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Tylutka A, Morawin B, Walas Ł, Zembron-Lacny A. Does excess body weight accelerate immune aging? Exp Gerontol 2024; 187:112377. [PMID: 38346543 DOI: 10.1016/j.exger.2024.112377] [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: 11/26/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Overweight and obesity in older adults increase the risk of a range of comorbidities by sustaining chronic inflammation and thus enhancing immunosenescence. This study aimed to assess whether excess body mass affected disproportion in T lymphocytes. Therefore, the study was designed to explain whether excess body mass in older individuals affected the disproportion in numbers of T lymphocytes and whether anthropometric indices and immune risk profile expressed as CD4/CD8 ratio are diagnostically useful in the analysis of immunosenescence. MATERIALS & METHODS One hundred three individuals aged 73.6 ± 3.1 years were allocated to the normal body mass (body mass index (BMI) 18.5-24.9 kg/m2,n = 39), the pre-obesity (BMI 25.0-29.9 kg/m2, n = 44) or the obesity (BMI ≥30.0 kg/m2, n = 20) group, based on WHO recommendations. Details on the subjects' medical history and lifestyle were obtained by health questionnaire. Anthropometric analysis was performed by bioelectrical impedance method, biochemical analysis was made by the automatic analyzer and ELISA immunoassays, and T and B lymphocyte counts were determined by eight-parameter flow cytometry. Additionally, visceral adiposity index, body adiposity index (BAI), and body shape index (ABSI) were evaluated based on body circumference, BMI and lipid-lipoprotein profile measurements. RESULTS The highest percentage of CD3+CD4+ T lymphocytes (59.4 ± 12.6 %) and the lowest CD3+CD8+ T lymphocytes (31.6 ± 10.0 %) were noted in patients the obesity group. The highest cut-off value of 1.9 for CD4/CD8 ratio was recorded in the normal body mass vs pre-obesity model. CD4/CD8 ratio > 2.5 was recorded in >20 % of our pre-obesity and obesity groups while 64.5 % of the normal body mass group had CD4/CD8 ratio < 1. High diagnostic usefulness was demonstrated for both BAI and lipid accumulation product (LAP) (AUC values of ~0.800 and ~ 0.900 respectively) in three models: normal body mass vs pre-obesity, normal body mass vs obesity, and pre-obesity vs obesity. CONCLUSION The odds ratios (OR) for CD4/CD8 ratio in the normal body mass vs obesity model (OR = 16.1, 95%CI 3.8-93.6) indicated a potential diagnostic value of T lymphocytes for clinical prognosis of immune aging in relation to excess body weight in older adults. High values of AUC obtained for the following models: CD4/CD8 + BAI (AUC = 0.927), CD4/CD8 + LAP (AUC = 1.00), CD4/CD8 + ABSI (AUC = 0.865) proved to provide excellent discrimination between older adults with obesity and with normal body mass.
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Affiliation(s)
- Anna Tylutka
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, Poland.
| | - Barbara Morawin
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, Poland.
| | - Łukasz Walas
- Institute of Dendrology, Polish Academy of Sciences, Parkowa 5, 62-035 Kórnik, Poland.
| | - Agnieszka Zembron-Lacny
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, Poland.
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Associations between Body Mass Index, Waist Circumference, and Myocardial Infarction in Older Adults Aged over 75 Years: A Population-Based Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121768. [PMID: 36556970 PMCID: PMC9783624 DOI: 10.3390/medicina58121768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/17/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
Background and Objectives: Body mass index (BMI) is widely used as a standard screening method for obesity and an indicator of related diseases. However, its inability to distinguish between lean body mass and body fat limits its utility. This limitation may be more prominent in older populations, wherein age-related sarcopenia and increased visceral fat due to the redistribution of adipose tissue may preclude a precise estimation of obesity. Many studies suggest that waist circumference (WC) is more strongly related to obesity-related diseases. There are also different opinions on whether the obesity paradox is real or a result of confusing interpretations. This study seeks to determine the association between myocardial infarction (MI), BMI, and WC in older adults and to determine if BMI and WC can reliably predict the risk of cardiovascular disease. Materials and Methods: We conducted a cohort study of older Korean adults aged over 75 years registered in the National Health Insurance System Senior database. Results: The results from the analysis using model 5, which was adjusted for each study variable, showed that the lower the BMI, the higher the hazard ratio (HR) of MI and vice versa. On the other hand, groups with lower than normal WC showed lower HR; even if it was higher, the difference was not statistically significant. Those with abdominal obesity tended to have an increased HR of MI. Conclusions: This study found that HR for MI has a negative relationship with BMI, whereas it has a positive relationship with WC. Furthermore, WC is a more appropriate indicator for predicting the risk of MI in the older population.
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Zhang X, Yan W, Wang B, Wang L, Mu Y, Wang S. Association Between Some Different Obesity Anthropometric Indices and Type 2 Diabetes Mellitus in Middle-Aged and Elderly Chinese Men and Women in Beijing, China: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:1799-1807. [PMID: 35719246 PMCID: PMC9199527 DOI: 10.2147/dmso.s359657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Obesity can lead to the development of type 2 diabetes mellitus (T2DM). However, the predictive power of different obesity anthropometric indices (ObAIs) for T2DM varies with race and geographical area. Therefore, the study aimed to investigate the association between different ObAIs and T2DM and determine the best index for screening T2DM in middle-aged and elderly men and women in Beijing, China. METHODS A cross-sectional study was conducted in Shijingshan district (Beijing, China) from November 2011 to August 2012, involving a total of 14,558 subjects aged ≥40 years. Data on demographic information, lifestyle, history of T2DM, hypertension and dyslipidemia were collected. Body height, body weight, waist circumference (WC), hip circumference, and blood pressure were recorded. The oral glucose tolerance test or a standard meal test and blood lipid test were performed. The relationship between different ObAIs and T2DM was analyzed using multiple logistic regression. RESULTS After adjustment for age, smoking status, alcohol intake, occupation and education degree, diabetes family history, hypertension and dyslipidemia, body mass index (BMI), WC, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were positively associated with T2DM in both men and women. Compared with the lowest BMI, WC, WHR, and WHtR quartiles, ORs of the highest quartiles were 2.131 (95% CI: 1.465-3.099), 1.752 (95% CI: 1.270-2.417), 1.342 (95% CI: 1.072-1.678), 2.739 (95% CI: 2.293-3.271) in men and 1.837 (95% CI: 1.584-2.130), 3.122 (95% CI: 1.980-4.924), 3.781 (95% CI: 2.855-5.007), 2.379 (85% CI: 2.040-2.775), respectively, in women. The areas under ROC curve of BMI, WC, WHR, and WHtR for men were 0.584 (95% CI: 0.568-0.600), 0.509 (95% CI: 0.492-0.525), 0.501 (95% CI: 0.485-0.518), and 0.642 (95% CI: 0.627-0.658) and 0.619 (95% CI: 0.607-0.632), 0.709 (95% CI: 0.697-0.720), 0.741 (95% CI: 0.730-0.752), and 0.654 (95% CI: 0.642-0.666), respectively, for women. CONCLUSION WHtR and WHR have been found to perform better as predictors of T2DM in middle-aged and elderly Chinese men and women, respectively.
