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Vajdi M, Khajeh M, Safaei E, Moeinolsadat S, Mousavi S, Seyedhosseini-Ghaheh H, Abbasalizad-Farhangi M, Askari G. Effects of chromium supplementation on body composition in patients with type 2 diabetes: A dose-response systematic review and meta-analysis of randomized controlled trials. J Trace Elem Med Biol 2024; 81:127338. [PMID: 37952433 DOI: 10.1016/j.jtemb.2023.127338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/30/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Several randomized controlled trials (RCTs) have demonstrated the beneficial effects of chromium supplementation in managing type 2 diabetes mellitus (T2DM). The current systematic review and meta-analysis aimed to investigate the associations between chromium supplementation and body composition in patients with T2DM. METHODS To achieve this, PubMed, Scopus, Embase, Cochrane Library, and Web of Science were searched for randomized clinical trials (RCTs) that reported the effects of chromium supplementation on body composition such as body weight (BW), body mass index (BMI), fat mass (FM), and waist circumference (WC) in patients with T2DM from inception until July 2023. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. RESULTS The meta-analysis included a total of 14 RCTs. The results showed that chromium supplementation did not have any significant effect on FM (WMD = -0.43%; 95% CI -0.94, 0.09), BMI (WMD: 0.09 kg/M2, 95% CI: -0.03, 0.20), WC (WMD: -0.47 cm, 95% CI: -1.10, 0.16), and BW (WMD: -0.26 kg, 95% CI: -0.69, 0.16). However, subgroup analysis revealed that chromium intake decreased FM in subjects aged ≥ 55 years and when chromium picolinate was used as an intervention. Additionally, there was a non-linear association between the dose of chromium supplementation and BW. CONCLUSIONS The meta-analysis suggests that chromium supplementation does not significantly reduce BW, BMI, WC, and FM in patients with T2DM. Further RCTs with large-scale are required to determine the possible anti-obesity effects of chromium in patients with T2DM.
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Affiliation(s)
- Mahdi Vajdi
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Khajeh
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Safaei
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Samin Mousavi
- Department of Pharmacognosy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Ojurongbe TA, Afolabi HA, Oyekale A, Bashiru KA, Ayelagbe O, Ojurongbe O, Abbasi SA, Adegoke NA. Predictive model for early detection of type 2 diabetes using patients' clinical symptoms, demographic features, and knowledge of diabetes. Health Sci Rep 2024; 7:e1834. [PMID: 38274131 PMCID: PMC10808992 DOI: 10.1002/hsr2.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 12/07/2023] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
Background and Aims With the global rise in type 2 diabetes, predictive modeling has become crucial for early detection, particularly in populations with low routine medical checkup profiles. This study aimed to develop a predictive model for type 2 diabetes using health check-up data focusing on clinical details, demographic features, biochemical markers, and diabetes knowledge. Methods Data from 444 Nigerian patients were collected and analysed. We used 80% of this data set for training, and the remaining 20% for testing. Multivariable penalized logistic regression was employed to predict the disease onset, incorporating waist-hip ratio (WHR), triglycerides (TG), catalase, and atherogenic indices of plasma (AIP). Results The predictive model demonstrated high accuracy, with an area under the curve of 99% (95% CI = 97%-100%) for the training set and 94% (95% CI = 89%-99%) for the test set. Notably, an increase in WHR (adjusted odds ratio [AOR] = 70.35; 95% CI = 10.04-493.1, p-value < 0.001) and elevated AIP (AOR = 4.55; 95% CI = 1.48-13.95, p-value = 0.008) levels were significantly associated with a higher risk of type 2 diabetes, while higher catalase levels (AOR = 0.33; 95% CI = 0.22-0.49, p < 0.001) correlated with a decreased risk. In contrast, TG levels (AOR = 1.04; 95% CI = 0.40-2.71, p-value = 0.94) were not associated with the disease. Conclusion This study emphasizes the importance of using distinct clinical and biochemical markers for early type 2 diabetes detection in Nigeria, reflecting global trends in diabetes modeling, and highlighting the need for context-specific methods. The development of a web application based on these results aims to facilitate the early identification of individuals at risk, potentially reducing health complications, and improving diabetes management strategies in diverse settings.
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Affiliation(s)
| | | | - Adesola Oyekale
- Department of Chemical PathologyLadoke Akintola University of TechnologyOgbomosoNigeria
| | | | - Olubunmi Ayelagbe
- Department of Chemical PathologyLadoke Akintola University of TechnologyOgbomosoNigeria
| | - Olusola Ojurongbe
- Humboldt Research Hub‐Center for Emerging and Re‐emerging Infectious DiseasesLadoke Akintola University of TechnologyOgbomosoNigeria
- Department of Medical Microbiology and ParasitologyLadoke Akintola University of TechnologyOgbomosoNigeria
| | - Saddam Akber Abbasi
- Statistics Program, Department of Mathematics, Statistics, and Physics, College of Arts and SciencesQatar UniversityDohaQatar
- Statistical Consulting Unit, College of Arts and SciencesQatar UniversityDohaQatar
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Al Akl NS, Haoudi EN, Bensmail H, Arredouani A. The triglyceride glucose-waist-to-height ratio outperforms obesity and other triglyceride-related parameters in detecting prediabetes in normal-weight Qatari adults: A cross-sectional study. Front Public Health 2023; 11:1086771. [PMID: 37089491 PMCID: PMC10117653 DOI: 10.3389/fpubh.2023.1086771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/17/2023] [Indexed: 04/09/2023] Open
Abstract
IntroductionThe triglyceride-glucose (TyG)-driven indices, incorporating obesity indices, have been proposed as reliable markers of insulin resistance and related comorbidities such as diabetes. This study evaluated the effectiveness of these indices in detecting prediabetes in normal-weight individuals from a Middle Eastern population.MethodsUsing the data of 5,996 adult Qatari participants from the Qatar Biobank cohort, we employed adjusted logistic regression to assess the ability of various obesity and triglyceride-related indices to detect prediabetes in normal-weight (18.5 ≤ BMI <25 kg/m2) adults (≥18 years).ResultsOf the normal-weight adults, 13.62% had prediabetes. TyG-waist-to-height ratio (TyG-WHTR) was significantly associated with prediabetes among normal-weight men [OR per 1-SD 2.68; 95% CI (1.67–4.32)] and women [OR per 1-SD 2.82; 95% CI (1.61–4.94)]. Compared with other indices, TyG-WHTR had the highest area under the curve (AUC) value for prediabetes in men [AUC: 0.76, 95% CI (0.70–0.81)] and women [AUC: 0.73, 95% CI (0.66–0.80)], and performed significantly higher than other indices (p < 0.05) in detecting prediabetes in men. Tyg-WHTR shared similar diagnostic values as fasting plasma glucose (FPG).DiscussionOur findings suggest that the TyG-WHTR index could be a better indicator of prediabetes for general clinical usage in normal weight Qatari adult men than other obesity and TyG-related indices. TyG-WHTR can help identify a person’s risk for developing prediabetes in both men and women when combined with FPG results.
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Affiliation(s)
- Neyla S. Al Akl
- Qatar Foundation, Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | | | - Halima Bensmail
- Qatar Computing Research Institute, Hamad Bin Khalifa University, Doha, Qatar
| | - Abdelilah Arredouani
- Qatar Foundation, Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
- Qatar Foundation, College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
- *Correspondence: Abdelilah Arredouani,
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Chung TL, Liu YH, Wu PY, Huang JC, Chen SC. Sex difference in the associations among obesity-related indices with incidence of diabetes mellitus in a large Taiwanese population follow-up study. Front Public Health 2023; 11:1094471. [PMID: 36741951 PMCID: PMC9895090 DOI: 10.3389/fpubh.2023.1094471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/02/2023] [Indexed: 01/21/2023] Open
Abstract
Background Obesity is a major risk factor for diabetes mellitus (DM), which is in turn a major risk factor for cardiovascular diseases such as coronary artery disease and stroke. As few studies have investigated sex differences in the association between obesity and incidence of DM, the aim of this longitudinal study was to explore this issue in a large group of Taiwanese participants. Methods A total of 24,346 participants were enrolled in this study, of whom 8,334 (mean age, 50.6 ± 11.0 years) were male and 16,012 (mean age, 50.5 ± 10.1 years) were female. The following obesity-related indices were studied: body mass index, waist-to-height ratio, waist-to-hip ratio (WHR), body roundness index, conicity index (CI), body adiposity index, abdominal volume index, lipid accumulation product (LAP), and visceral adiposity index (VAI). Results The analysis showed significant associations between all of these indices with incidence of DM (all p < 0.001). In the male participants, the strongest predictors for incidence of DM were LAP (AUC = 0.692), WHtR (AUC = 0.684), and WHR (AUC = 0.683). In the female participants, the strongest predictors were LAP (AUC = 0.744), WHtR (AUC = 0.710) and VAI (AUC = 0.710), followed by BRI (AUC = 0.708). Conclusion Strong associations were found between the studied obesity-related indices and incidence of DM, and sex differences were found. Hence, to better control DM, reducing body weight may be beneficial in addition to lifestyle modifications, diet control, and pharmacological interventions.
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Affiliation(s)
- Tung-Ling Chung
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yi-Hsueh Liu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Chi Huang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,*Correspondence: Szu-Chia Chen ✉
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Chen N, Hu LK, Sun Y, Dong J, Chu X, Lu YK, Liu YH, Ma LL, Yan YX. Associations of waist-to-height ratio with the incidence of type 2 diabetes and mediation analysis: Two independent cohort studies. Obes Res Clin Pract 2023; 17:9-15. [PMID: 36586764 DOI: 10.1016/j.orcp.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/11/2022] [Accepted: 12/18/2022] [Indexed: 12/31/2022]
Abstract
AIM To assess the relationship between waist-to-height ratio (WHtR) and the incidence of type 2 diabetes (T2D)/impaired fasting glucose (IFG) and to explore to what extent these associations are mediated by blood pressure, lipids and other indicators related to liver and kidney metabolism. MATERIALS AND METHODS This study was based on a functional community cohort included 6109 participants which were divided into two sub-cohorts. One sub-cohort included participants with normal fasting glucose (n = 5563), another included IFG individuals at baseline (n = 546). Cox regression models were used to evaluate the relationships of WHtR with T2D/IFG. Four-year time-dependent receiver operating characteristic (ROC) curve and area under curve (AUC) were calculated to estimate the discriminatory power of WhtR and other anthropometric indices on T2D. Mediation analysis was performed to estimate which risk factors mediate the association between WHtR and T2D. RESULTS Significant positive associations were found between WHtR and the incidence of T2D/IFG in both sub-cohort. WhtR was a useful predictor of T2D (P < 0.05). Mediation analysis showed that HOMA-IR (0.45 %), SBP (5.10 %), triglycerides (11.02 %), creatinine (9.36 %) and combined kidney indicators (17.48 %) partly mediated the effect of WHtR on T2D in men. For women, this association was partly mediated by SBP (13.86 %), HDL (24.54 %), ALT (6.29 %), UA (22.58 %) and combined kidney indicators (39.51 %). CONCLUSIONS WHtR was an independent risk factor for the development of T2D and IFG. This association was partly mediated by HOMA-IR, SBP, lipids and other liver and kidney metabolism indicators.
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Affiliation(s)
- Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Li-Kun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yue Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jing Dong
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xi Chu
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ya-Ke Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yu-Hong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Lin-Lin Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Racial and Ethnic Disparities in Diabetes Clinical Care and Management: A Narrative Review. Endocr Pract 2022; 29:295-300. [PMID: 36464131 DOI: 10.1016/j.eprac.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
Diabetes affects nearly 37 million Americans, with disproportionately higher disease burden amongst those from minoritized communities. The result of this is greater rates of diabetic complications and mortality. To close this gap in care, it is important to assess the differences in both diagnosis and care between White and ethnic/racial minoritized persons with diabetes. The purpose of this narrative review is to explore this further by assessing the differences in diagnosis, management, diabetes education, and complications.
