Predictive models for estimating visceral fat: The contribution from anthropometric parameters

Comparison of novel and traditional anthropometric indices in Eastern-China adults: which is the best indicator of the metabolically obese normal weight phenotype?

BACKGROUND

People with the metabolically obese normal weight (MONW) phenotype have been confirmed to significantly increase the risk of unfavorable health consequences. This study aimed to investigate the relationships between traditional and novel anthropometric indices with the MONW phenotype and compare the predictive ability of different anthropometric indices in identifying individuals with the MONW phenotype.

METHODS

This cross-sectional study involved a total of 26,332 participants aged 18 years or older with a normal weight from Nanjing, China. Sociodemographic information, biochemical measurements, and anthropometric indices were collected. The novel body fat anthropometric indices included body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), weight-adjusted-waist index (WWI), body adiposity index (BAI), conicity index (CI), waist-hip-height ratio (WHHR), as well as traditional indices such as waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).The prevalence ratio (PR) from modified poisson regression and area under the receiver-operating characteristic curve (AUC) were conducted to compare the association and predictive capacity of different obesity indicators for the MONW phenotype. All analyses were stratified by sex.

RESULTS

Modified poisson regression analyses revealed that weight, WC, HC, BMI, WHR, WHtR, ABSI, BRI, AVI, WWI, BAI, CI, and WHHR were independently associated with higher risk of the MONW phenotype, regardless of whether they were treated as a continuous or categorical variable (P < 0.05). Notably, BRI demonstrated the strongest association in both men (highest quartile VS lowest quartile; PR = 3.14, 95%CI, 2.49, 3.96; P < 0.001) and women (PR = 4.63, 95%CI, 3.81, 5.62; P < 0.001). Receiver operating characteristic analysis indicated that AUC for the different anthropometric indices ranged from 0.50 to 0.80. BRI and WHtR had the largest AUC in both males (both AUC = 0.733; 95% CI, 0.717, 0.750) and females (both AUC = 0.773; 95% CI, 0.761, 0.786). The optimal cut-off points for BRI, determined by maximizing the Youden's index, were 3.102 (sensitivity: 63.2%, specificity: 36.2%) in males and 3.136 (sensitivity: 68.9%, specificity: 44.2%) in females. Moreover, BRI and WHtR exhibited the highest diagnostic accuracy in younger age groups, specifically those aged 18-34 in both sexes.

CONCLUSIONS

BRI emerged as the optimal predictor and independent determinant of the MONW phenotype, regardless of gender. This association was particularly pronounced in young individuals.

Association between weight-adjusted waist index and risk of diabetes mellitus type 2 in United States adults and the predictive value of obesity indicators

BACKGROUND

The weight-adjusted waist index (WWI) is a quantitative anthropometric index that can be applied to evaluate obesity. This study examined the relationship between adult United States (US) residents' risk of diabetes mellitus type 2 (T2DM) and WWI.

METHODS

The NHANES (National Health and Nutrition Examination Survey) 2001-2018 provided the data for this investigation. This study used multifactorial logistic regression analysis, smoothed curve fitting, subgroup analysis, and interaction tests to assess the association between WWI and T2DM. Additionally, threshold effects were calculated using a two-stage linear regression model. The receiver operating characteristic(ROC) curves evaluated the diagnostic ability of the WWI and commonly used obesity indicators.

RESULTS

20,477 participants were enrolled in the analysis, and patients with greater levels of WWI had a higher prevalence of T2DM. WWI and T2DM have a non-linear relationship, with a positive association found on the left side of the breakpoint (WWI = 12.35) (OR = 1.82, 95%CI:1.64-2.02), whereas, on the right side, no such relationship was found (OR = 0.9, 95%CI:0.61-1.34). For every unit rise in WWI, the probability of having T2DM increased by 67% after controlling for all other variables (OR:1.67,95%CI:1.53-1.83). Based on subgroup analyses, individuals under 40 had a higher correlation between WWI and T2DM (P < 0.001).ROC analyses showed that WWI had the best discrimination and accuracy in predicting T2DM compared to other obesity indicators (WC, BMI, and Weight).

CONCLUSION

Higher WWI values had a higher prevalence of T2DM in US individuals, especially in adults under 40. WWI has the strongest ability to predict T2DM. Therefore, the importance of WWI in the early identification of T2DM in US adults should be emphasized.

