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Taharboucht S, Guermaz R, Brouri M, Bengherbia L, Chibane A. Ankle systolic pressure index in non-diabetic non-alcoholic fatty liver disease: A case-control study. JOURNAL DE MEDECINE VASCULAIRE 2023; 48:154-162. [PMID: 38035921 DOI: 10.1016/j.jdmv.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Several studies have shown that mortality in Non-alcoholic Fatty Liver Disease (NAFLD) or metabolic steatopathy is more related to cardiovascular diseases than to hepatic complications. Our work aimed to verify the relationship between this liver disease and the ankle-brachial pressure index (ABPI), which is a good screening tool for peripheral arterial disease (PAD) and a reliable marker of cardiovascular risk. PATIENTS AND METHODS A prospective sex- and age-matched case-control study was conducted in non-diabetic patients aged 30 to 70 years. All patients underwent a clinical and biological evaluation. Hepatic steatosis was diagnosed by ultrasound. All participants had their ankle-brachial pressure index measured using a Dopplex® Pocket Doppler in addition to arterial ultrasound of the supra-aortic trunk and a carotid-femoral pulse wave velocity (CfPWV) measurement. An ABPI<0.9 was considered pathological (suggestive of PAD). Statistical analyses were performed using SPSS 21.0 software (IBM). RESULTS In total, 213 NAFLD patients (100 men/113 women) with a mean age of 48.5±10.14 years were matched to 213 controls. Metabolic syndrome (MS) was more common in NAFLD than in controls, regardless of the International Diabetes Federation (IDF 2005) criteria used (P<0.001). Low ABPI (<0.90) was noted in 19 (8.9%) NAFLD patients vs. 5 (2.3%) in controls (P=0.003). The mean age of these patients was 48.8±8.6 years with a female predominance (20 patients). 62.5% reported dyslipidemia on questioning, 70.8% a metabolic syndrome according to the IDF and 12.5% (3/24) of them were active smokers. There were no records of mediacalcosis. PAD was significantly associated with NAFLD in univariate analysis (OR=4.0 CI 95% (1.4-11.1)). Factors independently associated with PAD in NAFLD patients were nocturnal systolic blood pressure, smoking, thigh circumference, and being a female. CONCLUSION The findings of our study show a significant association between NAFLD and low ABPI, likely reflecting the high vascular risk of this patient population.
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Affiliation(s)
| | | | | | | | - Ahcene Chibane
- Service de médecine interne, CHU de Douera, Alger, Algeria
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Kawamoto R, Kikuchi A, Ninomiya D, Kumagi T. Thigh-hip ratio is significantly associated with all-cause mortality among Japanese community-dwelling men. PLoS One 2023; 18:e0292287. [PMID: 37797075 PMCID: PMC10553839 DOI: 10.1371/journal.pone.0292287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023] Open
Abstract
Anthropometric evaluation is a simple yet essential indicator of muscle and fat mass when studying life prognosis in aging. This study aimed to investigate the contributions of anthropometric measurements, independent of body mass index, to measures of all-cause mortality. We examined data for 1,704 participants from the 2014 Nomura Cohort Study who attended follow-ups for the subsequent eight years (follow-up rate: 93.0%). Of these, 765 were male (aged 69 ± 11 years) and 939 were female (aged 69 ± 9 years). The Japanese Basic Resident Registry provided data on adjusted relative hazards for all-cause mortality. The data were subjected to a Cox regression analysis, wherein the time variable was age and the risk factors were gender, age, anthropometric index, smoking habits, drinking habits, exercise habits, cardiovascular history, hypertension, lipid levels, diabetes, renal function, and serum uric acid. Of the total number of participants, 158 (9.3%) were confirmed to have died, and of these, 92 were male (12.0% of all male participants) and 66 were female (7.0% of all female participants). The multivariable Cox regression analysis revealed that a smaller thigh-hip ratio predicted eight-year all-cause mortality in male participants, but only baseline body mass index was associated with all-cause mortality in female participants. Thigh-hip ratio is a useful predictor of death in Japanese community-dwelling men.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Ehime, Japan
| | - Asuka Kikuchi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Ehime, Japan
| | - Daisuke Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Ehime, Japan
| | - Teru Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Lu W, Zhao X, Sheng J, Zhao X, Tang Q, Zhang H, Feng Y, Niu Y. Hip circumference has independent association with the risk of hyperuricemia in middle-aged but not in older male patients with type 2 diabetes mellitus. Nutr J 2023; 22:45. [PMID: 37736731 PMCID: PMC10515053 DOI: 10.1186/s12937-023-00874-5] [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: 07/13/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Obesity and type 2 diabetes mellitus (T2DM) are risk factors for hyperuricemia. However, which anthropometric indices can better predict incident hyperuricemia in patients with T2DM remains inconsistent. This study aimed to examine the associations between hyperuricemia and different anthropometric indices in middle-aged and older male patients with T2DM. METHODS In this retrospective study, a total of 1447 middle-aged (45-65 years, n = 791) and older (≥ 65 years, n = 656) male patients with T2DM were collected from December 2015 to January 2020 at Shanghai Xinhua Hospital. Hyperuricemia was defined as a serum uric acid level above 7.0 mg/dL. Weight, height, waist circumference (WC) and hip circumference (HC) were measured by trained nurses at visit. RESULTS The median uric acid level of subjects was 5.6 (interquartile ranges: 4.7-6.7) mg/dl, and 279 (19.3%) were hyperuricemia, with 146 (18.5%) in the middle-aged group, and 133 (20.3%) in the older group. After adjusting for age, duration of T2DM, fasting plasma glucose and insulin, homeostasis model assessment-β, aspartate aminotransferase, triglycerides, high-density lipoprotein cholesterol and estimated glomerular filtration rate, body mass index (BMI), WC, HC, and waist-to-height ratio (WHtR) were associated with a higher risk of hyperuricemia in both middle-aged and older group (P < 0.05). After further adjusting for BMI and WC, HC still showed a positive relationship with the risk of hyperuricemia (Odds Ratio = 1.51, 95% confidence intervals: 1.06-2.14) in the middle-aged group, but such relationship was not found in the older group. Moreover, according to receiver operating characteristic analysis, the optimal cutoff value was 101.3 cm of HC for hyperuricemia screening in the middle-aged male patients with T2DM. CONCLUSION In middle-aged male patients with T2DM, more attention should be paid to HC with the cutoff value of 101.3 cm in clinical practice for early recognition of individuals with a high risk of hyperuricemia for targeted guidance on disease prevention, such as community screening.
