Association of visceral and total body fat with hypertension and prehypertension in a middle-aged Chinese population

Associations of maternal liver biomarkers in the first trimester with the risk of hypertensive disorders of pregnancy

This study aimed to evaluate the association between maternal liver biomarkers in early pregnancy and the risk of hypertensive disorders of pregnancy (HDP), as well as to evaluate interaction between liver enzymes and BMI on the development of HDP. Pregnant women in our study were recruited from the Zhoushan Pregnant Women Cohort. Participants who had their first prenatal follow-up and the blood pressure follow-up records, and measured liver biomarkers in the first trimester were eligible for inclusion in the study. A total of 10,610 pregnant women were included in the analysis, and 305 (2.87%) developed the HDP. There were positive associations between AST, GGT, ALP, HSI and SBP, as well as between ALT, GGT, ALP, HSI and DBP. In addition, AST/ALT level was negatively associated with DBP. The highest quartile of GGT, ALP, AST/ALT and HSI were significantly associated with 1.71-fold (95% Cl: 1.23-2.41), 1.53-fold (95% Cl: 1.10-2.14), 0.62-fold (95% Cl: 0.43-0.90) and 1.67-fold (95% Cl: 1.05-2.67) increased risk of HDP, respectively. There was no significant association between ALT, AST and HDP. These associations remained consistent in pregnant women with liver enzymes within the clinical reference range. Besides, we found an interaction between GGT and BMI (Pinteraction = 0.013) in the development of HDP. In summary, the level of GGT, ALP, AST/ALT and HSI were associated with the subsequent risk of HDP, even within the clinical reference range. And there was an interaction between liver biomarkers and BMI in the development of HDP. Our study showed the level of GGT, ALP, AST/ALT and HSI were associated with the subsequent risk of HDP. And there was an interaction between GGT and BMI in the risk of HDP.

Blood pressure patterns of hypertensive disorders of pregnancy in first and second trimester and contributing factors: a retrospective study

We aimed to investigate the blood pressure (BP) patterns of hypertensive disorders of pregnancy (HDP) in the first and second trimesters and its contributing factors, which may help us understand its pathogenesis and identify this group of diseases in a timely manner. SPSS 21.0 was used to describe the BP patterns of 688 HDP as well as 2050 normotensive pregnancies respectively before 28 gestational weeks, and the repeated measurements and two-way ANOVA was used to decide the significant difference of blood pressure in the same period. The results revealed blood pressure in HDP underwent a mid-pregnancy drop as normal while the drop was unremarkable in advanced-age or obesity pregnancies. Besides, we found blood pressure was significantly higher in patients during first and second trimesters, not just after 20 weeks. In conclusion, our study indicated a significant elevation of blood pressure had appeared before 20 weeks in HDP pregnancies, we should pay more attention to monitoring blood pressure before 20 weeks, especially for advanced age and obese women.IMPACT STATEMENTWhat is already known on this subject? Gestational hypertension, preeclampsia as well as eclampsia were supposed to have the similar pathogenesis and their time of onset was strictly defined after 20 gestational weeks, while the reason for the time point was not clear. On the other hand, higher blood pressure in the first trimester was associated with increasing risk of developing HDP, while the blood pressure(BP) pattern of normal as well as HDP pregnancy was still controversial, especially for the existence of mid-trimester drop.What do the results of this study add? Firstly, we found blood pressure in HDP underwent a mid-pregnancy drop as normal while the BP drop was unremarkable in advanced-age or obesity pregnancies. Secondly, we noticed the blood pressure in HDP was significantly higher than the normal before 20 weeks, which had not been proved before.What are the implications of these findings for clinical practice and/or further research? On one hand, both the abnormal elevation of BP and the development of the placenta happened in the first trimester suggested toxic substances caused by the defective placenta played a vital role in the onset and aggravation of HDP, which guides us to pay more attention to monitor blood pressure before 20 weeks, especially for advanced age and obesity pregnancies. On the other hand, our results about BP patterns in HDP help us identify this group of diseases in time which can contribute to a better outcome.

The association of body composition and fat distribution with hypertension in community-dwelling older adults: the Bushehr Elderly Health (BEH) program

BACKGROUND

A significant proportion of the global burden of disability and premature mortality has caused by hypertension. It seems that the relationship between obesity and hypertension is not only associated with excessive body fat mass (FM) but also with body adipose distribution patterns. The present study investigated the association between regional fat distribution using dual-energy X-ray absorptiometry and hypertension in older adults.

METHODS

This cross-sectional study was performed using the data from Bushehr Elderly Health Program (BEH) on a total of 2419 participants aged 60 and over. Hypertension was defined as SBP of at least 140 mmHg and/or DBP of at least 90 mmHg. SBP between 120 and 139 mmHg and/or a DBP between 80 and 89 mmHg were considered prehypertension. Participants underwent body composition measurement by dual-energy x-ray absorptiometry to analyze FM, fat-free mass (FFM) in trunk and extremities composition.

RESULTS

The results showed that 460 (19.02%) of participants had prehypertension, and 1,818 (75.15% ) had hypertension. The odds of having prehypertension (OR: 1.06, 95%CI: 1.01-1.12) and hypertension (OR: 1.08, 95%CI: 1.03-1.13) increased with a rise in total body FM percentage. Moreover, people with a higher FM to FFM ratio had increased odds of being prehypertensive (OR: 9.93, 95%CI: 1.28-76.99) and hypertensive (OR: 16.15, 95%CI: 2.47-105.52). Having a higher android to gynoid FM ratio was related to increased odds of being prehypertensive and hypertensive.

CONCLUSIONS

This study showed that a higher body FM, particularly in the android region, is associated with higher odds of having hypertension in older adults.

Mixed effects logistic regression analysis of blood pressure among Ghanaians and associated risk factors

Blood pressure (BP) control is a global health issue with an increase in BP beyond the normal BP leading to different stages of hypertension in humans and hence the need to identify risk factors of BP for efficient and effective control. Multiple BP measurement have proven to provide BP readings close to the true BP status of the individual. In this study, we used multiple BP measurement data on 3809 Ghanaians to determine risk factors associated with BP. The data were obtained from World Health Organization study on Global AGEing and Adult Health. We defined high blood pressure (HBP) as [Formula: see text] 130/80 mmHg or normal as [Formula: see text] 130/80 mmHg. We provide summary statistics and also used the Chi-Square test to assess significance of association between HBP versus risk factors of HBP. The aim of this study is to identify risk factors of BP using the mixed effects logistic regression model. Data were analyzed using R version 4.2.2. The results showed that the risk of high blood pressure (HBP) decreases across the three measurement periods. There is reduced risk (OR = 0.274, 95% CI = 0.2008, 0.405) of HBP among male participants relative to female participants. The risk (OR = 2.771, 95% CI = 1.8658, 4.1145) of HBP increased by 2.771-folds among those who are 60 years and above relative to those below the age of 60 years. Those whose work involves/requires vigorous exercise has 1.631-fold increase in the risk (OR = 1.631, 95% CI = 1.1151, 2.3854) of HBP relative to those whose work does not involve vigorous exercise. There is approximately 5-folds increased in the risk (OR = 4.896, 95% CI = 1.9535, 12.2268) of among those who have ever been diagnosed with diabetes. The results also revealed high risk (OR = 1.649, 95%CI = 1.1108, 2.4486) of HBP among those who have formal education. The risk (OR = 1.009, 95% CI = 1.0044, 1.0137) of HBP increases with increasing weight and a reduced risk (OR = 0.996, 95% CI = 0.9921, 0.9993) of HBP with increasing height. We found that sad experience, either mild, moderate or severe, is associated with a reduced risk of HBP. Those who have vegetable servings at least 2 cups per day have increased risk of HBP and those who have fruits servings at least 2 cups per day is associated with a reduced risk of HBP, however this is not statistically significant. To achieve success in BP control, programs should be designed with the aim of reducing weight, educate those with formal eduction on issues relating to HBP. Those whose work requires vigorous exercise are recommended to have regular check-ups to ensure that pressure build-up in the lungs is cleared. SBP is lower for women at young age but continue to increase after menopause as their BP increase becomes salt-sensitive. Hence there is need to give more attention to menopausal women so as to improve BP. Both young and old individuals are recommended to practice regular exercise since this has shown to reduce risk of being overweight or becoming diabetic and reduces the risk of HBP at yong age and old age. Also, to improve blood pressure control, programs for management of blood pressure or hypertension should focus more short stature individuals since such people are more likely to experience HBP.

