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Abe M, Fujii H, Funakoshi S, Satoh A, Kawazoe M, Maeda T, Tada K, Yokota S, Yamanokuchi T, Yoshimura C, Mimata R, Takahashi K, Ito K, Yasuno T, Kuga T, Mukoubara S, Akiyoshi K, Kawanami D, Masutani K, Arima H. Comparison of Body Mass Index and Waist Circumference in the Prediction of Diabetes: A Retrospective Longitudinal Study. Diabetes Ther 2021; 12:2663-2676. [PMID: 34448106 PMCID: PMC8479044 DOI: 10.1007/s13300-021-01138-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/04/2021] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Both body mass index (BMI) and waist circumference (WC) are associated with diabetes risk, and the difference between them in predictive ability for diabetes is still contentious. We conducted a population-based study to investigate and compare the association of them with diabetes by sex. METHODS This study included a total of 4754 subjects aged 40-80 years with no diabetes at baseline between 2008 and 2017. Using multivariate Cox proportional hazards models, we calculated hazard ratios for diabetes according to tertiles of BMI or WC. Harrell's C statistics was applied to assess and compare the predictive ability of the models using BMI and WC. RESULTS Both BMI and WC showed the significant positive trends with diabetes risk. In men, the extreme tertiles (BMI > 25.1 kg/m2 and WC > 88.0 cm) provided 1.58-fold or 2.04-fold higher risk compared with the first tertiles (< 22.6 kg/m2 and < 81.2 cm). In women, BMI > 24.4 kg/m2 showed 3.28-fold higher risk than the first tertile (< 21.6 kg/m2), whereas WC ≥ 78.2 cm was more than twice as likely to suffer from diabetes as WC < 78.2 cm. BMI and WC showed a comparative performance in predicting diabetes in both sexes (P value 0.447 in men, and 0.337 in women). CONCLUSION Both BMI and WC showed a positive association with diabetes and offered a comparative predictive performance for diabetes in both sexes. The cut-off points, BMI 25.1 kg/m2 and WC 88.0 cm in men and BMI 24.4 kg/m2 and WC 78.2 cm in women, might contribute to the effective prevention strategies for diabetes.
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Affiliation(s)
- Makiko Abe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hideyuki Fujii
- Division of Endocrinology and Diabetes Mellitus, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shunsuke Funakoshi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Miki Kawazoe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiki Maeda
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kazuhiro Tada
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Soichiro Yokota
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshitaka Yamanokuchi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Chikara Yoshimura
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryosuke Mimata
- Department of Anesthesiology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Koji Takahashi
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kenji Ito
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takeshi Kuga
- Department of Internal Medicine, Mitsutake Hospital, Iki, Japan
| | - Shigeki Mukoubara
- Department of Internal Medicine, Nagasaki Prefecture Iki Hospital, Iki, Japan
| | - Kozaburo Akiyoshi
- Department of Anesthesiology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Daiji Kawanami
- Division of Endocrinology and Diabetes Mellitus, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
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Issaka A, Cameron AJ, Paradies Y, Kiwallo JB, Bosu WK, Houehanou YCN, Wesseh CS, Houinato DS, Nazoum DJP, Stevenson C. Associations between obesity indices and both type 2 diabetes and impaired fasting glucose among West African adults: Results from WHO STEPS surveys. Nutr Metab Cardiovasc Dis 2021; 31:2652-2660. [PMID: 34226119 DOI: 10.1016/j.numecd.2021.05.028] [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: 02/15/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM Various obesity indices such as BMI, waist circumference (WC), waist-hip ratio, (WHR) and waist-to-height ratio (WHtR) are associated with the risk of type 2 Diabetes Mellitus (T2DM). Given few studies examining the strength of the association in this population, we aimed to identify which obesity indices are most strongly associated with T2DM and impaired fasting glucose (IFG) among adults from five West African countries. METHODS AND RESULTS Data from 15,520 participants from the World Health Organisation (WHO) STEPs surveys in Burkina Faso, Benin, Mali, Liberia, and Ghana were included in analyses. Multinomial logistic regression was used to calculate the relative risk (RR) per standard deviation (SD) of each anthropometric measure, modelled as both continuous variables and as categorical variables based on established cut-points. In the analyses with continuous variables, the unadjusted RRs for T2DM per SD were 1.30 (1.23, 1.37) for body mass index (BMI); 1.56 (1.46, 1.67) for WC; 2.57 (2.15, 3.09) for WHtR and 1.16 (1.03, 1.31) for WHR. WHtR showed the strongest association with T2DM in all adjusted analyses. For models using categorical variables based on established cut-points, obesity defined using waist circumference (OB-WC) and OB-BMI showed the strongest associations with T2DM, and OB-WHR, the weakest association in all adjusted analyses. CONCLUSION WHtR and WC appear to be the indices most strongly associated with T2DM and IFG respectively. Given its simplicity, WC may be the metric that most usefully conveys risk for T2DM in West African adults.
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Affiliation(s)
- Ayuba Issaka
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia; Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
| | - Adrian J Cameron
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
| | - Jean B Kiwallo
- Directorate of Population Health Protection (DPSP) of the Burkina Faso, Ministry of Health, Ouagadougou, Burkina Faso.
| | - William K Bosu
- West Africa Health Organization, 01 BP 153, Bobo-Dioulasso, Burkina Faso.
| | - Yèssito Corine N Houehanou
- National School of Senior Technicians Training in Public Health and Epidemiological Surveillance, University of Parakou, Postal Box 122, Parakou, Benin.
| | - Chea S Wesseh
- Ministry of Health, Republic of Liberia, Congo Town, Monrovia, Liberia.
| | - Dismand S Houinato
- Laboratory of Epidemiology of Chronic and Neurological Diseases (LEMACEN), Faculty of Health Sciences, 01 Postal Box 188 Cotonou, University of Abomey Calavi, Cotonou, Benin.
| | - Diarra J P Nazoum
- Former Head of Noncommunicable Diseases, National Directorate of Health, Ministry of Health and Public Hygiene, Bomako, Mali.