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Affiliation(s)
- Xuebing Zhang
- Department of Endocrinology, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, 100700, People’s Republic of China
| | - Wenhua Yan
- Department of Endocrinology, First Medical Centre of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Bing Wang
- Department of Endocrinology, Emergency General Hospital, Beijing, 100028, People’s Republic of China
| | - Lianjie Wang
- Department of Endocrinology, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, 100700, People’s Republic of China
| | - Yiming Mu
- Department of Endocrinology, First Medical Centre of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Shidong Wang
- Department of Endocrinology, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, 100700, People’s Republic of China
- Correspondence: Shidong Wang, Tel +86 13910965659, Email
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Moreira NCDV, Mdala I, Hussain A, Bhowmik B, Siddiquee T, Fernandes VO, Montenegro RM, Meyer HE. Cardiovascular Risk, Obesity, and Sociodemographic Indicators in a Brazilian Population. Front Public Health 2021; 9:725009. [PMID: 34917567 PMCID: PMC8669243 DOI: 10.3389/fpubh.2021.725009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023] Open
Abstract
Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population. Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs. Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined. Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age <45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index. Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.
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Affiliation(s)
- Nayla Cristina do Vale Moreira
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway.,Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil.,Faculty of Health Sciences, NORD University, Bodø, Norway
| | - Ibrahimu Mdala
- Department of General Practice, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway
| | - Akhtar Hussain
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil.,Faculty of Health Sciences, NORD University, Bodø, Norway.,Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh.,International Diabetes Federation, Brussels, Belgium
| | - Bishwajit Bhowmik
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Tasnima Siddiquee
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | | | - Renan M Montenegro
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil
| | - Haakon E Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
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High level of fatty liver index predicts new onset of diabetes mellitus during a 10-year period in healthy subjects. Sci Rep 2021; 11:12830. [PMID: 34145341 PMCID: PMC8213804 DOI: 10.1038/s41598-021-92292-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023] Open
Abstract
Fatty liver index (FLI), a predictor of nonalcoholic fatty liver disease, has been reported to be associated with several metabolic disorders. This study aimed to evaluate the relationship between FLI and new onset of diabetes mellitus (DM). We investigated the association of FLI with new onset of DM during a 10-year period in subjects who received annual health examinations (n = 28,990). After exclusion of subjects with DM at baseline and those with missing data, a total of 12,290 subjects (male/female: 7925/4365) who received health examinations were recruited. FLI was significantly higher in males than in females. During the 10-year period, DM was developed in 533 males (6.7%) and 128 females (2.9%). Multivariable Cox proportional hazard models with a restricted cubic spline showed that the risk of new onset of DM increased with a higher FLI at baseline in both sexes after adjustment of age, fasting plasma glucose, habits of alcohol drinking and current smoking, family history of DM and diagnosis of hypertension and dyslipidemia at baseline. When the subjects were divided into subgroups according to tertiles of FLI level at baseline (T1–T3) in the absence and presence of impaired fasting glucose (IFG), hazard ratios after adjustment of the confounders gradually increased from T1 to T3 and from the absence to presence of IFG in both male and female subjects. In conclusion, a high level of FLI predicts new onset of DM in a general population of both male and female individuals.
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Fatty liver index is independently associated with deterioration of renal function during a 10-year period in healthy subjects. Sci Rep 2021; 11:8606. [PMID: 33883636 PMCID: PMC8060251 DOI: 10.1038/s41598-021-88025-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/05/2021] [Indexed: 12/13/2022] Open
Abstract
A potential link between chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD) has been suggested. We investigated the relationship between fatty liver index (FLI), a noninvasive and simple predictor of NAFLD, and the development of CKD defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 or positive for urinary protein during a 10-year follow-up period in subjects who received annual health examinations (n = 28,890). After exclusion of CKD at baseline, a total of 14,163 subjects (male/female: 9077/5086) were recruited. During the 10-year period, 1458 males (16.1%) and 737 females (14.5%) had new onset of CKD. Multivariable Cox proportional hazard models with a restricted cubic spline showed that hazard ratios (HRs) of CKD development increased with a higher FLI at baseline in both males and females after adjustment of confounders. When divided by tertiles of FLI level at baseline (T1 ~ T3), the adjusted risk of CKD development in the T3 group (HR [95% confidence interval], male/female: 1.33 [1.16–1.54]/1.33 [1.08–1.63]) was significantly higher than that in both sexes in the T1 group as the reference. The addition of FLI into traditional risk factors significantly improved the discriminatory capability for predicting CKD. In conclusion, a high level of FLI predicts the development of CKD in both sexes in a general population.
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Darbandi M, Pasdar Y, Moradi S, Mohamed HJJ, Hamzeh B, Salimi Y. Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis. Prev Chronic Dis 2020; 17:E131. [PMID: 33092686 PMCID: PMC7587303 DOI: 10.5888/pcd17.200112] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Obesity is one of the main risk factors for cardiovascular disease (CVD) and cardiometabolic disease (CMD). Many studies have developed cutoff points of anthropometric indices for predicting these diseases. The aim of this systematic review was to differentiate the screening potential of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for adult CVD risk. METHODS We used relevant key words to search electronic databases to identify studies published up to 2019 that used receiver operating characteristic (ROC) curves for assessing the cut-off points of anthropometric indices. We used a random-effects model to pool study results and assessed between-study heterogeneity by using the I2 statistic and Cochran's Q test. RESULTS This meta-analysis included 38 cross-sectional and 2 cohort studies with 105 to 137,256 participants aged 18 or older. The pooled area under the ROC curve (AUC) value for BMI was 0.66 (95% CI, 0.63-0.69) in both men and women. The pooled AUC values for WC were 0.69 (95% CI, 0.67-0.70) in men and 0.69 (95% CI, 0.64-0.74) in women, and the pooled AUC values for WHR were 0.69 (95% CI, 0.66-0.73) in men and 0.71 (95% CI, 0.68-0.73) in women. CONCLUSION Our findings indicated a slight difference between AUC values of these anthropometric indices. However, indices of abdominal obesity, especially WHR, can better predict CVD occurrence.
