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Hu F, Zhou W, Wang T, Yu C, Zhu L, Bao H, Cheng X. Association between six different types of anthropometric indices and arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive Chinese adults. Heliyon 2024; 10:e28523. [PMID: 38601660 PMCID: PMC11004534 DOI: 10.1016/j.heliyon.2024.e28523] [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: 12/18/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
Background The associations of body fat parameters with arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive patients were scarce. Methods This cross-sectional study analyzed 4322 hypertensive adults. The correlations between the anthropometric indexes (body mass index [BMI], waist circumference, waist-tohip ratio [WHR], waist-to-height ratio [WHtR], a body shape index [ABSI], body round index [BRI]) and ba-PWV values were analyzed using multivariable linear regression model. Results In both sex categories, linear regression models showed that BMI levels were inversely related to baPWV (adjusted-β per SD increase in male: -0.51, 95% CI -0.66 to -0.36, P < 0.001; female: -0.50, 95% CI -0.63 to -0.37, P < 0.001). Waist circumference positively correlated with baPWV only in male hypertensive individuals. BaPWV positively correlated to WHR or WHtR levels (adjusted-β per SD increase: 0.32, 95% CI 0.21 to 0.43, P < 0.001; 0.64, 95% CI 0.47 to 0.82, P < 0.001; respectively), ABSI (adjusted-β per SD increase for ABSI × 100: 0.27, 95% CI 0.18 to 0.36, P < 0.001) and BRI (adjusted-β per SD increase: 0.64, 95% CI 0.46 to 0.81, P < 0.001) levels. The relationship between anthropometric indices and arterial stiffness based on baPWV values were also consistent. ABSI had the highest predictive power of arterial stiffness (area under the curve, 0.594; P < 0.001). Conclusion In Chinese adults with hypertension, BMI was inversely related to baPWV, while WHR, WHtR, ABSI and BRI were positively related. Waist circumference positively correlated with baPWV only in male hypertensive individuals.
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Affiliation(s)
- Feng Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, 350000, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Minato-Inokawa S, Honda M, Tsuboi-Kaji A, Takeuchi M, Kitaoka K, Kurata M, Wu B, Kazumi T, Fukuo K. Higher childhood weight gain, lower skeletal muscle mass, and higher cereal consumption in normal-weight Japanese women with high-percentage trunk fat: a subanalysis study. Diabetol Int 2024; 15:194-202. [PMID: 38524938 PMCID: PMC10959877 DOI: 10.1007/s13340-023-00670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/19/2023] [Indexed: 03/26/2024]
Abstract
Normal-weight but high-percentage trunk fat phenotype was characterized in a setting where adiposity is not associated with educational and socioeconomic status. Body size trajectory since birth, current body composition measured using whole-body dual-energy X-ray absorptiometry, cardiometabolic traits, serum adipokines, and dietary intake were measured cross-sectionally in 251 normal weight Japanese female university students whose fasting triglyceride and homeostasis model assessment-insulin resistance (HOMA-IR) averaged 56 mg/dL and 1.2, respectively. They were grouped according to tertile of percentage trunk fat. Although HOMA-IR did not differ among three groups, high-percentage trunk fat was associated with higher triglyceride and apolipoprotein B, and lower HDL cholesterol and apolipoprotein A1. In multivariate logistic regression analyses, weight-adjusted skeletal muscle mass (OR: 0.13, 95% CI: 0.04-0.38, p < 0.001), weight gain from birth to age 12 years (OR: 1.214、95% CI: 1.008-1.463、p = 0.04), and cereal consumption (OR:1.008, 95% CI: 1.000-1.016, p = 0.04) were associated with high-percentage trunk fat independent of birthweight, HOMA-IR, adipose tissue-insulin resistance index (the product of fasting insulin and free fatty acid), triglyceride, HDL cholesterol, apolipoprotein A1 and B, leptin, adiponectin, blood pressure, and high-sensitivity C-reactive protein. Early childhood growth, lower skeletal muscle mass, and higher cereal consumption may be associated with normal-weight but high-percentage trunk fat phenotype in Japanese female university students in this subanalysis study. Atherogenic profile of lipids and apolipoproteins may be directly related to abdominal fat accumulation.
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Affiliation(s)
- Satomi Minato-Inokawa
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime Japan
| | - Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University, Nishinomiya, Hyogo Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women’s University, Kobe, Hyogo Japan
| | - Ayaka Tsuboi-Kaji
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
- Department of Advanced Epidemiology, Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
- Department of Food Sciences and Nutrition, Mukogawa Women’s University, Nishinomiya, Hyogo Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University, Nishinomiya, Hyogo Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan China
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University, Nishinomiya, Hyogo Japan
- Department of Medicine, Kohan Kakogawa Hospital, Kakogawa, Hyogo Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, 6-46, Ikebiraki-Cho, Nishinomiya, Hyogo 663-8558 Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University, Nishinomiya, Hyogo Japan
- Department of Food Sciences and Nutrition, Mukogawa Women’s University, Nishinomiya, Hyogo Japan
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Lee MA, Hatcher C, McGuinness LA, McBride N, Battram T, Wan W, Fang S, Wade KH, Corbin LJ, Timpson NJ. Systematic review and meta-analyses: What has the application of Mendelian randomization told us about the causal effect of adiposity on health outcomes? Wellcome Open Res 2023; 7:308. [PMID: 38974363 PMCID: PMC11225060 DOI: 10.12688/wellcomeopenres.18657.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 07/09/2024] Open
Abstract
Mendelian randomization (MR) is increasingly used for generating estimates of the causal impact of exposures on outcomes. Evidence suggests a causal role of excess adipose tissue (adiposity) on many health outcomes. However, this body of work has not been systematically appraised. We systematically reviewed and meta-analysed results from MR studies investigating the association between adiposity and health outcomes prior to the SARS-CoV-2/COVID-19 pandemic (PROSPERO: CRD42018096684). We searched Medline, EMBASE, and bioRxiv up to February 2019 and obtained data on 2,214 MR analyses from 173 included articles. 29 meta-analyses were conducted using data from 34 articles (including 66 MR analyses) and results not able to be meta-analysed were narratively synthesised. Body mass index (BMI) was the predominant exposure used and was primarily associated with an increase in investigated outcomes; the largest effect in the meta-analyses was observed for the association between BMI and polycystic ovary syndrome (estimates reflect odds ratios (OR) per standard deviation change in each adiposity measure): OR = 2.55; 95% confidence interval (CI) = 1.22-5.33. Only colorectal cancer was investigated with two exposures in the meta-analysis: BMI (OR = 1.18; 95% CI = 1.01-1.37) and waist-hip ratio (WHR; OR = 1.48; 95% CI = 1.08-2.03). Broadly, results were consistent across the meta-analyses and narrative synthesis. Consistent with many observational studies, this work highlights the impact of adiposity across a broad spectrum of health outcomes, enabling targeted follow-up analyses. However, missing and incomplete data mean results should be interpreted with caution.
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Affiliation(s)
- Matthew A Lee
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- International Agency for Research on Cancer, Lyon, 69006, France
| | - Charlie Hatcher
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Luke A McGuinness
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nancy McBride
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Thomas Battram
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Wenxin Wan
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Si Fang
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kaitlin H Wade
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Laura J Corbin
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nicholas J Timpson
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
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Iida T, Morimoto S, Okuda H, Amari Y, Yurugi T, Nakajima F, Ichihara A. Impact of Abdominal Fat Distribution on Mortality and Its Changes Over Time in Patients Undergoing Hemodialysis: A Prospective Cohort Study. J Ren Nutr 2023; 33:575-583. [PMID: 36963738 DOI: 10.1053/j.jrn.2023.03.004] [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: 10/18/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVE Measures of fat distribution and visceral fat accumulation maintain a direct association with mortality in the general population. However, among patients undergoing hemodialysis (HD), there are few reports of this association. This study aimed to investigate the impact of computed tomography (CT)-measured abdominal fat levels, including the visceral fat area (VFA) and subcutaneous fat area (SFA), on all-cause mortality in patients undergoing HD and investigate whether there are sex-specific particularities regarding the associations between the abovementioned parameters. METHODS A total of 258 participants were selected from the population of patients undergoing stable HD. The baseline characteristics were collected by records and interviews. The following variables were assessed at baseline and every year: body mass index, abdominal circumference, VFA, and SFA. Abdominal circumference and body fat distribution were assessed at the level of the umbilicus via CT. All CT scans were performed on a nondialysis day with the subject in a supine position. The primary end point was the 5-year all-cause mortality. RESULTS This prospective cohort study revealed that age, cardiothoracic ratio, %VFA (VFA/[VFA + SFA]), and albumin were independent predictors of death via multivariable analyses. Regarding the %VFA, its area under the curve (0.599), which did not suffice to predict mortality, was higher than that of VFA, SFA, and body mass index. Also, the effect was recognized mainly in male patients. The %VFA of patients who survived for 60 months increased over time. CONCLUSION These data suggest that patients (especially men) with a high VFA-to-abdominal fat ratio have a high risk of death. Thus, more attention should be paid to such patients.
