individual and combined consumption of foods on cardiovascular diseases (CVD) is scarce. METHODS This study included 116,711 CVD-free participants (a median of 11.8 year follow-up) with 2 or more 24-h online dietary assessments. A total of 210 food items were classified into 45 food groups, and the mean amount of each food group was used in RRR to derive dietary patterns (DPs) explaining the maximum shared variation in obesity-related indicators. The associations of DPs and its main food groups (|factor loading| [Formula: see text] 0.2) with the incident CVD and all-cause mortality were examined by Cox model. In cross-sectional analyses, the associations of DP scores with cardiometabolic risk factors (biomarkers) were examined by linear regression. RESULTS The derived DP was characterized by higher intakes of beer and cider, high-sugar beverages, processed meat, red meat, artificial sweetener, and crisps, chips and savory snacks, and lower intakes of olive oil, high fiber breakfast cereals, tea, and vegetable. Compared to the lowest dietary score quintile, those in the highest were associated with higher risks of total CVD (adjusted-HR: 1.45, 95% CI 1.33-1.57) and all-cause mortality (adjusted-HR 1.31, 95% CI 1.18-1.45). We observed consumption alone of these food groups had a consistent but limited health effect on total CVD and all-cause death incidence. These associations were modified by age and sex. Higher DP scores were related to adverse biomarkers profiles. CONCLUSIONS We developed obesity-related DPs prospectively associated with increased risks of CVD and all-cause mortality.
Collapse
Affiliation(s)
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Huiping Li
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shu Li
- School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China.
| |
Collapse
|
3
|
Samadoulougou S, Diallo M, Cissé K, Ngwasiri C, Aminde LN, Kirakoya-Samadoulogou F. High Urban-Rural Inequities of Abdominal Obesity in Malawi: Insights from the 2009 and 2017 Malawi Noncommunicable Disease Risk Factors Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11863. [PMID: 36231161 PMCID: PMC9565120 DOI: 10.3390/ijerph191911863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Geographical disparities in abdominal obesity (AO) exist in low-income countries due to major demographic and structural changes in urban and rural areas. We aimed to investigate differences in the urban-rural prevalence of AO in the Malawi population between 2009 and 2017. We conducted a secondary analysis of data from the Malawi 2009 and 2017 STEPS surveys. AO (primary outcome) and very high waist circumference (secondary outcome) were defined using WHO criteria. Prevalence estimates of AO and very high waist circumference (WC) were standardized by age and sex using the age and sex structure of the adult population in Malawi provided by the 2018 census. A modified Poisson regression analysis adjusted for sociodemographic covariates was performed to compare the outcomes between the two groups (urban versus rural). In total, 4708 adults in 2009 and 3054 adults in 2017 aged 25-64 were included in the study. In 2009, the age-sex standardized prevalence of AO was higher in urban than rural areas (40.9% vs 22.0%; adjusted prevalence ratio [aPR], 1.51; 95% confidence interval [CI], 1.36-1.67; p < 0.001). There was no significant trend for closing this gap in 2017 (urban 37.0% and rural 21.4%; aPR, 1.48; 95% CI, 1.23-1.77; p < 0.001). This urban-rural gap remained and was slightly wider when considering the 'very high WC' threshold in 2009 (17.0% vs. 7.1%; aPR, 1.98; 95%CI, 1.58-2.47; p < 0.001); and in 2017 (21.4% vs. 8.3%; aPR, 2.03; 95%CI, 1.56-2.62; p < 0.001). Significant urban-rural differences exist in the prevalence of AO and very high WC in Malawi, and the gap has not improved over the last eight years. More effective weight management strategies should be promoted to reduce health care disparities in Malawi, particularly in urban areas.
Collapse
Affiliation(s)
- Sékou Samadoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Mariam Diallo
- Département de Biochimie et Microbiologie, UFR-SVT, Université Joseph Ki-Zerbo, Ouagadougou 03 BP 7021, Burkina Faso
| | - Kadari Cissé
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| | - Calypse Ngwasiri
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| | | | - Fati Kirakoya-Samadoulogou
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| |
Collapse
|
4
|
Digital Anthropometry for Body Circumference Measurements: European Phenotypic Variations throughout the Decades. J Pers Med 2022; 12:jpm12060906. [PMID: 35743690 PMCID: PMC9224732 DOI: 10.3390/jpm12060906] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/27/2023] Open
Abstract
This review summarizes body circumference-based anthropometrics that are in common use for research and in some cases clinical application. These include waist and hip circumference-based central body indices to predict cardiometabolic risk: waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, a body shape index (ABSI), hip index (HI), and body roundness index (BRI). Limb circumference measurements are most often used to assess sarcopenia and include: thigh circumference, calf circumference, and mid-arm circumference. Additionally, this review presents fascinating recent developments in optic-based imaging technologies that have elucidated changes over the last decades in average body size and shape in European populations. The classical apple and pear shape concepts of body shape difference remain useful, but novel and exciting 3-D optical “e-taper” measurements provide a potentially powerful new future vista in anthropometrics.
