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Chen X, Zhao Y, Wang Y, Ye Y, Xu S, Zhou L, Lin Y, Lu J, Yin W. Serum lipid ratios as novel prognostic biomarkers for patients with locally advanced breast cancer treated with neoadjuvant therapy. Postgrad Med 2024:1-10. [PMID: 38912905 DOI: 10.1080/00325481.2024.2370235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/14/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVES To investigate the association between lipid ratios and survival outcomes in patients with locally advanced breast cancer (LABC) undergoing neoadjuvant chemotherapy. METHOD This retrospective study included patients with LABC receiving neoadjuvant chemotherapy. Serum lipid levels were prospectively measured at baseline. Associations of triglyceride to total cholesterol (TG/TC), triglyceride to high-density lipoprotein (TG/HDL) and triglyceride to low-density lipoprotein (TG/LDL) ratios with prognosis were evaluated. RESULTS Patients with high TG/TC (adjusted hazard ratio [aHR] = 2.47, 95% CI: 1.10, 5.56, p = 0.029), TG/HDL (aHR = 2.73, 95% CI: 1.16, 6.41, p = 0.021) and TG/LDL (aHR = 2.50, 95% CI: 1.11, 5.65, p = 0.027) ratios were more likely to experience disease-free survival (DFS) events. Subgroup analysis suggested that the prognostic impact of lipid ratios was more pronounced in patients with negative HER2 status or those at a high risk of recurrence (e.g. clinical stage III, Ki67 > 30%). Additionally, higher lipid ratios tended to indicate early DFS events (0 ~ 2 years) (TG/TC p = 0.021, TG/HDL p = 0.046, TG/LDL p < 0.001), and the TG/LDL ratio demonstrated the best predictive efficacy (TG/TC vs. TG/HDL vs. TG/LDL, 1-year AUC: 0.724 vs. 0.676 vs. 0.846, 2-year AUC: 0.653 vs. 0.638 vs. 0.708). CONCLUSION Baseline serum TG/TC, TG/HDL and TG/LDL ratios were independent prognostic factors in patients with LABC undergoing neoadjuvant therapy. However, their utility in predicting the early DFS events warrants further investigation. CLINICAL TRIAL REGISTRATION NCT05621564.
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Affiliation(s)
- Xinru Chen
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingying Zhao
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yaohui Wang
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yumei Ye
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shuguang Xu
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liheng Zhou
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanping Lin
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingsong Lu
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjin Yin
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Deng G, Yin L, Liu W, Liu X, Xiang Q, Qian Z, Ma J, Chen H, Wang Y, Hu B, Li W, Jiang Y. Associations of anthropometric adiposity indexes with hypertension risk: A systematic review and meta-analysis including PURE-China. Medicine (Baltimore) 2018; 97:e13262. [PMID: 30508913 PMCID: PMC6283208 DOI: 10.1097/md.0000000000013262] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The association between hypertension and obesity has been confirmed, while no agreement has been reached about which anthropometric adiposity index is the best. This meta-analysis aimed to perform a systematic review and meta-analysis on the associations of hypertension risk with body mass index (BMI), waist circumstance (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), and a prospective urban and rural epidemiology study from China (PURE-China) was added into this meta-analysis as an individual study. METHODS Systematic literature searching was conducted to identify relevant articles published up to September 2018 in CNKI, WANFANG Data, Web of Science, SinoMed, PubMed, MEDLINE, EMBASE, Cochrane Library and cross-referencing. Literature reporting the association of hypertension risk with BMI, WC, WHR, and WHtR were defined as eligible. PURE-China data were analyzed and included as 1 eligible study into meta-analyses. Summary odds ratio (OR) and area under receiver operating characteristic curve (AUC) were pooled using meta-analysis methods. Heterogeneity and publication bias were evaluated. Subgroups based on gender, country and study design were conducted as well. RESULTS Thirty-eight original articles including PURE-China were included into meta-analyses, involving 309,585 subjects. WHtR had the strongest association with hypertension risk (OR, 1.68; 95% confidence interval, [CI]:1.29-2.19) and prediction ability (AUC, 70.9%; 95% CI: 67.8%-74.2%), which were also confirmed in subgroup analyses based on gender and country. However, BMI was found to have the highest prediction ability in adjusted models of PURE-China and followed WC, both of which were superior to WHtR (73.7% and 73.4% vs 73.2%). CONCLUSIONS Our overall meta-analysis further confirmed WHtR as a good indicator at discriminating those individuals at increased risk of hypertension, and in some cases, it is better than BMI, WC, and WHR.