Greenspace exposure and poststroke disability: A nationwide longitudinal study

INTRODUCTION

Exposure to greenspace has been reported to reduce stroke mortality, but there is a lack of evidence regarding poststroke disability. This study aimed to investigate the association between long-term greenspace exposure and the risk of poststroke disability.

METHODS

Based on the China National Stroke Screening Survey from 2013 to 2019, a total of 65,892 visits from 28,085 stroke survivors with ≥ 2 visits were included in this longitudinal study. Long-term greenspace exposure was assessed by a 3-year average of the Normalized Difference Vegetation Index (NDVI) and the proportion of green land cover according to participants' residential communities. Poststroke functional status was assessed with the modified Ranking Score (mRS) at each visit; a cutoff score > 2 indicated disability. Fixed effects regressions were used to examine the association of greenspace exposure with continuous mRS scores or binary indicators for disability.

RESULTS

The annual mean NDVI value was 0.369 (standard deviation = 0.120) for all visits among stroke survivors. With full adjustments, each 0.05 increase in NDVI was associated with a 0.056-unit (95 % confidence interval (CI): 0.034, 0.079) decrease in the mRS score and a 46.6 % (95 % CI: 10.0 %, 68.3 %) lower risk of poststroke disability. An L-shaped curve was observed for the nonlinear associations between NDVI and mRS score or disability. Additionally, each 1 % increase in grasslands, savannas, forest, and croplands was associated with 0.008- (95 % CI: 0.002, 0.014), 0.003- (95 % CI: 0.001, 0.005), 0.001- (95 % CI: -0.015, 0.018), and 0.002-unit (95 % CI: -0.003, 0.007) decreases in the mRS score, respectively.

CONCLUSIONS

Increasing greenspace was inversely associated with mRS score. Greenspace planning can be a potential intervention to prevent poststroke disability.

Body mass index, body fat percentage, and visceral fat as mediators in the association between health literacy and hypertension among residents living in rural and suburban areas

Background

Hypertension is a major cause of death and disability worldwide. Enhancing health literacy (HL) may help to alleviate the risk of hypertension and its burden. However, evidence on the association between HL and hypertension and potential mechanisms remain to be explored.

Objectives

This study examined the association between HL and hypertension; and explored whether body mass index (BMI), body fat percentage (PBF), and visceral fat (VF) were mediators of this association in people who resided in rural and suburban areas in Vietnam.

Methods

A cross-sectional survey was conducted from 1st July to 31st December 2019, involving 1655 residents and exploring participants' sociodemographic characteristics, HL, health-related behaviors, comorbidities, body composition, and blood pressure (BP). People with systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or using antihypertensive medication were classified as having hypertension. Multiple logistic regression and mediation analyses were used to explore associations.

Results

The hypertension prevalence was 41.9% (694/1,655). In adjusted models, a higher HL score was associated with a lower hypertension likelihood (OR = 0.96; 95%CI = 0.95–0.97; p < 0.001). Factors associated with a higher odd of hypertension were overweight/obese (OR = 1.69; 95%CI = 1.24–2.29; p = 0.001), high PBF (OR = 2.35; 95%CI = 1.85–2.99; p < 0.001), and high VF (OR = 2.27; 95%CI = 1.63–3.16; p < 0.001). Notably, PBF significantly mediated the association between HL and hypertension (indirect effect, OR = 0.99; 95%CI = 0.98–0.99; p = 0.009; percent mediated = 8.56%). The mediating roles of BMI and VF were not found.

Conclusion

The prevalence of hypertension was relatively high. People with better HL were less likely to have hypertension. The association between HL and hypertension was partially explained by PBF. Strategic approaches are required to improve people's HL and body fat which further help to manage hypertension in rural and suburban areas.

Comparative Assessment of the Utility of Anthropometric and Bioelectrical Impedance Indices as Potential Predictors of Hypertension within a Ghanaian Adult Population: A Cross-Sectional Study

Background

Hypertension is an important public health concern that is claiming millions of lives worldwide. In sub-Saharan African countries, where some of the highest prevalence rates are being recorded, sufficient attention has not been given to its control.

Objective

The aim of this study was to determine the association and predictive potential of different anthropometric and bioelectrical impedance analysis (BIA) measures for hypertension.

Methods

A total of 812 individuals (204 men and 608 women) were enrolled, and their blood pressure measurement was determined. Direct anthropometric measures (weight, height, waist circumference (WC), and hip circumference) and derived anthropometric measures (body mass index, conicity index, abdominal volume index (AVI), and body adiposity index) were determined. BIA indices investigated included visceral fat level (VF), percentage body fat (%BF), resting metabolic rate (RMR), and skeletal muscle mass.

Results

A prevalence of 31.28% was observed for hypertension in the total study population, with males having a slightly higher prevalence than females. Except for the skeletal muscle mass, all the other indices measured showed an increasing trend from normotension to prehypertension and hypertension. Age and visceral fat level showed the highest correlation with systolic blood pressure for both genders. Receiver operator characteristic analysis showed that age was the best predictor of hypertension in both genders, whereas, in predicting prehypertension, RMR was the best predictor in males, and WC was the best predictor in females. VF, WC, and AVI were other good predictors of hypertension in this study population. However, BMI and % BF had a low predictive value for hypertension.

Conclusion

The result of this study shows that within this study population in addition to age, measures of central obesity rather than general obesity are the likely drivers of the hypertension epidemic; thus, measures aimed at controlling central obesity may offer some therapeutic and preventive advantage.

Chinese Visceral Adiposity Index Is More Closely Associated With Hypertension and Prehypertension Than Traditional Adiposity Indices in Chinese Population: Results From the REACTION Study

PURPOSE

The optimal adiposity index that is strongly associated with hypertension or prehypertension remains inconclusive in Chinese population. This study aimed to investigate the relationship between Chinese visceral adiposity index (CVAI) and hypertension and prehypertension, as well as to compare the discriminative power of CVAI, visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), low-density lipoprotein cholesterol (LDL-C), and waist-to-hip ratio (WHR) with hypertension and prehypertension in Chinese general population.

