1
|
Phaswana M, Mchiza ZJR, Onagbiye SO, Gradidge PJL. Obesity, beverage consumption and sleep patterns in rural African women in relation to advertising of these beverages. Int Health 2024:ihae031. [PMID: 38733569 DOI: 10.1093/inthealth/ihae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND The burden of obesity-related, non-communicable diseases in South Africa is persistent, with poor and black South African women particularly vulnerable. The purpose of the present study was to determine relationships between obesity, physical activity, sleep patterns and beverage consumption among black South African women in a rural village in the Limpopo province. METHODS A cross-sectional study was conducted among 200 rural-dwelling African women. Data were collected on beverage consumption, sociodemographic information, sleep patterns and anthropometry using self-reported questionnaires. RESULTS The mean body mass index (BMI) was 28.5±7.3 kg/m2, with 40% being classified as obese (BMI ≥30 kg/m2) and the mean sleep score was 4.68±2.51. Participants with very bad habitual sleeping patterns consumed significantly more sugar-sweetened beverages and alcohol than those with very good sleeping patterns. We also observed that when total coffee with sugar, fruit juice, total sugar-sweetened beverages and weight decreased the number of hours participants slept increased. CONCLUSIONS The study identified significant associations between body weight, sleep duration and sugar-sweetened beverage consumption among rural black South African women. This underscores a need to address unhealthy lifestyle behaviours to lower incidences of non-communicable diseases in rural-dwelling women.
Collapse
Affiliation(s)
- Merling Phaswana
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zandile June-Rose Mchiza
- Non-Communicable Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, Tygerberg, Cape Town, South Africa
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | | | - Philippe Jean-Luc Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
2
|
Masoumvand M, Ramezani E, Rahimi VB, Askari VR. Promising Influences of Moringa oleifera in Functional Foods against Metabolic Syndrome: A Comprehensive and Mechanistic Review. Endocr Metab Immune Disord Drug Targets 2024; 24:1355-1370. [PMID: 38279759 DOI: 10.2174/0118715303269893231207071440] [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: 08/04/2023] [Revised: 10/22/2023] [Accepted: 11/02/2023] [Indexed: 01/28/2024]
Abstract
Metabolic syndrome (MetS) is now considered a global issue with a growing financial and health impact. Numerous herbal alternatives have been examined and researched due to the ever-increasing demand for new medications to treat metabolic syndrome disorders. People have empirically employed Moringa oleifera (MO), a native plant to several Asian nations, for a variety of diseases. We sought to examine recent research on MO in MetS and its potential mechanism of action in the current review. Four databases, including PubMed, Scopus, Web of Sciences, and Google Scholar, were thoroughly searched, and the data were then compiled. In total, 146 papers covering nonclinical and clinical MO investigations in metabolic syndromerelated disorders are included in this study. Numerous research confirmed MO's positive impact on the control of blood glucose, blood pressure, hyperlipidemia, and obesity. Many molecular processes have been investigated, including increasing glucose transporter type 4 (GLUT4) expression, inhibition of β-Hydroxy-β-methylglutaryl-coenzyme A (HMG-CoA), α-glucosidase inhibiting, AMP-activated protein kinase (AMPK) activation, and other suggested mechanisms. The current review established much data favoring MO's potential advantages in metabolic syndrome. However, further research involving human studies is required in this area to determine whether Moringa can effectively treat metabolic syndrome.
Collapse
Affiliation(s)
- Mohammad Masoumvand
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elmira Ramezani
- Department of Nutrition, Faculty of public health, Iran University of Medical Sciences, Tehran, Iran
| | - Vafa Baradaran Rahimi
- Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Reza Askari
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
3
|
Dietary Patterns and Their Association with Metabolic Syndrome and Their Components in Middle-Class Adults from Damascus, Syria: A Cross-Sectional Study. J Nutr Metab 2022; 2022:5621701. [PMID: 35371568 PMCID: PMC8970872 DOI: 10.1155/2022/5621701] [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: 11/10/2021] [Revised: 02/17/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022] Open
Abstract
Prior to the 2016 crisis in Syria, a study conducted in Aleppo found the prevalence of metabolic syndrome to be 39.6%, which is known to be favoured by age and poor lifestyle (including physical inactivity and the consumption of hypercaloric foods, rich in saturated fats, concentrated carbohydrates, and salt), so the objective of this study was to identify the association of different dietary patterns with metabolic syndrome and their components. A cross-sectional analytical study was carried out in 104 adults aged 40 to 65 years who did not suffer from previous diseases. The sample was chosen from middle-class citizens of the city of Damascus who were contacted by telephone; they were explained about the study, the information that would be collected, and the studies that should be carried out in the clinical analysis laboratory of the Private University of Syria. A nutritional and food study was carried out using previously validated forms containing 62 items in which the food intake of the participants was studied. We apply principal component analysis and factor analysis to detect nutritional components and dietary patterns. Dietary pattern 3 (foods with simple carbohydrates and saturated fat) increased glucose levels, while dietary patterns 1 (high intake of calories, protein, and saturated fat) and 5 (fast food) increased serum triglyceride levels. In addition, pattern 1 (carbonated beverages, grains, chicken, and meat) was associated with elevated LDL cholesterol levels and the presence of the metabolic syndrome. The study findings suggest that the presence of metabolic syndrome and its components are associated with dietary patterns high in calories, protein, simple carbohydrates, and saturated fat.
Collapse
|
4
|
Zeru MA, Tesfa E, Mitiku AA, Seyoum A, Bokoro TA. Prevalence and risk factors of type-2 diabetes mellitus in Ethiopia: systematic review and meta-analysis. Sci Rep 2021; 11:21733. [PMID: 34741064 PMCID: PMC8571297 DOI: 10.1038/s41598-021-01256-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/26/2021] [Indexed: 01/09/2023] Open
Abstract
Diabetes mellitus (DM) is a public health problem in developing as well as developed nations. DM leads to many complications that are associated with higher morbidity and mortality worldwide. Therefore, the current study was planned to assess the prevalence and risk factors of type-2 DM in Ethiopian population. Six electronic databases such as: PubMed, Scopus, Hinari, Web of science, Google Scholar, and African Journals Online were searched for studies published in English up December 30, 2020. Newcastle-Ottawa Scale was used for quality assessment of the included studies. The data was extracted by Microsoft excel and analyzed through Stata version 16 software. The random effect meta-regression analysis was computed at 95% CI to assess the pooled prevalence and risk factors of type-2 DM. Forty observational studies were included in this systematic review and meta-analysis. The pooled prevalence of DM in Ethiopia was 6.5% (95% CI (5.8, 7.3)). The sub-group analysis revealed that the highest prevalence of DM was found in Dire Dawa city administration (14%), and the lowest prevalence was observed in Tigray region (2%). The pooled prevalence of DM was higher (8%) in studies conducted in health facility. Factors like: Age ≥ 40 years ((Adjusted Odds Ratio (AOR): 1.91 (95% CI: 1.05, 3.49)), Illiterate (AOR: 2.74 (95% CI: 1.18, 6.34)), Cigarette smoking (AOR: 1.97 (95% CI: 1.17, 3.32)), Body mass index (BMI) ≥ 25 kg/m2 (AOR: 2.01 (95 CI: 1.46, 2.27)), family history of DM (AOR: 6.14 (95% CI: 2.80, 13.46)), history of hypertension (AOR: 3.00 (95% CI: 1.13, 7.95)) and physical inactivity (AOR: 5.79 (95% CI: 2.12, 15.77)) were significantly associated with type-2 DM in Ethiopian population. In this review, the prevalence of type-2 DM was high. Factors like: Older age, illiteracy, cigarette smoking, MBI ≥ 25, family history of DM, history of hypertension and physical inactivity were an identified risk factors of type-2 DM. Therefore, health education and promotion will be warranted. Further, large scale prospective studies will be recommended to address possible risk factors of type-2 DM in Ethiopian population.
Collapse
Affiliation(s)
- Melkamu A. Zeru
- grid.442845.b0000 0004 0439 5951Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalamaw Tesfa
- grid.442845.b0000 0004 0439 5951Department of Biochemistry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Aweke A. Mitiku
- grid.442845.b0000 0004 0439 5951Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia ,grid.16463.360000 0001 0723 4123School of Mathematics, Statistics and Computer Science, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban, South Africa
| | - Awoke Seyoum
- grid.442845.b0000 0004 0439 5951Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tesfaye Abera Bokoro
- grid.192267.90000 0001 0108 7468Department of Statistics, College Computing and Informatics, Haramaya University, Dire Dawa, Ethiopia
| |
Collapse
|
5
|
Taleb S, Boulaba K, Yousfi A, Taleb N, Difallah B, Negrichi S. Associations between body mass index, waist circumference, waist circumference to-height ratio, and hypertension in an Algerian adult population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:46514-46522. [PMID: 32681329 DOI: 10.1007/s11356-020-10122-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
The aim of our study was to analyze the associations between anthropometric measures and high blood pressure (HBP) in Algerian patients. A cross-sectional study was conducted among 785 adults with normal BMI (248), overweight (253), and obese (284), who were assessed with measurement of systolic and diastolic blood pressure, weight, height, and waist circumference (WC). Body mass index (BMI) and waist circumference-to-height ratio (WHtR) were calculated. We released receiver operating characteristic (ROC) curves for each anthropometric parameter to assess its discriminant power predictive of HBP in patients. Obese had a higher mean weight, WC, WHtR, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), total cholesterol (TC), and triglycerides (TG) than overweight and normal weight. The prevalence of hypertension and diabetes was higher in obese than overweight and normal weight. Results showed that obesity increased the risk of hypertension by a factor of 1.54 (95% CI [1.15, 2.06], (p = 0.004). Pearson's correlation data analysis showed that there was no relationship between systolic blood pressure and anthropometric parameters (BMI, WC, and WHtR). Only DBP was negatively associated with WHtR in the overweight group. All these parameters had areas under the curve between 0.409 and 0.618.The cutoff value of anthropometric WHtR parameters associated with the risk of hypertension was higher among women than men regardless of the BMI group considered. Contrary to the data of the literature, the discriminating power of anthropometry in the prediction of the HBP is limited or absent whatever the value of the BMI.
Collapse
Affiliation(s)
- Salima Taleb
- FESSNL. Applied Biology Department, University Larbi Tbessi-Tebessa, 12000, Tebessa, Algeria.
- INATAA, University of Constantine 1, Constantine, Algeria.
- Laboratory of Water and Environment, University Larbi Tbessi, 12000, Tebessa, Algeria.
| | - Kafila Boulaba
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Ahlem Yousfi
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Nada Taleb
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Basma Difallah
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Samira Negrichi
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
- Laboratory of Water and Environment, University Larbi Tbessi, 12000, Tebessa, Algeria
| |
Collapse
|
6
|
Darko SN, Meeks KAC, Owiredu WKBA, Laing EF, Boateng D, Beune E, Addo J, de-Graft Aikins A, Bahendeka S, Mockenhaupt F, Spranger J, Agyei-Baffour P, Klipstein-Grobusch K, Smeeth L, Agyemang C, Owusu-Dabo E. Anthropometric indices and their cut-off points in relation to type 2 diabetes among Ghanaian migrants and non-migrants: The RODAM study. Diabetes Res Clin Pract 2021; 173:108687. [PMID: 33571601 DOI: 10.1016/j.diabres.2021.108687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 08/20/2020] [Accepted: 01/25/2021] [Indexed: 12/11/2022]
Abstract
AIMS To compare body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) as determinants of type 2 diabetes (T2DM) and determine optimal cut-offs in a sub-Saharan African population. METHODS Data from the RODAM study including Ghanaians aged 25-70 living in rural Ghana, urban Ghana and Europe were used. Logistic regression was used to assess associations between BMI, WC, WHR and T2DM status, by sex and site. Area under the curve (AUC) were constructed to discriminate between indices and establish performance and cut-off values. RESULTS WHR had the strongest association with T2DM in men and women across sites, except for rural men. The highest adjusted odds ratio (aOR) and AUC were in rural women for WHR (aOR = 2.09, 95%CI = 1.47-2.99; AUC = 0.71). Among migrants, WHR had higher AUCs compared with BMI (p < 0.01) and WC (p < 0.05). Cut-offs for BMI and WC in men were lower compared with the WHO reference across sites (WC: 85.4-93.7 vs 102 cm, BMI: 23.1-28.2 vs 30.0 kg/m2). CONCLUSIONS WHR outperformed BMI and WC as anthropometric indices in relation to T2DM among Ghanaian migrants. The lower BMI and WC cut-offs for T2DM than WHO established standards, highlights the need for African specific cut-offs to avoid missing high risk populations.
