Abdominal obesity as assessed by anthropometric measures associates with urinary incontinence in females: findings from the National Health and Nutrition Examination Survey 2005-2018

BACKGROUND

Urinary incontinence (UI) is significantly link to abdominal obesity. This study aimed to assess the association between anthropometric indices of abdominal obesity, including body roundness index (BRI), conicity index (CI), and waist-to-height ratio (WHtR), and UI risk in adult females.

METHODS

We analyzed data from 10, 317 adult females in the National Health and Nutrition Examination Survey (NHANES) database (2005-2018). Weighted multivariable-adjusted regression analysis was conducted to determine the odds ratio (OR) and 95% confidence intervals (CI) for the association between BRI, CI, WHtR, and UI. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) analyses were used to assess the predictive value of UI.

RESULTS

All indices of abdominal obesity investigated were positively and independently associated with the prevalence and severity of three types of UI. After adjusting for all relevant confounding variables, a significantly positive association between BRI and the prevalence of UI were observed (OR quartile 4 vs. quartile 1: urge UI (UUI): 1.93, 95% CI 1.61-2.30; stress UI (SUI): 2.29, 95% CI 1.94-2.70; mixed UI (MUI): 2.26, 95% CI 1.82-2.82; all P < 0.0001, P for trend < 0.0001, respectively), as well as WHtR and CI, which particularly prominent for female in premenopausal. Moreover, a one-unit increment of BRI was significantly associated with an increased severity index of UUI (β: 0.06, 95% CI 0.04-0.09, P < 0.0001), SUI (β: 0.10, 95% CI 0.07-0.13, P < 0.0001) and MUI (β: 0.07, 95% CI 0.04-0.10, P < 0.0001), which this trend was also observed in each subtype of UI for WHtR and CI. Furthermore, the ROC analysis demonstrated a higher diagnostic efficacy of BRI and WHtR compared with BMI in discriminating UI with an AUC of 0.600 for SUI, 0.617 for UUI, and 0.622 for MUI (all P < 0.05).

CONCLUSIONS

An increased BRI, CI, and WHtR are significantly associated with higher prevalence and severity of UI in females.

Prevalence of associations among sarcopenia, obesity, and metabolic syndrome in Brazilian older adults

Background

Although aging is a process associated with the development of obesity, metabolic syndrome (MetS), and sarcopenia, the prevalence of these conditions in older adults from São Paulo, Brazil, is unclear.

Methods

Therefore, the current study aimed to investigate the prevalence of obesity, sarcopenia, and MetS, both separately and together, in a community-based sample of older adults from São Paulo, Brazil. Data from the medical records of 418 older adults of both genders, aged 60  years or older (mean age 69.3 ± 6.5  years), who were not physically active, were used to conduct this retrospective cross-sectional study. Anthropometric variables were used to determine both body mass index (BMI) and Conicity index (C index). Sarcopenia and MetS were defined according to the criteria of the European Working Group on Sarcopenia in Older People and by the Brazilian Society of Endocrinology and Metabolism, respectively.

Results

Based on BMI, the group of older men (n = 91) showed a predominance of adequate weight (n = 49) and the group of older women (n = 327) showed a predominance of obesity (n = 181). In association with obesity, while only the group of older women presented with sarcopenia (n = 5), 52 older women and 9 older men presented with MetS, and two older women presented with sarcopenia + MetS [prevalence ratio = 0.0385, 95% CI (0.007;0.1924)]. Based on the C index, 58 older women and 11 older men presented with MetS, while the occurrence of sarcopenia or MetS + sarcopenia was found in 32 and 5 older women, respectively [prevalence ratio = 0.0910, 95% CI (0.037;0.2241)].

Discussion

Our results suggest that obesity, as measured by BMI or the C Index, was more closely associated with the occurrence of MetS than sarcopenia, regardless of gender, and also that sarcopenic obesity was only found in the group of older women. Additionally, the prevalence ratio of obesity, sarcopenia, and MetS evidenced using the C index was 2.3 times higher than the values found using the BMI classification.

Cut points of the conicity index as an indicator of abdominal obesity in individuals undergoing hemodialysis: An analysis of latent classes

OBJECTIVES

Abdominal obesity favors the involvement of cardiometabolic complications in renal patients on hemodialysis. Thus, the aim of the study was to identify the cut-points of the conicity index in individuals undergoing hemodialysis.

