Comparison of anthropometric and body composition indices in the identification of metabolic risk factors

Association between body fat variation rate and risk of diabetic nephropathy - a posthoc analysis based on ACCORD database

BACKGROUND

Weight control has consistently been regarded as a significant preventive measure against diabetic nephropathy. however, the potential impact of substantial fluctuations in body fat during this process on the risk of diabetic nephropathy remains uncertain. This study aimed to investigate the association between body fat variation rate and diabetic nephropathy incident in American patients with type 2 diabetes.

METHODS

The study used data from the Action to Control Cardiovascular Risk in diabetes (ACCORD) trial to calculate body fat variation rates over two years and divided participants into Low and High groups. The hazard ratio and 95% confidence interval were estimated using a Cox proportional hazards model, and confounding variables were addressed using propensity score matching.

RESULTS

Four thousand six hundred nine participants with type 2 diabetes were studied, with 1,511 cases of diabetic nephropathy observed over 5 years. High body fat variation rate was linked to a higher risk of diabetic nephropathy compared to low body fat variation rate (HR 1.13, 95% CI 1.01-1.26). Statistically significant interaction was observed between body fat variation rate and BMI (P interaction = 0.008), and high level of body fat variation rate was only associated with increased risk of diabetic nephropathy in participants with BMI > 30 (HR 1.34 and 95% CI 1.08-1.66).

CONCLUSIONS

Among participants with Type 2 Diabetes Mellitus, body fat variation rate was associated with increased risk of diabetic nephropathy. Furthermore, the association was modified by BMI, and positive association was demonstrated in obese but not non-obese individuals. Consequently, for obese patients with diabetes, a more gradual weight loss strategy is recommended to prevent drastic fluctuations in body fat.

TRIAL REGISTRATION

Clinical Trials. gov, no. NCT000000620 (Registration Date 199909).

DXA Android-to-Gynoid Ratio and Cardiovascular Risk Assessment in Age and BMI Propensity-Matched Early Postmenopausal Women

Background and Objectives: The literature suggests that physiological menopause (MP) seems linked with increased adiposity with a preference for intra-abdominal fat accumulation, greater than what can be attributed only by aging, which could magnify this period's increased cardiovascular risk. Materials and Methods: We retrospectively analyzed two age and body mass index (BMI) propensity-matched subgroups each formed of 90 clinically healthy, 40-60-year-old postmenopausal women, within the first 5 and 5-10 years of MP. The 10-year ASCVD risk was assessed using medical history, anthropometric data, and lipid profile blood tests. The android-to-gynoid (A/G) ratio was computed using Lunar osteodensitometry lumbar spine and hip scans. Results: The A/G ratio was significantly higher for the subgroup evaluated in years 5-10 of MP than in the first 5 years of MP, even after controlling for BMI (1.05 vs. 0.99, p = 0.005). While displaying a significant negative correlation with HDL cholesterol (r = 0.406), the A/G ratio also had positive correlations with systolic blood pressure (BP) values (r = 0.273), triglycerides (r = 0.367), and 10-year ASCVD risk (r = 0.277). After adjusting for smoking, hypertension treatment, and type 2 diabetes, the 10-year ASCVD risk became significantly different for women in the first 5 years (3.28%) compared to those in years 5-10 of MP (3.74%), p = 0.047. Conclusions: In women with similar age and BMI, the A/G ratio appears to vary based on the number of years since menopause onset and correlates with either independent cardiovascular risk parameters like BP, triglycerides, and HDL cholesterol or with composite scores, such as 10-year ASCVD risk.

Living lab modelling as a pilot study assessing the potential psychological health benefits of forest environment for cancer survivors

OBJECTIVE

To evaluate the physiological and psychological changes in cancer survivors who engage in repeated forest therapy in a living environment.