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Affiliation(s)
- Mitra Darbandi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Jan Jan Mohamed
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Chang HC, Chen SP, Yang HJ. Including selective metabolic components in current diagnostic criteria does not improve discriminative validity for metabolic syndrome: a risk score approach. J Int Med Res 2019; 47:1298-1311. [PMID: 30678504 PMCID: PMC6421381 DOI: 10.1177/0300060518822919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To examine whether including additional metabolic components to the current
five-marker system can improve the discriminative validity for diagnosing
metabolic syndrome (MetS). Methods This longitudinal cohort study included data from subjects that had completed
at least three health examinations during a 5-year period. The study outcome
was the onset of MetS. Sociodemographic and biochemical variables were
recorded for all subjects so that the adjusted relative risks (ARRs) could
be calculated for 11 metabolic components. Risk scores for the development
of MetS based on the ARR values were determined. The sums of the risk scores
of different component combinations were used to conduct a receiver
operating characteristic (ROC) curve analysis of MetS diagnosis. Results A total of 3368 individuals with complete data was analysed. The ARRs of the
11 metabolic components were all statistically significant. According to ROC
analysis, although good discriminative validity (area under the curve [AUC]
range, 0.954–0.976) could be achieved for MetS diagnosis by using either all
11 or combinations of six metabolic components (the five current components
plus one extra component), the current five metabolic components used for
diagnosis had the best discriminative validity (AUC = 0.977). Conclusion The current five metabolic components used for the diagnosis of MetS still
represent the best combination with the highest discriminative validity.
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Affiliation(s)
- Huan-Cheng Chang
- Department of Community Medicine, Division of Family Medicine, Landseed Hospital, Tao-Yuan.,Department of Health Care Management, Chang Gung University, Tao-Yuan
| | - Sheng-Pyng Chen
- Department of Community Medicine, Division of Family Medicine, Landseed Hospital, Tao-Yuan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung.,Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung
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Tamaura Y, Nishitani M, Akamatsu R, Tsunoda N, Iwasawa F, Fujiwara K, Kinoshita T, Sakai M, Sakai T. Association Between Interdialytic Weight Gain, Perception About Dry Weight, and Dietary and Fluid Behaviors Based on Body Mass Index Among Patients on Hemodialysis. J Ren Nutr 2019; 29:24-32.e5. [DOI: 10.1053/j.jrn.2018.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 04/10/2018] [Accepted: 04/21/2018] [Indexed: 12/19/2022] Open
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Tanaka A, Takeuchi K, Furuta M, Takeshita T, Suma S, Shinagawa T, Shimazaki Y, Yamashita Y. Relationship of toothbrushing to metabolic syndrome in middle-aged adults. J Clin Periodontol 2018; 45:538-547. [PMID: 29421856 DOI: 10.1111/jcpe.12876] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 01/05/2023]
Abstract
AIM To examine the effect of toothbrushing on the development of metabolic syndrome (MetS), including assessment of periodontal status, in middle-aged adults. METHODS This 5-year follow-up retrospective study was performed in 3,722 participants (2,897 males and 825 females) aged 35-64 years who underwent both medical check-ups and dental examinations. Metabolic components included obesity, elevated triglycerides, blood pressure, fasting glucose and reduced high-density lipoprotein. Toothbrushing frequency was assessed using a questionnaire. Periodontal disease was defined as having at least one site with a pocket depth of ≥4 mm. Logistic regression analysis was performed to evaluate the relationship between toothbrushing frequency at the baseline examination and the development of MetS (≥3 components). RESULTS During follow-up, 11.1% of participants developed MetS. After adjusting for potential confounders including periodontal disease, participants with more frequent daily toothbrushing tended to have significantly lower odds of developing MetS (p for trend = .01). The risk of development of MetS was significantly lower in participants brushing teeth ≥3 times/day than in those brushing teeth ≤1 time/day (odds ratio = 0.64, 95% confidence interval = 0.45-0.92). CONCLUSIONS Frequent daily toothbrushing was associated with lower risk of development of MetS.
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Affiliation(s)
- Akihiko Tanaka
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shino Suma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | | | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Anari R, Amani R, Veissi M. Sugar-sweetened beverages consumption is associated with abdominal obesity risk in diabetic patients. Diabetes Metab Syndr 2017; 11 Suppl 2:S675-S678. [PMID: 28487104 DOI: 10.1016/j.dsx.2017.04.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/27/2017] [Indexed: 01/16/2023]
Abstract
AIM Sugar sweetened beverages (SSBs) are any beverages containing added-sugar and supposed to increase body lipogenesis and fat accumulation in healthy subjects. This study was performed to assess the possible association between SSBs consumption and obesity in type 2 diabetes (T2DM) patients. METHODS T2DM adults with no insulin treatment entered the study. Abdominal obesity and general adiposity were determined using waist circumference (WC) and body mass index (BMI), respectively. SSBs intake was extracted from a validated food frequency questionnaire. RESULTS Mean SSBs intake was 0.6 serving/d (145.6mL/d). There was no considerable association between SSBs intake and gender. About 46% of patients consumed at least one serving of SSBs per week. SSBs consumption was correlated neither to WC nor to BMI. After adjustment for confounding factors, abdominal obesity was associated with drinking SSBs ≥1 serving/week (OR=4.93, 95% CI: 1.35-18.03), and SSB ≥3 serving/week (OR=5.07, 95% CI: 1.22-21.15) compared to those consumed <1 serving/week. This association was not found for general obesity (OR=0.88, 95% CI: 0.60-1.23). Ex-smokers had higher SSBs intake compared to those never smoked (OR=3.94, 95% CI=1.06-14.71). Energy intake and macronutrients were similar in both SSBs sub-groups. Mean daily energy supplied by SSBs was 120kcal in participants having ≥1 serving of SSBs/week and 2.7kcal in <1 serving SSBs/week (OR=1.14, 95% CI: 1.09-1.20). Lower SSBs drinkers had 17% higher fiber intake (OR=0.83, 95% CI=0.73-0.96). CONCLUSION SSBs intake might increase abdominal obesity in diabetic population and therefore should be considered in diabetes control procedure.