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Song Y, Hwang JA, Shin J, Cho E, Ahn SY, Ko GJ, Kwon YJ, Kim JE. Waist-hip ratio measured by bioelectrical impedance analysis as a valuable predictor of chronic kidney disease development. BMC Nephrol 2022; 23:349. [PMID: 36319963 PMCID: PMC9623989 DOI: 10.1186/s12882-022-02981-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is a major health problem worldwide and is associated with chronic kidney disease (CKD). Body mass index (BMI) is a common method of diagnosing obesity, but there are concerns about its accuracy and ability to measure body composition. This study evaluated the risk of CKD development in a middle-aged population in association with various body composition metrics. From a prospective cohort of 10,030 middle-aged adults, we enrolled 6727 for whom baseline and follow-up data were available. We collected data pertaining to participants' BMI, manually measured waist-hip ratio (WHR), and various measurements of bioelectrical impedance analysis (BIA), including total body fat content, muscle content, and calculated WHR, and classified the participants into quintiles accordingly. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 in follow-up laboratory tests. While an increase in BMI, WHR, and total body fat were associated with an elevated risk of CKD, an increase in total body muscle decreased the risk. Among the body composition metrics, WHR measured by BIA had the highest predictive value for CKD (C-statistics: 0.615). In addition, participants who were "healthy overweight, (defined as low WHR but high BMI), exhibited a 62% lower risk of developing CKD compared to those with "normal-weight obesity," (defined as high WHR despite a normal BMI). In conclusion, we suggest that central obesity measured by BIA is a more accurate indicator than BMI for predicting the development of CKD.
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Affiliation(s)
- Younghoon Song
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea
| | - Jeong Ah Hwang
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea
| | - Jaeun Shin
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea
| | - Eunjung Cho
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea
| | - Shin Young Ahn
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea ,grid.222754.40000 0001 0840 2678Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Gang Jee Ko
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea ,grid.222754.40000 0001 0840 2678Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Young Joo Kwon
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea ,grid.222754.40000 0001 0840 2678Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ji Eun Kim
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Guro Hospital, Gurodong-Ro 148, Guro-Gu, Seoul, South Korea
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Disparity in association of obesity measures with ankle and brachial systolic blood pressures in Europeans and South Asians. Sci Rep 2022; 12:9174. [PMID: 35655080 PMCID: PMC9163110 DOI: 10.1038/s41598-022-13372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/17/2022] [Indexed: 11/22/2022] Open
Abstract
Obesity causes increases in brachial systolic-blood-pressures (SBP), risks of type 2 diabetes (T2DM) and cardiovascular diseases (CVD). Brachial and ankle SBPs have differential relationship with T2DM and CVD. Our objective was to study the relationship of obesity measures with brachial and ankle SBPs. A population of 1098 adults (South Asians n = 699; 41.70% male and 58.3% female) were recruited over 5 years from primary care practices in England. Their four limbs SBPs were measured using Doppler machine and body-mass-index (BMI) and waist-to-height-ratio (WHtR) calculated. Linear regressions were performed between SBPs and obesity measures, after adjustments for sex, age, ethnicity, T2DM and CVD. The mean age of all participants was 51.3 (SD = 17.2), European was 57.7 (SD 17.2) and South Asian was 47.8 (SD = 16.1). The left posterior tibial [Beta = 1.179, P = 4.559 × 10−15] and the right posterior tibial SBP [Beta = 1.178, P = 1.114 × 10−13] most significantly associated with the BMI. In South Asians, although the left brachial [Beta = 25.775, P = 0.032] and right brachial SBP [Beta = 22.792, P = 0.045] were associated to the WHtR, the left posterior tibial SBP [Beta = 39.894, P = 0.023], association was the strongest. For the first time, we have demonstrated that ankle SBPs had significant association with generalised obesity than brachial systolic blood pressures (SBP), irrespective of ethnicity. However, with respect to visceral obesity, the association with ankle SBP was more significant in South Asians compared to Europeans.
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Liu Q, Zhang M, He Y, Zhang L, Zou J, Yan Y, Guo Y. Predicting the Risk of Incident Type 2 Diabetes Mellitus in Chinese Elderly Using Machine Learning Techniques. J Pers Med 2022; 12:jpm12060905. [PMID: 35743691 PMCID: PMC9224915 DOI: 10.3390/jpm12060905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/21/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
Early identification of individuals at high risk of diabetes is crucial for implementing early intervention strategies. However, algorithms specific to elderly Chinese adults are lacking. The aim of this study is to build effective prediction models based on machine learning (ML) for the risk of type 2 diabetes mellitus (T2DM) in Chinese elderly. A retrospective cohort study was conducted using the health screening data of adults older than 65 years in Wuhan, China from 2018 to 2020. With a strict data filtration, 127,031 records from the eligible participants were utilized. Overall, 8298 participants were diagnosed with incident T2DM during the 2-year follow-up (2019–2020). The dataset was randomly split into training set (n = 101,625) and test set (n = 25,406). We developed prediction models based on four ML algorithms: logistic regression (LR), decision tree (DT), random forest (RF), and extreme gradient boosting (XGBoost). Using LASSO regression, 21 prediction features were selected. The Random under-sampling (RUS) was applied to address the class imbalance, and the Shapley Additive Explanations (SHAP) was used to calculate and visualize feature importance. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. The XGBoost model achieved the best performance (AUC = 0.7805, sensitivity = 0.6452, specificity = 0.7577, accuracy = 0.7503). Fasting plasma glucose (FPG), education, exercise, gender, and waist circumference (WC) were the top five important predictors. This study showed that XGBoost model can be applied to screen individuals at high risk of T2DM in the early phrase, which has the strong potential for intelligent prevention and control of diabetes. The key features could also be useful for developing targeted diabetes prevention interventions.
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Affiliation(s)
- Qing Liu
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan 430071, China; (Q.L.); (M.Z.)
| | - Miao Zhang
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan 430071, China; (Q.L.); (M.Z.)
| | - Yifeng He
- School of Geodesy and Geomatics, Wuhan University, Wuhan 430079, China; (Y.H.); (J.Z.)
| | - Lei Zhang
- School of Mathematics and Statistics, Wuhan University, Wuhan 430070, China;
| | - Jingui Zou
- School of Geodesy and Geomatics, Wuhan University, Wuhan 430079, China; (Y.H.); (J.Z.)
| | - Yaqiong Yan
- Wuhan Center for Disease Control and Prevention, Wuhan 430015, China;
| | - Yan Guo
- Wuhan Center for Disease Control and Prevention, Wuhan 430015, China;
- Correspondence:
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Nam MJ, Kim H, Choi YJ, Cho KH, Kim SM, Roh YK, Han K, Jung JH, Park YG, Park JH, Kim DH. A Longitudinal Retrospective Observational Study on Obesity Indicators and the Risk of Impaired Fasting Glucose in Pre- and Postmenopausal Women. J Clin Med 2022; 11:jcm11102795. [PMID: 35628921 PMCID: PMC9147611 DOI: 10.3390/jcm11102795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/29/2022] [Accepted: 05/14/2022] [Indexed: 12/10/2022] Open
Abstract
The impact of obesity could differ according to menopausal status since women undergo significant physiologic and metabolic changes due to menopause. We investigated the association between various major obesity indicators and the risk of impaired fasting glucose (IFG) according to menopausal status using nationally representative data. A total of 571,286 premenopausal and 519,561 postmenopausal women who underwent both Korean National Health Insurance Service (NHIS) cancer screening in 2009 and health check-ups in 2017 were analyzed. Multivariate logistic regression analyses were used to assess the effect of independent variables of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in 2009, on dependent variable IFG in 2017. After adjusting for potential confounders, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of developing IFG were analyzed. In the premenopausal group, the OR of obese BMI (≥25 kg/m2, <30 kg/m2) women was increased to 2.228 (95% CI: 2.139−2.321) compared to the normal BMI (≥18.5, <23 kg/m2) women as a reference. In the postmenopausal group, there was also a higher OR of 1.778 (95% CI: 1.715−1.843) in the obese BMI women compared to the normal group. A similar association of increasing ORs for IFG was shown in both groups when stratified by WC and WHtR. This nationwide study revealed that obesity and abdominal obesity, defined by various obesity indicators, consistently increased odds of acquiring IFG after 8 years in both pre- and postmenopausal groups, with the association being more robust in the premenopausal group. Our findings suggest that weight management and lifestyle modification may require more attention in premenopausal women.
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Affiliation(s)
- Myung Ji Nam
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Ansan 15355, Korea; (M.J.N.); (H.K.); (Y.J.C.)
| | - Hyunjin Kim
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Ansan 15355, Korea; (M.J.N.); (H.K.); (Y.J.C.)
| | - Yeon Joo Choi
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Ansan 15355, Korea; (M.J.N.); (H.K.); (Y.J.C.)
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea;
| | - Seon Mee Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea;
| | - Yong-Kyun Roh
- Department of Family Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea;
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea;
| | - Jin-Hyung Jung
- Department of Biostatistics, Catholic University College of Medicine, Seoul 06591, Korea; (J.-H.J.); (Y.-G.P.)
| | - Yong-Gyu Park
- Department of Biostatistics, Catholic University College of Medicine, Seoul 06591, Korea; (J.-H.J.); (Y.-G.P.)
| | - Joo-Hyun Park
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Ansan 15355, Korea; (M.J.N.); (H.K.); (Y.J.C.)
- Correspondence: (J.-H.P.); (D.-H.K.)
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Ansan 15355, Korea; (M.J.N.); (H.K.); (Y.J.C.)
- Correspondence: (J.-H.P.); (D.-H.K.)
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11
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Chi JH, Lee BJ. Risk factors for hypertension and diabetes comorbidity in a Korean population: A cross-sectional study. PLoS One 2022; 17:e0262757. [PMID: 35045123 PMCID: PMC8769319 DOI: 10.1371/journal.pone.0262757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/04/2022] [Indexed: 01/03/2023] Open
Abstract
Background Hypertension and diabetes are risk factors for severe cardiovascular disease and are prevalent comorbidities. No studies have examined the associations of various risk factors related to anthropometry, bone mineral density and body composition of specific body regions with hypertension and diabetes comorbidity (HDC). This study explored the association between HDC and various risk factors related to specific body regions. Method A total of 7,978 subjects (3,451 men and 4,527 women) aged ≥ 50 years were included in the analysis. A binary logistic regression analysis based on complex sample data analysis was conducted to examine associations between the normal and diabetes groups, between the normal and hypertension groups, and between the normal and HDC groups. Results Among Korean adults aged ≥ 50 years, 11.27% of men and 10.05% of women had both diabetes and hypertension. The HDC prevalence was higher in men than in women. In men, waist-to-height ratio (WHtR, adjusted OR = 1.63 [1.22–2.18], adjusted p<0.001) exhibited a more significant association with HDC than other indices, left leg fat mass (adjusted OR = 0.61 [0.45–0.81], adjusted p = 0.0009) and right leg fat mass (adjusted OR = 0.60 [0.45–0.81], adjusted p = 0.0007) displayed strong negative associations with diabetes, and left leg lean mass (adjusted OR = 0.77 [0.67–0.89], adjusted p = 0.0002) and trunk fat mass (adjusted OR = 1.28 [1.07–1.52], adjusted p = 0.0062) were significantly associated with hypertension. In women, left leg fat mass (adjusted OR = 0.29 [0.22–0.39], adjusted p<0.0001) and right leg fat mass (adjusted OR = 0.32 [0.23–0.45], adjusted p<0.0001) exhibited strong negative associations with HDC, waist circumference (WC) (adjusted OR = 2.15 [1.40–3.30], adjusted p = 0.0005) showed a stronger association with diabetes than did other indices, and WC (adjusted OR = 1.39 [1.11–1.74], adjusted p = 0.0040) and WHtR (adjusted OR = 1.39 [1.09–1.76], adjusted p = 0.0075) were significantly associated with hypertension. Discussion HDC was more strongly associated with fat and lean mass than diabetes and hypertension. The association between HDC and body fat variables was more robust in women than in men.
