Sex Difference in the Associations among Obesity-Related Indices with Hyperuricemia in a Large Taiwanese Population Study

Hyperuricemia has been linked with the development of diabetes, gout, kidney, and cardiovascular diseases. Although obesity is associated with hyperuricemia, data on sex differences in this association are scarce. Therefore, this study was conducted to explore sex differences in the correlations among various indices of obesity with hyperuricemia in Taiwan. Data were obtained from the Taiwan Biobank and included 122,067 participants. After excluding 179 participants with missing data, the remaining 121,888 participants (men: 43,790; women: 78,098) were enrolled. The prevalence rates of hyperuricemia (defined as serum uric acid >7.0/6.0 mg/dL in men/women) were 29.8% and 13.6%, respectively (p < 0.001). Multivariable analysis revealed high values of body shape index (ABSI), waist-to-height ratio (WHtR), waist-hip ratio (WHR), lipid accumulation product (LAP), conicity index (CI), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), body mass index (BMI), and body roundness index (BRI) were significantly associated with hyperuricemia in both the male and female participants (all p < 0.001). The interactions between sex and all 10 of these indices were significant (all p < 0.001) for hyperuricemia. In men, LAP had the highest area under the curve (0.669), followed by BMI (0.655), VAI (0.645), AVI (0.642), BRI (0.640), WHtR (0.633), BAI (0.605), WHR (0.599), CI (0.574), and ABSI (0.510). In women, LAP also had the highest area under the curve (0.754), followed by BMI (0.728), VAI (0.724), WHtR (0.721), BRI (0.720), AVI (0.713), WHR (0.676), BAI (0.673), CI (0.626), and ABSI (0.544). In conclusion, obesity-related indices were associated with hyperuricemia in this large Taiwanese study, and sex differences were found in these associations, with stronger associations in women than in men.

Associations of obesity-related indices with prediabetes regression to normoglycemia among Chinese middle-aged and older adults: a prospective study

Background

Prediabetes is associated with increased cardiovascular risk and all-cause mortality, while its regression will decrease the risks. This study investigated the associations of six obesity-related indices (waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CI), body shape index (ABSI), Chinese visceral adiposity index (CVAI), and triglyceride glucose (TyG) index) with prediabetes regression based on the China Health and Retirement Longitudinal Study (CHARLS), enrolling middle-aged and older adults.

Methods

We included 2,601 participants with prediabetes from CHARLS, who were followed up from 2011-2012 to 2015-2016, with blood samples collected for measuring fasting plasma glucose and hemoglobin A1c. All the obesity-related indices at baseline and their dynamic changes were calculated and categorized into tertiles. Logistic regression analysis was applied to obtain the odds ratio (OR) and 95% confidence intervals (CIs). Attributable fractions (AFs) and 95% CIs of these indices and the dynamic changes were calculated with the AF package in R software, and the cutoff values of initial obesity-related indices were obtained by the receiver operating characteristic (ROC) analysis.

Results

During the 4-year follow-up period, 562 (21.61%) participants regressed from prediabetes to normoglycemia. They had lower initial BRI, WHtR, CI, ABSI, CVAI, and TyG than those who did not (P < 0.05). After multivariable adjustment, participants in the first tertile of initial BRI (OR, 1.45, 95%CIs, 1.09-1.93), WHtR (OR, 1.46, 95%CIs, 1.10-1.95), and CVAI (OR, 1.47, 95%CIs, 1.11-1.93) had increased odds of prediabetes regression compared with those in the highest tertile. Participants with decreased TyG (OR, 2.08; 95%CIs, 1.61-2.70) also had increased odds of prediabetes regression compared with those with increased TyG. The cutoff values of initial obesity-related indices were 4.374 for BRI, 0.568 for WHtR, 8.621 for TyG, 1.320 for CI, 0.083 for ABSI, and 106.152 for CVAI, respectively. The AFs were 21.10% for BRI < 4.374, 20.85% for WHtR < 0.568, 17.48% for CVAI < 107.794, and 17.55% for ΔTyG < 0, respectively.

Conclusion

Low initial BRI, WHtR, and CVAI, as well as TyG reduction, were significantly related to prediabetes regression to normoglycemia, and the AFs were around 20%. Less abdominal fat and insulin resistance reduction would benefit future health outcomes among people with prediabetes.

Low Obesity-Related Indices Are Associated with a Low Baseline Calcaneus Ultrasound T-Score, and a Rapid Decline in T-Score in a Large Taiwanese Population Follow-Up Study

Osteoporosis results in reduced bone strength and an elevated risk of fractures. Both overweight and underweight have been associated with osteoporosis; however, few studies have examined associations between osteoporosis and indices related to obesity. Therefore, the aim of this study was to investigate the associations of obesity-related indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), body adiposity index (BAI), abdominal volume index (AVI), lipid accumulation product (LAP), and visceral adiposity index (VAI), with baseline and change in calcaneus ultrasound T-score between baseline and follow-up (ΔT-score). T-score was measured using ultrasound. A total of 26,983 subjects were enrolled (mean age 51.2 ± 10.4 years). Multivariable analysis showed significant associations between low BMI (per 1 kg/m²; β, 0.065), WHR (per 1%; β, 0.012), WHtR (per 1%; β, 0.024), BRI (per 1; β, 0.079), BAI (per 1; β, 0.032), AVI (per 1; β, 0.049), and LAP (per 1; β, 0.005) with low baseline T-scores (all p < 0.001). Furthermore, there were significant associations between low BMI (per 1 kg/m²; β, 0.005; p = 0.036), BAI (per 1; β, 0.010; p < 0.001), and VAI (per 1; β, 0.017; p = 0.002) with low ΔT-scores. A low baseline T-score was significantly associated with low values of LAP, AVI, BAI, BMI, BRI, WHR, and WHtR but not VAI. In addition, low BMI, BAI, and VAI were significantly associated with low ΔT-scores, representing a rapidly decreasing T-score. Consequently, avoiding being underweight may help prevent osteoporosis in the Taiwanese population.