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Affiliation(s)
- Wenyi Lu
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xuan Zhao
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jinye Sheng
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xuelin Zhao
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Qingya Tang
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Hongmei Zhang
- Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Yi Feng
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai JiaoTong University School of Medicine, Shanghai, China.
| | - Yang Niu
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Verma A, Jha A, Alagorie AR, Sharma R. Association of anthropometric parameters as a risk factor for development of diabetic retinopathy in patients with diabetes mellitus. Eye (Lond) 2023; 37:303-308. [PMID: 35058601 PMCID: PMC9873787 DOI: 10.1038/s41433-022-01934-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/15/2021] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To study the relationship of body fat distribution in patients with diabetes mellitus (DM), and its long-term complications like diabetic retinopathy (DR), in Indian population. METHODS This was a prospective, cross-sectional observational study involving 1773 subjects diagnosed with DM and 1778 age and gender-matched individuals. The patients with DM were assessed for the presence and severity of DR. Severe non-proliferative DR and proliferative DR were categorised as sight threatening DR (STDR). Anthropometric parameters, i.e., neck circumference (NC); mid-upper arm circumference (MAC); waist circumference (WC); hip circumference (HC); mid-thigh circumference (MTC) and body mass index (BMI) were measured using standardised technique. RESULTS The mean age was 59.33 ± 9.32 for DM group, and 66.03 ± 11.04 for non-DM group. DM group showed significantly greater NC, WC, and MTC and significantly reduced MAC and weight. HC and BMI were comparable between the groups. There was a significant positive correlation of MAC and WC (with any level of DR) and MAC, WC, and weight (for STDR); and a significant negative correlation of HC and MTC (with any level of DR) and NC, HC, MTC, and BMI (for STDR). Multiple logistic regression analysis confirmed that WC was the single most important predictor for any level of DR and STDR. CONCLUSIONS Association of body fat distribution with DM and DR appears multifactorial. However, central obesity signified by waist circumference appears to be the significant risk related to the development of DR and STDR in Indian population.
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Affiliation(s)
- Aditya Verma
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, College Road 18, Chennai, 600006, India
| | - Ashok Jha
- Department of Ophthalmology, Military Hospital, Gaya, Bihar, 823005, India.
| | | | - Rishi Sharma
- Department of Ophthalmology, Military Hospital, Yol, Himachal Pradesh, 176052, India
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Incorporation of Torsion Springs in a Knee Exoskeleton for Stance Phase Correction of Crouch Gait. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Crouch gait is a motor complication that is commonly associated with cerebral palsy, spastic diplegia, stroke, and motor-neurological pathologies, broadly defined as knee flexion in excess of 20° in the gait cycle. Uncorrected crouch gait results in fatigue, joint degradation, and loss of ambulation. Torsion springs have been used in cycling to store energy in the knee flexion to reduce fatigue in the quadriceps during knee extension. SolidWorks was used to design a passive exoskeleton for the knee, incorporating torsion springs of stiffnesses 20,000 N/mm and 30,000 N/mm at the knee joint, to correct four different crouch gaits. OpenSim was used to gather data from the moments produced, and knee angles from each crouch gait and the normal gait. Motion analysis of the exoskeleton was simulated using knee angles for each crouch gait and compared with the moments produced with the normal gait moments in the stance phase of the gait cycle. All crouch gait moments were significantly reduced, and the correction of peak crouch moments was achieved, corresponding to the normal gait cycle during the stance phase. These results offer significant potential for nonsurgical and less invasive options for wearable exoskeletons in crouch gait correction.
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Zhu Y, Wang Z, Maruyama H, Onoda K, Huang Q. Body Fat Percentage and Normal-Weight Obesity in the Chinese Population: Development of a Simple Evaluation Indicator Using Anthropometric Measurements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074238. [PMID: 35409919 PMCID: PMC8998592 DOI: 10.3390/ijerph19074238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 02/06/2023]
Abstract
Few studies explore the associations between body fat percentage (BFP) prediction and evaluation indicators for Chinese with normal-weight obesity. We aimed to explore convenient and cost-free BFP evaluation indicators to routinely monitor BFP status in Chinese patients with normal-weight obesity. Participants (N = 164) were divided into three groups according to body mass index (BMI) and BFP: normal-weight lean, normal-weight obese, and overweight and obese. Differences in body composition and circumference were compared to examine the relationship between BFP and circumference, determine a simple evaluation indicator reflecting BFP, and identify cutoff values for normal-weight obesity circumference. Significant differences in body composition and circumference were observed among the three groups. The correlation between thigh/height, hip/height, (hip + waist)/height, and BFP was stronger than that with BMI. The (hip + waist)/height ratio was the indicator most reflective of BFP (95% confidence interval: 3.004−9.018, p = 0.013), and a ratio above 1.115 (95% confidence interval: 0.936−0.992, p < 0.001) was predictive of normal-weight obesity. Furthermore, we suggest that the upper value for a normal BMI in Chinese individuals be lowered to 23.4 kg/m2 (95% confidence interval: 0.984−0.999, p < 0.001). The (hip + waist)/height ratio can be used with body mass index for a more accurate evaluations of BFP abnormalities and health risks.