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Affiliation(s)
- Guijuan Deng
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing
| | - Lu Yin
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Weida Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Xiaoyun Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Quanyong Xiang
- Jiangsu Province Center for Disease Control & Prevention
| | - Zhenzhen Qian
- Jiangxinzhou Community Health Service Center, Nanjing
| | - Juntao Ma
- Academy of Military Sciences, People's Liberation Army of China, Beijing, China
| | - Hui Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Yang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Bo Hu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Wei Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases
| | - Yu Jiang
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing
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Yang Z, Ding X, Liu J, Duan P, Si L, Wan B, Tu P. Associations between anthropometric parameters and lipid profiles in Chinese individuals with age ≥40 years and BMI <28kg/m2. PLoS One 2017. [PMID: 28632766 PMCID: PMC5478121 DOI: 10.1371/journal.pone.0178343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lipid abnormalities are associated with overweight and obesity. Some simple anthropometric measurements such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), may link to increased risk of dyslipidemia. However, diverse results were found in different population studies. We focused on the associations between these measurements and dyslipidemia in non-obese (BMI <28kg/m2) population aged more than 40 years. METHODS AND FINDINGS Cross-sectional study of 4185 non-obese adults aged more than 40 years was conducted in Nanchang, Jiangxi province, China. Questionnaire, anthropometric and laboratory tests were conducted. The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria were used to define high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia and dyslipidemia. The overall prevalence of high TC, high LDL-C, low HDL-C, hypercholesterolemia, hypertriglyceridemia and dyslipidemia were 15.68%, 27.98%, 20.12%, 44.01%, 21.98% and 49.06% respectively. Multiple logistic regressions showed only BMI (per quartile increment) increased risks for prevalent high LDL-C, low HDL-C, hypercholesterolemia, hypertriglyceridemia, and dyslipidemia. Regardless of sex, age and prevalent metabolic syndrome, increasing BMI was persistently independent risk factor for having low HDL-C, hypercholesterolemia and dyslipidemia, however was not associated with high TC. CONCLUSIONS In non-obese Chinese population aged more than 40 years, increasing BMI may better identify the prevalent dyslipidemia than other anthropometric measurements. However, due to the different meanings, both BMI and WC should be measured and monitored for metabolic risk assessment.
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Affiliation(s)
- Zhi Yang
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Xun Ding
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Jiang Liu
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Peng Duan
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Lian Si
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Binghua Wan
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
| | - Ping Tu
- Nanchang Key Laboratory of Diabetes, The Third Hospital of Nanchang, Jiangxi Province, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Jiangxi Province, China
- * E-mail:
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Hertelyová Z, Vašková J, Vaško L. Waist Circumference-to-Height Ratio Detected in a Convenient Sample of Young Slovak People with Increased Cardio-Metabolic Risk. Cent Eur J Public Health 2016; 24:95-102. [PMID: 27434238 DOI: 10.21101/cejph.a4007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 02/18/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular disease is a serious problem increasingly affecting young people worldwide. Cardio-metabolic risk factors include lipid profile parameters and atherogenic index of plasma (AIP), as well as basic anthropometric parameters such as the ratio of waist circumference to height (WHtR). The aim of our study was to determine WHtR. METHOD WHtR was determined in a group of 500 clinically healthy young people aged 18-25 and, on the basis of measured data, a reference range for WHtR was designed. RESULTS The average WHtR value for the whole group was 0.45±0.06, with 0.46±0.06 for men, and 0.44±0.06 for women. WHtR values in respondents with all other parameters in normal range were from 0.41 to 0.52 for men and from 0.38 to 0.50 for women. Values are similar to those observed in other studies across diverse world populations. A positive correlation was observed between WHtR and atherogenic indices (AP1, AIP) uric acid levels and lipid profile parameters at p<0.001, with the exception of glucose and HDL. WHtR and HDL were negatively correlated at p<0.001. CONCLUSION As WHtR can be easily determined, it can be used as another cardio-metabolic risk factor.