Collapse
Affiliation(s)
- Samuel N Darko
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana; Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Karlijn A C Meeks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands; Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, United States
| | - William K B A Owiredu
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Edwin F Laing
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Erik Beune
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Legon-Accra, Ghana
| | - Silver Bahendeka
- Mother Kevin Postgraduate Medical School (MKPGMS), Uganda Martyrs University, Kampala, Uganda
| | - Frank Mockenhaupt
- Institute of Tropical Medicine and International Health, Charite-University Medicine Berlin, Germany
| | - Joachim Spranger
- Department of Endocrinology and Metabolism, Charite-University Medicine Berlin, Berlin, Germany
| | - Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| |
Collapse
|
7
|
Basit A, Mustafa N, Waris N, Askari S, Fawwad A. Predicting the risk of type 2 diabetes through anthropometric indices in Pakistani adults- A sub-analysis of second National diabetes survey of Pakistan 2016-2017 (NDSP-07). Diabetes Metab Syndr 2021; 15:543-547. [PMID: 33684806 DOI: 10.1016/j.dsx.2021.02.030] [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: 11/09/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Excess adiposity is associated with an increased risk of diabetes. Amongst the various measures of adiposity, the most appropriate one to predict the risk of diabetes remains debatable. Therefore, the aim of this study was to compare the ability of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in predicting type 2 diabetes mellitus (DM) among Pakistani adults. SUBJECTS AND METHODS This was the sub-analysis of a large population based Second National Diabetes Survey of Pakistan (NDSP) 2016-2017. With this survey, 10834 individuals were recruited and 4788 individuals fulfilled the inclusion criteria for this sub-analysis (subjects with missing anthropometric details were excluded). Participants were categorized into two groups; subjects with type 2 DM and subjects without DM. Data of participants was collected via pre-designed detailed questionnaire. Clinical and anthropometric measurements were measured using standardized techniques. RESULTS Out of 4788 individuals, 3085(64.4%) were non-DM subjects and 1703(35.6%) were type 2 DM subjects with mean age of 39.78 ± 13.79 and 50.38 ± 11.33 years, respectively. Logistic regression analysis revealed a significant association of WC with type 2 diabetes after adjustment for possible confounders. Area under the curve (AUC) of WC was found higher than AUC of BMI and WHR. CONCLUSION The findings from second NDSP (2016-2017) demonstrated that WC is a better marker than WHR and BMI in predicting type 2 DM for Pakistani population.
Collapse
Affiliation(s)
- Abdul Basit
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Nida Mustafa
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Nazish Waris
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Saima Askari
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan; Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Asher Fawwad
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan; Department of Biochemistry, Baqai Medical University, Karachi, Sindh, Pakistan.
| |
Collapse
|
8
|
Ross R, Neeland IJ, Yamashita S, Shai I, Seidell J, Magni P, Santos RD, Arsenault B, Cuevas A, Hu FB, Griffin BA, Zambon A, Barter P, Fruchart JC, Eckel RH, Matsuzawa Y, Després JP. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol 2020; 16:177-189. [PMID: 32020062 PMCID: PMC7027970 DOI: 10.1038/s41574-019-0310-7] [Citation(s) in RCA: 764] [Impact Index Per Article: 191.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 02/06/2023]
Abstract
Despite decades of unequivocal evidence that waist circumference provides both independent and additive information to BMI for predicting morbidity and risk of death, this measurement is not routinely obtained in clinical practice. This Consensus Statement proposes that measurements of waist circumference afford practitioners with an important opportunity to improve the management and health of patients. We argue that BMI alone is not sufficient to properly assess or manage the cardiometabolic risk associated with increased adiposity in adults and provide a thorough review of the evidence that will empower health practitioners and professional societies to routinely include waist circumference in the evaluation and management of patients with overweight or obesity. We recommend that decreases in waist circumference are a critically important treatment target for reducing adverse health risks for both men and women. Moreover, we describe evidence that clinically relevant reductions in waist circumference can be achieved by routine, moderate-intensity exercise and/or dietary interventions. We identify gaps in the knowledge, including the refinement of waist circumference threshold values for a given BMI category, to optimize obesity risk stratification across age, sex and ethnicity. We recommend that health professionals are trained to properly perform this simple measurement and consider it as an important 'vital sign' in clinical practice.
Collapse
Affiliation(s)
- Robert Ross
- School of Kinesiology and Health Studies, School of Medicine, Department of Endocrinology and Metabolism, Queen's University, Kingston, ON, Canada.
| | - Ian J Neeland
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shizuya Yamashita
- Departments of Cardiovascular Medicine and Community Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jaap Seidell
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands
| | - Paolo Magni
- Department of Pharmacological and Biomolecular Sciences, Universita' degli Studi di Milano, Milan, Italy
- Scientific Institute for Research, Hospitalization and Health Care (IRCCS) MultiMedica, Sesto San Giovanni, Italy
| | - Raul D Santos
- Lipid Clinic Heart Institute (InCor), University of São Paulo, Medical School Hospital, São Paulo, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Benoit Arsenault
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Ada Cuevas
- Department of Clinical Nutrition and Metabolism, Clínica Las Condes, Santiago, Chile
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bruce A Griffin
- Department of Nutritional Sciences, University of Surrey, Guildford, UK
| | - Alberto Zambon
- Department of Medicine - DIMED, University of Padua, Padova, Italy
| | - Philip Barter
- School of Medical Sciences, University of New South Wales Australia, Sydney, NSW, Australia
| | | | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, and Division of Cardiology, Anschutz University of Colorado School of Medicine, Aurora, CO, USA
| | - Yuji Matsuzawa
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Jean-Pierre Després
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, Canada
- Department of Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
| |
Collapse
|
9
|
Xavier R, Sánchez C, Paulucio D, da Silva IM, Velasque R, Nogueira FS, Ferrini LSG, Dornelas Ribeiro M, Serrato M, Alvarenga R, Pompeu FAMS, Santos CGM. A Multidimensional Approach to Assessing Anthropometric and Aerobic Fitness Profiles of Elite Brazilian Endurance Athletes and Military Personnel. Mil Med 2019; 184:875-881. [PMID: 30941410 DOI: 10.1093/milmed/usz003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Military personnel must remain physically active to meet operational requirements. Military physical training not only provides the performance capabilities required for performing occupational tasks but also fosters the development of sport. Thus, Armed Forces across the world have historically invested in developing elite- and Olympic-level athletes. This study aimed to assess the anthropometric and physiological differences among groups of Brazilian military athletes (MA), non-military athletes (A), and military non-athletes (M). MATERIALS AND METHODS Seventy-five individuals participated in the study: 17 MA (23.7 ± 4.8 years), 27 A (24.7 ± 5.3 years), and 31 M (26.9 ± 3.3 years). MA and A individuals specialized in endurance sports, and had a mean weekly training volume of (100.0 ± 34.8 and 106.3 ± 40.5 Km; F = 0.894, p = 0.6), respectively. Anthropometric measures and maximal oxygen uptake (V̇O2máx) were assessed in all participants. Ergospirometry and anthropometry variables were analyzed with one-way analysis of variance (ANOVA) for independent measures. Comparisons of weekly training volume (km) and training experience (years) were performed only between the A and MA using the Student's t-test for independent samples. For a multidimensional approach, Partial least squares discriminant analysis (PLS-DA) was performed for all variables using the online tool MetaboAnalyst. RESULTS We found no differences in anthropometric and physiological profiles between A and MA, but significant differences between M and MA/A in body mass index (kg/m2) (BMI), body fat percentage, fat mass (kg), waist circumference (cm) (WC), somatotype, and V̇O2máx (mL min-1 kg-1). CONCLUSION In conclusion, military endurance athletes have similar anthropometric and physiological profiles to non-military athletes and superior levels to non-athlete military. These findings indicate that the Brazilian Armed Forces scouting system has been successful in identifying endurance athletic talent in line with their historic role of developing sport in Brazil.
Collapse
Affiliation(s)
- Raphael Xavier
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Carlos Sánchez
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Dailson Paulucio
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Izadora Moreira da Silva
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Rodolfo Velasque
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Fernando S Nogueira
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Luiz S G Ferrini
- Centro de Educação Física e Desportos (CEFD), Policia Militar do Estado do Rio de Janeiro (PMERJ). 2906 Marechal Fontenele, Rio de Janeiro, RJ, Brazil
| | - Marcos Dornelas Ribeiro
- Brazilian Army Institute of Biology. 102 Francisco Manuel - Triagem, Rio de Janeiro, RJ, Brazil
| | - Mauricio Serrato
- Departamento de Medicina Interna y Departamento de Fisiología, Universidad Nacional de Colombia. 30 Carrera 45-03, Medicina 471, Piso 5, Campus Ciudad Universitaria, Bogotá, Colombia
| | - Renato Alvarenga
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil
| | - Fernando A M S Pompeu
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil.,Visiting Scholar at the History and Philosophy Science Department, Cambridge University, UK. Free School Ln, Cambridge, UK
| | - Caleb G M Santos
- Biometrics Laboratory, School of Physical Education and Sports, Federal University of Rio de Janeiro. 540 Carlos Chagas Filho Avenue, Rio de Janeiro, RJ, Brazil.,Brazilian Army Institute of Biology. 102 Francisco Manuel - Triagem, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
10
|
Nasreddine L, Bachir N, Kharroubi S, Chamieh MC, Mehio Sibai A, Hwalla N, Naja F. Anthropometric Cutoffs for Increased Cardiometabolic Risk Among Lebanese Adults: A Cross-Sectional Study. Metab Syndr Relat Disord 2019; 17:486-493. [DOI: 10.1089/met.2019.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Nivine Bachir
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Marie Claire Chamieh
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Abla Mehio Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
11
|
Liens entre les paramètres anthropométriques et l’hypertension artérielle chez les diabétiques tunisiens de type 2. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
12
|
Zahran AM, Sayed SK, Abd El Hafeez HA, Khalifa WA, Mohamed NA, Hetta HF. Circulating microparticle subpopulation in metabolic syndrome: relation to oxidative stress and coagulation markers. Diabetes Metab Syndr Obes 2019; 12:485-493. [PMID: 31043798 PMCID: PMC6469468 DOI: 10.2147/dmso.s191750] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Circulating microparticles (MPs) contribute to the pathogenesis of atherothrombotic disorders and are raised in cardiovascular diseases. Herein, we aimed to investigate the effect of moderate metabolic abnormalities in an early stage of metabolic syndrome (MetS) on the level of MP subpopulations and to study relationships between MP subpopulations and both oxidative stress and coagulation markers. METHODS Flow cytometry used to evaluate circulating MPs subpopulations in 40 patients with an early stage MetS and 30 healthy controls. ELISA was used to quantify plasminogen activator inhibitor type 1/tissue plasminogen activator (PAI-1/TPA) while plasma glutathione peroxidase (GPx) activity was measured spectrophotometrically. RESULTS Total MPs were significantly elevated in MetS (P<0.001). Glutathione peroxidase and PAI1/TPA activity was significantly increased in subjects with MetS (P<0.001). Waist circumference, diastolic blood pressure, and total cholesterol positively influenced levels of total MPs, platelet-derived microparticles, and endothelium-derived microparticles. Fasting blood glucose, cholesterol, triglycerides, and low-density lipoprotein positively influenced the coagulation factors (TPA, PAI1). However, high-density lipoprotein negatively influenced platelet-derived MPs and factors associated with fibrinolysis (TPA, PAI1). CONCLUSION Elevated circulating MPs are associated with MetS abnormalities, oxidative stress and coagulation factors and may act as early predictor of metabolic syndrome with risk of cardiovascular disease.
