1
|
Hatano Y, Sawayama N, Miyashita H, Kurashina T, Okada K, Takahashi M, Matsumoto M, Hoshide S, Sasaki T, Nagashima S, Ebihara K, Mori H, Kario K, Ishibashi S. Sex-specific association of primary aldosteronism with visceral adiposity. J Endocr Soc 2022; 6:bvac098. [PMID: 35822200 PMCID: PMC9268741 DOI: 10.1210/jendso/bvac098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Indexed: 11/19/2022] Open
Abstract
Context The association between primary aldosteronism and obesity, especially its sex difference, remains unknown. Objective To assess the association for each subtype of primary aldosteronism with obesity parameters including visceral adipose tissue and differences between sexes. Methods In this case-control study, 4 normotensive controls were selected for each case with primary aldosteronism. Multivariable conditional logistic regression models were used to estimate the association between each type of primary aldosteronism and obesity indicators. We used a random forest to identify which visceral or subcutaneous tissue areas had a closer association with disease status. Results The study subjects included 42 aldosterone-producing adenoma cases (22 women) and 68 idiopathic hyperaldosteronism cases (42 women). In multivariable conditional logistic regressions, aldosterone-producing adenoma was significantly associated with body mass index only in men (odds ratio [OR] [95% CI)], 4.62 [1.98-10.80] per 2.89 kg/m2) but not in women (OR [95% CI], 1.09 [0.69-1.72] per 3.93 kg/m2) compared with the matched controls, whereas idiopathic hyperaldosteronism was associated with body mass index in both men (OR [95% CI], 3.96 [2.03-7.73] per 3.75 kg/m2) and women (OR [95% CI], 2.65 [1.77-3.96] per 3.85 kg/m2) compared with the matched controls. In random forests, visceral adipose tissue areas were the better predictor of both aldosterone-producing adenoma and idiopathic hyperaldosteronism than subcutaneous adipose tissue. Conclusions Aldosterone-producing adenoma cases were obese among men, but not among women. Idiopathic hyperaldosteronism cases were obese among both men and women. Visceral adipose tissue may contribute to the pathophysiology of primary aldosteronism.
Collapse
Affiliation(s)
- Yu Hatano
- Department of Family Medicine and Community Health, Duke University, 2200 West Main Street , Durham, NC, 27705 USA
| | - Nagisa Sawayama
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Hiroshi Miyashita
- Jichi Medical University Health Care Center, 2-35 Gion, Shimotsuke-shi , Tochigi-ken 329-0493, Japan
| | - Tomoyuki Kurashina
- School of Nursing, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Kenta Okada
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Manabu Takahashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Masatoshi Matsumoto
- Department of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku , Hiroshima 734-8551, Japan
| | - Satoshi Hoshide
- Division of Cardiology, Department of Internal Medicine, Jichi Medial University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Takahiro Sasaki
- Department of Radiology, Jichi Medial University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Shuichi Nagashima
- Department of Endocrinology and Metabolism, Jichi Medical University Saitama Medical center, 1-847 Amanumacho , Omiya-ku, Saitama-shi, Saitama-ken 330-8503, Japan
| | - Ken Ebihara
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medial University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Kazuomi Kario
- Division of Cardiology, Department of Internal Medicine, Jichi Medial University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
| |
Collapse
|
2
|
Association between Three Waist Circumference-Related Obesity Metrics and Estimated Glomerular Filtration Rates. J Clin Med 2022; 11:jcm11102876. [PMID: 35629005 PMCID: PMC9147861 DOI: 10.3390/jcm11102876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
Studies that have assessed the associations between obesity and the estimated glomerular filtration rate (eGFR) have reported inconsistent results. This cross-sectional study was performed to investigate the associations between three waist circumference (WC)-related obesity metrics (waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and waist-to-height0.5 ratio (WHt.5R)) and eGFRs. This study included 2133 men and 3443 women who were older than 40 years with eGFRs ≥ 60 mL/min/1.73 m² from the Korean Multi-Rural Communities Cohort. We calculated the residual body mass index (BMI) to reduce multicollinearity among the obesity metrics and performed multiple linear regression. For both sexes, among the adjusted models, most of the general obesity metrics were significantly associated with eGFRs. Particularly for women, the WC-related and general obesity metrics had a stronger effect on eGFRs in the quartile models that included the BMI and the residual BMI, respectively. When WC-related obesity metrics had a stronger effect than the general obesity metric, for both sexes, WHtR showed a significant impact than WHt.5R and WHR on eGFRs. Reducing multicollinearity had an important role in assessing the obesity metrics’ association with eGFRs. Overall, applying the residual method in further studies might help with evaluating the obesity paradox on renal function.