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Affiliation(s)
- Takeshi Iida
- Department of Nephrology and Dialysis, Higashioosaka Hospital, Osaka, Japan; Department of Nephrology and Dialysis, Moriguchi Keijinkai Hospital, Osaka, Japan; Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Satoshi Morimoto
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan.
| | - Hidenobu Okuda
- Department of Nephrology and Dialysis, Moriguchi Keijinkai Hospital, Osaka, Japan
| | - Yoshifumi Amari
- Department of Nephrology and Dialysis, Moriguchi Keijinkai Hospital, Osaka, Japan; Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Takatomi Yurugi
- Department of Nephrology and Dialysis, Moriguchi Keijinkai Hospital, Osaka, Japan
| | - Fumitaka Nakajima
- Department of Nephrology and Dialysis, Moriguchi Keijinkai Hospital, Osaka, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
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Mansoori A, Hosseini ZS, Ahari RK, Poudineh M, Rad ES, Zo MM, Izadi FS, Hoseinpour M, Miralizadeh A, Mashhadi YA, Hormozi M, Firoozeh MT, Hajhoseini O, Ferns G, Esmaily H, Mobarhan MG. Development of Data Mining Algorithms for Identifying the Best Anthropometric Predictors for Cardiovascular Disease: MASHAD Cohort Study. High Blood Press Cardiovasc Prev 2023; 30:243-253. [PMID: 37204657 DOI: 10.1007/s40292-023-00577-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION Many studies have been published to assess the best anthropometric measurements associated with cardiovascular diseases (CVDs), but controversies still exist. AIM Investigating the association between CVDs and anthropometric measurements among Iranian adults. METHODS For a total population of 9354 aged 35 to 65, a prospective study was designed. Anthropometric measurements including ABSI (A Body Shape Index), Body Adiposity Index (BAI), Body Mass Index (BMI), Waist to Height Ratio (WHtR), Body Round Index (BRI), HC (Hip Circumference), Demispan, Mid-arm circumference (MAC), Waist-to-hip (WH) and Waist Circumference (WC) were completed. The association between these parameters and CVDs were assessed through logistic regression (LR) and decision tree (DT) models. RESULTS During the 6-year follow-up, 4596 individuals (49%) developed CVDs. According to the LR, age, BAI, BMI, Demispan, and BRI, in male and age, WC, BMI, and BAI in female had a significant association with CVDs (p-value < 0.03). Age and BRI for male and age and BMI for female represent the most appropriate estimates for CVDs (OR: 1.07, (95% CI: 1.06, 1.08), 1.36 (1.22, 1.51), 1.14 (1.13, 1.15), and 1.05 (1.02, 1.07), respectively). In the DT for male, those with BRI ≥ 3.87, age ≥ 46 years, and BMI ≥ 35.97 had the highest risk to develop CVDs (90%). Also, in the DT for female, those with age ≥ 54 years and WC ≥ 84 had the highest risk to develop CVDs (71%). CONCLUSION BRI and age in male and age and BMI in female had the greatest association with CVDs. Also, BRI and BMI was the strongest indices for this prediction.
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Affiliation(s)
- Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Rana Kolahi Ahari
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran
| | - Mohadeseh Poudineh
- Student Research committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mostafa Mahmoudi Zo
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Faezeh Salmani Izadi
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Hoseinpour
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirreza Miralizadeh
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Hormozi
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | | | - Omolbanin Hajhoseini
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran.
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Ma W, Zhu H, Yu X, Zhai X, Li S, Huang N, Liu K, Shirai K, Sheerah HA, Cao J. Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003-2007. Front Cardiovasc Med 2023; 10:1055223. [PMID: 37273879 PMCID: PMC10233278 DOI: 10.3389/fcvm.2023.1055223] [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: 09/27/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives Evidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality. Method The study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified. Results In the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)]. Conclusion Moderate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.
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Affiliation(s)
- Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan, China
| | - Huiping Zhu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyi Yu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macao, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Nian Huang
- School of Public Health, Wuhan University, Wuhan, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Haytham A. Sheerah
- Assistant Deputyship for International Collaborations, Ministry of Health, Riyadh, Saudi Arabia
| | - Jinhong Cao
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
- Research Center for the Development of Chinese Medicine, Hubei Province Project of Key Research Institute of Humanities and Social Sciences at Universities, Wuhan, China
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Pattar S, Shetty P, Shetty GB. IMPACT OF VEGETARIAN VERSUS NON-VEGETARIAN DIET ON HEALTH OUTCOMES IN MALE INDIVIDUALS: A COMPARATIVE STUDY. ADVANCES IN INTEGRATIVE MEDICINE 2023. [DOI: 10.1016/j.aimed.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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8
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Lee MA, Hatcher C, McGuinness LA, McBride N, Battram T, Wan W, Fang S, Wade KH, Corbin LJ, Timpson NJ. Systematic review and meta-analyses: What has the application of Mendelian randomization told us about the causal effect of adiposity on health outcomes? Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18657.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Mendelian randomization (MR) is increasingly used for generating estimates of the causal impact of exposures on outcomes. Evidence suggests a causal role of excess adipose tissue (adiposity) on many health outcomes. However, this body of work has not been systematically appraised. We systematically reviewed and meta-analysed results from MR studies investigating the association between adiposity and health outcomes prior to the SARS-CoV-2/COVID-19 pandemic (PROSPERO: CRD42018096684). We searched Medline, EMBASE, and bioRxiv up to February 2019 and obtained data on 2,214 MR analyses from 173 included articles. 29 meta-analyses were conducted using data from 34 articles (including 66 MR analyses) and results not able to be meta-analysed were narratively synthesised. Body mass index (BMI) was the predominant exposure used and was primarily associated with an increase in investigated outcomes; the largest effect in the meta-analyses was observed for the association between BMI and polycystic ovary syndrome (estimates reflect odds ratios (OR) per standard deviation change in each adiposity measure): OR = 2.55; 95% confidence interval (CI) = 1.22–5.33. Only colorectal cancer was investigated with two exposures in the meta-analysis: BMI (OR = 1.18; 95% CI = 1.01–1.37) and waist-hip ratio (WHR; OR = 1.48; 95% CI = 1.08–2.03). Broadly, results were consistent across the meta-analyses and narrative synthesis. Consistent with many observational studies, this work highlights the impact of adiposity across a broad spectrum of health outcomes, enabling targeted follow-up analyses. However, missing and incomplete data mean results should be interpreted with caution.
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Shen FC, Chen ME, Wu WT, Kuo IC, Niu SW, Lee JJ, Hung CC, Chang JM, Hwang SJ. Normal weight and waist obesity indicated by increased total body fat associated with all-cause mortality in stage 3–5 chronic kidney disease. Front Nutr 2022; 9:982519. [PMID: 36185692 PMCID: PMC9523665 DOI: 10.3389/fnut.2022.982519] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Patients with chronic kidney disease (CKD) demonstrate a survival benefit with a high body mass index (BMI); this is the obesity paradox. Central obesity has a higher prognostic value than BMI, even in those with normal weight. Whether total body fat percentage (TBF%) provides more information than BMI and waist circumference (WC) remains unknown. We included 3,262 Asian patients with stage 3–5 CKD and divided these patients by TBF% and waist-to-height ratio (WHtR) quartiles (Q1–Q4). TBF% was associated with BMI, WC, nutritional markers, and C-reactive protein. In all patients, BMI but not TBF% or WHtR demonstrated a survival paradox. In patients with BMI <25 kg/m2, but not in those with BMI ≥ 25 kg/m2, TBF% Q4 and WHtR Q4 were associated with all-cause mortality, with hazard ratios [HRs; 95% confidence intervals (CIs)] of 2.35 (1.31–4.22) and 1.38 (1.06–1.80), respectively. The HRs of TBF% Q4 for all-cause mortality were 2.90 (1.50–5.58) in patients with a normal WC and 3.81 (1.93–7.50) in patients with normal weight and normal WC (All P for interaction < 0.05). In conclusion, TBF% can predict all-cause mortality in patients with advanced CKD and a normal weight, normal WC, or both.