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Affiliation(s)
- Jeong Hee Chi
- Department of Computer Science and Engineering, Konkuk University, Seoul, Republic of Korea
| | - Bum Ju Lee
- Digital Health Research Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
- * E-mail:
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12
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Van den Berge M, Van Oostrom SH, Van der Molen HF, Robroek SJW, Hulshof CTJ, Van der Beek AJ, Proper KI. Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers? Int Arch Occup Environ Health 2021; 95:465-475. [PMID: 34622342 PMCID: PMC8795025 DOI: 10.1007/s00420-021-01771-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/12/2021] [Indexed: 11/30/2022]
Abstract
Purpose To investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health. Methods A longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers’ Health Surveillance Programs during 2010–2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m2 and BMI ≥ 30.0 kg/m2, respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI). Results Mean follow-up duration was 31.7 (SD = 14.9) months. Construction workers with strenuous work postures (OR 1.35 95% CI 1.25–1.46), manual material handling (OR 1.29 95% CI 1.19–1.40), obesity (OR 1.31 95% CI 1.17–1.47) and low LTVPA (OR 1.13 95% CI 1.01–1.25) were more likely to report poor self-rated health at follow-up. No statistically significant interaction effects were found for OPA and obesity or low LTVPA. Conclusions OPA, obesity and low level of LTVPA were separate risk factors for poor self-rated health, but did not appear to have a synergistic effect.
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Affiliation(s)
- M Van den Berge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - S H Van Oostrom
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - H F Van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - S J W Robroek
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - C T J Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - A J Van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - K I Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands. .,Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
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13
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Lee BJ, Yim MH. Comparison of anthropometric and body composition indices in the identification of metabolic risk factors. Sci Rep 2021; 11:9931. [PMID: 33976292 PMCID: PMC8113511 DOI: 10.1038/s41598-021-89422-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Whether anthropometric or body composition indices are better indicators of metabolic risk remains unclear. The objectives of this study were to compare the association of metabolic risk factors with anthropometric and body composition indices and to identify the better indicators for risk factors in a large-scale Korean population. In this cross-sectional study, the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) as anthropometric indices and trunk fat mass (TFM), percent trunk fat mass (%TFM), whole-body total fat mass (WBTFM), and percent whole-body total fat mass (%WBTFM) as body composition indices with metabolic risk factors were compared by complex-samples multiple logistic regression models based on complex-sample survey data. In men, WHtR, BMI, and TFM were similarly associated with hypertension. Diabetes, hyperlipidemia, and hypo-high-density lipoprotein (HDL) cholesterolemia tended to be more strongly associated with WHtR and WC than body composition indices. Hypertriglyceridemia and hypercholesterolemia were more strongly associated with WHtR and %TFM than other indices. In women, hypertension tended to be more strongly associated with WHtR than other indices. TFM, %TFM, and WHtR were similarly associated with hyperlipidemia. Diabetes and hypo-HDL cholesterolemia were more strongly associated with WHtR and WC than body composition indices. Hypertriglyceridemia and hypercholesterolemia were more strongly associated with WHtR and %TFM than other indices. Among six metabolic risk factors, the validity and utility of the anthropometric indices in identifying risk factors tended to be similar to or better than those of the body composition indices, except for hypertension and hypercholesterolemia in men and hyperlipidemia and hypercholesterolemia in women.
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Affiliation(s)
- Bum Ju Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Deajeon, 305-811, Republic of Korea.
| | - Mi Hong Yim
- Future Medicine Division, Korea Institute of Oriental Medicine, Deajeon, 305-811, Republic of Korea
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Savran M, Engin M, Guvenc O, Yüksek HF, Sünbül SA, Turk T, Ata Y, Aydın U, Ozyazicioglu AF. Predictive Value of HATCH Scoring and Waist-to-Height Ratio in Atrial Fibrillation Following Coronary Artery Bypass Operations Performed with Cardiopulmonary Bypass. J Saudi Heart Assoc 2021; 33:117-123. [PMID: 34183907 PMCID: PMC8143722 DOI: 10.37616/2212-5043.1246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations. Methods Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively. Results A total of 255 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 196, mean age = 58.9 ± 9.4 years), and those who did were included in Group 2 (n = 59, mean age = 61.1 ± 12 years). There were no statistically significant differences between the two groups in terms of age, gender, presence of hypertension and hyperlipidemia. Rates of chronic obstructive pulmonary disease and previous percutaneous coronary interventions, waist circumference, waist to height ratio and HATCH score values were significantly higher in Group 2 compared to Group 1 ( p values: 0.019, 0.034, 0.001, <0.001, <0.001, respectively). In multivariate analysis, WHR (Odds ratio: 1.068, Confidence interval: 1.032–1.105, p < 0.001) and HATCH score (Odds ratio: 2.590, Confidence interval: 1.850–3.625, p < 0.001) were independent predictors of PoAF. Conclusions With this current prospective study, we showed that calculating WHR and HATCH score in the preoperative period can help us predict PoAF.
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Affiliation(s)
- Muhammed Savran
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
| | - Mesut Engin
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
| | - Orhan Guvenc
- Medical Faculty of Uludağ University, Departments of Cardiovascular Surgery, Bursa, Turkey
| | - Hasan F Yüksek
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Family Medicine, Bursa, Turkey
| | - Sadık Ahmet Sünbül
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
| | - Tamer Turk
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
| | - Yusuf Ata
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
| | - Ufuk Aydın
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
| | - Ahmet F Ozyazicioglu
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Bursa, Turkey
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Zhang FL, Ren JX, Zhang P, Jin H, Qu Y, Yu Y, Guo ZN, Yang Y. Strong Association of Waist Circumference (WC), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Waist-to-Hip Ratio (WHR) with Diabetes: A Population-Based Cross-Sectional Study in Jilin Province, China. J Diabetes Res 2021; 2021:8812431. [PMID: 34056007 PMCID: PMC8147550 DOI: 10.1155/2021/8812431] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/21/2021] [Accepted: 04/27/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUNDS The prevalence of diabetes has increased with the increase of obesity, and finding indicators to predict diabetes risk has become an urgent need. The purpose of this study is to compare the correlation between four anthropometric indices and the prevalence of diabetes. METHODS A total of 4052 participants aged 40 years and above were selected in Dehui City, Jilin Province, using a multistage stratified whole group sampling method. Face-to-face interviews and physical examinations were conducted. Multivariate logistic analysis was used. The values of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were divided into quartiles (Q1: <25%; Q2: ~25%; Q3: ~50%; and Q4: ~75%). The median of each quartile was used for a linear trend test. RESULTS For all four body fat-measuring indices of body mass index (adjusted OR: 3.300, 95% CI: 2.370, 4.595), WC (adjusted OR: 5.131, 95% CI: 3.433, 7.669), WHR (adjusted OR: 3.327, 95% CI: 2.386, 4.638), and WHtR (adjusted OR: 5.959, 95% CI: 3.922, 9.054), patients in the highest quartile were more likely to have diabetes than those in the lowest quartile. The areas under the curve of WHtR, WC, WHR, and BMI for diabetes were 0.683, 0.669, 0.654, and 0.629, respectively. In female participants, the areas under the curve of the waist-height ratio and WC were 0.710 (95% CI: 0.679-0.741) and 0.701 (95% CI: 0.670-0.732), respectively. CONCLUSIONS The WC and WHtR were more closely related to diabetes than BMI and WHR among study participants ≥ 40 years of age, especially in females.
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Affiliation(s)
- Fu-Liang Zhang
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Jia-Xin Ren
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Peng Zhang
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Jilin Provincial Key Laboratory, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Hang Jin
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Yang Qu
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Yao Yu
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Zhen-Ni Guo
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Jilin Provincial Key Laboratory, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
| | - Yi Yang
- China National Comprehensive Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
- Jilin Provincial Key Laboratory, The First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, China
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Llanaj E, Vincze F, Kósa Z, Sándor J, Diószegi J, Ádány R. Dietary Profile and Nutritional Status of the Roma Population Living in Segregated Colonies in Northeast Hungary. Nutrients 2020; 12:nu12092836. [PMID: 32947945 PMCID: PMC7551568 DOI: 10.3390/nu12092836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
Nutrition studies among Roma are scarce and to date no quantified dietary data are available. This report provides, for the first time, quantified dietary data and comprehensive anthropometric information for the Hungarian Roma (HR) population, with Hungarian general (HG) adults as reference. Data were obtained from a complex comparative health survey, involving 387 and 410 subjects of HR and HG populations, respectively. Using corporal measurements, body composition indicators were constructed, while daily nutrient intakes were evaluated in comparison with internationally accepted guidelines on nutrient requirements and recommended intakes. Associations between Roma ethnicity and nutrient intakes, as well as odds of achieving dietary recommendations were explored using regression models, adjusted for relevant covariates (i.e., age, gender, education, marital status and perceived financial status). Results showed occasional differences for selected nutrient intakes between the groups, with HR's intake being less favorable. Total fat intake, predominantly animal-sourced, exceeded recommendations among HR (36.1 g, 95% confidence interval (CI): 35.2-37.0) and was not dissimilar to HG group (37.1 g, 95% CI: 36.3-38.0). Sodium intake among HR was significantly lower (5094.4 mg, 95% CI: 4866.0-5322.8) compared to HG (5644.0 mg, 95% CI: 5351.9-5936.0), but significantly greater than recommended intake in both groups. HR had greater estimated body fatness (25.6-35.1%) and higher average body mass index (BMI, 27.7 kg/m2, 95% CI: 26.9-28.4), compared to HG. In addition, HR had lower odds of achieving dietary recommendations (odds ratio (OR) = 0.81, 95% CI: 0.67-0.97, p < 0.05). Findings warrant further research, while highlighting the importance of establishing and integrating Roma nutrition into national surveillance and monitoring systems for key dietary risk factors.
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Affiliation(s)
- Erand Llanaj
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Methodology for Health Visitors and Public Health, Faculty of Health, University of Debrecen, Sóstói street 2–4, H-4400 Nyíregyháza, Hungary;
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
| | - Judit Diószegi
- MTA-DE-Public Health Research Group, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary;
| | - Róza Ádány
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- MTA-DE-Public Health Research Group, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77147)
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Wang K, Pan L, Wang D, Dong F, Yu Y, Wang L, Li L, Liu T, Sun L, Zhu G, Feng K, Xu K, Pang X, Chen T, Pan H, Ma J, Zhong Y, Shan G. Association between obesity indicators and cardiovascular risk factors among adults in low-income Han Chinese from southwest China. Medicine (Baltimore) 2020; 99:e20176. [PMID: 32791656 PMCID: PMC7387039 DOI: 10.1097/md.0000000000020176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There may be differences in optimal anthropometric cut-offs for diagnosing obesity among different regions of China. However, there has been little studies about choosing effective obesity indicators in Han People of low-income Chinese adults in southwest China. The purpose of this study was to compare and evaluate the associations between different obesity indicators and cardiovascular disease risk factors (CVDRF) and choose the optimal cut-off values.A cross-sectional study was carried out in southwest of China, with multi-stage sampling enrolling 2112 subjects aged 20 to 80 years old. Anthropometric measurements included Body mass index (BMI), waist circumference (WC), Hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We measured the percentage of body fat (PBF) by bioelectrical impedance analyzer to assess the body composition. The validity of different obesity indicators in assessing CVDRF risk were assessed through comparison area under curve of different indicators in assessing CVDRF risk in different gender. Logistic regression models were used to evaluate the association between the obesity indicators and CVDRF.When both male and female were considered, the optimal indicators were WHtR and percentage of body fat PBF for hypertension, WHR and WHtR for dyslipidemia. Both WC and WHtR were optimal indicators in assessing metabolic syndrome risk for both genders. When both disease and gender were considered, WHtR was the best associated indicators with various CVDRF. The cut-off of BMI and WC were consistent to the definition of obesity in Working Group of China. The WHtR positively correlated with the CVDRF. The cut-off of WHtR to do what was approximately 0.50 for adults in both genders in southwest of China.WHtR may be the best associated indicators for obesity-related CVDRF among the others (BMI, WC, Hip circumference, PBF, and WHR) in southwest of China. The cut-off of WHtR was approximately 0.50 for adults in both genders in southwest of China.