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Affiliation(s)
- Zdenka Hertelyová
- Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Janka Vašková
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Ladislav Vaško
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
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Hertelyova Z, Salaj R, Chmelarova A, Dombrovsky P, Dvorakova MC, Kruzliak P. The association between lipid parameters and obesity in university students. J Endocrinol Invest 2016; 39:769-78. [PMID: 25601518 DOI: 10.1007/s40618-015-0240-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 01/08/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Abdominal obesity is associated with high plasma triglyceride and with low plasma high-density lipoprotein cholesterol levels. AIM AND METHODS Objective of the study was to find an association between plasma lipid and lipoprotein levels and anthropometric parameters in abdominal obesity in Slovakian university students. Lipid profile and anthropometric parameters of obesity were studied in a sample of 419 probands, including 137 men and 282 women. RESULTS Males had higher values of non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and very low-density lipoprotein cholesterol (VLDL-C) than females, but these differences were not significant. Females had significantly (P < 0.05) higher TC and HDL-C (P < 0.001) than males. In comparison, all anthropometric parameters in the males were significantly (P < 0.001) higher than in the females. A positive correlation between non-HDL-C, TG, VLDL-C and anthropometric parameters (BMI, WC, WHR, WHtR) was found at P < 0.001. LDL was positively correlated with BMI, WCF, WHtR and TC with BMI, WHtR at P < 0.001. We also observed a correlation between TC-WCF and LDL-WHR at P < 0.01. A negative correlation was found between HDL and all monitored anthropometric parameters at P < 0.001. On the other hand, no correlation between TC and WHR was detected. CONCLUSION This study shows an association between plasma lipid and lipoprotein levels and anthropometric parameters in abdominal obesity in young people, predominantly university students.
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Affiliation(s)
- Z Hertelyova
- Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic
| | - R Salaj
- Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic
| | - A Chmelarova
- Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic
| | - P Dombrovsky
- Department of Pathophysiology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic
| | - M C Dvorakova
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University in Prague, Plzen, Czech Republic
- Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - P Kruzliak
- Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital and Masaryk University, Pekarska 53, 656 91, Brno, Czech Republic.
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Goh LGH, Dhaliwal SS, Welborn TA, Lee AH, Della PR. Anthropometric measurements of general and central obesity and the prediction of cardiovascular disease risk in women: a cross-sectional study. BMJ Open 2014; 4:e004138. [PMID: 24503301 PMCID: PMC3918987 DOI: 10.1136/bmjopen-2013-004138] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/23/2013] [Accepted: 01/14/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES It is important to ascertain which anthropometric measurements of obesity, general or central, are better predictors of cardiovascular disease (CVD) risk in women. 10-year CVD risk was calculated from the Framingham risk score model, SCORE risk chart for high-risk regions, general CVD and simplified general CVD risk score models. Increase in CVD risk associated with 1 SD increment in each anthropometric measurement above the mean was calculated, and the diagnostic utility of obesity measures in identifying participants with increased likelihood of being above the treatment threshold was assessed. DESIGN Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. SETTING Population-based survey in Australia. PARTICIPANTS 4487 women aged 20-69 years without heart disease, diabetes or stroke. OUTCOME MEASURES Anthropometric obesity measures that demonstrated the greatest increase in CVD risk as a result of incremental change, 1 SD above the mean, and obesity measures that had the greatest diagnostic utility in identifying participants above the respective treatment thresholds of various risk score models. RESULTS Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio had larger effects on increased CVD risk compared with body mass index (BMI). These central obesity measures also had higher sensitivity and specificity in identifying women above and below the 20% treatment threshold than BMI. Central obesity measures also recorded better correlations with CVD risk compared with general obesity measures. WC and WHR were found to be significant and independent predictors of CVD risk, as indicated by the high area under the receiver operating characteristic curves (>0.76), after controlling for BMI in the simplified general CVD risk score model. CONCLUSIONS Central obesity measures are better predictors of CVD risk compared with general obesity measures in women. It is equally important to maintain a healthy weight and to prevent central obesity concurrently.