Collapse
|
5
|
Whittaker RL, Vidt ME, Lockley RME, Mourtzakis M, Dickerson CR. Upper extremity and trunk body segment parameters are affected by BMI and sex. J Biomech 2021; 117:110230. [PMID: 33493714 DOI: 10.1016/j.jbiomech.2021.110230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 12/28/2020] [Accepted: 01/03/2021] [Indexed: 01/05/2023]
Abstract
Although body mass index (BMI) relates to body segment parameters (BSPs), unknowns persist over whether: 1) BSPs relate to BMI group classifications, 2) sex influences BMI/BSP relationships, and 3) simple anthropometric measures sufficiently predict BSPs. Dual energy X-ray absorptiometry (DXA) scans and anthropometric measures were obtained from 76 participants (33M, 43F) of varying body composition. Trunk, neck and head (TNH), arm, forearm and hand masses were obtained from DXA scans and center of mass locations (COM) estimated from geometric models. Groups with larger BMIs had lesser hand and forearm mass (%total body mass; p<0.001) and greater TNH mass (p=0.014). Males had greater hand, forearm, and arm masses (p<0.05). TNH COM was inferior in groups with larger BMI (p<0.01) and in males (p=0.006). In females, arm COM was distal in Obese II/III versus Normal (p=0.024). Two sets of linear models were created to predict BSPs; a simplified set with only BMI, height, weight, sex and mass potential predictors and a complex set with additional anthropometric measures. Complex arm and TNH mass models (arm R2=0.43, TNH R2=0.61) explained more variance than simplified models (arm R2=0.1, TNH R2=0.33). Complex hand mass, forearm mass and TNH COM models had smaller R2 increases versus simplified models (hand=0.05, forearm=0.06, TNH=0.08). Explained variance in forearm COM (R2=0.2) and arm COM (R2=0.27) complex models was low, suggesting a constant may provide reasonable estimates. Certain BSPs can be estimated using simplified measures, whereas prediction of other BSPs markedly improves if additional anthropometric measures are included.
Collapse
Affiliation(s)
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, 331 Chemical and Biomedical Engineering Building, University Park, PA 16802, USA; Physical Medicine and Rehabilitation, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | | | | | - Clark R Dickerson
- Department of Kinesiology, University of Waterloo, Waterloo, Canada.
| |
Collapse
|
6
|
Fröhlich C, Garcez A, Canuto R, Paniz VMV, Pattussi MP, Olinto MTA. Obesidade abdominal e padrões alimentares em mulheres trabalhadoras de turnos. CIENCIA & SAUDE COLETIVA 2019; 24:3283-3292. [DOI: 10.1590/1413-81232018249.27882017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/30/2018] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivou-se identificar os padrões alimentares e a associação destes com a obesidade abdominal em mulheres trabalhadoras de turnos no sul do Brasil. Para isso, realizou-se um estudo de caso-controle não pareado, incluindo um total de 541 mulheres de 18 a 53 anos de idade (215 casos; 326 controles). A presença de obesidade abdominal foi verificada pela aferição da circunferência da cintura ≥ 88 centímetros e os padrões alimentares foram obtidos por meio da análise de componentes principais de 53 itens. Os padrões foram classificados com base nos alimentos de maior carga fatorial e características nutricionais. A associação entre obesidade abdominal e os padrões foi verificada por meio de regressão logística não condicional. Três padrões alimentares foram identificados: “gordura animal/calorias”, “lanches/fast-food” e “frutas/verduras”. Após análise ajustada, os casos apresentaram uma maior chance de adesão ao padrão “frutas/verduras” (OR = 2,26; IC95%:1,30-3,93) e uma menor chance de adesão ao padrão “lanches/fast-food” (OR = 0,60; IC95%:0,36-1,01). Assim, identificou-se três padrões alimentares entre as trabalhadoras de turnos e verificou-se uma melhora na alimentação naquelas com obesidade abdominal, representando uma possível alteração de hábitos alimentares após sua ocorrência.