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Affiliation(s)
- Ke Wang
- National Office for Maternal and Child Health Surveillance of China, Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Dingming Wang
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Fen Dong
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yangwen Yu
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Li Wang
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ling Li
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Tao Liu
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Liangxian Sun
- Guizhou Center for Disease Control and Prevention, Guizhou, China
| | - Guangjin Zhu
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Kui Feng
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ke Xu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinglong Pang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ting Chen
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Pan
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jin Ma
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yong Zhong
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
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Xue M, Su Y, Feng Z, Wang S, Zhang M, Wang K, Yao H. A nomogram model for screening the risk of diabetes in a large-scale Chinese population: an observational study from 345,718 participants. Sci Rep 2020; 10:11600. [PMID: 32665620 PMCID: PMC7360758 DOI: 10.1038/s41598-020-68383-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/23/2020] [Indexed: 12/31/2022] Open
Abstract
Our study is major to establish and validate a simple type||diabetes mellitus (T2DM) screening model for identifying high-risk individuals among Chinese adults. A total of 643,439 subjects who participated in the national health examination had been enrolled in this cross-sectional study. After excluding subjects with missing data or previous medical history, 345,718 adults was included in the final analysis. We used the least absolute shrinkage and selection operator models to optimize feature selection, and used multivariable logistic regression analysis to build a predicting model. The results showed that the major risk factors of T2DM were age, gender, no drinking or drinking/time > 25 g, no exercise, smoking, waist-to-height ratio, heart rate, systolic blood pressure, fatty liver and gallbladder disease. The area under ROC was 0.811 for development group and 0.814 for validation group, and the p values of the two calibration curves were 0.053 and 0.438, the improvement of net reclassification and integrated discrimination are significant in our model. Our results give a clue that the screening models we conducted may be useful for identifying Chinses adults at high risk for diabetes. Further studies are needed to evaluate the utility and feasibility of this model in various settings.
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Affiliation(s)
- Mingyue Xue
- College of Public Health, Xinjiang Medical University, Ürümqi, 830011, China
| | - Yinxia Su
- Center of Health Management, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, 830011, China
| | - Zhiwei Feng
- College of Basic Medicine, Xinjiang Medical University, Ürümqi, 830011, China
| | - Shuxia Wang
- Center of Health Management, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, 830011, China
| | - Mingchen Zhang
- The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, 830011, China
| | - Kai Wang
- College of Medical Engineering and Technology, Xinjiang Medical University, Ürümqi, 830011, China.
| | - Hua Yao
- Center of Health Management, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, 830011, China.
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Thomas R, Ambookan PV, Jose J, Unnikrishnan UG. The accuracy of anthropometric measurements of general and central obesity for the prediction of impaired glucose tolerance among the adult population of South India. J Family Med Prim Care 2020; 9:3416-3420. [PMID: 33102306 PMCID: PMC7567263 DOI: 10.4103/jfmpc.jfmpc_269_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/13/2020] [Accepted: 04/07/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The distribution of body fat and its variation is of great importance in determining the pathogenesis of insulin resistance. Central obesity has been recognized as an independent risk factor for diabetes. The objective of the study was to evaluate the predictive accuracy of various anthropometric measures of body fat in determining impaired glucose tolerance (IGT) or prediabetes among South Indian population. METHODOLOGY This was a community-based comparative cross-sectional study where the anthropometric measures of a representative sample of 171 individuals with glycosylated hemoglobin (HbA1c) in the range for IGT were compared with age- and gender-matched controls with HbA1c in the normal range. The predictive accuracy of the various anthropometric measures of obesity to identify individuals with IGT was estimated using the area under the receiver operating characteristic (ROC) curve. RESULTS Patients with IGT in both genders had significantly higher BMI, waist circumference (WC), neck circumference (NC), and waist-to-height ratio (WHtR). ROC analysis revealed WHtR in females and NC among males to have the largest area under the curve for predicting IGT. In both genders, WC, WHtR, and NC had better predictive accuracy for prediabetes as compared to BMI and waist-to-hip ratio (WHR). CONCLUSION It is suggested that the WHtR and WC are better screening tools for prediabetes in comparison to BMI and WHR among the South Indian population.
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Affiliation(s)
- Ronnie Thomas
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Prashanth Varkey Ambookan
- Department of Plastic Surgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Jobinse Jose
- Department of Nephrology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - U. G. Unnikrishnan
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
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20
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Engin M. The Relation Between Echocardiographic Epicardial Fat Thickness and CHA2DS2-Vasc Score in Patients with Sinus Rhythm. Braz J Cardiovasc Surg 2020; 35:406. [PMID: 32549113 PMCID: PMC7299591 DOI: 10.21470/1678-9741-2020-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Mesut Engin
- Mehmet Akif Inan Training and Research Hospital University of Health and Sciences Department of Cardiovascular Surgery Sanliurfa Turkey Department of Cardiovascular Surgery, University of Health and Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey. E-mail:
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Song ST, Shi J, Wang XH, Guo YB, Hu PF, Zhu F, Zeng X, Xie WF. Prevalence and risk factors for gallstone disease: A population-based cross-sectional study. J Dig Dis 2020; 21:237-245. [PMID: 32166900 DOI: 10.1111/1751-2980.12857] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the prevalence of and risk factors for gallstone disease in Shanghai, China. METHODS A population-based cross-sectional study was conducted in Shanghai between 2016 and 2017. Using a three-stage stratified sampling strategy, 4009 participants (1753 men and 2256 women) from 10 districts were enrolled. RESULTS The overall prevalence of gallstones was 6.83% (6.22% for men vs 7.31% for women, P = 0.173). According to the multivariate analysis, individuals aged ≥40 years (odds ratio [OR] 3.058, 95% confidence interval [CI] 2.110-4.433, P < 0.001), hypertension (OR 1.479, 95% CI 1.076-2.034, P = 0.016), thyroid disease (OR 1.409, 95% CI 1.029-1.928, P = 0.032), a family history of gallstones (OR 2.234, 95% CI 1.362-3.662, P = 0.001) and a waist-to-height ratio ≥0.5 (OR 1.656, 95% CI 1.197-2.292, P = 0.002) had an increased risk of developing gallstones. The risk of gallstone disease was 2.232 (95% CI 1.167-4.268, P = 0.015) times higher in individuals with elevated C4 levels than in those with normal C4 levels. Diabetes (OR 4.144, 95% CI 1.171-14.671, P = 0.028) was a risk factor for the formation of gallstones with diameters ≥1 cm, and men were more susceptible to develop multiple stones (OR 2.356, 95% CI 1.321-4.200, P = 0.004). CONCLUSION Individuals aged ≥40 years, with a history of hypertension and familial gallstones, a high waist-to-height ratio, thyroid disease and high C4 levels were related to an increased risk of gallstone disease.
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Affiliation(s)
- Sen Tao Song
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian Shi
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiao Hang Wang
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yi Bin Guo
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Ping Fang Hu
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Feng Zhu
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xin Zeng
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wei Fen Xie
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Ma A, Fang K, Dong J, Dong Z. Prevalence and Related Factors of Metabolic Syndrome in Beijing, China (Year 2017). Obes Facts 2020; 13:538-547. [PMID: 33232966 PMCID: PMC7802480 DOI: 10.1159/000508842] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) is one of the major public health problems worldwide. The aim of this study was to investigate the prevalence and associated risk factors of MetS in Beijing to formulate targeted policies. METHODS Data from the 2017 Beijing Chronic Disease and Risk Factors Surveillance were used in this study, in which multistage stratified cluster sampling was adopted to collect a representative sample of 12,597 Beijing residents aged from 18 to 79 years. According to the definition of the International Diabetes Federation, the weighted prevalence of MetS and clustering of MetS components were estimated. The Rao-Scott adjusted χ2 test was used to test differences in MetS and components rates, and complex sampling unconditional logistic regression was used to explore influencing factors of MetS. RESULTS The prevalence of MetS was 25.59% (95% CI 23.77-27.41), and the proportion of men and women was 30.53% (95% CI 28.32-32.75) and 20.44% (95% CI 18.29-22.58), respectively. The proportion of central obesity, high fasting plasma glucose, high triglyceride, low high-density lipoprotein cholesterol, and high blood pressure (BP) was 42.02, 27.96, 32.87, 27.25, and 43.06%, respectively. A total of 29.60% (95% CI 27.55-31.74) participants presented at least three components of MetS. The results from complex sampling unconditional logistic regression revealed that the risk factors for having MetS included being 45-59 years old, being 60-79 years old, being male, living in a rural area, education with junior middle school level, education with primary school or below level, harmful use of alcohol, inappropriate sleep time, and having an unhealthy waist-to-height ratio (WHtR); the OR values were 1.55 (95% CI 1.32-1.81), 1.94 (95% CI 1.62-2.31), 1.51 (95% CI 1.34-1.70), 1.27 (95% CI 1.06-1.52), 1.38 (95% CI 1.13-1.68), 1.44 (95% CI 1.13-1.84), 1.50 (95% CI 1.14-1.99), 1.23 (95% CI 1.10-1.37), and 238.20 (95% CI 92.54-613.12), respectively. CONCLUSIONS The prevalence of MetS is still in a rising trend in Beijing. Strategies aimed at prevention and control of high BP should be prioritized to reduce the occurrence of MetS. WHtR is more important to evaluate MetS. Health education and personalized lifestyle intervention should be promoted to keep a healthy WHtR and waist circumference. An appropriate sleep time should be kept, and harmful alcohol drinkers should limit or abstain from alcohol.
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Affiliation(s)
- Aijuan Ma
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Kai Fang
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Jing Dong
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Zhong Dong
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China,
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Chi JH, Shin MS, Lee BJ. Association of type 2 diabetes with anthropometrics, bone mineral density, and body composition in a large-scale screening study of Korean adults. PLoS One 2019; 14:e0220077. [PMID: 31339947 PMCID: PMC6656355 DOI: 10.1371/journal.pone.0220077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/07/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) is a common, chronic disease that is closely associated with anthropometric indices related to obesity. However, no study published to date has simultaneously examined the associations of T2DM with anthropometrics, bone mineral density (BMD), and body composition variables. The present study aimed to evaluate the associations of T2DM with anthropometrics, BMD and body composition variables and to identify the best indicator of T2DM in Korean adults. METHODS The data used in this study were obtained from the Korea National Health and Nutrition Examination Survey conducted from 2008 to 2011. A total of 7,835 participants aged from 40 to 90 years were included in this study. A binary logistic regression analysis was performed to examine the significance of differences between the groups with and without T2DM, and the areas under the receiver operating characteristic (AUCs) curves were calculated to compare the predictive power of all variables. RESULTS In men, waist-to-height ratio (WHtR) displayed the strongest association with T2DM (adjusted odds ratio (OR) = 1.838 [1.513-2.233], adjusted p<0.001), and waist circumference (WC) and WHtR were the best indicators (WC: AUC = 0.662 [0.639-0.685], WHtR: AUC = 0.680 [0.658-0.703]) of T2DM among all the variables. In women, left leg (LL) and right leg (RL) fat displayed strong negative associations with T2DM (LL fat: adjusted OR = 0.367 [0.321-0.419], adjusted p<0.001, RL fat: adjusted OR = 0.375 [0.329-0.428], adjusted p<0.001), and WC and WHtR were excellent indicators (WC: AUC = 0.730 [0.709-0.750], WHtR: AUC = 0.747 [0.728-0.766]) of T2DM among all the variables. In particular, the WHtR in men and LL and RL fat in women exhibited the strongest associations with T2DM, and the predictive power of the WC and WHtR was stronger than BMD, fat, and muscle mass variables in both men and women. Additionally, the predictive power of the WC and WHtR was stronger in women than in men. DISCUSSION Of the anthropometric indices, BMD, and body fat and muscle variables, the best indicators of T2DM were WC and WHtR in both Korean men and women. The results of the present investigation will provide basic information for clinical studies of patients with T2DM and evidence for the prevention and management of T2DM.
