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Wang Y, Pan L, He H, Li Z, Cui S, Yang A, Li W, Jia G, Han X, Wang X, Shan G. Prevalence, associated factors, and gene polymorphisms of obesity in Tibetan adults in Qinghai, China. BMC Public Health 2024; 24:305. [PMID: 38279121 PMCID: PMC10811834 DOI: 10.1186/s12889-023-17181-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/07/2023] [Indexed: 01/28/2024] Open
Abstract
OBJECTIVES To explore the prevalence and associated factors of obesity in Tibetan adults in Qinghai, China, and to determine the association between the FTO (rs1121980 and rs17817449) and MC4R gene (rs17782313 and rs12970134) polymorphisms with obesity. METHODS A cross-sectional survey was conducted in 2015 in Qinghai to selected Tibetan adults aged 20 to 80 years. Prevalence of obesity (BMI ≥ 28 kg/m2) and overweight (BMI 24 ~ 27.9 kg/m2) were evaluated. Multivariable logistic models were used to determine the associated factors. Pair-matched subjects of obesity cases and normal-weight controls were selected for the gene polymorphism analyses. Conditional logistic models were used to assess the association between gene polymorphisms with obesity. Additive and multiplicative gene-environment interactions were tested. RESULTS A total of 1741 Tibetan adults were enrolled. The age- and sex- standardized prevalence of obesity and overweight was 18.09% and 31.71%, respectively. Male sex, older age, heavy level of leisure-time exercise, current smoke, and heavy level of occupational physical activity were associated with both obesity and overweight. MC4R gene polymorphisms were associated with obesity in Tibetan adults. No significant gene-environment interaction was detected. CONCLUSION The prevalence of obesity and overweight in Tibetan adults was high. Both environmental and genetic factors contributed to the obesity prevalent.
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Affiliation(s)
- Ye Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, 5 Dong Dan San Tiao, Dong Cheng District, Beijing, 100005, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, 5 Dong Dan San Tiao, Dong Cheng District, Beijing, 100005, China
| | - Zhanquan Li
- Qinghai University Affiliated Hospital, Qinghai, China
| | - Sen Cui
- Qinghai University Affiliated Hospital, Qinghai, China
| | - Airong Yang
- Qinghai University Affiliated Hospital, Qinghai, China
| | - Wenfang Li
- Qinghai University Affiliated Hospital, Qinghai, China
| | - Guoqiang Jia
- Qinghai University Affiliated Hospital, Qinghai, China
| | - Ximing Han
- Qinghai University Affiliated Hospital, Qinghai, China
| | - Xianghua Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, 236 Baidi Road, Nankai District, Tianjin, 300192, China.
| | - Guangliang Shan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, 5 Dong Dan San Tiao, Dong Cheng District, Beijing, 100005, China.
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Ahmadinezhad M, Mansournia MA, Fahimfar N, Shafiee G, Nabipour I, Sanjari M, Khalagi K, Mansourzadeh MJ, Larijani B, Ostovar A. Prevalence of osteosarcopenic obesity and related factors among Iranian older people: Bushehr Elderly Health (BEH) program. Arch Osteoporos 2023; 18:137. [PMID: 37978092 DOI: 10.1007/s11657-023-01340-9] [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: 01/29/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
Osteosarcopenic obesity is a new syndrome that has been recently discussed in the scientific community. It is a condition that affects the elderly and involves the loss of bone, muscle, and fat tissue. The few studies that have been done on this disease showed that it has a high prevalence among the elderly and can cause various complications. This study was the first one to investigate this syndrome in Iran, and found that its prevalence was 19.83%. BACKGROUND Osteosarcopenic obesity syndrome (OSO) is a condition that involves osteopenia/osteoporosis, sarcopenia, and obesity. It leads to a reduction in the quality of life of the elderly and an increase in hospitalization which has attracted the attention of physicians. This study aimed to determine the prevalence and risk factors of osteosarcopenic obesity in people over 60 years of age in Bushehr. MATERIALS AND METHODS We used data from the Bushehr study, which included 2426 participants aged ≥ 60 years. We assessed osteoporosis/osteopenia based on T-score; sarcopenia based on hand grip strength, skeletal muscle mass index (SMI), and walking speed; and obesity based on fat mass and BMI for diagnosing OSO. We first examined the factors related to OSO in the univariable analysis and then fitted the multiple logistic regression model, separately for women and men. The result was summarized as adjusted odds ratios with a 95% confidence interval. RESULTS In total, 2339 elderly were examined in our study, of which 464 elderly were suffering from osteosarcopenic obesity. The standardized prevalence of OSO was 23.66% (95% CI: 21.15-26.16) in women and 18.53% (95% CI 16.35-20.87) in men. Age was positively linked to osteosarcopenic obesity in both genders and so was diabetes in men. However, education, physical activity, and protein intake were negatively linked to osteosarcopenic obesity in both genders, as well as hypertriglyceridemia and hypertension in women. CONCLUSION The prevalence of OSO among men and women of Bushehr city is high and is related to increasing age, low levels of education, physical activity, and protein intake among women and men.
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Affiliation(s)
- Mozhgan Ahmadinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, P. O. Box: 14155-6446, Tehran, Iran.
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No. 10-Jalal-e-ale-ahmad St, Chamran Hwy, P. O. Box: 14117-13137, Tehran, Iran.
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Mansourzadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kim KJ, Son S, Kim KJ, Kim SG, Kim NH. Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults. J Cachexia Sarcopenia Muscle 2023; 14:2196-2203. [PMID: 37550773 PMCID: PMC10570086 DOI: 10.1002/jcsm.13302] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 06/12/2023] [Accepted: 07/11/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Unhealthy body composition, including high fat mass, low muscle mass and low bone mass, is a critical health issue in adults. The weight-adjusted waist index (WWI) estimates fat and muscle mass and may have implications for bone health. We examined its association with body composition outcomes in a large Korean adult cohort. METHODS This study used data from the Korean National Health and Nutrition Examination Survey (2008-2011). WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD), appendicular lean mass (ALM) and total body fat percentage. Unhealthy body composition was defined as combined presence of high fat mass, low bone mass and low muscle mass. RESULTS A total of 5983 individuals (3034 men [50.7%] and 2949 women [49.3%]; mean age: 63.5 ± 8.7 years) were included. WWI was positively correlated with total body fat percentage (r = 0.478, P < 0.001) and inversely with ALM/weight (r = -0.485, P < 0.001) and BMD at the lumbar spine (r = -0.187, P < 0.001), femoral neck (r = -0.269, P < 0.001) and total hip (r = -0.255, P < 0.001). Higher WWI quartiles correlated with lower BMD, T-scores and ALM/weight, along with increased total body fat, evident in both genders and more pronounced in women, even after adjusting for confounders. This trend remained statistically significant across WWI quartiles for all analyses (P < 0.001). Higher WWI quartiles were also significantly associated with higher odds of unhealthy body composition, with adjusted odds ratio in the highest WWI group of 18.08 (95% CI, 4.32-75.61) in men and 6.36 (95% CI, 3.65-11.07) in women. The optimal cutoff values of WWI for unhealthy body composition were 10.4 cm/√kg in men and 10.5 cm/√kg in women. CONCLUSIONS In community-dwelling adults, high WWI values are associated with unfavourable body composition outcomes, indicating high fat mass, low muscle mass and low bone mass. WWI can potentially serve as an integrated index of body composition, underscoring the need for further research to validate its use in clinical settings.