Collapse
|
7
|
Cembranel F, Hallal ALC, González-Chica DA, d'Orsi E. [Relationship between dietary consumption of vitamins and minerals, body mass index, and waist circumference: a population-based study of adults in southern Brazil]. CAD SAUDE PUBLICA 2017; 33:e00136616. [PMID: 29267687 DOI: 10.1590/0102-311x00136616] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 02/06/2017] [Indexed: 12/21/2022] Open
Abstract
The study's objective was to investigate the association between inadequate dietary consumption of micronutrients and indicators of general and abdominal obesity. Cross-sectional analysis of the second wave of the EpiFloripa Adults longitudinal study, including 1,222 individuals, aged 22-63 years and residing in Florianópolis, Santa Catarina State, Southern Brazil. Food consumption data was obtained from two 24-hour food recalls, and habitual consumption and prevalence rates of inadequate consumption of calcium, iron, zinc, and vitamins A, C, D, and E were estimated according to the Institute of Medicine and National Research Council guidelines. General obesity was defined based on the body mass index (BMI) values and abdominal obesity was based on waist circumference (WC) values. For most of the micronutrients investigated (calcium and vitamins A, C, D, and E), consumption levels were below the recommendations, with high prevalence of inadequate consumption in the sample as a whole. Only inadequate vitamin C intake was higher among obese individuals (general or abdominal). In addition, there was an inverse association between lower consumption of calcium and iron and higher BMI and WC, and between lower consumption of vitamins A and D and higher WC levels (β = -0.92cm; 95%CI: -1.76; -0.08 and β = -0.69 cm; 95%CI: -1.32; -0.06, respectively), especially in young adults. The study showed an inverse association between inadequate dietary consumption of micronutrients and general and abdominal obesity in a sample of adults in Southern Brazil.
Collapse
Affiliation(s)
- Francieli Cembranel
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - Ana Luiza Curi Hallal
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | | | - Eleonora d'Orsi
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| |
Collapse
|
8
|
Maffetone PB, Rivera-Dominguez I, Laursen PB. Overfat Adults and Children in Developed Countries: The Public Health Importance of Identifying Excess Body Fat. Front Public Health 2017; 5:190. [PMID: 28791284 PMCID: PMC5523552 DOI: 10.3389/fpubh.2017.00190] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/12/2017] [Indexed: 12/13/2022] Open
Abstract
The global overfat pandemic is a serious public health crisis that places a substantial burden on economic resources in developed countries. The term overfat refers to the presence of excess body fat that can impair health, even for normal weight non-obese individuals. Excess body fat is associated with cardiometabolic dysfunction, a clinical situation that can progressively worsen, potentially leading to various common disease risk factors, chronic diseases, increased morbidity and mortality, and reduced quality of life. The prevalence of overfat populations in 30 of the world’s most developed countries is substantially higher than recent global estimations, with the largest growth due to a relatively recent increased number of people with excess abdominal fat. Abdominal overfat is the most unhealthful form of this condition, so it is concerning that average waist circumference measures, generally indicative of abdominal overfat, have increased. Despite a leveling off appearance of being overweight and/or obese in some developed countries, the overfat pandemic continues to grow.
Collapse
Affiliation(s)
| | | | - Paul B Laursen
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
9
|
Du P, Wang HJ, Zhang B, Qi SF, Mi YJ, Liu DW, Tian QB. Prevalence of abdominal obesity among Chinese adults in 2011. J Epidemiol 2017; 27:282-286. [PMID: 28427831 PMCID: PMC5463021 DOI: 10.1016/j.je.2017.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/06/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of abdominal obesity is increasing dramatically worldwide. This study aimed to estimate the current prevalence of abdominal obesity from the 2011 China Health and Nutrition Survey (CHNS) and compare the data with other countries. METHODS Waist circumference (WC) of 12,326 Chinese adults (aged 20 years or older) from the 2011 CHNS were analyzed by age group and region. Abdominal obesity was defined as a WC ≥90 cm for men and WC ≥80 cm for women based on World Health Organization (WHO) recommendations for Asians. RESULTS In 2011, the age-adjusted mean WC was 85.9 cm (95% confidence interval [CI], 85.6-86.2 cm) for men and 80.7 cm (95% CI, 80.4-80.9 cm) for women. Based on the WHO recommendations, the age-adjusted prevalence of abdominal obesity was 44.0% (95% CI, 43.1%-44.8%) overall, 35.3% (95% CI, 34.1%-36.6%) in men, and 51.7% (95% CI, 50.5%-52.9%) in women. Moreover, the age-adjusted prevalence was 44.0% (95% CI, 42.7%-45.2%) in rural populations, 42.5% (95% CI, 40.7%-44.2%) in urban populations, and 45.2% (95% CI, 43.5%-46.9%) in megacity populations. The prevalence in China (35.3% for men and 51.7% for women) was lower than in Japan (50.8% for men) and the United States (43.5% for men and 64.7% for women). Similar results were observed when applying the criteria suggested by the Working Group on Obesity in China. CONCLUSIONS In 2011, the age-adjusted prevalence of abdominal obesity in China was 35.3% in men and 51.7% in women.
