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He X, Zhu Z, Zang J, Wang Z, Liao P, Wang W, Shi Y, Fu C. Percent body fat, but not body mass index, is associated with cardiometabolic risk factors in children and adolescents. Chronic Dis Transl Med 2023; 9:143-153. [PMID: 37305104 PMCID: PMC10249195 DOI: 10.1002/cdt3.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/28/2022] [Accepted: 11/25/2022] [Indexed: 01/13/2023] Open
Abstract
Background The epidemic of overweight and obesity has become a worldwide public health problem. Cardiometabolic diseases may originate in childhood. We investigated the association between percent body fat (PBF) measured by the bioelectrical impedance assay and cardiometabolic risk (CMR) in pediatrics. Methods This cross-sectional study involved 3819 subjects (6-17 years old) in Shanghai. We assessed the association between PBF and body mass index (BMI) with multiple CMR factors. We examined the risk for cardiometabolic abnormalities attributable to overweight and obesity based on age- and sex-specific PBF Z-scores and BMI Z-scores, respectively. Results PBF, but not BMI, was positively associated with multiple CMR factors in males and females except for total cholesterol in females (all p < 0.05). Compared with the non-overweight group based on PBF, overweight and obese subjects had increasingly higher odds ratio of dyslipidemia (2.90 (1.99-4.23), 4.59 (2.88-7.32) for males and 1.82 (1.20-2.75), 2.46 (1.47-4.11) for females) and elevated blood pressure (BP) (3.26 (2.35-4.51), 4.55 (2.92-7.09) for males and 1.59 (1.07-2.34), 3.98 (2.27-6.17) for females). Obesity females showed a higher likelihood for hyperglycemia (2.19 (1.24-3.84)) than non-overweight females. In both sexes, the predictive effect of PBF on dyslipidemia and elevated BP in adolescents was better than that in children. For hyperglycemia, the predictive effect of PBF was better in male adolescents and female children. There was no risk difference for cardiometabolic abnormalities attributable to BMI-based obesity categories. Conclusions PBF but not BMI was associated with CMR. Overweight and obesity categories based on PBF had an increased risk for cardiometabolic abnormalities in children and adolescents.
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Affiliation(s)
- Xin He
- Laboratory of Functional Medicine, Division of Chronic Non‐communicable Diseases and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Zhenni Zhu
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and ControlShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Jiajie Zang
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and ControlShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Zhengyuan Wang
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and ControlShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Ping Liao
- Laboratory of Functional Medicine, Division of Chronic Non‐communicable Diseases and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Wenjing Wang
- Laboratory of Functional Medicine, Division of Chronic Non‐communicable Diseases and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Yan Shi
- Laboratory of Functional Medicine, Division of Chronic Non‐communicable Diseases and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Chen Fu
- Laboratory of Functional Medicine, Division of Chronic Non‐communicable Diseases and InjuryShanghai Municipal Center for Disease Control and PreventionShanghaiChina
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Noda M, Yoshida S, Kawakami C, Takeuchi M, Kawakami K, Ito S. Association of prepregnancy physical activity with obesity in offspring: The Japan Environment and Children's Study. Obesity (Silver Spring) 2022; 30:1851-1862. [PMID: 35927792 DOI: 10.1002/oby.23516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between maternal prepregnancy physical activity (PA) and overweight/obesity in 3-year-old children. METHODS Using data from the Japan Environment and Children's Study (a birth cohort study), maternal prepregnancy PA was categorized into low, moderate, and high with the International Physical Activity Questionnaire (IPAQ). The reference group was defined as children born to mothers with moderate PA. The association between prepregnancy PA and overweight/obesity or obesity in children was investigated using univariable and multivariable logistic regression analyses. RESULTS Of the 65,245 participants, 48.7%, 32.7%, and 18.6% were born to mothers in the low, moderate, and high PA groups, respectively. Furthermore, 24.9%, 24.6%, and 25.9% of children with overweight/obesity and 9.4%, 9.2%, and 10.4% of children with obesity were born to mothers in the low, moderate, and high PA groups, respectively. The adjusted odds ratios for overweight/obesity in the low and high PA groups were 1.02 (95% CI: 0.98-1.06) and 1.04 (95% CI: 0.98-1.09), and those for obesity were 1.03 (95% CI: 0.97-1.09) and 1.08 (95% CI: 0.99-1.16), respectively. CONCLUSIONS Maternal prepregnancy PA was not associated with overweight/obesity or obesity in 3-year-old children.