| | - Christopher Stevenson
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
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The Influence of Anthropometric Indices and Intermediary Determinants of Hypertension in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115646. [PMID: 34070454 PMCID: PMC8197532 DOI: 10.3390/ijerph18115646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
Hypertension is a major public health burden in Bangladesh. However, studies considering the underlying multifaceted risk factors of this health condition are sparse. The present study concurrently examines anthropometric parameters and intermediary factors influencing hypertension risk in Bangladesh. Using the 2018 World Health Organisation (WHO) STEPwise approach to non-communicable disease risk factor surveillance (STEPS) study conducted in Bangladesh and involving 8019 nationally representative adult respondents, bivariate and multivariate logistic regression analyses were performed to determine the association between anthropometrics, other intermediary factors and hypertension. The regression results were presented using the odds ratio (OR) and adjusted odds ratio (AOR) at 95% confidence intervals (CIs). The risk of hypertension was higher among females and males who were 40 years and older. However, among females, those who were age 60 years and older were more than twice and thrice more likely to be hypertensive compared to those in the younger age groups (18–39, 40–59). Females who were obese (body mass index [BMI], waist to hip ratio [WHR], waist to height ratio [WHtR]) or had high waist circumference [WC] were twice as likely to be hypertensive. Males and females who were physically active, consuming more fruits and vegetables daily and educated had lower odds of developing hypertension. Key findings suggest that the association between anthropometric indices (body mass index [BMI], waist to hip ratio [WHR], waist to height ratio [WHtR]), waist circumference [WC]), other intermediary determinants (e.g., education, physical activity) and hypertension exist across gender and with increasing age among adults in Bangladesh. Developing appropriate public health interventions (e.g., regular assessment of anthropometric parameters) for early identification of the risk and pattern of hypertension through appropriate screening and diagnosis is required to meet the specific health needs of the adult Bangladesh population.
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Luo X, Liu Z, Ge X, Huang S, Zhou Y, Li D, Li L, Chen X, Huang L, Hou Q, Cheng H, Xiao L, Liu C, Zou Y, Yang X. High manganese exposure decreased the risk of high triglycerides in workers: a cross-sectional study. BMC Public Health 2020; 20:874. [PMID: 32503499 PMCID: PMC7275562 DOI: 10.1186/s12889-020-09011-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 05/29/2020] [Indexed: 01/04/2023] Open
Abstract
Background Manganese (Mn) participates in lipid metabolism. However, the associations between Mn exposure and dyslipidaemia is unclear. Methods This was a cross-sectional study. Data were collected from the 2017 the Mn-exposed workers healthy cohort (MEWHC). Finally, 803 occupationally Mn-exposed workers included in the study. The workers were divided into two groups. The grouping of this study was based on Mn-Time Weighted Averages (Mn-TWA). The high-exposure group included participants with Mn-TWA greater than 0.15 mg/m3. The low-exposure group included participants with Mn-TWA less than or equal to 0.15 mg/m3. Mn-TWA levels and dyslipidaemia were assessed. Results After adjustment for seniority, sex, cigarette consumption, alcohol consumption, high-fat diet frequency, medicine intake in the past two weeks, egg intake frequency, drinking tea, WHR, and hypertension, Mn-TWA levels was negatively correlated with high triglycerides (TG) risk in workers overall (OR = 0.51; 95% CI: 0.36, 0.73; p < 0.01). The results of males and females were consistent (OR = 0.53; 95% CI: 0.34, 0.81; p < 0.01) and (OR = 0.47; 95% CI: 0.24, 0.94; p < 0.01), respectively. By performing interactions analyses of workers overall, we observed no significant interactions among confounders. Mn-TWA levels and pack-years on high TG risk (relative excess risk for the interactions (RERI = 2.29, 95% CI: − 2.07, 6.66), (RERI) = 2.98, 95% CI: − 2.30, 8.26). Similarly, smoking status, drinking status, high-fat diet frequency, and Waist-to-Hip Ratio (WHR) showed non-significant interactions with Mn-TWA levels on high TG risk. Conclusions This research indicates that high Mn exposure was negatively related to high TG risk in workers.
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Affiliation(s)
- Xiaoyu Luo
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhenfang Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoting Ge
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Sifang Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yanting Zhou
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Defu Li
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Longman Li
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiang Chen
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Lulu Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Qingzhi Hou
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Hong Cheng
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Lili Xiao
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Chaoqun Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yunfeng Zou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaobo Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China. .,Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi, China. .,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China.
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Kalyan M, Dhore P, Purandare V, Deshpande S, Unnikrishnan AG. Obesity and its Link to Undiagnosed Diabetes Mellitus and Hypertension in Rural Parts of Western India. Indian J Endocrinol Metab 2020; 24:155-159. [PMID: 32699782 PMCID: PMC7333747 DOI: 10.4103/ijem.ijem_582_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/26/2019] [Accepted: 02/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Obesity and overweight are becoming major health concerns worldwide. Hence, we studied the association between overweight and obesity with new-onset diabetes and hypertension in a selected rural population. METHODOLOGY Community health workers made house-to-house visits, inviting adults >20 years of age who were at a higher risk of diabetes, from a predefined rural area of Maharashtra, to visit a mobile diabetes clinic operating in a hub and spoke manner. Sociodemographic data and anthropometric measurements were recorded. BMI and waist circumference was classified according to the WHO recommended cutoffs for Asians. Subjects with capillary blood fasting glucose of ≥126 mg/dL or random glucose of ≥200 mg/dL by glucometer were diagnosed as diabetes and blood pressure of ≥140/90 mmHg by sphygmomanometer were diagnosed as hypertension. Subjects with a known history of diabetes mellitus and hypertension were excluded. RESULTS Out of 29,324 total population, 16.5% of subjects were overweight and 26.4% were obese. Mean ± SD of BMI of the participants was 22.9 ± 4.1 kg/m2 in males and 22.4 ± 4.2 kg/m2 in females. Around 35% of males and 30.5% of females had a high waist circumference of ≥90 cm and ≥80 cm, respectively, 20.5% of subjects had newly diagnosed hypertension, and 11.4% of subjects had newly diagnosed diabetes mellitus. The occurrence of newly diagnosed hypertension and diabetes showed an increasing trend with increasing BMI. CONCLUSION Our community-based screening suggested a high prevalence of overweight and obesity in rural India. There was a high prevalence of newly diagnosed hypertension and diabetes in this population.
