A body shape index is associated with endothelial dysfunction in both men and women

Association of body indices with mortality in older population: Japan Specific Health Checkups (J-SHC) Study

BACKGROUND

Obesity indices reflect not only fat mass but also muscle mass and nutritional status in older people. Therefore, they may not accurately reflect prognosis. This study aimed to investigate associations between a body shape index (ABSI), body mass index (BMI), and mortality in the general older population.

METHODS

This nationwide observational longitudinal study included individuals aged between 65 and 74 years who underwent annual health checkups between 2008 and 2014. Exposures of interest were ABSI and BMI, and the primary outcome was all-cause mortality. Association between the ABSI and BMI quartile (Q1-4) and mortality was assessed using Cox regression analysis. A restricted cubic spline was also used to investigate nonlinear associations. The missing values were imputed using multiple imputation by chained equations.

RESULTS

Among 315,215 participants, 5074 died during a median follow-up period of 42.5 (interquartile range: 26.2-59.3) months. Compared with ABSI Q1, ABSI Q3 and Q4 were associated with increased risk of mortality, with the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of 1.13 (1.05-1.22) and 1.23 (1.13-1.35), respectively. Compared with BMI Q3, BMI Q1 and Q2 were associated with an increased risk of mortality, with aHRs and 95% CIs of 1.51 (1.39-1.65) and 1.12 (1.03-1.22), respectively. The impacts of these indices were greater in male than in female. The heatmap of the aHR for mortality by continuous ABSI and BMI showed that higher ABSI was consistently associated with higher mortality risk regardless of BMI, and that the combination of low BMI and high ABSI was strongly associated with increased mortality risk.

CONCLUSIONS

High ABSI and low BMI are additively associated with the risk of all-cause mortality in the general older population in Japan. Combination of ABSI and BMI is useful for evaluating mortality risk in older people.

Body shape index (ABSI), body roundness index (BRI) and risk factors of metabolic syndrome among overweight and obese adults: a cross-sectional study

BACKGROUND

Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, which increases the risk of various diseases. Epidemiological evidence suggests that newer anthropometric measures, such as a body shape index (ABSI) and body roundness index (BRI) can be used to predict MetS. However, anthropometric measures to predict the risk for MetS should be clarified in each population. Therefore, this study aimed to examine the association between ABSI, BRI, and MetS risk factors among overweight and obese Iranian adults.

METHODS

This cross-sectional study included 347 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20-50 years in Tabriz, Iran. Anthropometric measures were assessed, including BMI, waist circumference (WC), and waist-to-hip ratio (WHR). Additionally, ABSI and BRI were calculated based on the collected data. Blood pressure was measured using standard protocols. Body composition also was measured using body impedance analysis (BIA). Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels.

RESULTS

Participants with higher ABSI exhibited significantly higher systolic blood pressure (SBP) (P = 0.001), diastolic blood pressure (DBP) (P = 0.010), and triglyceride (TG) levels (P < 0.001), along with significantly lower high-density lipoprotein cholesterol (HDL-C) levels (P < 0.001). In the crude model, individuals in the highest ABSI tertile (tertile 3) had a higher likelihood of having higher SBP (OR: 1.032; 95% CI: 1.014-1.051) and DBP (OR: 1.33; 95% CI: 1.009-1.058), as well as a significant association with lower HDL-C levels (OR: 0.945; 95% CI: 0.918-0.973). Additionally, both ABSI tertile 2 (OR: 1.005; 95% CI: 1.001-1.008) and tertile 3 (OR: 0.993; 95% CI: 1.003-1.011) were linked to a higher likelihood of having higher TG levels. No significant associations were found between BRI tertiles and MetS risk factors.

CONCLUSION

According to our results, ABSI and BRI are poor predictors of MetS risk variables, in overweight and obese individuals. High ABSI is only slightly linked with high SBP, DBP, and TG and low HDL-C. However, longitudinal and long-term investigations are encouraged to verify the efficacy of these two measures.