PATIENTS AND METHODS

A total of 34732 participants from REACTION study were recruited. Multiple logistic regression analyses were performed to detect the association between adiposity indices (CVAI, VAI, BMI, WC, WHtR, WHR, LDL-C) and hypertension and prehypertension.

RESULTS

Multivariate logistic regression analysis showed that compared with other obesity indices, CVAI remained significantly associated with hypertension and prehypertension (Hypertension: odds ratio (OR) 3.475, 95% confidence interval (CI) 3.158-3.824, p<0.001 in total subjects; OR 2.762, 95% CI 2.369-3.221, p<0.001 in men; OR 3.935, 95% CI 3.465-4.469, p<0.001 in women, Prehypertension: OR 2.747, 95% CI 2.460-3.068, p<0.001 in total subjects; OR 2.605, 95% CI 2.176-3.119, p<0.001 in men; OR 2.854, 95% CI 2.465-3.304, p<0.001 in women).In a stratified analysis, CVAI was significantly associated with hypertension and prehypertension at any level of blood glucose, age or estimated glomerular filtration rate(eGFR).

CONCLUSION

CVAI is significantly associated with hypertension and prehypertension. CVAI shows the superior discriminative ability for hypertension and prehypertension compared with VAI, BMI, WC, WHtR, WHR and LDL-C in Chinese general population.

Lower Visceral Fat Area in Patients with Type 2 Diabetic Peripheral Neuropathy

OBJECTIVE

There is preliminary evidence that visceral fat area (VFA) was associated with the presence of type 2 diabetic peripheral neuropathy (DPN) in the Korean population; however, no studies have reported the association in Chinese population. The purpose of this study was to explore the possible correlation of VFA with DPN in such a population.

METHODS

A total of 2498 hospitalized patients with type 2 diabetes mellitus (T2DM) undergone VFA measurement, and were divided into DPN group (n=900) and non-DPN group (n=1594). The association of VFA with the presence of DPN was evaluated by correlation and multiple logistic regression analyses, generalized additive model with a smooth curve fitting, and receiver operating characteristic (ROC) curve analysis.

RESULTS

The VFA was significantly lower in the DPN group than in the non-DPN group (P < 0.001). VFA was significantly and positively associated with sural nerve conduction velocity (SNCV) and amplitude potential (SNAP) and negatively associated with the presence of DPN (all P< 0.001); there was no significant difference in the curve fitting (P = 0.344). Multivariate logistic regression analysis showed that the risk of presence of DPN decreased progressively across the VFA quartiles (P for trend < 0.001) and was significantly lower in patients in the highest VFA quartile than in those in the lowest quartile (OR: 0.382, 95% CI 0.151-0.968, P< 0.001) after multivariate adjustment. The ROC analysis revealed that the best cut-off value of VFA for predicting the presence of DPN was 50.5cm² (sensitivity 84.40%; specificity 34.00%).

CONCLUSION

These results suggest that lower VFA level may be associated with increased risk of the presence of DPN in T2DM patients.

The effect of ABCA1 gene DNA methylation on blood pressure levels in a Chinese hyperlipidemic population

Hypertension is an important public health challenge worldwide. Epigenetic studies are providing novel insight into the underlying mechanisms of hypertension. We investigated the effect of DNA methylation in ATP-binding cassette transporter 1 (ABCA1) gene on blood pressure levels in a Chinese hyperlipidemic population. We randomly selected 211 individuals with hyperlipidemia who had not received any lipid-lowering treatment at baseline from our previous statin pharmacogenetics study (n = 734). DNA methylation loci at the ABCA1 gene were measured by MethylTarget, a next generation bisulfite sequencing-based multiple targeted cytosine-guanine dinucleotide methylation analysis method. Mean DNA methylation level was used in statistical analysis. In all subjects, higher mean ABCA1_B methylation was positively associated with systolic blood pressure (SBP) (β = 8.27, P = 0.008; β = 8.78, P = 0.005) and explained 2.7% and 5.8% of SBP variation before and after adjustment for lipids, respectively. We further divided all patients into three groups based on the tertile of body mass index (BMI) distribution. In the middle tertile of BMI, there was a significantly positive relationship between mean ABCA1_A methylation and SBP (β = 0.89, P = 0.003) and DBP (β = 0.32, P = 0.030). Mean ABCA1_A methylation explained 11.0% of SBP variation and 5.3% of DBP variation, respectively. Furthermore, mean ABCA1_A methylation (β = 0.79; P = 0.007) together with age and gender explained up to 24.1% of SBP variation. Our study provides new evidence that the ABCA1 DNA methylation profile is associated with blood pressure levels, which highlights that DNA methylation might be a significant molecular mechanism involved in the pathophysiological process of hypertension.

[The role of interval training in the physical rehabilitation of strength sports athletes with hypertension: a randomized controlled study]

OBJECTIVE

To evaluate the effect of high-intensity interval aerobic work on blood pressure and body composition in strength sports athletes of heavy weight categories.

MATERIAL AND METHODS

The examination and physical rehabilitation of 55 strength sports athletes of heavy weight categories with arterial hypertension were performed. Athletes were randomized into two groups: the main group (n=35) and the control group (n=20). The main group athletes trained 120 days (3 times a week) on a bicycle ergometer according to the high-intensity interval protocol, and the control group participants trained 120 days (3 times a week) according to their traditional strenght protocol. All athletes underwent a complex examination, including: a survey, examination, three-time measurement of blood pressure, bioelectrical impedance analysis and calculations of body composition indices, Before and after the physical rehabilitation.

RESULTS

After 120 days of physical rehabilitation, there was an improvement in body composition and a significant decrease in blood pressure: systolic blood pressure by 4.7%, diastolic blood pressure by 5.6%.

CONCLUSIONS

High-intensity aerobic interval work, regardless of the athlete's body composition, has a therapeutic and prophylactic effect on the cardiovascular system. The aerobic workout training protocol taking into account metabolic variables, that we developed, will allow athletes to effectively and safely influence the prevention and treatment of hypertension.

Role of body visceral fat in hypertension and dyslipidemia among the diabetic and nondiabetic ethnic population of Tripura-A comparative study

BACKGROUND

Excess fat in the upper part of human body correlates with increased mortality and risk for diabetes, dyslipidemia, and hypertension. In India, there are very limited data available on the association of excess body visceral fat with hypertension and dyslipidemia independent of obesity and diabetes.

OBJECTIVE

The objective of this study is to assess the role of body visceral fat percentage in hypertension and dyslipidemia among diabetic and nondiabetic indigenous ethnic population of Tripura.

METHODS

Random blood sugar test was done for each of the study subjects with the help of a standard and validated glucometer. Then, blood samples were obtained after an 8-12-h overnight fast using vacutainer. Later on, all the blood samples were transported to the MRU laboratory at Agartala Government Medical College maintaining cold chain for following investigations: (1) FBS, PP by GOD-POD method; (2) HbA1c by immunoturbidimetric method; (3) cholesterol estimation by CHOD-PAP method; and (4) triglyceride estimation by glycerol phosphate oxidase method.