METHODS

This was a cross-sectional study carried out with 953 individuals undergoing hemodialysis in clinics in a metropolitan region of southeastern Brazil. The conicity index was calculated using the following mathematical equation: waist circumference/0.109 × √weight/height. The receiver operating characteristic (ROC) curve was calculated from the analysis of latent classes by cross-validation through a latent variable of abdominal obesity. This latent variable was defined using the response pattern of the observed anthropometric variables considering the presence and absence of abdominal obesity: waist circumference, waist-to-height ratio, and body shape index. The cut-points identified were elucidated by the area under the curve (AUC), Youden index, sensitivity, and specificity.

RESULTS

The cut-points for the conicity index found for both sexes were similar, resulting in a cut-point for men of 1.275 (AUC, 0.921; Youden index, 0.666), with a sensitivity and specificity of 83% and 83.6%, and a cut-point for women of 1.285 (AUC, 0.921; Youden index, 0.679), with a sensitivity and specificity of 78.6% and 89.3%, respectively.

CONCLUSIONS

The conicity index showed high discriminatory power for the identification of abdominal obesity in hemodialysis patients, therefore it can be a simple and easily accessible tool to be incorporated into clinical practice in this population.

Predictors of central and general obesity in Iranian preschool children: which anthropometric indices can be used as screening tools?

AIM

To compare the ability of anthropometric indices [waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHR), conicity index (CI), body adiposity index (BAI), tri-ponderal mass index (TMI) and body mass index (BMI)] and,measuerments like neck(NC), hip(HC) and waist circumferences to predict overweight and obesity in Iranian preschool children.

MATERIALS AND METHODS

A total of 498 Iranian preschool children were included in this case-control study conducted in Tehran, Iran. The participants were selected using the stratified random sampling procedure based on gender and school. Using sex-based receiver operating curve (ROC) analysis, we compared the area under the curve and defined the cut-off points for detecting central and general obesity for each index in order to identify the most suitable tools in predicting obesity.

RESULTS

Boys had significantly higher values for NC, WC, WHR, NHR, CI, TMI and BMI as compared to girls, whereas BAI and HC were higher in girls. The area under the curve was calculated for all the possible predictors of central obesity, i.e., NC (0.841-0.860), WC (0.70-0.679), HC (0.785-0.697), WHR (0.446-0.639) and CI (0.773-0.653) in boys and girls, respectively. And according to the ROC curve analysis, BMI (0.959-0.948), TMI (0.988-0.981), WHtR (0.667-0.553) and NHR (0.785-0.769) were predictors of general obesity and NC (0.841-0.860) as predictor of central obesity in boys and girls, respectively. The optimal cut-off points for TMI (13.80-15.83), NC (28.68-27.5) and for other anthropometric indices were estimated in both boys and girls.

CONCLUSION

TMI and NC seem to predict general and central obesity in Iranian preschool children.

Association of Conicity Index with Different Cardiovascular Disease Risk Factors among Rural Elderly Women of West Bengal, India

Introduction:

In menopause, changes in body fat distribution lead to increasing risk of cardiovascular and metabolic diseases. Therefore, the prediction of cardiovascular disease (CVD) by the presence of risk factors is of importance in elderly women.

Objective:

To find out the conicity index (CI) and its association with different CVD risk factors among rural elderly women of West Bengal.

Materials and Methods:

The study was conducted among 236 rural elderly women, selected randomly from 30 villages of Amdanga block, West Bengal. Components of metabolic syndrome (MS), body fat percentage, different lipid profile fractions, CI, and body mass index (BMI) were measured. Statistical tests were calculated using SPSS software version 20.0. P ≤ 0.05 was considered statistically significant.

Results:

High CI (median 1.25 and interquartile range 1.05–1.45) was found. The proportion of participants with high CI were significantly higher among those with MS (87.95%), waist circumference having 80 cm or more (99.09%), blood pressure having ≥ 130/85 mm of Hg (75.66%), body fat percentage ≥25% (80.14%), and BMI ≥23 (93.18%).

Conclusion:

High prevalence of CI existed among rural elderly women. Significant correlation existed between CI and different CVD risk factors as well as some of the components of MS indicating a possible coexistence of different CVD risks.

Comparative assessment of anthropometric and bioimpedence methods for determining adiposity

Background

Obesity is a risk factor for different chronic conditions. Over the years, obesity has become a pandemic and it is therefore important that effective diagnostic tools are developed. Obesity is a measure of adiposity and it has become increasingly evident that anthropometric measures such as body mass index (BMI) used to estimate adiposity are inadequate. This study therefore examined the ability of different anthropometric measurements to diagnose obesity within a cross-section of Ghanaian women.