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Affiliation(s)
- Louise G H Goh
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Satvinder S Dhaliwal
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Timothy A Welborn
- Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, Western Australia, Australia
| | - Andy H Lee
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Phillip R Della
- School of Nursing and Midwifery, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
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Kweon SS, Shin MH, Choi JS, Nam HS, Lee YH, Park KS, Lee JY, Jeong SK. Prevalence of albuminuria and associated cardiovascular risk factors: a community cohort in Namwon City, Korea. Diabetes Res Clin Pract 2012; 97:492-8. [PMID: 22682946 DOI: 10.1016/j.diabres.2012.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 05/15/2012] [Accepted: 05/17/2012] [Indexed: 10/28/2022]
Abstract
AIM To document the prevalence of albuminuria and determine its relationship to risk factors for cardiovascular disease (CVD) among Korean adults. METHODS We performed a cross-sectional study of adults aged 45-74 years from Namwon City, South Korea. Albuminuria was defined as a urinary albumin-to-creatinine ratio (UACR)≥30mg/g. The values of UACR were categorized into 5 groups: <10, 10-19, 20-29, 30-299, and ≥300mg/g. Risk factors for CVD and the estimated glomerular filtration rate (eGFR) were analyzed for an association with UACR values. RESULTS Data were obtained from 10,534 participants (4140 men and 6394 women). Albuminuria was more prevalent among women than men (27.3% versus 22.7%, respectively, p<0.001), and it was also more prevalent among older participants (p<0.001). The prevalence of albuminuria was 36.3% among participants with hypertension or type 2 diabetes, and it was 16.6% among participants without these conditions. The UACR was positively associated with CVD risk factors, including blood pressure, obesity indexes, total cholesterol, and the eGFR. CONCLUSIONS The prevalence of albuminuria is high in the general population in Korea, even among Koreans without CVD risk factors. Lower UACR values are associated with reduced CVD risk factors.
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Affiliation(s)
- Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
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Park HA, Park JK, Park SA, Lee JS. Age, menopause, and cardiovascular risk factors among korean middle-aged women: the 2005 Korea National Health and Nutrition Examination Survey. J Womens Health (Larchmt) 2012; 19:869-76. [PMID: 20350203 DOI: 10.1089/jwh.2009.1436] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study examined the effects of menopause and age on cardiovascular disease (CVD) risk factors in a nationally representative sample of middle-aged Korean women. METHODS This study used the data of 1169 perimenopausal Korean women (mean age 50.1 +/- 7.2 years, 44% postmenopausal) from the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Menopausal status was confirmed by self-reports. Risk factors of CVD included reported lifestyle characteristics (smoking, physical activity level, and dietary and alcohol intake) and measured anthropometry, blood pressure, fasting glucose, and serum lipid levels. Sociodemographic characteristics and general health conditions were assessed by interviews. Descriptive statistics and multiple regression models were used to assess the effects of age and menopause on various CVD risk factors. RESULTS The mean age of natural menopause in Korean women was 50.2 +/- 3.7 years. Lifestyle risk factors of CVD were not significantly different by menopausal status or age except the percent of energy intake from fat, which decreased by menopause and age. Waist circumference increased with both age and menopause; blood pressure was elevated only with age, and serum lipids were associated only with menopausal status. However, fasting serum glucose was not related to either age or menopausal status. CONCLUSIONS This study showed the increasing CVD risk burdens with menopause and aging in Korean middle-aged women. More study is warranted to better understand ways to attenuate the deleterious changes.
