Body fat and blood rheology: Evaluation of the association between different adiposity indices and blood viscosity

A machine learning screening model for identifying the risk of high-frequency hearing impairment in a general population

BACKGROUND

Hearing impairment (HI) has become a major public health issue in China. Currently, due to the limitations of primary health care, the gold standard for HI diagnosis (pure-tone hearing test) is not suitable for large-scale use in community settings. Therefore, the purpose of this study was to develop a cost-effective HI screening model for the general population using machine learning (ML) methods and data gathered from community-based scenarios, aiming to help improve the hearing-related health outcomes of community residents.

METHODS

This study recruited 3371 community residents from 7 health centres in Zhejiang, China. Sixty-eight indicators derived from questionnaire surveys and routine haematological tests were delivered and used for modelling. Seven commonly used ML models (the naive Bayes (NB), K-nearest neighbours (KNN), support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGBoost), boosting, and least absolute shrinkage and selection operator (LASSO regression)) were adopted and compared to develop the final high-frequency hearing impairment (HFHI) screening model for community residents. The model was constructed with a nomogram to obtain the risk score of the probability of individuals suffering from HFHI. According to the risk score, the population was divided into three risk stratifications (low, medium and high) and the risk factor characteristics of each dimension under different risk stratifications were identified.

RESULTS

Among all the algorithms used, the LASSO-based model achieved the best performance on the validation set by attaining an area under the curve (AUC) of 0.868 (95% confidence interval (CI): 0.847-0.889) and reaching precision, specificity and F-score values all greater than 80%. Five demographic indicators, 7 disease-related features, 5 behavioural factors, 2 environmental exposures, 2 hearing cognitive factors, and 13 blood test indicators were identified in the final screening model. A total of 91.42% (1235/1129) of the subjects in the high-risk group were confirmed to have HI by audiometry, which was 3.99 times greater than that in the low-risk group (22.91%, 301/1314). The high-risk population was mainly characterized as older, low-income and low-educated males, especially those with multiple chronic conditions, noise exposure, poor lifestyle, abnormal blood indices (e.g., red cell distribution width (RDW) and platelet distribution width (PDW)) and liver function indicators (e.g., triglyceride (TG), indirect bilirubin (IBIL), aspartate aminotransferase (AST) and low-density lipoprotein (LDL)). An HFHI nomogram was further generated to improve the operability of the screening model for community applications.

CONCLUSIONS

The HFHI risk screening model developed based on ML algorithms can more accurately identify residents with HFHI by categorizing them into the high-risk groups, which can further help to identify modifiable and immutable risk factors for residents at high risk of HI and promote their personalized HI prevention or intervention.

Indicators of Obesity and Cardio-metabolic Risks: Important Consideration in Adults and Children

The prevalence of obesity has dramatically increased all over the world. Body mass index (BMI) has been used as the most common available measure to determining obesity status. While the site of excessive fat mass accumulation is a stronger determinant of cardio-metabolic complication, with respect to systemic and generalized obesity, which is only determined through BMI. So, it is concluded that using traditional anthropometric indices such as BMI for interpreting the obesity status and cardio-metabolic risk has considerable limitations. Thus, the main aims of the present study are to discuss possible drawbacks of anthropometric indices especially BMI, which in epidemiological studies are usually neglected, as well as lend important consideration to using other anthropometric indices such as measurement of obesity and related cardio-metabolic complications with a special emphasis on the use of waist circumference, waist-to-hip ratio and waist-to-height ratio.

Effect of Vibrotherapy on Body Fatness, Blood Parameters and Fibrinogen Concentration in Elderly Men

Elderly people need activities that will positively contribute to a satisfactory process of getting older. Vibration training uses mechanical stimulus of a vibrational character that, similarly to other forms of physical activity, affects metabolic processes and conditions of health. The aim of this work was to assess the influence of thirty vibration treatments on body fatness, hematologic and rheologic indexes of blood, and proteinogram and fibrinogen concentration in elderly men’s blood. The study included twenty-one males, aged 60–70 years (mean age 65.3 ± 2.7), who were randomly assigned into a vibrotherapy group (VG) and took part in interventions on mattresses generating oscillatory-cycloid vibrations, and a control group (CG), without interventions. In all patients the following assessments were performed twice: an assessment of body fatness using the bioimpedance method, a complete blood count with a hematology analyzer, and erythrocyte aggregation by a laser-optical rotational cell analyzer; whereas, total plasma protein and fibrinogen values were established, respectively, by biuret and spectrophotometric methods. In order to compare the impact of vibrotherapy on changes in the analyzed variables, analysis of variance (ANOVA) or the Wilcoxon test were used. After applying thirty vibration treatments in the VG, a significant decrease in body fatness parameters was confirmed: BM (∆BM: −2.7 ± 2.0; p = 0.002), BMI (∆BMI: −0.9 ± 0.7; p = 0.002), BF (∆BF: −2.5 ± 2.5; p = 0.013), and %BF (∆%BF: −2.0 ± 2.7; p = 0.041), as well as in RBC (∆RBC: −0.1 ± 0.1; p = 0.035). However, changes in erythrocyte aggregation and proteinogram were not confirmed. It was found that after thirty treatments with VG, a significant decrease of fibrinogen level took place (∆ = −0.3 ± 0.3, p = 0.005). Application of thirty vibrotherapy treatments positively affected body fatness parameters and fibrinogen concentrations in the examined. However, further research should include a greater number of participants.