Prediction of future visceral adiposity and application to cancer research: The Multiethnic Cohort Study

BACKGROUND

We previously developed a prediction score for MRI-quantified abdominal visceral adipose tissue (VAT) based on concurrent measurements of height, body mass index (BMI), and nine blood biomarkers, for optimal performance in five racial/ethnic groups. Here we evaluated the VAT score for prediction of future VAT and examined if enhancement with additional biomarkers, lifestyle behavior information, and medical history improves the prediction.

METHODS

We examined 500 participants from the Multiethnic Cohort (MEC) with detailed data (age 50-66) collected 10 years prior to their MRI assessment of VAT. We generated three forecasted VAT prediction models: first by applying the original VAT equation to the past data on the predictors ("original"), second by refitting the past data on anthropometry and biomarkers ("refit"), and third by building a new prediction model based on the past data enhanced with lifestyle and medical history ("enhanced"). We compared the forecasted prediction scores to future VAT using the coefficient of determination (R2). In independent nested case-control data in MEC, we applied the concurrent and forecasted VAT models to assess association of the scores with subsequent incident breast cancer (950 pairs) and colorectal cancer (831 pairs).

RESULTS

Compared to the VAT prediction by the concurrent VAT score (R2 = 0.70 in men, 0.68 in women), the forecasted original VAT score (R2 = 0.54, 0.48) performed better than past anthropometry alone (R2 = 0.47, 0.40) or two published scores (VAI, METS-VF). The forecasted refit (R2 = 0.61, 0.51) and enhanced (R2 = 0.62, 0.55) VAT scores each showed slight improvements. Similar to the concurrent VAT score, the forecasted VAT scores were associated with breast cancer, but not colorectal cancer. Both the refit score (adjusted OR for tertile 3 vs. 1 = 1.27; 95% CI: 1.00-1.62) and enhanced score (1.27; 0.99-1.62) were associated with breast cancer independently of BMI.

CONCLUSIONS

Predicted VAT from midlife data can be used as a surrogate to assess the effect of VAT on incident diseases associated with obesity, as illustrated for postmenopausal breast cancer.

Novel anthropometric measures are positively associated with erectile dysfunction: a cross-sectional study

BACKGROUND

Currently, a growing number of research studies have shown a positive association between obesity and erectile dysfunction, while traditional anthropometric measures, such as BMI, have limited ability to assess the risk of erectile dysfunction. Therefore, this study aimed to investigate the association between the new anthropometric index and erectile dysfunction.

METHODS

A study involving 3594 participants from the National Health and Nutrition Examination Survey was conducted. The study calculated various anthropometric indices such as waist circumference (WC), waist-to-height ratio (WtHR), body mass index (BMI), a body shape index (ABSI), conicity index (CI), and body roundness index (BRI). The relationship between anthropometric indices and erectile dysfunction (ED) was investigated using multivariate logistic regression and restricted cubic splines (RCS). Interaction analysis was conducted on subgroups to confirm the findings. Additionally, the efficacy of various anthropometric indicators in predicting the risk of erectile dysfunction was assessed using the receiver operating characteristic curve (ROC).

RESULTS

After adjusting for potential confounding factors, we identified a positive and independent correlation between erectile dysfunction (ED) and all other anthropometric measures except for BMI. Additionally, the risk of ED increased by 49% and 42% for each standard deviation increment in ABSI and CI, respectively. Dose-response curve analysis demonstrated that WC, BMI, WtHR, and CI displayed a non-linear correlation with the risk of ED. The subgroup analysis revealed that individuals classified as White, who had higher levels of WC, ABSI, and CI, were more susceptible to erectile dysfunction compared to people from other races. ROC analysis showed that ABSI was superior in detecting erectile dysfunction (area under the curve: 0.750; 95% CI 0.732-0.768; optimal cutoff value: 0.083) as compared to other indices. The combination of obesity defined by BMI and other anthropometric measures showed that higher ABSI and CI levels were positively associated with the prevalence of erectile dysfunction, independent of BMI (P < .001).

CONCLUSION

In this study, anthropometric indicators including ABSI, BRI, WtHR, CI, and WC were positively associated with erectile dysfunction. To improve the prevention and treatment of this condition, it is recommended that new anthropometric indicators receive greater consideration.

