Relationship between body composition parameters and metabolic syndrome in young Thai adults

Value of Adding Bioelectrical Impedance Analysis to Anthropometric Indices in the Diagnosis of Metabolic Syndrome in 10–16 Years Old Schoolgirls

The use of bioelectrical impedance analysis (BIA) in clinical settings is common. However, the value of BIA-based parameters in diagnosing metabolic syndrome (MetS) in children is under-investigated. Herein, we aimed to study the usefulness of BIA-indices in the diagnoses of MetS in 6–10-year-old girls. Therefore, a diagnostic accuracy case-control study was conducted, which included 75 girls aged 10–16 years, divided into three age-matched groups (normal, None-MetS, and MetS). Anthropometric indices, BIA parameters (including fat-free mass (FFM), body fat percent (BFP), and total body water (TBW)), blood pressure (BP), and blood samples were collected. Our main findings show that for girls in None-MetS and MetS groups, the waist circumference (WC) correlated positively with waist-hip ratio and mid-arm circumference (r = 0.58, 0.47, respectively), but not with BFP based on skinfold thickness (SFT), or mid-arm muscle area. WC was positively correlated with FFM and TBW, while high-density lipoprotein was inversely correlated with FFM. However, fasting blood glucose, triglycerides and BP showed no association with anthropometric measurements and BIA components. WC was the best indicator of MetS (AUC = 0.88, cut-off = 81.5 cm), followed by BMI (AUC = 0.84, cut-off = 26.9 kg/m²), while BFP based on SFT was the least sensitive (62.5%). In conclusion, apart from the FM index, anthropometric parameters such as WC are more valuable in diagnosing MetS in young adolescent girls.

Metabolic syndrome, biochemical markers, and body composition in youth living with perinatal HIV infection on antiretroviral treatment

People living with HIV who are on antiretroviral treatment are at increased risk of developing premature cardiovascular disease. Children with perinatal HIV infection (PHIV) have survived through their adolescence and are entering adulthood. We determined the prevalence of metabolic syndrome, abnormal biochemical markers, and characterized body composition parameters in youth living with perinatal HIV infection. This cross-sectional study was conducted at the Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand from December 2017 to February 2018. PHIV-youths between 15 <25 years of age who were receiving ART were enrolled. Data collection included ART-related history, blood pressure, and anthropometric measurements. Body composition including android, gynoid fat mass, and total body fat were measured by dual-energy X-ray absorptiometry. Fasting blood was drawn to test for lipid profile, glucose, and high sensitivity c-reactive protein (hsCRP). One hundred and twenty PHIV-youths (48% female) were enrolled. Their mean age and the median duration on ART were 20.3 (SD2.6) and 14.1 (IQR 10.4–14.9) years, respectively; 76 (63%) were on first-line non-nucleoside reverse transcriptase inhibitors-based regimens. Thirty-three (28%), 74 (62%), and 13 (11%) of PHIV-youths were underweight (BMI < 18.5 kg/m²), normal (BMI 18.5–24.9 kg/m²), and overweight (BMI ≥ 25.0 kg/m²), respectively. The prevalence of metabolic syndrome was 10.6% (95%CI 5.0–16.0). Seventy-six of 113 (67.3%) of PHIV-youths had lipid alteration; the most prevalent types being low HDL (46.9%) and increased triglycerides (27.4%). Overall 43 (35.9%) had increased hsCRP (16.7% with immediate and 19.2% with high risk for CVD). Females had significantly higher percentage of android and gynoid fat, but lower Android to gynoid ratio (AGR) compared to males. There were 77%, 31%, and 21% of PHIV-youths in the overweight, normal weight, and underweight group with AGR in tertile 3, respectively. In conclusion, we documented presence of metabolic syndrome in 10.6% of PHIV-youths on ART. Increase AGR representing abdominal obesity was detected even in youths with normal BMI or underweight.

