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Seo DH, Suh YJ, Cho Y, Ahn SH, Seo S, Hong S, Lee YH, Choi YJ, Lee E, Kim SH. Effect of low skeletal muscle mass and sarcopenic obesity on chronic kidney disease in patients with type 2 diabetes. Obesity (Silver Spring) 2022; 30:2034-2043. [PMID: 36062861 DOI: 10.1002/oby.23512] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/09/2022] [Accepted: 05/18/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between low muscle mass or sarcopenic obesity and the risk of incident chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 3123 patients with T2DM with preserved renal function were followed up for incident CKD. Skeletal muscle mass was estimated from bioelectrical impedance analysis. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 . Sarcopenic obesity was defined as the coexistence of sarcopenia and abdominal obesity. RESULTS During 8.9 years of follow-up, 530 (17.0%) patients developed incident CKD. When patients were divided into three groups based on sex-specific tertiles, lower muscle mass was not associated with an increased risk of incident CKD after adjustment for risk factors. However, when patients were divided into four groups according to the presence of sarcopenia and obesity, sarcopenic obesity was associated with an increased risk of incident CKD (adjusted hazard ratio 1.77; 95% CI: 1.24-2.51; p = 0.001) compared with the other groups. CONCLUSIONS Sarcopenic obesity, but not low muscle mass alone, may increase the risk of CKD in patients with T2DM.
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Affiliation(s)
- Da Hea Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University College of Medicine, Incheon, Republic of Korea
| | - Yongin Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Seongha Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Eunjig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - So Hun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
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Seo DH, Suh YJ, Cho Y, Ahn SH, Seo S, Hong S, Lee YH, Choi YJ, Lee E, Kim SH. Effect of Dapagliflozin in Combination with Lobeglitazone and Metformin in Korean Patients with Type 2 Diabetes in Real-World Clinical Practice. Yonsei Med J 2022; 63:825-833. [PMID: 36031782 PMCID: PMC9424781 DOI: 10.3349/ymj.2022.63.9.825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aimed to evaluate the efficacy and tolerability of dapagliflozin as an add-on or a switch therapy to lobeglitazone plus metformin (MFM) in Korean patients with inadequately controlled type 2 diabetes mellitus (T2DM) in real-world clinical practice. MATERIALS AND METHODS The study included 109 patients who started dapagliflozin as add-on or switch therapy to lobeglitazone plus MFM. The primary outcome was a change in glycated hemoglobin (HbA1c) level from baseline after 12 months of treatment. Secondary outcomes included changes in fasting plasma glucose (FPG), lipid profiles, body weight, visceral fat area (VFA), and blood pressure after 12 months of treatment. RESULTS The baseline HbA1c was 8.3±1.3% (8.7±1.5% in the add-on group and 8.1±1.0% in the switch group). After 12 months, mean HbA1c decreased (-0.91%) in all patients (p<0.05) (-1.39% in the add-on group and -0.63% in the switch group). Significant reductions in FPG were also observed in both the add-on and switch groups (-54.37 mg/dL and -24.68 mg/dL, respectively). Overall, there was a significant improvement in serum triglyceride (-24.74 mg/dL), low density lipoprotein cholesterol (-7.92 mg/dL), body weight (-2.98 kg), VFA (-9.00 cm²), and systolic blood pressure (-8.67 mm Hg). Approximately 35.8% of patients achieved HbA1c <7.0% after 12 months. CONCLUSION Dapagliflozin, as an add-on or a switch therapy to lobeglitazone plus MFM, can be a suitable alternative for Korean patients with inadequately controlled T2DM. The combination therapy resulted in significant reductions in HbA1c levels, body weight, and blood pressure.
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Affiliation(s)
- Da Hea Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University College of Medicine, Incheon, Korea
| | - Yongin Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seongha Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Eunjig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - So Hun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
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Zhang C, Wang J, Ding S, Gan G, Li L, Li Y, Chen Z, Duan Y, Xie J, Cheng ASK. Relationship between lifestyle and metabolic factors and carotid atherosclerosis: A survey of 47,063 fatty and non-fatty liver patients in China. Front Cardiovasc Med 2022; 9:935185. [PMID: 36035933 PMCID: PMC9411941 DOI: 10.3389/fcvm.2022.935185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aimsCarotid atherosclerosis and stenosis are common lesions of the artery wall that form the basis of cardiovascular events. Compared with coronary atherosclerosis, few studies have explored the influencing factors of carotid atherosclerosis. The aim of this study was to explore the influencing factors of carotid atherosclerosis and carotid stenosis without and with fatty liver disease (FLD).MethodsA total of 47,063 adults were recruited for this cross-sectional study. The color Doppler ultrasound, including metabolic factors and lifestyle surveys, was used to determine whether the participants had FLD and carotid artery disease. Multiple logistic regression was used to investigate the influencing factors of lifestyle and metabolism of carotid atherosclerosis and stenosis in the participants with and without FLD.ResultsIn participants without FLD, current alcohol consumption (OR: 0.749, 95% CI: 0.588) and hip circumference (OR: 0.970, 95% CI: 0.961, 0.979) were the main protective factors for carotid atherosclerosis. Systolic blood pressure (OR: 1.022, 95% CI: 1.019, 1.025) and diastolic blood pressure (OR: 1.005, 95% CI: 1.001, 1.010), elevated fasting blood glucose (OR: 1.012, 95% CI: 1.005, 1.019), and non-sedentary behavior (OR: 1.084, 95% CI: 1.014, 1.160) were the main risk factors for carotid atherosclerosis. Hip circumference (OR: 0.932, 95% CI: 0.910, 0.954) and low-density lipoprotein (OR: 0.979, 95% CI: 0.964, 0.994) were protective factors for carotid stenosis. Smoking (OR: 3.525, 95% CI: 1.113, 11.169) and unqualified exercise (OR: 1.402, 95% CI: 1.083, 1.815) were risk factors for carotid stenosis. In participants with FLD, smoking (OR: 0.827, 95% CI: 0.703, 0.973) and hip circumference (OR: 0.967, 95% CI: 0.958, 0.977) were the main protective factors for carotid atherosclerosis. BMI 18.5–23.9 (OR: 1.163, 95% CI: 1.002, 1.351), non-sedentary behavior (OR: 1.086, 95% CI: 1.009, 1.168), and waist circumference (OR: 1.030, 95% CI: 1.022, 1.038) were the main risk factors for carotid atherosclerosis.ConclusionBased on a large-sample check-up population in China, this study investigated the influencing factors of carotid atherosclerosis and carotid stenosis in fatty liver and non-fatty liver patients and explored the influencing factors of metabolism and lifestyle, which were mainly focused on exercise, sedentary behavior, smoking, alcohol consumption, hip circumference, and blood pressure.