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Affiliation(s)
- Meenakshi Kalyan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Prasanna Dhore
- Department of Education and outreach, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Vedavati Purandare
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Shailesh Deshpande
- Department of Education and outreach, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - A. G. Unnikrishnan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
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Biswas T, Magalhaes RJS, Townsend N, Das SK, Mamun A. Double Burden of Underweight and Overweight among Women in South and Southeast Asia: A Systematic Review and Meta-analysis. Adv Nutr 2020; 11:128-143. [PMID: 31634389 PMCID: PMC7442413 DOI: 10.1093/advances/nmz078] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/08/2018] [Accepted: 06/27/2019] [Indexed: 12/12/2022] Open
Abstract
The double burden of malnutrition (DBM) is characterized by the coexistence of underweight and overweight individuals in a population. The objective of this study was to assess the level of DBM, as well as its main determinants, in women in South and Southeast Asia. We searched scientific literature databases, including PubMed, EMBASE, CINAHL, and Google Scholar; gray literature; and reference lists from primary research published between 1969 and September 30, 2017. In total, 128 studies met our inclusion criteria, representing data of ∼5 million women >15 y of age from South and Southeast Asia. The findings show that prevalence rates of underweight and overweight varied by study from 7.0% to 61.0% and 1.0% to 64.0%, respectively. For the total study period, the pooled prevalence of underweight and overweight was 28% (95% CI: 25%, 31%) and 17% (95% CI: 15%, 19%) in South Asia, respectively, and 20% (95% CI: 15%, 26%) and 20% (95% CI: 15%, 24%) in Southeast Asia, respectively. In both regions, underweight was more prevalent in rural areas, among women of the youngest age group (15-19 y), and among those in the poorest wealth quintile. In contrast, overweight was higher in urban areas, among women of older age, and among those in the wealthiest households. This study also found that prevalence of overweight has recently exceeded that for underweight in this population.
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Affiliation(s)
- Tuhin Biswas
- Institute for Social Science Research, University of Queensland, Indooroopilly, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Indooroopilly, Australia
| | - R J Soares Magalhaes
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, Australia
- Children's Health and Environment Program, Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Nick Townsend
- Department for Health, University of Bath, Bath, United Kingdom
| | - Sumon Kumar Das
- Institute for Social Science Research, University of Queensland, Indooroopilly, Australia
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Child Health Division, Menzies School of Health Research, Tiwi, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, University of Queensland, Indooroopilly, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Indooroopilly, Australia
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Khader Y, Batieha A, Jaddou H, El-Khateeb M, Ajlouni K. The performance of anthropometric measures to predict diabetes mellitus and hypertension among adults in Jordan. BMC Public Health 2019; 19:1416. [PMID: 31664979 PMCID: PMC6820979 DOI: 10.1186/s12889-019-7801-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/17/2019] [Indexed: 01/22/2023] Open
Abstract
Objectives This study aimed to evaluate and compare the abilities of waist circumference (WC), body mass index (BMI), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict recently and previously diagnosed diabetes and hypertension and assess their appropriate cut-off values among Jordanian adults. Methods Data from the 2017 cardiovascular risk factors survey were analyzed to achieve the study objective. The survey collected extensive data from a national population-based sample of Jordanian residents. A structured questionnaire was used to collect sociodemographic variables and clinical data. Blood samples were taken for biochemical measurements. Anthropometric characteristics were measured by the same team of trained field researchers. Results This study included a total of 1193 men and 2863 women. Their age ranged from 18 to 90 year with a mean (SD) of 43.8 (14.2) year. WHtR performed better than other anthropometric measures and had a good ability (AUC > 0.80) among women and fair ability among men to predict newly diagnosed diabetes and previously diagnosed diabetes and hypertension. The appropriate cut-off points for anthropometric measures among women were 92 cm form WC, 104 cm for HC, 30 Kg/m2 for BMI, 0.85 for WHR, and 0.60 for WHtR. For men, the appropriate cut-off points were 100 cm for WC, 104 cm for HC, 27 Kg/m2 for BMI, 0.93 for WHR, and 0.57 for WHtR. Conclusion WHtR performed better than other anthropometric measures in predicting diabetes and hypertension among adult population in Jordan. We recommend WHtR as a measure of choice with a cut-off value of 0.6 for women and 0.57 for men to predict diabetes and hypertension among Jordanians.
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Affiliation(s)
- Yousef Khader
- Department of Public Health, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan.
| | - Anwar Batieha
- Department of Public Health, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Hashem Jaddou
- Department of Public Health, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Mohammed El-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics, The Jordan University, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics, The Jordan University, Amman, Jordan
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Adib Rad H, Sefidgar SAA, Tamadoni A, Sedaghat S, Bakouei F, Bijani A, Omidvar S. Obesity and iron-deficiency anemia in women of reproductive age in northern Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:115. [PMID: 31334267 PMCID: PMC6615127 DOI: 10.4103/jehp.jehp_371_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/12/2019] [Indexed: 06/03/2023]
Abstract
BACKGROUND Obesity and iron deficiency (ID) are two forms of the most usual nutritional disorders worldwide. Some studies have discovered a correlation between ID and obesity although more investigation is required. This study was aimed to determine the association between obesity and ID anemia (IDA) in Iranian childbearing age women. MATERIALS AND METHODS This cross-sectional study was done on 256 women of reproductive age in northern Iran. The anthropometric measurements including height and weight were measured, and body mass index (BMI) was calculated. Low blood index of the hemoglobin (Hb), mean cell volume (MCV), and mean corpuscular hemoglobin (MCH) were evaluated with ferritin, serum iron, and total iron-binding capacity. Baseline data were expressed as means ± standard deviations. Chi-square test was applied to compare the categorical variable. Differences between the two groups were evaluated with independent samples t-test. A value of P < 0.05 was considered as statistically significant. RESULTS Obesity was in urban women higher than rural women (55.1% vs. 44.9%), and this difference was significant (P < 0.021). There was found no association between hematological characteristics and BMI. The data showed that only 13.4% of obese women and 17.1% of the women with normal weight had IDA (odds ratio = 0.75; 95% confidence interval: 0.39-1.49, P > 0.05). CONCLUSIONS According to the results of this study, it seems that the relationship between obesity and IDA is controversial. Hence, further studies are needed to be done.
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Affiliation(s)
- Hajar Adib Rad
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sayed Ali Asghar Sefidgar
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ahmad Tamadoni
- Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sadegh Sedaghat
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Bakouei
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Deng G, Yin L, Liu W, Liu X, Xiang Q, Qian Z, Ma J, Chen H, Wang Y, Hu B, Li W, Jiang Y. Associations of anthropometric adiposity indexes with hypertension risk: A systematic review and meta-analysis including PURE-China. Medicine (Baltimore) 2018; 97:e13262. [PMID: 30508913 PMCID: PMC6283208 DOI: 10.1097/md.0000000000013262] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The association between hypertension and obesity has been confirmed, while no agreement has been reached about which anthropometric adiposity index is the best. This meta-analysis aimed to perform a systematic review and meta-analysis on the associations of hypertension risk with body mass index (BMI), waist circumstance (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), and a prospective urban and rural epidemiology study from China (PURE-China) was added into this meta-analysis as an individual study. METHODS Systematic literature searching was conducted to identify relevant articles published up to September 2018 in CNKI, WANFANG Data, Web of Science, SinoMed, PubMed, MEDLINE, EMBASE, Cochrane Library and cross-referencing. Literature reporting the association of hypertension risk with BMI, WC, WHR, and WHtR were defined as eligible. PURE-China data were analyzed and included as 1 eligible study into meta-analyses. Summary odds ratio (OR) and area under receiver operating characteristic curve (AUC) were pooled using meta-analysis methods. Heterogeneity and publication bias were evaluated. Subgroups based on gender, country and study design were conducted as well. RESULTS Thirty-eight original articles including PURE-China were included into meta-analyses, involving 309,585 subjects. WHtR had the strongest association with hypertension risk (OR, 1.68; 95% confidence interval, [CI]:1.29-2.19) and prediction ability (AUC, 70.9%; 95% CI: 67.8%-74.2%), which were also confirmed in subgroup analyses based on gender and country. However, BMI was found to have the highest prediction ability in adjusted models of PURE-China and followed WC, both of which were superior to WHtR (73.7% and 73.4% vs 73.2%). CONCLUSIONS Our overall meta-analysis further confirmed WHtR as a good indicator at discriminating those individuals at increased risk of hypertension, and in some cases, it is better than BMI, WC, and WHR.