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Affiliation(s)
- Kyoung Jin Kim
- Department of Internal Medicine, Division of Endocrinology and MetabolismKorea University College of MedicineSeoulRepublic of Korea
| | - Serhim Son
- Department of BiostatisticsKorea University College of MedicineSeoulRepublic of Korea
| | - Kyeong Jin Kim
- Department of Internal Medicine, Division of Endocrinology and MetabolismKorea University College of MedicineSeoulRepublic of Korea
| | - Sin Gon Kim
- Department of Internal Medicine, Division of Endocrinology and MetabolismKorea University College of MedicineSeoulRepublic of Korea
| | - Nam Hoon Kim
- Department of Internal Medicine, Division of Endocrinology and MetabolismKorea University College of MedicineSeoulRepublic of Korea
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Hibbing PR, Welk GJ, Ries D, Yeh HW, Shook RP. Criterion validity of wrist accelerometry for assessing energy intake via the intake-balance technique. Int J Behav Nutr Phys Act 2023; 20:115. [PMID: 37749645 PMCID: PMC10521469 DOI: 10.1186/s12966-023-01515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Intake-balance assessments measure energy intake (EI) by summing energy expenditure (EE) with concurrent change in energy storage (ΔES). Prior work has not examined the validity of such calculations when EE is estimated via open-source techniques for research-grade accelerometry devices. The purpose of this study was to test the criterion validity of accelerometry-based intake-balance methods for a wrist-worn ActiGraph device. METHODS Healthy adults (n = 24) completed two 14-day measurement periods while wearing an ActiGraph accelerometer on the non-dominant wrist. During each period, criterion values of EI were determined based on ΔES measured by dual X-ray absorptiometry and EE measured by doubly labeled water. A total of 11 prediction methods were tested, 8 derived from the accelerometer and 3 from non-accelerometry methods (e.g., diet recall; included for comparison). Group-level validity was assessed through mean bias, while individual-level validity was assessed through mean absolute error, mean absolute percentage error, and Bland-Altman analysis. RESULTS Mean bias for the three best accelerometry-based methods ranged from -167 to 124 kcal/day, versus -104 to 134 kcal/day for the non-accelerometry-based methods. The same three accelerometry-based methods had mean absolute error of 323-362 kcal/day and mean absolute percentage error of 18.1-19.3%, versus 353-464 kcal/day and 19.5-24.4% for the non-accelerometry-based methods. All 11 methods demonstrated systematic bias in the Bland-Altman analysis. CONCLUSIONS Accelerometry-based intake-balance methods have promise for advancing EI assessment, but ongoing refinement is necessary. We provide an R package to facilitate implementation and refinement of accelerometry-based methods in future research (see paulhibbing.com/IntakeBalance).
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Affiliation(s)
- Paul R Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St, Rm 650, Mail Code 517, Chicago, IL, 60612, USA.
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Daniel Ries
- Statistical Sciences Department, Sandia National Laboratories, Albuquerque, NM, USA
| | - Hung-Wen Yeh
- Biostatistics & Epidemiology Core, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA
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Zhuang H, Wang L, Wang F, Wang Y, Tang G, Zhao H. Prevalence of overweight/obesity and related factors in Keerqin District, Tongliao City: A cross-sectional study. PLoS One 2023; 18:e0282414. [PMID: 37540720 PMCID: PMC10403123 DOI: 10.1371/journal.pone.0282414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 02/14/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the prevalence of overweight/obesity and the factors influencing these conditions among 9- to 18-year-old adolescents in Keerqin District of Tongliao City. We explored whether overweight/obesity is accompanied by differences in eating habits, lifestyle, and mental health. METHODS A cross-sectional survey was administered to 1,736 adolescents in November 2020. A physical examination was performed for each participant, and an online questionnaire was adopted to collect information. The association of several risk factors with overweight/obesity was explored using a logistic regression model. RESULTS The prevalence of overweight/obesity in the study population was 43.32%. The risk of overweight/obesity was higher among nonresident students (odds ratio [OR] = 1.564, 95% CI = 1.182-2.069) who had an average of 3-4 (OR = 2.164, 95% CI = 1.087-4.308) or 5 or more (OR = 2.114, 95% CI = 1.376-3.248) PE classes per week. The risk of overweight/obesity was lower among girls (OR = 0.485, 95% CI = 0.396-0.593), students aged 15-16 years (OR = 0.288, 95% CI = 0.135-0.617) and those aged 17-18 years (OR = 0.282, 95% CI = 0.124-0.639), students who ate sweets more than once a week (OR = 0.570, 95% CI = 0.366-0.887), students who spent less than 1 hour per day on the computer each week (OR = 0.776, 95% CI = 0.620-0.971), students with depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score ≥ 16) (Model 2: OR = 0.618, 95% CI = 0.385-0.990; Model 3: OR = 0.623, 95% CI = 0.388-1.000), and students with depressed affect (Model 2: OR = 0.921, 95% CI = 0.877-0.967; Model 3: OR = 0.929, 95% CI = 0.885-0.976). CONCLUSION Overweight/obesity was influenced by eating habits and lifestyle factors. In addition, overweight/obesity adolescents had a lower risk of depressed than those with normal weight.
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Affiliation(s)
- Huiying Zhuang
- Inner Mongolia University for the Nationalities, Tongliao, Inner Mongolia, P.R. China
- Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Hohhot, P.R. China
| | - Limei Wang
- CDC: Centers for Disease Control and Prevention, Tongliao, Inner Mongolia, P.R. China
| | - Fengying Wang
- CDC: Centers for Disease Control and Prevention, Tongliao, Inner Mongolia, P.R. China
| | - Yu Wang
- Inner Mongolia University for the Nationalities, Tongliao, Inner Mongolia, P.R. China
| | - Geisi Tang
- Inner Mongolia University for the Nationalities, Tongliao, Inner Mongolia, P.R. China
| | - Honglin Zhao
- Inner Mongolia University for the Nationalities, Tongliao, Inner Mongolia, P.R. China
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Hirsch C, Roberts L, Salisbury J, Denney-Wilson E, Henry A, Gow M. The Association between Nutrition, Physical Activity, and Cardiometabolic Health at 6 Months following a Hypertensive Pregnancy: A BP 2 Sub-Study. Nutrients 2023; 15:3294. [PMID: 37571231 PMCID: PMC10421276 DOI: 10.3390/nu15153294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
Hypertensive disorders of pregnancy (HDP) complicate 5-10% of pregnancies, with resultant lifelong increased risks of cardiovascular disease (CVD). We aimed to describe lifestyle behaviours at 6 months post-HDP in four HDP subgroups, and their association with markers of cardiometabolic health. Subgroups were chronic hypertension (CH), gestational hypertension (GH), preeclampsia, and preeclampsia superimposed on chronic hypertension (CH + PE). The BP2 study is a multi-site, three-arm, randomised controlled trial. At 6 months postpartum, the NSW Population Health Survey and BP2 surveys collected lifestyle behaviours and demographic data. Body mass index (BMI), waist circumference, and blood pressure (BP) were also assessed. Descriptive statistics, ANOVA and Spearman's correlation coefficients were used. Of 484 women (16% CH, 23% GH, 55% preeclampsia, and 6% CH + PE), 62% were overweight or obese. Only 6% met the recommended five vegetable and two fruit serves per day, and 43% did not meet the recommended 150 min of moderate-vigorous physical activity in five sessions per week. Adherence to both diet and physical activity recommendations was correlated with more favourable cardiometabolic outcomes, including lower BMI, waist circumference, and systolic and diastolic BP. Lifestyle interventions that improve diet and physical activity post-HDP are needed to reduce BP, BMI, and long-term CVD in this high-risk population.
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Affiliation(s)
- Camilla Hirsch
- Discipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia; (C.H.); (A.H.)
| | - Lynne Roberts
- Women’s and Children’s Health, St. George Hospital, Sydney, NSW 2217, Australia;
- St. George and Sutherland Clinical Campus, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing, University of Sydney, Camperdown, Sydney, NSW 2006, Australia;
| | - Amanda Henry
- Discipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia; (C.H.); (A.H.)