Collapse
Affiliation(s)
- Asmaa M Zahran
- Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt
| | - Sohair K Sayed
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Heba A Abd El Hafeez
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Walaa A Khalifa
- Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nahed A Mohamed
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt,
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA,
| |
Collapse
|
13
|
Hasni Y, Bachrouch S, Mahjoub M, Maaroufi A, Rouatbi S, Ben Saad H. Biochemical Data and Metabolic Profiles of Male Exclusive Narghile Smokers (ENSs) Compared With Apparently Healthy Nonsmokers (AHNSs). Am J Mens Health 2019; 13:1557988319825754. [PMID: 30819065 PMCID: PMC6440044 DOI: 10.1177/1557988319825754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023] Open
Abstract
Studies evaluating the metabolic profiles of ENSs are scarce and presented controversial conclusions. This study aimed to compare the metabolic profiles of ENSs' and AHNSs' groups. Males aged 25-45 years and free from a known history of metabolic and/or cardiovascular diseases were included. According to the smoking status, two groups of ENSs and AHNSs were identified. Body mass index (BMI, kg/m2), waist circumference (WC, cm), systolic and diastolic blood pressures (SBP, DBP, mmHg), fasting blood data in mmol/L (blood glycemia [FBG], triglycerides [TG], total cholesterol [TC], high- and low- density lipoprotein cholesterol [HDL-C, LDL-C]) and obesity status were evaluated. The metabolic syndrome (MetS) was defined according to the 2006 International Diabetes Federation (IDF) recommendations. Data were expressed as mean ± standard deviation ( SD) or percentages. Compared to the AHNSs' group ( n = 29), the ENSs' one ( n = 29) had (a) higher values of BMI (26.5 ± 2.3 vs. 28.2 ± 3.6), WC (95 ± 7 vs. 100 ± 10), and TG (1.22 ± 0.40 vs. 1.87 ± 0.85); and (b) included a lower percentage of males having low HDL-C (82.7% vs. 62.0%), and higher percentages of males having obesity (6.9% vs. 37.9%) or hypertriglyceridemia (10.7% vs. 51.7%). Both the ENSs' and AHNSs' groups: (a) had similar values of FBG (5.38 ± 0.58 vs. 5.60 ± 0.37), TC (4.87 ± 1.16 vs. 4.36 ± 0.74), HDL-C (0.92 ± 0.30 vs. 0.82 ± 0.21), LDL-C (3.09 ± 0.98 vs. 2.92 ± 0.77), SBP (117 ± 9 vs. 115 ± 8), and DBP (76 ± 6 vs. 73 ± 7); and (b) included similar percentages of males having normal weight (17.2% vs. 31.0%); overweight (44.8% vs. 62.1%); android obesity (79.3% vs. 59.6%), hypertension (10.3% vs. 10.3%), hyperglycemia (37.9% vs. 48.2%), and MetS (51.7% vs. 34.5%). There is a need to monitor narghile use among male metabolic patients since it alters some components of the MetS.
Collapse
Affiliation(s)
- Yosra Hasni
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sabrine Bachrouch
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Hospital Hygiene, University Hospital Farhat Hached, Sousse, Tunisia
| | - Amel Maaroufi
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sonia Rouatbi
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
- Heart Failure (LR12SP09) Research Laboratory, University Hospital Farhat Hached, Sousse, Tunisia
| | - Helmi Ben Saad
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
- Heart Failure (LR12SP09) Research Laboratory, University Hospital Farhat Hached, Sousse, Tunisia
| |
Collapse
|
14
|
Msemo OA, Schmiegelow C, Nielsen BB, Kousholt H, Grunnet LG, Christensen DL, Lusingu JPA, Møller SL, Kavishe RA, Minja DTR, Bygbjerg IC. Risk factors of pre-hypertension and hypertension among non-pregnant women of reproductive age in northeastern Tanzania: a community based cross-sectional study. Trop Med Int Health 2018; 23:1176-1187. [PMID: 30280462 DOI: 10.1111/tmi.13149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine risk factors of pre-hypertension and hypertension in a cohort of 1247 rural Tanzanian women before conception. METHODS Demographic and socioeconomic data, anthropometric measurements, past medical and obstetric history and other risk factors for pre-hypertension and hypertension were collected using a structured questionnaire. Multiple logistic regression analysis was used to evaluate the associations between anthropometric indices and other risk factors of pre-hypertension and hypertension. The predictive power of different anthropometric indicators for identification of pre-hypertension and hypertension patients was determined by Receiver Operating Characteristic curves (ROC). RESULTS The median (range) age was 28.0 (18-40) years. The age-standardised prevalences of pre-hypertension and hypertension were 37.2 (95% CI 34.0-40.6) and 8.5% (95%CI 6.7-10.8), respectively. Of hypertensive patients (n = 98), only 20 (20.4%) were aware of their condition. In multivariate analysis, increasing age, obesity and haemoglobin levels were significantly associated with pre-hypertension and hypertension. CONCLUSION Despite a low prevalence of hypertension, over one third of the women had pre-hypertension. This poses a great challenge ahead as pre-hypertensive women may progress into hypertension as they grow older without appropriate interventions. Obesity was the single most important modifiable risk factor for pre-hypertension and hypertension.
Collapse
Affiliation(s)
- Omari A Msemo
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Christentze Schmiegelow
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte B Nielsen
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark
| | - Hannah Kousholt
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Louise G Grunnet
- Department of Endocrinology, University of Copenhagen Hospital, Copenhagen, Denmark
| | - Dirk L Christensen
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John P A Lusingu
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Sofie L Møller
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Daniel T R Minja
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Ib C Bygbjerg
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
15
|
Courel-Ibáñez J, Cordero J, Muñoz D, Sánchez-Alcaraz B, Grijota F, Robles M. Fitness benefits of padel practice in middle-aged adult women. Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
16
|
Silveira EA, Pagotto V, Barbosa LS, Oliveira CD, Pena GDG, Velasquez-Melendez G. Accuracy of BMI and waist circumference cut-off points to predict obesity in older adults. CIENCIA & SAUDE COLETIVA 2018; 25:1073-1082. [PMID: 32159675 DOI: 10.1590/1413-81232020253.13762018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 07/19/2018] [Indexed: 11/22/2022] Open
Abstract
The main objectives were to analyse the validity and accuracy of Body Mass Index (BMI) and Waist Circumference (WC) to evaluate obesity by excess of body fat in older adults and to identify more adequate cut-off points for this age group. The recommended cut-off points for BMI (25, 27 or 30 kg/m2) and WC (≥ 102 cm for men and ≥ 88 cm for women or ≥ 90cm for men and ≥ 80 cm for women) were compared to the total body densitometry. BF was defined by a value higher than the 90th percentile. Out of the 132 participants, 61% were women and aged between 60 and 91 years. The recommended cut-off points of BMI ≥ 25kg/m2 and BMI ≥ 27 kg/m2 showed similar performances. BMI ≥ 30 kg/m2 showed high specificity but low sensitivity to identify BF in men and better performance in women. Conventional WC cut-off points showed low sensitivity and specificity. Based on our analyses, new cut-off points for BMI (25 kg/m2 for men and 26.6 kg/m2 for women) and WC (98.8 cm for men and 77.8cm for women) were proposed. The new cut-off points showed sensitivity and specificity values > 74% and accuracy > 76%. The areas under the curve (ROC) were > 0.86. The new BMI and WC cut-off points proposed in the present study for the diagnosis of obesity in older adults showed the best levels of sensitivity and specificity for this age group.
Collapse
Affiliation(s)
- Erika Aparecida Silveira
- Faculdade de Medicina, Universidade Federal de Goiás. Av. Primeira Avenida s/nº, Setor Leste Universitário. 74000-000, Goiânia, GO, Brasil.
| | - Valéria Pagotto
- Faculdade de Enfermagem, Universidade Federal de Goiânia. Goiânia, GO, Brasil
| | - Larissa Silva Barbosa
- Faculdade de Medicina, Universidade Federal de Goiás. Av. Primeira Avenida s/nº, Setor Leste Universitário. 74000-000, Goiânia, GO, Brasil.
| | - César de Oliveira
- Department of Epidemiology and Public Health, University College. London UK
| | | | | |
Collapse
|
17
|
Pinilla-Roa AE, Barrera-Perdomo MDP. Prevención en diabetes mellitus y riesgo cardiovascular: enfoque médico y nutricional. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n3.60060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introducción. La epidemia de diabetes mellitus tipo 2 (DM2) incrementa la enfermedad cardiovascular y la morbimortalidad; por tanto, es importante prevenir, tratar integralmente y valorar complicaciones y comorbilidades asociadas.Objetivo. Presentar una revisión sobre prevención de DM2 y riesgo cardiovascular con enfoque médico y nutricional.Materiales y métodos. Se hizo una revisión en las bases de datos Embase, PubMed, Bireme (LILACS, SciELO) y Cochrane Library con términos específicos. La búsqueda se hizo en inglés y español sobre publicaciones entre 2001 y 2016.Resultados. Se encontraron 811 publicaciones y, después de aplicar los criterios de inclusión y exclusión, se seleccionaron 71 documentos clasificados así: 24 artículos de investigación, 14 artículos de revisión, 18 guías clínicas, 8 consensos y 7 de otras categorías (informes, capítulos de libro, normatividad y un libro)Conclusión. La educación es una herramienta fundamental para prevenir y tratar factores de riesgo. Se debe incentivar el trabajo en equipo con el paciente y la familia para reducir el desarrollo de comorbilidades asociadas a DM2.
Collapse
|
18
|
Beraldo RA, Meliscki GC, Silva BR, Navarro AM, Bollela VR, Schmidt A, Foss-Freitas MC. Anthropometric measures of central adiposity are highly concordant with predictors of cardiovascular disease risk in HIV patients. Am J Clin Nutr 2018; 107:883-893. [PMID: 29868914 DOI: 10.1093/ajcn/nqy049] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/28/2018] [Indexed: 01/05/2023] Open
Abstract
Background Body fat redistribution and metabolic abnormalities found in HIV patients receiving highly active antiretroviral therapy (HAART) contribute to an atherogenic profile, increasing cardiovascular disease risk. Objective We aimed to evaluate adiposity measures/indexes and propose cutoffs associated with predictors of cardiovascular disease risk in HIV patients on HAART. Design To evaluate cardiovascular disease risk in this cross-sectional study, we conducted electrocardiogram exams and stress electrocardiography, measured the ankle brachial index and blood pressure arterial hypertension, conducted lipid biochemical tests, and measured blood glucose. We measured circumferences [waist (WC), hip, thigh, calf, neck, trunk] and skinfold thicknesses (biceps, triceps, subscapular, suprailiac), conducted bioelectrical impedance analysis (BIA), and calculated indexes [body mass index, waist-to-hip ratio, waist-to-thigh ratio, waist-to-calf ratio, waist-to-height ratio (WHtR), trunk-to-arm ratio, body mass index corrected for body fat mass, Body Adiposity Index, conicity index, body shape index, fat mass (percentage), and phase angle]. For evaluating the performance of all adiposity measures/indexes, we used receiver operating characteristic (ROC) curves. Results Measures of central adiposity WC and WHtR showed the best performances-WC area under the curve (AUC) for men: 0.83 (95% CI: 0.78, 0.89; P < 0.05); WC AUC for women: 0.86 (95% CI: 0.81, 0.91; P < 0.05); WHtR AUC for men: 0.83 (95% CI: 0.78, 0.88; P < 0.05); and WHtR AUC for women: 0.85 (95% CI: 0.80, 0.91; P < 0.05). All adiposity measures/indexes presented different cutoffs from those proposed for the HIV seronegative population. The cutoffs for WC were 87.75 cm (sensitivity: 82.2%; specificity: 75.5%) for men and 90.5 cm (sensitivity: 84.0%; specificity: 73.0%) for women. Conclusions The measures/indexes of central adiposity presented excellent associations with predictors of cardiovascular disease risk, and the use of the cutoffs proposed in the present study aims to contribute to the early identification of increasing risk of cardiovascular diseases, enabling interventions. This trial was registered at the Brazilian clinical trials registry Registro brasileiro de ensaios clínicos (Rebec) as RBR-9rcxbq.