Correlation between serum lipid and prognosis of idiopathic sudden sensorineural hearing loss: a prospective cohort study

BACKGROUND

To investigate the correlation between blood lipids and the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL).

METHODS

We included 232 patients with ISSNHL at the Second Affiliated Hospital of Shanghai University from June 2015 to March 2017 using a prospective cohort study design. We collected information including age, gender, hypertension, diabetes, mellitus, vertigo, as well as the levels of blood total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL-C). We also recorded the ratio between the levels of low-density lipoproteins and the levels of high-density lipoproteins (LDL-C/HDL-C ratio). Correlations between the prognosis of ISSNHL and TC, TG, LDL-C, and LDL-C/HDL-C ratio were analyzed by univariable and multivariable logistic regression analyses.

RESULTS

The clinical effectiveness rate of patients with TC ranging from 5.2 to 6.2 mmol/L was significantly higher than that of patients with TC <5.2 mmol/L (P<0.001). No notable difference was found between patients with TC <5.2 mmol/L and patients with TC ≥6.2 mmol/L. The clinical effectiveness rate of patients in TG ranging from 1.7 mmol/L to 2.3 mmol/L was markedly higher than those in TG <1.7 mmol/L (P<0.001). No significant difference was found between patients with TG ranging from 2.3 to 5.6 mmol/L, TG ≥5.6 mmol/L, and TG <1.7 mmol/L. The clinical effectiveness rate of patients in LDL-C/HDL-C <1.5 was considerably higher than those in LDL-C/HDL-C ranging from 1.5 to 2.5, 2.5 to 3.5, and ≥3.5 (P<0.001).

CONCLUSIONS

Our findings indicated that TC, TG, and the LDL-C/HDL-C ratio are strongly associated with the prognosis of ISSNHL. These three indices could be recommended as independent markers to predict outcomes.

Standardization for obtaining blood viscosity: A systematic review

INTRODUCTION

There is evidence to suggest that blood viscosity (BV) is involved in several pathological processes. In this review, we evaluated the different methods of BV acquisition, analyzing the sample storage time, the storage temperature, the acquisition time, the acquisition temperature, sample volume, and shear rates, in order to standardize this technique.

METHODS

We selected 50 articles with methods of obtaining BV, evaluating pathologies through BV, comparing rheological equipment, monitoring, and regulating BV.

RESULTS AND CONCLUSION

Measurements should be obtained as soon as possible, to reduce hemorheological changes. It is necessary to refrigerate them at 4°C when the storage time is long. The acquisition time is related to the equipment used. BV measurements at 37°C will represent the real BV in vivo more faithfully. In order to understand the BV phenomena, the shear rates must be between 0.1 and 1000 s-1. There is a wide variety of equipment available for measuring the BV.

Growth, behavioural, serum biochemical and morphological changes in female rabbits fed high-fat diet

This study aimed to determine whether high-fat diet (HFD) could cause growth, behavioural, biochemical and morphological changes in young female rabbits. Thirty-six female rabbits were randomly divided into two groups fed with either a high-fat diet (HFD) or a standard normal diet (SND) for 5 weeks. Growth and behavioural changes were recorded during the 5-week feeding period. Tissue samples, including blood and adipose tissue, were obtained after slaughter. HFD rabbits weighed more by the end of the feeding period, had a higher percent body weight and adipose tissue weight change and had longer body and bust lengths than SND rabbits. HFD rabbits significantly reduced their feed intake and feeding frequency during the fourth and fifth weeks. HFD rabbits also showed lower frequency of drinking and resting and increased stereotypical behaviour. Besides, HFD rabbits showed significant physiological abnormalities. HFD rabbits had higher serum cholesterol (TC) and triglycerides (TG) levels than SND rabbits at the end of the feeding period, and higher free fatty acid (FFA) levels than rabbits in the SND group after the third week of feeding. Serum thyroxine (T4) increased significantly in week 2 and week 5 and triiodothyronine (T3) increased significantly in week four. However, there was no significant change in serum glucose (GLU) and insulin (INS) levels. Additionally, HFD reduced the area and diameter of perirenal and subcutaneous fat cells and increased their density. Our findings suggest that HFD rabbits had higher weight gains, accumulation of fat, and more behavioural changes than SND rabbits. Although high levels of fat in the diet had a low impact on hyperglycaemia, it could lead to hyperlipidemia and hyperthyroidism. Our results also suggest that sustained HFD may cause the proliferation of adipocytes in young female rabbits.