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Affiliation(s)
- Razieh Anari
- Department of Nutrition, Faculty of Autonomous Campus (Arvand International Unit), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Reza Amani
- Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Nutrition, Faculty of Paramedicine, Health Research Institute, Nutrition and Metabolic Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Masoud Veissi
- Department of Nutrition, Faculty of Paramedicine, Health Research Institute, Nutrition and Metabolic Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Corrêa MM, Tomasi E, Thumé E, Oliveira ERAD, Facchini LA. Waist-to-height ratio as an anthropometric marker of overweight in elderly Brazilians. CAD SAUDE PUBLICA 2017; 33:e00195315. [PMID: 28614456 DOI: 10.1590/0102-311x00195315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 07/18/2016] [Indexed: 02/14/2023] Open
Abstract
This study's objective was to identify the cut-off point for waist-to-height ratio (WHtR) with the best sensitivity, specificity, and accuracy for the elderly Brazilian population, using body mass index (BMI) as the anthropometric reference. A representative sample of the Brazilian population consisted of 5,428 elderly individuals participating in an epidemiological survey. The variables were weight, height, and waist circumference (WC). WHtR was assessed with BMI as the gold standard, using two proposals for classification of the elderly population's nutritional status. The ideal cut-off point for WHtR simultaneously showing the highest sensitivity and specificity was determined using the receiver operating characteristic (ROC) curve. Sensitivity from 94.9% to 98.4%, specificity from 43% to 55.4%, and values for area under the ROC curve from 0.878 to 0.883 were identified with a cut-off point of 0.55. We recommend use of WHtR in clinical practice due to its simplicity and good power to detect overweight in the elderly.
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Affiliation(s)
- Márcia Mara Corrêa
- Universidade Federal de Pelotas, Pelotas, Brasil.,Universidade Federal do Espírito Santo, Vitória, Brasil
| | | | - Elaine Thumé
- Universidade Federal de Pelotas, Pelotas, Brasil
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Anari R, Amani R, Latifi SM, Veissi M, Shahbazian H. Association of obesity with hypertension and dyslipidemia in type 2 diabetes mellitus subjects. Diabetes Metab Syndr 2017; 11:37-41. [PMID: 27477531 DOI: 10.1016/j.dsx.2016.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 07/21/2016] [Indexed: 11/29/2022]
Abstract
AIM Obesity and diabetes are contributed to cardiovascular disease risk. The current study was performed to evaluate the association of central and general obesity and cardio-metabolic risk factors, including dyslipidemia and hypertension in T2DM patients. METHODS This was a cross-sectional study in T2DM adults. Body mass index (BMI) was used to identify general obesity and waist circumference (WC) was measured to define abdominal obesity (based on ATP III). Biochemical analyses, and anthropometric and blood pressure measurements were done for all participants. RESULTS Participants with central obesity showed significantly higher systolic (132.5mmHg vs. 125.4mmHg, p=0.024) and diastolic blood pressures (84.9mmHg vs. 80mmHg, p=0.007) than participants without obesity. Dyslipidemia was more prevalent in all participants either by BMI (98.3% vs. 97%, 95% CI: 0.18-17.53) or by WC (97.2% vs. 98%, 95% CI: 0.07-7.19). Abdominal adiposity in diabetic subjects showed significant reverse association with high level of physical activity (OR=0.22, 95% CI: 0.06-0.85). Hypertriglyceridemia rate was increased with both central (OR=2.11; p=0.040) and general obesity (OR=2.68; p=0.021). After adjustment for energy intake and age, females had higher risk of general (OR=4.57, 95% CI=1.88-11.11) and central obesity (OR=7.93, 95% CI=3.48-18.08). CONCLUSIONS Females were more susceptible to obesity. Hypertension was associated with both obesity measures. Dyslipidemia, except for hypertriglyceridemia, was correlated to neither abdominal nor general obesity.
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Affiliation(s)
- Razieh Anari
- Department of Nutrition, Faculty of Arvand International Division, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Reza Amani
- Health Research Institute, Diabetes Research Center, Department of Nutrition, School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Seyed Mahmoud Latifi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Masoud Veissi
- Health Research Institute, Nutrition and Metabolic Disease Research Center, Department of Nutrition, School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hajieh Shahbazian
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Wang S, Ma W, Yuan Z, Wang SM, Yi X, Jia H, Xue F. Association between obesity indices and type 2 diabetes mellitus among middle-aged and elderly people in Jinan, China: a cross-sectional study. BMJ Open 2016; 6:e012742. [PMID: 27810975 PMCID: PMC5129047 DOI: 10.1136/bmjopen-2016-012742] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The relationship between obesity and type 2 diabetes mellitus (T2DM) varies with geographical area and race. OBJECTIVES To investigate the prevalence of T2DM and the proportion of subjects with undiagnosed T2DM. In addition, to compare the associations between different obesity indices and T2DM for middle-aged and elderly people from six communities in Jinan, China. SETTING A cross-sectional study was designed and the study subjects were chosen from blocks which were randomly selected in the 6 communities of Jinan, China in 2011-2012. PARTICIPANTS A total of 3277 residents aged ≥50 years were eligible for this study, but 1563 people were excluded because they did not provide anthropometric data such as height, weight, waist circumference (WC), hip circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, triglyceride (TG), total cholesterol (TC) or information about their current medication use. Hence, 1714 participants were included in the final data analysis. RESULTS The prevalence of T2DM among people aged ≥50 years was 16.6% (19.3% for men and 15.3% for women) and the proportion of patients with undiagnosed T2DM was 32.7%. Compared with the lowest levels of body mass index (BMI), WC, waist-to-hip ratio or waist-to-stature ratio (WSR), the ORs and 95% CIs of the highest levels for men, after adjusting for age, smoking, alcohol drinking, regular exercise, hypertension, TG and TC, were 1.607 (0.804 to 3.210), 2.189 (1.118 to 4.285), 1.873 (0.968 to 3.623) and 2.572 (1.301 to 5.083), respectively, and for women, 2.764 (1.622 to 4.712), 2.407 (1.455 to 3.985), 2.500 (1.484 to 4.211) and 2.452 (1.447 to 4.155), respectively. CONCLUSIONS Among adults aged ≥50 years in Jinan, China, the best indicator of the relationship between obesity and T2DM is WSR for men and BMI for women, respectively.