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Affiliation(s)
- Guijuan Deng
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing
| | - Lu Yin
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Weida Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Xiaoyun Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Quanyong Xiang
- Jiangsu Province Center for Disease Control & Prevention
| | - Zhenzhen Qian
- Jiangxinzhou Community Health Service Center, Nanjing
| | - Juntao Ma
- Academy of Military Sciences, People's Liberation Army of China, Beijing, China
| | - Hui Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Yang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Bo Hu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Wei Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Yu Jiang
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing
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Kim HR, Kim HS. Optimal Cutoffs of Cardiometabolic Risk for Postmenopausal Korean Women. Asian Nurs Res (Korean Soc Nurs Sci) 2017; 11:107-112. [PMID: 28688495 DOI: 10.1016/j.anr.2017.05.003] [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] [Received: 09/23/2016] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO). METHODS The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index. RESULTS Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC): 0.687, sensitivity: 61.7%, specificity: 68.9%], 0.87 (AUC: 0.660, sensitivity: 64.7%, Specificity: 60.2%) for MetS and 77.4 cm (AUC: 0.655, sensitivity: 65.6%, specificity: 57.8%), 0.86 (AUC: 0.680, sensitivity: 67.0%, specificity: 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC: 0.838, sensitivity: 71.5%, specificity: 79.6%) and 1.59 (AUC: 0.725, sensitivity: 65.9%, specificity: 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC: 0.773, sensitivity: 73%, specificity: 71.9%) and for MO was 1.17 (AUC: 0.713, sensitivity: 64.5%, specificity: 69.2%). CONCLUSIONS For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.
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Affiliation(s)
- Hye-Ryoung Kim
- College of Nursing, Shinhan University, Dongducheon-si, South Korea.
| | - Hee-Seung Kim
- College of Nursing, The Catholic University of Korea, Seoul, South Korea.
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Zaid M, Ameer F, Munir R, Rashid R, Farooq N, Hasnain S, Zaidi N. Anthropometric and metabolic indices in assessment of type and severity of dyslipidemia. J Physiol Anthropol 2017; 36:19. [PMID: 28241855 PMCID: PMC5330152 DOI: 10.1186/s40101-017-0134-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/15/2017] [Indexed: 01/01/2023] Open
Abstract
Background It has been shown that obesity is associated with increased rates of dyslipidemia. The present work revisits the association between plasma lipid levels and classical indicators of obesity including body mass index (BMI). The significance of various anthropometric/metabolic variables in clinical assessment of type and severity of dyslipidemia was also determined. Recently described body indices, a body shape index (ABSI) and body roundness index (BRI), were also assessed in this context. Methods For the present cross-sectional analytical study, the participants (n = 275) were recruited from the patients visiting different health camps. Participants were anthropometrically measured and interviewed, and their fasting intravenous blood was collected. Plasma lipid levels were accordingly determined. Results The values for different anthropometric parameters are significantly different between dyslipidemic and non-dyslipidemic participants. Receiver operating characteristics curve analyses revealed that all the tested variables gave the highest area under the curve (AUC) values for predicting hypertriglyceridemia in comparison to other plasma lipid abnormalities. BRI gave slightly higher AUC values in predicting different forms of dyslipidemia in comparison to BMI, whereas ABSI gave very low values. Conclusions Several anthropometric/metabolic indices display increased predictive capabilities for detecting hypertriglyceridemia in comparison to any other form of plasma lipid disorders. The capacity of BRI to predict dyslipidemia was comparable but not superior to the classical indicators of obesity, whereas ABSI could not detect dyslipidemia. Electronic supplementary material The online version of this article (doi:10.1186/s40101-017-0134-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Muhammad Zaid
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Fatima Ameer
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Rimsha Munir
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Rida Rashid
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Nimrah Farooq
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Shahida Hasnain
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Nousheen Zaidi
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan.
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Hypertension and diabetes prevalence among adults with moderately increased BMI (23·0–24·9 kg/m2): findings from a nationwide survey in Bangladesh. Public Health Nutr 2017; 20:1343-1350. [DOI: 10.1017/s1368980016003566] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AbstractObjectiveBMI is a proxy for fat accumulation in the body. Increased diabetes and CVD risks have been observed for Asian populations at lower BMI than the WHO-recommended BMI cut-off points for overweight (≥25·0 kg/m2) and obesity (≥30·0 kg/m2). The current study aimed to quantify the increased hypertension (HTN) and type 2 diabetes mellitus (T2DM) prevalence in Bangladeshi adults with moderately increased BMI (23·0–24·9 kg/m2).DesignData from the most recent Bangladesh Demographic and Health Survey (2011) were analysed. Modified Poisson regression models with robust error variance were used to calculate prevalence ratios (PR) for HTN or T2DM by BMI category, considering BMI=18·5–22·9 kg/m2 as the reference. All analyses incorporated the complex sampling design of the survey.SettingBMI, blood pressure, blood sugar and related information were collected from a nationally representative sample.SubjectsAdults (n 7433) aged≥35 years.ResultsAbout 12 % of Bangladeshi adults, both male and female, were within the BMI range 23·0–24·9 kg/m2 or moderately overweight. Compared with the reference BMI group (18·5–22·9 kg/m2), they had an increased PR for HTN (1·55–1·77) and T2DM (1·54–1·93). These increased PR are similar to those for the WHO-defined overweight group (BMI=25·0–29·9 kg/m2).ConclusionsOur findings support the recommendation that calls for setting the optimum BMI for Asian populations to 18·5–23·0 kg/m2 for health promotion and for public health interventions like leisure-time physical activity. WHO cut-off points for overweight (≥25 kg/m2) should be used to facilitate international comparisons.