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Affiliation(s)
- Chun Zhang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Jiangang Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siqing Ding
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Gang Gan
- Xiangya Nursing School, Central South University, Changsha, China
| | - Lijun Li
- Xiangya Nursing School, Central South University, Changsha, China
| | - Ying Li
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhiheng Chen
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yinglong Duan
- The Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Yinglong Duan
| | - Jianfei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China
- Jianfei Xie
| | - Andy S. K. Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Seo DH, Suh YJ, Cho Y, Ahn SH, Seo S, Hong S, Lee YH, Choi YJ, Lee E, Kim SH. Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease. Diabetes Metab J 2022; 46:630-639. [PMID: 35081304 PMCID: PMC9353562 DOI: 10.4093/dmj.2021.0130] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and CKD is uncertain, particularly in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with T2DM. METHODS In this longitudinal cohort study of patients with T2DM, 3,188 patients with preserved renal function were followed up for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography, without any other causes of chronic liver disease. Advanced liver fibrosis of NAFLD was defined as a fibrosis-4 index ≥2.67. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2. RESULTS At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3±3.6 years, 472 (14.8%) patients developed incident CKD: 220 (15.1%) in the non-NAFLD group, 231 (14.1%) in the NAFLD without advanced fibrosis group and 28 (31.1%) in the NAFLD with advanced fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared to the non-NAFLD group (P=0.435). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio, 1.75; 95% confidence interval, 1.15 to 2.66; P=0.009). CONCLUSION Advanced liver fibrosis in patients with NAFLD is independently associated with an increased risk of incident CKD in patients with T2DM.
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Affiliation(s)
- Da Hea Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University College of Medicine, Incheon, Korea
| | - Yongin Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seongha Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Yong-ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Eunjig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - So Hun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
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Differences in complication patterns in subgroups of type 2 diabetes according to insulin resistance and beta-cell function. Sci Rep 2022; 12:9384. [PMID: 35672344 PMCID: PMC9174240 DOI: 10.1038/s41598-022-13084-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/20/2022] [Indexed: 11/08/2022] Open
Abstract
This study aimed to determine whether the patterns of diabetic complications differed when patients with type 2 diabetes mellitus (T2DM) were simply classified according to insulin sensitivity and beta-cell function. This observational study included 8861 patients with T2DM who underwent concurrent testing for fasting glucose, fasting insulin, and one or more diabetic complications. We categorized the patients into four groups according to insulin sensitivity and beta-cell function. Compared with the reference group (mild insulin resistance and beta-cell dysfunction), the “severe beta-cell dysfunction” group had lower odds of chronic kidney disease [adjusted odds ratios (aOR) 0.611]. The “severe insulin resistance” group had higher odds of carotid artery plaque presence (aOR 1.238). The “severe insulin resistance and beta-cell dysfunction” group had significantly higher odds of large fiber neuropathy (aOR 1.397, all p < 0.05). After a median of five years of follow-up, this group distinction did not lead to a difference in risk of new diabetic retinopathy or chronic kidney disease. In addition, there was no significant difference among the groups in plaque progression risk over 8–10 years in the longitudinal follow-up analysis. The patterns of complications differ when patients with T2DM are classified according to insulin resistance and beta-cell dysfunction. However, there were no differences in the risk of developing new complications.
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Liu M, He P, Zhou C, Zhang Z, Zhang Y, Li H, Ye Z, Wu Q, Yang S, Zhang Y, Liu C, Qin X. Association of waist-calf circumference ratio with incident cognitive impairment in older adults. Am J Clin Nutr 2022; 115:1005-1012. [PMID: 35040872 DOI: 10.1093/ajcn/nqac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/13/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The longitudinal relation of central fat and muscle mass with cognitive function remains unclear. OBJECTIVES We aimed to evaluate the relation of anthropometric measures, including BMI, waist circumference (WC), calf circumference (CC), and waist-calf circumference ratio (WCR), with incident cognitive impairment in older adults. METHODS A total of 3312 participants aged ≥65 y (mean: 81.8 y) who were free of cognitive impairment [the Chinese version of the Mini-Mental State Examination (MMSE) scores ≥24 points] in the Chinese Longitudinal Healthy Longevity Survey were included. The primary outcome was incident cognitive impairment, defined as MMSE scores <24 points at the exit visit. Secondary outcomes were incident cognitive decline, defined as a reduction of MMSE scores ≥3 points at the exit visit, and incident decline in different cognitive domains, defined as a reduction of MMSE scores in the domain ≥15% at the exit visit. RESULTS During a median follow-up duration of 3.6 y, 565 (17.1%) participants developed incident cognitive impairment. Overall, with mutual adjustments, higher WC [≥89 cm (fourth quartile) compared with <75 cm (first quartile); adjusted HR: 1.56; 95% CI: 1.19, 2.04] and higher WCR [≥2.9 (fourth quartile) compared with <2.4 (first quartile); adjusted HR: 1.96; 95% CI: 1.52, 2.52] were significantly associated with a higher risk of cognitive impairment, and higher CC [≥34 cm (fourth quartile) compared with <28 cm (first quartile); adjusted HR: 0.44; 95% CI: 0.33, 0.59] was associated with a lower hazard of cognitive impairment. Similar results were found for the secondary outcomes. However, BMI was not significantly associated with the study outcomes. CONCLUSIONS High WC and low CC were significantly associated with higher incident cognitive impairment in older adults. Moreover, WCR had a relatively stronger association with cognitive impairment compared with each circumference, suggesting maintaining both higher lean mass and lower central fat in older adults for the prevention of cognitive impairment.
