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Luo H, Liu Y, Tian X, Zhao Y, Liu L, Zhao Z, Luo L, Zhang Y, Jiang X, Liu Y, Luo Y, Wang A. Association of obesity with cardiovascular disease in the absence of traditional risk factors. Int J Obes (Lond) 2024; 48:263-270. [PMID: 37938287 DOI: 10.1038/s41366-023-01408-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The association between obesity and cardiovascular disease (CVD) in people without traditional CVD risk factors is unclear. This study aimed to investigate the association of obesity with CVD and its subtypes in people without traditional CVD risk factors. METHODS Based on the Kailuan cohort study, the included participants were divided into different groups according to levels of body mass index (BMI) and waist height ratio (WHtR), respectively. Multivariate Cox proportional hazard models were used to evaluate the associations. RESULTS This study included 31,955 participants [men 63.99%; mean age (48.14 ± 3.33) years]. During a median follow-up period of 12.97 (interquartile range: 12.68-13.17) years, 1298 cases of CVD were observed. Compared with the normal BMI group, the hazard ratios (HRs) for CVD, stroke, and myocardial infarction (MI) in the BMI obese group were 1.31 (95% confidence interval [CI] 1.11-1.55), 1.21 (95%CI 1.01-1.46), 1.62 (95%CI 1.13-2.33), respectively. Compared with the WHtR non-obese group, the HRs for CVD, stroke, and MI in the obese group were 1.25(95%CI 1.11-1.41), 1.18 (95%CI 1.03-1.34), 1.57 (95%CI 1.18-2.09), respectively. There was an interaction between age and WHtR (P for interaction was 0.043). The association between WHtR and CVD was stronger in people under 60 years old, with a HR of 1.44 (95%CI 1.24-1.67). CONCLUSION We found that obesity increased the risk of CVD in people without traditional CVD risk factors. The association of WHtR with CVD was stronger in people under 60 years old.
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Affiliation(s)
- Hui Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yesong Liu
- Department of Neurology, Kailuan General Hospital, Tangshan, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yuhan Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lulu Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zemeng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lili Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yanmin Zhang
- Digestive Department, Tangshan Central Hospital, Tangshan, China
| | - Xiaozhong Jiang
- Digestive Department, Kailuan General Hospital, Tangshan, China
| | - Yeqiang Liu
- Department of Endocrinology, Tangshan Central Hospital, Tangshan, China.
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China.
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Sekgala MD, Sewpaul R, Opperman M, Mchiza ZJ. Comparison of the Ability of Anthropometric Indices to Predict the Risk of Diabetes Mellitus in South African Males: SANHANES-1. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063224. [PMID: 35328910 PMCID: PMC8949079 DOI: 10.3390/ijerph19063224] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/29/2022]
Abstract
This study aimed to assess the sensitivity of body mass index (BMI) to predict the risk of diabetes mellitus (DM) and whether waist circumference (WC), waist-to-hip (WHR) and waist-to-height (WHtR) ratios are better predictors of the risk of DM than BMI in South African men aged 20 years and older. Data from the first South African National Health and Nutrition Examination Survey (SANHANES-1) were used. Overall, 1405 men who had valid HbA1c outcomes were included. The sensitivity, specificity, and optimal cut-off points for predicting DM were determined using the receiver operating characteristic (ROC) curve analysis. A total of 34.6% percent of the study participants were overweight/obese, while 10.5%, 10.4%, 36.6% and 61.0% had HbA1c, WC, WHR and WHtR above the normal reference ranges, respectively. Based on age-adjusted logistic regression analysis, the highest likelihood of DM was observed for those participants who had increased WC and WHtR (odds ratios [OR] were 6.285 (95% CI: 4.136−9.550; p < 0.001) and 8.108 (95% CI: 3.721−17.667; p < 0.001)). The ROC curve analyses for WC, WHR, and WHtR displayed excellent ability to predict the risk of DM, with their areas under the curve (AUC) being 80.4%, 80.2% and 80.8%, respectively. The overall cut-off points to predict the risk of DM for WC, WHR, and WHtR were ≥88.95 cm, ≥0.92, and >0.54, respectively. The ROC analysis for BMI, on the other hand, showed acceptable ability to predict the risk of DM (AUC = 75.6%), with its cut-off point being ≥24.64 kg/m2. Even after stratifying the data by two age groups, WHtR remained a superior index to predict DM, especially in the younger age group. To conclude, no significant differences were observed between the AUC for BMI the AUCs for other indices. However, the AUCs for these indices showed significant excellent ability as opposed to the significant acceptable ability of BMI to predict DM in adult South African men.
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Affiliation(s)
- Machoene D. Sekgala
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa;
- Human and Social Capabilities, Human Sciences Research Council, Cape Town 8000, South Africa;
- Correspondence: ; Tel.: +27-21-466-8058
| | - Ronel Sewpaul
- Human and Social Capabilities, Human Sciences Research Council, Cape Town 8000, South Africa;
| | - Maretha Opperman
- Department of Biotechnology and Consumer Science, Cape Peninsula University of Technology, Cape Town 7535, South Africa;
| | - Zandile J. Mchiza
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa;
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
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