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Caminha TC, Ferreira HS, Costa NS, Nakano RP, Carvalho RES, Xavier AF, Assunção ML. Waist-to-height ratio is the best anthropometric predictor of hypertension: A population-based study with women from a state of northeast of Brazil. Medicine (Baltimore) 2017; 96:e5874. [PMID: 28079826 PMCID: PMC5266188 DOI: 10.1097/md.0000000000005874] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The WHO recommends the use of some anthropometric parameters as a screening resource for individuals under cardiometabolic risk. However, in the validation of these indicators, Brazilian women were not included. These women have different anthropometric profile compared to women who integrated the samples of the validation studies. We aimed to verify the accuracy of anthropometric indicators as a resource for the screening of women with hypertension. A cross-sectional study, with a probability sample of 3143 women (20-49 years) from the state of Alagoas (northeast of Brazil), was carried out. Hypertension was identified by systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or regular use of antihypertensive drugs. The anthropometric indicators analyzed were BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio (WHtR), body fat percentage, and conicity index. The accuracy definition of the indicators and the identification of best cut-off points were carried out on the basis of ROC curve analysis and Youden index, respectively. The prevalence of hypertension was 21.8%. All indicators used in hypertension identification had area under the ROC curve (AUC) >0.5. The WHtR with cut-off point of 0.54 was the best performance indicator (AUC = 0.72; P < 0.05; sensitivity = 67%, specificity = 66%). The WHtR with cut-off point of 0.54 has constituted the most accurate indicator in the screening of women with hypertension. In the absence of specific studies and considering the largest ethnic proximity and environmental/epidemiological similarity, the findings now obtained can be extended to women of other Brazilian states, especially those in the Northeastern region.
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Affiliation(s)
| | | | | | | | | | - Antônio F.S. Xavier
- Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A. C. Simões, Cidade Universitária, Maceió, AL, Brazil
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Alperet DJ, Lim WY, Mok-Kwee Heng D, Ma S, van Dam RM. Optimal anthropometric measures and thresholds to identify undiagnosed type 2 diabetes in three major Asian ethnic groups. Obesity (Silver Spring) 2016; 24:2185-93. [PMID: 27558457 DOI: 10.1002/oby.21609] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/02/2016] [Accepted: 06/03/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify optimal anthropometric measures and cutoffs to identify undiagnosed diabetes mellitus (UDM) in three major Asian ethnic groups (Chinese, Malays, and Asian-Indians). METHODS Cross-sectional data were analyzed from 14,815 ethnic Chinese, Malay, and Asian-Indian participants of the Singapore National Health Surveys, which included anthropometric measures and an oral glucose tolerance test. Receiver operating characteristic curve analyses were used with calculation of the area under the curve (AUC) to evaluate the performance of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) for the identification of UDM. RESULTS BMI performed significantly worse (AUCMEN = 0.70; AUCWOMEN = 0.75) than abdominal measures, whereas WHTR (AUCMEN = 0.76; AUCWOMEN = 0.79) was among the best performing measures in both sexes and all ethnic groups. Anthropometric measures performed better in Chinese than in Asian-Indian participants for the identification of UDM. A WHTR cutoff of 0.52 appeared optimal with a sensitivity of 76% in men and 73% in women and a specificity of 63% in men and 70% in women. CONCLUSIONS Although ethnic differences were observed in the performance of anthropometric measures for the identification of UDM, abdominal adiposity measures generally performed better than BMI, and WHTR performed best in all Asian ethnic groups.
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Affiliation(s)
- Derrick Johnston Alperet
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Wei-Yen Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Derrick Mok-Kwee Heng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Stefan Ma
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Rob M van Dam
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
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Fatema K, Rahman B, Zwar NA, Milton AH, Ali L. Short-term predictive ability of selected cardiovascular risk prediction models in a rural Bangladeshi population: a case-cohort study. BMC Cardiovasc Disord 2016; 16:105. [PMID: 27386836 PMCID: PMC4937534 DOI: 10.1186/s12872-016-0279-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 05/13/2016] [Indexed: 01/31/2023] Open
Abstract
Background Prediction of absolute risk of cardiovascular diseases (CVDs) has important clinical and public health significance, but the predictive ability of the available tools has not yet been tested in the rural Bangladeshi population. The present study was undertaken to test the hypothesis that both laboratory-based (Framingham equation and WHO/ISH laboratory-based charts) and non-laboratory-based tools may be used to predict CVDs on a short-term basis. Methods Data from a case-cohort study (52989 cohort and 439 sub-cohort participants), conducted on a rural Bangladeshi population, were analysed using modified Cox PH model with a maximum follow-up of 2.5 years. The outcome variable, coronary heart diseases (CHDs), was assessed in 2014 using electrocardiography, and it was used as a surrogate marker for CVDs in Bangladesh. The predictive power of the models was assessed by calculating C-statistics and generating ROC curves with other measures of diagnostic tests. Results All the models showed high negative prediction values (NPVs, 84 % to 92 %) and these did not differ between models or gender. The sensitivity of the models substantially changed based on the risk prediction thresholds (between 5–30 %); however, the NPVs and PPVs were relatively stable at various threshold levels. Hypertension and dyslipidaemia were significantly associated with CHD outcome in males and ABSI (a body shape index) in females. All models showed similar C-statistics (0.611–0.685, in both genders). Overall, the non-laboratory-based model showed better performance (0.685) in women but equal performance in men. Conclusions Existing CVD risk prediction tools may identify future CHD cases with fairly good confidence on a short-term basis. The non-laboratory-based tool, using ABSI as a predictor, may provide better predictive accuracy among women.
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Affiliation(s)
- Kaniz Fatema
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka-1216, Bangladesh. .,The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Bayzidur Rahman
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Nicholas Arnold Zwar
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Abul Hasnat Milton
- Centre for Clinical Epidemiology and Biostatistics (CCEB), The School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, NSW, 2008, Australia
| | - Liaquat Ali
- Department of Biochemistry and Cell Biology, BUHS, 125/1 Darus Salam, Mirpur, Dhaka-1216, Bangladesh
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Fatema K, Zwar NA, Milton AH, Rahman B, Awal ASMN, Ali L. Cardiovascular risk assessment among rural population: findings from a cohort study in a peripheral region of Bangladesh. Public Health 2016; 137:73-80. [PMID: 27036981 DOI: 10.1016/j.puhe.2016.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 01/20/2016] [Accepted: 02/15/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The incidences of non-communicable diseases including cardiovascular diseases (CVDs) is increasing in Bangladesh. The reasons for this increasing trend need to be explored. The aim of this study is to assess the risk of CVDs among a peripheral rural Bangladeshi population and to explore the sociodemographic, anthropometric and clinical variables associated with increased risk. STUDY DESIGN Cohort study. METHODS From a cohort of 190,471 individuals of all ages, originally included in a diabetic eye disease program initiated in 2008-2009, a purposive sub-cohort of 66,710 individuals, aged 31-74 years was recruited. During 2011-2012 these participants were assessed for CVDs using the WHO's risk assessment tool designed for primary care settings in low resource societies. Participant characteristics associated with higher risk were explored using univariable and multivariable regression analysis. RESULTS Out of all (95.5% participation rate) participants 1170 (1.84%) were found to be at high risk for CVD. The prevalence of hypertension (HTN), pre-HTN, obesity, underweight and self-reported DM were 8.9%, 15.2%, 9.6%, 7.8% and 0.5% respectively, among the study population. In multivariable regression analysis female sex, older age, temporary housing structure (i.e., tin shed), extremes of BMI (both underweight and obese) and central obesity were associated with higher risk for CVDs. CONCLUSIONS The prevalence of CVD risk factors and high CVD risk individuals in this cohort was found to be lower than previous studies. It may be the effects of urbanization are yet to reach this relatively traditional rural population. This study adds to the literature on use of the WHO risk assessment tool.