METHODS

This study included stay-based forest therapy for female cancer survivors aged ≥40 years. The program was conducted in two cycles, each spanning 3 weeks and consisting of a 2-night, 3-day stay, followed by daily life integration. The cycles were repeated from July 2, 2022, to August 18, 2022. Participant assessment included standard physical health parameters and a questionnaire on general characteristics, lifestyle habits, stress levels, and health status.

RESULTS

Thirty-seven female cancer survivors participated in the forest healing program, 56.8% of whom had a history of breast cancer. The median body mass index (BMI) was 23.80 kg/m2 (range, 21.00-25.60). More than half of the patients reported mild-to-moderate fatigue, chronic pain, and mild-to-moderate depression (81%, 65%, and 73%, respectively). After two cycles of forest therapy, no significant differences were observed in terms of fatigue, pain, or BMI levels. However, significant improvements were found in quality of life measures, particularly the psychological quality of life (mean score 12.54 at baseline vs. 13.48 after cycle 2; P=0.007). Positive improvements were also observed in terms of stress (mean score 17.03 vs. 13.76; P=0.002) and depression (mean score 8.35 vs. 6.11; P=0.002) levels.

CONCLUSION

Our forest-healing program demonstrated that nature-based therapies improve the mental health and quality of life of female cancer survivors, suggesting the need for further research on nature-based interventions to better support cancer survivors.

Association between arthritis and hand grip strength indices combined with anthropometry in an older Korean population

BACKGROUND

Hand grip strength (HGS) is related to arthritis and all-cause mortality. Many studies have examined the association between HGS and arthritis, but these studies did not consider relative HGS indices. The objectives of this study were to examine the association between arthritis and HGS indices in an older Korean population and to compare an absolute HGS index and a relative HGS indices.

METHODS

In a large-scale cross-sectional study, a total of 16,860 subjects older than 50 years from the Korea National Health and Nutrition Survey from 2014 to 2019 were included for statistical analysis. A binary logistic regression model was used to examine the association between arthritis and HGS indices in crude and covariate-adjusted models.

RESULTS

In the crude analysis, all anthropometric and HGS indices were associated with arthritis except for weight in men. In adjusted models 1 and 2, among the anthropometric indices, waist circumference (WC) and waist-to-height ratio (WHtR) were associated with arthritis in men but not in women. Absolute HGS and all relative HGS indices showed a negative association with arthritis among both men and women, and the magnitude of the association of arthritis with the absolute HGS index and the relative HGS indices was similar. However, the magnitude of the association between all HGS indices and arthritis was higher for men than for women except in the crude analysis.

DISCUSSION

Absolute and relative HGS indices had negative associations with arthritis, and the magnitude of the association between the absolute HGS index and arthritis and between the relative HGS indices and arthritis was similar in all models. To our knowledge, this is the first report of an association between arthritis and relative HGS indices, which was not observed in previous studies.

Anthropometric Indices With Insulin Resistance in Obese Patients: A Literature Review

The hormone insulin is responsible for regulating the metabolism of proteins, carbs, and lipids by promoting the absorption of molecules such as glucose from the bloodstream into fat, the liver, and skeletal muscle cells. Insulin resistance (IR) is considered to be a physiological response to obesity that inhibits fat from accumulating and supports weight stabilization. People with IR gain less weight than those with insulin sensitivity, and therefore IR individuals have a three-fold increased likelihood of losing more weight when compared with insulin-sensitive individuals. A person's health is jeopardized by obesity, which is defined as excessive or unusual storage of fat in adipose tissue. Early identification using different anthropometric measuring parameters and proper and suitable therapy is essential as the incidence of obesity cases is increasing as a result of sedentary lifestyles, bad eating habits, a lack of physical exercise, and a lack of knowledge among young adults. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, following which based on inclusion and exclusion criteria, eight articles were considered for the review. The analysis showed that all the parameters are easily accessible and hence can be used in daily practices. Due to being readily available, body mass index (BMI) and waist circumference (WC) constituted the most often employed anthropometric measures in everyday practices. In addition, variances in the values of the variables were seen due to differences in gender.