RESULTS

In this study, it has been found that 62.5% diabetic subjects having high body visceral fat are suffering from Dyslipidemia, whereas only 42.9% nondiabetic subjects with high body visceral fat percentage are having dyslipidemia. Fisher's exact test showed association between diabetes status and body visceral fat (P = 0.048). It has been also observed that there was significant (P < 0.05) association between hypertension and body visceral fat among local indigenous ethnic population of Tripura.

CONCLUSION

Body visceral fat percentage is significantly associated with hypertension, dyslipidemia, and type-2 diabetes among indigenous ethnic population of Tripura.

The Visceral Adipose Index in Relation to Incidence of Hypertension in Chinese Adults: China Health and Nutrition Survey (CHNS)

Hypertension is the most crucial single contributor to global burden of disease and mortality, while weight loss as a non-pharmacological strategy is recommended to reduce blood pressure. This study aims to examine the association between visceral adipose index (VAI) and hypertension in Chinese adults. Data were collected from the China Health and Nutrition Survey (CHNS), consisting of 8374 apparently healthy participants aged ≥18 years in the 2009 CHNS for cross-sectional analysis, and 4275 participants at entry from 2009 to 2011 for cohort analysis. Height, weight, waist circumference, blood pressure (BP), and blood lipid were measured. Information of population characteristics, smoking status, alcohol consumption, physical activity, and diet were determined by validated questionnaire. Higher VAI scores were significantly associated with higher BP levels and higher risk of hypertension after adjustment with potential confounders (all p-trend < 0.001). The adjusted hazard ratio of hypertension was 1.526 (95%CI: 1.194, 1.952; p-trend < 0.01) for participants in the highest quartile of VAI scores when compared with those in the lowest quartile after adjustment for age, physical activity, antihypertensive medication, total energy intake, salt intake, and other major lifestyle factors. VAI scores were significantly, longitudinally associated with hypertension development among apparently healthy Chinese adults.

Changes to cardiovascular risk factors over 7 years: a prospective cohort study of in situ urbanised residents in the Chaoyang District of Beijing

OBJECTIVES

To examine changes in cardiovascular risk factors of in situ urbanised residents between 2010 and 2017.

DESIGN

Population-based cohort study.

SETTING

The Chaoyang District of Beijing, China.

PARTICIPANTS

A total of 942 in situ urbanised rural residents aged 35-64 who participated in the cardiovascular disease (CVD) risk factors study in China between 2010 and 2017.

MAIN OUTCOME MEASURES

Lifestyles (smoking, drinking and effective exercise) and medical history (diabetes, hypertension, dyslipidaemia, overweight and obesity) were self-reported. New cases of diabetes, hypertension, dyslipidaemia, overweight and obesity were confirmed by physical examination or blood biochemical tests. Multiple linear regression and log-binomial models analyses adjusted for sociodemographic confounders were conducted to evaluate any changes of clinical indexes and to estimate prevalence rate ratios (PRRs), respectively.

RESULTS

During the study period of 2010-2017, diastolic blood pressure elevated by 3.55 mm Hg, central blood pressure increased by 4.39 mm Hg, total cholesterol decreased by 0.29 mmol/L and hypertension increased significantly (PRR=1.25, p<0.05) after adjusting for demographic, lifestyle and family history factors. Effective exercise rate (PRR=1.57), prevalence of diabetes (PRR=1.36) and dyslipidaemia (PRR=1.19) all increased from 2010 to 2017. However, these changes were not significant after adjusting for confounders (p>0.05). Prevalence of smoking, drinking, hypertension, overweight and obesity was significantly higher in males than females in both 2010 and 2017. In 2017, the 10-year risk of atherosclerotic CVD increased in 29.8% of participants and decreased in 6.1% of individuals.

CONCLUSIONS

CVD risk factors augmented remarkably for in situ urbanised rural residents aged 35-64 in the Chaoyang District of Beijing, especially those indicators related to blood pressure. Awareness of the direction and magnitude of these risk factor changes may be beneficial in informing targeted strategies for preventing CVDs of in situ urbanised populations.

Association of triglyceride-glucose index and its interaction with obesity on hypertension risk in Chinese: a population-based study

Hypertension and triglyceride-glucose (TyG) index are both closely associated with insulin resistance, respectively, while the role of TyG index and the association between TyG index and obesity on hypertension risk remain unclear. This study aimed to examine the association and interactive effect of TyG index and obesity on hypertension risk. There was a population-based cross-sectional survey in Henan, China. Multivariate logistic regression analysis was performed to estimate the association between TyG index and the risk of prehypertension and hypertension. The area under curves (AUC) of TyG index and joint indicators (TyG index and obesity indices) was calculated to assess the predictive ability of hypertension. The additive interaction was computed to evaluate the interactive effect between TyG index and obesity. Compared with the lowest TyG quartile, participants in the highest quartile had an increased risk of prehypertension (odds ratio (OR): 1.69, 95% confidence interval (CI): 1.18-2.44) and hypertension (OR: 2.53, 95% CI: 1.80-3.57). The AUCs of joint indicators were significantly higher than TyG index in predicting hypertension (all P < 0.01). Presence of higher TyG index enhanced the ORs of waist-to-height ratio (WHtR) and percent body fat (PBF) from 3.50 (95% CI: 2.55-4.80) to 6.51 (95% CI: 4.81-8.82), and from 3.88 (95% CI: 2.78-5.42) to 7.09 (95% CI: 5.11-9.84) with significant additive interaction on hypertension, respectively. Increased TyG index was significantly associated with a higher risk of prehypertension and hypertension in Chinese adults. Besides, our results also demonstrated the interactions of TyG index and WHtR and PBF on hypertension risk.

Study of correlations between metabolic risk factors, PWV and hypertension in college students

Objective: Obesity, dyslipidemia and diabetes have been recognized as risk factors of hypertension in the general population. This study focused on college students and correlations between serum lipids, serum uric acid, fasting plasma glucose, serum creatinine, body mass index, brachial-ankle pulse wave velocity and hypertension. The results suggested that there was no relevance between serum lipids and hypertension. However, it came out that hypertension is associated with normal fasting plasma glucose, BMI (thinness and normal weight), normal serum creatinine. Methods: A total of 5185 students were enrolled, and their blood pressure, height and weight were measured. 285 of the students were selected to take physical examinations including serum uric acid, total cholesterol, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol, fasting plasma glucose, serum creatinine, blood urea nitrogen, ankle-brachial index and brachial-ankle pulse wave velocity measured. Results: The values of systolic blood pressure(SBP), diastolic blood pressure(DBP), serum uric acid, fasting plasma glucose(FPG), serum creatinine, body mass index(BMI), and brachial-ankle pulse wave velocity(baPWV) were higher in hypertension group than those in non-hypertension group (P < .001, <0.001, <0.001, = 0.009, = 0.07, <0.001, <0.001, respectively). Logistic regression showed correlations between hypertension and hyperuricemia (OR = 2.975, 95%CI: 1.672-5.291), obesity (OR = 2.814, 95%CI: 1.297-6.105), fasting plasma glucose (OR = 2.184, 95%CI: 1.090-4.378) and brachial-ankle pulse wave velocity (OR = 1.005, 95%CI: 1.003-1.007). The AUC was 0.786 (95%CI: 0.729-0.842, P < .0001). We can draw a conclusion that hyperuricemia, obesity, fasting plasma glucose and brachial-ankle pulse wave velocity, listed in descending order of influence, are risk factors for hypertension in college students.