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Affiliation(s)
- Hyun Ah Park
- Department of Family Medicine, University of Inje College of Medicine, Seoul, Korea
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Park YS, Kim JS. Obesity phenotype and coronary heart disease risk as estimated by the Framingham risk score. J Korean Med Sci 2012; 27:243-9. [PMID: 22379333 PMCID: PMC3286769 DOI: 10.3346/jkms.2012.27.3.243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 01/02/2012] [Indexed: 12/17/2022] Open
Abstract
There are conflicting data as to whether general or abdominal obesity is a better predictor of cardiovascular risk. This cross-sectional study involved 4,573 subjects aged 30 to 74 yr who participated in the Fourth Korea National Health and Nutrition Examination Survey conducted in 2008. Obesity phenotype was classified by means of body mass index (BMI) and waist circumference (WC), and participants were categorized into 4 groups. Individuals' 10-yr risk of coronary heart diseases (CHD) was determined from the Framingham risk score. Subjects with obese WC had a higher proportion of high risk for CHD compared to the normal WC group, irrespective of BMI level. Relative to subjects with normal BMI/normal WC, the adjusted odds ratios (ORs) of normal BMI/obese WC group (OR 2.93 [1.70, 5.04] and OR 3.10 [1.49, 6.46]) for CHD risk in male were higher than obese BMI/obese WC group (OR 1.91 [1.40, 2.61] and OR 1.70 [1.16, 2.47]), whereas the adjusted ORs of obese BMI/obese WC group (OR 1.94 [1.24, 3.04] and OR 3.92 [1.75, 8.78]) were higher than the others in female. Subjects with obese BMI/normal WC were not significantly associated with 10-yr CHD risk in men (P = 0.449 and P = 0.067) and women (P = 0.702 and P = 0.658). WC is associated with increased CHD risk regardless of the level of BMI. Men with normal BMI and obese WC tend to be associated with CHD risk than those with obese BMI and obese WC.
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Affiliation(s)
- Yong Soon Park
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun-Su Kim
- Department of Family Medicine, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
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Pongsatha S, Morakot N, Sangchun K, Chaovisitsaree S. Correlation between waist circumference and other factors in menopausal women in Thailand. Health (London) 2012. [DOI: 10.4236/health.2012.42011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cai L, Zhang L, Liu A, Li S, Wang P. Prevalence, awareness, treatment, and control of dyslipidemia among adults in Beijing, China. J Atheroscler Thromb 2011; 19:159-68. [PMID: 22041495 DOI: 10.5551/jat.10116] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The present study aimed to determine the up-to-date prevalence, awareness, treatment, and control of dyslipidemia, and their distribution and related influencing factors in adults in Beijing, China. METHOD A cross-sectional study was conducted in 2008, using a four-stratified cluster sampling. Data from a questionnaire, physical examination, and blood sampling were obtained from 5761 adults aged 18-79 years. RESULTS The prevalence of high TC, high LDL-C, low HDL-C and TG was 12.2%, 17.9%, 12.0% and 15.1%, respectively. The prevalence of dyslipidemia was 35.4% (42.9% in men and 30.1% in women), and was similar in rural (35.3%) and urban (35.8%) areas. Dyslipidemia was associated with male gender, age, a family history of dyslipidemia, education at college or above, current smoker, overweight and obesity, intermediate and high waist circumference, hypertension and diabetes. Among all participants with dyslipidemia, 22.2% were aware of the diagnosis, 10.2% were receiving treatment, and 3.8% had dyslipidemia controlled. The proportion of those aware of their condition and those who were treated increased with age in both sexes. Of those aware of their dyslipidemia, 46.1% were on treatment, 51.0% had modified their lifestyle, and 24.5% were not receiving treatment or modifying their lifestyle. CONCLUSIONS The major type of dyslipidemia in Beijing is high LDL-C rather than high TG. The prevalence of dyslipidemia is similarly high in rural and urban areas, with low awareness, treatment and control. A comprehensive strategy toward the prevention, screening, treatment, and control of dyslipidemia is needed to slow the epidemic of cardiovascular disease.