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Affiliation(s)
- Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Chengzhang Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
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Ma W, Zhang H, Wu N, Liu Y, Han P, Wang F, Wang J, Xie F, Niu S, Hu H, Zhang C, Chen N, Zhang Y, Guo Q, Yu Y. Relationship between obesity-related anthropometric indicators and cognitive function in Chinese suburb-dwelling older adults. PLoS One 2021; 16:e0258922. [PMID: 34705855 PMCID: PMC8550380 DOI: 10.1371/journal.pone.0258922] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/11/2021] [Indexed: 11/19/2022] Open
Abstract
Background Studies relating obesity to cognition in older people show conflicting results, which may be explained by the choice of obesity indicators. Objectives This study aimed to investigate the relationship between obesity-related indicators and cognitive impairment, especially between different age or gender subgroups, and explore whether obesity-related indicators were related to specific cognitive domains. Methods This was a cross-sectional study on 1753 participants aged ≥ 60 years (41.0% men; aged 71.36 ± 5.96 years). Obesity-related indicators included body mass index (BMI), waist circumference (WC), calf circumference (CC), waist to hip ratio (WHR), waist to calf circumstance ratio (WCR), fat to fat-free mass ratio (FM/FFM). The Mini-Mental State Examination scale (MMSE) was used to assess cognitive function. Cognitive impairment was defined as a score ≤ 17 for illiterates, ≤ 20 for participants with primary school education, and ≤ 24 for those with junior high school degrees or above. Multiple logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were used to analyze and visualize the linear relationships. Results The prevalence of cognitive impairment was 18.77%. In the fully adjusted model, CC was negatively associated with cognitive impairment (OR = 0.94, 95% CI: 0.90−0.98). Further analysis showed that CC correlated positively with recall and place orientation. A higher FM/FFM was found to be associated with a higher prevalence of cognitive impairment (OR: 1.44, 95%CI: 0.88–2.35, P for trend = 0.029); this association was notable in women (P for trend = 0.002) and the oldest (P for trend = 0.009), and so did the potential effect of BMI on cognitive impairment (70–80 years: P for trend = 0.011; ≥ 80 years: P for trend = 0.013). No statistically significant association was found between cognitive impairment and WC, WHR, or WCR. Conclusion CC and FM/FFM were associated with cognitive impairment in older people. Future research needs to distinguish the effects of fat and muscle mass on cognitive function, with special attention to different ages and genders.
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Affiliation(s)
- Weibo Ma
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Economics and Management, East China Normal University, Shanghai, China
| | - Hui Zhang
- Department of Rehabilitation Clinic, Shanghai Jiangwan Hospital, Shanghai, China
| | - Ning Wu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yuewen Liu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Feng Wang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jingru Wang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Fandi Xie
- Department of Rehabilitation Clinic, Shanghai Jiangwan Hospital, Shanghai, China
| | - Shumeng Niu
- Department of Rehabilitation Clinic, Shanghai Jiangwan Hospital, Shanghai, China
| | - Hao Hu
- Department of Rehabilitation Clinic, Shanghai Jiangwan Hospital, Shanghai, China
| | - Chenyu Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Nuo Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yichen Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- * E-mail: (QG); (YY)
| | - Ying Yu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- * E-mail: (QG); (YY)
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Yang S, Wang S, Tai P, Jia W, Han K, Liu M, He Y. Central and Peripheral Adiposity Had Different Effect on Disability in Centenarians. Front Endocrinol (Lausanne) 2021; 12:635205. [PMID: 33796073 PMCID: PMC8008817 DOI: 10.3389/fendo.2021.635205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the correlations between waist circumference, body mass index, calf circumference (CC), and waist-calf circumference ratio (WCR) and activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in Hainan centenarians. Patients and Methods A total of 1,002 Hainan centenarians were selected by full sample household survey. ADLs and IADLs were used to investigate the ability of activity and instrumental activity in daily living. The possible non-linear associations were further analyzed using restricted cubic spline. Results After adjusting for demographic characteristics (gender, age, ethnicity, marital status, educational level, and type of residence) and lifestyle (smoking, drinking, and exercise), the odds ratio (OR) of CC (continuous variable) on ADL disability in centenarians was 0.90 (95% CI: 0.85-0.96), while high WCR (continuous variable) was related with high risk of ADL disability (OR=1.73; 95% confidence interval[CI], 1.07-2.80). The ORs of CC and WCR for IADL severe disability were 0.86 (95% CI, 0.82-0.91) and 2.23 (95% CI, 1.52-3.28), respectively. Conclusion Central (WCR) and peripheral (CC) adiposity had different effects on disability (ADL and IADL) in centenarians. Even in centenarians, maintaining muscle mass (with higher calf circumference) and avoiding central obesity are of positive significance for the prevention of ADL/IADL disability.