Diagnostic performance using obesity and lipid-related indices and atherogenic index of plasma to predict metabolic syndrome in the adult sudanese population

Background

Simple and accurate clinical indicators to detect metabolic abnormalities might be helpful for early management and lowering the risk of future consequences like cardiovascular disease and type 2 diabetes mellitus.

Aim

The visceral adiposity index (VAI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP) have been proposed as reliable, straightforward clinical markers and indications of metabolic syndrome (MetS). This study aimed to see how well these obesity and lipid-related indicators will predict MetS in adult Sudanese patients.

Subjects and Methods

This community hospital-based case-control study included 420 middle-aged people (154 men and 266 women). Anthropometric measurements, weight (kilogram), height (meters), and waist circumference (WC) were evaluated, and the body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. Fasting blood samples were collected for glycated hemoglobin (HbA1c) and lipid profile assessment. VAI, LAP, and AIP were calculated.

Results

Significantly higher means of BMI, WC, WHtR, HbA1c, triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio, LAP, VAI, AIP, and significantly decrease in high-density lipoprotein cholesterol (HDL-C) were seen among MetS when compared with non-MetS group. LAP had a significant proportion with BMI, WC, WHtR, TG, TG/HDL-C, VAI, and AIP, and it is inversely related to HDL-C in the MetS group. On ROC analysis, LAP had the largest operating characteristic curves (AUC) for both gender 0.970 (0.948-0.993) for men and 0.964 (0.945-0.982) for women, followed by WC, and VAI, while BMI showed the lowest AUCs for men and women. In multiple regression analyses, AIP values increased significantly with LDL-C, DBP, HbA1c, LAP, and VAI.

Conclusion

The LAP was considerably higher in middle-aged people with MetS in both gender and was considered the best diagnostic performance.

Obesity-and lipid-related indices as a predictor of hypertension in Mid-aged and Elderly Chinese: A Cross-sectional Study

Objective

Middle-aged and elderly people in China probably suffer from hypertension. There is a close relationship between obesity-and lipid-related index and hypertension, which is recognized by recent studies. However, these studies have not systematically compared the relationship between the two. We aim to find the most effective obesity-and lipid-related index for predicting hypertension.

Method

A total of 9488 middle-aged and elderly people in China participated in this study. In this study, the subjects were divided into male and female groups by the definition of the 2018 Chinese Guidelines for Prevention and Treatment of Hypertension. Searching for the best predictors among 13 obesity-and lipid-related indicators through binary logistic regression analyses and receiver operator curve (ROC). These 13 indicators are body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR).

Results

After adjusting bias, all 13 indexes are risk factors for hypertension. In ROC curve analysis, thirteen obesity-and lipid-related factors can predict the occurrence of hypertension. Among them, CVAI has the best prediction effect (male: AUC = 0.660, female: AUC = 0.699). AUC for WHtR was equal to that for BRI and TyG - WHtR in identifying hypertension in male. Similarly, AUC of TyG-BMI and BMI were the same. In females, AUC for WHtR and BRI were the same when predicting hypertension. AUC of ABSI was much lower than other test indexes.

Conclusion

In predicting hypertension, thirteen obesity-and lipid-related factors are effective. In addition, in males and females, CVAI is the best indicator to indicate hypertension. TyG-WHtR, WHtR, and BRI performed well in predicting metabolic syndrome in both males and females. ABSI has a poor ability to predict hypertension.