Collapse
|
3
|
Houghton SC, Eliassen H, Tamimi RM, Willett WC, Rosner BA, Hankinson SE. Central Adiposity and Subsequent Risk of Breast Cancer by Menopause Status. J Natl Cancer Inst 2021; 113:900-908. [PMID: 33367714 PMCID: PMC8491796 DOI: 10.1093/jnci/djaa197] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/25/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Increased body mass index (BMI) is associated with higher postmenopausal breast cancer risk and lower premenopausal breast cancer risk. Less is known about the central adiposity-breast cancer risk association, particularly for tumor subtypes. METHODS We used prospective waist (WC) and hip circumference (HC) measures in the Nurses' Health Studies. We examined associations of WC, HC, and waist-to-hip ratio (WHR) with breast cancer independent of BMI, by menopausal status. Cox proportional hazards models estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for breast cancer risk factors, with and without BMI. RESULTS Adjusting for BMI, WC and HC were not associated, and WHR was positively associated with premenopausal breast cancer risk (WHR, quintile 5 vs 1: HRQ5vQ1, BMI-adjusted = 1.27, 95% CI = 1.04 to 1.54; Ptrend = .01), particularly for estrogen receptor-negative (ER-) and progesterone receptor-negative (PR-) and basal-like breast cancers. Premenopausal WC, HC, and WHR were not associated with postmenopausal breast cancer risk, with or without BMI adjustment. Postmenopausal WC, HC, and WHR were each positively associated with postmenopausal breast cancer (eg, WC HRQ5vsQ1 = 1.59, 95% CI = 1.36 to 1.86); after adjustment for BMI, only WC remained statistically significant (HRQ5vsQ1, BMI-adjusted = 1.38, 95% CI = 1.15 to 1.64; Ptrend = .002). In postmenopausal women, associations were stronger among never-users of hormone therapy and for ER+/PR+ breast cancers. CONCLUSIONS Central adiposity was positively associated with pre- and postmenopausal breast cancers independent of BMI. This suggests that mechanisms other than estrogen may also play a role in the relationship between central adiposity and breast cancer. Maintaining a healthy waist circumference may decrease pre- and postmenopausal breast cancer risk.