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Affiliation(s)
- Shanshan Yang
- Department of Disease Control and Prevention, The Medical Center, Chinese PLA General Hospital, Beijing, China
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Penggang Tai
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Ke Han
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Yao He
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
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9
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Rao HA, Harischandra P, Yadav S. Correlation of Waist to Calf Circumference Ratio and Carotid Intima-Media Thickness in Diabetes Mellitus. Curr Diabetes Rev 2021; 17:387-393. [PMID: 32729422 DOI: 10.2174/1573399816999200729124903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/04/2020] [Accepted: 07/19/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Diabetes mellitus is a well-known risk factor for cardiovascular disease because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with the occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in the event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. AIMS & OBJECTIVES To ascertain if waist to calf circumference ratio (WCR) is a marker of carotid atherosclerosis in patients with type 2 diabetes mellitus, and the correlation between waist to calf circumference ratio and carotid intima-media thickness (CIMT ) in patients with Type 2 diabetes. MATERIALS AND METHODS A cross-sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018. Patients with type 2 DM as per ADA criteria, age >18years, are recruited for the study. RESULTS AND DISCUSSION In our study, with 150 population, 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07, and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p-value of <0.05. In our study, it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly, calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. CONCLUSION To conclude, in our population-based study of 150 subjects, we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful, and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima-media thickness and carotid plaques using better measures than ultrasound, such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.
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Affiliation(s)
- Harish A Rao
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Prakash Harischandra
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Srikanth Yadav
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
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10
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Tai P, Yang S, Liu W, Wang S, Chen K, Jia W, Han K, Liu M, He Y. Association of anthropometric and nutrition status indicators with cognitive functions in centenarians. Clin Nutr 2020; 40:2252-2258. [PMID: 33087249 DOI: 10.1016/j.clnu.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS How anthropometric and nutrition status indicators relate to cognitive function in the oldest old adults is an issue that needs to be explored. This study aimed to analyze the association of parameters and nutrition status indicators (waist circumference, BMI, calf circumference, and waist-calf circumference ratio [WCR]) with cognitive functions in centenarians. METHODS A cross-sectional observational study was conducted with the full sample of 1002 centenarians from Hainan. The mini-mental state examination (MMSE) was used to identify cognitive impairment. Multiple logistic regression analysis was used to examine the strength of association between each anthropometric index and the risk of cognitive impairment or severe cognitive impairment identified by MMSE. Locally Weighted Scatterplot Smoothing (LOWESS) curve was used to visualize the linear or non-linear relationship of each pair. RESULTS The risk of cognitive impairment identified by MMSE for centenarians was reduced by 12% for every 1 cm thickening of the calf circumference (OR = 0.88, 95% CI: 0.81-0.95) and the increase in each unit of WCR increased cognitive impairment the risk by 1.60 times (OR = 2.60, 95% CI: 1.31-5.13) after adjusting for demographic characteristics (i.e., gender, age, ethnicity, marital status, education level, and type of residence) and lifestyle (i.e., smoking, drinking, and exercise) related variables. CONCLUSIONS Results suggest that calf circumference is negatively associated with the risk of cognitive impairment identified by MMSE in centenarians. Older adults with lower calf circumference should pay attention to their cognitive function.
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Affiliation(s)
- Penggang Tai
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Shanshan Yang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China; Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Weiguo Liu
- Emergency Department, Henan Province Corps Hospital of CAPF, Zhengzhou, Henan, China
| | - Shengshu Wang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Kai Chen
- University of Texas Health Center at Houston, United States
| | - Wangping Jia
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ke Han
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Miao Liu
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Yao He
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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11
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Hsiang CH, Wu CJ, Kao TW, Chen WL. Calf circumference and risk of cardiovascular disease. Geriatr Gerontol Int 2020; 20:1133-1137. [PMID: 33009856 DOI: 10.1111/ggi.14052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 01/06/2023]
Abstract
AIM Calf circumference (CC) is an anthropometric parameter that is easily obtained. Increasingly, research has shown that CC related to cardiovascular events. We aimed to determine the correlation between CC and Framingham risk score (FRS) for the 10-year cardiovascular disease risk assessment in Taiwanese elderly aged ≥65 years. METHODS We included 540 men and 683 women aged ≥65 years. All participants and data were collected from geriatric physical screenings in Tri-Service General Hospital in Taiwan during 2017. The correlation between CC and FRS-coronary heart disease (CHD) were calculated. We used multivariate regression models to investigate the correlation between CC and FRS-CHD. Covariate adjustments were investigated by performing an extended model. RESULTS A significantly negative association was observed between FRS-CHD and CC in both genders in both models (all P < 0.05). Male and female participants were divided into quartiles at the CC level (Q1-Q4) and we compared their baseline characteristics separately. We further explored the association between CC divided in quartiles and the FRS-CHD, which exhibited a significant negative correlation comparing the largest quartiles with the first quartile in a fully adjusted model in both genders (P < 0.05). In addition, the higher quartiles of CC seemed to have a lower FRS-CHD with statistical significance (P for trend <0.05). DISCUSSION CC had a strongly negative correlation with FRS-CHD in both genders. In the future, CC might be an applicable tool in geriatric research in Taiwan for the early detection of developing cardiovascular events. Geriatr Gerontol Int 2020; 20: 1133-1137.