Effect of Tart Cherry Juice Consumption on Body Composition and Anthropometric Measures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The present systematic review and meta-analysis were accomplished to understand the effects of tart cherry juice consumption on body composition and anthropometric measures. Five databases were searched using relevant keywords from inception to January 2022. All clinical trials investigating the effect of tart cherry juice consumption on body weight (BW), body mass index (BMI), waist circumference (WC), fat mass (FM), fat-free mass (FFM), and percentage body fat (PBF) were included. Out of 441 citations, 6 trials that enrolled 126 subjects were included. Tart cherry juice consumption significantly did not reduce BW (weighted mean difference [WMD], -0.4 kg; 95% confidence interval [CI], -3.25 to 2.46; p = 0.789; GRADE = low), BMI (WMD, -0.07 kg/m²; 95% CI, -0.89 to 0.74; p = 0.857; GRADE = low), FM (WMD, 0.21 kg; 95% CI, -1.83 to 2.25; p = 0.837; GRADE = low), FFM (WMD, -0.12 kg; 95% CI, -2.47 to 2.27; p = 0.919; GRADE = low), WC (WMD, 1.69 cm; 95% CI, -1.88 to 5.27; p = 0.353; GRADE = low), and PBF (WMD, 0.18%; 95% CI, -1.81 to -2.17; p = 0.858; GRADE = low). Overall, these data suggest that tart cherry juice consumption has no significant effect on BW, BMI, FM, FFM, WC, and PBF.

Waist-to-height ratio and new-onset hypertension in middle-aged and older adult females from 2011 to 2015: A 4-year follow-up retrospective cohort study from the China Health and Retirement Longitudinal Study

Background

Central obesity was closely associated with hypertension. Middle-aged and older adult females, defined as those aged 45 and above, were more likely to suffer from central obesity. For waist-to-height ratio (WHtR) was used as central obesity assessment, the object of this study was to illustrate the relationship between WHtR and the incidence of hypertension in middle-aged and older adult females in China.

Methods

Data used in this prospective cohort study was derived from the China Health and Retirement Longitudinal Study (CHARLS) in a baseline survey from 2011 to 2012 with a follow-up duration of 4 years. The waist-to-height ratio was calculated as waist circumstance divided by height, and the cohort was divided into different groups based on WHtR level. The outcome variable was new-onset hypertension.

Results

Of the 2,438 participants included in the study, 1,821 (74.7%) had high WHtR levels (WHtR ≥ 0.5). As WHtR was closely related to new-onset hypertension in a multivariable logistics regression mode [OR: 7.89 (95% CI: 2.10-29.67)], individuals with high WHtR were also more likely to suffer from hypertension compared with low WHtR levels [OR: 1.34 (95% CI: 1.06-1.69)].

Conclusion

WHtR is positively related to the risk of hypertension incidents among middle-aged and older adult females. Individuals with WHtR ≥ 0.5 were more likely to suffer from hypertension.

Correlation between percentage of fat mass and level of disease activity in rheumatoid arthritis

Introduction:

Controversies exist regarding the relationship between body fat and disease activity in patients with rheumatoid arthritis. The evaluation of the disease is critical for establishing treatment and prognosis. Fat mass could be a predictive factor for poor prognosis in rheumatoid arthritis because of its association with low- and high-grade inflammation.

Objective:

To evaluate the correlation between fat mass values and disease activity in patients with rheumatoid arthritis.

Materials and methods:

This was a cross-sectional study. Eighty female patients diagnosed with rheumatoid arthritis (American College of Rheumatology of 1987) were evaluated. For each one, the evaluation determined fat mass using bioelectrical impedance analysis and disease activity using the Disease Activity Score on 28 joints (DAS28).

Results:

The mean age was 59.11 ± 9.92 years, with an average disease duration of 14.13 ± 10.13 years; 85% of patients showed a high body fat percentage. Pearson’s correlation between DAS28 values and fat mass was r = 0.035 (p = 0.76).

Conclusion:

The levels of DAS28 showed no correlation with fat mass percentage. Further studies are required to clarify the factors that can modify these levels.

Body Roundness Index and Waist–Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study

Background

The appropriate optimal anthropometric indices and their thresholds within each BMI category for predicting those at a high risk of cardiovascular disease risk factors (CVDRFs) among the Chinese are still under dispute.