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Affiliation(s)
- Shukang Wang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Shu-mei Wang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiangren Yi
- The College of Physical Education, Shandong University, Jinan, China
| | - Hongying Jia
- The Second Hospital of Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
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Bi X, Tey SL, Leong C, Quek R, Loo YT, Henry CJ. Correlation of adiposity indices with cardiovascular disease risk factors in healthy adults of Singapore: a cross-sectional study. BMC OBESITY 2016; 3:33. [PMID: 27398222 PMCID: PMC4936162 DOI: 10.1186/s40608-016-0114-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 06/30/2016] [Indexed: 12/14/2022]
Abstract
Background Obesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD). Nonetheless, the best adiposity indices to evaluate the CVD risk factors remain contentious and few studies have been performed in Asian populations. In the present study, we compared the association strength of percent body fat (PBF) to indirect anthropometric measures of general adiposity (body mass index (BMI) and body adiposity index (BAI)) and central adiposity (waist circumference (WC), and waist-to-hip ratio (WHR)) for the prediction of CVD risk factors in healthy men and women living in Singapore. Methods A total of 125 individuals (63 men and 62 women) took part in this study. PBF was measured by using three different techniques, including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Anthropometric measurements (WC, hip circumference (HC), height, and weight), fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were determined according to standard protocols. Correlations of anthropometric measurements and PBF with CVD risk factors were compared. Results Irrespective of the measuring techniques, PBF showed strong positive correlations with FSI, HOMA-IR, TC/HDL, TG/HDL, and LDL/HDL in both genders. While PBF was highly correlated with FBG, SBP, and DBP in females, no significant relationships were observed in males. Amongst the five anthropometric measures of adiposity, BAI was the best predictor for CVD risk factors in female participants (r = 0.593 for HOMA-IR, r = 0.542 for TG/HDL, r = 0.474 for SBP, and r = 0.448 for DBP). For males, the combination of WC (r = 0.629 for HOMA-IR, and r = 0.446 for TG/HDL) and WHR (r = 0.352 for SBP, and r = 0.366 for DBP) had the best correlation with CVD risk factors. Conclusion Measurement of PBF does not outperform the simple anthropometric measurements of obesity, i.e. BAI, WC, and WHR, in the prediction of CVD risk factors in healthy Asian adults. While measures of central adiposity (WC and WHR) tend to show stronger associations with CVD risk factors in males, measures of general adiposity (BAI) seems to be the best predictor in females. The gender differences in the association between adiposity indices and CVD risk factors may relate to different body fat distribution in males and females living in Singapore. These results may find further clinical utility to identify patients with CVD risk factors in a more efficient way. Electronic supplementary material The online version of this article (doi:10.1186/s40608-016-0114-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xinyan Bi
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore
| | - Siew Ling Tey
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore
| | - Claudia Leong
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore
| | - Rina Quek
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore
| | - Yi Ting Loo
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore ; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599 Singapore
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Corrêa MM, Thumé E, De Oliveira ERA, Tomasi E. Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review. Arch Gerontol Geriatr 2016; 65:174-82. [DOI: 10.1016/j.archger.2016.03.021] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 01/12/2023]
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Furuta M, Liu A, Shinagawa T, Takeuchi K, Takeshita T, Shimazaki Y, Yamashita Y. Tooth loss and metabolic syndrome in middle-aged Japanese adults. J Clin Periodontol 2016; 43:482-91. [PMID: 26847391 DOI: 10.1111/jcpe.12523] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2016] [Indexed: 12/18/2022]
Abstract
AIM Metabolic syndrome is associated with periodontal disease and dental caries; however, little attention has been given to the association between metabolic syndrome and tooth loss, which is the endpoint of these two diseases. This study examined this association in middle-aged adults over a 5-year period. METHODS A retrospective study was performed in 2107 participants (1718 males and 389 females) aged 35-60 years who underwent annual dental check-ups, to evaluate tooth loss and metabolic components, including obesity, elevated triglycerides, blood pressure, fasting glucose, and reduced high-density lipoprotein. Logistic regression analysis was performed to evaluate the association between metabolic syndrome (≥3 components) at the baseline examination and tooth loss. RESULTS Over a 5-year period, 10.8% of the participants lost at least one tooth. Compared to those with no metabolic components, participants with ≥3 components had an increased risk of tooth loss (odds ratio = 1.54; 95% confidence interval: 1.01-2.37), adjusting for age, gender, dental caries experience, attachment loss, oral hygiene status, number of teeth, tooth brushing frequency, smoking, and occupational status. CONCLUSIONS Metabolic syndrome was associated with the incidence of tooth loss among middle-aged adults.
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Affiliation(s)
- Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - An Liu
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | | | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan
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Body Composition in Asians and Caucasians: Comparative Analyses and Influences on Cardiometabolic Outcomes. ADVANCES IN FOOD AND NUTRITION RESEARCH 2015; 75:97-154. [PMID: 26319906 DOI: 10.1016/bs.afnr.2015.07.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Within the last four decades Asia has witnessed major transformation in its population demographics, which gave rise to changes in food availability, food habits and lifestyle. A significant consequence of these changes has been the continuing rise in overweight and obesity across Asia. In parallel, there has been a significant rise in Asians in the incidence of the major chronic diseases, particularly in cardiometabolic disorders such as metabolic syndrome, type 2 diabetes, hypertension, and other cardiovascular diseases. Given that the majority of the evidence, to date, investigating the associations between adiposity and cardiometabolic disorder risk have been obtained from studies undertaken either in European or in North American Caucasians, in this chapter, we have reviewed differences in body fat content and distribution between East Asians, South Asians, and Caucasians. The evidence is consistent that the content and distribution of body fat are markedly different between the various ethnic groups. We found that Asians have a greater predisposition towards adiposity at higher BMI than in Caucasians. Moreover, at any given level of adiposity, Asians have a much greater predisposition to risk of cardiometabolic disorders than Caucasians. We therefore strongly endorse the need for different adiposity cutoffs in Asians as compared to the Caucasians. We have also reviewed the predictive abilities of the various body composition/adiposity measures in determining risk of cardiometabolic disorders in Asians.
