Secular trends in the prevalence of abdominal obesity among Chinese adults with normal weight, 1993-2015

Combined association of abdominal obesity and depressive symptoms with risk of type 2 diabetes: A cohort study

OBJECTIVE

To explore the combined effect of abdominal obesity and depressive symptoms on the risk to type 2 diabetes, while also assessing the potential influence of various glycemic states and gender on this combined relationship.

METHODS

Data is acquired from the China Health and Retirement Longitudinal Study, and 5949 participants were included for analysis. Participants were divided into four groups: neither have abdominal obesity nor depressive symptoms (AO-/DS-), only have depressive symptoms (AO-/DS+), only have abdominal obesity (AO+/DS-), and have both abdominal obesity and depressive symptoms (AO+/DS+). Stratified analyses differentiating the glycemic statuses and sex of the participants were also carried out.

RESULTS

After adjusting for the confounders, the AO-/DS+, AO+/DS- and AO+/DS+ phenotypes were all discovered to be risk factors for type 2 diabetes (OR = 1.38, 95%CI: 1.06-1.79; OR = 2.07, 95%CI: 1.63-2.63; OR = 2.38, 95%CI: 1.83-3.11, respectively) compared with the AO-/DS- phenotype in the overall population. In further stratified analyses, we arrived at the same conclusion for normoglycemic individuals, especially in females. For prediabetes and males, the AO+/DS- and AO+/DS+ phenotypes are risk factors for type 2 diabetes compared with the AO-/DS- phenotype, but not with AO-/DS+.

CONCLUSION

Regardless of glycemic status and sex, the coexistence of abdominal obesity and depressive symptoms were associated with an increased risk of type 2 diabetes. Depressive symptoms were independent risk factors for type 2 diabetes only in normoglycemic individuals and females.

Body mass index-associated responses to an ABVD-like regimen in newly-diagnosed patients with Hodgkin lymphoma

Background: The role of body mass index (BMI) in the treatment outcomes of lymphoma patients is controversial. While investigating the efficacy of ABVD-like regimen in Hodgkin lymphoma (HL) patients, we observed that obese patients had poor responses. To better understand this clinical phenomenon, we evaluated the effect of BMI on responses to ABVD-like chemotherapy in HL patients. Methods: This retrospective cohort study evaluated the clinical outcomes of all 67 patients with confirmed HL who were treated at the First Affiliated Hospital of Soochow University from November 2016 to March 2023 with an ABVD-like regimen as first-line chemotherapy. Baseline patient characteristics and clinical outcomes were compared across different BMI categories. The primary end-point was the overall response rate defined as the proportion of the HL patients who achieved complete response or partial response. The additional end-points included progression-free survival and overall survival. Results: The median age of the HL patients was 31 years old. Of the patients, 10.4% were obese, and 17.9% patients were overweight. Interim and end-term response evaluations revealed overall response rates of 98.5% and 83.6%, respectively. The proportion of patients with potential poor prognostic factors (IPS risk factors) did not differ significantly in the responders versus non-responders. However, non-responders had a higher average BMI when compared with responders (p = 0.002). Poor overall response rates in higher BMI patients indeed manifested with shorter progression free survival (p = 0.013). The minimum relative dose of the ABVD-like regimen in the overweight and obese groups was significantly lower than in the normal weight group (p < 0.001). Conclusion: Our analyses show that >80% of newly-diagnosed HL patients responded to the ABVD-like regimen. We find that being obese or overweight at the time of diagnosis correlated with a poorer overall response rate and that BMI was an independent risk factor in HL patients treated with the ABVD-like regimen. Lower doses of ABVD-like regimen contributed to the discrepant findings of responses in the high BMI groups. These findings indicate that newly-diagnosed, obese HL patients receiving an ABVD-like regimen require personalized treatment.