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Affiliation(s)
- Feng-Ching Shen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-En Chen
- Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-Tsung Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Ching Kuo
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Wen Niu
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-Jung Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Chih Hung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- *Correspondence: Chi-Chih Hung
| | - Jer-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Zaragoza-García O, Gutiérrez-Pérez IA, Delgado-Floody P, Parra-Rojas I, Jerez-Mayorga D, Campos-Jara C, Guzmán-Guzmán IP. Emergent Anthropometric Indices in Differential Prediction of Prehypertension and Hypertension in Mexican Population: Results according to Age and Sex. Int J Hypertens 2022; 2022:4522493. [PMID: 35844253 PMCID: PMC9283069 DOI: 10.1155/2022/4522493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Hypertension (HTN) is recognized as a significant public health problem in the world. The objective of this study is to evaluate emergent anthropometric indices as predictors of preHTN and HTN according to age and sex in a sample of Mexican adults. Methods A cross-sectional study was conducted in 1,150 participants aged 18-80 years old. Anthropometric data and blood pressure measurements were analyzed. Comparisons between men and women were carried out by independent analysis. Cutoff points for each emergent anthropometric index were obtained using the values' upper second and third tertiles. Logistic regression models and receiver operating characteristics curve analyses were used to assess the association and the predictive value of several emergent anthropometric indices with the presence of preHTN and HTN. Results The prevalence of preHTN and HTN was 29.74% and 14.35%, respectively. In a logistic regression analysis adjusted by age and sex, the body roundness index (BRI) (OR = 2.08, p < 0.001) and conicity index (CI) (OR = 1.37, p=0.044) were associated with preHTN, while CI (OR = 2.47, p < 0.001) and waist to height squared (W/Ht2) (OR = 2.19, p < 0.001) were associated with HTN. Furthermore, in both sexes, BRI was the main predictor of preHTN (AUC: 0.634 and 0.656, respectively). Particularly, according to sex and age range, the predictive emergent anthropometric indices in men were the body shape index (ABSI) and waist to height cubic (W/Ht3) (AUC = 0.777 and 0.771, respectively), whereas in women, the predictors were CI and ABSI (AUC = 0.737 and 0.729, respectively). In men ≤40 years old, central body fat indices were predictors of preHTN and HTN, but in men >40 years old, the predictor indices were W/Ht3 and W/Ht2. In women ≤40 years, the pulse mass index (PMI) was the best main predictor (AUC = 0.909) of HTN. Conclusion CI, PMI, W/Ht3, W/Ht2, and ABSI could represent differential predictors of preHTN and HTN between men and women according to age range.
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Affiliation(s)
- Oscar Zaragoza-García
- Faculty of Chemical-Biological Sciences, Universidad Autónoma de Guerrero, Chilpancingo 39087, Guerrero, Mexico
| | | | - Pedro Delgado-Floody
- Department of Physical Education, Sport, and Recreation, Universidad de La Frontera, Temuco 4780000, Chile
| | - Isela Parra-Rojas
- Faculty of Chemical-Biological Sciences, Universidad Autónoma de Guerrero, Chilpancingo 39087, Guerrero, Mexico
| | - Daniel Jerez-Mayorga
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada 18011, Spain
| | - Christian Campos-Jara
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Iris Paola Guzmán-Guzmán
- Faculty of Chemical-Biological Sciences, Universidad Autónoma de Guerrero, Chilpancingo 39087, Guerrero, Mexico
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11
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Li F, Yang CP, Wu CY, Ho CA, Yeh HC, Chan YS, ChangChien WS, Ho CS. Contribution of Body Mass Index Stratification for the Prediction of Maximal Oxygen Uptake. Int J Med Sci 2022; 19:1929-1941. [PMID: 36438918 PMCID: PMC9682509 DOI: 10.7150/ijms.77818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/26/2022] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to investigate whether modeling within separate body mass index (BMI) stratifications improves the accuracy of maximal oxygen uptake (VO2max) prediction compared to a model developed regardless of adults' BMIs. A total of 250 Taiwanese adults (total group, TOG) aged 22-64 years participated in this study, and were stratified into a normal group (NOG: 135), an overweight group (OVG: 69), and an obesity group (OBG: 46), according to the BMI classification recommended by the Taiwan Ministry of Health and Welfare. VO2max was directly measured on an electromagnetic bicycle ergometer. Using the participant's heart rate in the 3-min incremental step-in-place test and demographic parameters, VO2max prediction models established for four groups were TOG model, NOG model, OVG model, and OBG model, respectively. Compared with the TOG model, the OVG and OBG models had higher coefficients of determination and lower standard error of estimates (SEEs), or %SEEs. The validities of the NOG (r = 0.780), OVG (r = 0.776), and OBG (r = 0.791) models for BMI subgroups increased by 1.79%, 4.64%, and 8.22% respectively, and the reliabilities (NOG model: ICC = 0.755; OVG model: ICC = 0.765; OBG model: ICC = 0.779) increased by 3.18%, 3.27%, and 9.63%, respectively. These results suggested using separate models established in BMI stratifications can effectively improve the prediction of VO2max.
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Affiliation(s)
- Fang Li
- School of Physical Education, Central China Normal University, Wuhan, China
| | - Cheng-Pang Yang
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taiwan
| | - Cheng-You Wu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Chia-An Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hung-Chih Yeh
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yuan-Shuo Chan
- Department of Special Education, National Taipei University of Education, Taipei, Taiwan
| | | | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
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12
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Singh P, Covassin N, Marlatt K, Gadde KM, Heymsfield SB. Obesity, Body Composition, and Sex Hormones: Implications for Cardiovascular Risk. Compr Physiol 2021; 12:2949-2993. [PMID: 34964120 PMCID: PMC10068688 DOI: 10.1002/cphy.c210014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in adults, highlighting the need to develop novel strategies to mitigate cardiovascular risk. The advancing obesity epidemic is now threatening the gains in CVD risk reduction brought about by contemporary pharmaceutical and surgical interventions. There are sex differences in the development and outcomes of CVD; premenopausal women have significantly lower CVD risk than men of the same age, but women lose this advantage as they transition to menopause, an observation suggesting potential role of sex hormones in determining CVD risk. Clear differences in obesity and regional fat distribution among men and women also exist. While men have relatively high fat in the abdominal area, women tend to distribute a larger proportion of their fat in the lower body. Considering that regional body fat distribution is an important CVD risk factor, differences in how men and women store their body fat may partly contribute to sex-based alterations in CVD risk as well. This article presents findings related to the role of obesity and sex hormones in determining CVD risk. Evidence for the role of sex hormones in determining body composition in men and women is also presented. Lastly, the clinical potential for using sex hormones to alter body composition and reduce CVD risk is outlined. © 2022 American Physiological Society. Compr Physiol 12:1-45, 2022.
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Affiliation(s)
- Prachi Singh
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | | | - Kara Marlatt
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Kishore M Gadde
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
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13
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U-Shaped Association between Waist-to-Hip Ratio and All-Cause Mortality in Stage 3-5 Chronic Kidney Disease Patients with Body Mass Index Paradox. J Pers Med 2021; 11:jpm11121355. [PMID: 34945829 PMCID: PMC8703404 DOI: 10.3390/jpm11121355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 12/20/2022] Open
Abstract
The obesity paradox, referring to the association of high body mass index (BMI) with low all-cause mortality risk, is found in patients with chronic kidney disease (CKD). Central obesity is associated with metabolic syndrome and may have better prognostic value than BMI for all-cause mortality. Whether central obesity is associated with all-cause mortality in cases of obesity paradox in CKD patients remains unknown. We included 3262 patients with stage 3–5 CKD, grouped into five quintiles (Q1–5) by waist-to-hip ratio (WHR). Low WHR and BMI were associated with malnutrition and inflammation. In Cox regression, high BMI was not associated with all-cause mortality, but BMI < 22.5 kg/m2 increased the mortality risk. A U-shaped association between central obesity and all-cause mortality was found: WHR Q1, Q4, and Q5 had higher risk for all-cause mortality. The hazard ratio (95% confidence interval) of WHR Q5 and Q1 for all-cause mortality was 1.39 (1.03–1.87) and 1.53 (1.13–2.05) in male and 1.42 (1.02–1.99) and 1.28 (0.88–1.85) in female, respectively. Waist-to-height ratio and conicity index showed similar results. Low WHR or low BMI and high WHR, but not high BMI, are associated with all-cause mortality in advanced CKD.