Methods

We obtained anthropometric measurements and used that to generate derived measures of adiposity such as body adiposity index (BAI) and conicity index. Furthermore we also measured adiposity using a bioimpedance analyser. Associations between these measurements and percentage body fat (%BF) were drawn in order to determine the suitability of the various measures to predict obesity. The prevalence of obesity was determined using both %BF and BMI.

Results

BMI, Waist and hip circumference and visceral fat (VF) were positively correlated with % BF whereas skeletal muscle mass was negatively correlated. Prevalence of obesity was 16% and 31.6% using BMI and %BF respectively. Receiver operating characteristic (ROC) analysis showed that these differences in prevalence was due to BMI based misclassification of persons who have obesity as overweight. Similar, shortfalls were observed for the other anthropometric measurements using ROC.

Conclusions

No single measure investigated could adequately predict obesity as an accumulation of fat using current established cut-off points within our study population. Large scale epidemiological studies are therefore needed to define appropriate population based cut-off points if anthropometric measurements are to be employed in diagnosing obesity within a particular population.

Predictive value of early cardiac magnetic resonance imaging functional and geometric indexes for adverse left ventricular remodelling in patients with anterior ST-segment elevation myocardial infarction: A report from the CIRCUS study

BACKGROUND

Postinfarction adverse left ventricular (LV) remodelling is strongly associated with heart failure events. Conicity index, sphericity index and LV global functional index (LVGFI) are new LV remodelling indexes assessed by cardiac magnetic resonance (CMR).

AIM

To assess the predictive value of the new indexes for 1-year adverse LV remodelling in patients with anterior ST-segment elevated myocardial infarction (STEMI).

METHODS

CMR studies were performed in 129 patients with anterior STEMI (58±12 years; 78% men) from the randomized CIRCUS trial (CMR substudy) treated with primary percutaneous coronary intervention and followed for the occurrence of major adverse cardiovascular events (MACE) (death or hospitalization for heart failure). Conicity index, sphericity index, LVGFI, infarct size and microvascular obstruction (MVO) were assessed by CMR performed 5±4 days after coronary reperfusion. Adverse LV remodelling was defined as an increase in LV end-diastolic volume of ≥15% by transthoracic echocardiography at 1 year.

RESULTS

Adverse LV remodelling occurred in 27% of patients at 1 year. Infarct size and MVO were significantly predictive of adverse LV remodelling: odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05 (P<0.001) and OR 1.12, 95% CI 1.05-1.22 (P<0.001), respectively. Among the newly tested indexes, only LVGFI was significantly predictive of adverse LV remodelling (OR 1.10, 95% CI 1.03-1.16; P=0.001). In multivariable analysis, infarct size remained an independent predictor of adverse LV remodelling at 1 year (OR 1.05, 95% CI 1.02-1.08; P<0.001). LVGFI and infarct size were associated with occurrence of MACE: OR 1.21, 95% CI 1.08-1.37 (P<0.001) and OR 1.02, 95% CI 1.00-1.04 (P=0.018), respectively. Conicity and sphericity indexes were not associated with MACE.

CONCLUSIONS

LVGFI was associated with adverse LV remodelling and MACE 1 year after anterior STEMI.

Comparison of abdominal obesity measures in predicting of 10-year cardiovascular risk in an Iranian adult population using ACC/AHA risk model: A population based cross sectional study

BACKGROUND

Several abdominal obesity measures have been used for prediction of 10-year cardiovascular disease (CVD) risk but the superiority of these measures remains controversial. The objective of this study was to assess the predictive ability of abdominal obesity measures for risk of CVD events in an Iranian adult population.

METHODS

We analyzed the data of population based cross-section study of 567 representative samples of adult population aged 40-70 years in Babol, the north of Iran. The demographic data, the anthropometric measures, lipid profile and cardiometabolic risk factors were measured with standard methods. Waist to hip ratio (WHR), waist to height ratio (WHtR), conicity index(CI), abdominal volume index (AVI) and body mass index(BMI)were calculated. The individual 10-year CVD risk was estimated based on ACC/AHA model. ROC analysis was performed to assess the diagnostic ability of different abdominal obesity measures and body mass index (BMI) in predicting of high risk of CVD events.