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Affiliation(s)
- Chih-Hsuan Hsiang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, 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.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, 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.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan.,Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan
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12
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Seo D, Lee YH, Park S, Choi Y, Huh B, Lee E, Huh K, Kim S, Cha BS. Sarcopenia is associated with non-alcoholic fatty liver disease in men with type 2 diabetes. DIABETES & METABOLISM 2020; 46:362-369. [DOI: 10.1016/j.diabet.2019.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/17/2019] [Accepted: 10/22/2019] [Indexed: 02/07/2023]
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13
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Seo DH, Lee YH, Suh YJ, Ahn SH, Hong S, Choi YJ, Huh BW, Park SW, Lee E, Kim SH. Low muscle mass is associated with carotid atherosclerosis in patients with type 2 diabetes. Atherosclerosis 2020; 305:19-25. [PMID: 32593855 DOI: 10.1016/j.atherosclerosis.2020.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/15/2020] [Accepted: 05/27/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Sarcopenia leads to metabolic and vascular abnormalities. However, little is known regarding the independent relationship between skeletal muscle mass and atherosclerosis in patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between skeletal muscle mass and carotid atherosclerosis in men and women with T2DM. METHODS In this cross-sectional study, a total of 8202 patients with T2DM were recruited from the Seoul Metabolic Syndrome cohort. Skeletal muscle mass was estimated using bioimpedance analysis, while skeletal muscle mass index (SMI, %) was defined as total skeletal muscle mass (kg)/body weight (kg) × 100. Both carotid arteries were examined by B-mode ultrasound. Carotid atherosclerosis was defined by having a carotid plaque or mean carotid intima-media thickness (IMT) ≥1.1 mm. RESULTS Among the entire population, 4299 (52.4%) subjects had carotid atherosclerosis. The prevalence of carotid atherosclerosis increased with decreasing SMI quartiles for both sexes. The odds ratios for carotid atherosclerosis were 2.33 (95% confidence interval [CI], 1.17-4.63) and 2.24 (95% CI, 1.06-4.741) in the lowest versus highest SMI quartile in men and women, respectively, after the adjustment for clinical risk factors. In men, the risk of atherosclerosis increased linearly with decreasing SMI quartiles (p for trend = 0.036). CONCLUSIONS Low skeletal muscle mass was independently associated with the presence of carotid atherosclerosis in men and women with T2DM.
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Affiliation(s)
- Da Hea Seo
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seong Hee Ahn
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seongbin Hong
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea
| | | | | | - Seok Won Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunjig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - So Hun Kim
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea.
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14
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Yang S, Liu M, Wang S, Jia W, Han K, He Y. Waist-Calf Circumference Ratio Is an Independent Risk Factor of HRQoL in Centenarians. Diabetes Metab Syndr Obes 2020; 13:277-287. [PMID: 32099434 PMCID: PMC7007801 DOI: 10.2147/dmso.s231435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/15/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To analyze the associations between waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), calf circumference, waist-calf circumference ratio (WCR), and quality of life in Hainan centenarians. PATIENTS AND METHODS A total of 1002 centenarians in Hainan were selected by a full sample survey. The EQ-5D visual analogue scale (EQ-5D-VAS) was used to investigate the quality of life. Restricted cubic splines were used to analyze and visualize the linear relationships. RESULTS After adjustment, the standard β values for BMI, WC, WHR, WHtR, calf circumference, and WCR associated with EQ-5D score were 0.101, 0.126, -0.018, 0.100, 0.302, and -0.219, respectively; all associations except for WHR were significant (P < 0.01). With increasing BMI, WC, and calf circumference, the risk of EQ-5D score <1 decreased (odds ratios [ORs] 0.91 [95% confidence interval (CI): 0.86-0.97), 0.97 [95% CI: 0.95-0.99], and 0.87 [95% CI: 0.82-0.92] after adjustment, respectively). With increasing WCR, the risk also increased (OR 2.70 [95% CI: 1.54-4.75]). CONCLUSION After excluding nutritional and muscle retention factors, fat central distribution negatively impacted the health-related quality of life of the oldest old population.
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Affiliation(s)
- Shanshan Yang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
- Department of Disease Control, Northern Military Area Center for Disease Control and Prevention, Jinan, People’s Republic of China
| | - Miao Liu
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Shengshu Wang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Wangping Jia
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Ke Han
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Yao He
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
- Correspondence: Yao He Institute of Geriatrics State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing100853, People’s Republic of ChinaTel +86-10-66876411Fax +86-10-68219351 Email
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15
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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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16
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Choe EY, Lee YH, Choi YJ, Huh BW, Lee BW, Kim SK, Kang ES, Cha BS, Lee EJ, Huh KB, Younossi ZM. Waist-to-calf circumstance ratio is an independent predictor of hepatic steatosis and fibrosis in patients with type 2 diabetes. J Gastroenterol Hepatol 2018; 33:1082-1091. [PMID: 28990251 DOI: 10.1111/jgh.14011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/08/2017] [Accepted: 09/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Although a combination of central obesity and decreased skeletal muscle mass has been associated with various cardiometabolic disorders, its influence on the presence of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes (T2D) is unclear. We investigated whether waist-to-calf circumference ratio (WCR) predicts NAFLD or hepatic fibrosis in T2D. METHODS Patients with T2D (n = 5507) were enrolled in this study. Hepatic steatosis was diagnosed using abdominal ultrasound and predicting score. NAFLD was defined as 'hepatic steatosis absent other causes of chronic liver disease,' such as virus or alcoholism. Degree of hepatic fibrosis was calculated using non-invasive serum biomarker-based models. Insulin resistance was assessed by short insulin tolerance test. RESULTS The prevalence of NAFLD and obesity (BMI ≥ 25 kg/m2 , Asian definition) were 46.4% and 38.9%, respectively. NAFLD prevalence was higher with increasing WCR tertiles: lowest tertile (36% in men, 28% in women) versus highest tertile (53.8% in men, 58.2% in women, both P < 0.001 after stratification by insulin resistance status. Increasing WCR tertiles were independently associated with presence of NAFLD: odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.22-1.68 and OR = 1.56, 95% CI = 1.31-1.86, in the middle and highest tertiles, respectively. Furthermore, patients with NAFLD and the highest WCR tertile had significant fibrosis (OR = 8.62, 95% CI = 1.39-53.36, P = 0.021). Also, WCR was correlated with risk of sarcopenia (OR = 3.18, 95% CI = 2.50-4.05, P < 0.001, highest tertile). CONCLUSIONS Higher WCR is associated with increased risk of NAFLD and hepatic fibrosis independent of insulin resistance. This suggests that WCR may be a useful index to predict high risk of hepatic steatosis in T2D.