Visceral Fat Area, Not Subcutaneous Fat Area, is Associated with Cardiac Hemodynamics in Type 2 Diabetes

BACKGROUND

This study was conducted in patients with type 2 diabetes mellitus (T2DM) to assess the association between visceral fat area (VFA) and cardiac hemodynamics.

METHODS

A total of 568 patients with type 2 diabetes (mean age 54±12 years; 40.8% of women) were enrolled. Visceral fat area (VFA, m²) and subcutaneous fat area (SFA, m²) were evaluated by a bioelectrical impedance analyzer. Cardiac hemodynamics were measured by echocardiography, and other clinical and laboratory variables were also assessed and recorded. Patients were divided into those with VFA ≤ 100 (n=369) and those with VFA > 100 (n=199).

RESULTS

VFA, SFA, LVMI (left ventricular mass index), left atrial diameter, left ventricular diastolic diameter (LvDd), interventricular septal thickness (IVST), left ventricular systolic diameter (LvSd), and posterior wall thickness (PWT) levels in high-V groups were significantly higher than those in low-V groups. Correlation analysis showed that VFA was positively correlated with LVMI (r=0.120, p=0.004), LVM (r=0.249, p<0.0001), left atrial diameter (r=0.375, p<0.0001), aortic root diameter (r=0.243, p<0.0001), left ventricular systolic diameter (LvSd) (r=0.211, p<0.0001) and negatively correlated with LVEF (r=-0.107, p=0.011). In multivariate linear regression analysis, VFA was the strongest independent determinant of LVMI (β=0.04, p=0.016), LVEF (β=-0.01, p=0.023), and left atrial diameter (β=0.035, p<0.0001), Internal diameter of the aortic root (β=0.014, p<0.0001) and LvSd (β=0.017, p<0.0001). In addition, the VFA also better predicted cardiovascular disease risk with AUC of 0.609 (95% CI:0.563-0.656), compared with SFA, waist-hip ratio (WHR), in a statistically significant manner.

CONCLUSION

We found a significant correlation between VFA (but not SFA) and cardiac hemodynamic parameters. The VFA has advantages as a predictor of visceral obesity and is significantly associated with the development of cardiovascular risk factors (CVD) in T2DM patients.

Interaction of lipid accumulation product and family history of hypertension on hypertension risk: a cross-sectional study in the Southern Chinese population

OBJECTIVES

This study aimed at investigating the applicability of a novel index based on waist circumference (WC) and triglyceride (TG) which was named lipid accumulation product (LAP) in the Southern Chinese population, and compared the predictive effects of LAP and other obesity indicators on hypertension risk. Moreover, this study investigated the interactive effects of LAP and family history of hypertension.

METHODS

A total number of 2079 of community-dwelling adults in Southern China were enrolled in this cross-sectional study. The participants underwent questionnaire surveys, anthropometric tests and laboratory examinations. Themultinomial logistic regression model and receiver operating characteristic curves, including LAP, body mass index (BMI), waist-to-hip ratio (WHR), WC and TG, were used to assess the association between hypertension risk and obesity indexes. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).

RESULTS

Higher LAP levels have a relatively higher risk of having hypertension in both sexes (males: adjusted OR=2.79 per SD increase, 95% CI 1.43 to 5.44, p<0.001; females: adjusted OR=3.15, 95% CI 1.56 to 6.39, p<0.001). LAP (area under the curve=0.721; 95% CI 0.680 to 0.761) is a better indicator in identifying hypertension risk than BMI, WHR and TG in females, but WC performed better in males. A significant interaction between LAP and family history of hypertension was observed in males (RERI=1.652, 95% CI 0.267 to 3.037; AP=0.516, 95% CI 0.238 to 0.794; SI=3.998, 95% CI 0.897 to 17.820), but there is no statistically significant difference in females.

CONCLUSIONS

LAP significantly associates with hypertension risk in the Southern Chinese population. It has better performance than BMI, WHR and TG on predicting hypertension risk of the Southern Chinese female population. Moreover, LAP and family history of hypertension might synergistically increase the risk of hypertension.

Visceral fat reduction is positively associated with blood pressure reduction in overweight or obese males but not females: an observational study

BACKGROUND

Visceral adiposity has been reported to play a key role in hypertension compared with other measurements of regional or general obesity. The aim of current study was to evaluate the relationship between visceral fat reduction and changes in blood pressure in a group of overweight or obese Chinese individuals.

METHODS

An observational study was conducted with 168 participants (ChiCTR-OOC-17012000). Body composition, blood parameters and blood pressure were assessed at the beginning and end of the intervention. Males and females were categorized separately into quartiles according to changes in visceral fat during the intervention. Multiple linear regression models were used to assess the associations of changes in systolic and diastolic blood pressure with changes of visceral fat area, adjusted for potential confounders.

RESULTS

Changes in visceral fat was significantly associated with systolic and diastolic blood pressure in men for systolic (β = 0.234, 95% CI: 0.103, 0.365; p = 0.001) and diastolic blood pressure (β = 0.237; 95% CI: 0.127, 0.346; p <0.001), but not in women after adjustment for the same potential confounders for systolic blood (β = - 0.003, 95% CI: - 0.260, 0.255; p = 0.984) and diastolic blood pressure (β = 0.101, 95% CI: - 0.072, 0.273; p = 0.249).

CONCLUSIONS

A positive association was observed between reduction in visceral fat and improvements in both systolic blood and diastolic blood pressures in males but not females in a 12-week meal replacement intervention.

TRIAL REGISTRATION

The Ethics Committee of Peking University Health Science Center approved the study protocol on 6 July 2017. The authors confirm that all ongoing and related trials for this intervention were carried out following the rules of the Declaration of Helsinki of 1975 and registered (ChiCTR-OOC-17012000). http://www.chictr.org.cn/showprojen.aspx?proj=20426.

Comparing the ability of anthropometric indicators in determining the prevalence of hypertension among Indian tribes

OBJECTIVE

We compared the ability of the selected anthropometric indicators to best predict the prevalence of hypertension among the Indian tribes.

METHODS

A cross-sectional study was undertaken among 1431 adult participants (705 males and 726 females) between the ages of 20 and 60 years from six major tribes in India. Selected anthropometric indicators such as body mass index (BMI), waist-hip-ratio (WHR), waist-height-ratio (WHtR), percentage body fat (PBF), visceral fat (VF), minimum-waist-circumference (MWC) and sum-of-the-four skinfold thickness (SF4), along with the physiological parameters such as blood pressure were recorded. Discriminant analysis (DA) was performed to examine and compare the ability of the selected anthropometric indicators towards classifying hypertension among males, females and the total population.