Collapse
Affiliation(s)
| | - Gabriela C Meliscki
- Nutrition and Metabolism graduate course, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Bruna R Silva
- Nutrition and Metabolism graduate course, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | | | | |
Collapse
|
19
|
Al-Rubeaan K, Bawazeer N, Al Farsi Y, Youssef AM, Al-Yahya AA, AlQumaidi H, Al-Malki BM, Naji KA, Al-Shehri K, Al Rumaih FI. Prevalence of metabolic syndrome in Saudi Arabia - a cross sectional study. BMC Endocr Disord 2018; 18:16. [PMID: 29506520 PMCID: PMC5838993 DOI: 10.1186/s12902-018-0244-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 02/27/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
- Khalid Al-Rubeaan
- University Diabetes Center, College of Medicine, King Saud University, PO Box 18397, Riyadh, Riyadh 11415 Saudi Arabia
| | - Nahla Bawazeer
- Nutrition Department, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Yousuf Al Farsi
- University Diabetes Center, College of Medicine, King Saud University, PO Box 18397, Riyadh, Riyadh 11415 Saudi Arabia
| | - Amira M. Youssef
- Registry Department, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | | | - Hamid AlQumaidi
- University Diabetes Center, College of Medicine, King Saud University, PO Box 18397, Riyadh, Riyadh 11415 Saudi Arabia
| | - Basim M. Al-Malki
- University Diabetes Center, College of Medicine, King Saud University, PO Box 18397, Riyadh, Riyadh 11415 Saudi Arabia
| | - Khalid A. Naji
- University Diabetes Center, College of Medicine, King Saud University, PO Box 18397, Riyadh, Riyadh 11415 Saudi Arabia
| | - Khalid Al-Shehri
- University Diabetes Center, College of Medicine, King Saud University, PO Box 18397, Riyadh, Riyadh 11415 Saudi Arabia
| | | |
Collapse
|
20
|
El Bilbeisi AH, Shab-Bidar S, Jackson D, Djafarian K. The Prevalence of Metabolic Syndrome and Its Related Factors among Adults in Palestine: A Meta-Analysis. Ethiop J Health Sci 2018; 27:77-84. [PMID: 28458493 PMCID: PMC5390231 DOI: 10.4314/ejhs.v27i1.10] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Metabolic syndrome (MetS)is increasingly becoming a challenging public health issue in Palestine. The current burden of MetS in the country is unknown. There has been limited research on the prevalence of MetS. This meta-analysis is the first to estimate the population prevalence of MetS and its related factors among adults in Palestine. Methods A PRISMA systematic search appraisal and meta-analysis were conducted. A systematic literature search of PubMed, Scopus and Google Scholar was conducted in December 2014 up to February 2015. Generic, methodological and statistical data was extracted from the eligible studies which reported MetS prevalence. A random effect meta-analysis was conducted on crude MetS prevalence rates. Heterogeneity was assessed by Cochran's Q and I2 tests. Subgroup analyses were also performed according to the predefined criteria. Results The literature search yielded a total of 49 studies. Eight papers were included in the final analysis with sample size ranging 163 to 992. In addition, 2937 cases with MetS among people aged 15 years or more were estimated in Palestine between 2001 and 2014. There was high heterogeneity among studies (I2 = 95.8% p<0.001). The prevalence of MetS was 37.0% among adult Palestinians population ranging from 17 to 59.5%. Subgroup analysis did not show source of heterogeneity based on subject's health status and MetS criteria. Conclusion Our meta-analysis clearly demonstrates that MetS is highly prevalent (37.0%) among Palestinian adults. The high prevalence of MetS in Palestine should be seriously considered and planners should take steps to reduce it.
Collapse
Affiliation(s)
- Abdel Hamid El Bilbeisi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences - International Campus IC-TUMS) Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Diane Jackson
- Public Health Nutrition Research Group, Rowett Institute of Nutrition and Health, Aberdeen University, Aberdeen, Scotland, UK
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences - International Campus IC-TUMS) Tehran, Iran
| |
Collapse
|
21
|
Younis A, Goldkorn R, Goldenberg I, Geva D, Tzur B, Mazu A, Younis A, Fisman Z, Tannenbaum A, Klempfner R. Impaired Fasting Glucose Is the Major Determinant of the 20-Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease. J Am Heart Assoc 2017; 6:JAHA.117.006609. [PMID: 29079562 PMCID: PMC5721758 DOI: 10.1161/jaha.117.006609] [Citation(s) in RCA: 10] [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] [Indexed: 01/08/2023]
Abstract
Background We wanted to explore the association of metabolic syndrome (MetS) versus its individual components with 20‐year all‐cause mortality among patients with stable coronary artery disease. Methods and Results The cohort comprised 12 403 nondiabetic patients with stable coronary artery disease who were enrolled in the Bezafibrate Infarction Prevention Registry between February 1990 and October 1992 and followed up through December 2014. The study cohort was divided into 4 groups: patients without MetS or impaired fasting glucose (IFG), patients with IFG but without MetS, patients with MetS but without IFG, and patients with both MetS and IFG. Kaplan‐Meier survival analysis showed that at 20 years of follow‐up, the rates of all‐cause mortality were the highest among patients with both MetS and IFG (66%). Patients with IFG without MetS experienced a significantly higher mortality rate compared with those with MetS without IFG (61% versus 56%; log‐rank P<0.001). Multivariable Cox proportional hazard analysis showed that the final Cox model demonstrated that the additive effect of MetS (hazard ratio, 1.13; 95% confidence interval, 1.1–1.16; P=0.02) and IFG (hazard ratio, 1.54; 95% confidence interval, 1.46–1.62; P<0.001) on 20 years mortality was nonsignificant (hazard ratio, 1.01; 95% confidence interval, 0.93–1.11; P=0.69). IFG was associated with the most pronounced increase in mortality risk among the individual components (hazard ratio, 1.22; 95% confidence interval, 1.14–1.3; P<0.001). Conclusions Our findings suggest that IFG alone is a major independent predictor of long‐term mortality among patients with stable coronary artery disease versus other components of the MetS.
Collapse
Affiliation(s)
- Arwa Younis
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel .,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Goldkorn
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Goldenberg
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Diklah Geva
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Boaz Tzur
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Mazu
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | - Anan Younis
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | - Zvi Fisman
- Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexander Tannenbaum
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Robert Klempfner
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
22
|
Li D, Xu Y, Nie Q, Li Y, Mao G. Predictors of urinary incontinence between abdominal obesity and non-obese male adults. Postgrad Med 2017; 129:747-755. [PMID: 28724322 DOI: 10.1080/00325481.2017.1357419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To investigate factors that may be associated with urinary incontinence (UI) in abdominal obese and non-obese adult males. METHODS Data were analyzed for 2671 men (≥40 years of age) who participated in the National Health and Nutrition Examination Survey (2005-2008). We define abdominal obesity as a waist circumference >102 cm. Men with Incontinence Severity Index ≥3 were defined as having UI. Logistic regression analyses were used to identify factors associated with stress and urge UI. RESULTS Multivariate analysis found that in abdominal obese men, stress UI was associated with enlarged prostate (odds ratio [OR] = 2.20, 95% confidence interval [CI]: 1.16-4.16), chronic respiratory tract disease (OR = 2.78, 95% CI: 1.55-4.97), and major depression (OR = 4.79, 95% CI: 1.79-12.84). In non-obese men, arthritis was associated with stress UI (odds ratio = 3.37, 95% CI: 1.06-10.73). Urge UI in abdominally obese men was associated with age ≥65 years (OR = 1.67, 95% CI: 1.05-2.67), being non-Hispanic black (OR = 1.63, 95% CI: 1.06-2.52), and with enlarged prostate (OR = 2.30, 95% CI: 1.54-3.40), arthritis (OR = 1.39, 95% CI: 1.03-1.88), and major depression (OR = 2.96, 95% CI: 1.89-4.64). Urge UI in non-obese men was associated with current smoking (OR = 1.79, 95% CI: 1.01-3.17), major depression (OR = 2.60, 95% CI: 1.33-5.09) and vitamin D deficiency (OR = 1.61, 95% CI: 1.01-2.59). CONCLUSION Factors associated with urinary incontinence varied with abdominal obesity status and type of UI. The findings identify important contributors to urinary incontinence that clinicians should consider to help manage and effectively treat the condition.
Collapse
Affiliation(s)
- Dongmei Li
- a Department of Neurovascular Surgery , The General Hospital of Chinese People's Armed Police Forces , Beijing , China
| | - Yi Xu
- a Department of Neurovascular Surgery , The General Hospital of Chinese People's Armed Police Forces , Beijing , China
| | - Qingbin Nie
- a Department of Neurovascular Surgery , The General Hospital of Chinese People's Armed Police Forces , Beijing , China
| | - Yan Li
- b Department of Neurosurgery, Liangxiang Teaching Hospital , Capital Medical University , Beijing , China
| | - Gengsheng Mao
- a Department of Neurovascular Surgery , The General Hospital of Chinese People's Armed Police Forces , Beijing , China
| |
Collapse
|
23
|
Okafor CI, Raimi TH, Gezawa ID, Sabir AA, Enang O, Puepet F, Fasanmade OA, Ofoegbu EN, Odusan O. Performance of waist circumference and proposed cutoff levels for defining overweight and obesity in Nigerians. Ann Afr Med 2017; 15:185-193. [PMID: 27853033 PMCID: PMC5402832 DOI: 10.4103/1596-3519.194275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data. Objectives: To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values. Subjects and Methods: Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization's STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P < 0.05. Results: A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities. Conclusions: The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.
Collapse
Affiliation(s)
- Christian I Okafor
- Department of Medicine, University of Nigeria, Enugu Campus/University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Enugu State, Nigeria
| | - Taiwo H Raimi
- Department of Medicine, Ekiti State University/Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
| | - Ibrahim D Gezawa
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - Anas A Sabir
- Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Ofem Enang
- Department of Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Cross-River State, Nigeria
| | - Fabian Puepet
- Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Olufemi A Fasanmade
- Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos, Lagos State, Nigeria
| | - Esther N Ofoegbu
- Department of Medicine, University of Nigeria, Enugu Campus/University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Enugu State, Nigeria
| | - Olatunde Odusan
- Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| |
Collapse
|
24
|
Al-Rubean K, Youssef AM, Al Farsi Y, Al-Sharqawi AH, Bawazeer N, Al Otaibi MT, AlRumaih FI, Zaidi MS. Anthropometric cutoff values for predicting metabolic syndrome in a Saudi community: from the SAUDI-DM study. Ann Saudi Med 2017; 37:21-30. [PMID: 28151453 PMCID: PMC6148981 DOI: 10.5144/0256-4947.2017.21] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of metabolic syndrome varies widely by ethnicity and by the criteria used in its definition. OBJECTIVE To identify the optimal cutoff values for waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) for identifying metabolic syndrome among the Saudi population. DESIGN Nationwide household cross-sectional population-based survey. SETTING Thirteen health sectors in Saudi Arabia. SUBJECTS AND METHODS We used data for subjects in the Saudi Abnormal Glucose Metabolism and Diabetes Impact Study (SAUDI-DM), which was conducted from 2007 to 2009. Using International Diabetes Federation (IDF) criteria, metabolic syndrome and its different components were assessed using anthropometric measurements, blood pressure, fasting plasma glucose, triglycerides and HDL cholesterol. Receiver operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cutoff values of WC, WHR, and BMI. The Youden index was used to calculate the optimal cutoff value for each anthropometric measurement. MAIN OUTCOME MEASURE(S) Optimal cutoff value for WC, WHR, and BMI for identifying the risk of metabolic syndrome. RESULTS The prevalence of two or more risk factors for metabolic syndrome was observed in 43.42% of the total cohort of 12126 study participants >=18 years of age. The presence of two or more risk factors were significantly higher among men (46.81%) than women (40.53%) (P < .001). The optimal cutoff values for WC, WHR, and BMI were 92 cm, 0.89, and 25 kg/m2 for men and 87 cm, 0.81 and 28 kg/m2 for women for identifying the risk of metabolic syndrome. The prevalence of elevated triglycerides, blood pressure, and fasting plasma glucose significantly increased with age for both genders. CONCLUSIONS The proposed WC cutoff values were better than WHR and BMI in predicting metabolic syndrome and could be used for screening people at high risk for metabolic syndrome in the Saudi population. LIMITATIONS No direct measure of body fatness and fat distribution, cross-sectional design.
