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Chen L, Wang X, Lin TZ, Xiang H, Liu H, Xu S, Yue J, Wu C. Steps to developing a DXA-based risk score for cardiovascular outcomes among older adults: the health, aging, and body composition study. Sci Rep 2024; 14:23311. [PMID: 39375399 PMCID: PMC11458873 DOI: 10.1038/s41598-024-74185-y] [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: 04/02/2024] [Accepted: 09/24/2024] [Indexed: 10/09/2024] Open
Abstract
Cardiovascular disease (CVD) is a major chronic disease worldwide and its risk factors have long been investigating in epidemiological studies. Our study aims to develop a body composition-based risk score and integrate it into the Framingham Risk Score (FRS) to improve CVD prediction among well-functioning older adults. We included 1882 older adults from the Health, Aging and Body Composition (Health ABC) study to screen body composition variables obtained from the Dual-energy X-ray absorptiometry (DXA). Three models were developed and compared: the 4-DXA model, the refit FRS, and the refit FRS plus 4-DXA model. C-statistics were 0.62 (95% CI: 0.59, 0.65) for the refit FRS, 0.58 (95% CI: 0.55, 0.61) for the 4-DXA model, and 0.63 (95% CI: 0.60, 0.66) for the refit FRS plus 4-DXA model. Compared to the refit FRS, the refit FRS plus 4-DXA model slightly improved CVD outcome prediction as the discrimination slope, net reclassification index, and the integrated discrimination index were 0.053 (95% CI: 0.041, 0.066), 0.098 (95% CI = - 0.0033, 0.20) and 0.013 (95% CI: 0.0069-0.019). This study provides a model for more accurate risk stratification and draws more attention on DXA-based indices in the clinical setting. It also encourages further research in validating the developed risk score in more diverse population and in investigating a broader range of CVD risk factors.
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Affiliation(s)
- Lihui Chen
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
| | - Xinran Wang
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
| | - Tian-Ze Lin
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Hua Liu
- Department of Neurosurgery, The Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Shen Xu
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, 8 Duke Avenue, Kunshan, 215316, Jiangsu, China.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
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Islam MT, Chowdhury AT, Siraj MS, Md Abdullah AY, Mazumder T, Trask M, Talukder MR, Rahman SM. Anthropometric indices in predicting 10-year cardiovascular risk among males and females aged 40-74 years in south and southeast Asia: analysis of 12 WHO STEPS survey data. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 29:100481. [PMID: 39315383 PMCID: PMC11418002 DOI: 10.1016/j.lansea.2024.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/22/2024] [Accepted: 08/30/2024] [Indexed: 09/25/2024]
Abstract
Background The relevance of anthropometric indices in predicting cardiovascular disease (CVD) or CVD risk factors is established across different countries, particularly in the high-income countries. However, past studies severely lacked representation from the south and southeast Asian countries. The main aim of this study was to determine the performance of conventional and new anthropometric indices to best predict 10-year cardiovascular disease (CVD) risk in south Asian and southeast Asian populations. Methods The present study examined data from 14,532 participants in three south Asian and 13,846 participants (all aged between 40 and 74 years) in six southeast Asian countries, drawn from twelve cross-sectional studies (WHO STEPwise approaches to NCD risk factor surveillance [STEPS] survey data from 2008 to 2019). A Predictive performance of ten anthropometric indices were examined for predicting 10-year CVD risk ≥ 10% (CVD-R ≥ 10%). The 10-year CVD-R ≥ 10% was calculated by utilising the WHO CVD risk non-laboratory-based charts. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal anthropometric index. Findings Among the ten anthropometric indices, a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), hip index (HI), and waist-height ratio (WHtR) performed best in predicting 10-year CVD risk among south Asian males and females. Improved performances were found for ABSI, BRI, conicity index (CI), WHtR, and waist-hip ratio (WHR) for 10-year CVD-R ≥ 10% predictions among southeast Asian males. Contrastingly, among southeast Asian females, ABSI and CI demonstrated optimal performance in predicting 10-year CVD-R ≥ 10%. Interpretation The performance of anthropometric indices in predicting CVD risk varies across countries. ABSI, BAI, BRI, HI, and WHtR showed better predictions in south Asians, whereas ABSI, BRI, CI, WHtR, and WHR displayed enhanced predictions in southeast Asians. Funding None.