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14
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Kesztyüs D, Lampl J, Kesztyüs T. The Weight Problem: Overview of the Most Common Concepts for Body Mass and Fat Distribution and Critical Consideration of Their Usefulness for Risk Assessment and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111070. [PMID: 34769593 PMCID: PMC8583287 DOI: 10.3390/ijerph182111070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
The prevalence of obesity already reached epidemic proportions many years ago and more people may die from this pandemic than from COVID-19. However, the figures depend on which measure of fat mass is used. The determination of the associated health risk also depends on the applied measure. Therefore, we will examine the most common measures for their significance, their contribution to risk assessment and their applicability. The following categories are reported: indices of increased accumulation of body fat; weight indices and mortality; weight indices and risk of disease; normal weight obesity and normal weight abdominal obesity; metabolically healthy obesity; the obesity paradox. It appears that BMI is still the most common measure for determining weight categories, followed by measures of abdominal fat distribution. Newer measures, unlike BMI, take fat distribution into account but often lack validated cut-off values or have limited applicability. Given the high prevalence of obesity and the associated risk of disease and mortality, it is important for a targeted approach to identify risk groups and determine individual risk. Therefore, in addition to BMI, a measure of fat distribution should always be used to ensure that less obvious but risky manifestations such as normal weight obesity are identified.
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Affiliation(s)
- Dorothea Kesztyüs
- Department of Medical Informatics at the University Medical Centre Göttingen, Georg August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
- Correspondence: ; Tel.: +49-731-37873521
| | - Josefine Lampl
- General Practitioner Centre Arnold & Liffers, Albstr. 6, 89081 Jungingen, Germany;
| | - Tibor Kesztyüs
- Department of Medical Informatics at the University Medical Centre Göttingen, Georg August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
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15
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Ghannadiasl F. Novel anthropometric predictors of subjective weight among women. Women Health 2021; 61:889-895. [PMID: 34649476 DOI: 10.1080/03630242.2021.1988811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The main aim of the current study was to examine novel anthropometric predictors of subjective weight among women. In this cross-sectional study, 229 women were selected through simple random sampling method. The participants completed the Multidimensional Body Self-Relation Questionnaire. Pearson correlation coefficient and linear regression were used to analyze the data. The mean subjective weight score was 4.05 ± 1.01. There was a significant relationship between anthropometric indices and subjective weight (Pearson r correlation range: 0.62-0.81, p < .01). Beta coefficients for predictor variables indicated that weight (ß = -2.774, t (229) = -2.868, p = .005), hip circumference (ß = 3.454, t (229) = 5.999, p < .001), waist to hip ratio (ß = 4.218, t (229) = 4.953, p < .001), waist to height ratio (ß = -3.284, t (229) = -2.067, p = .04), and conicity index (ß = -0.708, t (229) = -2.518, p = .013) significantly predicted the subjective weight. The waist to hip ratio was the most important predictor of the subjective weight. This study suggests using the waist to hip ratio as an anthropometric index in subjective weight studies in women. Considering the negative impact of subjective weight on women's health, these results indicate the need for interventions designed to control body weight and unsuitable anthropometric indices in women.
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Affiliation(s)
- Fatemeh Ghannadiasl
- Department of Food Sciences and Technology, University of Mohaghegh Ardabili, Ardabil, Iran
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16
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Abstract
Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.
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17
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Alzeidan R, Fayed A, Rabiee F, Hersi A, Elmorshedy H. Diagnostic performance of waist-to-height ratio in identifying cardiovascular risk factors and metabolic syndrome among adult Saudis. A cross-sectional study. Saudi Med J 2021; 41:253-260. [PMID: 32114597 PMCID: PMC7841557 DOI: 10.15537/smj.2020.3.24915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objectives: To evaluate the diagnostic performance of waist to height ratio (WHtR) to screen for cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) among Saudis. Methods: Between June 2013 and August 2014, a cross-sectional study of 3,063 adult Saudis of both genders from King Khalid Hospital, Riyadh, Saudi Arabia was conducted. Using the “WHO STEPwise Surveillance-Instrument V2.1”, which uses sequential steps including questionnaires and anthropometric and biochemical measurements of MetS and CVRF. Waist to height ratio validity in defining central obesity, MetS, and CVRF were tested using receiver operating characteristic curve (ROC), sensitivity, specificity, positive and negative predictive values, and accuracy. Using multivariate regression analyses for adjustment of confounders as age and gender were applied to compute adjusted odds ratios (aOR). Results: The diagnostic potential of WHtR was excellent for central obesity (area under the curve [AUC] = 0.98), and MetS (AUCs = 0.86); it was good for CVRF ≥2 (AUCs = 0.79) and was satisfactory for dyslipidemia (AUCs = 0.66). The sensitivities and negative predictive values exceeded 85% for diagnosing central obesity, diabetes, and hypertension. Adjusted odds ratios for age and gender showed that WHtR ≥0.50 significantly increased the risk of diabetes, hypertension, and ≥2 CVRF by almost 4-fold, and increased the risk of dyslipidemia by 2-fold. Conclusion: Waist height ratio showed a good diagnostic performance for CVRF and MetS among Saudis. Furthermore, WHtR ≥0.5 increased the risk of dyslipidemia, diabetes mellitus and hypertension.
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Affiliation(s)
- Rasmieh Alzeidan
- Cardiac Sciences Department, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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18
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Abdominal obesity and myocardial infarction risk - We demonstrate the anthropometric and mathematical reasons that justify the association bias of the waist-to-hip ratio. NUTR HOSP 2021; 38:502-510. [PMID: 33757289 DOI: 10.20960/nh.03416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Antecedentes: el índice cintura-cadera (ICC) se utiliza ampliamente para evaluar la asociación de la obesidad abdominal con el infarto de miocardio (IM). Objetivo: nuestro propósito era determinar si el riesgo asociado a la ICC produce sesgo. Métodos: estudio de casos y controles en 252 varones. Usamos la estratificación como criterio para eliminar los efectos del sesgo. Creamos una covariable basal (ICC0,95-0,99) para una nueva muestra emparejada en el estrato de valores entre 0,95 y 0,99. Este estrato coincide con el área común de solapamiento de la distribución de puntos, donde todos los sujetos tienen un índice de propensión similar. Consideramos otra covariable (ICCS) condicionada en ICC < 1 y una circunferencia de cintura (CC) donde la asignación de riesgo fuera espúrea. Hipotetizamos que restando CC del valor de la cadera se calculaba otra variable aritmética (DCC) que podría ser esencial para evidenciar el efecto de confusion que genera el ICC. Resultados: IMC: ABC: 0,694, IC 95 % (0,628-0,760); OR: 3,8. CC: ABC: 0,743, IC 95 % (0,681-0,805); OR: 5,7. ICC: ABC: 0,798, IC 95 % (0,740-0,855); OR: 8,6. Índice cintura-talla (ICT): ABC: 0,782, IC 95 % (0,724-0,840); OR: 8,5. DCC: ABC: 0,204, IC 95 % (0,146-0,261); OR: 0,36. Prevalencia en los casos: ICC ≥ 0,95 (84,1 % vs. 38 %; OR: 8,6); ICC < 1 (36,3 % vs. 85,7 %; OR: 2,3); ICC ≥ 1 (63,4 % vs. 14,2 %; OR: 4,4); CC ≥ 94,4 (71,4 % vs. 30,1 %; OR: 5,7); DCC ≥ 2,2 (27,7 % vs. 75,3 %; OR: 7,9); ICCs (50 % vs. 25 %; OR: 2). Conclusiones: el ICC produce un sesgo de asociación en los casos de IM. Ello puede extrapolarse a otras poblaciones de estudio. El sesgo se explica por un error de concepto matemático que sobreestima el efecto protector de la cadera con respecto a la CC y la altura. El riesgo asociado al ICC por encima del de la CC o el ICT presenta inconsistencia antropométrica y sesgo, llegando a ser epidemiológicamente falso.