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Affiliation(s)
- Jeong Hee Chi
- Department of Software, Konkuk University, Seoul, Republic of Korea
| | - Moon Sun Shin
- Department of Computer Engineering, Konkuk University, Chungju, Republic of Korea
| | - Bum Ju Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
- * E-mail:
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Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Anthropometric changes and risk of diabetes: are there sex differences? A longitudinal study of Alberta's Tomorrow Project. BMJ Open 2019; 9:e023829. [PMID: 31326923 PMCID: PMC6661609 DOI: 10.1136/bmjopen-2018-023829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 02/19/2019] [Accepted: 06/21/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To characterise the sex-specific difference in the association between anthropometric changes and risk of diabetes in the general population in Canada. SETTING AND PARTICIPANTS From 2000 to 2008, Alberta's Tomorrow Project (ATP) invited Alberta's residents aged 35-69 years to a prospective cohort study. A total of 19 655 diabetes-free ATP participants having anthropometrics measured at the baseline and follow-ups were included. DESIGN AND OUTCOME MEASURES A longitudinal study design was used to examine the association between anthropometric changes and risk of diabetes and the sex difference in this association. Changes in weight, body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) were calculated as the difference between baseline and follow-up measures. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm with administrative healthcare data (2000-2015) linked to the ATP cohort. The sex-specific association between anthropometric changes and incidence of diabetes were examined by multivariable Cox regression models. RESULTS Changes in weight, BMI, WC and WHR over time were positively associated with incidence of diabetes in both men and women. The sex difference in risk of diabetes associated with 1 standard deviation (SD) increase in anthropometrics was 0.07 (95% CI -0.02 to 0.14) for weight, 0.08 (95% CI -0.03 to 0.17) for BMI, 0.07 (95% CI -0.02 to 0.15) for WC and 0.09 (95% CI 0.03 to 0.13) for WHR. Similar results were found in sex difference in the associations with changes per 5% and changes per categories (5% loss, ±5%, 5% gain). CONCLUSIONS The positive association between anthropometric changes and risk of diabetes was generally stronger in men than in women. However, this sex-specific difference of approximately 10% of the total risk associated with anthropometric changes had limited significance. For population-based public health programmes aiming to control obesity and incidence of diabetes, it may not be necessary to set up sex-specific goals for anthropometric reduction.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paula J Robson
- CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
- Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jian-Yi Xu
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Rajput R, Rajput M, Mishra S, Ahlawat P. Prevalence of Metabolic Syndrome in Prediabetes. Metab Syndr Relat Disord 2019; 17:406-410. [PMID: 31305207 DOI: 10.1089/met.2019.0010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aims: To study the prevalence of metabolic syndrome and its components in prediabetes and to compare the anthropometric indices [waist circumference (WC), hip circumference, waist-hip ratio, waist-height ratio] as predictors of metabolic syndrome in prediabetes. Methods: A total of 300 subjects (200 prediabetic cases and 100 matched normoglycemic controls) in the age group of 18-70 years were recruited for the study. Among the cases, there were 38% of males and 62% of females; and there were 33% of males and 67% of females in the control group. Prediabetes was diagnosed using the American Diabetic Association (ADA) criteria, and metabolic syndrome was diagnosed using the International Diabetes Federation criteria. Results: Prevalence of metabolic syndrome was 63% among the cases and 26% among the normoglycemic controls. Among cases, 56.5% of males and 66.9% of females, and among the controls, 36.3% of males and 20.9% of females had metabolic syndrome. The prevalence of metabolic syndrome increased with age and increasing body mass index among both the cases and controls. Central obesity was found to be the most common component of metabolic syndrome among prediabetic males (80.2%) and females (82.2%). The most common cluster of abnormality among the cases and controls was found to be increased WC plus low high-density lipoprotein plus increased triglycerides. Logistic regression analysis was applied to anthropometric indices, and it was found that increased WC had the maximum predictive power for metabolic syndrome among the subjects with prediabetes. Conclusion: Metabolic syndrome was more prevalent in the prediabetic population in comparison to the normoglycemic individuals with increased WC being the most prevalent component. Increased WC had the maximum predictive power for occurrence of metabolic syndrome among prediabetic subjects.
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Affiliation(s)
- Rajesh Rajput
- Department of Endocrinology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Meena Rajput
- Department of Social and Preventive Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Sanat Mishra
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Parul Ahlawat
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
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Wang Y, Shirore RM, Ramakrishnan C, Tan NC, Jafar TH. Adiposity measures and pre‐diabetes or diabetes in adults with hypertension in Singapore polyclinics. J Clin Hypertens (Greenwich) 2019; 21:953-962. [DOI: 10.1111/jch.13587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/25/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Yeli Wang
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
| | - Rupesh M. Shirore
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
| | - Chandrika Ramakrishnan
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
| | - Ngiap Chuan Tan
- Health Services Research Centre SingHealth Singapore Singapore
- SingHealth Polyclinics Singapore Singapore
- SingHealth‐Duke NUS Family Academic Clinical Program Singapore Singapore
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research Duke‐NUS Medical School Singapore Singapore
- Health Services Research Centre SingHealth Singapore Singapore
- Department of Renal Medicine Singapore General Hospital Singapore Singapore
- Duke Global Health Institute Duke University Durham North Carolina
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Chu FL, Jeng C. Lowered obesity indicator cutoff points more effectively predict 5-year incidence of hypertension in premenopausal women. Int J Qual Health Care 2019; 31:365-370. [PMID: 30165634 DOI: 10.1093/intqhc/mzy183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/24/2018] [Accepted: 08/03/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare proposed new cutoff points for four obesity indicators-waist-to-height ratio (WHtR), waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI)-with their current cutoff points to determine which are better standards predicting 5-year incidence of hypertension (HT) and diabetes mellitus (DM) among premenopausal women. DESIGN Data were obtained from the 2002 and 2007 Survey on the Prevalence of HT, Hyperglycemia and Hyperlipidemia in Taiwan conducted by the Ministry of Health and Welfare, Taiwan. Premenopausal women were grouped based on the proposed cutoff points versus reference cutoff points for obesity indicators. PARTICIPANT A total of 1466 premenopausal women aged between 20 and 57 years old were recruited. MAIN OUTCOME MEASURE Five-year incidence of HT and DM. RESULTS Our new obesity indicator cutoff points-WHtR 0.49, WC 74.7 cm, WHR 0.79 and BMI 22.3 kg/m2-were better predictors for 5-year HT incidence in premenopausal women compared with those of current standards, but were not significantly different for DM. Among the four obesity indicators, WHtR and WC were optimal for their 5-year predictive ability for HT and DM in premenopausal women. CONCLUSIONS To avoid too many cutoff points for practitioners to adopt and memorize, the proposed new cutoff points were recommended preferentially to prevent the incidence of HT and DM in premenopausal women.
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Affiliation(s)
- Fu-Ling Chu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan
| | - Chii Jeng
- Graduate Institute of Nursing, School of Nursing, Taipei Medical University, Taipei 110, Taiwan
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Cho JH, Rhee EJ, Park SE, Kwon H, Jung JH, Han KD, Park YG, Park HS, Kim YH, Yoo SJ, Lee WY. The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study. Diabetes Metab J 2019; 43:206-221. [PMID: 30604597 PMCID: PMC6470098 DOI: 10.4093/dmj.2018.0039] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 09/03/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI). METHODS Our study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data. RESULTS A total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS. CONCLUSION WC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.
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Affiliation(s)
- Jung Hwan Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hyung Jung
- Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Do Han
- Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Soon Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yang Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Soon Jib Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
| | - Won Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Prevalence and relationship of hypertriglyceridaemic-waist phenotype and type 2 diabetes mellitus among a rural adult Chinese population. Public Health Nutr 2019; 22:1361-1366. [PMID: 30846007 DOI: 10.1017/s1368980019000181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Limited information is available on the prevalence and effect of hypertriglyceridaemic-waist (HTGW) phenotype on the risk of type 2 diabetes mellitus (T2DM) in rural populations. DESIGN In the present cross-sectional study, we investigated the prevalence of the HTGW phenotype and T2DM and the strength of their association among rural adults in China. SETTING HTGW was defined as TAG >1·7 mmol/l and waist circumference (WC) ≥90 cm for males and ≥80 cm for females. Logistic regression analysis yielded adjusted odds ratios (aOR) relating risk of T2DM with HTGW.ParticipantsAdults (n 12 345) aged 22·83-92·58 years were recruited from July to August of 2013 and July to August of 2014 from a rural area of Henan Province in China. RESULTS The prevalence of HTGW and T2DM was 23·71 % (males: 15·35 %; females: 28·88 %) and 11·79 % (males: 11·15 %; females: 12·18 %), respectively. After adjustment for sex, age, smoking, alcohol drinking, blood pressure, physical activity and diabetic family history, the risk of T2DM (aOR; 95 % CI) was increased with HTGW (v. normal TAG and WC: 3·23; CI 2·53, 4·13; males: 3·37; 2·30, 4·92; females: 3·41; 2·39, 4·85). The risk of T2DM with BMI≥28·0 kg/m2, simple enlarged WC and simple disorders of lipid metabolism showed an increasing tendency (aOR=1·31, 1·75 and 2·32). CONCLUSIONS The prevalence of HTGW and T2DM has reached an alarming level among rural Chinese people, and HTGW is a significant risk factor for T2DM.
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Zhang R, Dong SY, Wang F, Ma C, Zhao XL, Zeng Q, Fei A. Associations between Body Composition Indices and Metabolic Disorders in Chinese Adults: A Cross-Sectional Observational Study. Chin Med J (Engl) 2018; 131:379-388. [PMID: 29451141 PMCID: PMC5830821 DOI: 10.4103/0366-6999.225059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Obesity induces dyslipidemia, hypertension, glucose intolerance, and inflammatory state, which results in atherogenic processes, diabetes, and cardiovascular disease. We usually use body composition indices, such as body mass index (BMI), body fat percentage (BFP), waist circumference-height ratio (WHtR), and waist-hip ratio (WHR) to reflect the obesity. The aim of this large population-based cross-sectional study was to investigate the associations between body composition indices and metabolic parameters in Chinese adults. Methods A total of 12,018 Chinese adults were included. Body composition indices, such as BMI, BFP, WHtR, and WHR, and metabolic parameters, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), fasting blood glucose (FBG), 2 h postprandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), and white blood cell count (WBC), were measured and analyzed. All analyses were stratified by gender. Results All body composition indices and metabolic parameters except 2h PBG differed significantly between males and females (all P < 0.001). BMI was positively associated with SBP, DBP, LDL-C, TC, TG, FBG, 2h PBG, HbA1c, FINS, HOMA-IR, hs-CRP, and WBC, and inversely associated with HDL-C; similar relationships were identified between the metabolic parameters and BFP, WHtR, and WHR. In the multivariate analysis, the odds of impaired glucose regulation, dyslipidemia, insulin resistance, and increased hs-CRP were 1.36, 1.92, 3.44, and 1.27 times greater in the overweight group than those in the normal weight group, respectively, and 1.66, 3.26, 7.53, and 1.70 times greater in the obese group than those in the normal weight group, respectively. The odds of dyslipidemia and hs-CRP were 1.29 and 1.38 times greater in the BFP ≥28.0% group than in the BFP <28.0% group, respectively. The odds of dyslipidemia, HOMA-IR, and hs-CRP were 1.55, 1.26, and 1.48 times greater in the WHtR ≥0.96 group than in the WHtR <0.96 group, respectively. Among males, the odds of HOMA-IR were 1.46 times greater in the WHR ≥0.54 group than in the WHR <0.54 group. Similar results were observed in females. Conclusions This study identified positive associations between all evaluated body composition indices and metabolic parameters in Chinese adults. Among the body composition indices, BMI predicted four of the five evaluated metabolic disorders in both gender groups.