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Affiliation(s)
- Md Tauhidul Islam
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia
| | - Anika Tasneem Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, 1212, Bangladesh
| | - Md Shahjahan Siraj
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, 1212, Bangladesh
| | | | - Tapas Mazumder
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, 2617, Australia
| | - Mercedes Trask
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Sweden
| | - Mohammad Radwanur Talukder
- Blood Cancer Partnership Segment, The Leukaemia Foundation, Adelaide, Australia
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
| | - Syed Moshfiqur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, 1212, Bangladesh
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Sweden
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Rathnayake N, Alwis G, Lenora J, Lekamwasam S. Associations between body composition and cardiovascular disease risk in pre- and postmenopausal women. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:110. [PMID: 37848999 PMCID: PMC10583431 DOI: 10.1186/s41043-023-00455-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/25/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Menopause transition is a critical phase of women's life since body composition and cardiovascular risk factors begin to change during this period. This study investigated the associations between body composition and cardiovascular disease risk (CVDR) in pre (PrMW) and postmenopausal women (PMW). METHODS A community-based cross-sectional study involving 184 PrMW and 166 PMW, selected randomly from Bope-Poddala area in Galle, Sri Lanka was carried out. Total-body fat mass (TBFM, kg), total body skeletal muscle mass (TBSMM, kg), total body bone mineral density (TBBMD, g/cm2) and total body bone mineral content (TBBMC, g) were measured with total body DXA scanner and they were taken as indices of body composition. CVDR was evaluated using Framingham risk score (FRS%) and individual CVDR factors, such as systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), fasting blood sugar (FBS, mg/dl), total cholesterol, (TC, mg/dl), tryglycerides (TG, mg/dl), high-density lipoprotein (HDL, mg/dl) and low-density lipoprotein (LDL, mg/dl). Correlations between indices of body composition and CVDR factors were assessed with adjusted partial correlation (adjusted for socio-demographic and gynecologic status, age, daily calorie consumption and physical activity level). RESULTS Mean(SD) age of PrMW and PMW were 42.4(6.0) and 55.8(3.8) years respectively. TBFM correlated with SBP and DBP (r range; 0.15 to 0.21) and TBSMM correlated with SBP, DBP and HDL (r range; - 0.24 to 0.17) only in PrMW (p < 0.05). TBBMD correlated only with FBS in PMW (r; - 0.21, p = 0.01). TBBMC did not show correlations with CVDR factors (p > 0.05). Body composition indices did not show correlations with total CVDR estimated by FRS and in both groups of women (p > 0.05). CONCLUSIONS Both SBP and DBP are associated with FM and SMM in different ways among PrMW. This association, however, was not seen among PMW. FBS is associated with BMD only in PMW.
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Affiliation(s)
- Nirmala Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Matara, Sri Lanka.