- Women’s and Children’s Health, St. George Hospital, Sydney, NSW 2217, Australia;
- St. George and Sutherland Clinical Campus, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Megan Gow
- Women’s and Children’s Health, St. George Hospital, Sydney, NSW 2217, Australia;
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
- Children’s Hospital Westmead Clinical School, University of Sydney, Sydney, NSW 2006, Australia
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de Oliveira BR, Magalhães EIDS, Bragança MLBM, Coelho CCNDS, Lima NP, Bettiol H, Barbieri MA, Cardoso VC, dos Santos AM, Horta BL, da Silva AAM. Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults. Nutrients 2023; 15:2974. [PMID: 37447300 PMCID: PMC10346298 DOI: 10.3390/nu15132974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37-39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37-39 years. For FMI (kg/m2), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37-39 years. The BMI cut-off points (kg/m2) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37-39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.
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Affiliation(s)
- Bianca Rodrigues de Oliveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Elma Izze da Silva Magalhães
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Maylla Luanna Barbosa Martins Bragança
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Carla Cristine Nascimento da Silva Coelho
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Marco Antônio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Antônio Augusto Moura da Silva
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
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Zhang S, Jiang H, Wang L, Jia X, Zhang J, Wang H, Zhang B, Wang Z, Ding G. Longitudinal relationship between body fat percentage and risk of type 2 diabetes in Chinese adults: Evidence from the China Health and Nutrition Survey. Front Public Health 2022; 10:1032130. [PMID: 36523583 PMCID: PMC9744757 DOI: 10.3389/fpubh.2022.1032130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Body fat percentage (BF%) might be an alternative index of obesity which is the major risk factor for developing type 2 diabetes (T2D). We aim to longitudinally evaluated the relationship between BF% and risk of T2D. Methods A sample of 5,595 adults aged 18-65 who participated in two waves of China Health and Nutrition Survey (CHNS 2015 and 2018) was analyzed. Two level mixed-effects modified Poisson regression with robust estimation of variance stratified by sex was used to evaluate the risk ratios (RRs) for T2D according to quintiles of BF%, and the curves of receiver operating characteristic (ROC) were plotted to identify the optimal total and trunk BF% cut-off points for predicting an increased T2D risk. Results In males, compared with subjects in the first quintile of total BF%, those in the third (RR = 2.03, 95% CI 1.09-3.79), fourth (RR = 2.56, 95%CI 1.46-4.48), and fifth (RR = 2.16, 95%CI 1.22-3.82) quintile had higher risk of T2D after adjusting for all potential confounders (p-trend < 0.001). For females, the RR (95% CI) was 1.92 (1.14, 3.24) in the fifth quintile (p-trend = 0.014). Males and females with a trunk BF% >25.5 and 34.4% (≥ quintile 4), respectively, were at significantly increased risk of T2D (p-trend = 0.001). Besides, the optimal cut-off values of total and trunk BF% were 21.9 and 25.2% for males, and 36.7 and 30.3% for females, respectively. Conclusions The incident risk of T2D significantly increased over specific level of total and trunk BF% in both Chinese males and females, and the optimal BF% cut-off values were valuable for clinical application of BF% based on sex difference, which may be a cost-effective implementation for prevention and treatment of T2D in China.
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Affiliation(s)
- Siting Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Liusen Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,*Correspondence: Zhihong Wang
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Gangqiang Ding
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9
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Li D, Luo M, Liu Y, Dong J, Geng W, Li X, Yang L, Wang J, Cao P. Increased Rates of Health Management and Health Education on Hypertension and Diabetes in Inner Mongolia, China: 10-Year Population Level Trends (2009-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13048. [PMID: 36293621 PMCID: PMC9603444 DOI: 10.3390/ijerph192013048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Health management and health education are two important tasks in the national basic public health service project with a wide audience, large service volume, and high accessibility. From 2009 to 2018, the Inner Mongolia Autonomous Region of China launched the basic public health service (BPHS) project comprehensively. The implementation of health management and health education was supported and instructed actively. This study aimed to document population-level trends in health management and health education on chronic diseases such as hypertension and diabetes in Inner Mongolia, China. We collected monthly and annual reports on the implementation progress of the BPHS project in Inner Mongolia, China. A two-stage random sampling method was used to investigate health management and health education for hypertension and diabetes patients. The rate of standard health management for both hypertension and diabetes has significantly increased. The blood pressure control rate and glycemic control rate have also improved. This work provides the most comprehensive evidence to date regarding the upward trends in health management and health education on chronic diseases such as hypertension and diabetes in Inner Mongolia, China.
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Affiliation(s)
- Daxu Li
- Department of Medicine, Ordos Institute of Technology, Ordos 017000, China
- Prevention and Health Section, Pudong New Area People’s Hospital, Shanghai 201200, China
| | - Meixuan Luo
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yu Liu
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Jing Dong
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200032, China
| | - Wei Geng
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xiaoliu Li
- Department of Rehabilitation Medicine, Minhang Hospital, Fudan University, Shanghai 200032, China
| | - Lijun Yang
- SUMHS-SHUANG JIA Institute of Emergency Medical Rescue Technology, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Jin Wang
- Department of Medicine, Ordos Institute of Technology, Ordos 017000, China
| | - Peihua Cao
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
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10
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Blachman-Braun R, Talavera JO, Pérez-Rodríguez M, Roy-García I, Rivas-Ruiz R, Huitrón-Bravo G, Salmerón-Castro J. Self-reported body silhouettes: a diagnostic instrument for anthropometric parameters. Public Health 2021; 200:39-46. [PMID: 34662752 DOI: 10.1016/j.puhe.2021.09.001] [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: 05/30/2021] [Revised: 08/15/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Routine body size measurement of anthropometric values requires professionals, standardized techniques, and calibrated tools. Therefore, there is a need for easier screening tools such as the self-reported body silhouette (Self-bosi). The aim of this study was to analyze the performance of Self-bosi as a proxy of anthropometric values. STUDY DESIGN Prospective analytic study of the Health Workers Cohort Study. METHODS Adult participants of the Health Workers Cohort Study were included. Then, through the calculation sensitivity and specificity of Self-bosi to detect abnormal waist circumference (WC) (≥90 cm for male and ≥80 cm for female participants), elevated body fat percentage (BF%) (≥25% for male and ≥35% for female participants), as well as overweight and obesity (≥25 kg/m2) and obesity (≥30 kg/m2). RESULTS A total of 2471 male and 5940 female participants were analyzed. Overall, Self-bosi discriminate high WC values (area under the curve [AUC]; male participants: 0.80, female participants: 0.82); increased BF% (AUC: male participants: 0.78, female participants: 0.83); overweight and obesity (AUC: male participants: 0.81, female participants: 0.86); and obesity (AUC: male participants: 0.83, female participants: 0.89). CONCLUSION Self-bosi is an accurate method to assess increased WC, BF%, obesity, and overweight-obesity in Mexican adults. Given its simplicity and low-cost of the self-reported body silhouette, it might be considered a useful anthropometric screening instrument in large scale epidemiological research.