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Wang C, Ni W, Yao Y, Just A, Heiss J, Wei Y, Gao X, Coull BA, Kosheleva A, Baccarelli AA, Peters A, Schwartz JD. DNA methylation-based biomarkers of age acceleration and all-cause death, myocardial infarction, stroke, and cancer in two cohorts: The NAS, and KORA F4. EBioMedicine 2020; 63:103151. [PMID: 33279859 PMCID: PMC7724153 DOI: 10.1016/j.ebiom.2020.103151] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/25/2022] Open
Abstract
Background DNA methylation (DNAm) may play a role in age-related outcomes. It is not yet known which DNAm-based biomarkers of age acceleration (BoAA) has the strongest association with age-related endpoints. Methods We collected the blood samples from two independent cohorts: the Normative Ageing Study, and the Cooperative Health Research in the Region of Augsburg cohort. We measured epigenome-wide DNAm level, and generated five DNAm BoAA at baseline. We used Cox proportional hazards model to analyze the relationships between BoAA and all-cause death. We applied the Fine and Gray competing risk model to estimate the risk of BoAA on myocardial infarction (MI), stroke, and cancer, accounting for death of other reasons as the competing risks. We used random-effects meta-analyses to pool the individual results, with adjustment for multiple testing. Findings The mean chronological ages in the two cohorts were 74, and 61, respectively. Baseline GrimAgeAccel, and DNAm-related mortality risk score (DNAmRS) both had strong associations with all-cause death, MI, and stroke, independent from chronological age. For example, a one standard deviation (SD) increment in GrimAgeAccel was significantly associated with increased risk of all-cause death [hazard ratio (HR): 2.01; 95% confidence interval (CI), 1.15, 3.50], higher risk of MI (HR: 1.44; 95% CI, 1.16, 1.79), and elevated risk of stroke (HR: 1.42; 95% CI, 1.06, 1.91). There were no associations between any BoAA and cancer. Interpretation From the public health perspective, GrimAgeAccel is the most useful tool for identifying at-risk elderly, and evaluating the efficacy of anti-aging interventions. Funding National Institute of Environmental Health Sciences of U.S., Harvard Chan-NIEHS Center for Environmental Health, German Federal Ministry of Education and Research, and the State of Bavaria in Germany.
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Affiliation(s)
- Cuicui Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, West of Landmark Center, Boston, MA 02215, United States.
| | - Wenli Ni
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Yueli Yao
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Allan Just
- Department of Environmental Medicine, and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jonathan Heiss
- Department of Environmental Medicine, and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, West of Landmark Center, Boston, MA 02215, United States
| | - Xu Gao
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, West of Landmark Center, Boston, MA 02215, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Anna Kosheleva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, West of Landmark Center, Boston, MA 02215, United States
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute of Medical Information Science, Biometry, and Epidemiology, Ludwig Maximilians University, Munich, Germany
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, West of Landmark Center, Boston, MA 02215, United States
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20
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White AMB, Mishcon HR, Redwanski JL, Hills RD. Statin Treatment in Specific Patient Groups: Role for Improved Cardiovascular Risk Markers. J Clin Med 2020; 9:E3748. [PMID: 33233352 PMCID: PMC7700563 DOI: 10.3390/jcm9113748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 01/17/2023] Open
Abstract
Ample evidence supports the use of statin therapy for secondary prevention in patients with a history of atherosclerotic cardiovascular disease (ASCVD), but evidence is wanting in the case of primary prevention, low-risk individuals, and elderly adults 65+. Statins are effective in lowering low-density lipoprotein (LDL), which has long been a target for treatment decisions. We discuss the weakening dependence between cholesterol levels and mortality as a function of age and highlight recent findings on lipoprotein subfractions and other superior markers of ASCVD risk. The efficacy of statins is compared for distinct subsets of patients based on age, diabetes, ASCVD, and coronary artery calcium (CAC) status. Most cardiovascular risk calculators heavily weight age and overestimate one's absolute risk of ASCVD, particularly in very old adults. Improvements in risk assessment enable the identification of specific patient populations that benefit most from statin treatment. Derisking is particularly important for adults over 75, in whom treatment benefits are reduced and adverse musculoskeletal effects are amplified. The CAC score stratifies the benefit effect size obtainable with statins, and forms of coenzyme Q are discussed for improving patient outcomes. Robust risk estimator tools and personalized, evidence-based approaches are needed to optimally reduce cardiovascular events and mortality rates through administration of cholesterol-lowering medications.
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Affiliation(s)
- Alyssa M. B. White
- Department of Pharmaceutical Sciences and Administration, University of New England, Portland, ME 04103, USA; (A.M.B.W.); (H.R.M.)
| | - Hillary R. Mishcon
- Department of Pharmaceutical Sciences and Administration, University of New England, Portland, ME 04103, USA; (A.M.B.W.); (H.R.M.)
| | - John L. Redwanski
- Department of Pharmacy Practice, School of Pharmacy, University of New England, Portland, ME 04103, USA;
| | - Ronald D. Hills
- Department of Pharmaceutical Sciences and Administration, University of New England, Portland, ME 04103, USA; (A.M.B.W.); (H.R.M.)
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21
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The role of body composition assessment in obesity and eating disorders. Eur J Radiol 2020; 131:109227. [DOI: 10.1016/j.ejrad.2020.109227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
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Jayedi A, Soltani S, Zargar MS, Khan TA, Shab-Bidar S. Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies. BMJ 2020; 370:m3324. [PMID: 32967840 PMCID: PMC7509947 DOI: 10.1136/bmj.m3324] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included. DATA SYNTHESIS A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves. RESULTS Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index. CONCLUSIONS Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.
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Affiliation(s)
- Ahmad Jayedi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, PO Box 14155/6117, Tehran, Iran
| | - Sepideh Soltani
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Sadat Zargar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Tauseef Ahmad Khan
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis & Clinical Trials Unit, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, PO Box 14155/6117, Tehran, Iran
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23
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Christakoudi S, Tsilidis KK, Muller DC, Freisling H, Weiderpass E, Overvad K, Söderberg S, Häggström C, Pischon T, Dahm CC, Zhang J, Tjønneland A, Halkjær J, MacDonald C, Boutron-Ruault MC, Mancini FR, Kühn T, Kaaks R, Schulze MB, Trichopoulou A, Karakatsani A, Peppa E, Masala G, Pala V, Panico S, Tumino R, Sacerdote C, Quirós JR, Agudo A, Sánchez MJ, Cirera L, Barricarte-Gurrea A, Amiano P, Memarian E, Sonestedt E, Bueno-de-Mesquita B, May AM, Khaw KT, Wareham NJ, Tong TYN, Huybrechts I, Noh H, Aglago EK, Ellingjord-Dale M, Ward HA, Aune D, Riboli E. A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort. Sci Rep 2020; 10:14541. [PMID: 32883969 PMCID: PMC7471961 DOI: 10.1038/s41598-020-71302-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/06/2020] [Indexed: 11/29/2022] Open
Abstract
Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m2) or obese (BMI ≥ 30 kg/m2) categories, while the highest quartile of ABSI separated 18-39% of the individuals within each BMI category, which had 22-55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.
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Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
- MRC Centre for Transplantation, King's College London, Great Maze Pond, London, SE1 9RT, UK.
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45100, Ioannina, Greece
| | - David C Muller
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
| | - Heinz Freisling
- International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Kim Overvad
- Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
- Department of Cardiology, Aalborg University Hospital, DK-9000, Aalborg, Denmark
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christel Häggström
- Department of Biobank Research, Umeå University, Umeå, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tobias Pischon
- Max Delbrück Center for Molecular Medicine, 13125, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Christina C Dahm
- Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
| | - Jie Zhang
- Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jytte Halkjær
- Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen Ø, Denmark
| | - Conor MacDonald
- Centre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Centre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Francesca Romana Mancini
- Centre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | | | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian, 1, 20133, Milan, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale Ragusa (ASP), Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | | | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria-Jose Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Granada, Spain
- Universidad de Granada, Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Lluís Cirera
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Aurelio Barricarte-Gurrea
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain
| | - Pilar Amiano
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Ensieh Memarian
- Dept. Clinical Sciences, Skane University Hospital, Lund University, 20502, Malmö, Sweden
| | - Emily Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, 50603, Kuala Lumpur, Malaysia
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Kay-Tee Khaw
- School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 2QQ, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Hwayoung Noh
- International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Elom K Aglago
- International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Merete Ellingjord-Dale
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
| | - Heather A Ward
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
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Głuszek S, Ciesla E, Głuszek-Osuch M, Kozieł D, Kiebzak W, Wypchło Ł, Suliga E. Anthropometric indices and cut-off points in the diagnosis of metabolic disorders. PLoS One 2020; 15:e0235121. [PMID: 32569336 PMCID: PMC7307766 DOI: 10.1371/journal.pone.0235121] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/09/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Identifying metabolic disorders at the earliest phase of their development allows for an early intervention and the prevention of serious consequences of diseases. However, it is difficult to determine which of the anthropometric indices of obesity is the best tool for diagnosing metabolic disorders. The aims of this study were to evaluate the usefulness of selected anthropometric indices and to determine optimal cut-off points for the identification of single metabolic disorders that are components of metabolic syndrome (MetS). DESIGN Cross-sectional study. PARTICIPANTS We analyzed the data of 12,328 participants aged 55.7±5.4 years. All participants were of European descent. PRIMARY OUTCOME MEASURE Four MetS components were included: high glucose concentration, high blood triglyceride concentration, low high-density lipoprotein cholesterol concentration, and elevated blood pressure. The following obesity indices were considered: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body fat percentage (%BF), Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), body roundness index (BRI), and a body shape index (ABSI). RESULTS The following indices had the highest discriminatory power for the identification of at least one MetS component: CUN-BAE, BMI, and WC in men (AUC = 0.734, 0.728, and 0.728, respectively) and WHtR, CUN-BAE, and WC in women (AUC = 0.715, 0.714, and 0.712, respectively) (p<0.001 for all). The other indices were similarly useful, except for the ABSI. CONCLUSIONS For the BMI, the optimal cut-off point for the identification of metabolic abnormalities was 27.2 kg/m2 for both sexes. For the WC, the optimal cut-off point was of 94 cm for men and 87 cm for women. Prospective studies are needed to identify those indices in which changes in value predict the occurrence of metabolic disorders best.