Intergenerational Changes in the Waist Circumference and Selected Associated Indicators among Children and Adolescents from Kraków (Poland), between 1983 and 2020

The aim of the study was to examine the direction of the secular changes in the waist and hips circumferences, as well as selected associated body proportions, among children and adolescents from Kraków, Poland. The study group included 8-18-year-olds examined in three cross-sectional studies (1983, 2010, and 2020). The analyzed characteristics included body height, circumferences of the waist and hips, which were used to calculate Waist-to-Hip Ratio (WHR), and Waist-to-Height Ratio (WHtR). There was a secular increase regarding the majority of the analyzed features, particularly for the younger children (i.e., prepubertal/early pubertal age). The trends were also especially evident when comparing the results of the 1983 series to the results of their peers examined in 2020. An opposite trend was noted in adolescent girls. The observed changes reflect the secular trend resulting from changes in body composition and fat distribution happening due to alterations in the lifestyle and socio-economic environment of the population over the years. It should also be stressed that the increase in the studied characteristics occurred mainly in younger children. This suggests that the observed changes may have resulted from a shift in the age of maturation and also from the personal and social motivators characteristic for late adolescence.

Staple Food Preference and Obesity Phenotypes: The Regional Ethnic Cohort Study in Northwest China

Staple food preference vary in populations, but evidence of its associations with obesity phenotypes are limited. Using baseline data (n = 105,840) of the Regional Ethnic Cohort Study in Northwest China, staple food preference was defined according to the intake frequency of rice and wheat. Overall and specifically abdominal fat accumulation were determined by excessive body fat percentage and waist circumference. Logistic regression and equal frequency substitution methods were used to evaluate the associations. We observed rice preference (consuming rice more frequently than wheat; 7.84% for men and 8.28% for women) was associated with a lower risk of excessive body fat (OR, 0.743; 95%CI, 0.669-0.826) and central obesity (OR, 0.886; 95%CI, 0.807-0.971) in men; and with lower risk of central obesity (OR, 0.898; 95%CI, 0.836-0.964) in women, compared with their wheat preference counterparties. Furthermore, similar but stronger inverse associations were observed in participants with normal body mass index. Wheat-to-rice (5 times/week) reallocations were associated with a 36.5% lower risk of normal-weight obesity in men and a 20.5% lower risk of normal-weight central obesity in women. Our data suggest that, compared with wheat, rice preference could be associated with lower odds ratios of certain obesity phenotypes in the Northwest Chinese population.

Famine exposure in adolescence is associated with a higher risk of overweight/obesity and abdominal obesity in adulthood: A meta-analysis

Some studies have shown that famine exposure during adolescence can increase cardiovascular disease and diabetes susceptibility in later life. The association between famine exposure in adolescence and overweight/obesity and abdominal obesity in adulthood has been inconsistent. Based on previous studies, we hypothesized that famine exposure in adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. Eight databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched from their inception until November 2021. We initially identified 3982 records and finally included 7 articles after screening. The included articles were of moderate to high quality, containing 16 estimates of overweight/obesity and 3 estimates of abdominal obesity. Pooled odds ratios (ORs) with 95% CIs were used to estimate the association between them. The random effects model was adopted as the pooling method. There was a significant association between famine exposure in adolescence and overweight/obesity in adulthood (OR, 1.17; 95% CI, 1.02-1.33). Adolescents exposed to famine had a greater risk of abdominal obesity in adulthood than their unexposed counterparts (OR, 1.35; 95% CI, 1.03-1.76). These results were more pronounced in females than in males. In summary, our meta-analysis indicates that famine exposure during adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. This suggests that we need to pay timely attention to the nutritional status of adolescents to prevent adverse health consequences of malnutrition. More high-quality studies are needed to confirm these conclusions, given the limitations of this study.

Spicy food consumption is associated with abdominal obesity among Chinese Han population aged 30-79 years in the Sichuan Basin: a population-based cross-sectional study

BACKGROUND

Few animal experiments and volunteer-based intervention studies have showed a controversial effect of spicy foods on abdominal obesity. We aimed to examine the association between spicy food frequency, spicy flavor, and abdominal obesity among Chinese Han population in the Sichuan Basin which area eating spicy foods relatively often.

METHODS

A cross-sectional analysis was conducted using the Sichuan Basin baseline data from the China Multi-Ethnic Cohort (CMEC) study, including data from electronic questionnaires, anthropometric measurements and blood sample collection. A total of 40,877 adults (22,503 females) aged 30-79 years were included in the final analysis. Multivariable logistic regression yielded adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for abdominal obesity associated with the strength of spicy flavor and frequency of spicy food intake.