| | - Gayani Alwis
- Department of Anatomy, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | - Janaka Lenora
- Department of Physiology, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | - Sarath Lekamwasam
- Population Health Research Centre, Department of Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
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Duangjai A, Phanthurat N, Sajjapong W, Ontawong A, Pengnet S, Yosboonruang A, Jongsomchai K, Thatsanasuwan N. Association of abdominal obesity and systolic blood pressure indices with cardiovascular disease risk prediction among community-dwelling older adults. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
<b>Background:</b> Excess adiposity is an established risk factor for cardiovascular disease (CVD), therefore the early screening indies with predicted CVD risk is more useful for older adults. The current study evaluated the associations between anthropometric, body composition and dietary indices and elevated 10-year CVD risk in older people.<br />
<b>Methods:</b> This research, which involved 55 to 94-year-olds living in the community. Standard techniques were used to determine anthropometric factors and body composition indicators. The risk prediction chart created by World Health Organization and International Society of Hypertension was used to calculate the CVD risk score. Odds ratio (OR) and 95% confidence interval (CI) were determined.<br />
<b>Results:</b> CVD risk prediction was positively correlated with the anthropometric and body composition parameters. After controlling for confounding variables, the logistic regression analysis revealed that waist circumference (OR=16.34; 95% CI: 7.22, 36.98; <i>p</i><0.001), systolic blood pressure (BP) (OR=9.53; 95% CI: 4.52, 20.07; <i>p</i><0.001), and visceral adipose tissue percentage (OR=5.47; 95% CI: 2.98, 10.01; <i>p</i><0.001) were correlated with cardiovascular risk prediction.<br />
<b>Conclusions:</b> Abdominal obesity and increase of systolic BP were associated to increased risk for CVD. Additionally, a positive association between the risk factors for CVD (%visceral adipose tissue) and diet (cholesterol consumption) was established.
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Affiliation(s)
- Acharaporn Duangjai
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Naritsara Phanthurat
- Division of Nutrition and Dietetics, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Wittawas Sajjapong
- Division of Nutrition and Dietetics, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Atcharaporn Ontawong
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Sirinat Pengnet
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Atchariya Yosboonruang
- Division of Microbiology, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Kamonwan Jongsomchai
- Division of Anatomy, School of Medical Sciences, University of Phayao, Phayao, THAILAND
| | - Natthaphon Thatsanasuwan
- Division of Nutrition and Dietetics, School of Medical Sciences, University of Phayao, Phayao, THAILAND
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do Prado CB, Martins CA, Cremonini ACP, Ferreira JRS, Cattafesta M, Almeida-de-Souza J, Zandonade E, Bezerra OMDPA, Salaroli LB. Cut Points of the Conicity Index and Associated Factors in Brazilian Rural Workers. Nutrients 2022; 14:4487. [PMID: 36364746 PMCID: PMC9654182 DOI: 10.3390/nu14214487] [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: 10/06/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Metabolic syndrome is associated with cardiovascular complications. Therefore, this study aims to establish cut points for the conicity index based on the components of metabolic syndrome and to associate it with characteristic sociodemographic, food consumption and occupational factors in Brazilian rural workers; (2) Methods: A cross-sectional study carried out with farmers. The receiver operating characteristic curve was calculated and the cut-off points for the conicity index were identified by the area under the curve, sensitivity and specificity. The variables included in the binary logistic regression analysis were selected by considering p < 0.20 in the bivariate test; (3) Results: The cut points were similar in females according to both criteria, resulting in a single cut-off of 1.269. In males, the cut points showed differences, resulting in 1.272 according to the NCEP-ATP III and 1.252 according to the IDF. We have shown that younger people, those who work more than 40 h a week and the lowest contribution of culinary ingredients are associated with increased odds of abdominal obesity, while the consumption of the products they sell or produce decreases these chances; (4) Conclusions: The conicity index showed high discriminatory power for the identification of abdominal obesity in rural workers. Therefore, there is a need to improve eating habits and promote healthier eating environments for individuals, respecting traditional food culture, mainly to contain the advance of MS in rural areas.