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Affiliation(s)
- Rong Zhang
- International Medical Center, Health Management Institute, Chinese PLA General Hospital, Beijing 100853; Department of Cardiology, Chinese Navy General Hospital, Beijing 100048, China
| | - Sheng-Yong Dong
- Department of Healthcare, Agency for Offices Administration of PLA, Beijing 100048, China
| | - Fei Wang
- International Medical Center, Health Management Institute, Chinese PLA General Hospital, Beijing 100853, China
| | - Cong Ma
- International Medical Center, Health Management Institute, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiao-Lan Zhao
- Department of Health Management Center, Health Management Institute, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China
| | - Qiang Zeng
- International Medical Center, Health Management Institute, Chinese PLA General Hospital, Beijing 100853, China
| | - Ao Fei
- Navy Institutional Organization, Beijing 100841, China
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Liu F, Shen X, Wang R, Yu N, Shi Y, Xiong S, Xiong C, Zhou Y. Association of central obesity with sex hormonebinding globulin: a cross-sectional study of 1166 Chinese men. Open Med (Wars) 2018; 13:196-202. [PMID: 29770358 PMCID: PMC5952425 DOI: 10.1515/med-2018-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 03/26/2018] [Indexed: 11/28/2022] Open
Abstract
Background Both sex hormone-binding globulin and central obesity have been found to be associated with metabolic and cardiovascular diseases. However, the direct relation between sex hormone-binding globulin and central obesity has not been demonstrated. Methodology We performed a cross-sectional study of 1166 male participants from Zunyi, Guizhou, western China, in 2013. Each participant completed a questionnaire and had a brief clinical exam with a fasting blood sample taken. All blood samples underwent standard laboratory testing for sex hormone-binding globulin. Level of serum sex hormone-binding globulin was compared by demographic characteristics, and multiple linear regression was used to evaluate the independent association of variables and sex hormone-binding globulin level. Results The mean serum level of sex hormone-binding globulin was increased in old-aged men (older than 40 years; mean 44.68±20.58 nmol/L), low diastolic blood pressure (<90mmHg; 43.76±20.50 nmol/L), waist-to-height ratio <0.5 (48.73±20.59 nmol/L), no education (52.36±22.91 nmol/L), farm occupation (43.58±20.60nmol/L), non-alcohol or former user (44.78±20.94 nmol/L) and long-term medication history (44.79±21.50 nmol/L). Factors independently associated with sex hormone binding globulin level on multiple regression were waist-to-height ratio (β=- 11.84 [95% confidence interval -13.96,-9.72]), age(β=12.40 [9.63,15.17]) and diastolic blood pressure (β=-5.07 [-7.44,-2.71]). Conclusions Central obesity has an independent inverse relation with serum level of sex hormone binding globulin among western Chinese men
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Affiliation(s)
- Fangwei Liu
- School of Public Health , Zunyi Medical University , Zunyi , China
| | - Xubo Shen
- School of Public Health , Zunyi Medical University , Zunyi , China
| | - Ruifeng Wang
- Department of Chronic Noncommunicable Diseases , Huichuan District Center for Disease Control and Prevention , Zunyi , China
| | - Na Yu
- School of Public Health , Guangdong Medical University , Dong Guan , China
| | - Yongjun Shi
- Department of Neonatology, Guiyang Maternal and Child Healthcare Hospital , Guiyang , China
| | - Shimin Xiong
- School of Public Health , Zunyi Medical University , Zunyi , China
| | - Chengliang Xiong
- Institute of Family Planning , Huazhong University of Science and TechnologyTongji Medical College , Wuhan , China
| | - Yuanzhong Zhou
- School of Public Health , Zunyi Medical University , No.6 of Xuefuxi Road, Honghuagang District, Zunyi of Guizhou Province , Zunyi , PR of China
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Zhang F, Wan Q, Cao H, Tang L, Li D, Lü Q, Yan Z, Li J, Yang Q, Zhang Y, Tong N. Identical anthropometric characteristics of impaired fasting glucose combined with impaired glucose tolerance and newly diagnosed type 2 diabetes: anthropometric indicators to predict hyperglycaemia in a community-based prospective cohort study in southwest China. BMJ Open 2018; 8:e019735. [PMID: 29743321 PMCID: PMC5942465 DOI: 10.1136/bmjopen-2017-019735] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess the anthropometric characteristics of normoglycaemic individuals who subsequently developed hyperglycaemia, and to evaluate the validity of these measures to predict prediabetes and diabetes. DESIGN A community-based prospective cohort study. PARTICIPANTS In total, 1885 residents with euglycaemia at baseline from six communities were enrolled. SETTING Sichuan, southwest China. PRIMARY OUTCOME MEASURES The incidences of prediabetes and diabetes were the primary outcomes. METHODS The waist-to-height ratio (WHtR), body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) of all participants were measured at baseline and during follow-up. A 75 g glucose oral glucose tolerance test was conducted at each survey. RESULTS During a median of 3.00 (IQR: 2.92-4.17) years follow-up, the cumulative incidence of isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), IFG combined with IGT (IFG+IGT), and newly diagnosed diabetes mellitus (NDDM) were 8.44%, 18.14%, 8.06% and 13.79%, respectively. WHtR, BMI, WC and WHR were significantly different among subjects who subsequently progressed to isolated IFG or IGT, IFG+IGT or NDDM (p<0.05). The anthropometric characteristics of IFG+IGT subjects were similar to those of the NDDM population (p>0.005). All the baseline anthropometric measurements were useful for the prediction of future prediabetes and NDDM (p<0.05). The optimal thresholds for the four measurements were calculated for the prediction of hyperglycaemia, with a WHtR value of 0.52 performing best to identify isolated IFG or IGT, IFG+IGT and NDDM. CONCLUSIONS Anthropometric measures, especially WHtR, could be used to predict hyperglycaemia 3 years in advance. Distinct from isolated IFG and IGT, the individuals who developed combined IFG+IGT had identical anthropometric profiles to those who progressed to NDDM.
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Affiliation(s)
- Fang Zhang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Qin Wan
- Division of Endocrinology and Metabolism, Hospital Affiliated to Southwest Medical University, Luzhou, China
| | - Hongyi Cao
- Division of Endocrinology and Metabolism, The Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Lizhi Tang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Daigang Li
- Chengdu Yinchao Community Hospital, Chengdu, China
| | - Qingguo Lü
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Zhe Yan
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Li
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Qiu Yang
- Division of Endocrinology and Metabolism, The Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Yuwei Zhang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
| | - Nanwei Tong
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
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Borzouei S, Soltanian AR. Application of an artificial neural network model for diagnosing type 2 diabetes mellitus and determining the relative importance of risk factors. Epidemiol Health 2018. [PMID: 29529860 PMCID: PMC5968209 DOI: 10.4178/epih.e2018007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To identify the most important demographic risk factors for a diagnosis of type 2 diabetes mellitus (T2DM) using a neural network model. METHODS This study was conducted on a sample of 234 individuals, in whom T2DM was diagnosed using hemoglobin A1c levels. A multilayer perceptron artificial neural network was used to identify demographic risk factors for T2DM and their importance. The DeLong method was used to compare the models by fitting in sequential steps. RESULTS Variables found to be significant at a level of p<0.2 in a univariate logistic regression analysis (age, hypertension, waist circumference, body mass index [BMI], sedentary lifestyle, smoking, vegetable consumption, family history of T2DM, stress, walking, fruit consumption, and sex) were entered into the model. After 7 stages of neural network modeling, only waist circumference (100.0%), age (78.5%), BMI (78.2%), hypertension (69.4%), stress (54.2%), smoking (49.3%), and a family history of T2DM (37.2%) were identified as predictors of the diagnosis of T2DM. CONCLUSIONS In this study, waist circumference and age were the most important predictors of T2DM. Due to the sensitivity, specificity, and accuracy of the final model, it is suggested that these variables should be used for T2DM risk assessment in screening tests.
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Affiliation(s)
- Shiva Borzouei
- Department of Endocrinology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Soltanian
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Amirabdollahian F, Haghighatdoost F. Anthropometric Indicators of Adiposity Related to Body Weight and Body Shape as Cardiometabolic Risk Predictors in British Young Adults: Superiority of Waist-to-Height Ratio. J Obes 2018; 2018:8370304. [PMID: 30515323 PMCID: PMC6236774 DOI: 10.1155/2018/8370304] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 02/06/2023] Open
Abstract
Frequently reported poor dietary habits of young adults increase their risk of metabolic syndrome (MetS). Excess adiposity is the most established predictor of MetS, and numerous anthropometric measures have been proposed as proxy indicators of adiposity. We aimed to assess prevalence of MetS in young adult population and to make comparison between weight- and shape-oriented measures of adiposity to identify the best index in association with measured body fat and as a risk predictor for MetS. Healthy males and females aged 18-25 years from the Northwest of England were recruited using convenience sampling (n=550). As part of the assessment of the overall health of young adults, the biochemical variables and adiposity measures BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), new BMI, Body Adiposity Index (BAI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and A Body Shape Index (ABSI) were assessed. Linear regression analysis was used to investigate the association between the proxy indices of adiposity and measured percentage body fat. The odds ratio with 95% confidence interval was used to investigate the relationship between cardiometabolic (CM) risk factors and proxy measures of adiposity. The discriminatory power of these measures for diagnosis of MetS was investigated using area under the receiver operating characteristic curve. Body weight-related indicators of adiposity, particularly CUN-BAE, had stronger association with measured body fat compared with body shape-related indices. In relation with MetS, body shape-related indices, particularly elevated WC and WHtR, had stronger associations with CM risk compared with body weight-related measures. Amongst all indices, the best predictor for CM risk was WHtR, while ABSI had the weakest correlation with body fat, MetS, and CM risk. Indices directly associated with WC and specifically WHtR had greater diagnostic power in detection of CM risk in young adults.
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Affiliation(s)
| | - Fahimeh Haghighatdoost
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Prediction of a new body shape index and body adiposity estimator for development of type 2 diabetes mellitus: The Rural Chinese Cohort Study. Br J Nutr 2017; 118:771-776. [DOI: 10.1017/s0007114517002859] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractTo compare the ability of a body shape index (ABSI) and body adiposity estimator (BAE) to BMI, waist circumference (WC) and waist:height ratio (WHtR) for predicting development of type 2 diabetes mellitus (T2DM) in rural adult Chinese. The prospective cohort study included 11 687 eligible participants who were free of T2DM at baseline. The risk of new-onset T2DM for ABSI, BAE, BMI, WC and WHtR quintiles was estimated by Cox proportional-hazards regression at follow-up. We also compared the power of ABSI and BAE to BMI, WC and WHtR for predicting the development of T2DM. With increasing ABSI, BAE, BMI, WC and WHtR, T2DM incidence was substantially increased (Ptrend<0·0001). After adjustment for multi-covariates, risk of T2DM was increased from the second to fifth quintile as compared with first quintile for ABSI (1·27; 95 % CI 0·95, 1·69; 1·35; 95 % CI 1·00, 1·82; 1·75; 95 % CI 1·33, 2·32 and 1·87; 95 % CI 1·40, 2·49; Ptrend<0·0001); BAE (1·82; 95 % CI 1·38, 2·41; 1·93; 95 % CI 1·38, 2·68; 2·73; 95 % CI 1·94, 3·84 and 4·18; 95 % CI 2·98, 5·87; Ptrend<0·0001); BMI (1·42; 95 % CI 1·03, 1·97; 1·62; 95 % CI 1·18, 2·23; 2·59; 95 % CI 1·92, 3·50 and 3·90; 95 % CI 2·90, 5·26; Ptrend<0·0001); WC (1·53; 95 % CI 1·08, 2·17; 1·66; 95 % CI 1·18, 2·33; 2·72; 1·97, 3·76 and 4·09; 95 % CI 2·97, 5·62; Ptrend<0·0001); and WHtR (1·40; 95 % CI 0·98, 1·99; 2·06; 95 % CI 1·47, 2·88; 2·90; 95 % CI 2·10, 4·01 and 4·22; 95 % CI 3·05, 5·85; Ptrend<0·0001). ABSI, BAE, BMI, WC and WHR were effective and comparable in discriminating cases from non-cases of T2DM. Risk of T2DM was increased with elevated ABSI and BAE, but the predictive ability for T2DM did not differ than that of BMI, WC and WHtR in a rural Chinese population.
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Mitsuhashi K, Hashimoto Y, Tanaka M, Toda H, Matsumoto S, Ushigome E, Asano M, Yamazaki M, Oda Y, Fukui M. Combined effect of body mass index and waist-height ratio on incident diabetes; a population based cohort study. J Clin Biochem Nutr 2017; 61:118-122. [PMID: 28955128 PMCID: PMC5612813 DOI: 10.3164/jcbn.16-116] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/26/2016] [Indexed: 01/12/2023] Open
Abstract
We investigated the impact of combined effect of body mass index and waist-to-height ratio on risk of diabetes. Overweight and abdominal obesity were defined as body mass index ≥23 kg/m2 and waist-to-height ratio ≥0.5, respectively. We divided participants into four groups according to presence of overweight and/or abdominal obesity. About 20% individuals with overweight did not complicated with an abdominal obesity. Among 3,737 participants, 286 participants had diabetes at baseline-examination. Adjusted odds ratios for prevalence of diabetes compared with non-overweight participants without abdominal obesity were as follow: 1.87 (95% confidence interval 1.09-3.14, p = 0.024) in non-overweight participants with abdominal obesity, 1.51 (0.87-2.55, p = 0.141) in overweight participants without abdominal obesity and 3.25 (2.37-4.52, p<0.001) in overweight participants with abdominal obesity. In the follow-up examination, 86 participants were diagnosed as diabetes among 2,263 participants. Adjusted odds ratios for incident diabetes were as follow: 2.59 (0.98-6.44, p = 0.056) in non-overweight participants with abdominal obesity, 1.65 (0.64-4.00, p = 0.288) in overweight participants without abdominal obesity and 2.77 (1.55-5.15, p<0.001) in overweight participants with abdominal obesity. Non-overweight individuals with abdominal obesity as well as overweight individuals with abdominal obesity was associated with diabetes compared with non-overweight individuals without abdominal obesity.