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Affiliation(s)
- Eun Yeong Choe
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Korean Association of Health Promotion, Incheon, Korea.,Graduate school, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate school, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ju Choi
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Byung Wook Huh
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Byung-Wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Bong-Soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jig Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kap Bum Huh
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Zobair M Younossi
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA
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17
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Wu CJ, Kao TW, Lin YY, Liaw FY, Wu LW, Chang YW, Peng TC, Chen WL. Examining the association between anthropometric parameters and telomere length and mortality risk. Oncotarget 2018; 8:34057-34069. [PMID: 28423661 PMCID: PMC5470951 DOI: 10.18632/oncotarget.15976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/28/2017] [Indexed: 02/07/2023] Open
Abstract
A shorter telomere length is associated with several systemic disorders. Telomere length may be an informative biomarker for the maintenance of the overall health status and mortality. There are a limited number of empirical studies concerning the effect of anthropometric parameters on telomere length. The data are derived from the National Health and Nutrition Examination Survey from 1999 to 2002. The primary outcomes of this study were to examine the potential relationships between the anthropometric indices and the telomere length, while secondary outcomes of this study was to investigate the association between different anthropometric indices and mortality risk. A significant positive correlation was noted between the mean telomere length and the thigh circumference (TC) and calf circumference (CC) in all designed models. Participants in the highest TC and CC quartiles tended to have a longer telomere length and lowered the hazards for all-cause mortality to 43% and 57%, respectively. Notably, the anthropometric indices involving the CC with higher values seemed to be surrogate markers for the reduction of the risk of all-cause, cardiovascular and malignancy-related mortality (all P < 0.05). The CCmay be a valuable tool to guide public health policy and a clinical prognostic indicator for the risk of mortality.
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Affiliation(s)
- Chen-Jung Wu
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Community Medicine, Division of Family Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Tung-Wei Kao
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Family and Community Medicine, Division of Geriatric Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yuan-Yung Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Fang-Yih Liaw
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Family and Community Medicine, Division of Geriatric Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Family and Community Medicine, Division of Geriatric Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yaw-Wen Chang
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Family and Community Medicine, Division of Geriatric Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tao-Chun Peng
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Family and Community Medicine, Division of Geriatric Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Department of Family and Community Medicine, Division of Family Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Family and Community Medicine, Division of Geriatric Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Wu CJ, Kao TW, Chang YW, Peng TC, Wu LW, Yang HF, Chen WL. Does the Additional Component of Calf Circumference Refine Metabolic Syndrome in Correlating With Cardiovascular Risk? J Clin Endocrinol Metab 2018; 103:1151-1160. [PMID: 29346655 DOI: 10.1210/jc.2017-02320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/10/2018] [Indexed: 01/10/2023]
Abstract
CONTEXT Calf circumference (CC) was a useful anthropometric tool, but there was limited study on the effect of CC on metabolic syndrome (MetS) for cardiovascular risk. OBJECTIVE The objective of our study was to determine whether adding CC as a component of MetS refined correlating MetS with cardiovascular, all-cause, and cancer mortality risks. DESIGN, SETTING, PATIENTS, AND INTERVENTIONS From the National Health and Nutrition Examination Survey data set for 1999 through 2002, we analyzed four types of MetS: (1) increased waist circumference and two or more of four MetS components (WaistMetS); (2) decreased CC and two or more of four MetS components (CalfMetS); (3) increased waist-to-calf ratio and two or more of four MetS components (WCRMetS); and (4) decreased CC and three or more of five MetS components (CC+MetS). PRIMARY OUTCOME MEASURE The cause-specific hazard ratios were measured as categorized by the four types of MetS. RESULTS For cardiovascular mortality, the adjusted hazard ratios for WaistMetS, CalfMetS, WCRMetS, and CC+MetS were 1.867, 1.871, 1.949, and 2.306, respectively (all P < 0.001). Notably, CalfMetS showed the strongest positive correlation with serum C-reactive protein levels, and WCRMetS had the strongest positive relationship with homeostasis model assessment of insulin resistance. CONCLUSIONS Adding CC to the components of MetS correlated with higher cardiovascular and all-cause mortality risk than the traditional definition of MetS.