Collapse
Affiliation(s)
- Pei Du
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China; Department of Infection Control and Prevention, The Third Hospital of Hebei Medical University, China
| | - Hui-Jun Wang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, China
| | - Bing Zhang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, China
| | - Su-Fen Qi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China
| | - Ying-Jun Mi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China
| | - Dian-Wu Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China
| | - Qing-Bao Tian
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China.
| |
Collapse
|
10
|
Xue H, Wang C, Li Y, Chen J, Yu L, Liu X, Li J, Cao J, Deng Y, Guo D, Yang X, Huang J, Gu D. Incidence of type 2 diabetes and number of events attributable to abdominal obesity in China: A cohort study. J Diabetes 2016; 8:190-8. [PMID: 25619275 DOI: 10.1111/1753-0407.12273] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 12/28/2014] [Accepted: 01/10/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The aim of the present study was to estimate the incidence of type 2 diabetes (T2D) and the number of diabetes events attributable to abdominal obesity in China. METHODS A cohort study was conducted in a sample of 24,996 Chinese adults aged 35-74 years, with 19.9% of subjects lost to follow-up. Waist circumference (WC) was measured at baseline in 1998 and 2000-01, and abdominal obesity was defined as WC ≥ 90 cm in men and ≥80 cm in women. Information on incident diabetes was collected during follow-up in 2007-08. We estimated the number of T2D events attributed to abdominal obesity using confounder-adjusted population-attributable risk, incidence of diabetes, and the population size of China in 2010. RESULTS After a mean follow-up of 8.0 years, the age-standardized incidence of T2D was 9.6 and 9.2 per 1000 person-years in men and women, respectively. Abdominal obesity accounted for 28.1% (95% confidence interval [CI] 14.8%, 40.5%) of incident diabetes among men and 41.2% (95% CI 28.3%, 52.6%) among women using the diagnostic criteria of abdominal obesity recommended by the International Diabetes Federation. We estimated that, in 2010, 2.4 (95% CI 1.5, 3.2) million diabetes events were attributable to abdominal obesity: 1.0 (95% CI 0.5, 1.4) million in men and 1.4 (95% CI 1.0, 1.8) million in women. CONCLUSIONS Abdominal obesity is a major risk factor for T2D. Strengthening programs and initiatives for preventing and controlling obesity focusing on lifestyle changes should be a priority in the national strategy to reduce diabetes burden in China.
Collapse
Affiliation(s)
- Haifeng Xue
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Food and Environment, School of Public Health, Qiqihar Medical University, Qiqihar, China
| | - Chao Wang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ling Yu
- Fujian Provincial People's Hospital, Fuzhou, China
| | - Xiaoqing Liu
- Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Deng
- Sichuan Centre for Disease Control and Prevention, Chengdu, China
| | | | - Xueli Yang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
11
|
Xu W, Zhang H, Paillard-Borg S, Zhu H, Qi X, Rizzuto D. Prevalence of Overweight and Obesity among Chinese Adults: Role of Adiposity Indicators and Age. Obes Facts 2016; 9:17-28. [PMID: 26745807 PMCID: PMC5644857 DOI: 10.1159/000443003] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/21/2015] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The role of different body fat indicators and age in assessing the prevalence of obesity is unclear. We aimed to examine to what extent different body fat indicators including BMI, waist circumference (WC) and waist-to-hip ratio (WHR) affect the prevalence of overweight and obesity among Chinese adults taking age into account. METHODS This population-based cross-sectional study included a random sample of 7,603 adults aged 20-79 years across entire Tianjin, China. BMI, WC, and WHR were used to define overweight and obesity following standard criteria. Prevalence rates were calculated and standardized using local age- and gender-specific census data. Logistic regression was used in data analysis. RESULTS Using the combination of BMI, WC, and WHR, the prevalence of overweight and obesity was 69.8%, and increased with age till the age of 60 and a decline thereafter. The prevalence of overweight assessed by BMI was higher than that assessed by WC and WHR, while the prevalence of obesity defined by BMI was much lower than that defined by WC or WHR. CONCLUSION The prevalence of overweight and obesity is about 70% among Chinese adults. Adiposity indicators and age play an important role in the prevalence of overweight and obesity.