Fat distribution may predict intra- or extra-capsular hip fracture in geriatric patients after falling

INTRODUCTION

Hip fractures can be divided into intra-capsular and extra-capsular fracture based on fracture location; these two types of fracture have different pathogeneses, treatments and prognoses. Many factors influence the patterns of hip fractures, including the injury mechanism, areal bone mineral density and the geometry of the hip. However, the relationship between body composition and hip fracture pattern has not yet been discussed. In this investigation, an analysis of the body compositions of geriatric patients with hip fractures were conducted to identify differences between fat and muscle distributions between patients with intra- and extra-capsular hip fractures.

MATERIAL AND METHODS

From December 2017 to February 2019, 139 patients with a hip fracture were prospectively enrolled in this study. The groups of patients that were diagnosed as having intra- and extra-capsular hip fractures were compared in terms of patient demographics, pre-operative laboratory data, bone mineral density (BMD) and body composition including muscle and fat distributions obtained using dual-energy X-ray absorptiometry (DXA) .

RESULTS

Eighty-six and 53 patients were diagnosed with intra-capsular and extra-capsular hip fractures, respectively. A significantly higher serum glucose level, a lower hemoglobin level, a lower T-score level in the proximal femur region, a lower T-score of all parts of interest, and a lower percentage fat content on the region of bilateral proximal hips (gynoid region) and in the lower limb region, were observed in patients with an extra-capsular hip fracture than in those with an intra-capsular hip fracture. However, with all confounding factors controlled for, only the T-score at the proximal femur, percentage fat content in the region of bilateral proximal hips and the ratio of android fat content to gynoid fat content (A/G ratio) are the most relevant factors in predicting the patterns of hip fracture in geriatric patients after falling.

CONCLUSION

This work demonstrates that lower fat content in the region of bilateral proximal hips and a lower BMD on the proximal femur may predict greater vulnerability of geriatric patients to extra-capsular rather than intra-capsular hip fracture after a falling accident.

Dietary Patterns, Exercise, and the Metabolic Syndrome Among Young People in Urban Pakistan (Lahore)

Background: Increasing urbanization, mechanization, and rural-to-urban migration has led to deranged sleeping patterns, surplus energy intake, and sedentary lifestyles in South Asian young people. This shift poses an insidious health risk for the development of metabolic syndrome (MetS). Early detection is needed because in the South Asian population, this syndrome carries an increased risk of comorbidities compared to people without the syndrome. This study was designed to elucidate the prevalence of MetS and its risk factors in young people in urban areas of Pakistan. Methods: A cross-sectional study was conducted in four undergraduate institutions in Lahore, Pakistan. Five hundred and nine young people participated, and each provided their informed consent for the collection of data on their demographic, physical, and biochemical characteristics along with information on their dietary, sleep, and physical activity habits. Results: Most participants reported consuming greater-than-recommended amounts of protein and smaller-than-recommended amounts of vegetables and fruits. The International Diabetes Federation criteria for MetS were fulfilled by 6.1% of the students. Hypertension (67.7%) and hypo-HDL-emia (64.5%) were the most common risk factors. More than 50% of the respondents slept fewer hours per day than recommended, and 33% had a sedentary lifestyle. Men, participants with a family history of metabolic illness and those with low physical activity levels had higher odds of a positive result on screening for MetS. Conclusions: The early detection of MetS and early identification of probable risk factors may make beneficial contributions to both public health and clinical interventions directed at high-risk individuals. Establishing and using cutoff values for modified waist circumference and specific body mass index in Asian populations may aid in early detection.

Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents

OBJECTIVE

To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents.

SUBJECTS AND METHODS

Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement.

RESULTS

The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%).

CONCLUSIONS

Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.

Associations of Platelet Indices with Body Fat Mass and Fat Distribution

OBJECTIVE

This study was undertaken to investigate the associations of platelet indices with body fat, including body fat mass and fat distribution.

METHODS

A total of 3,327 individuals aged 18 to 80 were enrolled. Body fat was assessed by dual-energy x-ray absorptiometry. Blood samples were collected to measure platelet indices (platelet count [PLT], plateletcrit [PCT], mean platelet volume, platelet distribution width, and platelet large cell ratio). Adjusted multivariate linear regression models were used to identify the associations of platelet indices with body fat.