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Affiliation(s)
- Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yaw-Wen Chang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
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19
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Rezende FA, Ribeiro AQ, Mingoti SA, Pereira PF, Marins JC, Priore SE, Franceschini SC. Anthropometric patterns of adiposity, hypertension and diabetes mellitus in older adults of Viçosa, Brazil: A population-based study. Geriatr Gerontol Int 2018; 18:584-591. [PMID: 29292569 DOI: 10.1111/ggi.13219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/04/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
Abstract
AIM To identify anthropometric patterns of adiposity and estimate their association with hypertension and diabetes mellitus (DM) in older adults. METHODS A cross-sectional study with 537 older adults aged ≥60 years was carried out. Weight, height, and waist, hip and calf circumference were measured. The following indices were calculated: a body shape index, body roundness index, conicity index, body adiposity index, body mass index, waist-to-height ratio, waist-to-calf ratio, waist-to-hip ratio and waist-to-hip-to-height ratio. The anthropometric patterns of adiposity were obtained by factor analysis of principal components, and their association with hypertension and DM was identified by multiple Poisson regression with robust variance. RESULTS Two anthropometric patterns of adiposity were identified. Pattern 1 and 2 explained approximately 53% and 33% of the total variance, respectively, in both sexes. Pattern 1 indicated of global adiposity, and weight, body mass index and hip circumference were the variables most strongly correlated with this pattern in both sexes. Pattern 2 represented the body fat distribution, being a body shape index the most important variable in this factor. After adjustment by confounding factors, only the pattern 2 remained significantly associated with DM in women. CONCLUSIONS Only the anthropometric pattern of adiposity central was associated with DM in older women. Geriatr Gerontol Int 2018; 18: 584-591.
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Affiliation(s)
- Fabiane Ac Rezende
- Department of Nutrition, Federal University of Tocantins, Palmas, Brazil
| | - Andréia Q Ribeiro
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Brazil
| | - Sueli A Mingoti
- Department of Statistics of ICEX of the Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Patrícia F Pereira
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Brazil
| | - João Cb Marins
- Department of Physical Education, Federal University of Viçosa, Viçosa, Brazil
| | - Silvia E Priore
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Brazil
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20
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Jun JE, Choi YJ, Lee YH, Kim DJ, Park SW, Huh BW, Lee EJ, Jee SH, Hur KY, Choi SH, Huh KB. ApoB/ApoA-I ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels. Korean J Intern Med 2018; 33:138-147. [PMID: 29334727 PMCID: PMC5768554 DOI: 10.3904/kjim.2017.396] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIMS This study aimed to investigate whether the apolipoprotein (Apo) B/ApoA-I ratio is associated with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM) subjects with low density lipoprotein cholesterol (LDL-C) levels less than 100 mg/dL. METHODS This cross-sectional study included 845 subjects aged with T2DM 40 to 75 years who had visited Huh's Diabetes Center in Seoul, Republic of Korea for CIMT measurement. Traditional fasting lipid profiles, ApoB and ApoA-I levels were examined. CIMT was measured at three points on the far wall of 1 cm long section of the common carotid artery in the proximity of the carotid bulb. The mean value of six measurements from right and left carotid arteries were used as the mean CIMT. In this study, carotid atherosclerosis was defined as having a focal plaque or diffuse thickening of the carotid wall (mean CIMT ≥ 1.0 mm). RESULTS The prevalence of carotid atherosclerosis increased with ApoB/ApoA-I ratio. The ApoB/ApoA-I ratio, expressed as both quartiles (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.21 to 3.79; p for trend = 0.014) and continuous values (OR, 10.05; 95% CI, 3.26 to 30.97; p < 0.001), was significantly associated with a higher risk for carotid atherosclerosis, regardless of conventional cardiovascular disease risk factors. The optimal ApoB/ApoA-I ratio cutoff value for detecting carotid atherosclerosis was 0.57, based on receiver operating characteristic curve analysis with a sensitivity of 58.0% and a specificity of 55.1%. CONCLUSIONS A high ApoB/ApoA-I ratio was significantly associated with carotid atherosclerosis in T2DM patients with LDL-C levels less than 100 mg/dL.
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Affiliation(s)
- Ji Eun Jun
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Ju Choi
- Huh’s Diabetes Center and 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seok Won Park
- Department of Internal Medicine, CHA University, Seongnam, Korea
| | - Byung Wook Huh
- Huh’s Diabetes Center and 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Eun Jig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sun-Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Kyu Yeon Hur, M.D. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-1232 Fax: +82-2-3410-3849 E-mail:
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kap Bum Huh
- Huh’s Diabetes Center and 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
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21
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Kim YH, So WY. Relative lower body circumferences are associated with the prevalence of metabolic syndrome and arterial stiffness. Technol Health Care 2016; 25:211-219. [PMID: 27689563 DOI: 10.3233/thc-161264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Body circumference is a known health-related factor. This cross-sectional study aimed to investigate the associations of relative lower body circumferences with metabolic syndrome (MetS) and arterial stiffness (AS) in 684 men aged > 40 (mean, 54.6 ± 8.5) years. Participants were measured for waist, thigh, and calf circumferences; underwent blood tests and blood pressure measurements to detect MetS; and received brachial ankle pulse wave velocity measurements to measure AS. The waist-to-thigh, waist-to-calf, and thigh-to-calf circumferences were calculated and classified into quartiles. Age-adjusted multiple logistic regression models were used to assess the associations between the circumference ratios and AS vs. non-AS and MetS vs. non-MetS (systolic and diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting plasma glucose). The mean body mass index was 24.9 ± 2.8 kg/m2; the mean waist, thigh, and calf circumferences were 87.4 ± 7.6, 53.8 ± 4.2, and 36.4 ± 2.7 cm, respectively. Compared to the lowest quartiles, participants in waist-to-thigh circumference quartiles 3 (odds ratio [OR] = 3.195, 95% confidence interval [CI] = 1.825-5.594, p < 0.001) and 4 (OR = 4.755, 95% CI = 2.715-8.325, p < 0.001), and participants in waist-to-calf circumference quartiles 2 (OR = 2.511, 95% CI = 1.397-4.511, p = 0.002), 3 (OR = 3.929, 95% CI = 2.076-7.435, p < 0.001), and 4 (OR = 5.298, 95% CI = 2.847-9.858, p < 0.001) had significantly greater risks of MetS; participants in waist-to-calf circumference quartile 4 (OR = 2.481, 95% CI = 1.477-4.167, p < 0.001) and participants in waist-to-calf circumference quartile 4 (OR = 1.763, 95% CI = 1.088-2.856, p = 0.021) had a significantly greater risk of AS, indicating that age-adjusted relative lower body circumferences associate with MetS and AS. Large thigh and calf circumferences may indicate reduced risks for cardiovascular disease.