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Affiliation(s)
- Yuetong Zhu
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi 324-8501, Japan;
| | - Zimin Wang
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8397, Japan
- Correspondence: ; Tel.: +81-070-3610-1857
| | - Hitoshi Maruyama
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan; (H.M.); (K.O.)
| | - Ko Onoda
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan; (H.M.); (K.O.)
| | - Qiuchen Huang
- Department of Physical Therapy, School of Rehabilitation Medicine, Capital Medical University, Beijing 100069, China;
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Yang L, Deng H, Pan W, Huang X, Xu K, Zhang X, Hu X, Gu X. The Inverse Association of Leg Fat Mass and Osteoporosis in Individuals with Type 2 Diabetes Independent of Lean Mass. Diabetes Metab Syndr Obes 2022; 15:1321-1330. [PMID: 35519662 PMCID: PMC9063940 DOI: 10.2147/dmso.s358717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Recent studies revealed that high levels of thigh fat were independently associated with better glucose and lipid metabolism, as well as lower risk of hypertension and cardiometabolic disease. Therefore, the purpose of this study was to evaluate the association between leg fat mass (FM) and osteoporosis (OP) in individuals with type 2 diabetes (T2DM). PATIENTS AND METHODS In this cross-sectional study, a total of 1,259 individuals aged 50 years or older with T2DM (female 536, male 723) were included. A bioelectrical impedance analyser was used to assess the segment body composition containing FM and lean mass (LM) of arms, legs, and trunk. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry. RESULTS Leg FM was positively correlated with BMD of all sites in females and BMD of femoral neck and total hip in males after adjusting age, diabetes duration, glucose and lipid metabolism indexes, and lifestyle (all P<0.05). LM was positively associated with BMD at almost sites (P<0.001), while leg FM/LM ratio had no relationship with BMD at any skeleton sites (P>0.05). Compared with the bottom tertile group of leg FM, the risk of OP was significantly lower in the top tertile group both in females (T3 vs T1: OR=0.206, 95% CI=0.098-0.433, P<0.001) and males (T3 vs T1: OR=0.385, 95% CI=0.182-0.815, P<0.05), even after adjusting for LM. CONCLUSION In the present study, higher leg FM was correlated with the lower risk of OP in both men and postmenopausal women with T2DM independently of total LM.
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Affiliation(s)
- Lijuan Yang
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Huihui Deng
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Wei Pan
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xiaoyan Huang
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Ke Xu
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xingxing Zhang
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xiang Hu
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- Correspondence: Xiang Hu; Xuejiang Gu, Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, People’s Republic of China, Tel/Fax +86-577-55579381, Email ;
| | - Xuejiang Gu
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
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Darroudi S, Sharifan P, Sadeghzadeh P, Namjou N, Zamiri Bidary M, Zamani P, Esmaily H, Ferns GA, Moohebati M, Ghayour-Mobarhan M. Overweight and Obesity are Potential Risk Factors for Disrupted Nocturnal Sleep in Iranian Adults: A Cross-Sectional Study. Int J Public Health 2021; 66:633183. [PMID: 34744585 PMCID: PMC8565265 DOI: 10.3389/ijph.2021.633183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Obesity is a risk factor for several chronic conditions, including sleep disorders. We aimed to analyze the relationship between BMI, body fat percentage (FAT%), hip and waist circumference, and weight on the duration of nocturnal sleep. Methods: This study was part of the MASHAD cohort study. In all participants BMI and FAT% were measured. BMI was used to categorize individuals as obese, overweight, and normal subjects. FAT% was used to categorize individuals into tertile: tertile 1 (low) < 27.5, tertile 2 (medium) 27.5-41, and tertile 3 (high) > 41. The level of nightly sleep duration was categorized into three groups: <6, 6-8 (reference group), and >8 h. Results: There was a significant inverse association between body weight and duration of sleep (p < 0.05). Obese and overweight participants had 1.152 OR (CI:1.083-1.225) and 1.126 OR (CI:1.063-1.194) for a short duration of nocturnal sleep, respectively, relative to those with a normal BMI. Conclusion: BMI was an independent determinant of nocturnal sleep duration; obesity and overweight may have negative consequences on sleep duration. Weight control should be considered as a factor in adjusting sleep quality.
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Affiliation(s)
- Susan Darroudi
- Student Research Committee, International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Sharifan
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parastoo Sadeghzadeh
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Namjou
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Zamiri Bidary
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Zamani
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A. Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Student Research Committee, International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Wu IW, Liao PJ, Ting MK, Chen SW, Yang NI, Hsu KH. Combination of Thigh Circumference and Indices of Central Obesity Helps Predict Incident Chronic Kidney Disease: A 14-Year Prospective Cohort Study Using a Three-Dimensional Body Laser Scanner. J Ren Nutr 2021; 32:405-413. [PMID: 34330568 DOI: 10.1053/j.jrn.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/10/2021] [Accepted: 06/19/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Obesity, high body mass index, and visceral fat accumulation are associated with renal diseases. However, the association between body measurements and chronic kidney disease (CKD) is still unclear. METHODS A cohort of 7,825 participants scheduled for follow-up of CKD was recruited from 2000 to 2008 in Taiwan. A questionnaire was developed to collect the basic demographics, lifestyle variables, personal disease history, and family disease history of the participants. A 3-dimensional body surface scanning system was used to take their body measurements. The participants underwent an average follow-up of 14.3 years for evaluation of the incidence of CKD. A multiple Cox regression model was built. RESULTS Three body measurements, namely chest width (hazard ratio [HR] 1.059, 95% confidence interval [CI] 1.011-1.110), waist circumference (HR 1.017, 95% CI 1.006-1.029), and thigh circumference (HR 0.941, 95% CI 0.922-0.961), were significantly associated with CKD. Two combinations of body measurements, namely the waist-to-thigh ratio and chest-to-thigh ratio, were derived to predict the occurrence of CKD. Participants with the highest quartile of waist-to-thigh ratio and chest-to-thigh ratio had a 2.175-fold and 2.182-fold risk of developing CKD, respectively. CONCLUSIONS This study suggests that along with central obesity, body limb measurements can be used as an indicator to predict the occurrence of CKD. The effects of limb measurements on CKD could help provide an innovative perspective regarding the intervention to be developed for the treatment of CKD and a preventive medicine for high-risk individuals. The association of thigh circumference with CKD warrants further investigation.