Associations of Gain in Weight-Related Anthropometric Indices with a Marker of Lipid Peroxidation: A Cohort Study Among Urban Adults in China

BACKGROUND

Obesity is reported to be associated with oxidative stress which can cause lipid peroxidation. However, the effects of gain in various weight-related anthropometric indices on lipid peroxidation remain unclear. We aimed to examine the cross-sectional and longitudinal associations between altered weight-related anthropometric indices and a marker of lipid peroxidation among urban adults in China.

METHODS

A total of 3762 participants from the Wuhan-Zhuhai cohort were included in the present study, with a follow-up of 3 years. Six weight-related anthropometric indicators were measured and calculated, including waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body adiposity index (BAI). Individual urinary 8-iso-prostaglandin-F_2α (8-iso-PGF_2α) was determined via enzyme-linked immunosorbent assay to evaluate lipid peroxidation. We used generalized linear models to analyze the cross-sectional and longitudinal associations of weight-related anthropometric indices with a marker of lipid peroxidation and stratified analyses to estimate effect modification.

RESULTS

We found significant relationships between WHR, WHtR, ABSI, and urinary 8-iso-PGF_2α at baseline. Each 1% increase in WHR, WHtR, and ABSI was significantly associated with a 0.007, 0.004, and 0.104 increase in log-transformed 8-iso-PGF_2α concentration, respectively (P<0.05). In longitudinal analysis, positive dose-response relationships were observed between gains in BMI, BAI, and increased 8-iso-PGF_2α after adjusting for potential confounders (P _trend<0.05). We also found that gender and smoking status modified the association of BMI gain and 8-iso-PGF_2α increment, and such an association was more obvious in female and non-smokers.

CONCLUSION

Our research implied that gain in anthropometric indices may result in a higher level of lipid peroxidation.

Potential Role of New Anthropometric Parameters in Childhood Obesity with or Without Metabolic Syndrome

BACKGROUND

Obese children and adolescents are more prone to have metabolic syndrome (MS).MS is a cluster of cardiovascular risk factors associated with insulin resistance. Body round index [BRI], visceral adiposity index [VAI] and a body shape index [ABSI] are among the new obesity anthropometric parameters.

AIM

To evaluate the new markers for obesity in children and their possible association with other laboratory and clinical variables of MS.

METHODS

Eighty nine obese children and 40 controls aged 10-18 years were recruited. Full history taking, thorough clinical examination, anthropometric and biochemical features were performed in the studied groups. Subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were estimated by ultrasonography.

RESULTS

Obese children, exhibited significantly higher values in all anthropometric measurements (P < 0.001). Diastolic and systolic blood pressure were significantly higher (P < 0.001) in the obese group. ABSI, BRI and VAI have been found to be significantly higher in obese subjects (P < 0.001), with no significant gender difference. BMI, WHtR, WC/HR, SBP, DBP, subcutaneous fat thickness and visceral fat thickness, Liver Span, ABSI, BRI, VAI and HOMA_IR were significantly higher among children with MS than those without MS. Positive significant correlations of VAI with BMI, WC/Ht, WC/Hip, SBP, DBP, SFT, VFT, Liver size and HOMA-IR (r = 0.384, 0.239, 0.268, 0.329, 0.516, 0.320, 0.254, 0.251, and 0.278 respectively) are shown. The area under the ROC curve (AUC) of BMI, VAI, ABSI, BRI for predicting MS was 0.802 (0.701-0.902), 0.737 (0.33-0.841), 0.737 (0.620-0.855), 0.816 (0.698-0.934).

CONCLUSION

We suggest using the VAI and WHtR indexes, as they are better predictor of MS.

Anthropometric parameter that best predict metabolic syndrome in South west Nigeria

AIM

This study compared the ability of anthropometric parameters to predict Metabolic Syndrome (MetS).

METHODS

Eleven anthropometric parameters: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), abdominal volume index (AVI), Conicity Index (CI), body adiposity index (BAI), lipid accumulation product (LAP) and waist circumference-triglyceride index (WTI) were measured and calculated in apparently healthy subjects with and without MetS. A receiver operating characteristic (ROC) curve was applied to assess their ability to predict MetS.