RESULTS

Significant independent association was observed for hypertension and similar conditions within gender and selected age-group categories. The overall hypertension prevalence among the studied tribes was observed at 12.6%. Standardized function coefficients (SFCs) in discriminant analysis revealed PBF(0.89, 0.36, and 0.76 for overall, males, and females respectively) as the most powerful discriminator of hypertension. In addition, visceral fat (0.74, 1.46, and 0.58 for overall, males and females respectively) was observed to be the other significant indicator of hypertensive blood pressure. These exploratory findings for the first time indicate fat deposition, rather than body density alone, as an emerging physiological and metabolic risk among Indian tribes.

CONCLUSION

In the context of the highly prevalent chronic undernutrition, internal fat deposition is a major classifying factor of physiological and metabolic intolerance. It also indicates the increasing trend in lifestyle changes and the associated adversities among the Indian tribes.

Salem A. Metformin, sitagliptin, and liraglutide modulate serum retinol-binding protein-4 level and adipocytokine production in type 2 diabetes mellitus rat model

Many adipocytokines correlate with obesity and insulin resistance. We examined the effects of metformin, sitagliptin, and liraglutide in diabetic rats. Group 1: control normal (CN) rats received oral saline daily. Group 2: diabetic non-treated (DNT) rats were injected with streptozotocin (STZ) to get diabetic then after 72 h received oral saline daily. Group 3: rats were injected with STZ then after 72 h were treated with metformin (200 mg/kg) orally. Group 4: rats were injected with STZ then after 72 h received sitagliptin 6 mg/kg orally twice daily. Group 5: rats were injected with STZ then after 72 h were treated with liraglutide at a dose of 0.3 mg/kg every 12 h subcutaneous injection. After 8 weeks, body mass, fasting blood glucose, adipocytokines, and lipid profile were assessed. From the results, we concluded that the 3 drugs improved blood glucose and insulin resistance with correction of adipocytokines serum levels; however, the liraglutide-treated group was the only group that showed significant body mass reduction.

Association of Age-Related Trends in Blood Pressure and Body Composition Indices in Healthy Adults

Purpose: Adiposity is one of the important determinants of blood pressure. The aim of this study is to evaluate the association between blood pressure and body composition indices throughout the whole lifespan of healthy adults.

Patients and Methods: This study was from an ongoing cross-sectional survey of the Chinese health wherein data included basic physiological parameters. Partial Pearson correlation analysis was used to assess the correlation between blood pressure and body composition indices. Multiple linear regression analysis was used to assess the association of body mass index, lean mass percent, and visceral fat rating against blood pressure in each age group.

Results: In the whole population stratified by gender, while body mass index had the highest r-value of correlation with systolic blood pressure in both males (r = 0.296, p < 0.001) and females(r = 0.237, p < 0.001), and fat mass percent had the highest r-value of correlation with diastolic blood pressure in males (r = 0.351, p < 0.001) and females(r = 0.277, p < 0.001), the strength of association with blood pressure were similar across most of the body composition indices. In multiple linear regression analysis, both body mass index and visceral fat rating were positively while lean mass percent was negatively associated with blood pressure in all age groups in both genders, whereas all the association was weaker in the elderly compared to the younger.

Conclusion: Maintain the total body fat in a favorable range and appropriately increase the body muscle mass is a strategy to reduce the occurrence of cardiovascular event by decreasing the risk of hypertension through the whole adult life.

Sex-specific relationship between visceral fat index and dyslipidemia in Chinese rural adults: The Henan Rural Cohort Study

The study aimed to explore the relationship between visceral fat index (VFI) and dyslipidemia and evaluate the efficiency of VFI as a marker for identifying dyslipidemia in Chinese rural adults. The cross-sectional study recruited 35,832 aged 18-79 years eligible participants from The Henan Rural Cohort Study. VFI was measured by bioelectrical impendence methods and classified into sex-specific quartiles. Fasting blood samples were collected. Logistic regression models with VFI as a categorical variable and restricted cubic spline regression models with VFI as a continuous variable were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Receiver-operating characteristic (ROC) curve was conducted to evaluate the identifying performance of VFI. The age-standardized prevalence of dyslipidemia was 29.80% and 26.01% in male and female, respectively. Increasing VFI quartiles were significantly positively related to the risk of dyslipidemia and its components (P_{for trend} < 0.01). The adjusted ORs (95% CIs) for per 1-SD increase in VFI were 2.11 (2.02-2.20) and 1.52 (1.47-1.56) in male and female, respectively, and dose-response relationships were observed in both genders (P_{for nonlinearity} < 0.01). In addition, area under the curves (AUCs) in male (0.697) was larger than in female (0.655) (P < 0.05). VFI was significantly positively related to the risk of dyslipidemia and its components, and the risk was shown to be more prominent in male. Meanwhile, dose-response relationships were observed in both genders. Furthermore, VFI might be a relatively effective marker for identifying dyslipidemia in male, but not in female.

Comparison of adiposity indices in relation to prehypertension by age and gender: A community-based survey in Henan, China

BACKGROUND

To compare the efficiency of bioelectrical indices (visceral fat index [VFI], percentage body fat [PBF]) and anthropometric indices (body mass index, waist circumference, waist-to-height ratio, a body shape index ) in the relation to prehypertension (120-139/80-89 mm Hg) among the Chinese population.

METHODS

Using stratified multistage random sampling method, a general population-based sample of 11 175 adults in Henan province were selected from 2013 to 2015. The individuals were divided into three categories by blood pressure levels: normotension (<120 and 80 mm Hg), stage 1 prehypertension (120-129/80-84 mm Hg) and stage 2 prehypertension (130-139/85-89 mm Hg).

RESULTS

VFI and PBF tended to increase with age in men and women. However, for each age-specific group, men tended to have higher VFI than women (all P < 0.01) and women tended to have greater PBF (all P < 0.0001). The odds ratios (OR) and area under the receiver operating characteristic curves for prehypertension associated with adiposity indices declined with age. VFI and PBF showed higher standardized adjusted ORs for prehypertension in young (~40 years) men (VFI: 2.02-3.05; PBF: 1.82-2.80) and young women (VFI: 1.90-2.58; PBF:1.70-2.29). Moreover, based on Youden's index, VFI and PBF exhibited the superiority for identifying prehypertension in men (0.20-0.32) and women (0.31-0.39), respectively.

CONCLUSION

In summary, there was stronger association of VFI and PBF with prehypertension in men than in women, respectively, especially for young adults.