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Affiliation(s)
- I-Wen Wu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung; College of Medicine, Chang Gung University, Taiwan
| | - Pei-Ju Liao
- Master Degree Program in Healthcare Industry, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Kuo Ting
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shuo-Wei Chen
- Division of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ning-I Yang
- Division of Cardiology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Kuang-Hung Hsu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan; Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, Taipei, Taiwan.
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Kawamoto R, Kikuchi A, Akase T, Ninomiya D, Kumagi T. Thigh circumference and handgrip strength are significantly associated with all-cause mortality: findings from a study on Japanese community-dwelling persons. Eur Geriatr Med 2021; 12:1191-1200. [PMID: 34027601 DOI: 10.1007/s41999-021-00515-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE In addition to playing a critical role in cardiovascular health, muscle mass and strength independently impact aging-related health outcomes in adults. There are limited predictive data for all-cause mortality, particularly for community-dwelling persons in Japan. This study examined whether handgrip strength (HGS) and thigh circumference are related to survival prognosis based on a 6-year follow-up period. METHODS Participants were 787 men (aged 69 ± 11 years) and 963 women (aged 69 ± 9 years) who took part in a Nomura cohort study conducted in 2014 and who continued with follow-ups for the subsequent 6 years (follow-up rate: 95.5%). We obtained adjusted relative hazards of all-cause mortality from the basic resident register. The data were subjected to a Cox regression with age as the time variable and gender, age, anthropometric index, smoking habits, drinking habits, exercise habits, cardiovascular history, blood pressure, lipid levels, diabetes, renal function, and serum uric acid as risk factors. RESULTS Of the 1750 participants, a total of 97 (5.5%) were confirmed to have died, of which 56 were men (7.1% of all male participants), and 41 were women (4.3% of all female participants). The multivariable Cox regression analysis revealed that smaller thigh circumference and lower HGS in men were found to predict 6-year all-cause mortality, but in women only baseline HGS was associated with all-cause mortality. CONCLUSION Thigh circumference and HGS are useful predictors of death in Japanese community-dwelling men.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan. .,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan.
| | - Asuka Kikuchi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan
| | - Taichi Akase
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan
| | - Daisuke Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan
| | - Teru Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan
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Wang XH, Jiang WR, Zhang MY, Shi YX, Ji YP, Li CJ, Lin JN. The visceral fat area to leg muscle mass ratio is significantly associated with the risk of hyperuricemia among women: a cross-sectional study. Biol Sex Differ 2021; 12:17. [PMID: 33514431 PMCID: PMC7847040 DOI: 10.1186/s13293-021-00360-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/17/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND A significant positive association was found in previous studies among obesity, visceral fat accumulation, and hyperuricemia. The purpose of this study was to explore the association between the ratio of visceral fat area to leg muscle mass (VFA-to-LMM) and hyperuricemia, and verify the role of gender differences in the association. METHODS A total of 3393 (43.3% are men) participants from Tianjin Union Medical Center-Health Management Center were recruited for this cross-sectional study. The VFA-to-LMM ratio was used as the independent variable. Hyperuricemia, a serum uric acid level ≥ 416 μmol/L in men and in menopausal women and ≥ 357 μmol/L in premenopausal women, was used as the dependent variable. Multiple logistic regression analysis was used to estimate the odds ratio and the 95% confidence interval between the VFA-to-LMM ratio and hyperuricemia. RESULTS The overall prevalence of hyperuricemia was 14.8% (8.9% in women, and 22.5% in men). After adjustment by age, smoking status (for males), menopause status (for females), drinking status, exercise frequency, blood pressure, alanine aminotransferase, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, creatinine, and history of diseases, a strong positive association was found between the VFA-to-LMM ratio and hyperuricemia in both men (4th vs. 1st quartile 1.60, 95%CI: 1.03-2.49) and women (4th vs. 1st quartile 5.22, 95%CI: 2.44-12.56). After additional adjustment by BMI, there was still a significant positive association in women (4th vs. 1st quartile 2.57, 95%CI: 1.06-6.77). The results of subgroup analysis showed that pre-menopausal women (4th vs. 1st quartile OR: 3.61) have a higher risk of hyperuricemia than postmenopausal women (4th vs. 1st quartile OR: 1.94) with the increase of the VFA-to-LMM ratio. Besides, the interaction analysis results showed the highest risk of hyperuricemia when VFA and LMM were both in the highest quantile (OR: 11.50; 95% CI: 4.86-31.98). CONCLUSION The VFA-to-LMM ratio was positively associated with the risk of hyperuricemia in women after adjustment by confounders. Pre-menopausal women have a higher risk of hyperuricemia than postmenopausal women with the increase of the VFA-to-LMM ratio. In addition, the highest risk of hyperuricemia was demonstrated when both VFA and LMM were at the highest quartile.
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Affiliation(s)
- Xiao-He Wang
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 of Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Wei-Ran Jiang
- Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, New York, NY, USA
| | | | - Ying-Xin Shi
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 of Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Yun-Ping Ji
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 of Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Chun-Jun Li
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 of Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
| | - Jing-Na Lin
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 of Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
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Anthropometric Factors on Safe Distances between Popliteal Vessels to the Femur for Cerclage Wiring of the Distal Femoral Fracture: A Magnetic Resonance Imaging Study. ACTA ACUST UNITED AC 2020; 56:medicina56120655. [PMID: 33260736 PMCID: PMC7761162 DOI: 10.3390/medicina56120655] [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] [Received: 09/15/2020] [Revised: 11/16/2020] [Accepted: 11/26/2020] [Indexed: 11/23/2022]
Abstract
Background and Objectives: The proximity of the popliteal vessels in the distal femur may increase the risk of iatrogenic vascular injury during cerclage wiring. In this study, the closest location and distance of the popliteal vessels to the femur was examined using magnetic resonance imaging (MRI). The associations between anthropometric factors and the distance that would guide the placement of wires safely during surgery were also identified. Materials and Methods: We reviewed adult knee magnetic resonance images and recorded: (1) the relation and the shortest horizontal distance (d-H) from the femoral cortex to the popliteal vessels in axial images and (2) the vertical distance (d-V) from the adductor tubercle to the axial level of the d-H values in coronal images. The effects of anthropometric factors (sex, age, body height, body weight, body mass index, thigh circumference, femoral length and femoral width) on these distances were analysed. Results: Analysis of 206 knee magnetic resonance images revealed that the closet locations of popliteal vessels were at the posteromedial aspect of the femur. The d-H and d-V were 7.38 ± 3.22 mm and 57.01 ± 11.14 mm, respectively, and were both shorter in women than in men (p < 0.001). Multivariate analysis identified thigh circumference and femoral length as the most influential factors for the d-H and d-V, respectively (p < 0.001). Linear regression demonstrated a strong positive linear correlation between the thigh circumference and the d-H and between the femoral length and the d-V (Pearson’s r = 0.891 and 0.806, respectively (p < 0.001)). Conclusions: The closet location and distance of the popliteal vessels to the femur provide useful information for wire placement during distal femoral fracture surgery while minimising the risk of vascular injury. Given that patients with a smaller thigh circumference and a shorter femoral length are more likely to have a smaller d-H and a shorter d-V, respectively, cautious measures should be taken in such cases.