Collapse
Affiliation(s)
| | - Amira M. Youssef
- Department of Registry, King Saud University, Riyadh, Saudi Arabia
| | - Yousuf Al Farsi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad H. Al-Sharqawi
- Department of Biostatistics, Diabetes Center, King Saud University, Riyadh, Saudi Arabia
| | - Nahla Bawazeer
- Department of Nutrition, King Saud University, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
25
|
Haregu TN, Oti S, Egondi T, Kyobutungi C. Measurement of overweight and obesity an urban slum setting in sub-Saharan Africa: a comparison of four anthropometric indices. BMC OBESITY 2016; 3:46. [PMID: 27833755 PMCID: PMC5100227 DOI: 10.1186/s40608-016-0126-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 10/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND As a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations. Accordingly, globally accepted anthropometric markers may perform differently in African populations. In the era of rapid emergence of cardio-vascular diseases in sub-Saharan Africa, evidence about the performance of these markers in African settings is essential. The aim of this study was to investigate the inter-relationships among the four main anthropometric indices in measuring overweight and obesity in an urban poor African setting. METHODS Data from a cardiovascular disease risk factor assessment study in urban slums of Nairobi were analyzed. In the major study, data were collected from 5190 study participants. We considered four anthropometric markers of overweight and obesity: Body Mass Index, Waist Circumference, Waist to Hip Ratio, and Waist to Height Ratio. Pairwise correlations and kappa statistics were used to assess the relationship and agreement among these markers, respectively. Discordances between the indices were also analyzed. RESULTS The weighted prevalence of above normal body composition was 21.6 % by body mass index, 28.9 % by waist circumference, 45.5 % by waist to hip ratio, and 38.9 % by waist to height ratio. The overall inter-index correlation was +0.44. Waist to hip ratio generally had lower correlation with the other anthropometric indices. High level of discordance exists between body mass index and waist to hip ratio. Combining the four indices shows that 791 (16.1 %) respondents had above normal body composition in all four indices. Waist circumference better predicted hypertension and hyperglycemia while waist to height ratio better predicted hypercholesterolemia. CONCLUSIONS There exists a moderate level of correlation and a remarkable level of discordance among the four anthropometric indices with regard to the ascertainment of abnormal body composition in an urban slum setting in Africa. Waist circumference is a better predictor of cardio-metabolic risk.
Collapse
Affiliation(s)
- Tilahun Nigatu Haregu
- African Population and Health Research Center, P.O. Box 10787 code 00100, Nairobi, Kenya
| | - Samuel Oti
- International Development Research Centre, PO Box 62084-00200, Nairobi, Kenya
| | - Thaddaeus Egondi
- Drugs for Neglected Diseases initiative (DNDi) Africa, P.O. Box 21936-00505, Nairobi, Kenya
| | - Catherine Kyobutungi
- African Population and Health Research Center, P.O. Box 10787 code 00100, Nairobi, Kenya
| |
Collapse
|
26
|
VALIDITY OF USING WAIST AND HIP CIRCUMFERENCE MEASUREMENTS TO DETERMINE BODY COMPOSITION OF YOUNG SYRIAN MEN. J Biosoc Sci 2016; 48:647-57. [PMID: 26971838 DOI: 10.1017/s0021932015000413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined the relation between waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR) and triceps skin-fold thickness and percentage body fat in young Syrian men. The aim was to develop equations that can use these anthropometric characteristics to estimate percentage body fat in this group of subjects. A total of 2470 healthy Syrian men aged 18-19 years were enrolled in the study in 2010-2011. The anthropometric characteristics of all subjects were measured. The percentage body fat of 213 of the subjects was determined using the deuterium dilution (DD) technique as a reference method. The validity of using WC, HC, WHpR and WHtR to calculate percentage body fat, in comparison with the reference method (DD technique), was assessed by calculating biases and limits of agreement. The estimates of percentage body fat using 'WC' and 'WC with triceps skin-fold' measurements ranged from 13.00±5.56% to 14.55±8.63%, and were lower than those determined using the reference method (21.32±6.42%). A better prediction equation is proposed for young adults, based on a multiple linear regression model using WC, HC and WHtR.
Collapse
|
27
|
Beraldo RA, Meliscki GC, Silva BR, Navarro AM, Bollela VR, Schmidt A, Foss-Freitas MC. Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients. PLoS One 2016; 11:e0149905. [PMID: 26919174 PMCID: PMC4769013 DOI: 10.1371/journal.pone.0149905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/05/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Highly active antiretroviral therapy (HAART) can cause side effects in HIV patients, as the metabolic syndrome. Early identification of risk for development of cardiovascular diseases using available reliable and practical methods is fundamental. On this basis, the aim of this study was to compare the effectiveness of anthropometric indicators to identify metabolic syndrome in HIV patients on HAART. METHODS It is a cross-sectional study. A number of 280 stable HIV patients were studied. It measured weight, height, waist circumference (WC), hip circumference (HP), thigh circumference (TC) and calculated body mass index (BMI), body adiposity index (BAI), waist to hip ratio (WHR) and waist to thigh ratio (WTR). There was also a performance of biochemical tests of lipid profile and fasting glucose. Systemic blood pressure was measured. The criteria proposed by the National Cholesterol Education Program III (NCEP-ATP III) to metabolic syndrome classification was used. Individuals were divided in groups with or without metabolic alterations and their anthropometric indicators were compared. Receiver operating characteristic (ROC) curves were designed for each anthropometric indicator using the metabolic syndrome classification to identify sensitivity and specificity. RESULTS WC was a good tool to identify each metabolic disorder separately: total cholesterol (only females, p<0.05), triglycerides (only males, p<0.001), HDL cholesterol (p<0.05), LDL cholesterol (p<005) and fasting glycemic (p<005). WC also showed the best performance to identify metabolic syndrome in both genders (areas under the curve (AUCs): 0.79 and 0.76 for male and female, respectively), while BAI proved to be an inadequate indicator (AUCs: 0.63 and 0.67 for males and females), respectively, in this population. CONCLUSIONS The central adiposity measure (WC) had the best performance to identify metabolic syndrome, and it is a convenient, cheap and reliable tool that can be used in clinical practice routinely to prevent cardiovascular complications in HIV patients.
Collapse
Affiliation(s)
- Rebeca Antunes Beraldo
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Cristina Meliscki
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Bruna Ramos Silva
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Anderson Marliere Navarro
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Valdes Roberto Bollela
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - André Schmidt
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Cristina Foss-Freitas
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
28
|
Assaad-Khalil SH, Mikhail MM, Aati TA, Zaki A, Helmy MA, Megallaa MH, Hassanien R, Rohoma KH. Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among adult Egyptian population. Indian J Endocrinol Metab 2015; 19:804-810. [PMID: 26693432 PMCID: PMC4673810 DOI: 10.4103/2230-8210.167556] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine the best anthropometric measurement of obesity, and its optimal cutoff, that best predicts the presence of cardiovascular risk factors among adult Egyptian population. METHODS This is a cross-sectional study including a representative randomly chosen sample of the adult Egyptian population from all Alexandria Districts (the second largest governorate in Egypt) based on the multistage random technique. It included 3209 subjects (1567 men, 1642 women) aged 18-80 years from urban and rural areas. The response rate was 80.2%. History, blood pressure, and anthropometric measurements were taken. Laboratory investigations included fasting lipid profile, fasting plasma glucose, and serum uric acid. Different criteria of metabolic syndrome were used and compared. Receiver operator characteristic curve and Youden index were used to determine predictability and cutoffs. RESULTS Waist circumference (WC) is the best to predict at least two other components of the metabolic syndrome as defined by the International Diabetes Federation (IDF). The optimal WC cutoffs were 100.5 and 96.25 cm for Egyptian men and women, respectively. The Joint Interim Statement definition (JIS) of metabolic syndrome was the best to predict cardiovascular disease in both genders and diabetes mellitus in women. The prevalence of metabolic syndrome and abdominal obesity was 42.5%, 61%, respectively (ATPIII definition); 43.8%, 61% (American Heart Association definition); 44.3%, 76.4% (IDF definition); 33.8%, 51.7% (IDF definition with Egyptian cutoffs); and 41.5%, 51.7% (JIS with Egyptian cutoffs). CONCLUSION WC cutoffs in Egyptians differ from those currently recommended. Prevalence of metabolic syndrome and abdominal obesity is high in Egypt, despite being lower on using the Egyptian cutoffs.
Collapse
Affiliation(s)
- Samir H. Assaad-Khalil
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Magued M. Mikhail
- Department of Clinical Pathology, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Talaat Abdel Aati
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Adel Zaki
- Department of Biostatistics, University of Alexandria, Medical Research Institute, Alexandria, Egypt
| | - Myriam A. Helmy
- Department of Clinical Pathology, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Magdy H. Megallaa
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Rehab Hassanien
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Kamel H. Rohoma
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| |
Collapse
|
29
|
Slim I, Khalaf F, Latiri I, Elfkih Z, Rouatbi S, Khochtali I, Ghannouchi I, Zinelabidine A, Ben Othman L, Miled H, Chaieb L, Ben Saad H. Lung function in poorly controlled type 1 North African diabetic patients: A case-control study. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2015.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
30
|
Zaki ME, El-Bassyouni HT, El-Gammal M, Kamal S. Indicators of the metabolic syndrome in obese adolescents. Arch Med Sci 2015; 11:92-8. [PMID: 25861294 PMCID: PMC4379376 DOI: 10.5114/aoms.2015.49214] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/02/2013] [Accepted: 04/04/2013] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION To assess the prevalence of metabolic risk indicators for the metabolic syndrome (MS) in a sample of obese Egyptian adolescents and to compare anthropometric and biochemical parameters in subjects with one or two parameters of the MS with those who meet MS criteria. MATERIAL AND METHODS A descriptive, cross-sectional study was conducted on 300 obese adolescents, with a mean age of 15.45 ±2.54 years. Variables examined included body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), systolic and diastolic blood pressure (BP), fasting blood glucose, cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoproteins (LDL), insulin and insulin resistance (IR) measured by Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Receiver operating characteristic (ROC) curve analysis was used to determine the predictive powers of anthropometric parameters associated with increased risk for the MS. RESULTS The overall prevalence of the MS was 20%. Individuals meeting 3 or more MS criteria had significantly higher levels of BP, TG, glucose, insulin and HOMA-R and low HDL levels compared with those who had 1 or 2 MS criteria. Area under the curve (AUC) for identifying the MS risk factors was the highest for WHR, followed by WC and BMI in both genders (p < 0.001). CONCLUSIONS The most prevalent metabolic risk factors that compose the MS were arterial hypertension, low HDL and hypertriglyceridemia; BMI tended to be the weakest index for identifying MS risk factors, while WHR was the best predictive index in both genders.
Collapse
Affiliation(s)
- Moushira Erfan Zaki
- Biological Anthropology Department, Medical Research Division, National Research Centre, Giza, Cairo, Egypt
| | - Hala T. El-Bassyouni
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Giza, Cairo, Egypt
| | - Mona El-Gammal
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Giza, Cairo, Egypt
| | - Sanaa Kamal
- Biological Anthropology Department, Medical Research Division, National Research Centre, Giza, Cairo, Egypt
| |
Collapse
|
31
|
Traissac P, Pradeilles R, El Ati J, Aounallah-Skhiri H, Eymard-Duvernay S, Gartner A, Béji C, Bougatef S, Martin-Prével Y, Kolsteren P, Delpeuch F, Ben Romdhane H, Maire B. Abdominal vs. overall obesity among women in a nutrition transition context: geographic and socio-economic patterns of abdominal-only obesity in Tunisia. Popul Health Metr 2015; 13:1. [PMID: 25745363 PMCID: PMC4350904 DOI: 10.1186/s12963-015-0035-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 01/13/2015] [Indexed: 01/31/2023] Open
Abstract
Background Most assessments of the burden of obesity in nutrition transition contexts rely on body mass index (BMI) only, even though abdominal adiposity might be specifically predictive of adverse health outcomes. In Tunisia, a typical country of the Middle East and North Africa (MENA) region, where the burden of obesity is especially high among women, we compared female abdominal vs. overall obesity and its geographic and socio-economic cofactors, both at population and within-subject levels. Methods The cross-sectional study used a stratified, three-level, clustered sample of 35- to 70-year-old women (n = 2,964). Overall obesity was BMI = weight/height2 ≥ 30 kg/m2 and abdominal obesity waist circumference ≥ 88 cm. We quantified the burden of obesity for overall and abdominal obesity separately and their association with place of residence (urban/rural, the seven regions that compose Tunisia), plus physiological and socio-economic cofactors by logistic regression. We studied the within-subject concordance of the two obesities and estimated the prevalence of subject-level “abdominal-only” obesity (AO) and “overall-only” obesity (OO) and assessed relationships with the cofactors by multinomial logistic regression. Results Abdominal obesity was much more prevalent (60.4% [57.7-63.0]) than overall obesity (37.0% [34.5-39.6]), due to a high proportion of AO status (25.0% [22.8-27.1]), while the proportion of OO was small (1.6% [1.1-2.2]). We found mostly similar associations between abdominal and overall obesity and all the cofactors except that the regional variability of abdominal obesity was much larger than that of overall obesity. There were no adjusted associations of AO status with urban/rural area of residence (P = 0.21), education (P = 0.97) or household welfare level (P = 0.94) and only non-menopausal women (P = 0.093), lower parity women (P = 0.061) or worker/employees (P = 0.038) were somewhat less likely to be AO. However, there was a large residual adjusted regional variability of AO status (from 16.6% to 34.1%, adjusted P < 0.0001), possibly of genetic, epigenetic, or developmental origins. Conclusion Measures of abdominal adiposity need to be included in population-level appraisals of the burden of obesity, especially among women in the MENA region. The causes of the highly prevalent abdominal-only obesity status among women require further investigation.