RESULTS

About 42.5% of men and 15% of women had at least 10% risk of 10-year cardiovascular events and 21.1% of men and 3.0% of women had ≥20% risk. Except WHR for men, all abdominal obesity measures significant predictors for ≥10% risk CVD risk in both sexes but not BMI. The greater ability of CVD risk prediction was observed by WHtR and CI in both sexes with higher AUC in females compared with men for ≥10% risk.

CONCLUSION

WHtR and CI are superior indexes in predicting of high risk of CVD events in both sexes.

Correlation of Adiposity Indices with Electrocardiographic Ventricular Variables and Vascular Stiffness in Young Adults

INTRODUCTION

Excess adiposity constitute an important public health problem because of the associated increased risk of hypertension, coronary heart disease, type 2 diabetes and other disorders. Not only the contribution of general measures of adiposity but also central measures of adiposity have been observed.

AIM

To compare and correlate the central and general adiposity indices with ventricular electrocardiographic variables and vascular stiffness indices in normal, overweight and obese young adults.

MATERIALS AND METHODS

This was a cross-sectional study. Nearly ninety subjects were enrolled and were divided into 30 normal weight, 30 overweight and 30 obese group based on the BMI classification of WHO for Asian population with their age ranging from 18-25 years. Waist and hip circumferences were measured using stretchable tape. Two novel indices-conicity index and abdominal volume index were calculated using standard formula. ECG and pulse wave were recorded using the Physiopac - Medicaid systems. Statistical analysis was done using SPSS version 19.0 software. ANOVA test was done to compare the variables among three groups. Pearson's correlation coefficients were applied to establish the correlations between variables.

RESULTS

In our study Body Mass Index (BMI) and Conicity Index (CI) was significantly and strongly correlated with the ventricular electrocardiographic variables especially with QRS duration, QTc interval and with vascular stiffness indices. These indices can be used to assess the electrocardiographic abnormalities and vascular stiffness status.

CONCLUSION

Excess adipose tissue in young adults was closely linked to ventricular depolarization and repolarization abnormalities and also to increased vascular stiffness. Adiposity indices in particular (BMI, CI) provide a simple and non invasive approach to assess these abnormalities at the earliest in order to prevent future complications.

Association of anthropometric measures with kidney disease progression and mortality: a retrospective cohort study of pre-dialysis chronic kidney disease patients referred to a specialist renal service

BACKGROUND

Although elevated body mass index (BMI) is a predictor of better clinical outcomes in dialysis patients, the evidence in pre-dialysis chronic kidney disease (CKD) is conflicting. Clinical measures of central obesity may be better prognostic indicators, although investigation has been limited. The aim of this study was to assess the predictive value of anthropometric measures for kidney failure progression and mortality in stage 3-4 CKD.

METHODS

The study included newly referred stage 3-4 CKD patients at a single centre between 1/1/2008 and 31/12/2010. The associations between clinical measures of obesity (BMI, waist circumference [WC] and conicity index [ConI]) and time to a composite primary outcome of doubling of serum creatinine, commencement of renal replacement therapy or mortality were evaluated using the Kaplan-Meier method and multivariable Cox regression models.

RESULTS

Over a median follow-up period of 3.3 years, 229 (25.4 %) patients of a total population of 903 experienced the composite primary renal outcome. When compared to normal BMI (18.5-24.9 kg/m(2), n = 174), the risk of the composite primary outcome was significantly lower in both the overweight (BMI 25-29.9 kg/m(2), n = 293; adjusted hazard ratio [HR] 0.50, 95 % CI 0.33-0.75) and obese class I/II groups (BMI 30-39.9 kg/m(2), n = 288; HR 0.62, 95 % CI 0.41-0.93), but not in the obese class III group (BMI ≥40 kg/m(2), n = 72; HR 0.94, 95 % CI 0.52-1.69). All-cause mortality was also lower in the overweight group (HR 0.50, 95 % CI 0.30-0.83). WC and ConI were not associated with either the composite primary outcome or mortality.

CONCLUSION

BMI in the overweight range is associated with reduced risks of kidney disease progression and all-cause mortality in stage 3-4 CKD. WC and ConI were not independent predictors of these outcomes in this population.

Comparing the Physiological, Socio-economic and Nutritional Status among Male and Female Undergraduate College Students of Metropolitan City of Kolkata

BACKGROUND

In the present days, increasing trend of eating disorders are noticed among college students (both male and female) which can disturb their overall physiological and health status. It is more prevalent in metropolitan cities, like Kolkata. But, the existing literature about the physiological and nutritional status of the undergraduate college students of Kolkata is insufficient.