Metabolic Syndrome and Obesity-Related Indices Are Associated with Rapid Renal Function Decline in a Large Taiwanese Population Follow-Up Study

A rapid decline in renal function can cause many complications, and therefore it is important to detect associated risk factors. Few studies have evaluated the associations among obesity-related indices and metabolic syndrome (MetS) with renal function decline. This longitudinal study aimed to explore these relationships in a large cohort of Taiwanese participants. The studied obesity-related indices were waist-to-height ratio (WHtR), A body shape index (ABSI), visceral adiposity index (VAI), lipid accumulation product (LAP), waist-to-hip ratio (WHR), body roundness index (BRI), conicity index (CI), body mass index (BMI), body adiposity index (BAI) and abdominal volume index (AVI). We included 122,068 participants in the baseline study, of whom 27,033 were followed for a median of four years. The baseline prevalence of MetS was 17.7%. Multivariable analysis showed that the participants with MetS and high VAI, WHtR, WHR, LAP, CI, BRI, BMI, BAI, AVI, and ABSI values were significantly associated with a high baseline estimated glomerular filtration rate (eGFR) (all p < 0.001). In addition, the participants with MetS (p < 0.001), high WHtR (p = 0.007), low LAP (p < 0.001), high BRI (p = 0.002), high CI (p = 0.002), high AVI (p = 0.001), high VAI (p = 0.017), and high ABSI (p = 0.013) were significantly associated with a low △eGFR, indicating a rapid decline in renal function. These results showed associations between MetS and high values of obesity-related indices except LAP with high baseline eGFR and rapid decline in kidney function. These findings suggest that screening for MetS and obesity may help to slow the decline in renal function in high-risk populations.

Metabolic Syndrome and High-Obesity-Related Indices Are Associated with Poor Cognitive Function in a Large Taiwanese Population Study Older than 60 Years

Metabolic syndrome (MetS) is prevalent in Taiwan; however, the association between MetS and cognitive function is unclear. The aim of this study was to explore the associations between MetS, its components, and obesity-related indices with cognitive function in a large Taiwanese cohort. We enrolled a total of 28,486 participants who completed the Mini-Mental State Examination (MMSE) questionnaire, which was used to evaluate cognitive function. MetS was defined according to the NCEP-ATP III guidelines and modified criteria for Asians. Ten obesity-related indices were also evaluated: body mass index (BMI), abdominal volume index (AVI), body adiposity index (BAI), waist−hip ratio (WHR), a body shape index (ABSI), lipid accumulation product, waist-to-height ratio (WHtR), conicity index (CI), body roundness index (BRI), and triglyceride glucose index. The prevalence of MetS and its components (except for hypertriglyceridemia) and the number of MetS components increased while the cognitive impairment worsened (from MMSE ≥ 24, 18−23 to 0−17). In addition, increases in all obesity-related index values were associated with a decline in cognitive function (from MMSE ≥ 24, 18−23 to 0−17, ANOVA p < 0.001). Multivariable analysis showed that MetS (p = 0.002), abdominal obesity (p < 0.001), low high-density lipoprotein cholesterol (p = 0.004), and hyperglycemia (p = 0.012) were significantly associated with a low MMSE score. Further, participants with high BMI (p = 0.001), WHR (p < 0.001), WHtR (p < 0.001), BRI (p < 0.001), CI (p < 0.001), BAI (p < 0.001), AVI (p < 0.001), and ABSI (p < 0.001) values were significantly associated with a low MMSE score. Our results show that MetS and its components (except for hypertriglyceridemia and high blood pressure) may lead to cognitive impairment, and that high values of obesity-related indices were associated with poor cognitive function.

Sex Difference in the Associations among Obesity-Related Indices with Metabolic Syndrome in Patients with Type 2 Diabetes Mellitus

Background: The aim of this study was to investigate the associations among obesity-related indices and MetS in diabetic patients, and explore sex differences in these associations. Methods: Patients with type 2 DM were included from two hospitals in southern Taiwan. The Adult Treatment Panel III criteria for an Asian population were used to define MetS. In addition, the following obesity-related indices were evaluated: waist-to-height ratio, waist-hip ratio (WHR), conicity index (CI), body mass index (BMI), body roundness index, body adiposity index, lipid accumulation product (LAP), abdominal volume index, visceral adiposity index (VAI), abdominal volume index and triglyceride-glucose index. Results: A total of 1,872 patients with type 2 DM (mean age 64.0 ± 11.3 years, 808 males and 1,064 females) were enrolled. The prevalence rates of MetS were 59.8% and 76.4% in the males and female (p < 0.001), respectively. All of the obesity-related indices were associated with MetS in both sex (all p < 0.001). LAP and BMI had the greatest areas under the receiver operating characteristic curves in both sex. In addition, the interactions between BMI and sex (p = 0.036), WHR and sex (p = 0.016), and CI and sex (p = 0.026) on MetS were statistically significant. Conclusions: In conclusion, this study demonstrated significant relationships between obesity-related indices and MetS among patients with type 2 DM. LAP and VAI were powerful predictors in both sex. The associations of BMI, WHR and CI on MetS were more significant in the men than in the women.