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Affiliation(s)
- Li Cai
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
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A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev 2010; 23:247-69. [PMID: 20819243 DOI: 10.1017/s0954422410000144] [Citation(s) in RCA: 803] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This systematic review collated seventy-eight studies exploring waist-to-height ratio (WHtR) and waist circumference (WC) or BMI as predictors of diabetes and CVD, published in English between 1950 and 2008. Twenty-two prospective analyses showed that WHtR and WC were significant predictors of these cardiometabolic outcomes more often than BMI, with similar OR, sometimes being significant predictors after adjustment for BMI. Observations from cross-sectional analyses, forty-four in adults, thirteen in children, supported these predictions. Receiver operator characteristic (ROC) analysis revealed mean area under ROC (AUROC) values of 0·704, 0·693 and 0·671 for WHtR, WC and BMI, respectively. Mean boundary values for WHtR, covering all cardiometabolic outcomes, from studies in fourteen different countries and including Caucasian, Asian and Central American subjects, were 0·50 for men and 0·50 for women. WHtR and WC are therefore similar predictors of diabetes and CVD, both being stronger than, and independent of, BMI. To make firmer statistical comparison, a meta-analysis is required. The AUROC analyses indicate that WHtR may be a more useful global clinical screening tool than WC, with a weighted mean boundary value of 0·5, supporting the simple public health message 'keep your waist circumference to less than half your height'.
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Kwon HR, Min KW, Ahn HJ, Seok HG, Koo BK, Kim HC, Han KA. Effects of aerobic exercise on abdominal fat, thigh muscle mass and muscle strength in type 2 diabetic subject. KOREAN DIABETES JOURNAL 2010; 34:23-31. [PMID: 20532017 PMCID: PMC2879901 DOI: 10.4093/kdj.2010.34.1.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 12/17/2009] [Indexed: 11/08/2022]
Abstract
BACKGROUND Aerobic exercise can effectively reduce visceral fat. However, few studies have examined the effect of daily physical activity on obesity and cardiopulmonary function in the subjects with diabetes. We examined the effect of moderate intensity of walking in obese diabetes patients by monitoring of daily activity and measuring the change in abdominal fat area, muscle are and maximal muscle strength. METHODS We randomly assigned 27 obese women with type 2 diabetes to an aerobic exercise group (AG, n = 13) and control group (CG, n = 14). The AG performed moderate intensity walking for 60 minutes per exercise, 5 times per week, and for 12 weeks. The activity energy expenditure was monitored by a multi-record accelerometer. The CG maintained routine daily activities. At the time of the initiation of the study and after 12 weeks of exercise, the aerobic exercise capacity was assessed using oxygen consumption rate at anaerobic threshold (VO(2)-AT). The abdominal fat area and the quadriceps muscle area were measured by computed tomography, and the maximum muscle strength of the upper and lower limbs was measured by a chest press and a leg press, respectively. RESULTS The mean age of the study subjects was 56.6 +/- 8.0 years, the mean duration of diabetes was 6.3 +/- 6.0 years, and the body weight index (BMI) was 27.3 +/- 2.7 kg/m(2). The BMI of the AG was significantly decreased (P = 0.003). In the AG, the visceral fat area and subcutaneous fat area were also significantly decreased (P = 0.018 and P < 0.001, respectively) but not in CG. VO(2)-AT of the AG was significantly improved, while that of the CG did not change (P = 0.009 and P = 0.115, respectively). The quadriceps muscle mass and the maximal muscle strength of the AG did not change, however, the CG showed a significant decrease. Duration of moderate intensity exercise was correlated with the decrease in total abdominal fat area (r = -0.484; P = 0.011) and that of high intensity exercise was correlated with improvement of cardiopulmonary function (r = 0.414; P = 0.032). CONCLUSION Daily moderate intensity aerobic exercise is effective at reducing abdominal fat mass, while high intensity exercise improves cardiopulmonary function.