Sexual dysfunction and its associated factors among patients with heart failure in public hospitals in Gondar town, North and West Gondar, 2024

INTRODUCTION

Sexual dysfunction is characterized by difficulties that interfere with achieving satisfying sexual activity, affecting desire, arousal, orgasm, and overall satisfaction. A recent study in Ethiopia identified heart failure as one of the most common cardiovascular diseases in the country. Sexual dysfunction significantly affects the quality of life in individuals with heart failure, yet it often goes underdiagnosed and underreported. Understanding the prevalence of sexual dysfunction and the factors influencing sexuality in these patients is essential. Therefore, the primary objective of this study was to determine the prevalence of sexual dysfunction among patients with heart failure in Gondar City and the northern and western zones of Gondar public hospitals.

METHOD

This study included 423 participants diagnosed with heart failure, selected through simple random sampling from January 3 to February 30, 2024. Data were collected using an interviewer-administered questionnaire covering socio-demographic, behavioral, and clinical information. Sexual dysfunction in males was assessed using the International Index of Erectile Function-5, while the Female Sexual Function Index-6 was used for females. Data were entered into Epidata version 3.6 and later exported to SPSS version 25 for analysis. Binary logistic regression was employed to identify factors associated with sexual dysfunction, with a significance level set at p ≤ 0.05.

RESULT

A total of 423 heart failure patients participated in the study, achieving a 100% response rate. The results indicated a significant prevalence of sexual dysfunction, affecting 57.92% of participants (95% CI 54.76%-63.76%). Female participants reported a higher prevalence of sexual dysfunction, with 63% of the 138 female heart failure patients affected. Among the 285 male participants, 55.4% (158 patients) were identified as having erectile dysfunction. Multivariable logistic regression analysis revealed that factors such as body mass index, age, insufficient physical activity, and smoking were significantly associated with sexual dysfunction in females. In males, erectile dysfunction was significantly linked to diabetes mellitus, heart failure classification, age, and insufficient physical activity.

CONCLUSION AND RECOMMENDATION

This study identified a high prevalence of sexual dysfunction, with females being more affected than males. Additionally, the research identified several factors influencing sexual dysfunction among patients with heart failure, including BMI, age, cigarette smoking, diabetes mellitus, and the classification of heart failure. The study recommends that healthcare providers and other stakeholders take proactive measures to alleviate the burden of sexual dysfunction in patients with heart failure. Strategies should focus on controlling the severity of heart failure symptoms, effectively managing comorbidities, and addressing factors such as body weight, psychological well-being, and behavioral patterns. By targeting these areas, healthcare providers can work toward minimizing the risk of sexual dysfunction and improving the overall quality of life for patients with heart failure.

Association of body shape phenotypes and body fat distribution indexes with inflammatory biomarkers in the European Prospective Investigation into Cancer and Nutrition (EPIC) and UK Biobank

BACKGROUND

The allometric body shape index (ABSI) and hip index (HI), as well as multi-trait body shape phenotypes, have not yet been compared in their associations with inflammatory markers. The aim of this study was to examine the relationship between novel and traditional anthropometric indexes with inflammation using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) and UK Biobank cohorts.

METHODS

Participants from EPIC (n = 17,943, 69.1% women) and UK Biobank (n = 426,223, 53.2% women) with data on anthropometric indexes and C-reactive protein (CRP) were included in this cross-sectional analysis. A subset of women in EPIC also had at least one measurement for interleukins, tumour necrosis factor alpha, interferon gamma, leptin, and adiponectin. Four distinct body shape phenotypes were derived by a principal component (PC) analysis on height, weight, body mass index (BMI), waist (WC) and hip circumferences (HC), and waist-to-hip ratio (WHR). PC1 described overall adiposity, PC2 tall with low WHR, PC3 tall and centrally obese, and PC4 high BMI and weight with low WC and HC, suggesting an athletic phenotype. ABSI, HI, waist-to-height ratio and waist-to-hip index (WHI) were also calculated. Linear regression models were carried out separately in EPIC and UK Biobank stratified by sex and adjusted for age, smoking status, education, and physical activity. Results were additionally combined in a random-effects meta-analysis.

RESULTS

Traditional anthropometric indexes, particularly BMI, WC, and weight were positively associated with CRP levels, in men and women. Body shape phenotypes also showed distinct associations with CRP. Specifically, PC2 showed inverse associations with CRP in EPIC and UK Biobank in both sexes, similarly to height. PC3 was inversely associated with CRP among women, whereas positive associations were observed among men.