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Cheong KC, Ghazali SM, Hock LK, Subenthiran S, Huey TC, Kuay LK, Mustapha FI, Yusoff AF, Mustafa AN. The discriminative ability of waist circumference, body mass index and waist-to-hip ratio in identifying metabolic syndrome: Variations by age, sex and race. Diabetes Metab Syndr 2015; 9:74-78. [PMID: 25819369 DOI: 10.1016/j.dsx.2015.02.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Many studies have suggested that there is variation in the capabilities of BMI, WC and WHR in predicting cardiometabolic risk and that it might be confounded by gender, ethnicity and age group. The objective of this study is to examine the discriminative abilities of body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (high blood pressure, hypertriglyceridemia, low high density lipoprotein-cholesterol and high fasting plasma glucose) among the adult Malaysian population by gender, age group and ethnicity. METHODS Data from 2572 respondents (1044 men and 1528 women) aged 25-64 years who participated in the Non Communicable Disease Surveillance 2005/2006, a population-based cross sectional study, were analysed. Participants' socio-demographic details, anthropometric indices (BMI, WC and WHR), blood pressure, fasting lipid profile and fasting glucose level were assessed. Receiver operating characteristics curves analysis was used to evaluate the ability of each anthropometric index to discriminate MetS cases from non-MetS cases based on the area under the curve. RESULTS Overall, WC had better discriminative ability than WHR for women but did not perform significantly better than BMI in both sexes, whereas BMI was better than WHR in women only. Waist circumference was a better discriminator of MetS compared to WHR in Malay men and women. Waist circumference and BMI performed better than WHR in Chinese women, men aged 25-34 years and women aged 35-44 years. CONCLUSIONS The discriminative ability of BMI and WC is better than WHR for predicting two or more non-adipose components of MetS. Therefore, either BMI or WC measurements are recommended in screening for metabolic syndrome in routine clinical practice in the effort to combat cardiovascular disease and type II diabetes mellitus.
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Affiliation(s)
- Kee C Cheong
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia.
| | - Sumarni M Ghazali
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lim K Hock
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Teh C Huey
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lim K Kuay
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Feisul I Mustapha
- Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Ahmad F Yusoff
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Amal N Mustafa
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Kim JH, Cho JJ, Park YS. Relationship between sarcopenic obesity and cardiovascular disease risk as estimated by the Framingham risk score. J Korean Med Sci 2015; 30:264-71. [PMID: 25729248 PMCID: PMC4330480 DOI: 10.3346/jkms.2015.30.3.264] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 11/17/2014] [Indexed: 11/24/2022] Open
Abstract
This study was conducted to assess the association between sarcopenic obesity and cardiovascular disease (CVD) risk in Korean adults (n=3,320; ≥40 yr) who participated in the 5th Korean National Health and Nutrition Examination Survey in 2010. The appendicular skeletal muscle mass divided by body weight was calculated for each participant; participants with values <1 standard deviation below the mean reference value (i.e., aged 20-39 yr) were considered sarcopenic. Subjects were further classified into 4 groups according to their obesity (i.e., body mass index ≥25 kg/m(2)) and sarcopenic status. Individuals' 10-yr CVD risk was determined using the Framingham risk model. The sarcopenic obese group had more participants (43.8% men, 14.6% women) with a high risk of CVD (≥20%). The sarcopenic obese group was associated with an increased 10-yr CVD risk than the non-sarcopenic, non-obese group (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.53-4.06, P<0.001 in men; OR, 1.87; 95% CI, 1.02-3.41, P=0.041 in women). Sarcopenic non-obese and non-sarcopenic obese subjects were not associated with an increased 10-yr CVD risk. Sarcopenic obesity, but not non-sarcopenic obesity, was closely associated with an increased CVD risk in Korean adults.
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Affiliation(s)
- Jeong-Hyeon Kim
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Jung Jin Cho
- Department of Family Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
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Hori A, Nanri A, Sakamoto N, Kuwahara K, Nagahama S, Kato N, Fukasawa K, Nakamoto K, Ohtsu M, Matsui A, Kochi T, Eguchi M, Imai T, Nishihara A, Tomita K, Murakami T, Shimizu C, Shimizu M, Miyamoto T, Uehara A, Yamamoto M, Nakagawa T, Yamamoto S, Honda T, Okazaki H, Sasaki N, Kurotani K, Pham NM, Kabe I, Mizoue T, Sone T, Dohi S. Comparison of body mass index, waist circumference, and waist-to-height ratio for predicting the clustering of cardiometabolic risk factors by age in Japanese workers--Japan Epidemiology Collaboration on Occupational Health study. Circ J 2014; 78:1160-8. [PMID: 24662439 DOI: 10.1253/circj.cj-13-1067] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Waist-to-height ratio (WHtR) has been suggested as a better screening tool than body mass index (BMI) and waist circumference (WC) for assessing cardiometabolic risk. However, most previous studies did not consider age. METHODS AND RESULTS Participants were 45,618 men and 8,092 women aged 15-84 years who received periodic health checkups in 9 companies in Japan. Clustering of cardiometabolic risk factors was defined by the existence of 2 or more of high blood pressure, hyperglycemia, and dyslipidemia. In both men and women, unadjusted area under the curve (AUC) of the receiver-operating characteristic curve for WHtR in detecting the clustering of cardiometabolic risk factors was significantly higher than that for either BMI or WC; the AUCs for WHtR, BMI, and WC, respectively, were 0.734, 0.705, and 0.717 in men and 0.782, 0.762, and 0.755 in women. After adjustment for age, however, such differences were not observed; the corresponding values were 0.702, 0.701, and 0.696 in men. In women, the age-adjusted AUC for BMI was slightly higher than for other indices (WHtR, 0.721; BMI, 0.726; WC, 0.707). CONCLUSIONS The screening performance of WHtR for detecting the clustering cardiometabolic risk factors was not superior to that of BMI.
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Affiliation(s)
- Ai Hori
- Department of Safety and Health, Tokyo Gas Co, Ltd
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Goh LGH, Dhaliwal SS, Welborn TA, Lee AH, Della PR. Anthropometric measurements of general and central obesity and the prediction of cardiovascular disease risk in women: a cross-sectional study. BMJ Open 2014; 4:e004138. [PMID: 24503301 PMCID: PMC3918987 DOI: 10.1136/bmjopen-2013-004138] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/23/2013] [Accepted: 01/14/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES It is important to ascertain which anthropometric measurements of obesity, general or central, are better predictors of cardiovascular disease (CVD) risk in women. 10-year CVD risk was calculated from the Framingham risk score model, SCORE risk chart for high-risk regions, general CVD and simplified general CVD risk score models. Increase in CVD risk associated with 1 SD increment in each anthropometric measurement above the mean was calculated, and the diagnostic utility of obesity measures in identifying participants with increased likelihood of being above the treatment threshold was assessed. DESIGN Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. SETTING Population-based survey in Australia. PARTICIPANTS 4487 women aged 20-69 years without heart disease, diabetes or stroke. OUTCOME MEASURES Anthropometric obesity measures that demonstrated the greatest increase in CVD risk as a result of incremental change, 1 SD above the mean, and obesity measures that had the greatest diagnostic utility in identifying participants above the respective treatment thresholds of various risk score models. RESULTS Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio had larger effects on increased CVD risk compared with body mass index (BMI). These central obesity measures also had higher sensitivity and specificity in identifying women above and below the 20% treatment threshold than BMI. Central obesity measures also recorded better correlations with CVD risk compared with general obesity measures. WC and WHR were found to be significant and independent predictors of CVD risk, as indicated by the high area under the receiver operating characteristic curves (>0.76), after controlling for BMI in the simplified general CVD risk score model. CONCLUSIONS Central obesity measures are better predictors of CVD risk compared with general obesity measures in women. It is equally important to maintain a healthy weight and to prevent central obesity concurrently.