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Affiliation(s)
- Camila Bruneli do Prado
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Cleodice Alves Martins
- Graduate Program Nutrition and Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | | | - Júlia Rabelo Santos Ferreira
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Monica Cattafesta
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Juliana Almeida-de-Souza
- Centro de Investigação de Montanha (CIMO), Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-25 Bragança, Portugal
| | - Eliana Zandonade
- Graduate Program Collective Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil
| | - Olívia Maria de Paula Alves Bezerra
- Departament of Family Medicine, Mental and Collective Health, Medical School, Federal University of Ouro Preto, Ouro Preto 35400-000, MG, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program Collective Health and Graduate Program Nutrition and Health, Health Sciences, Federal University of Espírito Santo, Espírito Santo 29075-910, ES, Brazil;
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Chi JH, Lee BJ. Risk factors for hypertension and diabetes comorbidity in a Korean population: A cross-sectional study. PLoS One 2022; 17:e0262757. [PMID: 35045123 PMCID: PMC8769319 DOI: 10.1371/journal.pone.0262757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/04/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Hypertension and diabetes are risk factors for severe cardiovascular disease and are prevalent comorbidities. No studies have examined the associations of various risk factors related to anthropometry, bone mineral density and body composition of specific body regions with hypertension and diabetes comorbidity (HDC). This study explored the association between HDC and various risk factors related to specific body regions. METHOD A total of 7,978 subjects (3,451 men and 4,527 women) aged ≥ 50 years were included in the analysis. A binary logistic regression analysis based on complex sample data analysis was conducted to examine associations between the normal and diabetes groups, between the normal and hypertension groups, and between the normal and HDC groups. RESULTS Among Korean adults aged ≥ 50 years, 11.27% of men and 10.05% of women had both diabetes and hypertension. The HDC prevalence was higher in men than in women. In men, waist-to-height ratio (WHtR, adjusted OR = 1.63 [1.22-2.18], adjusted p<0.001) exhibited a more significant association with HDC than other indices, left leg fat mass (adjusted OR = 0.61 [0.45-0.81], adjusted p = 0.0009) and right leg fat mass (adjusted OR = 0.60 [0.45-0.81], adjusted p = 0.0007) displayed strong negative associations with diabetes, and left leg lean mass (adjusted OR = 0.77 [0.67-0.89], adjusted p = 0.0002) and trunk fat mass (adjusted OR = 1.28 [1.07-1.52], adjusted p = 0.0062) were significantly associated with hypertension. In women, left leg fat mass (adjusted OR = 0.29 [0.22-0.39], adjusted p<0.0001) and right leg fat mass (adjusted OR = 0.32 [0.23-0.45], adjusted p<0.0001) exhibited strong negative associations with HDC, waist circumference (WC) (adjusted OR = 2.15 [1.40-3.30], adjusted p = 0.0005) showed a stronger association with diabetes than did other indices, and WC (adjusted OR = 1.39 [1.11-1.74], adjusted p = 0.0040) and WHtR (adjusted OR = 1.39 [1.09-1.76], adjusted p = 0.0075) were significantly associated with hypertension. DISCUSSION HDC was more strongly associated with fat and lean mass than diabetes and hypertension. The association between HDC and body fat variables was more robust in women than in men.
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Affiliation(s)
- Jeong Hee Chi
- Department of Computer Science and Engineering, Konkuk University, Seoul, Republic of Korea
| | - Bum Ju Lee
- Digital Health Research Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
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Bramhankar M, Pandey M, Rana GS, Rai B, Mishra NL, Shukla A. An assessment of anthropometric indices and its association with NCDs among the older adults of India: evidence from LASI Wave-1. BMC Public Health 2021; 21:1357. [PMID: 34238276 PMCID: PMC8268209 DOI: 10.1186/s12889-021-11421-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to assess the status of physical body indices such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) among the older adults aged 45 and above in India. Further, to explore the association of anthropometric indices with various non-communicable morbidities. METHODS The study uses secondary data of the Longitudinal Ageing Survey's first wave in India (2017-18). The national representative sample for older adults 45 and above (65,662) considered for the analysis. The prevalence of the non-communicable diseases (NCDs) included in the study is based on the self-reporting of the participants. Diseases included are among the top ten causes of death, such as cancer, hypertension, stroke, chronic heart diseases, diabetes, chronic respiratory diseases, and multi-morbidity. Multi-morbidity is a case of having more than one of the morbidities mentioned above. BMI-obese indicates an individual having a BMI ≥30, and the critical threshold value for high-risk WC for men is ≥102 cm while for women is ≥88 cm. The critical limit for the high-risk WHR for men and women is ≥0.90 and ≥ 0.85, respectively. Descriptive statistics and multiple logistic regressions are used to assess the association BMI, WC, and WHR with non-communicable morbidities. RESULTS Based on the multivariate-adjusted model, odds shows that an Indian older adult aged 45 and above is 2.3 times more likely (AOR: 2.33; 95% CI (2.2, 2.5)) by obesity, 61% more likely (AOR: 1.61; 95% CI (1.629, 1.631)) by high-risk WHR and 98% more likely (AOR: 1.98; 95% CI (1.9, 2.1)) by high-risk WC to develop CVDs than their normal counterparts. Similarly, significant positive associations of obesity, high-risk WC, and high-risk WHR were observed with other NCDs and multi-morbidity. CONCLUSION Our study shows that obesity, high-risk WC, and high-risk WHR are significant risks for developing NCDs and multi-morbidity among the older adults in India. There is a need for a multi-sectoral approach to reduce the share of the elderly population in high-risk groups of BMIs, WHR, and WC.