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Chen CL, Liu L, Huang JY, Yu YL, Shen G, Lo K, Huang YQ, Feng YQ. Thigh Circumference and Risk of All-Cause, Cardiovascular and Cerebrovascular Mortality: A Cohort Study. Risk Manag Healthc Policy 2020; 13:1977-1987. [PMID: 33116978 PMCID: PMC7549877 DOI: 10.2147/rmhp.s264435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/15/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The relationship between thigh circumference and all-cause and cause-specific mortality has not been consistent. We aimed to examine how thigh circumference associates with all-cause, cardiovascular, and cerebrovascular mortality among US adults. Patients and Methods This cohort study included 19,885 US adults who participated in the 1999–2006 National Health and Nutrition Examination Survey (NHANES) with thigh circumference being measured at baseline, and survival status was ascertained until 31 December 2015. We used Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for mortality according to thigh circumference in quartiles. Kaplan–Meier survival curve and restricted cubic spline regression were performed to evaluate the prospective association. Finally, subgroup analyses by age, gender, body mass index (BMI), and medical history at baseline were conducted. Results During a median follow-up of 11.9 years, 3513 cases of death, 432 death cases due to cardiovascular disease, and 143 death cases due to cerebrovascular disease have occurred. Multivariate Cox regression indicated that every 1cm increase in thigh circumference was related to 4% and 6% decreased risk of all-cause mortality and cardiovascular mortality, respectively. Compared to the reference group, the highest quartile of thigh circumference significantly decreased all-cause mortality by 21% (HR 0.79, 95% CI 0.62–1.00, P<0.05). However, the association of thigh circumference with cerebrovascular mortality was not significant. BMI was a significant effect modifier among individuals with a BMI of less than 25 kg/m2 (P<0.0001). Conclusion A low thigh circumference appears to be associated with increased risk of all-cause and cardiovascular mortality, but not cerebrovascular mortality.
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Affiliation(s)
- Chao-Lei Chen
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Lin Liu
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Jia-Yi Huang
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Yu-Ling Yu
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Geng Shen
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Kenneth Lo
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China.,Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Yu-Qing Huang
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Ying-Qing Feng
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
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Effects of low-dose milk protein supplementation following low-to-moderate intensity exercise training on muscle mass in healthy older adults: a randomized placebo-controlled trial. Eur J Nutr 2020; 60:917-928. [PMID: 32524231 PMCID: PMC7900046 DOI: 10.1007/s00394-020-02302-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE The purpose of this study was to examine whether long-term ingestion of low-dose milk protein supplementation causes a greater increase in muscle mass and strength of older adults during low-to-moderate intensity exercise training intervention than isocaloric carbohydrate. METHODS In a randomized, double-blind, and placebo-controlled design, 122 healthy older adults (60-84 year) received either an acidified milk protein drink containing 10 g of milk protein (MILK; n = 61) or an isocaloric placebo drink (PLA; n = 61) daily throughout 6 months of body weight and medicine ball exercise training. Measurements before and after the intervention included body composition, physical performance and blood biochemistry. RESULTS Lean body mass significantly increased in the MILK group (+ 0.54 kg, p < 0.001), but did not change in the PLA group (- 0.10 kg, p = 0.534). The increases in the MILK group were significantly greater than in the PLA group (p = 0.004). Fat mass (- 0.77 kg) and plasma uric acid levels (- 0.3 mg/dL) significantly decreased only in the MILK group (p < 0.001), with a significant group difference (p = 0.002 and p < 0.001, respectively). Most of the physical performance tests significantly improved in both groups, but no group differences were found. CONCLUSION We conclude that low-dose milk protein supplementation (10 g of protein/day) combined with low-to-moderate intensity exercise training is associated with increased muscle mass, but not improved physical performance compared to carbohydrate combined with exercise in healthy older adults. This study was registered in the UMIN Clinical Trials Registry (UMIN000032189).
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15
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Yoon MK, Kang JG, Lee SJ, Ihm SH, Huh KB, Kim CS. Relationships between Thigh and Waist Circumference, Hemoglobin Glycation Index, and Carotid Plaque in Patients with Type 2 Diabetes. Endocrinol Metab (Seoul) 2020; 35:319-328. [PMID: 32615716 PMCID: PMC7386106 DOI: 10.3803/enm.2020.35.2.319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 04/07/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study investigated the relationships of thigh and waist circumference with the hemoglobin glycation index (HGI) and carotid atherosclerosis in patients with type 2 diabetes. METHODS This observational study included 3,075 Korean patients with type 2 diabetes, in whom anthropometric measurements and carotid ultrasonography were conducted. HGI was defined as the measured hemoglobin A1c (HbA1c) level minus the predicted HbA1c level, which was calculated using the linear relationship between HbA1c and fasting plasma glucose levels. Carotid atherosclerosis was defined as a clearly isolated focal plaque or focal wall thickening >50% of the surrounding intima-media thickness. RESULTS The frequency of a positive HGI decreased with increasing thigh circumference in men and increased with increasing waist circumference in women after adjusting for potential confounding variables. Thigh and waist circumference had a combined augmentative effect on the likelihood of positive HGI, which was dramatically higher in patients in higher waist-to-thigh ratio quartiles (adjusted odds ratios for the highest compared to the lowest quartile: 1.595 in men and 1.570 in women). Additionally, the larger the thigh circumference, the lower the risk of carotid atherosclerosis, although in women, this relationship lacked significance after adjustment for potential confounders. CONCLUSION HGI was associated with thigh circumference in men and waist circumference in women. In addition, the combination of low thigh circumference and high waist circumference was strongly associated with a higher HGI in Korean patients with type 2 diabetes. In particular, thigh circumference was associated with carotid atherosclerosis in men. However, further longitudinal studies are warranted.