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Affiliation(s)
- R Blachman-Braun
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México; Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - J O Talavera
- Jefatura de Enseñanza, Centro Médico ABC, Ciudad de México, México.
| | - M Pérez-Rodríguez
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - I Roy-García
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - R Rivas-Ruiz
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - G Huitrón-Bravo
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, Estado de México, México
| | - J Salmerón-Castro
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Ciudad de México, México
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11
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Zhang B, Fan Y, Wang Y, Zhang L, Li C, He J, Guo P, Zhang M, Zhang M. Comparison of bioelectrical body and visceral fat indices with anthropometric measures and optimal cutoffs in relation to hypertension by age and gender among Chinese adults. BMC Cardiovasc Disord 2021; 21:291. [PMID: 34116640 PMCID: PMC8196495 DOI: 10.1186/s12872-021-02100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background Few studies have compared bioelectrical body and visceral fat indices with anthropometric measures, or evaluated their optimal cutoffs in relation to hypertension among Asians. We compared the efficiencies of bioelectrical indices (percentage of body fat, PBF; visceral fat area, VFA) with anthropometric measures (body mass index, BMI; waist-hip ratio, WHR) for hypertension and re-evaluated the optimal cutoffs of each index by age and gender. Methods We conducted a cross-sectional survey among 8234 adults for health examination. PBF, VFA, BMI, WHR, and data on hypertension and behaviors were collected. Receiver operating characteristic (ROC) curve and areas under curves (AUCs) were used to analyze the efficiencies of the indices for hypertension, optimal cutoffs were estimated using the Youden index. Results A total of 8234 individuals aged 21–91 with median age 44 (interquartile range [IQR] 33–56) years were included and 40.56% were men. The overall prevalence of hypertension was 27.47%. The studied indices were all associated with hypertension in all age-specific groups both among men and women except for WHR in 21–29 years old men and PBF in in 21–29 years old women. Among males, there were no statistical differences in powers of four indices for hypertension in all age-specific groups, except for 40–49 years, in which WHR was better than VFA. Among females, no differences were found among the indices in 30–39 and 70–79 years groups, while WHR was the best in 21–29 years group, VFA was better than PBF in 30–39 and 50–59 years groups, BMI was better than PBF and WHR in 60–69 years group. The optimal cutoffs of PBF, VFA, BMI and WHR ranged from 23.9 to 28.7%, 86.4 to 106.9cm2, 23.5 to 27.1 kg/m2, 0.92 to 0.96 across the age categories in males, and 32.8 to 36.3%, 75.9 to 130.9cm2, 21.9 to 26.4 kg/m2, 0.84 to 0.95 across the age categories in females, respectively. Conclusions The obesity indices’ efficiencies for hypertension varied by age and gender, and their cutoff values varied across the age categories and gender. Specific indices and cutoffs based on person’s age and gender should be used to identify individuals with hypertension.
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Affiliation(s)
- Binbin Zhang
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Yaqi Fan
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Yuxue Wang
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Li Zhang
- Tianjin First Central Hospital, Tianjin, China
| | - Chunjun Li
- Tianjin Union Medical Center, Tianjin, China
| | - Jiangshan He
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Pei Guo
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Mianzhi Zhang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Minying Zhang
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China.
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12
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Chiba I, Lee S, Bae S, Makino K, Shinkai Y, Shimada H. Visceral fat accumulation is associated with risk of diabetes in community-dwelling Japanese older adults. Geriatr Gerontol Int 2021; 21:306-312. [PMID: 33555133 DOI: 10.1111/ggi.14131] [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: 01/07/2020] [Revised: 12/11/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022]
Abstract
AIM The prevalence of diabetes generally increases with age, and older adults with diabetes are at a higher risk of adverse outcomes. Visceral fat accumulation is a well-known risk factor for diabetes in middle-aged adults, and its association with diabetes increases with age. The present study investigated the association between visceral fat and risk of diabetes in older adults that is yet to be completely elucidated. METHODS This cross-sectional study enrolled 2850 community-dwelling older adults. Participants underwent abdominal bioelectrical impedance analysis to estimate the visceral fat area (VFA). The risk of diabetes was assessed using the value of hemoglobin A1c according to the diagnostic criteria of diabetes. We examined the relationship of VFA and risk of diabetes, and explored the optimal cut-off value stratified by sex. RESULTS In total, 47 of 1640 (2.9%) women and 41 of 1210 (3.4%) men had a high risk of diabetes. Higher values of VFA in units of 10 cm2 were significantly associated with a higher risk of diabetes for both women (adjusted odds ratio [aOR]: 1.17; 95% confidence interval [95% CI]: 1.02-1.34) and men (aOR: 1.18; 95% CI: 1.06-1.31) in multivariate logistic regression analysis. The cut-off value to classify 30% of subjects into high VFA (72 cm2 ) had a relatively higher sensitivity of 0.660 and was significantly associated with a higher risk of diabetes for women (aOR: 3.49; 95% CI: 1.54-8.12), whereas all cut-off values we examined had no relation in men. CONCLUSIONS Increases in VFA is associated with a high risk of diabetes in older adults but the optimal cut-off value is inconclusive in men. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yohei Shinkai
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
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13
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Itani L, Tannir H, El Masri D, Kreidieh D, El Ghoch M. Development of an Easy-to-Use Prediction Equation for Body Fat Percentage Based on BMI in Overweight and Obese Lebanese Adults. Diagnostics (Basel) 2020; 10:diagnostics10090728. [PMID: 32967261 PMCID: PMC7555778 DOI: 10.3390/diagnostics10090728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 12/23/2022] Open
Abstract
An accurate estimation of body fat percentage (BF%) in patients who are overweight or obese is of clinical importance. In this study, we aimed to develop an easy-to-use BF% predictive equation based on body mass index (BMI) suitable for individuals in this population. A simplified prediction equation was developed and evaluated for validity using anthropometric measurements from 375 adults of both genders who were overweight or obese. Measurements were taken in the outpatient clinic of the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). A total of 238 participants were used for model building (training sample) and another 137 participants were used for evaluating validity (validation sample). The final predicted model included BMI and sex, with non-significant prediction bias in BF% of −0.017 ± 3.86% (p = 0.946, Cohen’s d = 0.004). Moreover, a Pearson’s correlation between measured and predicted BF% was strongly significant (r = 0.84, p < 0.05). We are presenting a model that accurately predicted BF% in 61% of the validation sample with an absolute percent error less than 10% and non-significant prediction bias (−0.028 ± 4.67%). We suggest the following equations: BF% females = 0.624 × BMI + 21.835 and BF% males = 1.050 × BMI − 4.001 for accurate BF% estimation in patients who are overweight or obese in a clinical setting in Lebanon.
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14
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Lee K. Association of osteosarcopenic obesity and its components: osteoporosis, sarcopenia and obesity with insulin resistance. J Bone Miner Metab 2020; 38:695-701. [PMID: 32335754 DOI: 10.1007/s00774-020-01104-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/28/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION To evaluate the differences in the associations of combinations of co-existent osteopenia, obesity, and/or sarcopenia with insulin resistance (IR) according to different criteria of obesity. MATERIALS AND METHODS Among 4500 Korean men and postmenopausal women who were aged ≥ 50 years and did not have diabetes mellitus, osteopenia, sarcopenia, and obesity were defined using bone mineral density, skeletal mass index, and body fat % (or BMI). Body composition groups were generated based on the combinations of these components. IR was defined using the HOMA-IR ≥ 2.5. RESULTS When obesity was defined by body fat % and the relationships were adjusted for age, sex, education, and health behaviors, the odds ratios (ORs) for IR was highest in the groups with obesity and osteopenic obesity, followed by sarcopenic obesity and osteosarcopenic obesity, followed by osteopenia and sarcopenia, and followed by osteosarcopenia. When BMI was additionally adjusted, the ORs for IR were not significantly different between body composition groups except for osteopenia: those groups had higher ORs for IR compared to osteopenia. When obesity was defined by BMI, obesity co-existent groups had higher ORs for IR than the obesity non-coexistent groups. The ORs for IR were not significantly different within obesity co-existent groups or obesity non-coexistent groups. CONCLUSIONS Combinations of co-existent osteopenia, obesity, and/or sarcopenia had different associations with IR according to obesity classification methods and consideration of BMI adjustment. Osteosarcopenic obesity may not have a stronger association with IR compared to obesity only and obesity co-existent other conditions.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea.