Prediction of high visceral adipose tissue for sex-specific community residents in Taiwan

Visceral adipose tissue accumulation is strongly linked with numerous chronic diseases; however, the accessibility for visceral adipose tissue measurement is limited. This study employed a cross-sectional design to determine the optimal strongest predictor of high visceral adipose tissue in each sex and identified the optimal cutoff value thereof. Purposive sampling was used to recruit 94 men and 326 women aged ≥40 years in southern Taiwan. Receiver operating characteristic curve analysis was used to explore the optimal predictor of high visceral adipose tissue (defined as ≥135 cm2 for men and ≥100 cm2 for women) in each sex. The waist-to-hip ratio was the strongest predictor for men, with a cutoff value of 0.96 yielding the maximum sensitivity (94.29%) and specificity (93.22%). By contrast, body mass index was the strongest predictor for women, with a cutoff value of 25.45 kg/m2 yielding the maximum sensitivity (87.18%) and specificity (87.55%). The results may serve as a reference for health policy-makers in screening for high visceral adipose tissue to identify individuals at high risk of developing chronic diseases for health promotion.

The Visceral Adiposity Index Is a Better Predictor of Excess Visceral Fat in Military Pilots: A Cross-sectional Observational Study

INTRODUCTION

Visceral adipose tissue (VAT) is related to cardiometabolic risk. Estimating it using the visceral adiposity index (VAI) could identify this risk in the Brazilian Air Force (BAF) aviator population. The aim here is to verify the predictive capacity of the VAI for identifying visceral fat areas compared to traditional obesity indicators in BAF pilots.

MATERIALS AND METHODS

Forty male BAF pilots were recruited. The study was conducted in two stages: the first applied a structured questionnaire to characterize the sample and identify sedentary behavior and the second obtained nutritional, anthropometric, and body composition data, carrying out biochemical and magnetic resonance imaging tests and investigating physical activity level in this stage. The comparison of the predictive capacity of the VAI with that of other adiposity indicators (body mass index [BMI], waist circumference, waist-height ratio, waist-hip ratio, and neck circumference) for detecting increased VAT and the determination of the optimal cutoff points for the different adiposity indicators were carried out using receiving operating characteristic (ROC) curves. An association was verified between the adiposity indicators and excess visceral fat using Poisson regression analysis with robust variance.

RESULTS

The VAI presented a better predictive capacity for VAT (area under the ROC curve = 0.941), while the BMI did not present diagnostic accuracy (95% CI < 0.5). The strength of the association with high visceral fat was also greater for the VAI than for the other indicators evaluated.

CONCLUSIONS

The VAI was shown to be a better predictor of excess VAT in relation to the other indicators studied. As it is a more easy-access and lower-cost technique than resonance, it enables greater applicability in tracing and monitoring the visceral obesity of a large contingent of military personnel.

Cut points of the conicity index as an indicator of abdominal obesity in individuals undergoing hemodialysis: An analysis of latent classes

OBJECTIVES

Abdominal obesity favors the involvement of cardiometabolic complications in renal patients on hemodialysis. Thus, the aim of the study was to identify the cut-points of the conicity index in individuals undergoing hemodialysis.

METHODS

This was a cross-sectional study carried out with 953 individuals undergoing hemodialysis in clinics in a metropolitan region of southeastern Brazil. The conicity index was calculated using the following mathematical equation: waist circumference/0.109 × √weight/height. The receiver operating characteristic (ROC) curve was calculated from the analysis of latent classes by cross-validation through a latent variable of abdominal obesity. This latent variable was defined using the response pattern of the observed anthropometric variables considering the presence and absence of abdominal obesity: waist circumference, waist-to-height ratio, and body shape index. The cut-points identified were elucidated by the area under the curve (AUC), Youden index, sensitivity, and specificity.

RESULTS

The cut-points for the conicity index found for both sexes were similar, resulting in a cut-point for men of 1.275 (AUC, 0.921; Youden index, 0.666), with a sensitivity and specificity of 83% and 83.6%, and a cut-point for women of 1.285 (AUC, 0.921; Youden index, 0.679), with a sensitivity and specificity of 78.6% and 89.3%, respectively.

CONCLUSIONS

The conicity index showed high discriminatory power for the identification of abdominal obesity in hemodialysis patients, therefore it can be a simple and easily accessible tool to be incorporated into clinical practice in this population.