CONCLUSIONS

Specific indexes of body size and body fat distribution showed differential associations with inflammation in adults. Notably, our results suggest that in women, height may mitigate the impact of a higher WC and HC on inflammation. This suggests that subtypes of adiposity exhibit substantial variation in their inflammatory potential, which may have implications for inflammation-related chronic diseases.

Progression of Chronic Kidney Disease to Dialysis in the Roma Population With Type 2 Diabetes Mellitus in Comparison With Caucasian Patients

Background Chronic kidney disease (CKD) poses a significant health challenge among patients, contributing to substantial morbidity and mortality outcomes. However, there remains a paucity of data within the medical literature on the Roma population, one of the most significant minority groups globally, with studies indicating that these individuals are disproportionately affected by CKD compared to the general population, with higher prevalence rates. Materials and methods We conducted an observational, cross-sectional study from October 2022 to March 2024, evaluating 735 adult patients with type 2 diabetes mellitus, of which 402 were Roma, aged 18 to 89 years, following the hospital's standard protocols for diabetes management, at the "Nicolae Malaxa" Clinical Hospital in Bucharest, Romania, a tertiary care center for diabetes. Results The prevalence of CKD was higher among the Roma patients, reaching 56.50% (n=203), in comparison with the Caucasian group (43.50%, n=156), however, with a lower mean age (55.53±10.56 years versus 63.32±10.04 years). Roma patients with CKD had a higher prevalence of cardiovascular disease compared to Caucasians, including myocardial infarction, stroke, stable angina, and heart failure. Cardiovascular risk factors, such as hypertension, obesity, and dyslipidemia, in patients with CKD, were also more prevalent among the Roma population. Taking into consideration the natural progression of CKD, the anthropometric measurements and laboratory parameters stratified by ethnicity revealed that Roma patients in the very high risk of CKD progression category had a lower mean age, and a lower median duration of diabetes (56.37±10.79 versus 59.92±7.48 years, and 4.00±2.00 versus 10.00±10.30 years, respectively), as well as a more elevated mean waist circumference (WC), body mass index (BMI), total cholesterol (TC), and low-density lipoprotein-cholesterol (LDL-c) compared to Caucasians. Moreover, patients in the very high risk of CKD progression category among both groups showed the highest level of insulin resistance, measured by the triglyceride-glucose (TyG) index (mean value of 10.13±0.60 among the Roma patients, and 10.09±0.82 among Caucasians). Among the study group, weight, WC, BMI, and A Body Shape Index (ABSI) were associated with a very high risk of progression of CKD. In Caucasian patients, it was demonstrated that weight, WC, BMI, ABSI, and triglycerides (TG) have contributed to the very high risk of progression of CKD, while among the Roma patients, no association was found. Conclusion In conclusion, our findings suggested a high prevalence of CKD among both groups. There is still a need for further investigation of additional risk factors, such as genetics, limited access to health education, and appropriate treatments that could synergistically accelerate the progression of CKD among Roma patients.

Association between anthropometric indices and 5-year hypertension incidence in the general Japanese population

No existing reports demonstrate the association between anthropometric indices (body mass index, waist circumference, body roundness index, a body shape index) and hypertension according to sex and age in the general Japanese population. This retrospective analysis involved individuals aged 30-69 years who underwent annual medical checkups at Kagoshima Koseiren Hospital in 2005-2019, and who did not meet hypertension criteria at baseline. The outcome was hypertension incidence after 5 years, and its association with baseline anthropometric indices was evaluated using multivariable logistic regression analysis by sex and age. In 41,902 participants (age 52.3 ± 10.2 years, 47.7% men), 7622 individuals (18.2%) developed hypertension after 5 years. Body mass index, waist circumference, and body roundness index were significantly associated with the development of hypertension in both men and women across all age categories from 30 s to 60 s. In the population with a body mass index <25 kg/m2, waist circumference and body roundness index were significantly associated with hypertension after 5 years. A body shape index was significantly associated with the development of hypertension in men in their 40 s and 50 s but not in women of any age group. The area under the curve values were lower for a body shape index than for body mass index, waist circumference, and body roundness index in both men and women of all age groups. A body shape index was not a stronger indicator for 5-year hypertension incidence than body mass index, waist circumference, or body roundness index in both men and women across age groups from their 30s-60 s. The results of this study will help to more efficiently identify populations at high risk of developing hypertension and provide preventive interventions. A total of 41,902 participants from health checkup programs were stratified by gender and age to investigate the association between baseline anthropometric indices and hypertension incidence over a 5-year period. BMI, WC, and BRI were almost equally effective and showed a better association with risk of developing hypertension in women and young adults compared to men and old adults. Conversely, ABSI showed no greater association than BMI or WC in any age group in both men and women. ABSI, a body shape index; AUC, area under the curve from receiver operating characteristic curve analysis; BMI, body mass index; BRI, body roundness index; WC, waist circumference.