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15
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Bawadi H, Hassan S, Shanbeh Zadeh A, Sarv H, Kerkadi A, Tur JA, Shi Z. Age and gender specific cut-off points for body fat parameters among adults in Qatar. Nutr J 2020; 19:75. [PMID: 32711520 PMCID: PMC7382859 DOI: 10.1186/s12937-020-00569-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/20/2020] [Indexed: 12/15/2022] Open
Abstract
Background Excessive body fat is the leading cause of many metabolic disorders. Therefore, assessing levels of body fat associated with risk of disease in specific populations is crucial. The present study aimed to identify optimal cut-off values of body fat composition including total body fat, body fat percentage, visceral fat, and trunk fat, in order to predict metabolic risk in the Qatari population. Methods This cross-sectional study was based on Qatar Biobank data of 2407 Qatari adults (1269 male and 1138 female) aged 21–70 years old. Individuals’ height, weight and body fat percentage were obtained. Blood test data including lipid profile, blood glucose and HbA1c data were also obtained. The area under the curve was calculated using ROC analysis to obtain the body fat percentage associated with risk of disease. Results The cut-off points for total fat for those aged < 40 were 34.0 kg, and for those aged ≥40 were 30.7 kg and 35.6 kg in men and women, respectively. The cut-off for body fat percent for those aged < 40 were 35.1 and 45.1%, and for those aged ≥40 were 34.8 and 46.3% in men and women, respectively. The cut-off points for trunk fat percent for those aged < 40 were 19.5 and 22.4%, and for those aged ≥40 were 21.6 and 23.4% in men and women, respectively. The cut-off points for visceral fat percent for those aged < 40 were 1.4 and 1.0%, and for those aged ≥40 were 1.9 and 1.4% in men and women, respectively. Conclusion This study established Qatari adult-specific cut-off values of body fat for different age and gender groups.
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Affiliation(s)
- H Bawadi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar.
| | - S Hassan
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - A Shanbeh Zadeh
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - H Sarv
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - A Kerkadi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands & CIBEROBN, 07122, Palma de Mallorca, Spain
| | - Z Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
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16
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Jia L, Lu H, Wu J, Wang X, Wang W, Du M, Wang P, Du S, Su Y, Zhang N. Association between diet quality and obesity indicators among the working-age adults in Inner Mongolia, Northern China: a cross-sectional study. BMC Public Health 2020; 20:1165. [PMID: 32711506 PMCID: PMC7382798 DOI: 10.1186/s12889-020-09281-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
Background Obesity is a major risk factor for the global burden of disease in countries that are economically developed or not. This study aimed to investigate the association between diet quality and obesity indicators applying DASH and aMed. Methods This cross-sectional study on adult nutrition and chronic disease in Inner Mongolia (n = 1320). Dietary data were collected using 24-h diet recall for 3 consecutive days and weighing method. DASH and aMed were used to assess the dietary quality. WC, BMI and WC-BMI were used as obesity indicators. Logistic regression models were used to examine the associations between diet quality and obesity indicators. Results Higher diet quality, assessed by DASH, was only associated with WC. The odds ratio (OR) for abdominal obesity in the highest tertile of DASH scores compared with the lowest was 0.71 (95% confidence interval (CI) 0.53, 0.96; Ptrend = 0.03). Furthermore, aMed was inversely associated with obesity indicators. OR for abdominal obesity in the highest tertile of aMed score compared with the lowest were 0.63 (95% CI 0.47, 0.87; Ptrend = 0.005) and 0.57 (95% CI 0.41, 0.77; Ptrend = 0.02) for overweight and obesity, respectively, and 0.60 (95% CI 0.44, 0.81; Ptrend = 0.02) for high obesity risk. Conclusions Our findings suggest that dietary quality assessed using aMed is more closely associated with obesity than assessment using DASH in working-age adults in Inner Mongolia. The Mediterranean diet can be recommended as a healthy diet to control weight.
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Affiliation(s)
- Lu Jia
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Haiwen Lu
- Department of Medical Imaging, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Medical University, Hohhot, 010050, China
| | - Jing Wu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Xuemei Wang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China.
| | - Wenrui Wang
- Department of Chronic Disease Control and Prevention, Inner Mongolia Center for Disease Control and Prevention, Hohhot, 010031, China
| | - Maolin Du
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Sha Du
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Yuenan Su
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Nan Zhang
- Department of Hygienic Toxicology, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China
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Macek P, Biskup M, Terek-Derszniak M, Krol H, Smok-Kalwat J, Gozdz S, Zak M. Optimal cut-off values for anthropometric measures of obesity in screening for cardiometabolic disorders in adults. Sci Rep 2020; 10:11253. [PMID: 32647283 PMCID: PMC7347554 DOI: 10.1038/s41598-020-68265-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/11/2020] [Indexed: 02/06/2023] Open
Abstract
Excessive accumulation of body fat (BF) promotes obesity, whilst posing a significant health hazard. There being no agreed, optimal quantifying methods, application of BF variable in clinical practice is not deemed an effective assessment option. The study, involving 4,735 patients (33.6% men), aged 45-64, aimed to identify optimal cut-off values for anthropometric indicators of obesity to evaluate cardiometabolic risk. A minimum P-value approach was applied to calculate the cut-offs for BF%. Threshold values for body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height (WHTR) ratio, facilitating optimal differentiation of cardiometabolic risk, were based on BF%, expressed as a binary classifier. The newly estimated cut-off values for predicting cardiometabolic risk, based on BMI, were lower than the referential obesity thresholds, whereas the threshold values of WC, WHR, and WHTR were higher. Apart from dyslipidemia, the odds of cardiometabolic disorders were higher, when the anthropometric indicators under study exceeded the cut-off points in both sexes. The proposed cut-offs proved instrumental in predicting cardiometabolic risk, whilst highlighting diagnostic and clinical potential of BF%, whereas BMI boasted the highest predictive potential. Cardiometabolic risk also proved significantly higher even in the overweight patients.
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Affiliation(s)
- Pawel Macek
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, 25-734, Kielce, Poland
| | - Malgorzata Biskup
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Department of Rehabilitation, Holycross Cancer Centre, 25-734, Kielce, Poland
| | | | - Halina Krol
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Research and Education Department, Holycross Cancer Centre, 25-734, Kielce, Poland
| | | | - Stanislaw Gozdz
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Clinical Oncology Clinic, Holycross Cancer Centre, 25-734, Kielce, Poland
| | - Marek Zak
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.
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Macek P, Biskup M, Terek-Derszniak M, Stachura M, Krol H, Gozdz S, Zak M. Optimal Body Fat Percentage Cut-Off Values in Predicting the Obesity-Related Cardiovascular Risk Factors: A Cross-Sectional Cohort Study. Diabetes Metab Syndr Obes 2020; 13:1587-1597. [PMID: 32494175 PMCID: PMC7229792 DOI: 10.2147/dmso.s248444] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Reliable obesity assessment is essential in evaluating the risk of cardiovascular risk factors (CRFs). Non-availability of clearly defined cut-offs for body fat percentage (BF%), as well as a widespread application of surrogate measures for obesity assessment, may result in incorrect prediction of cardio-metabolic risk. PURPOSE The study aimed to determine optimal cut-off points for BF%, with a view of predicting the CRFs related to obesity. PATIENTS AND METHODS The study involved 4735 (33.6% of men) individuals, the Polish-Norwegian Study (PONS) participants, aged 45-64. BF% was measured with the aid of bioelectrical impedance analysis (BIA) method. The gender-specific cut-offs of BF% were found with respect to at least one CRF. A P-value approach, and receiver operating characteristic curve analyses were pursued for BF% cut-offs, which optimally differentiated normal from the risk groups. The associations between BF% and CRFs were determined by logistic regression models. RESULTS The cut-offs for BF% were established as 25.8% for men and 37.1% for women. With the exception of dyslipidemia, in men and women whose BF% was above the cut-offs, the odds for developing CRFs ranged 2-4 times higher than those whose BF% was below the cut-offs. CONCLUSION Controlling BF% below the thresholds indicating an increased health hazard may be instrumental in appreciably reducing overall exposure to developing cardio-metabolic risk.