Collapse
Affiliation(s)
- Pierre Traissac
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911 av. Agropolis, 34394 Montpellier, France
| | - Rebecca Pradeilles
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911 av. Agropolis, 34394 Montpellier, France
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia ; SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
| | - Hajer Aounallah-Skhiri
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia ; INSP (National Institute of Public Health), 5-7 rue de Khartoum, 1002 Tunis, Tunisia ; Faculty of Medicine, Tunis El Manar University, 15 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
| | - Sabrina Eymard-Duvernay
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911 av. Agropolis, 34394 Montpellier, France
| | - Agnès Gartner
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911 av. Agropolis, 34394 Montpellier, France
| | - Chiraz Béji
- INNTA (National Institute of Nutrition and Food Technology), 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
| | - Souha Bougatef
- INSP (National Institute of Public Health), 5-7 rue de Khartoum, 1002 Tunis, Tunisia
| | - Yves Martin-Prével
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911 av. Agropolis, 34394 Montpellier, France
| | - Patrick Kolsteren
- ITM (Institute of Tropical Medicine), 155 Nationalestraat, 2000 Antwerp, Belgium
| | - Francis Delpeuch
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
| | - Habiba Ben Romdhane
- Epidemiology and Prevention of Cardiovascular Diseases Research Laboratory, Faculty of Medicine, 15 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
| | - Bernard Maire
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911 av. Agropolis, 34394 Montpellier, France
| |
Collapse
|
32
|
Simonova GI, Mustafina SV, Nikitin YP, Shcherbakova LV. WAIST CIRCUMFERENCE AS INDICATOR COMPONENTS OF METABOLIC SYNDROME IN THE SIBERIAN POPULATION. BULLETIN OF SIBERIAN MEDICINE 2014. [DOI: 10.20538/1682-0363-2014-2-88-94] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Object of research: to determine the cut-off point of waist circumference (WC) identify the components of metabolic syndrome (MS) in a large industrial center of Western Siberia.In the period from 2003 to 2005 in the screening population surveyed 9362 people, including 4268 men (45.6%) and 5094 women (54.4%).The response rate was 61%. The study protocol included a sociodemographic data, measurement of blood pressure (BP), anthropometry (height, weight, WC), the definition of biochemical parameters. Statistical analysis was performed using the package SPSS. To determine the cut-off points of the used ROC model.In the group with ≥2 components of MS cut-off point WC from the men was 93.3 cm (sensitivity 72%, specificity 83%), women – 90.2 cm (sensitivity 72%, specificity 62%).The lowest cut-off point WC marked BP ≥ 130/85 mm Hg for men – 90 cm (sensitivity 66.8%, specificity 58.1%), for women – 86.5 cm (sensitivity 71.0%, specificity 55.7%). The highest cut-off point from the defined patients with diabetes for men was 99.0 cm (sensitivity 61%, specificity 70.2%), for women – cm (sensitivity 64.1%, specificity 65.9%).Conclusions: Cut-off point from the persons with the presence of ≥2 MS components in Siberian population 45–69 years, in accordance with the ROC analysis are 93.3 cm for men and 90.2 cm for women. The lowest cut-off point WC marked BP ≥ 130/85 mm Hg for men – 90 cm, for women – 86.5 cm. The highest cut-off point from the defined patients with diabetes for men was 99.0 cm, for women – 95 cm.
Collapse
|
33
|
Gierach M, Gierach J, Ewertowska M, Arndt A, Junik R. Correlation between Body Mass Index and Waist Circumference in Patients with Metabolic Syndrome. ISRN ENDOCRINOLOGY 2014; 2014:514589. [PMID: 24729884 PMCID: PMC3960736 DOI: 10.1155/2014/514589] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/30/2013] [Indexed: 12/18/2022]
Abstract
Metabolic syndrome is defined as a group of coexisting metabolic risk factors, such as central obesity, lipid disorders, carbohydrate disorders, and arterial hypertension. According to the 2005 IDF criteria, subsequently revised in 2009, abdominal obesity is identified as the waist circumference of ≥80 cm in women and ≥94 cm in men. It is responsible for the development of insulin resistance. The aim of our study was to demonstrate a correlation between waist circumference (WC) and body mass index (BMI) in patients with metabolic syndrome in relation with hypertension, lipid disorders, and carbohydrate disorders. A cross-sectional two-site study was conducted in the Kuyavian-Pomeranian Voivodeship for 24 months. The study group consisted of 839 patients with diagnosed metabolic syndrome: 345 men (41.1%) and 494 women (58.9%) aged 32-80. In the study group, WC was found to be significantly correlated with BMI (R = 0.78, P < 0.01). The presence of overweight in men (BMI 25, 84 kg/m(2)) and even normal body weight in women (BMI 21,62 kg/m(2)) corresponds to an increased volume of visceral tissue in the abdomen. Introduction of primary prophylaxis in those people to limit the development of diabetes mellitus type 2 and cardiovascular diseases should be considered.
Collapse
Affiliation(s)
- Marcin Gierach
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland ; Internal Ward in District Hospital in Wabrzezno, 87-200 Wabrzezno, Poland
| | - Joanna Gierach
- Internal Ward in District Hospital in Wabrzezno, 87-200 Wabrzezno, Poland
| | - Marlena Ewertowska
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Adam Arndt
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Roman Junik
- Department of Endocrinology and Diabetology and Laboratory of Nuclear Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| |
Collapse
|
34
|
Veghari G, Sedaghat M, Joshaghani H, Banihashem S, Moharloei P, Angizeh A, Tazik E, Moghaddami A, Hajian-Tilaki K, ZahedPasha Y. The association of fasting blood glucose (FBG) and waist circumference in northern adults in Iran: a population based study. J Diabetes Metab Disord 2014; 13:2. [PMID: 24393143 PMCID: PMC3937214 DOI: 10.1186/2251-6581-13-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/12/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the association between Fasting Blood Glucose (FBG) level and Waist Circumference (WC) in men and women among 25-65 years old people in the north of Iran. MATERIAL AND METHODS This was a cross-sectional and analytical research gender that carried out on the 1797 subjects (941 males and 856 females) between 25-65 years old using multistage cluster sampling technique. FBG was measured in the morning after a 12-hour fast and was determined by using laboratory kits (enzymatic methods) and spectrophotometry technique. Central obesity was defined based on World Health Organization criteria: waist circumference ≥102 cm and ≥88 cm in men and women, respectively. The SPSS.16 software was used for statistical analysis. RESULTS As whole, the mean of FBG in women (98.3 ± 40.1 mg/dl) was higher than in men (94.6 ± 32.2 mg/dl). Also, the mean of WC in men 4.5 cm was lower than in women. In men, the mean of FBG statistically differs between normal and central obese subjects both in 35-45 year-age group (P = 0.001) and in 45-55 year-age group (P = 0.042). As whole, in men, the FBG level increased up 2.82 mg/dl in each 10 cm of WC with the highest rate in 35-45 year-age group. In totally, in women, the FBG level increased up 3.48 mg/dl in each 10 cm of WC and in 25-35 year-age group and it was higher than in other age groups. In men, the regression coefficients were constant with age increasing while in women it was decreased. Constant trend in men and decreasing trend in women with age was shown between FBG and WC. The cut-off point of WC for detecting of diabetes obtained 89 cm and 107 cm in men and women, respectively. CONCLUSION The positive correlation was seen between WC and FBG level and it was declined with age in women. Cut-off point for detecting of diabetes in men was less than in women. WC is useable as a predictor of type 2 diabetes mellitus risk among adults in the north of Iran.
Collapse
Affiliation(s)
- Gholamreza Veghari
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mehdi Sedaghat
- Deputy of Health; Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamidreza Joshaghani
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Samieh Banihashem
- Deputy of Health; Golestan University of Medical Sciences, Gorgan, Iran
| | - Pooneh Moharloei
- Deputy of Health; Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Ebrahim Tazik
- Deputy of Health; Golestan University of Medical Sciences, Gorgan, Iran
| | - Abbas Moghaddami
- Deputy of Health; Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Yedolla ZahedPasha
- Non-Communicable Pediatrics Disease Research Center, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
35
|
Hsouna S, Ben Halim N, Lasram K, Arfa I, Jamoussi H, Bahri S, Ammar SB, Miladi N, Abid A, Abdelhak S, Kefi R. Association study of mitochondrial DNA polymorphisms with type 2 diabetes in Tunisian population. ACTA ACUST UNITED AC 2013; 26:367-72. [PMID: 24102601 DOI: 10.3109/19401736.2013.836508] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mitochondrial DNA (mtDNA) variation may play an important role in the pathogenesis of type 2 diabetes (T2Ds). In this study, we aimed to explore whether mtDNA variants contribute to the susceptibility to T2Ds in a Tunisian population. The hypervariable region 1 (HVS1) of the mtDNA of 64 T2Ds patients and 77 healthy controls was amplified and sequenced. Statistical analysis was performed using the STATA program. Analysis of the total screened variants (N = 88) from the HVS1 region showed no significant difference in the distribution of all polymorphisms between T2Ds and controls, except for the variant G16390A which was more frequent in T2Ds (15.9%) than in controls (5.4%) (p = 0.04). The association of G16390A was not detected after multivariate regression analysis. Similarly, analysis of the distribution of mitochondrial haplogroups within our dataset showed 18 distinct major haplogroups with no significant difference between T2Ds and controls. Except, the weakly association found for the G16390A variant, our results showed that none of the tested polymorphisms from the HVS1 region have a major role in T2Ds pathogenesis in the studied Tunisian population even when taking into account the population stratification.
Collapse
Affiliation(s)
- Sana Hsouna
- Biomedical Genomics and Oncogenetics Laboratory (LR 11 IPT 05), Institut Pasteur de Tunis, Université El Manar de Tunis , Tunis , Tunisia
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Bellido D, López de la Torre M, Carreira J, de Luis D, Bellido V, Soto A, Luengo LM, Hernández A, Vidal J, Becerra A, Ballesteros M. [Anthropometric measures of central abdominal fat and discriminant capacity for metabolic syndrome in a Spanish population]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2013; 25:105-9. [PMID: 23916262 DOI: 10.1016/j.arteri.2013.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/19/2013] [Accepted: 05/27/2013] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The metabolic syndrome (MS) carries an increased risk of cardiovascular disease and diabetes mellitus. Insulin resistance is probably the mechanism underlying the changes detected in lipid and carbohydrate metabolism in these patients, who have, as a common anthropometric feature, a predominantly increased abdominal fat distribution. PATIENTS AND METHODS A total of 3316 patients were studied, of whom 63.40% were female and 36.60 male, with a mean age of 42.36±14.63 years, and a body mass index (BMI) of 32.76±6.81kg/m(2). Weight, height and waist circumference (CC) were measured using standard techniques. The waist/height (ICA) was calculated using two indicators, expressed as waist in cm divided by height in m(2), and as waist divided by height, both in cm. The prevalence of metabolic syndrome in the sample was 33.70%. In order to assess the predictive ability of BMI, ICA and CC to detect the existence of MS, receiver operating curves (ROC) were constructed and the areas under the curve (AUC) calculated for each anthropometric parameter. RESULTS An AUC of 0.724 (95%CI: 0.706 to 0.742), P<.001, was obtained for CC, 0.709 (95%CI: 0.691 to 0.728), P<.001 for ICA with height in m(2), and 0.729 (95%CI: 0.711 to 0.747), P<.001 for ICA with height in cm, and for the BMI it was 0.680 (95%CI 0.661-0.699), P<.001. CONCLUSIONS Anthropometric indices that assess abdominal fat distribution have a better predictive capacity for detecting MS, compared to total adiposity indicators such as BMI.