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Affiliation(s)
| | - Mohit Pandey
- International Institute For Population Sciences, Mumbai, 400088 India
| | | | - Balram Rai
- International Institute For Population Sciences, Mumbai, 400088 India
| | - Nand Lal Mishra
- International Institute For Population Sciences, Mumbai, 400088 India
| | - Anandi Shukla
- International Institute For Population Sciences, Mumbai, 400088 India
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Hachbardt NB, Hattori TY, do Nascimento VF, da Silva JH, Terças-Trettel ACP, Oliveira VKV, Atanaka M. Cardiovascular Risk in Women Deprived of Freedom from a Public Prison in Mato Grosso, Brazil. High Blood Press Cardiovasc Prev 2020; 27:139-150. [PMID: 32144728 DOI: 10.1007/s40292-020-00365-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/25/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases occur worldwide and have progressively affected the female sex, without distinction of life context; however, the prison environment may intensify the risk of developing them. AIM To evaluate the cardiovascular risk in women deprived of freedom from a public prison in Mato Grosso, Brazil. METHODS This is a quantitative, cross-sectional and analytical study performed with all incarcerated women from the prison institution in the second half of the years 2016, 2017 and 2018, through a structured questionnaire and statistical analysis through the RStudio. RESULTS The results showed that, although participants presented low cardiovascular risk, the BMI values pointed to overweight in all the years analyzed, in addition to the waist-to-height ratio, conicity index, waist circumference and waist-hip ratio presenting similar means or that transcend the established cutoff point. There was an association between the anthropometric variables and age, conjugal status, education, alcoholism, systolic blood pressure, metabolic complications, sleep and a family history of non-communicable chronic diseases. The BMI variable showed association with all anthropometric variables related to cardiovascular risk, except to WHR. CONCLUSION When considering the ambience factor, modifiable risk factors may negatively influence the long-term health of these women, particularly in relation to the cardiovascular system. The found scenario, in relation to the cardiovascular risk, points to the need for interventions, regarding the clinical condition and life-styles adopted by this population.
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Affiliation(s)
| | - Thalise Yuri Hattori
- Nursing Department, State University of Mato Grosso, Tangará da Serra, Mato Grosso, Brazil
| | | | | | - Ana Cláudia Pereira Terças-Trettel
- Nursing Department, State University of Mato Grosso, Tangará da Serra, Mato Grosso, Brazil.
- Postgraduate Program in Collective Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil.
| | | | - Marina Atanaka
- Postgraduate Program in Collective Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil
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Comparison of anthropometric indices as predictors of the risk factors for cardiovascular disease in Iran: The PERSIAN Guilan Cohort Study. Anatol J Cardiol 2020; 25:120-128. [PMID: 33583819 DOI: 10.14744/anatoljcardiol.2020.73557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults. METHODS A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), conicity index, hip circumference (HC), waist to hip to height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out of range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model. RESULTS The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high density lipoprotein cholesterol (HDL C) and high low density lipoprotein cholesterol (LDL C) was found in an increase in the WHR and ABSI, respectively. CONCLUSION Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL C/HDL C ratio.