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Affiliation(s)
- Pawel Macek
- Department of Physical Activity, Posturology, and Gerontology, Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, Kielce, Poland
| | - Malgorzata Biskup
- Department of Physical Activity, Posturology, and Gerontology, Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland
| | | | - Michal Stachura
- Department of Economics and Finance, Faculty of Law and Social Sciences, The Jan Kochanowski University, Kielce, Poland
| | - Halina Krol
- Department of Physical Activity, Posturology, and Gerontology, Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Clinical Oncology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Stanislaw Gozdz
- Department of Physical Activity, Posturology, and Gerontology, Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Research and Education Department, Holycross Cancer Centre, Kielce, Poland
| | - Marek Zak
- Department of Physical Activity, Posturology, and Gerontology, Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
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Osailan AM, Alqahtani B, Elnaggar R. Obesity and parasympathetic reactivation of the heart following exercise testing in young male adults: a pilot study. Ann Saudi Med 2020; 40:113-119. [PMID: 32241165 PMCID: PMC7118237 DOI: 10.5144/0256-4947.2020.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In elderly people, obesity may induce changes in the autonomic nervous system via alteration of the balance between the sympathetic and parasympathetic nervous systems. Little is known about obesity and parasympathetic reactivation following exercise testing, particularly in young people in Saudi Arabia, and its relationship with body composition parameters. OBJECTIVES Compare parasympathetic reactivation using heart rate recovery (HRR) following the exercise test between young obese and nonobese people and explore the association between body composition parameters with HRR. DESIGNS Cross-sectional study. SETTING University research lab. PATIENTS AND METHODS Twenty-seven young male college students underwent anthropometric measurements and treadmill exercise testing, during which the heart rate was monitored via 12-lead electro-cardiography. Participants were divided into a group (n=15) with high body fat percentage (>30%), and a group (n=12) with a normal body fat percentage (<30%) to compare multiple parameters including HRR, which was defined as the absolute change from heart rate (HR) peak during exercise to 1-minute post-HR peak. MAIN OUTCOME MEASURES HRR, body mass index, waist-to-hip ratio, fat percentage, and trunk fat. SAMPLE SIZE AND CHARACTERISTICS: n=27, mean (SD) age=22.4 (0.98) years, range 21-25 years. RESULTS There was no significant difference in HRR between the groups (32.20 [13.42] bpm for high body fat percentage vs 35.42 [13.35] bpm for normal body fat percentage) ( P=.54). We found a non-significant inverse correlations of HRR with BMI (r=-0.18, P=.37), WHR (r=-0.04, P=.86), fat percentage (r=-0.18, P=.38) and trunk fat (r=-0.23, P=.25). CONCLUSION HRR was preserved in our young obese people and was not different from nonobese people. Furthermore, it seems that obese people with higher body composition parameters may have slower HRR, or slower recovery indicating poorer parasympathetic reactivation. LIMITATIONS Need a larger sample to confirm the findings of this pilot study. CONFLICT OF INTEREST None.
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Affiliation(s)
- Ahmed M. Osailan
- From the Department of Physical Therapy and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Central, Saudi Arabia
| | - Badr Alqahtani
- From the Department of Physical Therapy and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Central, Saudi Arabia
| | - Ragab Elnaggar
- From the Department of Physical Therapy and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Central, Saudi Arabia
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Wang Y, Shan G, Gan L, Qian Y, Chen T, Wang H, Pan X, Wang W, Pan L, Zhang X, Wang M, Ma J, Zhong Y. Prevalence and associated factors for pterygium in Han and Mongolian adults: a cross-sectional study in inner Mongolian, China. BMC Ophthalmol 2020; 20:45. [PMID: 32013911 PMCID: PMC6998068 DOI: 10.1186/s12886-020-1324-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 01/21/2020] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the prevalence of pterygium and associated factors in Han and Mongolian adults at four survey sites in Inner Mongolia, China. Methods We conducted a population-based, cross-sectional study as part of the China National Health Survey (CNHS). By means of a stratified sampling method, we finally included 2651 participants of 30 years of age or older from a total of 3468 eligible residents. Factors associated with pterygium were analysed by a univariate analysis and logistic regression models. Results The study population included 1910 Han and 741 Mongolian adults. The mean age ± standard deviation of the study cohort was 48.93 ± 11.06 years. The overall prevalence of pterygium was 6.4% (n = 169); 1.4% (n = 38) of the cases were bilateral and 4.8% (n = 128) were unilateral. The most common grade of pterygium was Grade 2. Based on the results of the univariate analysis, eleven factors were included in a multivariate analysis. The results indicated that age (P < 0.001), outdoor occupation (P = 0.026), and time spent in rural areas (P < 0.001) were significantly associated with pterygium. Sex and ethnicity were not identified as risk factors. Conclusions Our results indicated that outdoor occupation, old age and more time spent in rural areas were risk factors for pterygium in Inner Mongolia. At the same time, town as a survey site (Hohhot and Tsining District) was a protective factor for pterygium. Ethnicity, gender, smoking, diabetes and high blood pressure are not associated with pterygium.
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Affiliation(s)
- Yuhan Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Linyang Gan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Yonggang Qian
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, Inner Mongolia Autonomous Region, China
| | - Ting Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Hailing Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, Inner Mongolia Autonomous Region, China
| | - Xiaodan Pan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, Inner Mongolia Autonomous Region, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xia Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Meng Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.
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Kerkadi A, Suleman D, Abu Salah L, Lotfy C, Attieh G, Bawadi H, Shi Z. Adiposity Indicators as Cardio-Metabolic Risk Predictors in Adults from Country with High Burden of Obesity. Diabetes Metab Syndr Obes 2020; 13:175-183. [PMID: 32021363 PMCID: PMC6983675 DOI: 10.2147/dmso.s238748] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In Qatar more than 70% 0f the adults are overweight and obese. Different adiposity assessment methods have been proposed to identify individuals at cardio-metabolic risk. PURPOSE This study aimed to compare anthropometric indicators with Dual-energy X-ray absorptiometry (DXA) -derived adiposity indicators in predicting cardio-metabolic risk among Qatari adults. PATIENTS AND METHODS A random sample of five hundred and fifty-eight (558) healthy Qatari adults (men and women) aged 20 to 50 years was obtained from Qatar Biobank survey data. Anthropometric data (weight, height, and waist circumference), the DXA-derived data, and cardio-metabolic (CM) risk parameters were analyzed. A Spearman partial correlation coefficient, Receiver Operating Characteristics (ROC) curve and an area under curve (AUC) were used to assess the predicting ability of adiposity indicators for CM risk factors. RESULTS Adiposity indices (anthropometric and DXA) were significantly correlated with most of the CM indicators (r= -0.292 to 0.486, p< 0.001). The AUC of waist to height ratio (WHtR) was significantly higher than that of body mass index (BMI) and waist circumference (WC) in the prediction of low high density lipoprotein (HDL) (AUC=0.65, AUC=0.59; AUC=0.64), high low density lipoprotein (LDL) (AUC=0.67; AUC=0.62; AUC=0.66), high cholesterol (AUC=0.66; AUC=0.63; AUC=0.63), and high Homeostatic Model Assessment- (HOMA) (AUC= 0.81; AUC= 0.78; AUC=0.78). Among DXA- parameters, trunk fat had the highest AUCs for total cholesterol (AUC= 0.64, CI=0.56, 0.73), triglycerides and glucose index (TyG) (AUC=0.69, CI=0.64, 0.74), and HOMA (AUC=0.78, CI= 0.73, 0.84). CONCLUSION Results of the present study show that adiposity indicators (WC and WHtR) are clinically valuable tools to identify individuals at risk of CVD compared to DXA-derived parameters, while DXA can provide more accurate estimates.