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Affiliation(s)
- Myung Ki Yoon
- Hallym University College of Medicine, Chuncheon,
Korea
| | - Jun Goo Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon,
Korea
| | - Seong Jin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon,
Korea
| | - Sung-Hee Ihm
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon,
Korea
| | - Kap Bum Huh
- Huh’s Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul,
Korea
| | - Chul Sik Kim
- Department of Endocrinology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin,
Korea
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16
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Shi J, Yang Z, Niu Y, Zhang W, Lin N, Li X, Zhang H, Gu H, Wen J, Ning G, Qin L, Su Q. Large thigh circumference is associated with lower blood pressure in overweight and obese individuals: a community-based study. Endocr Connect 2020; 9:271-278. [PMID: 32247281 PMCID: PMC7159266 DOI: 10.1530/ec-19-0539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A small thigh circumference is associated with an increased risk of diabetes, cardiovascular diseases, and total mortality. The purpose of this study was to evaluate the association between thigh circumference and hypertension in the middle-aged and elderly population. METHODS A total of 9520 individuals aged 40 years and older with measurement of thigh circumference were available for analysis. The measurement of thigh circumference was performed directly below the gluteal fold of the thigh. The association of thigh circumference with hypertension was tested in logistic regression analyses and reported as odds ratio (OR) with 95% CI. RESULTS Thigh circumference was negatively correlated with systolic blood pressure, diastolic blood pressure, fasting glucose, and total cholesterol. Compared with the lowest thigh circumference tertile group, the risk of hypertension was significantly lower in the highest tertile group, both in overweight individuals (OR 0.68; 95% CI 0.59-0.79, P < 0.001) and obese individuals (OR 0.51; 95% CI 0.38-0.70, P < 0.001). CONCLUSION In the present study, large thigh circumference is associated with lower risk of hypertension in overweight and obese Chinese individuals.
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Affiliation(s)
- Jie Shi
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhen Yang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Correspondence should be addressed to Z Yang or L Qin or Q Su: or or
| | - Yixin Niu
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weiwei Zhang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ning Lin
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoyong Li
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongmei Zhang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongxia Gu
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Wen
- Department of Endocrinology and Metabolism, Institute of Endocrinology and Diabetes, Huashan Hospital, Fudan University, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Qin
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Correspondence should be addressed to Z Yang or L Qin or Q Su: or or
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Correspondence should be addressed to Z Yang or L Qin or Q Su: or or
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Jayawardena R, Ranasinghe P, Ranathunga T, Mathangasinghe Y, Wasalathanththri S, Hills AP. Novel anthropometric parameters to define obesity and obesity-related disease in adults: a systematic review. Nutr Rev 2019; 78:498-513. [DOI: 10.1093/nutrit/nuz078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Context
Obesity is defined as an abnormal or excessive accumulation of body fat. Traditionally, it has been assessed using a wide range of anthropometric, biochemical, and radiological measurements, with each having its advantages and disadvantages.
Objective
A systematic review of the literature was conducted to identify novel anthropometric measurements of obesity in adults.
Data Sources
Using a combination of MeSH terms, the PubMed database was searched.
Data Extraction
The current systematic review was conducted in accordance with the PRISMA guidelines. The data extracted from each study were (1) details of the study, (2) anthropometric parameter(s) evaluated, (3) study methods, (4) objectives of the study and/or comparisons, and (5) main findings/conclusions of the study.
Data Analysis
The search yielded 2472 articles, of which 66 studies were deemed eligible to be included. The literature search identified 25 novel anthropometric parameters. Data on novel anthropometric parameters were derived from 26 countries. Majority were descriptive cross-sectional studies (n = 43), while 22 were cohort studies. Age range of the study populations was 17–103 years, while sample size varied from 45 to 384 612.
Conclusions
The novel anthropometric parameters identified in the present study showed variable correlation with obesity and/or related metabolic risk factors. Some parameters involved complex calculations, while others were derived from traditional anthropometric measurements. Further research is required in order to determine the accuracy and precision.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Yasith Mathangasinghe
- Department of Anatomy, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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18
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Wu CJ, Kao TW, Chen YY, Peng TC, Wang CC, Zhou YC, Yang HF, Chen WL. Examining the association between vestibular function and lower extremity circumference in an aged population. Geriatr Gerontol Int 2019; 19:622-627. [PMID: 31025472 DOI: 10.1111/ggi.13679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/20/2019] [Accepted: 04/03/2019] [Indexed: 01/01/2023]
Abstract
AIM To explore the association between vestibular dysfunction and specific anthropometric parameters. METHODS The results from 2420 participants of the 1999-2004 National Health and Nutrition Examination Survey were included for the evaluation of vestibular dysfunction using the Romberg test of standing balance and anthropometric measurements, including waist circumference, thigh circumference, calf circumference (CC), waist-to-thigh ratio (WTR) and waist-to-calf ratio (WCR). Passing the balance test was defined as participants keeping their balance for 30 s while in the standing position with their eyes closed. Multivariable logistic regression models were the main statistical tools in the present study. RESULTS The mean age of the participants was approximately 65 years, and half of the study participants were men. The full adjusted odds ratio of vestibular dysfunction for the CC, thigh circumference, WCR and WTR was 0.941 (95% confidence interval [CI], 0.894-0.992), 0.948 (95% CI 0.912-0.986), 1.856 (95% CI 1.087-3.170) and 2.516 (95% CI 1.235-5.126), respectively. Higher waist circumference along with lower thigh circumference and CC were observed in the participants in the higher WTR and WCR quartiles. Furthermore, a dose-response relationship between vestibular dysfunction and anthropometric ratios was detected. DISCUSSION The present study showed that individuals with lower CC and thigh circumference or higher WCR and WTR exhibited higher odds of having vestibular dysfunction. Geriatr Gerontol Int 2019; 19: 622-627.