Collapse
Affiliation(s)
- Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Aging Research Center (ARC), Department Neurobiology, Health Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Hua Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | | | - Hong Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- *Prof. Dr. Xiuying Qi, Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, 300070 Tianjin, China,
| | - Debora Rizzuto
- Aging Research Center (ARC), Department Neurobiology, Health Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
12
|
Yu D, Peat G, Bedson J, Jordan KP. Annual consultation incidence of osteoarthritis estimated from population-based health care data in England. Rheumatology (Oxford) 2015; 54:2051-60. [PMID: 26163287 PMCID: PMC4603278 DOI: 10.1093/rheumatology/kev231] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To estimate the consultation incidence of OA using population-based health care data in England and compare OA incidence figures with those derived in other countries. METHODS A population-based health care database (Consultations in Primary Care Archive) in England was used to derive the consultation incidence of OA (overall and by joint site) using the maximum available run-in period method. These estimates, and their distribution by age and sex, were compared with those published from population-based health care databases in Canada, the Netherlands and Spain. A novel age-stratified run-in period method was then used to investigate whether the consultation incidence has been increasing over time in younger adults. RESULTS The annual consultation incidence of OA (any joint) was 8.6/1000 persons ≥15 years of age (95% CI 7.9, 9.3) [6.3 (95% CI 5.5, 7.1) in men and 10.8 (95% CI 9.8, 12.0) in women]. Incidence increased sharply between 45 and 64 years of age, peaking at 75-84 years. The joint-specific incidence was 1.4 (95% CI 1.1, 1.7), 3.5 (95% CI 3.1, 3.9) and 1.3 (95% CI 1.1, 1.6) for hip OA, knee OA and hand OA, respectively. The estimates and their distribution by age and sex were broadly consistent with international estimates. Between 2003 and 2010, incidence in those aged 35-44 years increased from 0.3 to 2.0/1000 persons. CONCLUSION Newly diagnosed cases of OA in England occur in 9 in 1000 at-risk adults each year, similar to other international estimates. Although lower, the consultation incidence proportion in younger adults appears to have increased in the past decade.
Collapse
Affiliation(s)
- Dahai Yu
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| | - George Peat
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| | - John Bedson
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| | - Kelvin P Jordan
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| |
Collapse
|
13
|
Freedman DS, Ford ES. Are the recent secular increases in the waist circumference of adults independent of changes in BMI? Am J Clin Nutr 2015; 101:425-31. [PMID: 25733625 PMCID: PMC4609894 DOI: 10.3945/ajcn.114.094672] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Several studies showed that the waist circumference of US adults has increased over the past 25 y. However, because of the high correlation between waist circumference and body mass index (BMI; in kg/m²) (r ∼ 0.9), it is uncertain if these trends in waist circumference exceed those expected on the basis of BMI changes over this time period. OBJECTIVE We assessed whether the recent trend in waist circumference was independent of changes in BMI, age, and race-ethnicity. DESIGN We analyzed data from the 1999-2000 through 2011-2012 cycles of the NHANES. RESULTS The mean waist circumference increased by ∼2 cm (in men) and ∼4 cm (in women) in adults in the United States over this 12-y period. In men, this increase was very close to what would be expected because of the 0.7 increase in mean BMI over this period. However, in women, most of the secular increase in waist circumference appeared to be independent of changes in BMI (mean: 0.6), age, and race-ethnicity over the 12-y period. We estimated that, independent of changes in these covariates, the mean waist circumference increased by 0.2 cm in men and 2.4 cm in women from 1999-2000 through 2011-2012; only the latter estimate was statistically significant. CONCLUSIONS Our results indicate that, in women but not men, the recent secular trend in waist circumference is greater than what would be expected on the basis of changes in BMI. Possible reasons for this secular increase, along with sex differences, are uncertain.