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Affiliation(s)
- Stanisław Głuszek
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Elzbieta Ciesla
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Martyna Głuszek-Osuch
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Dorota Kozieł
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Wojciech Kiebzak
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Łukasz Wypchło
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Edyta Suliga
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
- * E-mail:
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25
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Troll M, Brandmaier S, Reitmeier S, Adam J, Sharma S, Sommer A, Bind MA, Neuhaus K, Clavel T, Adamski J, Haller D, Peters A, Grallert H. Investigation of Adiposity Measures and Operational Taxonomic unit (OTU) Data Transformation Procedures in Stool Samples from a German Cohort Study Using Machine Learning Algorithms. Microorganisms 2020; 8:E547. [PMID: 32290101 PMCID: PMC7232268 DOI: 10.3390/microorganisms8040547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 01/14/2023] Open
Abstract
The analysis of the gut microbiome with respect to health care prevention and diagnostic purposes is increasingly the focus of current research. We analyzed around 2000 stool samples from the KORA (Cooperative Health Research in the Region of Augsburg) cohort using high-throughput 16S rRNA gene amplicon sequencing representing a total microbial diversity of 2089 operational taxonomic units (OTUs). We evaluated the combination of three different components to assess the reflection of obesity related to microbiota profiles: (i) four prediction methods (i.e., partial least squares (PLS), support vector machine regression (SVMReg), random forest (RF), and M5Rules); (ii) five OTU data transformation approaches (i.e., no transformation, relative abundance without and with log-transformation, as well as centered and isometric log-ratio transformations); and (iii) predictions from nine measurements of obesity (i.e., body mass index, three measures of body shape, and five measures of body composition). Our results showed a substantial impact of all three components. The applications of SVMReg and PLS in combination with logarithmic data transformations resulted in considerably predictive models for waist circumference-related endpoints. These combinations were at best able to explain almost 40% of the variance in obesity measurements based on stool microbiota data (i.e., OTUs) only. A reduced loss in predictive performance was seen after sex-stratification in waist-height ratio compared to other waist-related measurements. Moreover, our analysis showed that the contribution of OTUs less prevalent and abundant is minor concerning the predictive power of our models.
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Affiliation(s)
- Martina Troll
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (S.B.); (J.A.); (S.S.)
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
| | - Stefan Brandmaier
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (S.B.); (J.A.); (S.S.)
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
| | - Sandra Reitmeier
- ZIEL Institute for Food & Health, Technical University of Munich, 85354 Freising-Weihenstephan, Germany; (S.R.); (K.N.); (T.C.); (D.H.)
- Chair of Nutrition and Immunology, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
| | - Jonathan Adam
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (S.B.); (J.A.); (S.S.)
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
| | - Sapna Sharma
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (S.B.); (J.A.); (S.S.)
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
| | - Alice Sommer
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, MA 02138-2901, USA;
| | - Marie-Abèle Bind
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, MA 02138-2901, USA;
| | - Klaus Neuhaus
- ZIEL Institute for Food & Health, Technical University of Munich, 85354 Freising-Weihenstephan, Germany; (S.R.); (K.N.); (T.C.); (D.H.)
| | - Thomas Clavel
- ZIEL Institute for Food & Health, Technical University of Munich, 85354 Freising-Weihenstephan, Germany; (S.R.); (K.N.); (T.C.); (D.H.)
- Functional Microbiome Research Group, Institute of Medical Microbiology, RWTH University Hospital, 52074 Aachen, Germany
| | - Jerzy Adamski
- Research Unit Molecular Endocrinology and Metabolism, Helmholtz Zentrum München, 85764 Neuherberg, Germany;
- Chair of Experimental Genetics, Technical University of Munich, 85350 Freising-Weihenstephan, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Dirk Haller
- ZIEL Institute for Food & Health, Technical University of Munich, 85354 Freising-Weihenstephan, Germany; (S.R.); (K.N.); (T.C.); (D.H.)
- Chair of Nutrition and Immunology, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
- Chair of Epidemiology, Faculty of Medicine, Ludwig-Maximilians-University München, 81377 Munich, Germany
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (S.B.); (J.A.); (S.S.)
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (A.S.); (A.P.)
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
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What are the effects of exercise training in childhood cancer survivors? A systematic review. Cancer Metastasis Rev 2020; 39:115-125. [DOI: 10.1007/s10555-020-09852-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Ghazizadeh H, Mirinezhad SMR, Asadi Z, Parizadeh SM, Zare-Feyzabadi R, Shabani N, Eidi M, Mosa Farkhany E, Esmaily H, Mahmoudi AA, Mouhebati M, Oladi MR, Rohban M, Sharifan P, Yadegari M, Saeidi F, Ferns GA, Ghayour-Mobarhan M. Association between obesity categories with cardiovascular disease and its related risk factors in the MASHAD cohort study population. J Clin Lab Anal 2019; 34:e23160. [PMID: 31837061 PMCID: PMC7246371 DOI: 10.1002/jcla.23160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/22/2022] Open
Abstract
Background Cardiovascular disease (CVD) is a significant cause of morbidity and mortality globally. Obesity is an important CVD risk factor and is increasing in prevalence. Methods In this study, 3829 men and 5720 women (35‐65 years) were enrolled as part of the MASHAD cohort study. Four categories were identified according to body mass index and waist circumference that was defined by the World Health Organization. Logistic regression analysis was used to determine the adjusted odds ratio (OR) for the occurrence of CVD, and Cox regression model was used to evaluate the association of obesity with CVD incidence. Results We found that the higher risk groups defined by categories of adiposity were significantly related to a higher prevalence of a high serum total cholesterol (TC), and triglycerides (TG), and lower high‐density lipoprotein cholesterol (HDL), and higher fasting blood glucose (FBG) in both genders and a higher low‐density lipoprotein cholesterol (LDL) in women (P < .001). Additionally, a high percentage of participants with dyslipidemia, high LDL, high TC, and low HDL and a high percentage of participants with metabolic syndrome, diabetes, hypertension, and a high serum TG were observed across obesity categories (P < .001). Moreover, women with the very high degrees of obesity had a greater risk of CVD (HR: 1.91, 95% CI: 1.06‐3.43, P = .03). Conclusion Obesity strongly predicts several CVD risk factors. Following 6 years of follow‐up, in individuals within increasing degrees of obesity, there was a corresponding significant increase in CVD events, rising to approximately a twofold higher risk of cardiovascular events in women compared with men.
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Affiliation(s)
- Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Asadi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mostafa Parizadeh
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare-Feyzabadi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niloofar Shabani
- Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Marziyeh Eidi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Mosa Farkhany
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Ali Asghar Mahmoudi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mouhebati
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Oladi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohadeseh Rohban
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Sharifan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehran Yadegari
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Saeidi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Lumish HS, O'Reilly M, Reilly MP. Sex Differences in Genomic Drivers of Adipose Distribution and Related Cardiometabolic Disorders: Opportunities for Precision Medicine. Arterioscler Thromb Vasc Biol 2019; 40:45-60. [PMID: 31747800 DOI: 10.1161/atvbaha.119.313154] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This review focuses on the human genetics, epidemiology, and molecular pathophysiology of sex differences in central obesity, adipose distribution, and related cardiometabolic disorders. Distribution of fat is important for cardiometabolic health, with peripheral fat depots having a protective effect and central visceral fat depots conferring a detrimental effect on health. There are important sex differences in fat distribution that are masked when studying body mass index as a measure of obesity. From epidemiological, murine, and in vitro studies, several mechanisms have been proposed to explain the sex differences in adipose distribution, including sex hormonal effects, cell-intrinsic properties, and the microenvironment in fat depots. More recently, human genetics have revealed hundreds of loci for central obesity providing disruptive opportunities for mechanistic discoveries and clinical translation. A striking feature is that over one-third of these loci have reproducible but poorly understood sexual dimorphic associations with central obesity, most having stronger effects in women. Understanding the genetic and molecular mechanisms of adipose distribution and its sexual dimorphism in humans provides a unique opportunity to promote the use of precision medicine for early identification of at-risk individuals, and the development of novel therapeutic strategies for central obesity and related cardiometabolic disorders.
