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Penny P, Ho WLJ, Villa B, Kayastha A, Englander K, Sapell J, Mhaskar R, Velanovich V. Evaluation of body mass index, ponderal index, visceral cross-sectional area, subcutaneous fat cross-sectional area, and liver volume as predictive factors for obesity-related comorbidities: a retrospective cohort study. J Gastrointest Surg 2024:S1091-255X(24)00493-1. [PMID: 38852929 DOI: 10.1016/j.gassur.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND The body mass index (BMI) is an imperfect clinical measure of obesity that should be used in conjunction with other valid measures of weight-related risk. We studied whether there is a superior measure of obesity-related comorbidities. METHODS Records of bariatric clinic patients who had an abdominal computed tomography (CT) within 1 year of visit were reviewed. The presence of obesity-related comorbidities was determined at the time of the scan. BMI and ponderal index (PI) were calculated, and CT scans were reviewed to determine the visceral cross-sectional area (VCSA), subcutaneous fat cross-sectional area (SFCSA), and liver volume (LV). Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test. RESULTS A higher number of comorbidities were found to be associated with a larger BMI (P = .011), VCSA (P = .014), SFCSA (P = .007), and LV (P = .014), but not a larger PI (P = .11). Of the 16 comorbidities assessed, VCSA and LV were associated with more than BMI and SFCSA. However, each measure could be associated with different comorbidities. A higher BMI was associated with increased insulin use (P = .034), hypertension (P = .007), and history of obstructive sleep apnea (P = .015), none of which were associated with PI. BMI and PI were the only measures associated with a history of deep vein thrombosis/pulmonary embolism (both P < .01). Only SFCSA was found to be associated with gastroesophageal reflux disease (P = .029). VCSA (P = .038) and LV (P = .001) were associated with nonalcoholic fatty liver disease. CONCLUSION No measure could account for all obesity-related comorbidities, implying the need for targeted measurements. However, PI was the least effective measure.
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Affiliation(s)
- Parker Penny
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States.
| | - Wai Lone Jonathan Ho
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
| | - Brian Villa
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
| | - Ahan Kayastha
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
| | - Kate Englander
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
| | - Jacob Sapell
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
| | - Rahul Mhaskar
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
| | - Vic Velanovich
- Department of Surgery, Morsani College of Medicine, University of South Florida, Florida, United States
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Vizzuso S, Torto AD, Fiore G, Carugo S, Zuccotti G, Verduci E. Tri-ponderal mass index and left ventricular hypertrophy in a cohort of caucasian children and adolescents with obesity. Ital J Pediatr 2024; 50:75. [PMID: 38637874 PMCID: PMC11027303 DOI: 10.1186/s13052-024-01634-9] [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: 05/11/2023] [Accepted: 03/23/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Pediatric obesity is a global emerging burden for society; among its health-related consequences there are hypertension (HTN) and left ventricular hypertrophy (LVH). Several anthropometric indices have been investigated for the early identification of cardiovascular risk in children. The aim of the present study was to assess whether tri-ponderal mass index (TMI) was associated with LVH in a cohort of Caucasian children and adolescents with obesity. METHODS In this observational study, 63 children and adolescents with obesity aged 7-to-16 years were enrolled. During outpatient visits, adiposity, and cardio-metabolic indices (BMI z-score, WHR, TMI, ABSI) were collected. All subjects underwent a 24-hour ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography. RESULTS Children and adolescents with obesity with LVH had significantly higher BMI z-score (p = 0.009), WHR (p = 0.006) and TMI (p = 0.026) compared to children without LVH. WC and WHR were the only indices significantly associated with left ventricular mass index (LVMI). CONCLUSION Left ventricular remodeling is associated with the cardio-metabolic risk markers WC and WHR, but not with the adiposity index TMI among children with obesity.