RESULTS

Of the 535 subjects recruited 23% had MetS. WC had the largest area under the curve (AUC) in both men (0.814 95% CI 0.721-0.907) and women (0.819 95%CI 0.771-0.867). This did not differ from the AUC of BMI, WHtR, BRI, CI, BAI, LAP in men and BMI, WHtR, BAI, LAP, VAI and WTI in women (P > 0.05). The cutoff point for WC was 89.5 cm and 91.8 cm in men and women respectively. The AUC of WC was the largest in the 40-49 and 60 years and above age groups while the AUC of LAP was the largest for age groups 30-39 and 50-59 years.

CONCLUSION

Of the 11 anthropometric parameters assessed, the WC was the best at predicting MetS in both men and women. There is need to ascertain the cutoff point and establish landmark for measuring WC especially for the sub Saharan region.

Obesity, blood rheology and angiogenesis

Adipose tissue is actively involved in angiogenesis through secretion of biologically active substances. This topic has been the subject of many recent publications concerning the pathophysiology and treatment of obesity. We discuss the relationship between obesity, angiogenesis and blood rheology.

Twelve Weeks of Yoga or Nutritional Advice for Centrally Obese Adult Females

Background: Central obesity is associated with a higher risk of disease. Previously yoga reduced the BMI and waist circumference (WC) in persons with obesity. Additional anthropometric measures and indices predict the risk of developing diseases associated with central obesity. Hence the present study aimed to assess the effects of 12 weeks of yoga or nutritional advice on these measures. The secondary aim was to determine the changes in quality of life (QoL) given the importance of psychological factors in obesity. Material and Methods: Twenty-six adult females with central obesity in a yoga group (YOG) were compared with 26 adult females in a nutritional advice group (NAG). Yoga was practiced for 75 min/day, 3 days/week and included postures, breathing practices and guided relaxation. The NAG had one 45 min presentation/week on nutrition. Assessments were at baseline and 12 weeks. Data were analyzed with repeated measures ANOVA and post-hoc comparisons. Age-wise comparisons were with t-tests. Results: At baseline and 12 weeks NAG had higher triglycerides and VLDL than YOG. Other comparisons are within the two groups. After 12 weeks NAG showed a significant decrease in WC, hip circumference (HC), abdominal volume index (AVI), body roundness index (BRI), a significant increase in total cholesterol and LDL cholesterol. YOG had a significant decrease in WC, sagittal abdominal diameter, HC, BMI, WC/HC, a body shape index, conicity index, AVI, BRI, HDL cholesterol, and improved QoL. With age-wise analyses, in the 30-45 years age range the YOG showed most of the changes mentioned above whereas NAG showed no changes. In contrast for the 46-59 years age range most of the changes in the two groups were comparable. Conclusions: Yoga and nutritional advice with a diet plan can reduce anthropometric measures associated with diseases related to central obesity, with more changes in the YOG. This was greater for the 30-45 year age range, where the NAG showed no change; while changes were comparable for the two groups in the 46-59 year age range. Hence yoga may be especially useful for adult females with central obesity between 30 and 45 years of age.

TRIAL REGISTRATION

(CTRI/2018/05/014077).

Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study

OBJECTIVES

Our study aimed to distinguish the ability of anthropometric indices to assess the risk of metabolic syndrome (MetS).

DESIGN

Prospective cohort study.

SETTING

Shenyang, China.

PARTICIPANTS

A total of 379 residents aged between 40 and 65 were enrolled. 253 of them were free of MetS and had been followed up for 4.5 years.

METHODS

At baseline, all the participants underwent a thorough medical examination. A variety of anthropometric parameters were measured and calculated, including waist circumference (WC), body mass index (BMI), a body shape index (ABSI), abdominal volume index (AVI), body adiposity index, body roundness index, conicity index, waist-to-hip ratio and visceral adiposity index (VAI). After 4.5 year follow-up, we re-examined whether participants were suffering from MetS. A receiver operating characteristic (ROC) curve was applied to examine the potential of the above indices to identify the status and risk of MetS.

OUTCOMES

Occurrence of MetS.

RESULTS

At baseline, 33.2% participants suffered from MetS. All of the anthropometric indices showed clinical significance, and VAI was superior to the other indices as it was found to have the largest area under the ROC curve. After a 4.5 year follow-up, 37.8% of men and 23.9% of women developed MetS. ROC curve analysis suggested that baseline BMI was the strongest predictor of MetS for men (0.77 (0.68-0.85)), and AVI was the strongest for women (0.72 (0.64-0.79)). However, no significant difference was observed between WC and both indices. In contrast, the baseline ABSI did not predict MetS in both genders.

CONCLUSIONS

The present study indicated that these different indices derived from anthropometric parameters have different discriminatory abilities for MetS. Although WC did not have the largest area under the ROC curve for diagnosing and predicting MetS, it may remain a better index of MetS status and risk because of its simplicity and wide use.