Collapse
Affiliation(s)
- David S Freedman
- From the Divisions of Nutrition, Physical Activity, and Obesity (DSF) and Adult and Community Health (ESF), CDC, Atlanta, GA
| | - Earl S Ford
- From the Divisions of Nutrition, Physical Activity, and Obesity (DSF) and Adult and Community Health (ESF), CDC, Atlanta, GA
| |
Collapse
|
14
|
Funtikova AN, Subirana I, Gomez SF, Fitó M, Elosua R, Benítez-Arciniega AA, Schröder H. Soft drink consumption is positively associated with increased waist circumference and 10-year incidence of abdominal obesity in Spanish adults. J Nutr 2015; 145:328-34. [PMID: 25644355 DOI: 10.3945/jn.114.205229] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The accumulation of abdominal fat increases risk of metabolic disorders and premature death. There is a dearth of prospective data on the association between caloric beverage consumption and surrogate markers of abdominal adiposity. OBJECTIVE The aim of this study was to assess the relation between consumption of nonalcoholic caloric beverages, including soft drinks, fruit juice, whole milk, and skim and low-fat milk, and changes in waist circumference (WC) and odds of 10-y incidence of abdominal obesity. METHODS We conducted a prospective, population-based study of 2181 Spanish men and women aged 25-74 y who were followed from 2000 to 2009. We measured weight, height, and WC, and recorded data on diet and leisure-time physical activity (LTPA) with the use of validated questionnaires. We fit multivariable linear and logistic regression models. RESULTS A 100 kcal increase in soft drink consumption was associated with a 1.1 cm increase in WC (P = 0.018) after 10 y of follow-up. Substitution of 100 kcal of soft drinks with 100 kcal of whole milk or 100 kcal of juice was associated with a 1.3 cm (95% CI: 0.3, 2.4) and 1.1 cm (95% CI: 0.03, 2.2) decrease in WC, respectively. Increasing consumption of soft drinks from baseline to follow-up led to WC gain compared with maintaining nonconsumption. Greater soft drink consumption was positively associated (P = 0.029) with increased odds of 10-y incidence of abdominal obesity. CONCLUSION Adults' consumption of soft drinks was associated with increased WC and odds of 10-y incidence of abdominal obesity. This association was moderate but consistent in all statistical models.
Collapse
Affiliation(s)
- Anna N Funtikova
- Cardiovascular Risk and Nutrition Research Group and CIBER Epidemiology and Public Health (CIBERESP) and Food and Nutrition PhD program, University of Barcelona, Barcelona, Spain
| | - Isaac Subirana
- Cardiovascular Epidemiology and Genetics, Research Program in Epidemiology and Public Health, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiology and Public Health (CIBERESP) and
| | - Santiago F Gomez
- Cardiovascular Risk and Nutrition Research Group and Thao Foundation, Barcelona, Spain; and
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group and CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics, Research Program in Epidemiology and Public Health, Hospital del Mar Research Institute, Barcelona, Spain
| | | | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group and CIBER Epidemiology and Public Health (CIBERESP) and
| |
Collapse
|
15
|
Lindholm ES, Altman D, Norman M, Blomberg M. Health Care Consumption during Pregnancy in relation to Maternal Body Mass Index: A Swedish Population Based Observational Study. J Obes 2015; 2015:215683. [PMID: 26101664 PMCID: PMC4460241 DOI: 10.1155/2015/215683] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 05/14/2015] [Accepted: 05/18/2015] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To assess whether antenatal health care consumption is associated with maternal body mass index (BMI). DESIGN A register based observational study. METHODS The Swedish Medical Birth Register, the Maternal Health Care Register, and the Inpatient Register were used to determine antenatal health care consumption according to BMI categories for primiparous women with singleton pregnancies, from 2006 to 2008, n = 71,638. Pairwise comparisons among BMI groups are obtained post hoc by Tukey HSD test. RESULT Obese women were more often admitted for in-patient care (p < 0.001), had longer antenatal hospital stays (p < 0.001), and were more often sick-listed by an obstetrician (p < 0.001) during their pregnancy, compared to women with normal weight women. Preeclampsia was more than four times as common, hypertension five times as common, and gestational diabetes 11 times as common when comparing in-patient care, obese to normal weight women (p < 0.001 for all comparisons). Underweight mothers had longer stay in hospitals (p < 0.05) and hydronephrosis and hyperemesis gravidarum were more than twice as common (both p < 0.001). CONCLUSION Obese and underweight mothers consumed significantly more health care resources and obese women were significantly more often sick-listed during their pregnancy when compared to pregnant women of normal weight.