Collapse
Affiliation(s)
- Serena C Houghton
- Department of Biostatistics and Epidemiology,
University of Massachusetts Amherst, Amherst, MA, USA
| | - Heather Eliassen
- Channing Division of Network Medicine, Brigham and
Women’s Hospital and Harvard Medical School, Boston, MA,
USA
- Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill
Cornell Medicine, New York, NY, USA
| | - Walter C Willett
- Channing Division of Network Medicine, Brigham and
Women’s Hospital and Harvard Medical School, Boston, MA,
USA
- Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of
Public Health, Boston, MA, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Brigham and
Women’s Hospital and Harvard Medical School, Boston, MA,
USA
- Department of Biostatistics, Harvard T.H. Chan
School of Public Health, Boston, MA, USA
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology,
University of Massachusetts Amherst, Amherst, MA, USA
| |
Collapse
|
4
|
Zheng R, Li M, Xu M, Lu J, Wang T, Dai M, Zhang D, Chen Y, Zhao Z, Wang S, Lin H, Wang W, Bi Y, Xu Y, Ning G. Chinese Adults Are More Susceptible to Effects of Overall Obesity and Fat Distribution on Cardiometabolic Risk Factors. J Clin Endocrinol Metab 2021; 106:e2775-e2788. [PMID: 33570562 DOI: 10.1210/clinem/dgab049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Indexed: 01/19/2023]
Abstract
CONTEXT The body mass index (BMI) and waist circumference (WC) as diagnostic tools of obesity do not reflect the same level of fat mass and whether obesity leads to various effects on cardiometabolic risk factors among different racial/ethnic population is unknown. OBJECTIVE The study aims to address the multicollinearity between BMI and WC by using the residual model approach and to assess and compare the effects of obesity metrics on cardiometabolic risk factors among different races/ethnicities. DESIGN, SETTING, AND PARTICIPANTS Data from a nationally representative sample of mainland Chinese adults collected in 2010 and data from the National Health and Nutrition Evaluation Survey 2005-2016 were used. By conducting a regression analysis between WC and BMI, the variation of BMI was removed from WC measures and residual of WC was obtained. The associations between obesity metrics and cardiometabolic risk factors were compared among different races/ethnicities by sex. RESULTS The residual WC was significantly associated with all the cardiometabolic risk factors in mainland Chinese, and most of the factors in non-Hispanic white and non-Hispanic black adults, but not in the other races/ethnicities. The standardized regression coefficients of the associations between obesity metrics and cardiometabolic factors showed that the obesity metrics had greater impact on systolic blood pressure, diastolic blood pressure, and triglyceride in Chinese adults than those of other racial/ethnic groups. CONCLUSIONS Chinese adults are more susceptible to the effects of overall obesity and fat distribution on cardiometabolic risk factors than the other racial/ethnic population.
Collapse
Affiliation(s)
- Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hong Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
5
|
Medehouenou TCM, Roy C, Tremblay PY, St-Jean A, Meziou S, Muckle G, Ayotte P, Lucas M. Metabolic features of adiposity and glucose homoeostasis among school-aged inuit children from Nunavik (Northern Quebec, Canada). Int J Circumpolar Health 2021; 80:1858605. [PMID: 33395372 PMCID: PMC7801047 DOI: 10.1080/22423982.2020.1858605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In contrast to most Indigenous people in Canada, Inuit appeared until recently to have been protected from type 2 diabetes (T2D) related to obesity. We assessed the associations of metabolites (amino acids, acylcarnitines) with adiposity and biomarkers of T2D in school-aged Inuit children of Nunavik (Canada). Concentrations of metabolite were measured in plasma samples from a cross-sectional analysis of 248 children (mean age = 10.8 years). We assessed associations of plasma metabolites with adiposity measures (BMI, skinfold thicknesses) and T2D markers (insulin, glucose, adiponectin). Plasma concentrations of valine and tyrosine were higher in obese and overweight children compared to those of normal weight children (P < 0.05). An increment of 1-SD in BMI (SD = 3.3 kg/m2) was statistically associated with an increment of 0.21 (95% CI: 0.08, 0.33) for valine, 0.15 (95% CI: 0.02, 0.27) for isoleucine and 0.17 (95% CI: 0.04, 0.29) for tyrosine. Insulin concentration increased with concentrations of all amino acids (P < 0.05) except methionine. None of the acylcarnitines measured were statistically significantly associated with adiposity or T2D biomarkers A signature of metabolites, particularly higher levels of branched-chain amino acids, might allow for early detection of T2D among school-aged Inuit children.