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Affiliation(s)
- Heidi S Lumish
- From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY (H.S.L., M.O., M.P.R.)
| | - Marcella O'Reilly
- From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY (H.S.L., M.O., M.P.R.)
| | - Muredach P Reilly
- From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY (H.S.L., M.O., M.P.R.).,Irving Institute for Clinical and Translational Research, Columbia University, New York, NY (M.P.R.)
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Lind L, Strand R, Michaelsson K, Kullberg J, Ahlström H. Relationship between endothelium-dependent vasodilation and fat distribution using the new "imiomics" image analysis technique. Nutr Metab Cardiovasc Dis 2019; 29:1077-1086. [PMID: 31377180 DOI: 10.1016/j.numecd.2019.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/09/2019] [Accepted: 06/17/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS We investigated how vasoreactivity in the brachial artery and the forearm resistance vessels were related to fat distribution and tissue volume, using both traditional imaging analysis and a new technique, called "Imiomics", whereby vasoreactivity was related to each of the >2M 3D image elements included in the whole-body magnetic resonance imaging (MRI). METHODS AND RESULTS In 326 subjects in the Prospective investigation of Obesity, Energy and Metabolism (POEM) study (all aged 50 years), endothelium-dependent vasodilation was measured by acetylcholine infusion in the brachial artery (EDV) and flow-mediated vasodilation (FMD). Fat distribution was evaluated by dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). EDV, but not FMD, was significantly related to total fat mass, liver fat, subcutaneous (SAT) and visceral (VAT) adipose tissue in a negative fashion in women, but not in men. Using Imiomics, an inverse relationship was seen between EDV and a local tissue volume of SAT in both the upper part of the body, as well as the gluteo-femoral part and the medial parts of the legs in women. Also the size of the liver, heart and VAT was inversely related to EDV. In men, less pronounced relationships were seen. FMD was also significantly related to local tissue volume of upper-body SAT and liver fat in women, but less so in men. CONCLUSION EDV, and to a lesser degree also FMD, were related to liver fat, SAT and VAT in women, but less so in men. Imiomics both confirmed findings from traditional methods and resulted in new, more detailed results.
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Affiliation(s)
- Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Robin Strand
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Karl Michaelsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Joel Kullberg
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Antaros Medical AB, BioVenture Hub, Mölndal, Sweden
| | - Håkan Ahlström
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Antaros Medical AB, BioVenture Hub, Mölndal, Sweden.
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30
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Censin JC, Peters SAE, Bovijn J, Ferreira T, Pulit SL, Mägi R, Mahajan A, Holmes MV, Lindgren CM. Causal relationships between obesity and the leading causes of death in women and men. PLoS Genet 2019; 15:e1008405. [PMID: 31647808 PMCID: PMC6812754 DOI: 10.1371/journal.pgen.1008405] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/09/2019] [Indexed: 12/25/2022] Open
Abstract
Obesity traits are causally implicated with risk of cardiometabolic diseases. It remains unclear whether there are similar causal effects of obesity traits on other non-communicable diseases. Also, it is largely unexplored whether there are any sex-specific differences in the causal effects of obesity traits on cardiometabolic diseases and other leading causes of death. We constructed sex-specific genetic risk scores (GRS) for three obesity traits; body mass index (BMI), waist-hip ratio (WHR), and WHR adjusted for BMI, including 565, 324, and 337 genetic variants, respectively. These GRSs were then used as instrumental variables to assess associations between the obesity traits and leading causes of mortality in the UK Biobank using Mendelian randomization. We also investigated associations with potential mediators, including smoking, glycemic and blood pressure traits. Sex-differences were subsequently assessed by Cochran's Q-test (Phet). A Mendelian randomization analysis of 228,466 women and 195,041 men showed that obesity causes coronary artery disease, stroke (particularly ischemic), chronic obstructive pulmonary disease, lung cancer, type 2 and 1 diabetes mellitus, non-alcoholic fatty liver disease, chronic liver disease, and acute and chronic renal failure. Higher BMI led to higher risk of type 2 diabetes in women than in men (Phet = 1.4×10-5). Waist-hip-ratio led to a higher risk of chronic obstructive pulmonary disease (Phet = 3.7×10-6) and higher risk of chronic renal failure (Phet = 1.0×10-4) in men than women. Obesity traits have an etiological role in the majority of the leading global causes of death. Sex differences exist in the effects of obesity traits on risk of type 2 diabetes, chronic obstructive pulmonary disease, and renal failure, which may have downstream implications for public health.
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Affiliation(s)
- Jenny C. Censin
- Big Data Institute at the Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sanne A. E. Peters
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jonas Bovijn
- Big Data Institute at the Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Teresa Ferreira
- Big Data Institute at the Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Sara L. Pulit
- Big Data Institute at the Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Anubha Mahajan
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Michael V. Holmes
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, United Kingdom
| | - Cecilia M. Lindgren
- Big Data Institute at the Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
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Is health status impaired in childhood cancer survivors? A systematic review and meta-analysis. Crit Rev Oncol Hematol 2019; 142:94-118. [PMID: 31394434 DOI: 10.1016/j.critrevonc.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND An increase in survival rates of childhood cancer is associated with long-term health issues in survivors. METHODS We conducted a systematic review and meta-analysis comparing health status-related endpoints in childhood cancer survivors (CCS) versus controls. RESULTS Eighty-six studies (n = 98,480 participants, 62% CCS) were included in the review. Of these, 73 studies (n = 96,550, 63% CCS) could be meta-analyzed. CCS showed a lower left ventricular ejection and fractional shortening (SMD=-0.59 and -0.55, respectively, both p < 0.01 [n=1,824 and 1,880]), a lower HDL-cholesterol concentration (SMD=-0.48, p<0.001, n=1,378) and a higher waist-to-hip ratio (SMD=0.61, p < 0.01, n=229) than their healthy peers. No significant differences were found for the remaining endpoints. CONCLUSIONS CCS is associated with a lower left ventricular function and HDL-cholesterol level, and a higher waist-to-hip ratio than healthy controls. These findings support the need to closely monitor the cardiometabolic health status of CCS and to implement preventive lifestyle interventions for this population.
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32
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Ferreira TDS, Barreto Silva MI, da Costa MS, Pontes KSDS, Castro FG, Antunes VP, Rosina KTDC, Menna Barreto APM, Souza E, Klein MRST. High abdominal adiposity and low phase angle in overweight renal transplant recipients. Clin Transplant 2019; 33:e13654. [PMID: 31241791 DOI: 10.1111/ctr.13654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/19/2019] [Accepted: 06/20/2019] [Indexed: 12/14/2022]
Abstract
Obesity is associated with increased risk of cardiovascular disease (CVD). Body mass index (BMI) is the most used parameter for obesity screening. However, the evaluation of CVD risk in overweight individuals should include the assessment of body fat distribution and body composition. Renal transplant recipients (RTR) have a high CVD risk and frequently present weight gain and loss of lean mass. The aim of this study was to evaluate body fat distribution and body composition in overweight RTR. This cross-sectional study was conducted with 86 RTR and 86 hypertensive individuals (comparison group, CG) presenting BMI 25-35 Kg/m2 and 45-70 years. Anthropometric evaluation included BMI, waist circumference, waist-to-height ratio, and a body shape index. Body composition was evaluated with bioelectrical impedance analysis (BIA). Glomerular filtration rate was estimated (eGFR) by CKD-EPI equation. RTR group (RTRG) and CG presented similar age and BMI. RTRG when compared to CG presented lower percentage of women and eGFR; higher central adiposity; and lower values of reactance, intracellular water, body cell mass and phase angle, more consistently observed in women. This study suggests that overweight RTR present higher abdominal adiposity and impairment in BIA parameters that are sensitive indicators of impaired membrane integrity, water distribution, and body cell mass.