Collapse
Affiliation(s)
- Elisabeth S. Lindholm
- Division of Obstetrics and Gynecology, Department of Clinical Science, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Daniel Altman
- Division of Obstetrics and Gynecology, Department of Clinical Science, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Margareta Norman
- Division of Obstetrics and Gynecology, Department of Clinical Science, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, 581 83 Linköping, Sweden
- *Marie Blomberg:
| |
Collapse
|
16
|
Boylan EA, McNulty BA, Walton J, Flynn A, Nugent AP, Gibney MJ. The prevalence and trends in overweight and obesity in Irish adults between 1990 and 2011. Public Health Nutr 2014; 17:2389-97. [PMID: 24721159 PMCID: PMC10282270 DOI: 10.1017/s1368980014000536] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 02/11/2014] [Accepted: 03/10/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Obesity is a serious public health issue, the prevalence of which is increasing globally. The present study aimed to investigate trends in overweight and obesity in Irish adults between 1990 and 2011. DESIGN Anthropometric data from three Irish national food consumption surveys were used to calculate trends in BMI, waist circumference and waist:hip ratio. SETTING Three cross-sectional food consumption surveys: the Irish National Nutrition Survey (1990), the North/South Ireland Food Consumption Survey (2001) and the National Adult Nutrition Survey (2011). SUBJECTS A collective sample of free-living Irish adults (n 3125), aged 18-64 years. RESULTS There were significant increases in mean weight, height and BMI from 1990 to 2011. Significant increments were also reported in waist and hip circumferences and waist:hip ratio between 2001 and 2011, with concurrent increases in the proportion of individuals at risk of developing CVD, particularly females aged 18-35 years. In 2011, 23·4 % of the Irish population was classified as obese; with the mean BMI increasing by 1·1 kg/m2 between 1990 and 2001 and by 0·6 kg/m2 between 2001 and 2011. CONCLUSIONS The present paper characterises obesity levels in Irish adults from 1990 to 2011. Absolute levels of overweight and obesity have increased between these time points. Of concern is the increase in the proportion of young women classified as at risk of CVD, using waist circumference and waist:hip ratio. Effective prevention strategies are needed to avoid further increases.
Collapse
Affiliation(s)
- Elaine A Boylan
- UCD Institute of Food and Health, University College Dublin, Room L2.57, Science Centre South, Belfield, Dublin 4, Republic of Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Room L2.57, Science Centre South, Belfield, Dublin 4, Republic of Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | - Anne P Nugent
- UCD Institute of Food and Health, University College Dublin, Room L2.57, Science Centre South, Belfield, Dublin 4, Republic of Ireland
| | - Michael J Gibney
- UCD Institute of Food and Health, University College Dublin, Room L2.57, Science Centre South, Belfield, Dublin 4, Republic of Ireland
| |
Collapse
|
17
|
Kim KD, Nam HS, Shin HI. Characteristics of abdominal obesity in persons with spinal cord injury. Ann Rehabil Med 2013; 37:336-46. [PMID: 23869331 PMCID: PMC3713290 DOI: 10.5535/arm.2013.37.3.336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 11/07/2012] [Indexed: 01/17/2023] Open
Abstract
Objective To investigate the characteristics of community-dwelling spinal cord injury (SCI) persons with obesity, including diet, socioeconomic factors, weight reduction method, and frequency of body weight and abdominal circumference measurements. Methods We developed a questionnaire based on 'the Fourth Korea National Health and Nutrition Examination Survey, 2009'. A total of 371 community-dwelling SCI persons were enrolled in this study. Inclusion criteria were SCI persons older than 20 years with more than 1 year elapsed since the injury. Trained investigators visited SCI persons' home to complete the questionnaire and measure abdominal obesity (AO) as defined by the waist circumference. Results Prevalence of AO was 29.2% in SCI persons and 27.4% in the general population (GP), showing no significant difference. Education showed correlation with AO in both SCI persons and the GP. The injury level, type of injury and income did not show any correlation with AO in SCI persons. Only 28.8% and 48.8% of SCI persons measured their waist circumference and body weight within the past year, respectively. Also, SCI persons with AO thought that their body was less obese compared to persons with AO in the GP (p<0.001). The method of weight reduction was diet modification in 53.6% of SCI persons with AO, which was higher than 37.1% of persons with AO in the GP. Conclusion In SCI persons, obesity perception as well as socioeconomic factors correlated with AO, but these were not relevant factors in the GP. Therefore, development of a specific and intensive weight control program for SCI persons is necessary.