Obesity, Visceral Fat, and Hypertension-Related Complications

Background: Hypertension and obesity are very common and complex cardiovascular (CV) risk factors. Our aim was to provide a comprehensive assessment of associations between visceral fat depots and vascular or cardiac complications of hypertension. Methods: All the consecutive patients (age: 45-80 years old) scheduled for elective coronary angiography in the Department of Cardiology were screened, and 400 patients were included into the study group. All the patients had a comprehensive clinical assessment focused on hypertension and obesity, risk factors, fat depots, and several hypertension-related vascular or cardiac complications. Results: The study group (n = 400; F/M: 140/260; age: 61 ± 7 years) included patients with hypertension (n = 354; 88.5%) and normal blood pressure (n = 46; 11.5%) and individuals with obesity (n = 192; 48%), diabetes (n = 139; 35%), metabolic syndrome (n = 240; 60%), and coronary artery disease (n = 286; 71%). Patients with higher degrees of hypertension (grade 3 vs. 2 vs. 1) showed increased body mass index (BMI) and waist circumference and ultrasound indexes of perivascular, epicardial, and abdominal visceral fat with no differences in age, waist-hip ratio, and subcutaneous fat. Both visceral fat depots: perivascular fat (carotid extra-media thickness) and abdominal visceral fat (intra-abdominal thickness) assessed as single measures and ratios were significantly increased in hypertensive patients with high versus low global CV risk in a hypertension-focused risk model (differences more pronounced in patients ≤60 years old). Visceral fat parameters were not independent, but rather additive to general obesity (BMI), except for visceral abdominal fat depot. Conclusions: Visceral abdominal and perivascular fat depots assessed as ultrasound indexes are associated with complications of hypertension and CV risk indicators, especially in patients with a mild-to-moderate hypertension and in younger patients.

Maternal prepregnancy BMI or weight and offspring's blood pressure: Systematic review

Emerging evidence suggests that maternal prepregnancy body mass index or weight (MPBW) may be associated with offspring's blood pressure (BP). Therefore, we conducted a systematic review-following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement-to assess and judge the evidence for an association between MPBW with offspring's later BP. Five data bases were searched without limits. Risk of bias was assessed using the "Tool to Assess Risk of Bias in Cohort Studies," and an evidence grade was allocated following the World Cancer Research Fund criteria. Of 2,011 publications retrieved, 16 studies (all cohort studies) were included in the systematic review; thereof, 5 studies (31%) were rated as good-quality studies. Overall, data from 63,959 participants were enclosed. Systolic BP was analysed in 15 (5 good quality), diastolic BP in 12 (3 good quality), and mean arterial pressure in 3 (no good quality) studies. Five good-quality studies of MPBW with offspring's systolic BP as the outcome and 1 good-quality study with offspring's diastolic BP as the outcome observed a significant association. However, after adding offspring's anthropometry variables to the statistical model, the effect attenuated in 4 studies with systolic BP to nonsignificance, the study with diastolic BP remained significant. No good-quality studies were found with respect to offspring's later mean arterial pressure. In conclusion, this systematic review found suggestive, but still limited, evidence for an association between MPBW with offspring's later BP. The available data suggest that the effect might be mainly mediated via offspring's anthropometry.

Dose-response relationship between visceral fat index and untreated hypertension in Chinese rural population: the RuralDiab study

The study aimed to explore the association of visceral fat index (VFI) with untreated hypertension in different genders and evaluate the practicability of VFI as a marker for discriminating untreated hypertension in Chinese rural population. A total of 12,536 eligible participants aged 35 years and older were derived from the RuralDiab study in China. VFI was assessed with bioelectrical impendence methods and divided into sex-specific quartiles. Logistic regression and restricted cubic spline regression were performed. Receiver operating characteristic curve was applied to analyze the discriminating performance of VFI. Meanwhile, a meta-analysis was conducted to validate the result of this study. Compared with the lowest VFI quartile, the adjusted odds ratios (ORs) and 95% confidence interval (95% CI) in the highest VFI quartile were 3.68 (2.91-4.66) in male and 2.63 (2.12-3.25) in female (P_trend < .01). Nonlinear increasing trends about the risk of untreated hypertension were observed with the continuously increasing VFI in both genders (P_linearity < .01). The sensitivity and specificity in the optimal cutoff values for VFI were 58.37% and 62.26% in male, and 49.09% and 66.67% in female. The area under the curves (95% CI) were 0.64 (0.63-0.66) in male and 0.61 (0.60-0.62) in female. Meta-analysis results displayed the pooled odds ratios (95% CI) of 2.65 (1.79-3.93) in male and 2.27 (1.74-2.95) in female. VFI was significantly positively correlated with the risk of untreated hypertension, and dose-response relationships were observed in both genders in Chinese rural population. However, VFI as a marker had limited potential for discriminating untreated hypertension.

Elucidating the role of adipose tissue secreted factors in malignant transformation

Although there is a growing number of incidences of obesity and obesity-linked cancers, how excess adiposity actually causes cancer has not been fully explained. Our previous study showed that removal of visceral adipose tissue significantly reduced the number of ultraviolet radiation (UVR)-initiated, high-fat diet-promoted skin cancers. This commentary focuses on our recently published study (Chakraborty, et al., 2017) which demonstrated that fibroblast growth factor-2 (FGF2) released from visceral adipose tissue is a key factor in the malignant transformation of epithelial cells. Within this commentary we have provided additional interpretations and new data in support of the role of FGF2 in adiposity-associated tumorigenesis.

Plasminogen activator inhibitor links obesity and thrombotic cerebrovascular diseases: The roles of PAI-1 and obesity on stroke

One of the global socioeconomic phenomena occurred during the last decades is the increased prevalence of obesity, with direct consequence on the risk of developing thrombotic disorders. As the physiological inhibitor of tissue plasminogen activator (tPA) and urokinase plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1) is well known for its role in fibrinolysis. More and more evidences have shown that PAI-1 involves in physiopathologic mechanisms of many diseases and metabolic disorder. Increased serum level of PAI-1 has been observed in obesity and it also contributes to the development of adipose tissue and then has effects on obesity. Meantime, obesity affects also the PAI-1 levels. These evidences indicate the complicated interaction between PAI-1 and obesity. Many clinic studies have confirmed that obesity relates to the stroke outcome although there are many contradictory results. Simultaneously, correlation is found between plasma PAI-1 and thrombotic cerebrovascular diseases. This article reviews contemporary knowledge regarding the complex interplay of obesity, PAI-1 and stroke.

Association of body composition assessed by bioelectrical impedance analysis with metabolic risk factor clustering among middle-aged Chinese

Body composition monitor (BCM) based on the bioelectric impedance analysis is very convenient to use. However, whether percentage body fat (PBF) and visceral fat index (VFI) that acquired by BCM are superior to anthropometric measures is unknown. The study explored whether PBF and VFI are better than anthropometric indexes [body mass index (BMI), waist circumference (WC) and waist circumference to height ratio(WHtR)] in predicating metabolic risk factor clustering in a representive sample across China which included 9574 Chinese men and women that were investigated in 2009–2010. PBF and VFI were compared with the BMI, WC, and WHtR through the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and logistic regression. The results showed that the AUC for VFI was higher than BMI and PBF but lower than WHtR and WC in both men and Women. The AUC for WHtR, WC, VFI, BMI and PBF was 0.710, 0.706, 0.700, 0.693, 0.656 in men and 0.705, 0.699, 0.698, 0.675, 0.657 in women, respectively. After adjusting for the potential confounding factors, the odds ratios (ORs) tended to increase with all the indexes. The curve of ORs for WHtR was steepest and the curve for PBF was flattest in both men and women; the curve for VFI was similar to WC in women, but flatter than WC in men. From the data we concluded that VFI seems better than BMI and PBF, but not superior to WC and WHtR in predicating metabolic risk factor clustering in the middle-aged Chinese.