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Skinfold thickness and the incidence of type 2 diabetes mellitus and hypertension: an analysis of the PERU MIGRANT study. Public Health Nutr 2019; 23:63-71. [PMID: 31159908 DOI: 10.1017/s1368980019001307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the association between excess body fat, assessed by skinfold thickness, and the incidence of type 2 diabetes mellitus (T2DM) and hypertension (HT). DESIGN Data from the ongoing PERU MIGRANT Study were analysed. The outcomes were T2DM and HT, and the exposure was skinfold thickness measured in bicipital, tricipital, subscapular and suprailiac areas. The Durnin-Womersley formula and SIRI equation were used for body fat percentage estimation. Risk ratios and population attributable fractions (PAF) were calculated using Poisson regression. SETTING Rural (Ayacucho) and urban shantytown district (San Juan de Miraflores, Lima) in Peru. PARTICIPANTS Adults (n 988) aged ≥30 years (rural, rural-to-urban migrants, urban) completed the baseline study. A total of 785 and 690 were included in T2DM and HT incidence analysis, respectively. RESULTS At baseline, age mean was 48·0 (sd 12·0) years and 47 % were males. For T2DM, in 7·6 (sd 1·3) years, sixty-one new cases were identified, overall incidence of 1·0 (95 % CI 0·8, 1·3) per 100 person-years. Bicipital and subscapular skinfolds were associated with 2·8-fold and 6·4-fold risk of developing T2DM. On the other hand, in 6·5 (sd 2·5) years, overall incidence of HT was 2·6 (95 % CI 2·2, 3·1) per 100 person-years. Subscapular and overall fat obesity were associated with 2·4- and 2·9-fold risk for developing HT. The PAF for subscapular skinfold was 73·6 and 39·2 % for T2DM and HT, respectively. CONCLUSIONS We found a strong association between subscapular skinfold thickness and developing T2DM and HT. Skinfold assessment can be a laboratory-free strategy to identify high-risk HT and T2DM cases.
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Quaye L, Owiredu WKBA, Amidu N, Dapare PPM, Adams Y. Comparative Abilities of Body Mass Index, Waist Circumference, Abdominal Volume Index, Body Adiposity Index, and Conicity Index as Predictive Screening Tools for Metabolic Syndrome among Apparently Healthy Ghanaian Adults. J Obes 2019; 2019:8143179. [PMID: 31565431 PMCID: PMC6745169 DOI: 10.1155/2019/8143179] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/21/2019] [Accepted: 08/10/2019] [Indexed: 12/17/2022] Open
Abstract
The prevalence of the metabolic syndrome (MetS) continues to increase. There is therefore the need for early detection to avert possible adverse outcomes. Several anthropometric methods have been suggested to predict MetS, but no consensus has been reached on which is best. The aim of the study was to explore the comparative abilities of conicity index, body adiposity index, abdominal volume index, body mass index, and waist circumference in predicting cardiometabolic risk among apparently healthy adults in the Tamale metropolis. This study was a cross sectional study conducted from September 2017 to January 2018, among one hundred sixty (160) apparently healthy normoglycemic normotensive adults. A self-designed questionnaire was administered to gather sociodemographic data. Anthropometric and haemodynamic measurements were also taken. Blood samples were collected for fasting blood glucose (FBG) and lipid profile. MetS was classified using the harmonised criteria as indicated by the joint interim statement (JIS). Of 160 participants, 42.5% were male and 57.5% were female. Body mass index (BMI) and waist circumference (WC) associated better with MetS and other cardiovascular risk factors. Generally, BMI and WC showed largest area under curves (AUCs) than abdominal volume index (AVI), body adiposity index (BAI), and conicity index (CI) in predicting MetS and its components. Upon gender stratification, AVI and CI had the larger AUCs in females whiles BMI remained the superior index in males. Whiles BMI and WC remained useful parameters, they were not useful in predicting MetS and its components in the female population in this study.