Collapse
Affiliation(s)
- Thierry Comlan Marc Medehouenou
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada
| | - Cynthia Roy
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada.,Centre de Toxicologie du Québec, INSPQ , Québec, Quebec, Canada
| | - Pierre-Yves Tremblay
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada.,Centre de Toxicologie du Québec, INSPQ , Québec, Quebec, Canada
| | - Audray St-Jean
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada
| | - Salma Meziou
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada
| | - Gina Muckle
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada.,School of Psychology, Université Laval , Québec, Quebec, Canada
| | - Pierre Ayotte
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada.,Centre de Toxicologie du Québec, INSPQ , Québec, Quebec, Canada.,Department of Social and Preventive Medicine, Université Laval , Québec, Quebec, Canada
| | - Michel Lucas
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval , Québec, Quebec, Canada.,Department of Social and Preventive Medicine, Université Laval , Québec, Quebec, Canada
| |
Collapse
|
6
|
Davila-Batista V, Molina AJ, Vilorio-Marqués L, Lujan-Barroso L, de Souza-Teixeira F, Olmedo-Requena R, Arias de la Torre J, García-Martínez L, Álvarez-Álvarez L, Freisling H, Llorca J, Delgado-Rodríguez M, Martin V. Net contribution and predictive ability of the CUN-BAE body fatness index in relation to cardiometabolic conditions. Eur J Nutr 2019; 58:1853-1861. [PMID: 29948218 PMCID: PMC6647072 DOI: 10.1007/s00394-018-1743-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/24/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). METHODS The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. RESULTS The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07-1.21) and MetS (OR 1.48, 1.37-1.60), but not with diabetes (OR 1.05, 0.94-1.16). In subjects with a BMI < 25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. CONCLUSIONS The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings.
Collapse
Affiliation(s)
- Veronica Davila-Batista
- The Research Group in Gene-Environment and Health Interactions (GIIGAS), University of León, León, Spain.
- Instituto de Biomedicina (IBIOMED), University of León, León, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- Área de Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Universidad de León, 24071, León, Spain.
| | - Antonio J Molina
- The Research Group in Gene-Environment and Health Interactions (GIIGAS), University of León, León, Spain
- Instituto de Biomedicina (IBIOMED), University of León, León, Spain
| | - Laura Vilorio-Marqués
- The Research Group in Gene-Environment and Health Interactions (GIIGAS), University of León, León, Spain
| | - Leila Lujan-Barroso
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Nursing of Public Health, Mental Health and Maternity and Child Health, School of Nursing, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Fernanda de Souza-Teixeira
- Exercise and Neuromuscular System Research Group, Superior School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Rocío Olmedo-Requena
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Biosanitaria de Granada (Ibs.Granada), Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Jorge Arias de la Torre
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
| | - Lidia García-Martínez
- The Research Group in Gene-Environment and Health Interactions (GIIGAS), University of León, León, Spain
| | - Laura Álvarez-Álvarez
- The Research Group in Gene-Environment and Health Interactions (GIIGAS), University of León, León, Spain
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Javier Llorca
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universidad de Cantabria, IDIVAL, Santander, Spain
| | - Miguel Delgado-Rodríguez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universidad de Jaén, Jaén, Spain
| | - Vicente Martin
- The Research Group in Gene-Environment and Health Interactions (GIIGAS), University of León, León, Spain
- Instituto de Biomedicina (IBIOMED), University of León, León, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| |
Collapse
|
7
|