Proposal of a Mathematical Model to Monitor Body Mass over Time in Subjects on a Diet

Nowadays, slimming diet methodology works within a reduction of body mass using a decrease of dietary energy intake. However, there is no suitable method for understanding the dynamic process of body mass metabolic transformation over time. In the present paper, we have developed a biomathematic model to explain the temporal trend of body mass and its variations of people who have undergone a change in their diet using the solving equation of the model. Data relating to sex, age, body mass, and BMI were collected, and the compartmental model used to interpret the body mass trends was constructed by assuming that the mass results from the sum of the metabolic processes: catabolic, anabolic, distributive. The validation of the model was carried out by variance analysis both on the total and individual data sets. The results confirm that the trend of body mass and its variations over time depends on metabolic rates. These are specific to each individual and characterize the distribution of nutritional molecules in the various body districts and the processes catabolic, anabolic, distributive. Body mass and its variations are justified by the metabolic transformations of the nutritional quantities. This would explain why energetically equal diets can correspond to people of different body mass and that energy-different diets can correspond to people of body mass at all similar.

Estimation of visceral fat area using criteria for metabolic syndrome: A cross-sectional study

BACKGROUND AND AIMS

The aim of this study was to calculate the visceral fat area (VFA) based on the criteria for metabolic syndrome (MetS).

METHODS

A multiple regression analysis was performed to determine the estimated VFA using data from Japanese participants (2315 men and 1684 women). Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal estimated VFA cutoff for the diagnosis of central obesity. The cutoff was also applied to a second cohort to validate the model.

RESULTS

The estimated VFA was calculated using the MetS criteria, age, and body mass index (adjusted coefficient of determination = 0.682 for men and 0.726 for women). The area under the ROC curve for waist circumference, VFA, and estimated VFA were 0.669, 0.741, and 0.749, respectively, for men and 0.711, 0.787, and 0.803, respectively, for women. The optimal cutoffs for estimated VFA were 128.1 cm² for men and 82.2 cm² for women. Multivariate logistic regression for heart disease revealed that estimated VFA, rather than waist circumference, was associated with a high risk of heart disease.

CONCLUSION

The estimated VFA is a better index of central obesity than waist circumference and VFA for the diagnosis of MetS.

Evaluation of the Value of Waist Circumference and Metabolomics in the Estimation of Visceral Adipose Tissue

Visceral adipose tissue (VAT) is a strong prognostic factor for cardiovascular disease and a potential target for cardiovascular risk stratification. Because VAT is difficult to measure in clinical practice, we estimated prediction models with predictors routinely measured in general practice and VAT as outcome using ridge regression in 2,501 middle-aged participants from the Netherlands Epidemiology of Obesity study, 2008-2012. Adding waist circumference and other anthropometric measurements on top of the routinely measured variables improved the optimism-adjusted R2 from 0.50 to 0.58 with a decrease in the root-mean-square error (RMSE) from 45.6 to 41.5 cm2 and with overall good calibration. Further addition of predominantly lipoprotein-related metabolites from the Nightingale platform did not improve the optimism-corrected R2 and RMSE. The models were externally validated in 370 participants from the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS, 2006-2009) and 1,901 participants from the Multi-Ethnic Study of Atherosclerosis (MESA, 2000-2007). Performance was comparable to the development setting in PIVUS (R2 = 0.63, RMSE = 42.4 cm2, calibration slope = 0.94) but lower in MESA (R2 = 0.44, RMSE = 60.7 cm2, calibration slope = 0.75). Our findings indicate that the estimation of VAT with routine clinical measurements can be substantially improved by incorporating waist circumference but not by metabolite measurements.

Abdominal Obesity is Associated with Physical Activity Index in Indonesian Middle-Aged Adult Rural Population: A Cross-Sectional Study

Background

Obesity is one of the significant health problems. Physical activity includes a potential modifier in the development of abdominal obesity.

Objective

The objective of the study is to analyze the association between physical activity and abdominal obesity in middle-aged adults in the Indonesian rural population.

Methods

A community-based study was conducted in a rural area of Malang, Indonesia. Data were collected using interviews to obtain sociodemographic and physical activity index (PAI). Waist circumference was measured using a tape measure. Data were analyzed using one-way ANOVA and logistic regression.

Results

A total of 75 adults (62.7% were female) was included in this study. Mean waist circumference was 88.18 ± 9.21 cm. Total prevalence of abdominal obesity was 69.3%. Among the total of participants, 29.3% were inactive. A significant association was found between physical activity and abdominal obesity. Participants with inactive PAI have a higher risk of suffering from abdominal obesity than those with active PAI with odds ratio = 7.04; 95% confidence interval: 1.55-31.99.