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Affiliation(s)
- Lawrence Quaye
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | | | - Nafiu Amidu
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | | | - Yussif Adams
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
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Klisić A, Kavarić N, Bjelaković B, Jovanović M, Zvrko E, Stanišić V, Ninić A, Šćepanović A. Cardiovascular Risk Assessed by Reynolds Risk Score in Relation to Waist Circumference in Apparently Healthy Middle-Aged Population in Montenegro. Acta Clin Croat 2018; 57:22-30. [PMID: 30256008 PMCID: PMC6400353 DOI: 10.20471/acc.2018.57.01.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
SUMMARY – Reynolds Risk Score (RRS) is regarded as a good screening tool for cardiovascular disease (CVD) risk. Since CVD is the leading cause of death in Montenegro, we aimed to assess the risk of CVD as assessed by RRS and to examine its association with cardiometabolic parameters in apparently healthy middle-aged population. In addition, we aimed to test whether obesity had an independent influence on RRS. A total of 132 participants (mean age 56.2±6.73 years, 69% females) were included. Body mass index (BMI), waist circumference (WC), blood pressure (BP) and biochemical parameters (fasting glucose, insulin, lipid parameters, creatinine and high sensitivity C-reactive protein) were determined. Insulin resistance (HOMA-IR) and glomerular filtration rate (eGFR) were calculated. Compared with females, a significantly higher number of males were in the high RRS subgroup (χ2=45.9, p<0.001). Furthermore, significantly higher fasting glucose (p=0.030), insulin, HOMA-IR, triglycerides (p<0.001 all), anthropometric parameters (e.g., BMI and WC; p=0.004 and p<0.001, respectively), and creatinine, but lower eGFR and HDL-c (p<0.001 both) were recorded in the high-risk subgroup compared with low and medium risk subgroups. In all participants, in addition to LDL-c, diastolic BP and creatinine, WC was independently positively associated with RRS (β=0.194, p=0.006; β=0.286, p=0.001; β=0.267, p=0.001; and β=0.305, p=0.019, respectively), and 40% of variation in RRS could be explained with this model. In conclusion, middle-aged population with higher WC should be screened for RRS in order to estimate CVD risk.
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Affiliation(s)
| | | | - Bojko Bjelaković
- University Department of Pediatrics, Faculty of Medicine, University of Niš, Niš, Serbia
| | | | - Elvir Zvrko
- Clinical Center of Montenegro, Podgorica, Montenegro
| | | | - Ana Ninić
- Department of Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
| | - Anđelka Šćepanović
- Department of Biology, Faculty of Natural Science and Mathematics, University of Montenegro, Podgorica, Montenegro
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Salari A, Shakiba M, Mahdavi-Roshan M, Gholipour M, Naghshbandi M, Rajabi R. The association between various indices of obesity and severity of atherosclerosis in adults in the north of Iran. Medicine (Baltimore) 2016; 95:e5670. [PMID: 27977617 PMCID: PMC5268063 DOI: 10.1097/md.0000000000005670] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Recent observational studies have reported controversial results for the association between different anthropometric indices of obesity and severity of atherosclerosis. The aim of the current study is to determine the associations between anthropometric indices with severity of atherosclerosis in adult population in north of Iran.The cross-sectional study was performed on 610 participants, who were admitted to a hospital for elective angiographyin Rasht, Iran, Anthropometric indices, including waist circumference (WC), waist-to-height ratio (WHtR), conicity index (CI), body mass index (BMI), and hematological factors, were measured using the standard methods. According to angiography reports, severity of atherosclerosis was determined.Sixty-two percent of participants had moderate to severe atherosclerosis. According to BMI, 44% were overweight and 25.8% were obese. Based on WHtR and WC, 90%, and 57% were obese, respectively. The prevalence of moderate to severe atherosclerosis in centrally obese women was significantly higher than in centrally nonobese women (52% vs 28% P = 0.02). According to multivariate adjustment analysis, age, sex, systolic blood pressure, hemoglobin A1c, uric acid, and triglyceride were independently associated with severity of atherosclerosis. BMI, WC, CI, and WHtR had no significant association with severity of atherosclerosis.Our findings showed that anthropometric indices reflective of general and abdominal obesity were not independently related to the severity of atherosclerosis in adults, in northern Iran.