Collapse
Affiliation(s)
- Diego Bellido
- Endocrinología y Nutrición, Complexo Hospitalario Universitario de Ferrol, Chuf, SERGAS, Ferrol, A Coruña, España.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
El Ati J, Traissac P, Delpeuch F, Aounallah-Skhiri H, Béji C, Eymard-Duvernay S, Bougatef S, Kolsteren P, Maire B, Ben Romdhane H. Gender obesity inequities are huge but differ greatly according to environment and socio-economics in a North African setting: a national cross-sectional study in Tunisia. PLoS One 2012; 7:e48153. [PMID: 23118943 PMCID: PMC3485235 DOI: 10.1371/journal.pone.0048153] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 09/21/2012] [Indexed: 11/30/2022] Open
Abstract
Introduction Southern Mediterranean countries have experienced a marked increase in the prevalence of obesity whose consequences for gender related health inequities have been little studied. We assessed gender obesity inequalities and their environmental and socio-economic modifiers among Tunisian adults. Methods Cross-sectional survey in 2005; national, 3 level random cluster sample of 35–70 years Tunisians (women: n = 2964, men: n = 2379). Overall adiposity was assessed by BMI = weight(kg)/height(m)2 and obesity was BMI≥30, WHtR = waist circumference to height ratio defined abdominal obesity as WHtR≥0.6. Gender obesity inequality measure was women versus men Prevalence Proportion Odds-Ratio (OR); models featuring gender x covariate interaction assessed variation of gender obesity inequalities with area (urban versus rural), age, marital status or socio-economic position (profession, education, household income proxy). Results BMI was much higher among women (28.4(0.2)) versus men (25.3(0.1)), P<0.0001) as was obesity (37.0% versus 13.3%, OR = 3.8[3.1–7.4], P<0.0001) and abdominal obesity (42.6% versus 15.6%, 4.0[3.3–4.8], P<0.0001). Gender obesity inequalities (women versus men adjusted OR) were higher in urban (OR = 3.3[1.3–8.7]) than rural (OR = 2.0[0.7–5.5]) areas. These gender obesity inequalities were lower for subjects with secondary education or more (OR = 3.3[1.3–8.6]), than among those with no schooling (OR = 6.9[2.0–23.3]). They were also lower for those with upper/intermediate profession (OR = 1.4[0.5–4.3]) or even employees/workers OR = 2.3[1.0–5.4] than those not professionaly active at all (OR = 3.3[1.3–8.6]). Similar results were observed for addominal obesity. Conclusion The huge overall gender obesity inequities (women much more corpulent than men) were higher in urban settings, but lower among subjects of higher education and professional activity. Reasons for gender inequalities in obesity and their variation with socio-economic position should be sought so that appropriate policies to reduce these inequalities can be implemented in Tunisia and similar settings.
Collapse
Affiliation(s)
- Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), Tunis, Tunisia
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Shabnam AA, Homa K, Reza MTM, Bagher L, Hossein FM, Hamidreza A. Cut-off points of waist circumference and body mass index for detecting diabetes, hypercholesterolemia and hypertension according to National Non-Communicable Disease Risk Factors Surveillance in Iran. Arch Med Sci 2012; 8:614-21. [PMID: 23056071 PMCID: PMC3460497 DOI: 10.5114/aoms.2012.30284] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 09/14/2011] [Accepted: 10/25/2011] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The cut-off points of waist circumference and body mass index (BMI) are varied according to different races. There is a dearth of information on these indices especially in Iranian adults. We sought to estimate the cut-off points of waist circumference and BMI for detecting diabetes, hypercholesterolemia, and hypertension. MATERIAL AND METHODS The data were gathered by the First Iranian Non-Communicable Disease Survey in 2005. In total, 70,981 participants between 25 and 64 years of old were selected via random multistage cluster sampling. Receiver operating characteristic curves were used to show the cut-off points of waist circumference and BMI for detecting diabetes, hypercholesterolemia, and hypertension. The maximum value the sum of sensitivity and specificity indicated the cut-off point. RESULTS The cut-off points of waist circumference according to maximum sum of sensitivity and specificity for detecting hypertension, diabetes, and hypercholesterolemia in men were 89.7 cm, 89.4 cm and 88.2 cm and in women were 93.9 cm, 96.2 cm and 90 cm respectively. The cut-off points of BMI according to maximum sum of sensitivity and specificity for detecting hypertension, diabetes, and hypercholesterolemia in men were 25.7 kg/m(2), 24.8 kg/m(2) and 24 kg/m(2) and in women were 26.9 kg/m(2), 26.3 kg/m(2) and 26.1 kg/m(2) respectively. CONCLUSIONS This was a population-based study on a huge sample on the basis of a national survey. The Iranian BMI was different from the values suggested by the WHO. The waist circumference in Iranian women was higher than that in men.
Collapse
Affiliation(s)
| | - Kashani Homa
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran
| | | | - Larijani Bagher
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Iran
| | - Forouzanfar Mohammad Hossein
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran
| | | |
Collapse
|
39
|
Al-Odat AZ, Ahmad MN, Haddad FH. References of anthropometric indices of central obesity and metabolic syndrome in Jordanian men and women. Diabetes Metab Syndr 2012; 6:15-21. [PMID: 23014249 DOI: 10.1016/j.dsx.2012.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AIMS To set references and evaluate the associations between the predictive powers of the anthropometric indices of obesity, particularly central obesity, including body mass index (BMI), waist circumference (WC), waist to hip ratio (WHpR) and waist to height ratio (WHtR), and the risk factor accumulations of ≥ 2 of the components of the metabolic syndrome (MS) in a group of Jordanian men and women. METHODS Five hundreds subjects were randomly selected from among the visitors attending several family clinics in Amman. Obesity was assessed using BMI, WC, WHpR and WHtR anthropometric indices. MS risk factors as defined by the International Diabetes Federation were determined. Receiver operating characteristic curve (ROC) analysis was used to determine the predictive powers and the cut off points of each index associated with increased MS risk. RESULTS There were 212 men and 288 women with age ranged 20-85 years. Optimal cut off points of BMI, WC, WHpR for MS diagnosis in men were 28.4 kg/m(2), 97.8 cm and 0.89, respectively. In women, these were 30.3 kg/m(2), 95.6 cm and 0.84, respectively. WHtR was 0.61 in both genders. Area under the curve (AUC) of ROC analysis for identifying of MS (≥ 2 risk factors) was the highest for WHpR (AUC=0.71), followed by WHtR (AUC=0.67), WC (AUC=0.64) and BMI (AUC=0.59) in men; whereas in women WHpR, WHtR and WC were almost equal (AUC=0.76, 0.75 and 0.74, respectively), followed by BMI (AUC=0.67). Correlation coefficients (r) between WHpR and MS risk factors were the strongest among the other obesity indices, followed by WC and WHtR. WHpR correlated significantly with FBG (r=0.27, p<0.01), systolic blood pressure (r=0.20, p<0.01), TGs (r=0.24, p<0.01) and HDL-C (r=-0.39, p<0.01). The respective r-values between WC and WHtR and each MS risk factors were: FBG (r=0.15, p<0.001 or r=0.13, p<0.01), systolic blood pressure (r=0.16, p<0.01 or r=0.11, p<0.05), TGs (r=0.20, p<0.01 or r=0.14, p<0.01) and HDL-C (r=-0.25, p<0.01 or r=-0.11, p<0.01). CONCLUSION This study showed that BMI tended to be the weakest index for identifying MS risk factors in both sexes. WHpR exhibited the best predictive index for MS, particularly in men. Almost similar predictive powers of WHtR, WHpR and WC for identifying MS risk factors were seen in women. WHtR had the highest sensitivity for MS diagnosis among obesity indices in men and its boundary value was the same for both men and women. These cut off values of obesity particularly waist circumference should be advocated and used in Arab Jordanians until larger cross sectional studies shows different results.
Collapse
Affiliation(s)
- Areej Zaal Al-Odat
- Department of Nutrition and Food Technology, University of Jordan, Amman, Jordan
| | | | | |
Collapse
|
40
|
Talaei M, Thomas GN, Marshall T, Sadeghi M, Iranipour R, Oveisgharan S, Sarrafzadegan N. Appropriate cut-off values of waist circumference to predict cardiovascular outcomes: 7-year follow-up in an Iranian population. Intern Med 2012; 51:139-46. [PMID: 22246480 DOI: 10.2169/internalmedicine.51.6132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Due to the lack of compelling evidence for waist circumference (WC) as a cardiovascular disease (CVD) risk factor in many ethnic groups, the need for local research has been expressed by international authorities. This study was undertaken to determine the optimal cut-off points of WC for predicting incident CVD and metabolic syndrome in an Iranian population. MATERIALS AND METHODS A total of 6,504 participants from three areas in central Iran were followed over 7 years. Receiver operating characteristics (ROC) and area under the curve (AUC) were used to identify the maximum value of sensitivity and specificity combinations corresponding to the appropriate cut-off points of WC for the detection of the metabolic syndrome and CVD events. The optimal cut-off values were defined as the point at which the value of "sensitivity+specificity-1" reached the maximum value. Finally, Cox proportional hazard modeling was used to determine which cut-off point was better fit in the CVD risk prediction model. RESULTS After 394,418 person-years of follow-up, 427 incident primary CVD events (233 men) were identified. Considering CVD, the optimum cut-off points were 99/103.5 cm (men/women) but these had a low sensitivity (AUC: 0.59, 95%CI 0.55-0.63 in both men and women). The second highest values for discriminating CVD were 93/97 cm that resulted in acceptable sensitivity. Regarding the metabolic syndrome, 92.6/97.8 cm were identified as optimum (AUC: 0.67, 95%CI 0.65-0.69 in men and 0.65, 95%CI 0.63-0.67 in women). The best cut-off values that fit in the Cox regression model were 90/97 cm. CONCLUSION International recommended WC cut-off values for the Middle East are not appropriate compared to the locally defined cut-off values in Iran.
Collapse
Affiliation(s)
- Mohammad Talaei
- Public Health, Epidemiology & Biostatistics, University of Birmingham, UK.
| | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
Metabolic syndrome (MS) is a combination of medical disorders that, in concert, increase the risk of developing cardiovascular disease and diabetes. It affects about one in four people in the Middle East, and prevalence increases with age. The aim of current review is to discuss the prevalence of MS and its component in different regions in the Middle East. The recorded high prevalence of the MS and its key cardiovascular risk factors (15-60%) among Middle East population mandates the need for a national and international prevention programs to combat obesity, diabetes, hypertension, dyslipidemia, smoking and related comorbidities. Consideration of early prevention and control is of utmost importance.