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Affiliation(s)
- Yong Hwan Kim
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, Korea
| | - Wi-Young So
- Sports and Health Care Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si, Korea
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22
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Lim JS, Choi YJ, Kim SK, Huh BW, Lee EJ, Huh KB. Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes. Diabetes Metab J 2015; 39:253-63. [PMID: 26124996 PMCID: PMC4483611 DOI: 10.4093/dmj.2015.39.3.253] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/15/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Visceral obesity is the most powerful contributor to the development of metabolic syndrome (MetS) and cardiovascular diseases. In light of visceral obesity, however, there is a paucity of data on the appropriate cutoff point of waist circumference (WC) in subjects with type 2 diabetes. The aim of this study was to investigate the optimal cutoff value for WC that signals insulin resistance (IR) and visceral obesity in Koreans with type 2 diabetes. METHODS We evaluated 4,252 patients with type 2 diabetes (male 2,220, female 2,032, mean age 57.24 years) who visited our clinic between January 2003 and June 2009. WC was measured at the midpoint between the lower rib and the iliac crest, and insulin sensitivity was assessed by the rate constant of plasma glucose disappearance (Kitt %/min) using an insulin tolerance test. Visceral fat thickness was measured using ultrasonography. Statistical analysis was performed using receiver operating characteristic curve. RESULTS The optimal cutoff points for WC for identifying the presence of IR and visceral obesity, as well as two or more metabolic components, were 87 cm for men and 81 cm for women. Moreover, these cutoff points had the highest predictive powers for the presence of visceral obesity. The MetS defined by new criteria correlated with the increased carotid intima-media thickness in female subjects. CONCLUSION Our results suggest that the optimal cutoff values for WC in Koreans with type 2 diabetes should be reestablished based on IR and visceral obesity.
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Affiliation(s)
- Jung Soo Lim
- Division of Endocrinology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Ju Choi
- Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Byoung Wook Huh
- Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea
| | - Eun Jig Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kap Bum Huh
- Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea
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23
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Gepner AD, Young R, Delaney JA, Tattersall MC, Blaha MJ, Post WS, Gottesman RF, Kronmal R, Budoff MJ, Burke GL, Folsom AR, Liu K, Kaufman J, Stein JH. Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the Multi-Ethnic Study of Atherosclerosis. Circ Cardiovasc Imaging 2015; 8:CIRCIMAGING.114.002262. [PMID: 25596139 DOI: 10.1161/circimaging.114.002262] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Presence of coronary artery calcium (CAC), carotid plaque, and increased carotid intima-media thickness (IMT) may indicate elevated cardiovascular disease (CVD) risk; however, no large studies have compared them directly. This study compares predictive uses of CAC presence, carotid artery plaque presence, and high IMT for incident CVD events. METHODS AND RESULTS Participants were from the Multi-Ethnic Study of Atherosclerosis (MESA). Predictive values of carotid plaque, IMT, and CAC presence were compared using Cox proportional hazards models, c-statistics, and net reclassification indices. The 6779 participants were mean (SD) 62.2 (10.2) years old; 49.9% had CAC, and 46.7% had carotid plaque. The mean left and right IMT were 0.754 (0.210) mm and 0.751 (0.187) mm, respectively. After 9.5 years (mean), 538 CVD events, 388 coronary heart disease (CHD) events, and 196 stroke/transient ischemic attacks were observed. CAC presence was a stronger predictor of incident CVD and CHD than carotid ultrasound measures. Mean IMT≥75th percentile (for age, sex, and race) alone did not predict events. Compared with traditional risk factors, c-statistics for CVD (c=0.756) and CHD (c=0.752) increased the most by the addition of CAC presence (CVD, 0.776; CHD, 0.784; P<0.001) followed by carotid plaque presence (CVD, c=0.760; CHD, c=0.757; P<0.05). Compared with risk factors (c=0.782), carotid plaque presence (c=0.787; P=0.045) but not CAC (c=0.785; P=0.438) improved prediction of stroke/transient ischemic attacks. CONCLUSIONS In adults without CVD, CAC presence improves prediction of CVD and CHD more than carotid plaque presence or high IMT. CAC and carotid ultrasound parameters performed similarly for stroke/transient ischemic attack event prediction.
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Affiliation(s)
- Adam D Gepner
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Rebekah Young
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Joseph A Delaney
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Matthew C Tattersall
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Michael J Blaha
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Wendy S Post
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Rebecca F Gottesman
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Richard Kronmal
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Matthew J Budoff
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Gregory L Burke
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Aaron R Folsom
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Kiang Liu
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - Joel Kaufman
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.)
| | - James H Stein
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (A.D.G., M.C.T., J.H.S.); Departments of Biostatistics (R.Y., R.K.), Environmental & Occupational Health Sciences (J.K.), Epidemiology (J.A.D., J.K.), and Statistics (R.K.), University of Washington, Seattle, WA; Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD (M.J.B., W.S.P., R.F.G.); Department of Medicine, University of California, Los Angeles (M.J.B.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); Department of Epidemiology, University of Minnesota School of Public Health, Minneapolis (A.R.F.); and Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.L.).
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