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Affiliation(s)
- Sara Vizzuso
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy.
| | | | - Giulia Fiore
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Stefano Carugo
- Department of Internal Medicine, Cardiology Unity, University of Milan, Fondazione Ospedale Maggiore IRCCS Policlinico Milano, Milano, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
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Niazi S, Moshirfar M, Dastjerdi MH, Niazi F, Doroodgar F, Ambrósio R. Association between obesity and age-related cataract: an updated systematic review and dose-response meta-analysis of prospective cohort studies. Front Nutr 2024; 10:1215212. [PMID: 38357464 PMCID: PMC10866009 DOI: 10.3389/fnut.2023.1215212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/26/2023] [Indexed: 02/16/2024] Open
Abstract
Objective There are inconsistent findings on the association between obesity and age-related cataract (ARC). This systematic review was done to summarize available findings on the association between obesity [defined by body mass index (BMI)] and ARC by performing a dose-response meta-analysis on eligible prospective cohort studies. Methods We performed a systematic search in PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until June 2022 to identify eligible publications. Results In total, 16 studies with a total sample size of 1,607,125 participants were included. Among all of these studies, there were 103,897 cases of ARC. In the follow-up periods ranging between 4 and 28 years, 4,870 cases of nuclear cataract, 1,611 cases of cortical cataract, and 1,603 cases of posterior subcapsular cataracts (PSC) were detected. By comparing the highest and lowest categories of BMI, we found that higher BMI was associated with an increased risk of ARC (RR: 1.18, 95% CI: 1.09-1.28) and PSC (RR: 1.44, 95% CI: 1.08-1.90). In the dose-response analysis, each 5 kg/m2 increase in BMI was associated with a 6 and 27% increased risk of ARC (RR: 1.06, 95% CI: 1.01-1.12) and PSC (RR: 1.27, 95% CI: 1.14-1.41), respectively. In addition, we found a positive association for cortical cataract among high-quality studies, in which higher BMI was associated with a 20% increased risk of cortical cataract (RR: 1.20, 95% CI: 1.02-1.42). In terms of nuclear cataract, we found no significant association either in the comparison between the highest and lowest categories of BMI or in the dose-response meta-analysis. Conclusion Obesity (defined by BMI) was associated with an increased risk of ARC, PSC, and cortical cataract in adults. However, such a positive association was not seen for nuclear cataract. PROSPERO registration CRD42022357132.
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Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran, Iran
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Moshirfar
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, United States
| | - Mohammad H. Dastjerdi
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Feizollah Niazi
- Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran, Iran
- Negah Specialty Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Renato Ambrósio
- Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil
- BrAIN: Brazilian Artificial Intelligence Networking in Medicine, Rio de Janeiro, Brazil
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Department of Ophthalmology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Kuciene R, Dulskiene V. Associations between tri-ponderal mass index, body mass index, and high blood pressure among children and adolescents: a cross-sectional study. Sci Rep 2023; 13:18148. [PMID: 37875577 PMCID: PMC10598122 DOI: 10.1038/s41598-023-45432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
High blood pressure (HBP) and obesity are major public health issues globally. The aim of the study was to evaluate the associations between tri-ponderal mass index (TMI) and body mass index (BMI) and HBP and to determine which anthropometric parameters may best predict HBP among Lithuanian children and adolescents aged 7-18 years. This cross-sectional study included 3710 Lithuanian children and adolescents aged 7-18 (52.7% boys and 47.3% girls). Each subject's height, weight, and other anthropometric parameters, as well as blood pressure were measured according to standardized protocols; subsequently, TMI and BMI were calculated. The prevalence of HBP was 27% (the prevalence of elevated BP and hypertension was 13.7% and 13.3%, respectively), significantly higher for boys than for girls. The Pearson correlation coefficients between the BMI z-score and BP were higher than those between the TMI z-score and BP. In both sexes combined, the adjusted odds ratios (aOR) for HBP were increased significantly with increasing quartiles of TMI and BMI as compared to the first quartile (Q1) (Q2: aOR = 1.37 and aOR = 1.69; Q3: aOR = 2.10 and aOR = 2.27; Q4: aOR = 3.95 and aOR = 4.91, respectively). Significant associations also were observed between overweight and obesity (defined according to two methods: age- and sex-specific TMI percentiles and IOTF criteria) among boys and girls separately. BMI presented a higher area under the curve value than TMI for predicting HBP in children and adolescents. The findings of the study suggest that BMI and TMI are significantly associated with HBP. However, BMI is a better predictor for HBP than TMI among Lithuanian children and adolescents aged 7-18 years.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50162, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50162, Kaunas, Lithuania