Shah RV, Anderson A, Ding J, Budoff M, Rider O, Petersen SE, Jensen MK, Koch M, Allison M, Kawel-Boehm N, Wisocky J, Jerosch-Herold M, Mukamal K, Lima JAC, Murthy VL. Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure: The Multi-Ethnic Study of Atherosclerosis. JACC Cardiovasc Imaging 2017; 10:1016-1027. [PMID: 28330662 PMCID: PMC5591038 DOI: 10.1016/j.jcmg.2016.10.024] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/23/2016] [Accepted: 10/27/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The study sought to determine the associations between local (pericardial) fat and incident cardiovascular disease (CVD) events and cardiac remodeling independent of markers of overall adiposity. BACKGROUND The impact of pericardial fat-a local fat depot encasing the heart-on myocardial function and long-term CV prognosis independent of systemic consequences of adiposity or hepatic fat is an area of active debate. METHODS We studied 4,234 participants enrolled in the MESA (Multi-Ethnic Study of Atherosclerosis) study with concomitant cardiac magnetic resonance imaging and computed tomography (CT) measurements for pericardial fat volume and hepatic attenuation (a measure of liver fat). Poisson and Cox regression were used to estimate the annualized risk of incident hard atherosclerotic CVD (ASCVD), all-cause death, heart failure, all-cause CVD, hard coronary heart disease, and stroke as a function of pericardial and hepatic fat. Generalized additive models were used to assess the association between cardiac magnetic resonance indices of left ventricular (LV) structure and function and pericardial fat. Models were adjusted for relevant clinical, demographic, and cardiometabolic covariates. RESULTS MESA study participants with higher pericardial and hepatic fat were more likely to be older, were more frequently men, and had a higher prevalence of cardiometabolic risk factors (including dysglycemia, dyslipidemia, hypertension), as well as adiposity-associated inflammation. Over a median 12.2-year follow-up (interquartile range: 11.6 to 12.8 years), pericardial fat was associated with a higher rate of incident hard ASCVD (standardized hazard ratio: 1.22; 95% confidence interval: 1.10 to 1.35; p = 0.0001). Hepatic fat by CT was not significantly associated with hard ASCVD (standardized hazard ratio: 0.96; 95% confidence interval: 0.86 to 1.08; p = 0.52). Higher pericardial fat was associated with greater indexed LV mass (37.8 g/m2.7 vs. 33.9 g/m2.7, highest quartile vs. lowest quartile; p < 0.01), LV mass-to-volume ratio (1.2 vs. 1.1, highest quartile vs. lowest quartile; p < 0.01). In adjusted models, a higher pericardial fat volume was associated with greater LV mass (p < 0.0001) and concentricity (p < 0.0001). CONCLUSIONS Pericardial fat is associated with poorer CVD prognosis and LV remodeling, independent of insulin resistance, inflammation, and CT measures of hepatic fat.
Collapse
Affiliation(s)
- Ravi V Shah
- Cardiology Division and Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
| | - Amanda Anderson
- Cardiology Division and Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jingzhong Ding
- Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Matthew Budoff
- Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, California
| | - Oliver Rider
- Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, United Kingdom
| | | | - Manja Koch
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Matthew Allison
- Department of Family and Preventative Medicine, University of California-San Diego, San Diego, California
| | - Nadine Kawel-Boehm
- Department of Radiology, Kantonsspital Graubünden, Chur, Switzerland; Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland
| | - Jessica Wisocky
- Cardiology Division and Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Jerosch-Herold
- Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kenneth Mukamal
- Cardiology Division and Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - João A C Lima
- Cardiology Division, Johns Hopkins Medical Institute, Baltimore, Maryland
| | - Venkatesh L Murthy
- Cardiovascular Medicine Division, Department of Medicine, University of Michigan, Ann Arbor, Michigan; Nuclear Medicine Division, Department of Radiology, University of Michigan, Ann Arbor, Michigan; Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Ann Arbor, Michigan.