Conclusion

In middle-aged adults living in a rural area of Indonesia, physical activity was associated with a lower risk of abdominal obesity. Strategies for preventing and reducing abdominal obesity in rural areas should consider improving physical activity.

Comparison of anthropometric indices for predicting the risk of metabolic syndrome in older adults

Background. The prevalence of obesity and metabolic syndrome (MetS) is increasing, worldwide. Using a simple, efficient and reliable tool for predicting MetS is an essential approach in preventive health programs. The aim of this study was to compare the different anthropometric indices in predicting metabolic syndrome in older adults.Methods. This cross-sectional study is a part of the Amirkola Health and Ageing cohort Project (2011-2016). Of total, 1,488 older people aged 60-92 years were entered to the study. Medical and personal information of participants were collected by a questionnaire. After measuring the height, weight, waist circumference, hip circumference and neck circumference, body mass index, waist to hip ratio, waist to height ratio, abdominal volume index and conicity index were calculated. Independent t-test, chi-square and ROC curve were used to analyze the data.Results. Based on ATPIII-2005 diagnostic criteria, the prevalence of metabolic syndrome was 71.57%.The prevalence in female was higher than male. All of examined anthropometric indices, except neck circumference (p = 0.10), showed a significant difference in people with MetS compared to the individuals without metabolic syndrome (p<0.001). Waist to height ratio showed the largest area under the curve for predicting MetS (0.786; 95% CI: 0.76-0.81) followed by BMI (0.746; 95% CI: 0.71-0.77), AVI (0.745; 95% CI: 0.71-0.77), and waist circumference (0.743; 95% CI: 0.71-0.77).Conclusion. Waist to height ratio was the best predictor of MetS in older adults.

Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults

Background

Metabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease. Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.

Methods

Cross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.

Results

After adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: − 0.227 for male, − 0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female’s high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.

Conclusions

AVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.

DEVELOPMENT AND VALIDATION OF EQUATIONS TO ESTIMATE VISCERAL ADIPOSE TISSUE IN MILITARY MEN

ABSTRACT Introduction It has been suggested that visceral adipose tissue (VAT) is associated with several non-communicable chronic diseases, but measuring it is difficult. Thus, anthropometry could be used because is easily applied in clinical practice. Objectives The present study aimed to develop and validate VAT estimation equations (Eq) in military men. Methods The sample consisted of 409 (mean age, 36.5 ± 6.7 years) military men in the Brazilian Army (BA) divided into an equation group (EG) ( n = 270; mean age, 37.0 ± 6.3 years) and a validation group (VG) ( n =139; mean age, 36.0 ± 7.2 years). Anthropometric, hemodynamic and DXA body composition evaluations ( GE iLunar ) were performed. The Student’s t test, Pearson’s correlation, and stepwise general linear regression were applied. Bland-Altman graphics were used to assess the concordance between VAT by Eq and by DXA. The level of significance was 95% ( p < 0.05). Results Age, waist circumference (WC), hip circumference and body mass index presented the main significant positive correlations with the VAT-DXA. Four Eq were created Eq1 ( r 2 = 0.793), Eq2 ( r 2 = 0.810), Eq3 ( r 2 = 0.817), and Eq 4 ( r 2 = 0.823) ( p < 0.05). No differences were observed between VAT by DXA and VAT by Eq ( p = 0.982, p = 0.970, p = 0.495 and p = 0.698). Bland-Altman analysis also presented good concordance as the bias was close to zero and was not statistically significant. Conclusion Eq2 (age*13.0 + WC*60.0 - 4975,.5) was more suitable because it is easier to apply, has a higher predictive power (81.0%), less bias (1.86) and validation yielded average VAT values close to those found in DXA. It may still be considered a valuable tool for other extensive epidemiological studies in military men in the BA and can be used in adult men. Evidence Level I: Development of diagnostic criteria on consecutive patients (with universally applied reference ‘‘gold’’ standard).

Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: A multicentric prospective evaluation

AIMS

COVID-19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID-19 inpatients.