The relationship of circulating neuregulin 4 and irisin, and traditional and novel cardiometabolic risk factors with the risk and severity of coronary artery disease

BACKGROUND AND AIMS

Neuregulin 4 (NRG4) and irisin are adipokines that have been suggested to be associated with cardiometabolic risk factors and coronary artery disease (CAD), but the data are inconclusive. This study aimed to investigate the relationship between circulating NRG4 and irisin and cardiometabolic risk factors with CAD risk and severity.

METHODS AND RESULTS

In this cross-sectional study, the presence of CAD and the severity of stenosis (gensini score) were documented based on coronary angiography in 166 adults. Circulating NRG4 and irisin, glucose homeostasis markers, hs-CRP, lipid profiles, blood pressure, and anthropometric measurements were assessed as well. Age (p = 0.005), sex (p = 0.008), SBP (p = 0.033), DBP (p = 0.04), MAP (p = 0.018), FBG (p = 0.012), insulin (p = 0.039) and HOMA-IR (p = 0.01) were significantly associated with odds of having CAD. The final logistic regression model showed that age, sex, HOMA-IR, and MAP were the most important determinants of having CAD. There were no significant associations between circulating irisin and NRG4 with odds of having CAD. The final general linear model showed that being men (β = 17.303, 95% CI: 7.086-27.52, P = 0.001), age (Aβ = 0.712, 95% CI: 0.21-1.214, P = 0.006), HOMA-IR (Aβ = 2.168, 95% CI: 0.256 to 4.079, P = 0.027), and NRG4 level (β = 1.836, 95% CI: 0.119-3.553, P = 0.036) were directly associated with higher gensini score. Participants with the three-vessel disease had a mean increase of about 5 units in circulating irisin compared to those with no clinical CAD (β = 5.221, 95% CI: 0.454-9.987, p = 0.032).

CONCLUSIONS

This study showed that the adipokines NRG4 and Irisin might be associated with the severity of coronary stenosis.

Air pollution combined with high-fat feeding aggravates metabolic and cardiovascular diseases: A dangerous, oxidative, and immune-inflammatory association

Obesity and particulate air pollutant (PM_2.5) are important risk factors for cardiometabolic diseases. PM_2.5 exacerbates insulin resistance and lipid ectopic deposition in obese animals. The inorganic fraction of PM_2.5, the Residual Oil Fly Ash (ROFA), is related to cardiovascular events, by enhancing the generation of reactive species, inflammatory cytokines, and leukocyte activation. However, the synergistic effects of ROFA and a high-fat diet (HFD) are still poorly described, and the studies were mainly conducted with males.

AIMS

To investigate if ROFA could potentiate the cardiometabolic effects of diet-induced obesity in female rats.

MATERIAL AND METHODS

Wistar female rats were divided into four groups: Control (n = 6), Polluted (n = 6), HFD (n = 6), and HFD + Polluted (n = 6). HFD and HFD + Polluted received a high-fat diet (HFD) (58.3 % as fats), whilst Control and Polluted groups received a standard diet (Nuvilab CR-1). In addition, Polluted and HFD + Polluted groups received intranasal instillation of ROFA (250 μg/50 μL), while Control and HFD groups received saline solution (50 μL) daily, five days per week. Both interventions occurred 24 weeks after the animals were euthanized.