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Affiliation(s)
- Louise G H Goh
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Satvinder S Dhaliwal
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Timothy A Welborn
- Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, Western Australia, Australia
| | - Andy H Lee
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Phillip R Della
- School of Nursing and Midwifery, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
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Jang SY, Ju EY, Choi S, Seo S, Kim DE, Kim DK, Park SW. Prehypertension and obesity in middle-aged Korean men and women: the third Korea national health and nutrition examination survey (KNHANES III) study. J Public Health (Oxf) 2012; 34:562-9. [PMID: 22580384 DOI: 10.1093/pubmed/fds033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between obesity and prehypertension (preHT) after adjustment for socioeconomic position and health behavior factors. METHODS The study sample included 1973 Korean men and women, 45-64 years of age. Subjects were classified into three groups based on their baseline blood pressure: prehypertensive, hypertensive and normotensive. Men with a waist circumference ≥90 cm or women ≥80 cm were considered abdominally obese. Body mass index (BMI) obesity was defined as having a BMI ≥25. The prevalence of abdominal obesity and BMI obesity was calculated with age adjustment using a direct method. Multinomial logistic regression analysis was applied. RESULTS The prevalence of preHT in our study was 52.8%. We found that subjects with abdominal obesity were 2.06 times as likely to be prehypertensive as those without it and people with BMI obesity were 1.89 times as likely to be prehypertensive as those without it. Interestingly, men with BMI obesity had a higher preHT risk, while women with abdominal obesity had a higher preHT risk. CONCLUSIONS Statistical analyses of a community-based random sample of the Korean population indicate that obesity is associated with preHT in Korean middle-aged subjects.
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Affiliation(s)
- Shin Yi Jang
- Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Kangnam-Gu, Seoul 135-710, Republic of Korea
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Sanada K, Iemitsu M, Murakami H, Gando Y, Kawano H, Kawakami R, Tabata I, Miyachi M. Adverse effects of coexistence of sarcopenia and metabolic syndrome in Japanese women. Eur J Clin Nutr 2012; 66:1093-8. [PMID: 22569087 DOI: 10.1038/ejcn.2012.43] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND/OBJECTIVES Little information is available regarding the interactions of sarcopenia and metabolic syndrome (MetS) in the risks of these age-associated diseases in women. The present cross-sectional study was performed to investigate whether the coexistence of sarcopenia and MetS further increases the risks of lifestyle-related diseases in Japanese women. SUBJECTS/METHODS Healthy Japanese women (n=533) aged 30-84 participated in this study. MetS was defined as higher body mass index, fasting plasma glucose, systolic or diastolic blood pressure and blood lipid abnormalities. Appendicular muscle mass and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry. The criterion of low muscle mass and strength defined median skeletal muscle index (appendicular muscle mass/height², kg/m²) and handgrip strength. RESULTS Two-way ANCOVA with adjustment for age, body fat percentage and whole-body lean tissue mass indicated that sarcopenia and MetS interacted to produce a significant effect on HbA1c, systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity in Japanese women. The systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity were significantly higher in women with coexisting sarcopenia and MetS than in healthy controls or in those with sarcopenia or MetS alone. The HbA1c in the coexisting sarcopenia and MetS group was higher than in healthy controls and sarcopenia subjects. CONCLUSIONS The coexistence of sarcopenia and MetS further increases the risks of cardiovascular diseases, such as type 2 diabetes mellitus, hypertension, arterial stiffness and hyperlipidemia even adjustment of age and body composition in adult Japanese women.
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Affiliation(s)
- K Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan.
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Park YS, Kim JS. Obesity phenotype and coronary heart disease risk as estimated by the Framingham risk score. J Korean Med Sci 2012; 27:243-9. [PMID: 22379333 PMCID: PMC3286769 DOI: 10.3346/jkms.2012.27.3.243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 01/02/2012] [Indexed: 12/17/2022] Open
Abstract
There are conflicting data as to whether general or abdominal obesity is a better predictor of cardiovascular risk. This cross-sectional study involved 4,573 subjects aged 30 to 74 yr who participated in the Fourth Korea National Health and Nutrition Examination Survey conducted in 2008. Obesity phenotype was classified by means of body mass index (BMI) and waist circumference (WC), and participants were categorized into 4 groups. Individuals' 10-yr risk of coronary heart diseases (CHD) was determined from the Framingham risk score. Subjects with obese WC had a higher proportion of high risk for CHD compared to the normal WC group, irrespective of BMI level. Relative to subjects with normal BMI/normal WC, the adjusted odds ratios (ORs) of normal BMI/obese WC group (OR 2.93 [1.70, 5.04] and OR 3.10 [1.49, 6.46]) for CHD risk in male were higher than obese BMI/obese WC group (OR 1.91 [1.40, 2.61] and OR 1.70 [1.16, 2.47]), whereas the adjusted ORs of obese BMI/obese WC group (OR 1.94 [1.24, 3.04] and OR 3.92 [1.75, 8.78]) were higher than the others in female. Subjects with obese BMI/normal WC were not significantly associated with 10-yr CHD risk in men (P = 0.449 and P = 0.067) and women (P = 0.702 and P = 0.658). WC is associated with increased CHD risk regardless of the level of BMI. Men with normal BMI and obese WC tend to be associated with CHD risk than those with obese BMI and obese WC.