MATERIALS AND METHODS

We prospectively and consecutively enrolled COVID-19 adult patients admitted to dedicated medical wards of two Italian hospitals from 25 March to 7 April 2020. On admission, clinical, biochemical and anthropometric data, including BMI and NC were collected. As primary outcome measure, the maximum respiratory support received was evaluated. Follow-up time was 30 days from hospital admission.

RESULTS

We enrolled 132 subjects (55.0-75.8 years, 32% female). During the study period, 26 (19.7%) patients underwent IMV. In multivariable logistic regression analyses, after adjusting for age, sex, diabetes, hypertension and COPD, NC resulted independently and significantly associated with IMV risk (adjusted OR 1.260-per 1 cm increase 95% CI:1.120-1.417; P < .001), with a stronger association in the subgroup with BMI ≤30 Kg/m² (adjusted OR 1.526; 95% CI:1.243-1.874; P < .001). NC showed a good discrimination power in predicting patients requiring IMV (AUC 0.783; 95% CI:0.684-0.882; P < .001). In particular, NC > 40.5 cm (>37.5 for females and >42.5 for males) showed a higher and earlier IMV risk compared to subjects with lower NC (Log-rank test: P < .001).

CONCLUSIONS

NC is an easy to measure parameter able to predict the need for IMV in adult COVID-19 inpatients.

Registration-based Construction of a Whole-body Human Phantom Library for Anthropometric Modeling

Various computational human phantoms have been proposed in the past decades, but few of them include delicate anthropometric variations. In this study, we build a whole-body phantom library including 145 anthropometric parameters. This library is constructed by registration-based pipeline, which transfers a standard whole-body anatomy template to an anthropometry-adjustable body shape library (MakeHuman™). Therefore, internal anatomical structures are created for body shapes of different anthropometric parameters. Based on the constructed library, we can generate individualized whole-body phantoms according to given arbitrary anthropometric parameters. Moreover, the proposed phantom library can also be converted to voxel-based and tetrahedron-based model for further personalized simulation. We hope this phantom library will serve as a computational tool in research community.

Neck circumference is an independent risk factor for hyperuricemia within 3 years in women: a longitudinal study

INTRODUCTION

Our previous cross-sectional study revealed the association between neck circumference (NC) and hyperuricemia. This study aimed to further investigate the longitudinal association between NC and hyperuricemia and to compare the strengths of longitudinal association of NC and waist circumference (WC) with hyperuricemia.

METHODS

A total of 4383 subjects without hyperuricemia at baseline were included. Multivariable linear regression was used to assess the association between baseline anthropometric indices and uric acid level at follow-up. Cox regression was used to assess the relationship between baseline anthropometric indices and the risk of future hyperuricemia. A receiver-operating characteristic curve was used to compare the predictive ability of baseline anthropometric indices for future hyperuricemia.

RESULTS

Among women, only baseline NC was positively, linearly associated with uric acid level at follow-up (β = 1.75) and risk of future hyperuricemia (p_trend < 0.05); risk of hyperuricemia in the third and fourth quartile groups of baseline NC significantly increased, compared with the first quartile group of baseline NC (HR = 1.48 and 1.81, respectively). Among men, neither NC nor WC was associated with hyperuricemia after adjusting for confounder factors. The area under the curve of baseline NC and WC for hyperuricemia was comparable in both genders (0.606 for NC and 0.599 for WC in women, 0.578 for NC and 0.602 for WC in men).

CONCLUSIONS

For women, only baseline NC is an independent risk factor of hyperuricemia within 3 years. NC and WC have a similar 3-year predictive ability for hyperuricemia in both genders. Key Points • This is the first study to assess the longitudinal association between neck circumference and hyperuricemia. • According to the results of this study, we propose for the first time that neck circumference is an independent risk factor for hyperuricemia in women in the future, rather than waist circumference. • We found for the first time that neck circumference and waist circumference have similar predictive ability for future hyperuricemia in both genders.

Prevalence of Systemic Arterial Hypertension and Associated Factors Among Adults from the Semi-Arid Region of Pernambuco, Brazil

Background

Systemic arterial hypertension is a substantial public health problem responsible for millions of deaths per year worldwide. However, little is known about the epidemiology of this disease in areas distant from large urban centers in Brazil. Such information is necessary to plan health promotion strategies.

Objective

To estimate the prevalence of hypertension and determine its associated factors in adults residing in the semi-arid region of the state of Pernambuco, Northeastern Brazil.