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Affiliation(s)
- Masahiro Noda
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Chihiro Kawakami
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Ziętek M, Machniak M, Wójtowicz D, Chwałczyńska A. The Incidence of Body Posture Abnormalities in Relation to the Segmental Body Composition in Early School-Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10815. [PMID: 36078524 PMCID: PMC9517756 DOI: 10.3390/ijerph191710815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
Children are exposed to multiple factors that contribute to an increase in body mass and the development of posture defects. The aim of the study is to assess the relationship between the segmental distribution of fat mass and muscle mass and the incidence of body posture abnormalities in early school-aged children. A total of 190 children aged 7-9 were included in the research project. The examined children were divided according to age (class level) into three groups. Height, weight and body composition, BMI, and body posture were determined. Thoracic and lumbar spine abnormalities occurred most frequently in the examined children (7-95%, 8-92%, 9-89.5%). During the assessment of the segmental body composition, the lowest fat-fat-free index was found in the trunk. The number of abnormalities of the cervical spine, pelvis, and lower extremities increases with age. The number of abnormalities of the thoracic and lumbar spine, as well as of upper extremities and the pectoral girdle decreases with age. Body posture abnormalities are correlated with body composition and in particular with the fat mass percentage. The segmental body com-position analyzer can be used to screen for posture defects.
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Association of the triglyceride-glucose index with weight-adjusted appendicular lean mass in Chinese adolescents aged 12-18 years old. Sci Rep 2022; 12:11160. [PMID: 35778446 PMCID: PMC9249753 DOI: 10.1038/s41598-022-15012-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/16/2022] [Indexed: 11/09/2022] Open
Abstract
There is no study exploring the association between triglyceride-glucose (TyG) index and skeletal muscle mass in Chinese adolescents. Therefore, the objective of this study is to explore the association between TyG index and appendicular lean mass (ALM) in Chinese adolescents. In this study, 1336 adolescents (805 boys, 60.25%) aged 12-18 years in China were randomly selected through a stratified cluster sampling. According to the tertiles of TyG index, we separated all participants into three groups, and LM was measured by Bioelectrical Impedance Analysis. The TyG index was negatively related to ALM/weight in Chinese adolescents whether stratified by gender (boys: β = - 0.293; girls: β = - 0.195; all P < 0.001). After adjusting for age and BMI, a significant correlation between the TyG index and ALM/weight was observed only in boys (β = - 0.169, P = 0.001). The highest TyG index tertile was significantly associated with low ALM/weight after adjusting for all covariates in the full sample (OR = 3.04, 95% CI 1.12-8.26, P = 0.029) and boys (OR = 4.68, 95% CI 1.22-17.95, P = 0.025) only in overweight/obese group. Our findings suggested elevated levels of TyG index may be a risk factor of low ALM/weight in Chinese adolescents, especially in boys.