RESULTS

PLT was positively associated with BMI, waist circumference, waist-hip ratio, total fat mass percentage, trunk fat mass percentage, android fat mass percentage, and android to gynoid fat ratio but negatively associated with gynoid fat mass percentage, total lean mass percentage, and skeletal muscle mass index. Similar associations were found between PCT and body fat. However, no significant associations were found between the other three platelet indices and body fat.

CONCLUSIONS

Both PLT and PCT were associated with body fat, and the associations depended on fat location. Because PCT is mainly influenced by PLT, these associations suggest that platelet quantity is more closely related to body fat mass and fat distribution.

Android fat as a determinant of metabolic syndrome: Sex differences

OBJECTIVES

Regional fat accumulation may play an important role in the pathogenesis of metabolic syndrome (MetS) and cardiovascular diseases, yet the results are controversial. The aim of this study was to determine the relationship between regional fat accumulation and MetS as well as the underlying mechanism in Chinese adults.

METHODS

We conducted a cross-sectional study of 428 Chinese adults (166 men and 262 women). Android and gynoid fat percentage (AFP and GFP) were measured by dual energy x-ray absorptiometry. Fasting lipid parameters were analyzed by chemistry analyzer COBAS.

RESULTS

Forty-six (28%) men and 34 (13%) women had MetS according to the modified National Cholesterol Education Panel Adult Treatment Panel III definition for South Asia. AFP was strongly correlated with more metabolic risk factors than GFP in men. In women, AFP and GFP showed significant opposite effects on triacylglycerol, high-density lipoprotein cholesterol, and waist circumference. On multivariate regression, AFP was an independent determinant of MetS in men after adjustment for confounding factors. For women, both AFP and the homeostatic model assessment for insulin resistance were predictors for MetS.

CONCLUSIONS

Increased android fat may play a direct role in the development of MetS in Chinese adults. However, the associations between android fat, insulin resistance, and MetS are sex-dependent. This is probably due to different effects of sex hormones on adipose tissue or by genetic factors between sexes. Knowing the sex differences in developing MetS may help design sex-specific preventive strategies that will benefit the overall population health.

Comparison of waist to height ratio and body indices for prediction of metabolic disturbances in the Korean population: the Korean National Health and Nutrition Examination Survey 2008-2011

BACKGROUND

The aim of the present study of the general population was to identify the best predictor of metabolic risk among the body index variables evaluated with dual-energy X-ray absorptiometry (DEXA) or anthropometric indices including the waist to height ratio (WHtR).

PATIENTS AND METHODS

Data from the Korean National Health and Nutrition Examination Survey 2008-2011 were used for the analyses. As a result, 15,965 participants were included in this study. The body mass (BM) index was calculated as the body weight divided by the height squared. The WHtR was calculated as the waist circumference divided by height. Body composition indices such as lean mass (LM), fat mass (FM), trunk fat mass (TFM), and bone mineral content (BMC) were determined by using DEXA. Skeletal muscle mass (SM) was defined as the sum of the lean soft masses of both extremities. The LM, FM, BMC, TFM, and SM indices were calculated by dividing the total LM, total FM, total BMC, TFM, or SM by the height squared.

RESULTS

The WHtR had the highest area under the curve (AUC) and was the best predictor of metabolic syndrome for both sexes. In addition, the WHtR had the highest AUCs for components of metabolic syndrome (male: AUC 0.823, 95 % confidence interval [CI] 0.814-0.832; female: AUC 0.870, 95 % CI 0.863-0.877). There was a small statistically significant difference in AUC between WHtR and the other indices. Multivariate logistic regression showed that male participants in the second, third, and fourth quartiles had a 4.0 (95 % CI, 3.1-5.2), 9.6 (95 % CI, 7.5-12.3), and 36.1 (95 % CI, 28.0-46.4) times increased risk of metabolic syndrome compared with patients in the first quartile and female participants in the second, third, and fourth quartiles had a 4.3 (95 % CI, 3.1-6.0), 18.0 (95 % CI, 13.3-24.5), and 58.5 (95 % CI, 42.9-79.9) times increased risk of metabolic syndrome compared with patients in the first quartile.

CONCLUSION

Among the BM, FM, LM, SM, TFM, and WHtR indices, WHtR is most useful to predict the presence of metabolic syndrome and insulin resistance in the Korean population.