AIM

Thus, the objective of this small-scale cross-sectional study is to report and compare the prevalence of malnutrition (both obesity and undernutrition) among undergraduate male and female college students of Kolkata, based on body mass index (BMI) and some direct and derived anthropometric measures describing the body composition of the subjects.

SUBJECTS AND METHODS

This cross-sectional study conducted in October-December 2011. The present investigation was carried out in randomly selected male (mean age 20.9 [2.25]) and female college students (mean age 20.3 [2.34]) of Kolkata. A total of 100 students of different colleges has participated, having the age of 18-22 years. Measures included a total of 24 variables which included thirteen direct anthropometric measures and 11 derived variables.

RESULTS

Analysis of collected data showed significantly higher BMI, fat mass, body adiposity index, but, lower waist-to-hip ratio, conicity index in female students. Anthropometric data also showed lower waist circumference and abdominal extension in female college students. Conversely, male students showed a higher fat free mass (FFM), mid-upper arm circumference (MUAC) and thigh circumferences (TCs).

CONCLUSION

Based on the findings of the present study, it can be reported that higher body fat distribution and increased propensity of being overweight/obese was observed in female students, though they have shown lower abdominal fat distribution, which is a cue of female physical attractiveness. However, male students are found to have a higher FFM, MUAC and TCs, which is the indicator of strength and energy.

Screening obesity by direct and derived anthropometric indices with evaluation of physical efficiency among female college students of kolkata

BACKGROUND

The available information regarding the obesity pattern of the undergraduate female students of Kolkata is inadequate, though there are several reports which indicate the complications and/or awful consequences of obesity on female health particularly, during the reproductive years.

AIM

The present investigation has thus been carried out to report their present physiological status along with the prevalence of obesity, based on their body mass index (BMI), some direct and derived anthropometric indices, and physical fitness.

SUBJECTS AND METHODS

This small-scale cross-sectional study conducted in randomly selected 100 female students of different colleges of Kolkata with the age of 18-22 [mean age 20.4 (2.3)] years. Measurements of body composition included total 24 variables, with thirteen direct and eleven derived anthropometric variables; while physical efficiency parameters were physical fitness index, VO2max, energy expenditure and anaerobic power. The data of the experimental group were compared with those of the control group by t-test, using SPSS v.15.0 and MS-Excel v.2013.

RESULTS

Analysis of collected data showed majority of the students have normal range of BMI (67.95%), but, 21.95% of students found to be overweight and 3.84% are obese. They also showed higher fat mass [14.40 (4.11)], but, lower waist-to-hip ratio and conicity index. They were found to have poor to moderate physical fitness [57.60 (3.90)] and higher energy expenditure [5.61 (0.72)].

CONCLUSION

The findings of the present obesity screening reports almost one of four female students (24 out of 100 participants) are overweight/obese, indicated higher body fat distribution and increased propensity of being obese with age. Thus, the overall data along with their low physical fitness points out to health risks among female undergraduates of Kolkata.

The impact of different anthropometric measures on sustained normotension, white coat hypertension, masked hypertension, and sustained hypertension in patients with type 2 diabetes

BACKGROUND

Many studies have aimed to determine whether body mass index (BMI), waist circumference (WC), or waist to hip ratio (WHR) best predicts hypertension in diabetic patients, with conflicting results. However, no study has examined the specific relationship between these anthropometric parameters with sustained normotension (SNT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT) based on office and ambulatory blood pressure (BP) measurements in these patients.

METHODS

Patients with newly diagnosed type 2 diabetes underwent the following procedures: history taking, measurements of anthropometric parameters, office and ambulatory BP measurements, physical examination, laboratory analysis, and random and 24-hour urine analysis.

RESULTS

In total, there were 65 dippers and 37 nondipper patients. None of the anthropometric parameters were different between the dippers and the nondippers. There were 25 patients with SNT, 32 with WCHT, seven with MHT, and 38 with SHT. A comparison of anthropometric parameters between these four groups of patients showed that WC (P=0.016) and WHR (P=0.015) were different among all groups. According to regression analysis, only BMI was independently related with MHT (odds ratio [OR], 1.373, P=0.022), whereas only WC has been associated with SHT (OR, 1.321, P=0.041).

CONCLUSION

Among anthropometric parameters, only WC and WHR were different in SNT, WCHT, MHT, and SHT in newly diagnosed patients with type 2 diabetes.