| |
Collapse
|
8
|
Diet quality indices in relation to metabolic syndrome in an Indigenous Cree (Eeyouch) population in northern Québec, Canada. Public Health Nutr 2017; 21:172-180. [DOI: 10.1017/s136898001700115x] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AbstractObjectiveTo assess associations between three diet quality indices and metabolic syndrome (MetS) in the Cree (Eeyouch) of northern Québec, Canada, as well as to evaluate their pertinence in this Indigenous context.DesignThe alternative-Healthy Eating Index 2010 (aHEI-2010), the Food Quality Score (FQS) and the contribution of ultra-processed products (UPP) to total daily dietary energy intake using the NOVA classification were calculated from 24 h food recalls. MetS was determined with the latest harmonized definition. Logistic regressions assessed the relationship between quintiles of dietary quality scores with MetS and its components.SettingStudy sample from the 2005–2009 cross-sectional Nituuchischaayihititaau Aschii Environment-and-Health Study.SubjectsEeyouch (n 811) from seven James Bay communities (≥18 years old).ResultsMetS prevalence was 56·6 % with 95·4 % abdominal adiposity, 50·1 % elevated fasting plasma glucose, 43·4 % hypertension, 38·6 % elevated TAG and 44·5 % reduced HDL cholesterol. Comparing highest and lowest quintiles of scores, adjusted OR (95 % CI) of MetS was 0·70 (0·39, 1·08; P-trend=0·05) for aHEI-2010, 1·06 (0·63, 1·76; P-trend=0·87) for FQS and 1·90 (1·14, 3·17; P-trend=0·04) for the contribution of UPP to total daily dietary energy intake.ConclusionsAlthough diet quality indices have been associated with cardiometabolic risk, only the dietary intake of UPP was significantly associated with MetS in the Eeyouch. Indices tailored to the food environment of northern communities are essential to further understand the impact of diet quality in this context.
Collapse
|
9
|
Rodríguez López S, Bensenor IM, Giatti L, Molina MDC, Lotufo PA. Association between maternal education and blood pressure: mediation evidence through height components in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Ann Hum Biol 2016; 44:243-251. [DOI: 10.1080/03014460.2016.1188983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Santiago Rodríguez López
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- Research and Study Centre on Culture and Society, National Scientific and Technical Research Council (CIECS-CONICET-UNC), Córdoba, Argentina
- Department of Biology, Autonomous University of Madrid, Madrid, Spain
| | - Isabela M. Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luana Giatti
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | | | - Paulo A. Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
10
|
Santos LP, Ong KK, Day F, Wells JCK, Matijasevich A, Santos IS, Victora CG, Barros AJD. Body shape and size in 6-year old children: assessment by three-dimensional photonic scanning. Int J Obes (Lond) 2016; 40:1012-7. [PMID: 26880232 PMCID: PMC4899819 DOI: 10.1038/ijo.2016.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 12/11/2015] [Accepted: 12/22/2015] [Indexed: 02/06/2023]
Abstract
Background: Body shape and size are typically described using measures such as body mass index (BMI) and waist circumference, which predict disease risks in adults. However, this approach may underestimate the true variability in childhood body shape and size. Objective: To use a comprehensive three-dimensional photonic scan approach to describe variation in childhood body shape and size. Subjects/Methods: At age 6 years, 3350 children from the population-based 2004 Pelotas birth cohort study were assessed by three-dimensional photonic scanner, traditional anthropometry and dual X-ray absorptiometry. Principal component analysis (PCA) was performed on height and 24 photonic scan variables (circumferences, lengths/widths, volumes and surface areas). Results: PCA identified four independent components of children's body shape and size, which we termed: Corpulence, Central:peripheral ratio, Height and arm lengths, and Shoulder diameter. Corpulence showed strong correlations with traditional anthropometric and body composition measures (r>0.90 with weight, BMI, waist circumference and fat mass; r>0.70 with height, lean mass and bone mass); in contrast, the other three components showed weak or moderate correlations with those measures (all r<0.45). There was no sex difference in Corpulence, but boys had higher Central:peripheral ratio, Height and arm lengths and Shoulder diameter values than girls. Furthermore, children with low birth weight had lower Corpulence and Height and arm lengths but higher Central:peripheral ratio and Shoulder diameter than other children. Children from high socio-economic position (SEP) families had higher Corpulence and Height and arm lengths than other children. Finally, white children had higher Corpulence and Central:peripheral ratio than mixed or black children. Conclusions: Comprehensive assessment by three-dimensional photonic scanning identified components of childhood body shape and size not captured by traditional anthropometry or body composition measures. Differences in these novel components by sex, birth weight, SEP and skin colour may indicate their potential relevance to disease risks.
Collapse
Affiliation(s)
- L P Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK
| | - K K Ong
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK
| | - F Day
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK
| | - J C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - A Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - I S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - C G Victora
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - A J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|