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Affiliation(s)
- Chen-Jung Wu
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chao Zhou
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
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19
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Han SJ, Boyko EJ, Kim SK, Fujimoto WY, Kahn SE, Leonetti DL. Association of Thigh Muscle Mass with Insulin Resistance and Incident Type 2 Diabetes Mellitus in Japanese Americans. Diabetes Metab J 2018; 42:488-495. [PMID: 30302961 PMCID: PMC6300439 DOI: 10.4093/dmj.2018.0022] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/17/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Skeletal muscle plays a major role in glucose metabolism. We investigated the association between thigh muscle mass, insulin resistance, and incident type 2 diabetes mellitus (T2DM) risk. In addition, we examined the role of body mass index (BMI) as a potential effect modifier in this association. METHODS This prospective study included 399 Japanese Americans without diabetes (mean age 51.6 years) who at baseline had an estimation of thigh muscle mass by computed tomography and at baseline and after 10 years of follow-up a 75-g oral glucose tolerance test and determination of homeostasis model assessment of insulin resistance (HOMA-IR). We fit regression models to examine the association between thigh muscle area and incidence of T2DM and change in HOMA-IR, both measured over 10 years. RESULTS Thigh muscle area was inversely associated with future HOMA-IR after adjustment for age, sex, BMI, HOMA-IR, fasting plasma glucose, total abdominal fat area, and thigh subcutaneous fat area at baseline (P=0.033). The 10-year cumulative incidence of T2DM was 22.1%. A statistically significant interaction between thigh muscle area and BMI was observed, i.e., greater thigh muscle area was associated with lower risk of incident T2DM for subjects at lower levels of BMI, but this association diminished at higher BMI levels. CONCLUSION Thigh muscle mass area was inversely associated with future insulin resistance. Greater thigh muscle area predicts a lower risk of incident T2DM for leaner Japanese Americans.
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Affiliation(s)
- Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Soo Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Wilfred Y Fujimoto
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Steven E Kahn
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, USA
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20
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Ting MK, Liao PJ, Wu IW, Chen SW, Yang NI, Lin TY, Hsu KH. Predicting Type 2 Diabetes Mellitus Occurrence Using Three-Dimensional Anthropometric Body Surface Scanning Measurements: A Prospective Cohort Study. J Diabetes Res 2018; 2018:6742384. [PMID: 30116743 PMCID: PMC6079414 DOI: 10.1155/2018/6742384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/07/2018] [Accepted: 02/27/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND An accurate and comprehensive anthropometric measure for predicting type 2 diabetes mellitus (T2DM) has not yet been depicted. METHODS A total of 8450 nondiabetic participants were recruited during 2000-2010 in Taiwan. The cohort was followed up to the end of 2013, over an average of 8.87 years. At recruitment, participants completed a questionnaire related to basic demographics, lifestyle variables, personal disease history, and family disease history. 3D body surface scanning was used to obtain 35 anatomical measurements. A Cox proportional hazard model was used to conduct multivariable analyses. RESULTS A total of 2068 T2DM cases at an incidence rate of 27.59 × 10-3 (year-1) were identified during the follow-up period. Multivariable-adjusted hazard ratios (HRs) demonstrated that neck circumference (NC) (HR = 1.048; 95% CI = 1.033-1.064), waist width (WW) (HR = 1.061; 95% CI = 1.040-1.081), and left thigh circumference (TC) (HR = 0.984; 95% CI = 0.972-0.995) were significant predictors of the occurrence of T2DM. While dividing body measurement into median high/low groups, an increased risk of T2DM was observed among participants with a larger NC and smaller TC (HR = 1.375; 95% CI = 1.180-1.601) and a larger WW and smaller TC (HR = 1.278; 95% CI = 1.085-1.505) relative to other participants. CONCLUSIONS This study suggests that as well as using traditional waist and TC measurements, NC can be used as an indicator to provide an early prediction of developing T2DM, while providing clues for future mechanistic investigations of T2DM.
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Affiliation(s)
- Ming-Kuo Ting
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Pei-Ju Liao
- Department of Health Care Administration, Oriental Institute of Technology, New Taipei City, Taiwan
| | - I-Wen Wu
- Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shuo-Wei Chen
- Division of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ning-I Yang
- Division of Cardiology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tzu-Yu Lin
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Kuang-Hung Hsu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Yoshii N, Sato K, Ogasawara R, Kurihara T, Hamaoka T, Fujita S. Relationship between Dietary Protein or Essential Amino Acid Intake and Training-Induced Muscle Hypertrophy among Older Individuals. J Nutr Sci Vitaminol (Tokyo) 2018; 63:379-388. [PMID: 29332899 DOI: 10.3177/jnsv.63.379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Dietary protein intake is critical for maintaining an optimal muscle mass, especially among older individuals. Although protein supplementation during resistance training (RT) has been shown to further augment training-induced muscle mass in older individuals, the impact of daily variations in protein intake on training-induced muscle mass has not been explored thus far. Therefore, this study aimed to investigate the relationship between the dietary protein and amino acid intake and RT-induced muscle hypertrophy among older individuals. Ten healthy older men (n=10; mean age=69±2 y; body weight (BW)=61.5±2.2 kg; height=1.65±0.02 m) participated in progressive RT performed 3 times/wk for 12 wk. Body composition (using DXA) and nutritional assessments (using a 3-d dietary record) were performed before and after the training period. Leg lean mass (LLM) increased significantly (15.0±0.8 vs. 15.4±0.8 kg, p<0.05) after RT, with no change in dietary nutrient intake. The average dietary protein intake was 1.62±0.11 g/kg BW/d, while essential amino acids was 600±51 mg/kg BW/d. Although the correlation between the increase in LLM and dietary protein intake was not significant, a significant correlation was found between the increase in LLM and dietary essential amino acid (EAA) intake. Furthermore, there were significant correlations between the increase in LLM and protein as well as EAA (especially leucine) intake at breakfast among subjects with suboptimal protein intake (p<0.05). Our study findings indicate that dietary protein as well as EAA intake may be significant contributing factors in muscle hypertrophic response during RT among healthy older men.