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Ashwell M, Gibson S. Waist to height ratio is a simple and effective obesity screening tool for cardiovascular risk factors: Analysis of data from the British National Diet And Nutrition Survey of adults aged 19-64 years. Obes Facts 2009; 2:97-103. [PMID: 20054212 PMCID: PMC6444829 DOI: 10.1159/000203363] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE AND METHOD To analyse data from the nationally representative National Diet and Nutrition Survey (NDNS) collected in 2000/2001 and to investigate how the BMI and two proxy indicators of central fat distribution, namely the waist circumference and the waist to height ratio (WHtR), are associated with each other and with cardiovascular disease (CVD) risk factors. RESULTS Screening health risk by BMI alone would 'miss' 35% of men and 14% of women who are within the normal BMI range (18.5-25 kg/m(2)) but have central fat distribution, defined by WHtR > 0.5. In the total population this equates to 17% of all men and 6% of all women who would be inadequately screened by BMI alone. Compared to BMI, WHtR was more closely associated with CVD risk factors among both men and women. Furthermore, in a combined analysis of men and women, central fat distribution with a normal BMI was associated with higher levels of CVD risk factors than being overweight without central fat distribution. CONCLUSION WHtR is a simple and effective, non-invasive screening tool for CVD risk factors. Our proposed boundary value of 0.5 translates into a simple public health message: 'Keep your waist circumference to less than half your height'.
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Jeong SK, Kim YK, Park JW, Shin YJ, Kim DS. Impact of visceral fat on the metabolic syndrome and nonalcoholic fatty liver disease. J Korean Med Sci 2008; 23:789-95. [PMID: 18955783 PMCID: PMC2580019 DOI: 10.3346/jkms.2008.23.5.789] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Visceral fat has been reported to be associated with nonalcoholic fatty liver disease (NAFLD) and the metabolic syndrome (MetS). We assessed the prevalence of both NAFLD and the MetS, measured visceral fat thickness VFT), and estimated the physical activity indexes of 224 relatively healthy hospital workers. We also investigated the associations between both VFT and physical activity index and each of NAFLD and the MetS. The MetS was diagnosed according to the guidelines outlined by the Adult Treatment Panel III, and NAFLD was diagnosed by ultrasonography. Subjects with hepatitis B and C infections and those reporting moderate alcohol consumption were excluded from the study. The prevalence of the MetS was 11.6% and that of NAFLD was 41.5%. Many subjects with the MetS had NAFLD (73.1%), and some subjects with NAFLD (20.4%) also had several components of the MetS (p=0.001). VFT was significantly increased by both the addition of components of the MetS and the severity of NAFLD (p<0.001). In addition, VFT was independently associated with NAFLD (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.19) in subjects with more than 2 components of the MetS. In contrast, habitual physical activity was reversely associated with NAFLD (OR, 0.29; 95% CI, 0.10-0.87). In conclusion, an increased visceral fat content and reduced physical activity could be not only biological markers but also therapeutic targets in the treatment of NAFLD and the MetS.
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Affiliation(s)
- Seul-Ki Jeong
- Department of Neurology, Chonbuk National University Medical School, Jeonju, Korea
| | - Young-Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Medical School, Jeonju, Korea
| | - Jin-Woo Park
- Department of Biochemistry, Chonbuk National University Medical School, Jeonju, Korea
| | - Yong-Ju Shin
- Department of Internal Medicine, Catholic Medical Center, Seoul, Korea
| | - Dal-Sik Kim
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea
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Association between Serum Lipids, Blood Pressure, and Simple Anthropometric Measures in an Adult Chinese Population. Arch Med Res 2008; 39:610-7. [DOI: 10.1016/j.arcmed.2008.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 05/05/2008] [Indexed: 11/23/2022]
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