KEY FINDINGS

HFD combined with ROFA exposure impaired lipid profile challenged systemic and cardiac antioxidant defense, and presented a synergistic effect in inducing an immune-inflammatory condition. We found that the lipid profile disturbance is associated with HFD-induced hepatic, but not cardiac, deposition of triglycerides in female animals.

SIGNIFICANCE

Our results support the hypothesis that ROFA exposure combined with bad feeding can exacerbate metabolic and cardiovascular diseases.

Association of Body Shape Index with Cerebral Small Vessel Disease

INTRODUCTION

A body shape index (ABSI) is an anthropometric index designed to reflect the influence of visceral fat. ABSI has been previously associated with various atherosclerosis, metabolic diseases, and cardiovascular diseases; however, relatively few studies have been conducted on cerebrovascular disease. In this study, we evaluated the association between ABSI and cerebral small vessel disease (cSVD) in health check-up participants.

METHODS

We evaluated consecutive health check-up participants between January 2006 and December 2013. As subtypes of cSVD, we quantitatively measured the volume of white matter hyperintensity (WMH) and qualitatively measured the presence of silent brain infarct (SBI) and cerebral microbleed (CMB). ABSI was calculated according to the following formula: ABSI (m11/6/kg-2/3) = waist circumference (m)/(body mass index [kg/m2]2/3 × height [m]1/2).

RESULTS

A total of 3,219 health check-up participants were assessed (median age, 56 years; male sex, 54.0%). In the multivariable analysis, ABSI was significantly associated with WMH volume (β = 0.107, 95% confidence interval [CI] = 0.013-0.200), SBI (adjusted odds ratio [aOR] = 1.62, 95% CI = 1.14-2.31), and CMB (aOR = 1.64, 95% CI = 1.16-2.33) after adjusting for confounders (per 100 m11/6/kg-2/3). Furthermore, ABSI showed a dose-response relationship with the burden of each cSVD pathology.

CONCLUSIONS

High ABSI was associated with a higher burden of cSVD in health check-up participants. As ABSI showed close associations with all subtypes of cSVD, visceral fat may be a common risk factor penetrating cSVD pathologies.

Obesity and Endothelial Function

Obesity is a major public health problem and is related to increasing rates of cardiovascular morbidity and mortality. Over 1.9 billion adults are overweight or obese worldwide and the prevalence of obesity is increasing. Obesity influences endothelial function through obesity-related complications such as hypertension, dyslipidemia, diabetes, metabolic syndrome, and obstructive sleep apnea syndrome. The excess fat accumulation in obesity causes adipocyte dysfunction and induces oxidative stress, insulin resistance, and inflammation leading to endothelial dysfunction. Several anthropometric indices and imaging modalities that are used to evaluate obesity have demonstrated an association between obesity and endothelial function. In the past few decades, there has been great focus on the mechanisms underlying endothelial dysfunction caused by obesity for the prevention and treatment of cardiovascular events. This review focuses on pathophysiological mechanisms of obesity-induced endothelial dysfunction and therapeutic targets of obesity.

The A Body Shape Index Might Be a Stronger Predictor of Chronic Kidney Disease Than BMI in a Senior Population

The A Body Shape Index (ABSI) was recently introduced to quantify abdominal adiposity relative to the body mass index (BMI) and height. This cross-sectional study was performed to explore whether the ABSI is linked to chronic kidney disease (CKD) in older adults and compare the predictive capacity of the ABSI versus BMI for CKD. In total, 7053 people aged ≥ 60 years were divided into normal, mild, and moderate-to-severe CKD groups based on their estimated glomerular filtration rate (eGFR). The correlation of the ABSI with the eGFR and the differences and trends in the ABSI and BMI among the groups were analyzed, and the cutoff points for moderate-to-severe CKD were calculated. The association between the ABSI and CKD was stronger than that between the BMI and CKD. The ABSI had a better capacity to discriminate the CKD stage than did the BMI. The capacity of the ABSI to predict moderate-to-severe CKD was higher than that of the BMI and was more substantial in women than men. The ABSI cutoff points for CKD were ≥0.0822 and 0.0795 in men and women, respectively. In conclusion, the ABSI serves as a better index than the BMI for screening and detecting high-risk individuals with CKD.