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Affiliation(s)
- Thaís da Silva Ferreira
- Rio de Janeiro State University, Rio de Janeiro, Brazil.,Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Inês Barreto Silva
- Rio de Janeiro State University, Rio de Janeiro, Brazil.,Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | | - Ana Paula Medeiros Menna Barreto
- Rio de Janeiro State University, Rio de Janeiro, Brazil.,Federal University of Rio de Janeiro (Macaé Campus), Rio de Janeiro, Brazil
| | - Edison Souza
- Rio de Janeiro State University, Rio de Janeiro, Brazil
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Mroczek A, Kicka K, Kaczorowska A. Intergenerational differences in the body build of women. MEDICAL SCIENCE PULSE 2019. [DOI: 10.5604/01.3001.0013.2793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study analyzed generational differences in body build of woman. Aim of the study: The aim of the study was to examine the intergenerational differences in the body build of women. Material and methods: 90 women (30 female physiotherapy students, their mothers and grandmothers) were examined. Their heights, weights, waist circumferences, and waist and hip circumferences were measured. Their Body mass index (BMI) and Waist to Hip Ratio (WHR) were calculated. Their frequency of underweight, overweight and obesity were estimated. WHO criteria were applied. The results were subjected to statistical analysis. Descriptive statistics were calculated. The Shapiro-Wilk test for testing the normal distribution was used. The Kruskal-Wallis test and post-hoc test were used. A significance level alpha of 0.05 was assumed. Statistica 13.1 was used for calculations. Results: The median body height of the female students was 166.8 cm, their mothers 160.8 cm, and grandmothers 158.0 cm. Their median body masses were, respectively: 59.4 kg, 70.1 kg and 72.5 kg. Their median BMIs were 21.4 kg/m2, 26.3 kg/m2, and 29.2 kg/ m2, and their WHRs were 0.80, 0.86, and 0.87, respectively. Underweight was only seen in students (13%). The prevalence of overweight female students (BMI ≥30) was 10%, their mothers 33% and their 13% grandmothers, whereas obesity was 7%, 30% and 50%, respectively. Conclusions: There were intergenerational differences in the body structure of women. In subsequent generations, the size of the body increased, and height of the body decreased. There were differences between mothers and offspring. From an early age, body growth should be monitored to prevent obesity development with age.
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Affiliation(s)
- Agata Mroczek
- Department of Physiotherapy, Opole Medical School, Poland
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34
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Blomquist GE. Unpacking the heritability of body mass index and other ratios. Am J Hum Biol 2019; 31:e23289. [PMID: 31243841 DOI: 10.1002/ajhb.23289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/20/2019] [Accepted: 06/09/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Ratios of weight to height, especially body mass index (BMI = kg/m2 ), are often used in epidemiological and genetic studies of health, but the limitations of quantitative genetic analysis of ratios are not widely known. The heritability of these ratios can be closely approximated from a bivariate quantitative genetic model of weight and height which clarifies how BMI heritabilities change. METHODS I explored this bivariate approximation and alternative measures through simulated datasets fit with linear mixed models. Simulated data were based on published heritabilities and other statistics for BMI and related anthropometric dimensions from four human samples. RESULTS Inspection of the bivariate approximation and analysis of simulated data show the heritability of weight/height crucially depends on the phenotypic (rP ) and genetic correlations (rA ) between weight and height. Changes in these correlations can have dramatic effects on the heritability of BMI. For example, when rP ≪ rA heritability of BMI is reduced to 35-50% of its value when the correlations are equal. DISCUSSION Increasing adiposity likely decreases the phenotypic correlations more than the genetic correlation resulting in reduced heritability of the ratio. This contrasts with the commonly reported stability or increase of BMI heritability and implies it may result from increased genetic variance in weight in obesogenic environments. The bivariate model offers other advantages over ratios, including estimating the conditional genetic variance or heritability of weight that is unassociated with height, which may prove useful in quantitative and molecular genetic studies.
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Santoro A, Bazzocchi A, Guidarelli G, Ostan R, Giampieri E, Mercatelli D, Scurti M, Berendsen A, Surala O, Jennings A, Meunier N, Caumon E, Gillings R, Kadi F, Capel F, Cashman KD, Pietruszka B, Feskens EJM, De Groot LCPGM, Battista G, Salvioli S, Franceschi C. A Cross-Sectional Analysis of Body Composition Among Healthy Elderly From the European NU-AGE Study: Sex and Country Specific Features. Front Physiol 2018; 9:1693. [PMID: 30555339 PMCID: PMC6283977 DOI: 10.3389/fphys.2018.01693] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/09/2018] [Indexed: 12/31/2022] Open
Abstract
Body composition (BC) is an emerging important factor for the characterization of metabolic status. The assessment of BC has been studied in various populations and diseases such as obesity, diabetes, endocrine diseases as well as physiological and paraphysiological conditions such as growth and aging processes, and physical training. A gold standard technique for the assessment of human BC at molecular level is represented by dual-energy X-ray absorptiometry (DXA), which is able to precisely assess the body mass (and areal bone mineral density-aBMD) on a regional and whole-body basis. For the first time, within the framework of the NU-AGE project, BC has been assessed by means of a whole-body DXA scan in 1121 sex-balanced free-living, apparently healthy older adults aged 65–79 years enrolled in 5 European countries (Italy, France, United Kingdom, Netherlands, and Poland). The aim of this analysis is to provide a complete profile of BC in healthy elderly participants from five European countries and to investigate country- and sex-related differences by state-of-the-art DXA technology. To compare BC data collected in different centers, specific indexes and ratios have been used. Non-parametric statistical tests showed sex-specific significant differences in certain BC parameters. In particular, women have higher fat mass (FM) (Fat/Lean mass ratio: by 67%, p < 2.2e-16) and lower lean mass (Lean Mass index: by -18%, p < 2.2e-16) than men. On the other hand, men have higher android FM than women (Android/gynoid FM ratio: by 56%, p < 2.2e-16). Interesting differences also emerged among countries. Polish elderly have higher FM (Fat/Lean mass ratio: by 52%, p < 2.2e-16) and lower lean mass (Skeletal Mass index: by -23%, p < 2.2e-16) than elderly from the other four countries. At variance, French elderly show lower FM (Fat/Lean mass ratio: by -34%, p < 2.2e-16) and higher lean mass (Skeletal Mass index: by 18%, p < 2.2e-16). Moreover, five BC profiles in women and six in men have been identified by a cluster analysis based on BC parameters. Finally, these data can serve as reference for normative average and variability of BC in the elderly populations across Europe.
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Affiliation(s)
- Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Giulia Guidarelli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Enrico Giampieri
- Department of Physics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Maria Scurti
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
| | - Agnes Berendsen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Olga Surala
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw, Poland
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | | | | | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Fawzi Kadi
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Frederic Capel
- Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw, Poland
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Lisette C P G M De Groot
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Stefano Salvioli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
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36
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Liu XZ, Li HH, Huang S, Zhao DB. Association between hyperuricemia and nontraditional adiposity indices. Clin Rheumatol 2018; 38:1055-1062. [PMID: 30498873 DOI: 10.1007/s10067-018-4374-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 10/18/2018] [Accepted: 11/16/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND The association between several novel adiposity indices and hyperuricemia is inconclusive. Therefore, we aimed to investigate this association so as to provide theoretical support for the management of hyperuricemia in overweight/obese individuals. METHODS A cross-sectional study was carried out among 174,698 adults. The values of body adiposity index (BAI), conicity index (CI), a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), lipid accumulation product (LAP) index, and cardiometabolic index (CMI) were divided into four quartiles, and multivariate logistic analysis was used to analyze the association between them and hyperuricemia. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the power of predictions for hyperuricemia. RESULTS After adjusting for confounding variables, LAP and CMI exhibited stronger association with hyperuricemia than other indices. The odd ratio (OR) for hyperuricemia in the highest quartile of the LAP and CMI was 2.049 (CI 95% = 1.824-2.302) and 4.332(CI 95% = 3.938-4.765). The AUC value of LAP was 0.632 (95% CI = 0.626-0.637), p < 0.001; and the AUC value of CMI was 0.687 (95% CI = 0.682-0.692), p < 0.001. The optimal cutoff values of LAP and CMI were 26.21 and 0.485, respectively. CONCLUSIONS LAP and CMI, combination of WC and lipid parameters and reliable visceral adiposity indices, were strongly associated with hyperuricemia than other indices. So they could be potential monitoring indicators for hyperuricemia management in overweight/obese individuals.
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Affiliation(s)
- Xing Zhen Liu
- Army Convalescence Area, Hangzhou Sanatorium of People's Liberation Army, Hangzhou, China
| | - Hui Hua Li
- Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, China
| | - Shan Huang
- Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, China.
| | - Dong Bao Zhao
- Department of Rheumatology, Changhai Hospital, Naval Military Medical University (The Second Military Medical University), Shanghai, China.
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