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Affiliation(s)
- Yong Soon Park
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun-Su Kim
- Department of Family Medicine, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
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Guo X, Li Y, Sun G, Yang Y, Zheng L, Zhang X, Sun Z, Ma H, Wang N, Jiang M, Li J, Sun Y. Prehypertension in children and adolescents: association with body weight and neck circumference. Intern Med 2012; 51:23-7. [PMID: 22214619 DOI: 10.2169/internalmedicine.51.6347] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The present study was undertaken to investigate the role of neck circumference (NC) in predicting prehypertension in children and adolescents. METHODS We conducted a cross-sectional study including 6,802 children and adolescents (3,631 boys and 3,171 girls) aged 5-18 years. Main anthropometric data and related information were collected. RESULTS The prevalence of prehypertension was 14.4%, 16.4% and 17.1% in normal weight, overweight and obese group respectively. Among the participants with normal body mass index (BMI), higher NC was significantly associated with increased odds of prehypertension (OR: 1.439; 95% CI: 1.118 to 1.853) after adjustment for age, gender, BMI and WC. Significant associations between NC and either systolic blood pressure (SBP) (β=0.581 mmHg) or diastolic blood pressure (DBP) (β=0.236 mmHg) were found in the linear regression. No significant ORs were observed either in overweight or in obese categories. CONCLUSION We concluded that additional measure of NC might expand the ability of BMI for the identification of prehypertension in normal weight children and adolescents.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, the First Affiliated Hospital of China Medical University, People's Republic of China
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Suka M, Miwa Y, Ono Y, Yanagisawa H. BMI, waist circumference, and clustering of cardiovascular risk factors in Japanese adults. Environ Health Prev Med 2011; 16:90-6. [PMID: 21432223 PMCID: PMC3047660 DOI: 10.1007/s12199-010-0169-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 07/14/2010] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To examine whether the association between waist circumference (WC) and clustering of cardiovascular risk factors varies with obesity (BMI) status. METHODS Using the 2008 health examination data of a Japanese health service association, eligible 57,141 adults aged 20-65 years without coronary heart disease or stroke, whose blood sample had been taken in the fasting state, were enrolled in the study. The participants were classified as being underweight (BMI <18.5), normal weight (BMI 18.5-24.9), and overweight (BMI ≥25.0). Multiple logistic regression analysis was performed to calculate adjusted odds ratios (OR) for clustering of cardiovascular risk factors. Receiver operating characteristic analysis was performed to assess the ability of WC to discriminate subjects with and without a clustering of cardiovascular risk factors. RESULTS Clustering of cardiovascular risk factors was found in 16.0% of men and 3.4% of women. The adjusted OR [95% confidence intervals (CI)] per 5-cm increase in WC of the underweight, normal weight, and overweight groups was 1.57 (1.12-2.20), 1.55 (1.49-1.62), and 1.34 (1.30-1.38), respectively, for men and 1.50 (0.84-2.69), 1.53 (1.40-1.68), and 1.32 (1.23-1.41), respectively, for women. The area under curve (95% CI) of the underweight, normal weight, and overweight groups was 0.68 (0.59-0.77), 0.70 (0.69-0.71), and 0.62 (0.61-0.63), respectively, for men and 0.70 (0.53-0.86), 0.75 (0.73-0.78), and 0.64 (0.61-0.68), respectively, for women. CONCLUSION High WC was associated with increased risk of clustering of cardiovascular risk factors independent of BMI. As well as the magnitude of the association, the ability of WC to discriminate subjects with and without a clustering of cardiovascular risk factors varied with obesity (BMI) status.
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Affiliation(s)
- Machi Suka
- Department of Public Health and Environmental Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
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Sanada K, Iemitsu M, Murakami H, Tabata I, Yamamoto K, Gando Y, Suzuki K, Higuchi M, Miyachi M. PPARγ2 C1431T genotype increases metabolic syndrome risk in young men with low cardiorespiratory fitness. Physiol Genomics 2011; 43:103-9. [DOI: 10.1152/physiolgenomics.00129.2010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The peroxisome proliferator-activated receptor gamma 2 (PPARγ2) genotypes are related to obesity and the metabolic syndrome (MetS). A low level of cardiorespiratory fitness is also a strong determining factor in the development of MetS. This cross-sectional study was performed to investigate the influence of the interaction between the PPARγ2 genotype and cardiorespiratory fitness on the risk of MetS. Healthy Japanese men ( n = 211) and women ( n = 505) participated in this study. All subjects were divided into 8 groups according to sex, fitness level (high and low fitness groups), and age (younger, age < 40 yr; middle-aged/older, age ≥ 40 yr). The PPARγ2 genotypes (Pro12Ala and C1431T) were analyzed by real-time PCR with Taq-Man probes. Two-way ANCOVA with adjustment for age as a covariate indicated that fitness and the CC genotype of C1431T in the PPARγ2 gene interacted to produce a significant effect on MetS risk in younger men and that the risk of MetS in the CC genotype group with low cardiorespiratory fitness was significantly higher than that in the corresponding CT+TT genotypes or in the high fitness groups. There was no significant interaction between fitness and genotype in determining MetS risk in middle-aged/older men or in women in any group. With regard to the Pro12Ala genotype of the PPARγ2 gene, there were no significant differences in fitness or genotype effects nor were there any interactions between measurement variables. We concluded that the CC genotype of C1431T in the PPARγ2 gene together with low cardiorespiratory fitness may increase the risk of MetS in younger men (age < 40 yr), even with adjustment for age.
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Affiliation(s)
- Kiyoshi Sanada
- College of Sport and Health Science, Ritsumeikan University, Shiga
- Consolidated Research Institute for Advanced Science and Medical Care, Waseda University
| | - Motoyuki Iemitsu
- College of Sport and Health Science, Ritsumeikan University, Shiga
| | - Haruka Murakami
- Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo; and
| | - Izumi Tabata
- College of Sport and Health Science, Ritsumeikan University, Shiga
| | - Kenta Yamamoto
- Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo; and
| | - Yuko Gando
- Faculty of Sports Sciences, Waseda University, Tokorozawa, Japan
| | - Katsuhiko Suzuki
- Faculty of Sports Sciences, Waseda University, Tokorozawa, Japan
| | - Mitsuru Higuchi
- Faculty of Sports Sciences, Waseda University, Tokorozawa, Japan
| | - Motohiko Miyachi
- Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo; and
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Oda E. Multiple metabolic risk factors per se are more important than anthropometric cutoff points to predict morbid effects of obesity. Intern Med 2010; 49:2653; author reply 2655. [PMID: 21139315 DOI: 10.2169/internalmedicine.49.4163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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