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Affiliation(s)
- Abdelhamid Kerkadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
- Correspondence: Abdelhamid Kerkadi Tel +974 4403 4806Fax +974 4403 4801 Email
| | - Dana Suleman
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Lana Abu Salah
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Christina Lotfy
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Grace Attieh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
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Baveicy K, Mostafaei S, Darbandi M, Hamzeh B, Najafi F, Pasdar Y. Predicting Metabolic Syndrome by Visceral Adiposity Index, Body Roundness Index and a Body Shape Index in Adults: A Cross-Sectional Study from the Iranian RaNCD Cohort Data. Diabetes Metab Syndr Obes 2020; 13:879-887. [PMID: 32273739 PMCID: PMC7102908 DOI: 10.2147/dmso.s238153] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The use of anthropometric indices is one of the new and low-cost diagnostic methods of metabolic syndrome (MetS). The present study aimed to determine optimal cutoff points for the visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (ABSI) in the prediction of MetS. METHODS This cross-sectional study was performed on 10,000 individuals aged from 35 to 65 years, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort study, in the west region of Iran, in 2019. MetS was defined according to International Diabetes Federation (IDF) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive anthropometric indices and determine optimal cutoff values. RESULTS The optimal cutoff points for VAI were 4.11 (AUC: 0.82; 95% CI: 0.81-0.84) in men and 4.28 (AUC: 0.86; 95% CI: 0.85-0.87) in women to prediction of MetS. The optimal cutoff points for BRI were 4.75 (AUC: 0.75; 95% CI: 0.74-0.77) in men and 6.17 (AUC: 0.62; 95% CI: 0.61-0.64) in women to prediction of MetS. The optimal cutoff points for ABSI were 0.12 (AUC: 0.49; 95% CI: 0.47-0.51) in men and 0.13 (AUC: 0.49; 95% CI: 0.47-0.51) in women to prediction of MetS. The risk of MetS in men and women with a VAI higher than the optimal cutoff point was, respectively, 9.82 and 11.44 times higher than that in those with a VAI lower than the cutoff point. CONCLUSION Although VAI might not be very cost-beneficial compared to IDF, our study showed VAI is a better predictor of MetS than BRI in adults. ABSI was not a suitable predictor for MetS.
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Affiliation(s)
- Kamran Baveicy
- Student Research Committee, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shayan Mostafaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Correspondence: Yahya Pasdar Tel +98 83 38262005Fax +98 83 38263048 Email
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Pasdar Y, Hamzeh B, Najafi F, Darbandi M. Optimal cutoff values of fat mass index, body fat percentage and visceral fat area for identifying metabolic syndrome in the Kurdish population: Results from an Iranian RaNCD cohort study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-190324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Kermanshah Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Student Research Committee, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Sinaga M, Yemane T, Tegene E, Lidstrom D, Belachew T. Performance of newly developed body mass index cut-off for diagnosing obesity among Ethiopian adults. J Physiol Anthropol 2019; 38:14. [PMID: 31655610 PMCID: PMC6815360 DOI: 10.1186/s40101-019-0205-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 09/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity is defined as unhealthy excess body fat, which increases the risk of premature mortality from noncommunicable diseases. Early screening and prevention of obesity is critical for averting associated morbidity, disability, and mortality. Ethiopia has been using the international (WHO's) BMI cut-off for diagnosing obesity even though its validity among Ethiopian population was questioned. To address this problem, a new body mass index cut-off was developed for Ethiopian adults using population-specific data. However, its performance in diagnosing obesity has not been validated. Therefore, this study determined the performance of the newly developed Ethiopian and World Health Organization (WHO) BMI cut-offs in detecting obesity among Ethiopian adults. METHODS A cross-sectional study was carried out among 704 employees of Jimma University from February to April 2015. The study participants were selected using simple random sampling technique based on their payroll. Data on sociodemographic variables were collected using an interviewer-administered structured questionnaire. Anthropometric parameters including body weight and height were measured according to WHO recommendation. Body fat percentage (BF%) was measured using the air displacement plethysmography (ADP) after calibration of the machine. The diagnostic accuracy of the WHO BMI cut-off (≥ 30 kg/m2) for obesity in both sexes and Ethiopian BMI cut-off (> 22.2 kg/m2 for males and > 24.5 kg/m2 for females) were compared to obesity diagnosed using ADP measured body fat percentage (> 35% for females and > 25% for males). Sensitivity, specificity, predictive values, and kappa agreements were determined to validate the performance of the BMI cut-offs. RESULTS In males, WHO BMI cut-off has a sensitivity of 5.3% and specificity of 99.4% (Kappa = 0.047) indicating a slight agreement. However, the Ethiopian cut-off showed a sensitivity of 87.5% and specificity of 87.7% (Kappa = 0.752) indicating a substantial agreement. Similarly, in females, the WHO BMI cut-off showed a sensitivity of 46.9%, while its specificity was 100% (Kappa = 0.219) showing a fair agreement. The Ethiopian BMI cut-off demonstrated a sensitivity 80.0% and a specificity 95.6% (Kappa = 0.701) showing a substantial agreement. The WHO BMI cut-off underestimated the prevalence of obesity by a maximum of 73.7% and by a minimum of 28.3% among males, while the values for underestimation ranged from 31.4-54.1% in females. The misclassification was minimal using the newly developed Ethiopian BMI cut-off. The prevalence of obesity was underestimated by a maximum of 9.2% and overestimated by a maximum of 6.2%. The WHO BMI cut-off failed to identify nearly half (46.6%) of Ethiopian adults who met the criteria for obesity using BF% in the overall sample. CONCLUSIONS The findings suggest that WHO BMI cut-off (≥ 30 kg/m2) is not appropriate for screening obesity among Ethiopian adults. The newly developed Ethiopian BMI cut-off showed a better performance with excellent sensitivity, specificity, predictive values, and agreement indicating the diagnostic significance of it use as a simple, cost-effective, and valid indicator in clinical and community setups.
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Affiliation(s)
- Makeda Sinaga
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Po. Box 378, Jimma, Ethiopia
| | - Tilahun Yemane
- Faculty of Health Sciences, Department of Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Elsah Tegene
- Department of Internal Medicine, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - David Lidstrom
- Population Studies Centre, Brown University, Providence, USA
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Po. Box 378, Jimma, Ethiopia
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Kim YM, Kim S, Won YJ, Kim SH. Clinical Manifestations and Factors Associated with Osteosarcopenic Obesity Syndrome: A Cross-Sectional Study in Koreans with Obesity. Calcif Tissue Int 2019; 105:77-88. [PMID: 30997575 DOI: 10.1007/s00223-019-00551-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/11/2019] [Indexed: 12/28/2022]
Abstract
Demonstrating the clinical consequences of osteosarcopenic obesity (OSO) is complex. This study evaluated clinical manifestations and factors associated with bone and muscle loss in Koreans with obesity. This cross-sectional observational study enrolled Koreans with obesity aged ≥ 50 years from the Korea National Health and Nutrition Examination Survey. Clinical manifestations were compared among four groups: obesity (O), sarcopenic obesity (SO), osteopenic obesity (OO), and OSO. Factors associated with appendicular skeletal muscle mass (ASM) or bone mineral density (BMD) were evaluated. OSO increases with age in both sexes. Men with SO and OSO had increased cardiometabolic diseases and markers, percentages of body fat (BF %), and trunk fat (TF %), and decreased limb fat percentage (LF %). Women with SO and OSO had increased metabolic markers, BF %, and TF % but those with OSO had increased cardiometabolic diseases and lower LF %. Both sexes with OSO had decreased ASM and vitamin D, and higher vitamin D deficiency. BF % was negatively associated with ASM and femur BMD in both sexes. TF % was negatively and LF % was positively associated with ASM in both sexes and with femur BMD in women. Vitamin D was positively associated with femur BMD in men and with ASM and BMD at all sites in women. ASM and BMD were positively associated with each other. Appendicular muscle loss is metabolically significant regardless of bone loss in men; however, appendicular muscle loss with bone loss is metabolically more significant in women. Regional body composition, fat distribution, and vitamin D deficiency were associated with OSO phenotype in both sexes.