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Affiliation(s)
- K Fatema
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), 125/1 Darus Salam, Mirpur, Dhaka 1216, Bangladesh; The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - N A Zwar
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - A H Milton
- Centre for Clinical Epidemiology and Biostatistics (CCEB), The School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW 2008, Australia.
| | - B Rahman
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - A S M N Awal
- ORBIS International, Apartment No, B4 & C4, Plot #1, Road #137, Gulshan, Dhaka 1212, Bangladesh.
| | - L Ali
- Department of Biochemistry and Cell Biology, BUHS, 125/1 Darus Salam, Mirpur, Dhaka 1216, Bangladesh.
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Hartwig S, Kluttig A, Tiller D, Fricke J, Müller G, Schipf S, Völzke H, Schunk M, Meisinger C, Schienkiewitz A, Heidemann C, Moebus S, Pechlivanis S, Werdan K, Kuss O, Tamayo T, Haerting J, Greiser KH. Anthropometric markers and their association with incident type 2 diabetes mellitus: which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study. BMJ Open 2016; 6:e009266. [PMID: 26792214 PMCID: PMC4735317 DOI: 10.1136/bmjopen-2015-009266] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. METHODS Data of 10,258 participants from 4 prospective population-based cohorts were pooled to assess the association of body weight, body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident T2DM by calculating HRs of the crude, adjusted and standardised markers, as well as providing receiver operator characteristic (ROC) curves. Differences between HRs and ROCs for the different anthropometric markers were calculated to compare their predictive ability. In addition, data of 3105 participants from the nationwide survey were analysed separately using the same methods to provide a nationally representative comparison. RESULTS Strong associations were found for each anthropometric marker and incidence of T2DM. Among the standardised anthropometric measures, we found the strongest effect on incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women) and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC analysis showed WHtR to be the strongest predictor for incident T2DM. Differences in HR and ROCs between the different markers confirmed WC and WHtR to be the best predictors of incident T2DM. Findings were consistent across study regions and age groups (<65 vs ≥ 65 years). CONCLUSIONS We found stronger associations between anthropometric markers that reflect abdominal obesity (ie, WC and WHtR) and incident T2DM than for BMI and weight. The use of these measurements in risk prediction should be encouraged.
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Affiliation(s)
- Saskia Hartwig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Daniel Tiller
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Julia Fricke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Grit Müller
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Sabine Schipf
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Michaela Schunk
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Christa Meisinger
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Sonali Pechlivanis
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Karl Werdan
- Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Oliver Kuss
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Johannes Haerting
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Karin Halina Greiser
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Bhowmik B, Akhter A, Ali L, Ahmed T, Pathan F, Mahtab H, Khan AKA, Hussain A. Simple risk score to detect rural Asian Indian (Bangladeshi) adults at high risk for type 2 diabetes. J Diabetes Investig 2015; 6:670-7. [PMID: 26543541 PMCID: PMC4627544 DOI: 10.1111/jdi.12344] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 01/27/2015] [Accepted: 02/22/2015] [Indexed: 01/29/2023] Open
Abstract
AIMS/INTRODUCTION To develop and evaluate a simple, non-invasive, diabetes risk score for detecting individuals at high risk for type 2 diabetes in rural Bangladesh. MATERIALS AND METHODS Data from 2,293 randomly selected individuals aged ≥20 years from a cross-sectional study in a rural community of Bangladesh (2009 Chandra Rural Study) was used for model development. The validity of the model was assessed in another rural cross-sectional study (2009 Thakurgaon Rural Study). The logistic regression model used included age, sex, body mass index, waist-to-hip ratio and hypertension status to predict individuals who were at high risk for type 2 diabetes. RESULTS On applying the developed model to both cohorts, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval 0.68-0.72) for the Chandra cohort and 0.71 (95% confidence interval 0.68-0.74) for the Thakurgaon cohort. The risk score of >9 was shown to have the optimal cut-point to detect diabetes. This score had a sensitivity of 62.4 and 75.7%, and specificity of 67.4 and 61.6% in the two cohorts, respectively. This risk score was shown to have improved sensitivity and specificity to detect type 2 diabetes cases compared with the Thai, Indian, Omani, UK, Dutch, Portuguese and Pakistani diabetes risk scores. CONCLUSIONS This simple, non-invasive risk score can be used to detect individuals at high risk for type 2 diabetes in rural Bangladesh. Subjects with a score of 9 or above (out of 15) should undergo an oral glucose tolerance test for definitive diagnosis of diabetes.