Objectives

We aimed to identify the best indicators of CVDRFs and the optimal threshold within each BMI category among the Chinese.

Methods

Between 2012 and 2020, a total of 500,090 participants were surveyed in Hunan, China. Six anthropometric indices including waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist–hip ratio (WHR), hip circumference (HC), and waist–height ratio (WHtR) were evaluated in the present study. Considered CVDRFs included dyslipidaemia, hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD). The associations of anthropometrics with CVDRFs within each BMI category were evaluated through logistic regression models. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive abilities.

Results

For the presence of at least one CVDRFs, the WHR had the highest AUROC in overweight [0.641 (95%CI:0.638, 0.644)] and obese [0.616 (95%CI:0.609, 0.623)] men. BRI had the highest AUROC in underweight [0.649 (95%CI:0.629, 0.670)] and normal weight [0.686 (95%CI:0.683, 0.690)] men. However, the BRI had the highest discrimination ability among women in all the BMI categories, with AUROC ranging from 0.641 to 0.727. In most cases, the discriminatory ability of WHtR was similar to BRI and was easier to calculate; therefore, thresholds of BRI, WHR, and WHtR for CVDRFs identification were all calculated. In men, BRI thresholds of 1.8, 3.0, 3.9, and 5.0, WHtR thresholds of 0.41, 0.48, 0.53, and 0.58, and WHR thresholds of 0.81, 0.88, 0.92, and 0.95 were identified as optimal thresholds across underweight, normal weight, overweight, and obese populations, respectively. The corresponding BRI values in women were 1.9, 2.9, 4.0, and 5.2, respectively, and WHtR were 0.41, 0.48, 0.54, and 0.59, while the WHR values were 0.77, 0.83, 0.88, and 0.90. The recommended BRI, WHtR, or WHR cut-offs could not statistically differentiate high-risk CKD or hypercholesterolemia populations.

Conclusions

We found that BRI and WHR were superior to other indices for predicting CVD risk factors, except CKD or hypercholesterolemia, among the Chinese.

Body composition of the upper limb associated with hypertension, hypercholesterolemia, and diabetes

The associations between segmental body composition and metabolic diseases remain equivocal. This study aimed to investigate this association using the example of U.S. adults. This cross-sectional study included 12,148 participants from the National Health and Nutrition Examination Survey (NHANES) (2011-2018). Multivariable logistic regression models were used to estimate associations between segmental body composition quartiles of hypertension, hypercholesterolemia, and diabetes. Among 12,148 participants, 3,569, 5,683, and 1,212 had hypertension, hypercholesterolemia, and diabetes, respectively. After adjusting for potential confounders, increased percent upper limb lean body mass was associated with a lower risk of hypertension (OR= 0.88, 95%CI: 0.84, 0.92, P _trend<0.001), hypercholesterolemia (OR= 0.93, 95%CI: 0.89, 0.96, P _trend<0.001), and diabetes (OR= 0.96, 95%CI: 0.95, 0.98, P _trend<0.001). Increased upper limb fat mass is associated with an increased risk of hypertension (OR= 1.11, 95%CI: 1.07, 1.15, P _trend<0.001), hypercholesterolemia (OR= 1.05, 95%CI: 1.01, 1.09, P _trend=0.07), and diabetes (OR= 1.03, 95%CI: 1.01, 1.05, P _trend=0.014). The same correlations were found in the torso and whole-body composition parameters. We observed that for women, lean body mass has a better protective effect on metabolic diseases [hypertension (OR= 0.88, 95%CI: 0.82, 0.93), hypercholesteremia (OR =0.86, 95%CI: 0.81, 0.92), diabetes (OR= 0.97, 95%CI: 0.85, 0.99)]; for men, increased body fat is associated with greater risk of metabolic disease[hypertension (OR= 1.24, 95%CI: 1.15, 1.33), hypercholesteremia (OR =1.09, 95%CI: 1.01, 1.18), diabetes (OR= 1.06, 95%CI: 1.01, 1.10)]. There were significant differences between different gender. These findings suggested that upper limb and torso adiposity should be considered when assessing chronic metabolic disease risk using body composition.