Method

This is a cross-sectional study conducted with a random sample of male and female adults. Individuals with systolic blood pressure ≥ 140 mm/Hg and/or diastolic blood pressure ≥ 90 mm/Hg and those who reported being under treatment with antihypertensive drugs were considered hypertensive. We collected data on demographic, socioeconomic, behavioral, and anthropometric characteristics, as well as health and nutrition. The statistical analysis used Pearson’s chi-square test, the chi-square test for trend, and multivariate Poisson regression analysis. A p-value < 0.05 in the final model was considered indicative of statistical significance.

Results

The sample consisted of 416 individuals, and the prevalence of hypertension was 27.4% (95%CI 23.2 - 32.0). In the final model, the independent predictors of hypertension were age of 40 years or older (p = 0.000), low economic class (p = 0.007), smoking (p = 0.023), overweight determined by the body mass index (p = 0.003), and reduced glucose tolerance/diabetes mellitus (p = 0.012).

Conclusion

The prevalence of hypertension was high and related to important risk factors. Thus, prevention and control strategies are recommended.

Metabolic Score for Visceral Fat (METS-VF), a novel estimator of intra-abdominal fat content and cardio-metabolic health

BACKGROUND & AIMS

Intra-abdominal and visceral fat (VAT) are risk factors for the development of cardio-metabolic comorbidities; however its clinical assessment is limited by technology and required expertise for its assessment. We aimed to develop a novel score (METS-VF) to estimate VAT by combining the non-insulin-based METS-IR index, waist-height ratio (WHtr), age and sex.

METHODS

We developed METS-VF in a sample of 366 individuals with Dual X-ray absorptiometry (DXA). METS-VF was modeled using non-linear regression and validated in two replication cohorts with DXA (n = 184, with n = 118 who also had MRI) and bio-electrical impedance (n = 991). We also assessed METS-VF to predict incident type 2 diabetes (T2D) and arterial hypertension independent of body-mass index (BMI) in our Metabolic Syndrome Cohort (n = 6144).

RESULTS

We defined METS-VF as: 4.466 + 0.011*(Ln(METS-IR))³ + 3.239*(Ln(WHtr))³ + 0.319*(Sex) + 0.594*(Ln(Age)). METS-VF showed better performance compared to other VAT surrogates using either DXA (AUC 0.896 95% CI 0.847-0.945) or MRI (AUC 0.842 95% CI 0.771-0.913) as gold standards. We identified a METS-VF cut-off point >7.18 in healthy patients which has 100% sensitivity (95% CI 76.8-100) and 87.2% specificity (95% CI 79.1-93.0) to identify increased VAT (>100 cm²). METS-VF also had adequate performance in subjects with metabolically-healthy obesity. Finally, in our metabolic syndrome cohort, subjects in the upper quintiles of METS-VF (>7.2) had 3.8 and 2.0-fold higher risk of incident T2D and hypertension, respectively (p < 0.001). This effect was independent of BMI for both outcomes.

CONCLUSION

METS-VF is a novel surrogate to estimate VAT, which has better performance compared to other surrogate VAT indexes and is predictive of incident T2D and hypertension. METS-VF could be a useful tool to assess cardio-metabolic risk in primary care practice and research settings.

A relação pescoço-coxa (RPCx) pode servir como índice antropométrico para diagnosticar a síndrome metabólica?

Resumo Objetivo: Investigar a Relação Pescoço-Coxa (RPCx) como índice antropométrico para diagnosticar a Síndrome Metabólica em estudantes universitários brasileiros. Métodos: Estudo transversal com 691 adultos (> 18 anos) de ambos os sexos. Foram investigados os seguintes parâmetros antropométricos: circumferência abdominal, circumferência de pescoço, circumferência de coxa, índice de massa corporal e RPCx. Além disso, foram coletados dados laboratoriais, tais como: triglicérides, glicemia e colesterol HDL. Resultados: Foram encontrados valores de circumferência abdominal (83,59 ± 10,68 cm), de pescoço (37,29 ± 2,36 cm), coxa (52,37 ± 5,71 cm) e relação de pescoço-coxa (0,72 ± 0,07 cm) superiores entre os homens (p <0,001). Ao analisar os componentes da síndrome, a RPCx mostrou uma correlação linear positiva estatisticamente significante com todos. Conclusão: Nesta pesquisa foi demonstrado que a RPCx não serve como critério diagnóstico da SM, mas indica alterações nos componentes constituintes da síndrome.