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Affiliation(s)
| | - Afroza Akhter
- Department of Epidemiology & Biostatistics, Bangladesh Institute of Health Sciences (BIHS)Mirpur, Bangladesh
| | - Liaquat Ali
- Department of Biochemistry & Cell Biology, BUHSMirpur, Bangladesh
| | - Tofail Ahmed
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM)Dhaka, Bangladesh
| | - Faruque Pathan
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM)Dhaka, Bangladesh
| | - Hajera Mahtab
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM)Dhaka, Bangladesh
| | - Abul Kalam Azad Khan
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM)Dhaka, Bangladesh
| | - Akhtar Hussain
- Department of International Health, University of OsloOslo, Norway
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Obesity and associated type 2 diabetes and hypertension in factory workers of Bangladesh. BMC Res Notes 2015; 8:460. [PMID: 26386828 PMCID: PMC4575450 DOI: 10.1186/s13104-015-1377-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 08/24/2015] [Indexed: 12/30/2022] Open
Abstract
Background Recent data suggest that the prevalence of obesity and its associate cardiometabolic risks are increasing in Bangladesh. Published data of obesity in Bangladeshi industry workers is scarce. The purpose of this study was to assess the prevalence of general and central obesity in Bangladeshi factory workers and their associations with diabetes and hypertension. Methods A total of 791 male factory workers aged ≥20 years in capital Dhaka city of Bangladesh were investigated in a population-based cross-sectional survey. According to the International Association for the Study of Obesity and the International Obesity Task Force guidelines for Asian population, general obesity was defined as body mass index (BMI) ≥25 kg/m2, central obesity was defined as a waist circumference (WC) of ≥90 cm and waist hip ratio (WHR) of ≥0.90. Pearson’s correlation coefficient and logistic regression analysis were used to observe the association between anthropometric indices (BMI, WC and WHR) and cardiometabolic risk indicators (FBG, 2hBG, SBP and DBP). Results The prevalence of overweight (BMI 23–24.9 kg/m2) and general obesity (BMI ≥25 kg/m2) in this study population was 29.8 and 43.5 % respectively. Central obesity defined by WC and WHR was 35.3 and 78.3 % respectively. Both general and central obesity were found to be significantly associated with diabetes and hypertension in separate logistic regression analyses. Conclusion The prevalence of general and central obesity in Bangladeshi factory workers was high, and it was associated with diabetes and hypertension.
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Siddiquee T, Bhowmik B, Da Vale Moreira NC, Mujumder A, Mahtab H, Khan AKA, Hussain A. Prevalence of obesity in a rural Asian Indian (Bangladeshi) population and its determinants. BMC Public Health 2015; 15:860. [PMID: 26341552 PMCID: PMC4560882 DOI: 10.1186/s12889-015-2193-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 08/27/2015] [Indexed: 12/25/2022] Open
Abstract
Background Obesity has reached epidemic proportions worldwide including Bangladesh. To assess the prevalence and associated factors of general and central obesity in a rural Bangladeshi population based on newly proposed cut off level for Asian population. Methods 2293 subjects aged ≥20 years from rural Bangladesh were randomly recruited to participate in a population-based, cross sectional survey, conducted in 2009. Both socio-demographic and anthropometric measurements were recorded. Age adjusted data for anthropometric indices were examined. Results The age standardized prevalence of overweight (BMI 23-24.9 kg/m2) and obesity (BMI ≥25 kg/m2) were 17.7 (95 % confidence interval (CI): 16.1, 19.2 %) and 26.2 % (95 % CI: 24.4, 27.9 %), respectively. The age standardized prevalence of central obesity based on WC (M ≥90 & F ≥80 cm) and WHR (M ≥0.90 & F ≥0.80) were 39.8 % (95 % CI: 37.9, 41.7 %) and 71.6 % (95 % CI: 69.8, 73.4 %) respectively. The result shows that prevalence of central obesity was more in female than male. Study shows middle age, medium and high socioeconomic status (SES), low education levels, physical inactivity, high consumption of carbohydrate, protein and fat, were significant risk indicators for general and central obesity. Smoking was shown as protective factor for both general and central obesity. Conclusions In rural Bangladeshi population, the prevalence of both general and central obesity was high among both sexes with the use of newly proposed cut off points for Asian population. Gender, diet, physical activity, education levels and SES were associated with the increase prevalence of obesity.
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Affiliation(s)
- Tasnima Siddiquee
- Department of International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, N-0317, Oslo, Norway.
| | - Bishwajit Bhowmik
- Department of International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, N-0317, Oslo, Norway.
| | - Nayla Cristina Da Vale Moreira
- Department of International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, N-0317, Oslo, Norway.
| | - Anindita Mujumder
- Department of Pathology, Ibrahim Medical College, Diabetic Association of Bangladesh, Dhaka, 1200, Bangladesh.
| | - Hajera Mahtab
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh.
| | - A K Azad Khan
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh.
| | - Akhtar Hussain
- Department of International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, N-0317, Oslo, Norway.
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Fatema K, Zwar NA, Zeba Z, Milton AH, Rahman B, Ali L. Clinical and biochemical characterization of high risk and not high risk for cardiovascular disease adults in a population from peripheral region of Bangladesh. BMC Public Health 2015; 15:559. [PMID: 26084331 PMCID: PMC4471932 DOI: 10.1186/s12889-015-1919-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/09/2015] [Indexed: 12/31/2022] Open
Abstract
Background A group of 63708 Bangladeshi adults from a rural area were screened in 2011–12 for cardiovascular diseases (CVD) risk using a questionnaire based tool developed as part of the ‘WHO CVD-RISK Management Package for low-and medium resource setting’. In the current study participants who were found to be high risk and a sample of the not high risk participants from the screening were further characterized clinically and biochemically to explore the burden and determinants of CVD risk factors in a remote rural Bangladeshi population. Methods The high risk participants comprised all 1170 subjects who screened positive in 2011–12 and the not high risk group comprised 563 randomly sampled participants from the 62538 who screened negative. Socio-demographic, behavioral, anthropometric, clinical and biochemical data (glucose and lipids) were collected by standardized procedures. Body Mass Index (BMI) was classified following Asian BMI criteria. Data was analyzed using univariable and multivariable methods. Results On univariable analysis in high risk and not high risk participants respectively, age in years (M ± SD) was 50 ± 11 for both groups, ratio of male: female was 40:60 and 66:44, current smoking 28.5 % and 50.6 %; smokeless tobacco use 37.1 % and 34.8 %; overweight and obesity measured by body mass index (BMI) was 39.1 % and 20.5 %; high waist circumference (WC) 36.1 % and 11.9 %; high waist to hip ratio (WHR) 53.8 % and 26.3 %; and with high waist to height ratio (WHtR) 56.4 % and 28.4 %, existence of hypertension (HTN) was 15.8 % and 3.6 %, pre-HTN 43.8 % and 12.1 %, diabetes (DM) 14.0 % and 10.5 %, pre-DM 16.9 % and 12.1 % and dyslipidaemia 85.8 % and 89.5 %. In multivariable logistic regression analysis female sex, BMI, WC, WHR and WHtR, HTN and dyslipidaemia remain significantly more common among high risk participants (p < 0.05 and p < 0.001). Conclusions The prevalence of clinical and biochemical risk factors of CVDs are quite high even in this rural population and this may be related to the socioeconomic and cultural transition in Bangladeshi society. Surprisingly more of the high risk group was female and there were fewer smokers. Obesity and hypertension were more frequent in high risk participants.