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Controversy remains with regard to the best index for diagnosis of obesity.

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A representive sample of 9574 middle-aged Chinese across China were analyzed.

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The value of Visceral fat index (VFI) and percentage body fat (PBF) were explored.

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VFI seems better than BMI and PBF in predicating metabolic risk factor clustering.

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VFI is not superior to WC and WHtR in predicating metabolic risk factor clustering.

Greater visceral abdominal fat is associated with a lower probability of conversion of prehypertension to normotension

OBJECTIVE

Prehypertension is associated with increased risk for incident hypertension. However, little is known about how frequently prehypertension converts to normotension, and which variables predict this conversion.

METHODS

We identified 186 Japanese Americans with prehypertension (110 men, 76 women) aged 34-75 years (mean age of 52.3 years) who were followed at 5 and 10 years after enrollment. Blood pressure was measured with a mercury sphygmomanometer and average blood pressure was calculated. Subcutaneous adipose tissue, visceral adipose tissue (VAT), and subcutaneous thigh adipose tissue area were measured by computed tomography.

RESULTS

Approximately one-third of those with prehypertension converted to normotension over 10 years of follow-up. Those who converted to normotension were younger, less obese, and had significantly lower baseline SBP, fasting glucose, cholesterol levels, and homeostasis model assessment insulin resistance compared with study participants who continued to have prehypertension or progressed to hypertension. With regard to body fat compartments, study participants with conversion to normotension showed a significantly smaller VAT area compared with the nonconversion group (P < 0.001); but, subcutaneous adipose tissue and subcutaneous thigh adipose tissue were not significant. In multivariate logistic regression analysis, baseline VAT was inversely associated with the conversion independent of age, sex, waist circumference, diabetes, fasting glucose, homeostasis model assessment insulin resistance, non-high-density lipoprotein cholesterol, and SBP [odds ratio per 1 SD VAT increment (95% confidence interval), 0.35 (0.15-0.80), P = 0.012].

CONCLUSION

This is the first prospective study showing the role of body fat distribution, determined by computed tomography scan, in predicting the natural history of prehypertension. Baseline VAT was inversely and independently associated with the conversion to normal blood pressure. No other adipose variable was significant. The mechanisms responsible for these observations remain to be elucidated.

Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China

We aimed to compare the relative strength of the association between anthropometric obesity indices and chronic kidney disease (CKD). Another objective was to examine whether the visceral adiposity index (VAI) and lipid accumulation product index (LAPI) can identify CKD in the rural population of China. There were 5168 males and 6024 females involved in this cross-sectional study, and 237 participants (2.12%) suffered from CKD. Obesity indices included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), VAI and LAPI. VAI and LAPI were calculated with triglyceride (TG), high-density lipoprotein (HDL), BMI and WC. VAI = [WC/39.68 + (1.88 × BMI)] × (TG /1.03) × (1.31/ HDL) for males; VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL) for females. LAPI = (WC-65) × TG for males, LAPI = (WC-58) × TG for females. CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m². The prevalence of CKD increased across quartiles for WHtR, VAI and LAPI. A multivariate logistic regression analysis of the presence of CKD for the highest quartile vs. the lowest quartile of each anthropometric measure showed that the VAI was the best predictor of CKD in females (OR: 4.21, 95% CI: 2.09–8.47, p < 0.001). VAI showed the highest AUC for CKD (AUC: 0.68, 95% CI: 0.65–0.72) and LAPI came second (AUC: 0.66, 95% CI: 0.61–0.70) in females compared with BMI (both p-values < 0.001). However, compared with the traditional index of the BMI, the anthropometric measures VAI, LAPI, WC, and WHtR had no statistically significant capacity to predict CKD in males. Our results showed that both VAI and LAPI were significantly associated with CKD in the rural population of northeast China. Furthermore, VAI and LAPI were superior to BMI, WC and WHtR for predicting CKD only in females.

Higher visceral to subcutaneous fat ratio is associated with small intestinal bacterial overgrowth

BACKGROUND AND AIMS

There is a lack of studies evaluating the association between small intestinal bacterial overgrowth (SIBO) and abdominal fat. The aim of this study was to evaluate whether visceral fat area (VFA), subcutaneous fat area (SFA) or visceral to subcutaneous fat ratio (VFA/SFA ratio) were associated with SIBO.

METHODS AND RESULTS

In this case-control study, 152 eligible patients submitted to glucose hydrogen/methane breath test who also had computed tomography (CT) of the abdomen performed were included. Clinical and demographic information was obtained. VFA and SFA were measured using Image J software at lumbar 3 level on CT cross-sectional image of the 152 patients included in this study, 68 patients (44.7%) tested positive for SIBO. In the univariate analysis, the presence of SIBO was associated with older age (65.2 ± 1.5 vs. 59.3 ± 1.5, p = 0.007); type 2 diabetes mellitus (33.8% vs. 17.9%; p = 0.019); hypertension (63.2% vs. 39.3%; p = 0.003); metabolic syndrome (85.3% vs. 64.3%; p = 0.003); and higher VFA/SFA ratio (1.0 ± 0.1 vs. 0.7 ± 0.1; p < 0.001). In multivariate analysis, metabolic syndrome (odds ratio [OR]: 2.5; 95% confidence interval [CI]: 1.1-5.7; p = 0.035) and higher VFA/SFA ratio (OR: 3.3; 95% CI: 1.6-7.2; p = 0.002) remained independently associated with SIBO.

CONCLUSION

The presence of SIBO was found to be associated with high VFA/SFA ratio measured from cross-sectional CT image.

Comparison of visceral and body fat indices and anthropometric measures in relation to untreated hypertension by age and gender among Chinese

BACKGROUND

The aim of the study was to compare the efficiency of bioelectrical indices (percentage body fat, PBF; visceral fat index, VFI) and various anthropometric measures (body mass index, BMI; waist circumference, WC; waist-to-height ratio, WHtR) on determining hypertension in Chinese.

METHODS

We conducted the community-based cross-sectional survey during August of 2013 to August of 2015 in 66 sample sites selected by multistage random sampling method from Henan province. 14,364 residents were included in the study.

RESULTS

In both genders, VFI and PBF tended to rise with age. However, for each age-specific group, men consistently had significantly greater VFI than women (all P<0.0001) and women had considerably higher PBF (all P<0.0001). The odds ratios and area under the ROC curves (AUCs) for hypertension associated with adiposity indices decreased with age. In younger (15~34year) men and women, VFI had the highest crude (2.43-7.95) and adjusted (2.40-11.63) odds ratio for hypertension. The AUCs for PBF, VFI and WHtR were significantly larger than those for BMI and WC (all P<0.01). Whereas no statistically significant difference were found in AUCs among PBF, VFI and WHtR (all P>0.10). Additionally, VFI and PBF yielded the greatest Youden index in identifying hypertension in men (0.27) and women (0.34), respectively. Optimal cutoffs for VFI/PBF were 11.70/24.45 and 7.55/33.65 in men and women, respectively.

CONCLUSIONS

VFI and PBF could be better candidates for identifying hypertension in men and women, respectively. Adolescents and young adults should be highlighted in preventing hypertension by control of excess body and visceral fat.