Sex Differences in the Association Between Obesity and Cognitive Impairment in a Low-Income Elderly Population in Rural China: A Population-Based Cross-Sectional Study

Background: Obesity is a potentially modifiable risk factor for cognitive impairment. However, sex-specific relationships between obesity and cognitive impairment in late life remain unclear.

Objective: We aimed to assess sex differences in the association between various obesity parameters and cognitive impairment in a low-income elderly population in rural China.

Methods: A population-based cross-sectional study was conducted to collect basic information from elderly residents aged 60 years and older from April 2014 to August 2014 in rural areas of Tianjin, China. Obesity parameters, including body mass index (BMI) and waist circumference (WC), and Mini Mental State Examination scores were measured, and the relationships between these variables were assessed.

Results: A total of 1,081 residents with a mean age of 67.70 years were enrolled in this study. After adjusting for age, educational attainment, smoking status, drinking status, physical exercise participation, and the presence of diabetes and hyperlipidemia, blood pressure group; a high BMI was found to be associated with an increased prevalence of cognitive impairment in elderly women. Each 1-unit increase in BMI was associated with a 5.9% increase in the prevalence of cognitive impairment. WC was related to the prevalence of cognitive impairment in elderly men, and each 1-cm increase in WC was associated with a 4.0% decrease in the prevalence of cognitive impairment. However, there were no significant associations between WC and cognitive function in women or between BMI and cognitive impairment in men.

Conclusion: A greater WC was positively associated with better cognitive function in low-income elderly men in rural China, whereas a higher BMI was associated with an increased risk of cognitive impairment in elderly women, independent of sociodemographic, lifestyle, and health-related comorbid factors. Our results suggest weight management of elderly women in rural China may have cognitive benefits. However, randomized controlled trials would be needed to confirm causality.

Utility of Three Adiposity Indices for Identifying Left Ventricular Hypertrophy and Geometric Remodeling in Chinese Children

BACKGROUND

Previous studies have shown that waist-to-height ratio (WHtR) performed similarly well when compared to body mass index (BMI) and waist circumference (WC) for identifying cardiovascular risk factors. However, to our knowledge, the performance of these three adiposity indices for identifying left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling in youth has not been assessed. We aimed to determine the utility of BMI, WC and WHtR for identifying LVH and LVG in Chinese children.

METHODS

This study included 1,492 Chinese children aged 6-11 years. Adiposity indices assessed were BMI, WC and WHtR. LVH and high relative wall thickness (RWT) were defined using sex- and age-specific 90th percentile values of left ventricular mass index and RWT, respectively, based on the current population. LVG remodeling included concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH), which was defined based on the combination of LVH and high RWT.

RESULTS

The magnitude of association of central obesity defined by WHtR with LVH [odds ratio (OR) =10.09, 95% confidence interval (CI) =6.66-15.29] was similar with general obesity defined by BMI (OR=10.49, 95% CI=6.97-15.80), and both were higher than central obesity defined by WC (OR=6.87, 95% CI=4.57-10.33). Compared with BMI, WHtR had better or similar predictive utility for identifying LVH, EH, and CH [the area under the curve (AUC): 0.84 vs. 0.79; 0.84 vs. 0.77; 0.87 vs. 0.88, respectively]; WC had worse or similar discriminatory utility with AUCs of 0.73, 0.70, 0.83, respectively.

CONCLUSION

WHtR performed similarly or better than BMI or WC for identifying LVH and LVG remodeling among Chinese children. WHtR provides a simple and convenient measure of central obesity that might improve the discrimination of children with cardiac structural damage.