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Affiliation(s)
- Kazuteru Mitsuhashi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hitoshi Toda
- Department of Internal Medicine, Oike Clinic, 11 Shimoai-cho, Nishinokyo, Nakagyo-ku, Kyoto, 604-8436, Japan
| | - Shinobu Matsumoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yohei Oda
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Park J, Lee ES, Lee DY, Kim J, Park SE, Park CY, Lee WY, Oh KW, Park SW, Rhee EJ. Waist Circumference as a Marker of Obesity Is More Predictive of Coronary Artery Calcification than Body Mass Index in Apparently Healthy Korean Adults: The Kangbuk Samsung Health Study. Endocrinol Metab (Seoul) 2016; 31:559-566. [PMID: 28029026 PMCID: PMC5195833 DOI: 10.3803/enm.2016.31.4.559] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 08/06/2016] [Accepted: 08/23/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We aimed to assess the risk for coronary artery calcification (CAC) according to groups subdivided by body mass index (BMI) and waist circumference (WC) in apparently healthy Korean adults. METHODS Thirty-three thousand four hundred and thirty-two participants (mean age, 42 years) in a health screening program were divided into three groups according to BMI: <23 kg/m² (normal), 23 to 25 kg/m² (overweight), and >25 kg/m² (obese). In addition, the participants were divided into two groups according to WC. Coronary artery calcium score (CACS) was measured with multi-detector computed tomography in all participants. Presence of CAC was defined as CACS >0. RESULTS When logistic regression analysis was performed with the presence of CAC as the dependent variable, the risk for CAC increased as BMI increased after adjusting for confounding variables (1.102 [95% confidence interval (CI), 1.000 to 1.216]; 1.284 [95% CI, 1.169 to 1.410]; in the overweight and obese groups vs. the normal weight group). When the participants were divided into six groups according to BMI and WC, the subjects with BMI and WC in the obese range showed the highest risk for CAC (1.321 [95% CI, 1.194 to 1.461]) and those with BMI in the overweight range and WC in the obese range showed the second highest risk for CAC (1.235 [95% CI, 1.194 to 1.461]). CONCLUSION Participants with obesity defined by both BMI and WC showed the highest risk for CAC. Those with BMIs in the overweight range but with WC in the obese range showed the second highest risk for CAC, suggesting that WC as a marker of obesity is more predictive of CAC than BMI.
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Affiliation(s)
- Jongsin Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Seo Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Da Young Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihyun Kim
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Eun Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol Young Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Young Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Won Oh
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Woo Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Wang S, Ma W, Yuan Z, Wang SM, Yi X, Jia H, Xue F. Association between obesity indices and type 2 diabetes mellitus among middle-aged and elderly people in Jinan, China: a cross-sectional study. BMJ Open 2016; 6:e012742. [PMID: 27810975 PMCID: PMC5129047 DOI: 10.1136/bmjopen-2016-012742] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The relationship between obesity and type 2 diabetes mellitus (T2DM) varies with geographical area and race. OBJECTIVES To investigate the prevalence of T2DM and the proportion of subjects with undiagnosed T2DM. In addition, to compare the associations between different obesity indices and T2DM for middle-aged and elderly people from six communities in Jinan, China. SETTING A cross-sectional study was designed and the study subjects were chosen from blocks which were randomly selected in the 6 communities of Jinan, China in 2011-2012. PARTICIPANTS A total of 3277 residents aged ≥50 years were eligible for this study, but 1563 people were excluded because they did not provide anthropometric data such as height, weight, waist circumference (WC), hip circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, triglyceride (TG), total cholesterol (TC) or information about their current medication use. Hence, 1714 participants were included in the final data analysis. RESULTS The prevalence of T2DM among people aged ≥50 years was 16.6% (19.3% for men and 15.3% for women) and the proportion of patients with undiagnosed T2DM was 32.7%. Compared with the lowest levels of body mass index (BMI), WC, waist-to-hip ratio or waist-to-stature ratio (WSR), the ORs and 95% CIs of the highest levels for men, after adjusting for age, smoking, alcohol drinking, regular exercise, hypertension, TG and TC, were 1.607 (0.804 to 3.210), 2.189 (1.118 to 4.285), 1.873 (0.968 to 3.623) and 2.572 (1.301 to 5.083), respectively, and for women, 2.764 (1.622 to 4.712), 2.407 (1.455 to 3.985), 2.500 (1.484 to 4.211) and 2.452 (1.447 to 4.155), respectively. CONCLUSIONS Among adults aged ≥50 years in Jinan, China, the best indicator of the relationship between obesity and T2DM is WSR for men and BMI for women, respectively.
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Affiliation(s)
- Shukang Wang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Shu-mei Wang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiangren Yi
- The College of Physical Education, Shandong University, Jinan, China
| | - Hongying Jia
- The Second Hospital of Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
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Alperet DJ, Lim WY, Mok-Kwee Heng D, Ma S, van Dam RM. Optimal anthropometric measures and thresholds to identify undiagnosed type 2 diabetes in three major Asian ethnic groups. Obesity (Silver Spring) 2016; 24:2185-93. [PMID: 27558457 DOI: 10.1002/oby.21609] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/02/2016] [Accepted: 06/03/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify optimal anthropometric measures and cutoffs to identify undiagnosed diabetes mellitus (UDM) in three major Asian ethnic groups (Chinese, Malays, and Asian-Indians). METHODS Cross-sectional data were analyzed from 14,815 ethnic Chinese, Malay, and Asian-Indian participants of the Singapore National Health Surveys, which included anthropometric measures and an oral glucose tolerance test. Receiver operating characteristic curve analyses were used with calculation of the area under the curve (AUC) to evaluate the performance of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) for the identification of UDM. RESULTS BMI performed significantly worse (AUCMEN = 0.70; AUCWOMEN = 0.75) than abdominal measures, whereas WHTR (AUCMEN = 0.76; AUCWOMEN = 0.79) was among the best performing measures in both sexes and all ethnic groups. Anthropometric measures performed better in Chinese than in Asian-Indian participants for the identification of UDM. A WHTR cutoff of 0.52 appeared optimal with a sensitivity of 76% in men and 73% in women and a specificity of 63% in men and 70% in women. CONCLUSIONS Although ethnic differences were observed in the performance of anthropometric measures for the identification of UDM, abdominal adiposity measures generally performed better than BMI, and WHTR performed best in all Asian ethnic groups.
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Affiliation(s)
- Derrick Johnston Alperet
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Wei-Yen Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Derrick Mok-Kwee Heng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Stefan Ma
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Rob M van Dam
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
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40
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Zhang H, Deng M, Xu H, Wang H, Song F, Bao C, Paillard-Borg S, Xu W, Qi X. Pre- and undiagnosed-hypertension in urban Chinese adults: a population-based cross-sectional study. J Hum Hypertens 2016; 31:263-269. [PMID: 27654328 DOI: 10.1038/jhh.2016.73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/28/2016] [Accepted: 08/12/2016] [Indexed: 01/19/2023]
Abstract
Hypertension is common in adults and often undiagnosed, and the prevalence of pre- and undiagnosed-hypertension remains unclear. We aimed to investigate the prevalence of pre- and undiagnosed-hypertension and their correlates among urban Chinese adults. A total of 7435 participants aged 20-79 were included in this study. Data on demographics, lifestyle and medical history were collected through a structured interview. Pre- and undiagnosed-hypertension was defined as systolic blood pressure/ diastolic blood pressure (SBP/DBP) of 120-139/80-89 mm Hg and SBP⩾140 mm Hg and/or DBP⩾90 mm Hg, respectively, in participants without a history of hypertension and use of antihypertensive medication. Prevalence rates were calculated and standardized using local age- and gender-specific census data. Data were analysed using multinomial logistic regression with adjustment for potential confounders. Of all the participants, 2726 (36.7%) were diagnosed with pre-hypertension and 919 (12.3%) with undiagnosed-hypertension. Undiagnosed-hypertension accounted for 37.3% of all participants with hypertension. The prevalence of pre-hypertension gradually decreased with age, while undiagnosed-hypertension increased, although presenting different changing patterns among men and women. In a fully adjusted multinomial logistic regression, age, male sex, low socio-economic status (SES), abdominal obesity, alcohol drinking, physical inactivity and type 2 diabetes mellitus (T2DM) were significantly associated with increased odds of pre- and undiagnosed-hypertension. In conclusions, the prevalence of pre- and undiagnosed-hypertension was ~50% among urban Chinese adults. Abdominal obesity, low SES, alcohol drinking, physical inactivity and T2DM may be indicators for pre- and undiagnosed-hypertension.
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Affiliation(s)
- H Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Fundamental Nursing, School of Nursing, Tianjin Medical University, Tianjin, China
| | - M Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - H Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - H Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - F Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - C Bao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - S Paillard-Borg
- Department of Medicine and Public Health, The Swedish Red Cross University College, Stockholm, Sweden
| | - W Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Aging Research Center (ARC), Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - X Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Poltavskiy E, Kim DJ, Bang H. Comparison of screening scores for diabetes and prediabetes. Diabetes Res Clin Pract 2016; 118:146-53. [PMID: 27371780 PMCID: PMC4972666 DOI: 10.1016/j.diabres.2016.06.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/02/2016] [Accepted: 06/06/2016] [Indexed: 02/03/2023]
Abstract
AIMS There are numerous risk or screening scores for the prediction of type-2 diabetes mellitus (DM). In contrast, few scores are available for preDM. In this paper, we compare the two screening scores from the American Diabetes Association (ADA) and Centers for Disease Control and Prevention (CDC) that can be used for DM as well as preDM. METHODS Adult participants (N=9391) without known DM from the National Health and Nutrition Examination Surveys 2009-12 were included. We fitted the factors/items in the ADA and CDC scores in logistic regression with the outcomes of undiagnosed DM, preDM, and combination, and assessed the association and discrimination accuracy. We also evaluated the suggested cutpoints that define high risk individuals. We mimicked the original models/settings but also tested various deviations/modifications often encountered in practice. RESULTS Both scores performed well and robustly, while the ADA score performed somewhat better (e.g., AUC=0.77 for ADA and 0.73-0.74 for CDC for DM; 0.72-0.74 and 0.70-0.71 for preDM). The same predictors and scoring rules seem to be reasonably justified with different cutpoints for DM and preDM, which can make usage easier and consistent. Some factors such as race and HDL/LDL cholesterols may be useful additions to health education. CONCLUSIONS Current DM education and screening focus on the prevention and management of DM. The ADA and CDC scores could further help when we identify individuals at high risk for preDM, and teach the importance of preDM during which lifestyle intervention can be effective and urgently needed.
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Affiliation(s)
- Eduard Poltavskiy
- Graduate Group in Epidemiology, University of California, Davis, USA
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
| | - Heejung Bang
- Graduate Group in Epidemiology, University of California, Davis, USA; Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, USA.
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42
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Corrêa MM, Thumé E, De Oliveira ERA, Tomasi E. Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review. Arch Gerontol Geriatr 2016; 65:174-82. [DOI: 10.1016/j.archger.2016.03.021] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 01/12/2023]
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Oguoma VM, Nwose EU, Ulasi II, Akintunde AA, Chukwukelu EE, Araoye MA, Edo AE, Ijoma CK, Onyia IC, Ogbu II, Onyeanusi JC, Digban KA, Onodugo OD, Adediran O, Opadijo OG, Bwititi PT, Richards RS, Skinner TC. Maximum accuracy obesity indices for screening metabolic syndrome in Nigeria: A consolidated analysis of four cross-sectional studies. Diabetes Metab Syndr 2016; 10:121-127. [PMID: 26907969 DOI: 10.1016/j.dsx.2016.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 01/04/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND In sub-Saharan Africa, there is no precise use of metabolic syndrome (MetS) definitions and risk factors screening indices in many clinical and public health services. Methods proposed and used in Western populations are adopted without validation within the local settings. The aim of the study is to assess obesity indices and cut-off values that maximise screening of MetS and risk factors in the Nigerian population. METHOD A consolidated analysis of 2809 samples from four population-based cross-sectional study of apparently healthy persons≥18 years was carried out. Optimal waist circumference (WC) and waist-to-height ratio (WHtR) cut points for diagnosing MetS and risk factors were determined using Optimal Data Analysis (ODA) model. The stability of the predictions of the models was also assessed. RESULTS Overall mean values of BMI, WC and WHtR were 24.8±6.0kgm(-2), 84.0±11.3cm and 0.52±0.1 respectively. Optimal WC cut-off for discriminating MetS and diabetes was 83cm in females and 85cm in males, and 82cm in females and 89cm in males, respectively. WC was stable in discriminating diabetes than did WHtR and BMI, while WHtR showed better stability in predicting MetS than WC and BMI. CONCLUSION The study shows that the optimal WC that maximises classification accuracy of MetS differs from that currently used for sub-Saharan ethnicity. The proposed global WHtR of 0.50 may misclassify MetS, diabetes and hypertension. Finally, the WC is a better predictor of diabetes, while WHtR is a better predictor of MetS in this sample population.