Collapse
Affiliation(s)
- Kwang Dong Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | | |
Collapse
|
18
|
Lindholm ES, Altman D. Risk of obstetric anal sphincter lacerations among obese women. BJOG 2013; 120:1110-5. [DOI: 10.1111/1471-0528.12228] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2013] [Indexed: 11/28/2022]
Affiliation(s)
- ES Lindholm
- Division of Obstetrics and Gynecology; Department of Clinical Science; Karolinska Institutet at Danderyd Hospital; Stockholm; Sweden
| | | |
Collapse
|
19
|
Pollock RF, Chilcott J, Muduma G, Valentine WJ. Laparoscopic adjustable gastric banding vs standard medical management in obese patients with type 2 diabetes: a budget impact analysis in the UK. J Med Econ 2013; 16:249-59. [PMID: 23163313 DOI: 10.3111/13696998.2012.751388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the financial consequences of using laparoscopic adjustable gastric banding (LAGB) in place of standard medical management (SMM) in obese patients with type 2 diabetes from a UK healthcare payer perspective. DESIGN AND METHODS A budget impact model was constructed to evaluate the budgetary implications of LAGB in obese patients with type 2 diabetes in the UK. For patients undergoing LAGB, the model captured pre-, peri-, and post-operative costs including consultations with physicians, psychologists, nurses, and dieticians, the cost of surgery, and costs associated with post-surgical complications. The model also captured costs associated with medication for diabetes, asthma, hypertension, and hyperlipidemia, costs of diabetes complications, sleep apnea, and asthma, and costs of diagnostic tests. The SMM arm also captured costs associated with very low calorie diet products. Costs were modeled in a simulated UK cohort of 100 obese patients with newly-diagnosed diabetes. Future costs were discounted at 3.5% per annum and all costs were reported in 2010 pounds sterling. RESULTS Over the 5-year time horizon, the cohort of 100 patients who underwent LAGB incurred costs £91,287 lower than an equivalent cohort receiving SMM (£818,668 and £909,955, respectively). Costs of surgery and post-surgical complications (£254,000 and £40,981, respectively) were more than offset by savings arising from reduced diabetes, asthma, and sleep apnea medication costs, reduced incidence of diabetes complications, and fewer healthcare professional contacts. Sensitivity analysis (SA) showed that the model was most sensitive to assumptions around diabetes medication use, although none of the SA findings showed LAGB to be more costly than SMM. LIMITATIONS In order to capture the diverse resource use and medical care costs arising in obese patients with type 2 diabetes, the analysis made use of a range of heterogeneous data sources. While the vast majority of data were applicable to obese patients with recently-diagnosed diabetes in the UK setting, some surrogate data (e.g. from different geographies) were used in cases where data in the target population were unavailable. Additionally, given the largely uncharacterized long-term risk profile in patients with remission of type 2 diabetes, remission was captured using a transparent and highly conservative approach. CONCLUSIONS Based on the findings of the present analysis, the high initial costs of performing LAGB are offset within 5 years after surgery when compared with SMM in a population of obese patients with type 2 diabetes. The high up-front costs associated with surgery should not therefore be a barrier to its reimbursement in this patient group.
Collapse
Affiliation(s)
- R F Pollock
- Ossian Health Economics and Communications GmbH, Bäumleingasse 20, Basel, Switzerland.
| | | | | | | |
Collapse
|
20
|
Howel D. Waist circumference and abdominal obesity among older adults: patterns, prevalence and trends. PLoS One 2012; 7:e48528. [PMID: 23119047 PMCID: PMC3485367 DOI: 10.1371/journal.pone.0048528] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 09/26/2012] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To describe the patterns and trends in waist circumference and abdominal obesity for those aged 70-89 contrasting the standard and new age-related cut-points, and to investigate how they vary with time, age and educational level. METHODS The subjects were 7129 men and 9244 women aged 70-89 years who participated in the Health Survey for England during 1993-2010. The outcome measures were the percentiles of waist circumference and standard and new indicators of abdominal obesity based on waist circumference. Binomial and quantile regression were used to investigate the relationship with key explanatory variables. RESULTS The distribution of waist circumference among community-dwelling older adults in England has shifted upwards since 1993 (an increase in median of 4.5 cm in men and 5.1 cm in women). The prevalence of abdominal obesity has increased, while those in the low-risk group have decreased. Abdominal obesity was higher in those aged 70-79 compared to 80-89, and in those who left education earlier. The prevalence of abdominal obesity varies considerably with new and standard cut-points, which makes it impractical to use the new ones on a population that includes subjects across the adult age range. CONCLUSIONS Obesity is increasing among the elderly, but more work is needed on devising age-appropriate indicators of high risk based on waist circumference.
Collapse
Affiliation(s)
- Denise Howel
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
| |
Collapse
|