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Córdoba-Rodríguez DP, Iglesia I, Gomez-Bruton A, Rodríguez G, Casajús JA, Morales-Devia H, Moreno LA. Fat-free/lean body mass in children with insulin resistance or metabolic syndrome: a systematic review and meta-analysis. BMC Pediatr 2022; 22:58. [PMID: 35065638 PMCID: PMC8783460 DOI: 10.1186/s12887-021-03041-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lean / Fat Free Body Mass (LBM) is metabolically involved in active processes such as resting energy expenditure, glucose uptake, and myokine secretion. Nonetheless, its association with insulin sensitivity / resistance / glucose tolerance and metabolic syndrome remains unclear in childhood. METHODS The current investigation aimed to examine the differences in fat-free mass /lean body mass according to the presence of insulin sensitivity/insulin resistance/glucose tolerance/metabolic syndrome in children. A systematic search was carried out in Medline/PubMed, Embase, Scopus, Web of Science, and SciELO, covering the period from each database's respective start to 21 June 2021. Two researchers evaluated 7111 studies according to the inclusion criteria: original human studies, written in English or Spanish, evaluating fat-free mass/lean body mass in children and adolescents including both with and without insulin sensitivity/insulin resistance /glucose tolerance and metabolic syndrome and reported the differences between them in terms of fat free mass/lean body mass. The results of the studies were combined with insulin sensitivity, insulin, resistance, glucose tolerance and metabolic syndrome. The standardized mean difference (SMD) in each study was calculated and combined using the random-effects model. Heterogeneity between studies was tested using the index of heterogeneity (I2), leave-one-out sensitivity analyses were performed, and publication bias was assessed using the Egger and Begg tests. RESULTS Finally, 15 studies which compared groups defined according to different glucose homeostasis criteria or metabolic syndrome out of 103 eligible studies were included in this systematic review and 12 studies in the meta-analysis. Meta-analysis showed lower fat-free mass/lean body mass percentage in participants with insulin resistance/glucose tolerance/metabolic syndrome (SMD -0.47; 95% CI, - 0.62 to - 0.32) while in mass units (kg), higher values were found in the same group (SMD, 1.01; 95% CI, 0.43 to 1.60). CONCLUSIONS Our results identified lower values of fat-free mass/lean body mass (%) in children and adolescents with insulin resistance/glucose tolerance/metabolic syndrome and higher values of fat-free mass/lean body mass when these are expressed in kg. The evidence of the impact of lean mass on children's glucose homeostasis or metabolic syndrome is limited, so future studies research should focus on explaining the effect of fat-free mass/lean body mass on different metabolic outcomes. Moreover, it may be interesting to evaluate the quality (muscle density) or functional (muscle strength) outcomes in addition to both absolute (kg) and relative (%) values in future studies. The systematic review was prospectively registered at PROSPERO (registration number CRD42019124734; available at: http://www.crd.york.ac.uk/prospero [accessed: 05 April 2019]).
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Affiliation(s)
| | - Iris Iglesia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro Gomez-Bruton
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerardo Rodríguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Pediatría, Universidad de Zaragoza, Zaragoza, Spain
| | - José Antonio Casajús
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Hernan Morales-Devia
- Biblioteca General Alfonso Borrero Cabal, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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Fan Z, Shi Y, Huang G, Hou D, Liu J. Long-term changes in body composition and their relationships with cardiometabolic risk factors: A population-based cohort study. PLoS One 2021; 16:e0251486. [PMID: 33984012 PMCID: PMC8118322 DOI: 10.1371/journal.pone.0251486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to classify the latent body fat trajectories of Chinese adults and their relationships with cardiometabolic risk factors. Data were obtained from the China Health Nutrition Survey for 3,013 participants, who underwent six follow-up visits between 1993 and 2009. Skinfold thickness and other anthropometric indicators were used to estimate body composition. The latent growth model was used to create fat mass to fat-free mass ratio (F2FFMR) trajectory groups. Blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and high- and low-density lipoprotein-cholesterol were measured in venous blood after an overnight fast. Logistic regression was used to explore the relationships of F2FFMR trajectory with cardiometabolic risk factors. In men, four types of F2FFMR trajectory were identified. After adjustment for behavioral and lifestyle factors, age, and weight status, and compared with the Low stability group, the High stability group showed a significant association with diabetes. In women, three types of F2FFMR trajectory were identified. Compared to the Low stability group, the High stability group showed significant associations with diabetes and hypertension after adjustment for the same covariates as in men. Thus, in this long-term study we have identified three F2FFMR trajectory groups in women and four in men. In both sexes, the highly stable F2FFMR is associated with the highest risk of developing diabetes, independent of age and body mass. In addition, in women, it is associated with the highest risk of hypertension, independent of age and body mass.