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Affiliation(s)
- Victor M Oguoma
- School of Psychological and Clinical Sciences, Charles Darwin University, Northern Territory, Australia.
| | - Ezekiel U Nwose
- School of Community Health, Charles Sturt University, New South Wales, Australia; Department of Public and Community Health, Novena University Ogume, Delta State, Nigeria
| | - Ifeoma I Ulasi
- College of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Nigeria
| | - Adeseye A Akintunde
- Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Ekene E Chukwukelu
- Department of Chemical Pathology, College of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Nigeria
| | - Matthew A Araoye
- Department of Internal Medicine, Benue State University, Makurdi, Benue State, Nigeria
| | - Andrew E Edo
- Department of Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria
| | - Chinwuba K Ijoma
- College of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Nigeria
| | | | - Innocent I Ogbu
- Department of Medical Laboratory Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Joel C Onyeanusi
- Department of Medical laboratory sciences, Faculty of Health Sciences and Technology, University of Nigeria, Enugu, Nigeria
| | - Kester A Digban
- Department of Public and Community Health, Novena University Ogume, Delta State, Nigeria
| | - Obinna D Onodugo
- College of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Nigeria
| | - Olufemi Adediran
- Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Oladimeji G Opadijo
- Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Phillip T Bwititi
- School of Community Health, Charles Sturt University, New South Wales, Australia
| | - Ross S Richards
- School of Community Health, Charles Sturt University, New South Wales, Australia
| | - Timothy C Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Northern Territory, Australia
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Jung SH, Ha KH, Kim DJ. Visceral Fat Mass Has Stronger Associations with Diabetes and Prediabetes than Other Anthropometric Obesity Indicators among Korean Adults. Yonsei Med J 2016; 57:674-80. [PMID: 26996568 PMCID: PMC4800358 DOI: 10.3349/ymj.2016.57.3.674] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/21/2015] [Accepted: 01/04/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study determined which obesity measurement correlates the best with diabetes and prediabetes. MATERIALS AND METHODS This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines. RESULTS After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity. CONCLUSION Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.
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Affiliation(s)
- Suk Hwa Jung
- Ajou University School of Medicine, Suwon, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
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45
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Son YJ, Kim J, Park HJ, Park SE, Park CY, Lee WY, Oh KW, Park SW, Rhee EJ. Association of Waist-Height Ratio with Diabetes Risk: A 4-Year Longitudinal Retrospective Study. Endocrinol Metab (Seoul) 2016; 31:127-33. [PMID: 26754587 PMCID: PMC4803548 DOI: 10.3803/enm.2016.31.1.127] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of various baseline adiposity indices, including WHtR, with the development of diabetes over 4 years of follow-up in apparently healthy Korean individuals. METHODS A total of 2,900 nondiabetic participants (mean age, 44.3 years; 2,078 men) in a health screening program, who repeated the medical check-up in 2005 and 2009, were recruited. Subjects were divided into two groups according to development of diabetes after 4 years. The cut-off values of baseline body mass index (BMI), waist circumference (WC), and WHtR for the development of diabetes over 4 years were calculated. The sensitivity, specificity, and mean area under the receiver operator characteristic curve (AUROC) of each index were assessed. The odds ratio (OR) for diabetes development was analyzed for each of the three baseline adiposity indices. RESULTS During the follow-up period, 101 new cases (3.5%) of diabetes were diagnosed. The cut-off WHtR value for diabetes development was 0.51. Moreover, WHtR had the highest AUROC value for diabetes development among the three adiposity indices (0.716, 95% confidence interval [CI], 0.669 to 0.763; 0.702, 95% CI, 0.655 to 0.750 for WC; 0.700, 95% CI, 0.651 to 0.750 for BMI). After adjusting for confounding variables, the ORs of WHtR and WC for diabetes development were 1.95 (95% CI, 1.14 to 3.34) and 1.96 (95% CI, 1.10 to 3.49), respectively. No significant differences were observed between the two groups regarding BMI. CONCLUSION Increased baseline WHtR and WC correlated with the development of diabetes after 4 years. WHtR might be a useful screening measurement to identify individuals at high risk for diabetes.
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Affiliation(s)
- Yoon Jeong Son
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihyun Kim
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Jeong Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Eun Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol Young Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Young Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Won Oh
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Woo Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Oh HG, Nallamshetty S, Rhee EJ. Increased Risk of Progression of Coronary Artery Calcification in Male Subjects with High Baseline Waist-to-Height Ratio: The Kangbuk Samsung Health Study. Diabetes Metab J 2016; 40:54-61. [PMID: 26912156 PMCID: PMC4768051 DOI: 10.4093/dmj.2016.40.1.54] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of baseline WHtR and progression of coronary artery calcification (CAC) over 4 years of follow-up in apparently healthy Korean men. METHODS A total of 1,048 male participants (mean age, 40.9 years) in a health-screening program in Kangbuk Samsung Hospital, Seoul, Korea who repeated a medical check-up in 2010 and 2014 were recruited. Baseline WHtR was calculated using the value for the waist in 2010 divided by the value for height in 2010. The CAC score (CACS) of each subject was measured by multi-detector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years greater than 0. RESULTS During the follow-up period, progression of CAC occurred in 278 subjects (26.5%). The subjects with CAC progression had slightly higher but significant baseline WHtR compared to those who did not show CAC progression (0.51±0.04 vs. 0.50±0.04, P<0.01). The proportion of subjects with CAC progression significantly increased as the baseline WHtR increased from the 1st quartile to 4th quartile groups (18.3%, 18.7%, 28.8%, and 34.2%; P<0.01). The risk for CAC progression was elevated with an odds ratio of 1.602 in the 4th quartile group of baseline WHtR even after adjustment for confounding variables (95% confidence interval, 1.040 to 2.466). CONCLUSION Increased baseline WHtR was associated with increased risk for CAC progression. WHtR might be a useful screening tool to identify individuals at high risk for subclinical atherosclerosis.
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Affiliation(s)
- Hyung Geun Oh
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Shriram Nallamshetty
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Eun Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Hartwig S, Kluttig A, Tiller D, Fricke J, Müller G, Schipf S, Völzke H, Schunk M, Meisinger C, Schienkiewitz A, Heidemann C, Moebus S, Pechlivanis S, Werdan K, Kuss O, Tamayo T, Haerting J, Greiser KH. Anthropometric markers and their association with incident type 2 diabetes mellitus: which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study. BMJ Open 2016; 6:e009266. [PMID: 26792214 PMCID: PMC4735317 DOI: 10.1136/bmjopen-2015-009266] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. METHODS Data of 10,258 participants from 4 prospective population-based cohorts were pooled to assess the association of body weight, body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident T2DM by calculating HRs of the crude, adjusted and standardised markers, as well as providing receiver operator characteristic (ROC) curves. Differences between HRs and ROCs for the different anthropometric markers were calculated to compare their predictive ability. In addition, data of 3105 participants from the nationwide survey were analysed separately using the same methods to provide a nationally representative comparison. RESULTS Strong associations were found for each anthropometric marker and incidence of T2DM. Among the standardised anthropometric measures, we found the strongest effect on incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women) and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC analysis showed WHtR to be the strongest predictor for incident T2DM. Differences in HR and ROCs between the different markers confirmed WC and WHtR to be the best predictors of incident T2DM. Findings were consistent across study regions and age groups (<65 vs ≥ 65 years). CONCLUSIONS We found stronger associations between anthropometric markers that reflect abdominal obesity (ie, WC and WHtR) and incident T2DM than for BMI and weight. The use of these measurements in risk prediction should be encouraged.
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Affiliation(s)
- Saskia Hartwig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Daniel Tiller
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Julia Fricke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Grit Müller
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Sabine Schipf
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Michaela Schunk
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Christa Meisinger
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Sonali Pechlivanis
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Karl Werdan
- Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Oliver Kuss
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Johannes Haerting
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Karin Halina Greiser
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Binge eating in pre-clinical models. Pharmacol Rep 2015; 67:504-12. [DOI: 10.1016/j.pharep.2014.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 11/25/2014] [Accepted: 11/26/2014] [Indexed: 01/28/2023]
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Duarte GV, Silva LPD. Correlation between psoriasis' severity and waist-to-height ratio. An Bras Dermatol 2015; 89:846-7. [PMID: 25184937 PMCID: PMC4155976 DOI: 10.1590/abd1806-4841.20142854] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 09/09/2013] [Indexed: 12/05/2022] Open
Abstract
In the absence of ideal biomarkers, the research for clinical markers correlated to
the severity of psoriasis and/or its comorbidities becomes crucial. Recently, studies
have shown positive correlation between body mass index and prevalence and severity
of psoriasis. Abdominal circumference showed stronger correlation with disease
severity than body mass index. We evaluated the waist-to-height ratio in a sample of
297 adult patients with psoriasis and observed that it has a significant correlation
with body mass index and PASI, and together with body mass index allows the
identification of central obesity, reducing its subdiagnosis.
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Karlage RE, Wilson CL, Zhang N, Kaste S, Green DM, Armstrong GT, Robison LL, Chemaitilly W, Srivastava DK, Hudson MM, Ness KK. Validity of anthropometric measurements for characterizing obesity among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study. Cancer 2015; 121:2036-43. [PMID: 25728221 DOI: 10.1002/cncr.29300] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/27/2015] [Accepted: 01/29/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Childhood cancer survivors (CCSs) are at risk for obesity. The purpose of this project was to determine which clinical measures of body composition are most accurate among CCSs in comparison with dual-energy x-ray absorptiometry (DXA). METHODS The agreement between the body mass index (BMI), skinfold percent body fat, and waist-to-height ratio (WHtR) and DXA was evaluated among 1361 CCSs (mean age, 32.4 ± 7.7 years) 10 or more years after the diagnosis. The sensitivity and specificity of BMI, skinfold, and WHtR obesity classifications were calculated with respect to DXA. Log-binomial regression, stratified by sex, was used to evaluate treatment-related factors for misclassification as nonobese by BMI, skinfolds, and WHtR. RESULTS The mean body fat values were 23.3% ± 7.7% (males) and 32.3% ± 8.1% (females) for skinfolds and 26.9% ± 7.4% (males) and 38.4% ± 7.7% (females) for DXA. Pearson correlations between skinfolds and DXA were high (R = 0.83 for males, R = 0.84 for females). Skinfolds incorrectly classified 34.5% of obese males and 27.3% of obese females. BMI measures were the least sensitive with false-negative rates of 46.4% (males) and 53.1% (females). Males exposed to abdominal/pelvic radiation were at increased risk for misclassification as nonobese by BMI (relative risk, 1.57; 95% confidence interval, 1.25-1.95). The percentages classified as obese were highest with DXA (males, 63.1%; females, 84.8%) and lowest with BMI (males, 35.7%; females, 39.7%). Although skinfolds and WHtR underestimated the percentage classified as obese in comparison with DXA, the differences were not as large. CONCLUSIONS Findings suggest that skinfolds and WHtR are better than BMI for obesity classification in CCSs. Clinicians should be aware of the high risk of misclassifying obese CCSs as nonobese.
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Affiliation(s)
- Robyn E Karlage
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Carmen L Wilson
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nan Zhang
- Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Sue Kaste
- Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Daniel M Green
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Gregory T Armstrong
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wassim Chemaitilly
- Endocrinology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Melissa M Hudson
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kirsten K Ness
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
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