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Affiliation(s)
- Kaniz Fatema
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka, 1216, Bangladesh. .,The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Nicholas Arnold Zwar
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Zebunnesa Zeba
- Department of Biochemistry, BUHS, 125/1 Darus Salam, Mirpur, Dhaka, 1216, Bangladesh.
| | - Abul Hasnat Milton
- Centre for Clinical Epidemiology and Biostatistics (CCEB), The School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, NSW 2008, Australia.
| | - Bayzidur Rahman
- The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.
| | - Liaquat Ali
- Department of Molecular and Cell Biology, BUHS, 125/1 Darus Salam, Mirpur, Dhaka, 1216, Bangladesh.
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Mbanya VN, Kengne AP, Mbanya JC, Akhtar H. Body mass index, waist circumference, hip circumference, waist-hip-ratio and waist-height-ratio: which is the better discriminator of prevalent screen-detected diabetes in a Cameroonian population? Diabetes Res Clin Pract 2015; 108:23-30. [PMID: 25700625 DOI: 10.1016/j.diabres.2015.01.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 11/21/2014] [Accepted: 01/18/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND The link between measures of adiposity and prevalent screen-detected diabetes (SDM) in Africa has been less well investigated. We assessed and compared the strength of association and discriminatory capability of measures of adiposity including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-hip-ratio (WHR) and waist-height-ratio (WHtR) for prevalent SDM risk in a sub-Saharan African population. METHODS Participants were 8663 adults free of diagnosed type 2 diabetes, who took part in the nationally representative Cameroon Burden of Diabetes (CAMBoD) 2006 survey. Logistic regression models were used to compute the odd ratio (OR) and 95% confidence interval (95%CI) for a standard deviation (SD) higher level of BMI (7.3), WC (12.5), HC (11.7), WHR (0.19) and WHtR (0.08) with prevalent SDM risk. Assessment and comparison of discrimination used C-statistic and relative integrated discrimination improvement (RIDI, %). RESULTS The adjusted OR and 95%CI for prevalent SDM with each SD higher adipometric variable were: 1.05 (0.98-1.13) for BMI, 1.30 (1.16-1.46) for WC, 1.18 (1.05-1.34) for HC, 1.05 (1.00-1.16) for WHR and 1.26 (1.11-1.39) for WHtR. C-statistic comparisons and RIDI analyses showed a trend toward a significant superiority of WC over other adipometric variables in multivariable models. Combining adiposity variables did not improve discrimination beyond multivariable models with WC alone. CONCLUSION WC was the best predictors and to some extent WHtR of prevalent SDM in this population, while BMI and WHR were less effective.
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Affiliation(s)
- V N Mbanya
- Section of International Health, Department of Community Medicine, University of Oslo, Norway; Health of Populations in Transition (HoPiT) Research Group, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé, Cameroon.
| | - A P Kengne
- Health of Populations in Transition (HoPiT) Research Group, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé, Cameroon; South African Medical Research Council Cape Town, South Africa; University of Cape Town, Cape Town, South Africa.
| | - J C Mbanya
- Health of Populations in Transition (HoPiT) Research Group, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé, Cameroon.
| | - H Akhtar
- Section of International Health, Department of Community Medicine, University of Oslo, Norway.
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Bhowmik B, Afsana F, Siddiquee T, Munir SB, Sheikh F, Wright E, Bhuiyan FR, Ashrafuzzaman SM, Mahtab H, Azad Khan AK, Hussain A. Comparison of the prevalence of metabolic syndrome and its association with diabetes and cardiovascular disease in the rural population of Bangladesh using the modified National Cholesterol Education Program Expert Panel Adult Treatment Panel III and International Diabetes Federation definitions. J Diabetes Investig 2014; 6:280-8. [PMID: 25969712 PMCID: PMC4420559 DOI: 10.1111/jdi.12268] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/06/2014] [Accepted: 07/08/2014] [Indexed: 01/10/2023] Open
Abstract
Aims/Introduction To compare the prevalence of metabolic syndrome (MS) using the modified National Cholesterol Education Program Adult Treatment Plan III (NCEP) and the International Diabetes Federation (IDF) definitions and, using both definitions, determine and compare the association of MS, prediabetes, type 2 diabetes, hypertension (HTN) and cardiovascular disease risk (CVD). Materials and Methods A total of 2,293 randomly selected participants (aged ≥20 years) in a rural community in Bangladesh were investigated in a population-based cross-sectional study. Sociodemographic and anthropometric characteristics, blood pressure, blood glucose, and lipid profiles were studied. Age-adjusted data for MS and cardiometabolic risk factors were assessed, and their relationships were examined. Results The age-adjusted prevalence of MS was 30.7% (males 30.5%; females 30.5%) using the NCEP definition, and 24.5% (males 19.2%, females 27.5%) using the IDF definition. The prevalence of MS using the NCEP definition was also higher in study participants with prediabetes, type 2 diabetes, HTN and CVD risk. The agreement rate between both definitions was 92% (k = 0.80). The NCEP definition had a stronger association with type 2 diabetes and HTN (odds ratio 12.4 vs 5.2; odds ratio 7.0 vs 4.7, respectively) than the IDF definition. However, the odds ratios for prediabetes and CVD risk were not significantly different. Conclusions The prevalence of MS was higher using the NCEP definition, and was more strongly associated with prediabetes, type 2 diabetes, HTN and CVD in this Bangladeshi population.
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Affiliation(s)
- Bishwajit Bhowmik
- Department of Community Medicine, Institute of Health and Society, University of Oslo Oslo, Norway
| | - Faria Afsana
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Dhaka, Bangladesh
| | - Tasnima Siddiquee
- Department of Community Medicine, Institute of Health and Society, University of Oslo Oslo, Norway
| | - Sanjida B Munir
- Executive Diabetes Care Center, NHN, Diabetic Association of Bangladesh Dhaka, Bangladesh
| | - Fareeha Sheikh
- Department of Community Medicine, Institute of Health and Society, University of Oslo Oslo, Norway
| | - Erica Wright
- ACT Diabetes Service, Division of Medicine, Canberra Hospital Canberra, Australia
| | - Farjana R Bhuiyan
- Department of Biochemistry & Cell Biology, Bangladesh University of Health Sciences (BUHS) Dhaka, Bangladesh
| | - Sheikh Mohammad Ashrafuzzaman
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Dhaka, Bangladesh
| | - Hajera Mahtab
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Dhaka, Bangladesh
| | - Abul Kalam Azad Khan
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Dhaka, Bangladesh
| | - Akhtar Hussain
- Department of Community Medicine, Institute of Health and Society, University of Oslo Oslo, Norway
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Takahara M, Katakami N, Kaneto H, Noguchi M, Shimomura I. Contribution of Visceral Fat Accumulation and Adiponectin to the Clustering of Metabolic Abnormalities in a Japanese Population. J Atheroscler Thromb 2014. [DOI: 10.5551/jat.22343] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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