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Zadarko-Domaradzka M, Sobolewski M, Zadarko E. Comparison of Several Anthropometric Indices Related to Body Fat in Predicting Cardiorespiratory Fitness in School-Aged Children-A Single-Center Cross-Sectional Study. J Clin Med 2023; 12:6226. [PMID: 37834868 PMCID: PMC10573168 DOI: 10.3390/jcm12196226] [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: 09/05/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Body fat (BF) and cardiorespiratory fitness (CRF) are important health markers that ought to be considered in screening exams. The aim of this study was to assess the value of six indicators, i.e., tri-ponderal mass index (TMI), relative fat mass (RFM), waist-BMI ratio, waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and body mass index (BMI) in predicting CRF in school-aged children. The analysis was based on the data coming from the examination of 190 children participating in school physical education (PE) classes. Their body weight (BW) and height (BH), waist and hip circumference (WC; HC) and percentage of body fat (%BF) were measured; the CRF test was performed with the use of the 20 m shuttle run test (20 mSRT); peak heart rate (HRpeak) was measured; TMI, relative fat mass pediatric (RFMp), waist-BMI ratio, WHtR, BMI and WHR were calculated. Statistical analysis was mainly conducted using regression models. The developed regression models, with respect to the sex and age of the children, revealed RFMp as the strongest CRF indicator (R2 = 51.1%) and WHR as well as waist-BMI ratio as the weakest ones (R2 = 39.2% and R2 = 40.5%, respectively). In predicting CRF in school-aged children, RFMp turned out to be comparable to body fat percentage obtained by means of the bioimpedance analysis (BIA) (R2 = 50.3%), and as such it can be used as a simple screening measure in prophylactic exams of school children. All of these models were statistically significant (p < 0.001).
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Affiliation(s)
- Maria Zadarko-Domaradzka
- Institute of Physical Culture Sciences, College of Medical Sciences, Rzeszow University, 35-959 Rzeszow, Poland;
| | - Marek Sobolewski
- Department of Quantitative Methods Rzeszow, University of Technology, 35-959 Rzeszow, Poland;
| | - Emilian Zadarko
- Institute of Physical Culture Sciences, College of Medical Sciences, Rzeszow University, 35-959 Rzeszow, Poland;
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Tabib A, Samiei N, Ghavidel AA, Bakhshandeh H, Noohi F, Hosseini S, Rezaei Y. Reference percentiles for tri-ponderal mass index and its association with general and abdominal obesity among Iranian children and adolescents: A report from the SHED LIGHT study. Am J Hum Biol 2023:e23885. [PMID: 36840415 DOI: 10.1002/ajhb.23885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/18/2023] [Accepted: 02/14/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The body mass index (BMI) has some limitations in identifying obesity, particularly among children and adolescents. OBJECTIVES We sought to determine the reference percentiles of tri-ponderal mass index (TMI) for Iranian population, and its relation to BMI, waist circumference (WC), and waist circumference-to-height ratio (WHtR). METHODS Baseline characteristics for 14 641 children and adolescents were applied. The area under the characteristics (AUC) curve and optimal cut-off points for TMI were used to define the accuracy of TMI for discriminating general and central obesity compared to other anthropometric measurements. RESULTS TMI levels remained stable from 6 to 18 years with a small range of difference. The highest AUCs for discriminating obesity according to BMI and WHtR ≥0.5 from non-obese subjects were related to TMI (0.980) and TMI (0.912), respectively, and these findings were similar for both sexes. Moreover, the AUC for TMI to discriminate central obesity by WHtR was higher than that for BMI (0.912 vs. 0.833, p < .001), and this difference was similar among sex and age groups. The optimal value of TMI for discriminating general obesity, obesity by WC, and obesity by WHtR were 15.2 (sensitivity 96.2 and specificity 89.8), 15 (sensitivity 86.9 and specificity 79.9), and 13.9 (sensitivity 85.1 and specificity 81.5), respectively. CONCLUSIONS TMI discriminated central obesity by WHtR more accurately than obesity by BMI among Iranian children and adolescents irrespective of sex. Besides it remained relatively constant across age- and sex-specific groups providing a single optimal cut-off point for screening obesity during childhood and adolescence.
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Affiliation(s)
- Avisa Tabib
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Samiei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza A Ghavidel
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Bakhshandeh
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Feridoun Noohi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Hosseini
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Rezaei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- Behyan Clinic, Pardis New Town, Tehran, Iran
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