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Affiliation(s)
- Naomi Yoshii
- Graduate School of Sport and Health Science, Ritsumeikan University
| | - Koji Sato
- Graduate School of Human Development and Environment, Kobe University
| | - Riki Ogasawara
- Department of Life Science and Applied Chemistry, Nagoya Institute of Technology
| | | | | | - Satoshi Fujita
- Graduate School of Sport and Health Science, Ritsumeikan University
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Lisboa KWDSC, Lira Neto JCG, Araújo MFMD, Freitas RWJFD, Gomes EB, Bispo GMB, Rodrigues EMD, Damasceno MMC. A relação pescoço-coxa (RPCx) pode servir como índice antropométrico para diagnosticar a síndrome metabólica? ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
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.
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Choi SI, Chung D, Lim JS, Lee MY, Shin JY, Chung CH, Huh JH. Relationship between Regional Body Fat Distribution and Diabetes Mellitus: 2008 to 2010 Korean National Health and Nutrition Examination Surveys. Diabetes Metab J 2017; 41:51-59. [PMID: 28029016 PMCID: PMC5328696 DOI: 10.4093/dmj.2017.41.1.51] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/13/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between regional body fat distribution, especially leg fat mass, and the prevalence of diabetes mellitus (DM) in adult populations. METHODS A total of 3,181 men and 3,827 postmenopausal women aged 50 years or older were analyzed based on Korea National Health and Nutrition Examination Surveys (2008 to 2010). Body compositions including muscle mass and regional fat mass were measured using dual-energy X-ray absorptiometry. RESULTS The odds ratios (ORs) for DM was higher with increasing truncal fat mass and arm fat mass, while it was lower with increasing leg fat mass. In a partial correlation analysis adjusted for age, leg fat mass was negatively associated with glycosylated hemoglobin in both sexes and fasting glucose in women. Leg fat mass was positively correlated with appendicular skeletal muscle mass and homeostasis model assessment of β cell. In addition, after adjusting for confounding factors, the OR for DM decreased gradually with increasing leg fat mass quartiles in both genders. When we subdivided the participants into four groups based on the median values of leg fat mass and leg muscle mass, higher leg fat mass significantly lowered the risk of DM even though they have smaller leg muscle mass in both genders (P<0.001). CONCLUSION The relationship between fat mass and the prevalence of DM is different according to regional body fat distribution. Higher leg fat mass was associated with a lower risk of DM in Korean populations. Maintaining leg fat mass may be important in preventing impaired glucose tolerance.
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Affiliation(s)
- Soo In Choi
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dawn Chung
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Soo Lim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi Young Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jang Yel Shin
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Choon Hee Chung
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji Hye Huh
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Kang DY, Kim HS, Lee KS, Kim YM. The effects of bodyweight-based exercise with blood flow restriction on isokinetic knee muscular function and thigh circumference in college students. J Phys Ther Sci 2015; 27:2709-12. [PMID: 26504274 PMCID: PMC4616075 DOI: 10.1589/jpts.27.2709] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/25/2015] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of bodyweight-based exercise with blood flow restriction on isokinetic muscular function and thigh circumference in college students. [Subjects and Methods] The subjects were 17 college students who were recruited and randomly assigned to bodyweight-based exercise with blood flow restriction and bodyweight-based exercise groups. Participants performed front lunges and squats at ratings of perceived exertion of 11-13 three times a week during a 6-week training period. The peak torque/ body weight (%) of the knee flexor and extensor was measured using a HUMAC NORM System (Cybex 770-NORM(®), Cybex International, Medway, MA, USA), and the circumference of the thigh was measured. PASW Statistics was used for data analysis. [Results] There were significant differences in the peak torque/ body weight (%) of the flexors in both thighs (at 180°/sec) after bodyweight-based exercise with blood flow restriction. In addition, the circumference changes in both thighs were significant after bodyweight-based exercise with blood flow restriction and between the two groups. [Conclusion] This study suggests that bodyweight-based exercise with blood flow restriction may be an effective method to improve the muscle power and hypertrophy of the lower extremity in a clinical setting.
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Affiliation(s)
- Dong Yeon Kang
- Department of Physical Therapy, DongJu College, Republic of Korea
| | - Hyoung Su Kim
- Department of Physical Therapy, DongJu College, Republic of Korea
| | - Kyung Soon Lee
- Department of Physical Therapy, DongJu College, Republic of Korea
| | - Young Mi Kim
- Department of Physical Therapy, College of Rehabilitation
Science, Daegu University, Republic of Korea
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Colley D, Cines B, Current N, Schulman C, Bernstein S, Courville AB, Zambell K, Reynolds JC, Yanovski J. Assessing Body Fatness in Obese Adolescents: Alternative Methods to Dual-Energy X-Ray Absorptiometry. THE DIGEST 2015; 50:1-7. [PMID: 27398414 PMCID: PMC4936189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Danielle Colley
- Nutrition Department, Clinical Center, National Institutes of Health
| | - Brittany Cines
- Nutrition Department, Clinical Center, National Institutes of Health
| | - Nina Current
- Nutrition Department, Clinical Center, National Institutes of Health
| | - Chelsea Schulman
- Nutrition Department, Clinical Center, National Institutes of Health
| | - Shanna Bernstein
- Nutrition Department, Clinical Center, National Institutes of Health
| | | | - Kirsten Zambell
- Nutrition Department, Clinical Center, National Institutes of Health
| | - James C. Reynolds
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health
| | - Jack Yanovski
- National Institute for Child Health and Human Development, National Institutes of Health
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