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Affiliation(s)
- Zhaoyang Fan
- Department of Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yunping Shi
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Guimin Huang
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
- * E-mail:
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Lycett K, Kerr JA. A Helpful Reminder of BMI's Nuances but Little Support for the "Obesity Paradox". J Nutr 2021; 151:1051-1052. [PMID: 33758945 DOI: 10.1093/jn/nxab035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/12/2021] [Accepted: 01/28/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kate Lycett
- Centre for Social & Early Emotional Development, School of Psychology, Deakin University, Burwood, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Jessica A Kerr
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
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Misakian A, McLoughlin M, Pyle LC, Kolon TF, Kelly A, Vogiatzi MG. Case Report: Low Bone and Normal Lean Mass in Adolescents With Complete Androgen Insensitivity Syndrome. Front Endocrinol (Lausanne) 2021; 12:727131. [PMID: 34526969 PMCID: PMC8435790 DOI: 10.3389/fendo.2021.727131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Osteopenia and osteoporosis have been reported in adults with Complete Androgen Insensitivity Syndrome (CAIS). Little is known about changes in bone mineral density (BMD) in adolescents with CAIS and whether it is affected by early gonadectomy. Body composition data have not been reported. METHODS Single-center, retrospective study of CAIS adolescents who underwent dual-energy x-ray absorptiometry (DXA) (Hologic, Horizon A). Body composition is presented as lean and fat mass indices (LMI, FMI). Z-scores for lumbar spine areal BMD (LBMD), total body less head (TBLH), bone mineral content (BMC), LMI, and FMI were calculated using female normative data. Results are expressed as median and min, max. RESULTS Six females with genetically confirmed CAIS were identified-one with intact gonads and five with history of gonadectomy at 2-11 months. In the subject with intact gonads, LBMD-Z and TBLH BMC-Z were -1.56 and -1.26, respectively, at age 16 years. Among those with gonadectomy, LBMD-Z was -1.8 (-3.59 to 0.49) at age 15.6 years (12-16.8) and decreased in all three subjects who had longitudinal follow-up despite hormone replacement therapy (HRT). Adherence to HRT was intermittent. LMI-Z and FMI-Z were 0.1 (-1.39 to 0.7) and 1.0 (0.22 to 1.49), respectively. CONCLUSIONS These limited data indicate that adolescents with CAIS have bone mass deficit. Further studies are needed to understand the extent of BMD abnormalities and the effect of gonadectomy, especially early in childhood, and to establish the optimal HRT regimen for bone accrual. Data on lean mass are reassuring.
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Affiliation(s)
- Aaron Misakian
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- *Correspondence: Aaron Misakian,
| | - Michelle McLoughlin
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Louisa C. Pyle
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Thomas F. Kolon
- Division of Urology, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Andrea Kelly
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Maria G. Vogiatzi
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
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Hukportie DN, Li FR, Zhou R, Zou MC, Wu XX, Wu XB. Association of Predicted Lean Body Mass and Fat Mass With Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus: A Post Hoc Analysis of ACCORD Trial. Front Endocrinol (Lausanne) 2021; 12:719666. [PMID: 34777240 PMCID: PMC8578879 DOI: 10.3389/fendo.2021.719666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/21/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Lean body mass (LBM) and fat mass (FM) have been shown to have different associations with several chronic diseases but little is known about the sex-specific association of LBM and FM with diabetic nephropathy (DN) risk among participants with diabetes. METHODS Participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used in a post hoc analysis to examine the association of predicted LBM index (LBMI) and FM index (FMI) with incident DN risk (defined as a composite outcome of three types of predefined DN). Because of sex differences in body composition, analyses were conducted separately using sex-specific quartiles of predicted LBMI and FMI. RESULTS Of the 9,022 participants with type 2 diabetes (5,575 men and 3,447 women) included in this study, 5,374 individuals developed DN (3,396 in men and 1,978 in women). Higher quartiles of LBMI were associated with a reduced risk of DN while higher quartiles of FMI were associated with an increased higher risk of DN among men but not women. Compared with the lowest quartile, the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs)for the highest quartile of predicted LBMI and FMI were respectively 0.83 (95% CI 1.71 - 0.96) and 1.23 (95% CI 1.06-1.43) among men; and 0.92 (95% CI 0.63 - 1.33) and 1.14 (95% CI 0.79 - 1.63) among women. CONCLUSIONS Among participants with diabetes, predicted LBMI was inversely associated with risk of DN while predicted FMI was positively associated with an increased risk of incident DN among men but not women. Trial registration: ClinicalTrials.gov., no. NCT00000620.
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Affiliation(s)
- Daniel Nyarko Hukportie
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Fu-Rong Li
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Meng-Chen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Xiang Wu
- Department of General Surgery, 157Hospital, General Hospital of Guangzhou Military Command, Guangzhou, China
- *Correspondence: Xian-Bo Wu, ; Xiao-Xiang Wu,
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
- *Correspondence: Xian-Bo Wu, ; Xiao-Xiang Wu,
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