RESULTS

The prevalence of daily spicy food eating was 47.3% in males and 52.7% in females, the percentages of abdominal obesity were 52.3%, 48.8%, 51.6% and 55.5% in the spicy food intake subgroups of never, 1-2 days/week, 3-5 days/week and 6-7 days/week, respectively. Compared with males who never consumed spicy food, the adjusted ORs (95% CIs) in the 1-2 days/week, 3-5 days/week and 6-7 days/week subgroups were 1.21 (1.09, 1.34), 1.35 (1.21, 1.51), and 1.35 (1.25, 1.47), respectively (P_trend < 0.001). The corresponding odds ratios for females were 0.95 (0.87, 1.05), 1.14 (1.03, 1.26), and 1.25 (1.16, 1.35), respectively (P_trend < 0.001). Similarly, compared with no spicy flavor, the adjusted ORs (95% CIs) of mild, middle, and strong spicy strength for abdominal obesity in males were 1.27 (1.17, 1.38), 1.51 (1.37, 1.67), and 1.36 (1.11, 1.67) respectively (P_trend < 0.001). The corresponding odds ratios for females were 1.14 (1.06, 1.23), 1.27 (1.15, 1.40), and 1.32 (1.06, 1.65), respectively (P_trend < 0.001).

CONCLUSIONS

The data indicated that spicy food consumption was a risk factor for abdominal obesity among Chinese adult population in the Sichuan Basin. The results need to be approved by large cohort studies.

Obesity Pillars Roundtable: Obesity and East Asians

Background

Individuals from East Asia make up about 1/5th of the world's population. Individuals from South Asia with obesity are well-described to have increased susceptibility to cardiovascular disease (CVD) risk factors and increased risk of CVD events. Less well described are the adiposopathic effects of the disease of obesity among East Asians.

Methods

This roundtable discussion includes 3 obesity medicine specialists with experience in the clinical management of obesity among patients of East Asian descent. Included are citations regarding obesity and East Asians.

Results

In general, East Asians are at decreased risk for CVD compared to Whites and South Asians. However, compared to Whites, for the same body mass index, East Asians are at increased risk for metabolic diseases such as type 2 diabetes mellitus. Both obesity and type 2 diabetes mellitus are epidemics in East Asian countries. In this Roundtable, the panelists discuss East Asian nutrition and physical activity, with special attention given to Asian foods, especially rice. The panelists also discuss East Asian genetic predispositions for development of visceral adiposity, type 2 diabetes mellitus, as well as genetic predisposition to drug metabolism and potential drug and herbal interactions, as commonly encountered in patients with obesity. Finally, the panelists give summary tips for managing East Asian patients with obesity.

Conclusion

The three panelists of this roundtable describe their practical diagnostic processes and treatment plans for patients from East Asia, with an emphasis on a patient-centered approach to obesity in this unique population.

Effects of obesity indices/GDM on the pregnancy outcomes in Chinese women: A retrospective cohort study

OBJECTIVE

To analyze pregnancy complications and outcomes of mothers with obesity or gestational diabetes mellitus (GDM).

METHODS

15065 mothers were categorized into four and three groups by pre-pregnancy body mass index (preBMI) and abdominal circumference (AC), respectively, or divided into GDM or non-GDM groups. Logistic regression analysis was utilized to identify independent factors associated with pregnancy complications and outcomes.

RESULTS

The overweight and obesity groups accounted for 16.0% and 4.0% of the total population, respectively. GDM incidence rate was 12.3%. The overweight and obesity groups (pre-pregnancy body mass index [preBMI] ≥ 24 kg/m²) were at higher risks for GDM, hypertensive disorders of pregnancy (HDP), gestational proteinuria, postpartum hemorrhage, preterm delivery, fetal malformation or stillbirth, neonatal asphyxia, large for gestational age (LGA), shoulder dystocia, and increased cesarean section rate. Similar results were obtained with AC grouping. GDM pregnant women had higher risks of HDP, preterm delivery, small for gestational age (SGA), LGA, and increased cesarean section rate.

CONCLUSION

People with obesity had a higher risk of adverse pregnancy outcomes. The recommended preBMI is 19.2-22.7 kg/m². The recommended AC at 11-13⁺⁶ gestational weeks is 74.0-84.0 cm, and that value in normal preBMI is 74.0-82.0 cm.