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Affiliation(s)
- Arsalan Salari
- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center
| | - Maryam Shakiba
- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center
| | - Marjan Mahdavi-Roshan
- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahboobeh Gholipour
- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center
| | - Moona Naghshbandi
- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center
| | - Ramin Rajabi
- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center
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Pigłowska M, Kostka T, Drygas W, Jegier A, Leszczyńska J, Bill-Bielecka M, Kwaśniewska M. Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome--a 25 year cohort study. Lipids Health Dis 2016; 15:84. [PMID: 27117476 PMCID: PMC4847354 DOI: 10.1186/s12944-016-0249-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 04/14/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The purpose of this analysis was to investigate the relationship between body composition, metabolic parameters and endothelial function among physically active healthy middle-aged and older men. METHODS Out of 101 asymptomatic men prospectively tracked for traditional cardiovascular risk factors (mean observation period 25.1 years), 55 metabolically healthy individuals who maintained stable leisure time physical activity (LTPA) level throughout the observation and agreed to participate in the body composition assessment were recruited (mean age 60.3 ± 9.9 years). Body composition and raw bioelectrical parameters were measured with bioelectrical impedance analysis (BIA). Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. RESULTS Strong correlations were observed between lifetime physical activity (PA), aerobic fitness and most of analyzed body composition parameters. The strongest inverse correlation was found for fat mass (p < 0.01) while positive relationship for fat-free mass (p < 0.01), total body water (p < 0.05 for current aerobic capacity and p < 0.01 for historical PA), body cell mass (p < 0.001), muscle mass (p < 0.001), calcium and potassium (p < 0.01 and p < 0.001 for current aerobic capacity and p < 0.001 and p < 0.01 for historical PA, respectively) and glycogen mass (p < 0.001). Among metabolic parameters, HDL cholesterol (HDL-C) and uric acid were significantly associated with most body composition indicators. Regarding endothelial function, a negative correlation was found for RHI and body mass (p < 0.05) while positive relationship for RHI and body cell mass (p < 0.05), calcium (p < 0.05) and potassium mass (p < 0.05). Impaired endothelial function was observed among 8 subjects. Among bioelectrical parameters, impedance (Z) and resistance (R) normalized for subjects' height were negatively related with body mass, body mass index (BMI) and waist circumference (p < 0.001); while reactance (Xc) normalized for patients' height was negatively related with body mass (p < 0.05). The mean phase angle value was relatively high (8.83 ± 1.22) what reflects a good level of cellularity and cell function. Phase angle was positively related with body mass and BMI (p < 0.05). CONCLUSIONS Both fat mass and muscle mass components are important predictors of metabolic profile. Maintaining regular high PA level and metabolically healthy status through young and middle adulthood may have beneficial influence on body composition parameters and may prevent age-related decrease of fat-free mass and endothelial dysfunction.
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Affiliation(s)
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Lodz, Poland
| | - Wojciech Drygas
- Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752, Lodz, Poland
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland
| | - Anna Jegier
- Department of Sports Medicine, Medical University of Lodz, 92-213, Lodz, Poland
| | - Joanna Leszczyńska
- Department of Sports Medicine, Medical University of Lodz, 92-213, Lodz, Poland
| | | | - Magdalena Kwaśniewska
- Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752, Lodz, Poland.
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