Collapse
Affiliation(s)
| | - Seham Ahmed
- Department of Internal Medicine, Suez Canal University, Egypt
| | - Nader Nemr
- Department of Endemic and Infectious Disease, Suez Canal University, Egypt
| | - Iman El-Sherif
- Department of Internal Medicine, Suez Canal University, Egypt
| |
Collapse
|
42
|
Beltaifa L, Chaouachi A, Zérifi R, Boussaidi L, Bouzrati I, Abid A, Elkhadi A, Chamari K, Raies A. Walk-run transition speed training as an efficient exercise adjunct to dietary restriction in the management of obesity: a prospective intervention pilot study. Obes Facts 2011; 4:45-52. [PMID: 21372610 PMCID: PMC6444746 DOI: 10.1159/000324579] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to test the utility of preferred walk-run transition speed (WRTS) in exercise training adjunct to dietary restriction for obesity management in healthy obese women. MATERIALS AND METHODS 37 obese women (age: 35 ± 9 years, body mass index (BMI): 34.9 ± 4.6 kg/m(2)) were assigned to an intervention pilot study during 6 months of restricted diet alone (RD) followed by 6 months of RD combined with WRTS (RD and WRTS) as a training exercise. Body mass, waist circumference (WC), fat mass (FM), fat free mass (FFM), active cell mass (ACM), fasting glucose, serum lipids (triacylglycerol (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), apo-lipoproteins A1 (ApoA1) and B (ApoB)], leptin and insulin concentrations, and HOMA-IR were assessed at baseline (T0), at the end of the RD alone (T1), and at the end of the RD and WRTS programme (T2). RESULTS Mean weight loss was 8.6 ± 4.9 kg and 2.2 ± 2.9 kg for (T0-T1) and (T1-T2), respectively. Significant BMI and WC reductions were reported at T1 and T2. FM decreased significantly both with RD and with RD and WRTS training whereas FFM and ACM increased with RD and WRTS training only. TG decreased significantly with the two phases of the programme. A significant increase in HDL-C, and a decrease in LDL-C and TC/HDL-C ratio were noticed with RD and WRTS training. Heart rate monitored in training improved significantly after RD and WRTS training. A significant relationship (r = 0.542, p < 0.02) was demonstrated between reductions in serum leptin and insulin concentrations observed with both RD and WRTS training. CONCLUSION The addition of WRTS training to RD promoted a greater reduction in body mass, WC, FM, leptin and insulin concentrations, improved metabolic and cardiovascular risk factors, and enhanced cardiovascular fitness.
Collapse
Affiliation(s)
- Latifa Beltaifa
- Tunesian Research Laboratory Sports Performance Optimisation, National Centre of Medicine and Science in Sports, Tunis, Tunisia
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Marcadenti A, Fuchs SC, Moreira LB, Wiehe M, Gus M, Fuchs FD. Accuracy of anthropometric indexes of obesity to predict diabetes mellitus type 2 among men and women with hypertension. Am J Hypertens 2011; 24:175-80. [PMID: 20885370 DOI: 10.1038/ajh.2010.212] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Anthropometric measurements and indexes that assess excess of adiposity are associated with cardiovascular risk factors, and predict diabetes mellitus. METHODS This cross-sectional study reported the performance of adiposity indexes to detect or turn diabetes unlikely in patients with hypertension. Patients with hypertension (blood pressure (BP) ≥140/90 mm Hg or antihypertensive drug use) aged 18-80 years, being 150 men and 332 women, had weight, height, waist circumference (WC), hip circumference, body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), and waist-to-square height ratio (WHt(2)R) calculated. Diabetes was diagnosed by fasting blood glucose ≥126 mg/dl or antidiabetic drug use (23% of the sample). RESULTS All anthropometric indexes were associated with diabetes in a modified Poisson regression, adjusting for age, smoking, and physical activity, in women, but not in men. In men, only the area under the receiver-operating characteristic curve (AUC) for WHR was statistically associated with diabetes (0.67, 95% confidence interval (CI) 0.57-0.77). A cutoff of ≥0.95 had sensitivity of 84.6% (73.3-95.9) and negative post-test probability of 12.8% (3.2-22.4). Among women, WC >88 cm, WHR ≥0.85, and WHtR > 0.54 had sensitivity >93% and negative post-test probability <7.5%. CONCLUSIONS WHR ≥0.85, WC >88.0 cm, and WHtR >0.54 for women and WHR ≥0.95 for men are highly suggestive of diabetes among this population of hypertensive patients. Indexes below these cutoffs turn diabetes unlikely in this context. The investigation of reproducibility of this performance in other outpatient clinics is warranted.
Collapse
|
44
|
Tulloch-Reid MK, Ferguson TS, Younger NOM, Van den Broeck J, Boyne MS, Knight-Madden JM, Samms-Vaughan ME, Ashley DE, Wilks RJ. Appropriate waist circumference cut points for identifying insulin resistance in black youth: a cross sectional analysis of the 1986 Jamaica birth cohort. Diabetol Metab Syndr 2010; 2:68. [PMID: 21134291 PMCID: PMC3017019 DOI: 10.1186/1758-5996-2-68] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 12/07/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While the International Diabetes Federation (IDF) has ethnic specific waist circumference (WC) cut-points for the metabolic syndrome for Asian populations it is not known whether the cut-points for black populations should differ from those for European populations. We examined the validity of IDF WC cut points for identifying insulin resistance (IR), the underlying cause of the metabolic syndrome, in predominantly black, young Jamaican adults. METHODS Participants from a 1986 birth cohort were evaluated between 2005 and 2007 when they were 18-20 years old. Trained observers took anthropometric measurements and collected a fasting blood sample. IR was assessed using the homeostasis model assessment computer programme (HOMA-IR). Sex specific quartiles for IR were generated using HOMA-IR values and participants in the highest quartile were classified as "insulin resistant". Receiver operator characteristic (ROC) curves were used to estimate the best WC to identify insulin resistance. The sensitivity and specificity of these values were compared with the IDF recommended WC cut-points. RESULTS Data from 707 participants (315 males; 392females) were analysed. In both sexes those with IR were more obese, had higher mean systolic blood pressure, glucose and triglycerides and lower mean HDL cholesterol. The WC was a good predictor of IR with an ROC area under the curve (95% CI) of 0.71(0.64,0.79) for men and 0.72(0.65,0.79) for women. Using the Youden Index (J) the best WC cut point for identifying IR in male participants was 82 cm (sensitivity 45%, specificity 93%, J 0.38) while the standard cut point of 94 cm had a sensitivity of 14% and specificity of 98% (J 0.12). In the female participants 82 cm was also a good cut point for identifying IR (sensitivity 52%, specificity 87%, J 0.39) and was similar to the standard IDF 80 cm cut point (sensitivity 53%, specificity 82%, J 0.35). CONCLUSIONS The WC that identified IR in young black men is lower than the IDF recommended WC cut point. Sex differences in WC cut points for identifying IR were less marked in this population than in other ethnic groups.
Collapse
Affiliation(s)
| | - Trevor S Ferguson
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Jamaica
| | - Novie OM Younger
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Jamaica
| | | | - Michael S Boyne
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Jamaica
| | | | - Maureen E Samms-Vaughan
- Department of Obstetrics, Gynaecology and Child Health, The University of the West Indies Mona, Jamaica
| | - Deana E Ashley
- Institute for Sustainable Development, The University of the West Indies, Jamaica
| | - Rainford J Wilks
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Jamaica
| |
Collapse
|
45
|
Receiver-operating characteristics of adiposity for metabolic syndrome: the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Public Health Nutr 2010; 14:77-92. [PMID: 20854721 DOI: 10.1017/s1368980010002648] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the predictive values of various adiposity indices for metabolic syndrome (MetS) among adults using baseline data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) cohort. DESIGN In a cross-sectional study, BMI, waist circumference (WC), body composition by dual-energy X-ray absorptiometry (DEXA) and metabolic risk factors such as TAG, HDL cholesterol, blood pressure, fasting glucose and insulin, uric acid and C-reactive protein were measured. Receiver-operating characteristic (ROC) curves and logistic regression analyses were conducted. SETTING Baltimore, Maryland. SUBJECTS White and African-American US adults (n 1981), aged 30-64 years. RESULTS In predicting risk of MetS using obesity-independent National Cholesterol Education Program Adult Treatment Panel III criteria, percentage total body fat mass (TtFM) assessed using DEXA measuring overall adiposity had no added value over WC. This was true among both men (area under the ROC curve (AUC) = 0.680 v. 0.733 for TtFM and WC, respectively; P < 0.05) and women (AUC = 0.581 v. 0.686). Percentage rib fat mass (RbFM) was superior to TtFM only in women for MetS (AUC = 0.701 and 0.581 for RbFM and TtFM, respectively; P < 0.05), particularly among African-American women. Elevated percentage leg fat mass (LgFM) was protective against MetS among African-American men. Among white men, BMI was inferior to WC in predicting MetS. Optimal WC cut-off points varied across ethnic-sex groups and differed from those recommended by the National Institutes of Health/North American Association for the Study of Obesity. CONCLUSIONS The study provides evidence that WC is among the most powerful tools to predict MetS, and that optimal cut-off points for various indices including WC may differ by sex and race.
Collapse
|
46
|
Optimal cut-off values and population means of waist circumference in different populations. Nutr Res Rev 2010; 23:191-9. [PMID: 20642876 DOI: 10.1017/s0954422410000120] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abdominal obesity is a risk factor for cardiometabolic disease, and has become a major public health problem in the world. Waist circumference is generally used as a simple surrogate marker to define abdominal obesity for population screening. An increasing number of publications solely rely on the method that maximises sensitivity and specificity to define ‘optimal’ cut-off values. It is well documented that the optimal cut-off values of waist circumference vary across different ethnicities. However, it is not clear if the variation in cut-off values is a true biological phenomenon or an artifact of the method for identifying optimal cut-off points. The objective of the present review was to assess the relationship between optimal cut-offs and population waist circumference levels. Among sixty-one research papers, optimal cut-off values ranged from 65·5 to 101·2 cm for women and 72·5 to 103·0 cm for men. Reported optimal cut-off values were highly correlated with population means (correlation coefficient: 0·91 for men and 0·93 for women). Such a strong association was independent of waist circumference measurement techniques or the health outcomes (dyslipidaemia, hypertension or hyperglycaemia), and existed in some homogeneous populations such as the Chinese and Japanese. Our findings raised some concerns about applying the sensitivity and specificity approach to determine cut-off values. Further research is needed to understand whether the differences among populations in waist circumference were genetically or environmentally determined, and to understand whether using region-specific cut-off points can identify individuals with the same absolute risk levels of metabolic and cardiovascular outcomes among different populations.
Collapse
|
47
|
The optimal cutoff values and their performance of waist circumference and waist-to-hip ratio for diagnosing type II diabetes. Eur J Clin Nutr 2009; 64:23-9. [PMID: 19690576 DOI: 10.1038/ejcn.2009.92] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
48
|
Lear SA, James PT, Ko GT, Kumanyika S. Appropriateness of waist circumference and waist-to-hip ratio cutoffs for different ethnic groups. Eur J Clin Nutr 2009; 64:42-61. [DOI: 10.1038/ejcn.2009.70] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
49
|
Delavari A, Forouzanfar MH, Alikhani S, Sharifian A, Kelishadi R. First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East: the national survey of risk factors for noncommunicable diseases of Iran. Diabetes Care 2009; 32:1092-7. [PMID: 19279302 PMCID: PMC2681035 DOI: 10.2337/dc08-1800] [Citation(s) in RCA: 271] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study was to provide the first national estimate on the prevalence of the metabolic syndrome and its components and the first ethnic-specific cutoff point for waist circumference in the Eastern Mediterranean Region. RESEARCH DESIGN AND METHODS This national survey was conducted in 2007 on 3,024 Iranians aged 25-64 years living in urban and rural areas of all 30 provinces in Iran. The metabolic syndrome was defined by different criteria, namely the definition of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), the International Diabetes Federation (IDF) criteria, and the modified definition of the NCEP/ATP III (ATP III/American Heart Association [AHA]/National Heart, Lung, and Blood Institute [NHLBI]). RESULTS The age-standardized prevalence of the metabolic syndrome was about 34.7% (95% CI 33.1-36.2) based on the ATP III criteria, 37.4% (35.9-39.0%) based on the IDF definition, and 41.6% (40.1-43.2%) based on the ATP III/AHA/NHLBI criteria. By all definitions, the prevalence of the metabolic syndrome was higher in women, in urban areas, and in the 55- to 64-year age-group compared with the prevalence in men, in rural areas, and in other age-groups, respectively. The metabolic syndrome was estimated to affect >11 million Iranians. The optimal cutoff point of waist circumference for predicting at least two other components of the metabolic syndrome as defined by the IDF was 89 cm for men and 91 cm for women. CONCLUSIONS The high prevalence of the metabolic syndrome with its considerable burden on the middle-aged population mandates the implementation of national policies for its prevention, notably by tackling obesity. The waist circumference cutoff points obtained can be used in the region.
Collapse
Affiliation(s)
- Alireza Delavari
- Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | |
Collapse
|
50
|
Enquête sur la prévalence des facteurs de risque de maladies cardiovasculaires à Tlemcen (Algérie). ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1957-2557(09)74761-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|