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Affiliation(s)
- Yoo Mee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100Gil 25, Seo-gu, Incheon, 22711, South Korea
- Institute for Translational and Clinical Research, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100Gil 25, Seo-gu, Incheon, 22711, South Korea
- Institute for Bio-Medical Convergence, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea
| | - Se Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100Gil 25, Seo-gu, Incheon, 22711, South Korea.
- Institute for Translational and Clinical Research, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea.
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Effect of BMI and Its Optimal Cut-Off Value in Identifying Hypertension in Uyghur and Han Chinese: A Biethnic Study from the China National Health Survey (CNHS). Int J Hypertens 2018; 2018:1508083. [PMID: 30643642 PMCID: PMC6311287 DOI: 10.1155/2018/1508083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/19/2018] [Indexed: 01/13/2023] Open
Abstract
Objective The effect of adiposity on hypertension among Uyghur Chinese is not clear. This study aimed to compare the effect of BMI and its optimal cut-off value in identifying hypertension in Uyghur and Han adults in China. Methods By using a multistage stratified sampling method, 3072 Uyghur and 3195 Han adults underwent questionnaire interview, physical examination, and biochemical tests. Age- and sex-standardized prevalence of hypertension was calculated. Adjusted odds ratios for adiposity associated with hypertension were estimated. ROC analyses were used for assessing the ethnic and sex specific optimal BMI cut-off values in identifying hypertension. Results Both in Uyghur and Han, increased BMI was consistent with the elevated systolic and diastolic blood pressure. Although more Uyghur were overweight/obese, their standardized prevalence of hypertension (17.87%) was lower than that of Han (20.28%). Han adults had 1.42 times odds than Uyghur of hypertension. The adjusted ORs of overweight and obesity were 2.67 and 6.04 in Uyghur and 2.74 and 7.58 in Han. In male, the optimal cut-off values of BMI identifying hypertension in Uyghur and Han were 24.6 kg/m2 and 24.9 kg/m2 , respectively, but the correspond values in Uyghur and Han females were 27.2 kg/m2 and 25.0 kg/m2. Conclusions Adiposity had strong effect on hypertension, but this effect was less strong in Uyghur female than in Han female.
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Sinaga M, Worku M, Yemane T, Tegene E, Wakayo T, Girma T, Lindstrom D, Belachew T. Optimal cut-off for obesity and markers of metabolic syndrome for Ethiopian adults. Nutr J 2018; 17:109. [PMID: 30466421 PMCID: PMC6251157 DOI: 10.1186/s12937-018-0416-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 10/29/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is defined as the presence of central obesity plus any two of the following markers: high triglycerides (> 150 mg/dl), low high density lipoprotein (HDL) cholesterol < 40 mg/dl in men and < 50 mg/dl in women, hypertension (blood pressure > 130/85 mmHg or use of antihypertensive medication), high fasting blood glucose (> 100 mg/dl or use of treatment for diabetes mellitus). Since recently, metabolic syndrome and obesity have become emerging problems of both low and middle income countries, although they have been the leading cause of morbidity and mortality in high income countries for the past decades. It has been indicated that the international anthropometric cut-off for detecting obesity is not appropriate for Ethiopians. This study developed optimal cut off values for anthropometric indicators of obesity and markers of metabolic syndrome for Ethiopian adults to enhance preventive interventions. METHODS A total of 704 employees of Jimma University were randomly selected using their payroll as a sampling frame. Data on socio-demographic, anthropometry, clinical and blood samples were collected from February to April 2015. Receiver Operating Characteristic Curve analyses were used to determine optimal anthropometric cut-off values for obesity and markers of the metabolic syndrome. WHO indicators of obesity based on body fat percent (> 25% for males and > 35% for females) were used as binary classifiers for developing anthropometric cut-offs. Optimal cut-off values were presented using sensitivity, specificity and area under the curve. RESULTS The optimal cut-off for obesity using body mass index was 22.2 k/m2 for males and 24.5 kg/m2 for females. Similarly, the optimal waist circumference cut-off for obesity was 83.7 cm for males and 78.0 cm for females. The cut-off values for detecting obesity using waist to hip ratio and waist to height ratio were: WHR (0.88) and WHtR (0.49) for males, while they were 0.82 and 0.50 for females, respectively. Anthropometric cut-off values for markers of metabolic syndrome were lower compared to the international values. For females, the optimal BMI cut-offs for metabolic syndrome markers ranged from 24.8 kg/m2 (triglycerides) to 26.8 kg/m2 (fasting blood sugar). For WC the optimal cut-off ranged from of 82.1 cm (triglyceride) to 96.0 cm(HDL); while for WHtR the optimal values varied from 0.47(HDL) to 0.56(fasting blood sugar). Likewise, the optimal cut-offs of WHR for markers of metabolic syndrome ranged from 0.78(fasting blood sugar) to 0.89(HDL and blood pressure). For males, the optimal BMI cut-offs for metabolic syndrome markers ranged from 21.0 kg/m2 (HDL) to 23.5 kg/m2 (blood pressure). For WC, the optimal cut-off ranged from 85.3 cm (triglyceride) to 96.0 cm(fasting blood sugar); while for WHtR the optimal values varied from 0.47(BP, FBS and HDL) to 0.53(Triglyceride). Similarly, the optimal cut-offs of WHR form markers of metabolic syndrome ranged from 0.86(blood pressure) to 0.95(fasting blood sugar). CONCLUSION The optimal anthropometric cut-offs for obesity and markers of metabolic syndrome in Ethiopian adults are lower than the international values. The findings imply that the international cut-off for WC, WHtR, WHR and BMI underestimate obesity and metabolic syndrome markers among Ethiopian adults, which should be considered in developing intervention strategies. It is recommended to use the new cut-offs for public health interventions to curb the increasing magnitude of obesity and associated metabolic syndrome and diet related non-communicable diseases in Ethiopia.
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Affiliation(s)
- Makeda Sinaga
- Human Nutrition Unit, Faculty of public Health, Jimma University, PO.BOX: 378, Jimma, Southwest Ethiopia
| | - Meron Worku
- College of Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Tilahun Yemane
- Faculty of Health Sciences, Department of Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Elsah Tegene
- Department of Internal Medicine, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - Tolassa Wakayo
- Human Nutrition Unit, Faculty of public Health, Jimma University, PO.BOX: 378, Jimma, Southwest Ethiopia
| | - Tsinuel Girma
- Department of Paediatrics and Child Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - David Lindstrom
- Population Studies Centre, Brown University, Providence, USA
| | - Tefera Belachew
- Human Nutrition Unit, Faculty of public Health, Jimma University, PO.BOX: 378, Jimma, Southwest Ethiopia
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