Objective: This review examines the evolution of obesity evaluation methods, from traditional anthropometric indices to advanced imaging techniques, focusing on their clinical utility, limitations, and potential for personalized assessment of visceral adiposity and associated metabolic risks.

Methods: A comprehensive analysis of existing literature was conducted, encompassing anthropometric indices (BMI, WC, WHR, WHtR, NC), lipid-related metrics (LAP, VAI, CVAI, mBMI), and imaging technologies (3D scanning, BIA, ultrasound, DXA, CT, MRI). The study highlights the biological roles of white, brown, and beige adipocytes, emphasizing visceral adipose tissue (VAT) as a critical mediator of metabolic diseases.

Conclusion: Although BMI and other anthropometric measurements are still included in the guidelines, indicators that incorporate lipid metabolism information can more accurately reflect the relationship between metabolic diseases and visceral obesity. At the same time, the use of more modern medical equipment, such as ultrasound, X-rays, and CT scans, allows for a more intuitive assessment of the extent of visceral obesity.

Testosterone levels are closely associated with visceral obesity, insulin resistance, and lipid metabolism. The objective of this study was to investigate the associations among eight indicators related to visceral obesity, insulin resistance, lipid metabolism, and testosterone levels.

The data were obtained from a cross-sectional survey based on National Health and Nutrition Examination Survey (NHANES) 2013-2016. Logistic and linear regression were employed to assess the associations between these inicators and testosterone levels. Simultaneously, the receiver operating characteristic (ROC) curve was utilized to evaluate their predictive capacity for testosterone deficiency (TD).

Data from a collective of 1514 individuals selected from NHANES were analyzed. After adjusting all potential confounders, a tight association was identified between these eight indexes and TD. The ROC curve analysis showed that the triglyceride-glucose waist-to-height ratio (TyG-WHtR)is the best predictor of testosterone deficiency (AUC: 0.7760, 95%CI: 0.7460-0.8060), with a cut-off value of 5.375. Further analyses indicated that participants with higher TyG-WHtR index exhibitrd a lower total testosterone level(β: -79.36,95%CI: -105.90, -52.82). Additionally, males in TyG-WHtR index tertile 3 had a higher risk of TD (OR: 6.61, 95%CI: 2.90,15.07), and lower total testosterone levels (β: -121.9, 95%CI: -186.82, -56.98). All the results remained stable in the subgroup analyses stratified by diabetes and hypertension.

We found that these indexses are tightly associated with testosterone levels in U.S. adult men. Moreover, the TyG-WHtR index demonstrates the most effective predictive performance in the population. However, more well-designed studies are still needed to validate their association.

Insulin resistance in adipose tissue causes dysregulation of various adipokine levels and ectopic fat accumulation in other organs, such as the liver. This study investigated the effects of insulin resistance in adipose tissue and concomitant fatty liver on each stage of impaired glucose metabolism compared with visceral fat mass.

This observational study included 3644 individuals who underwent two 75-g oral glucose tolerance tests at baseline and follow-up. Adipose insulin resistance index (Adipo-IR), lipid accumulation product (LAP) and fatty liver index (FLI) were used as indicators of insulin resistance in the adipose tissue, visceral fat mass and fatty liver, respectively.

Over a mean 2.9-year follow-up period, 463 (32.4%) individuals progressed from normoglycaemia to prediabetes, and 198 (10.6%) developed type 2 diabetes from prediabetes. Comparing the highest-to-lowest quartiles, baseline levels and changes in Adipo-IR were associated with an increased odds of progression from normoglycaemia to prediabetes (odds ratio [OR], 2.22; 95% CI, 1.36-3.65, OR, 2.70; 95% CI, 1.83-3.98, respectively) and from prediabetes to the onset of type 2 diabetes (OR, 2.02; 95% CI, 1.04-3.92, OR, 3.09; 95% CI, 1.84-4.19, respectively), after adjusting for possible confounders. Changes in FLI were associated with progression from prediabetes to type 2 diabetes. LAP did not affect the progression of impaired glucose metabolism.

Adipose tissue insulin resistance, rather than fat mass, is crucial in all stages of deterioration of glycaemic status. Fatty liver plays a decisive role in the eventual development of type 2 diabetes.

This study aimed to assess whether novel anthropometric indices-Visceral Adiposity Index (VAI), Conicity Index (CI), and Lipid Accumulation Product (LAP)-could predict Cardiovascular Disease (CVD) risk in individuals with Type 2 Diabetes Mellitus (T2DM).

A methodological study was conducted with 371 hospitalized T2DM patients aged 19-64 at Bandırma Education and Research Hospital. Anthropometric measurements, including waist circumference and Body Mass Index (BMI), were used to calculate VAI, CI, and LAP. The 10-year CVD risk was estimated using the Systematic Coronary Risk Estimation (SCORE) model, and Receiver Operating Characteristic (ROC) curves assessed the predictive performance of the indices.

The mean SCORE risk was significantly higher in individuals aged ≥ 65 years (p < 0.001), with 70.4 % classified as high-risk. ROC analysis showed that VAI, CI, and LAP had limited discriminatory ability, with Area Under the Curve (AUC) values of 0.454, 0.563, and 0.468, respectively. No significant correlation was found between these indices and the SCORE model in both age groups.

VAI, CI, and LAP do not adequately predict CVD risk in T2DM patients, suggesting that traditional risk assessment methods may remain more reliable for this population.

To investigate the relationship between four metabolic indices-visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and cholesterol-HDL-glucose (CHG) index-and the presence of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with long-standing type 2 diabetes mellitus (T2DM).

This prospective cross-sectional study included 175 T2DM patients with disease duration >10 years who attended an endocrinology outpatient clinic between July 2021 and January 2022. DR was assessed via fundus photography, and DN was defined using the urinary albumin-to-creatinine ratio and eGFR. VAI, LAP, TyG, and CHG indices were calculated using anthropometric and biochemical parameters. Logistic regression was used to identify independent predictors.

The mean age was 60 ± 10.1 years; 63.4% were female. DR and DN were observed in 50.3% and 38.9% of patients, respectively. VAI, LAP, and TyG were significantly higher in patients with DN but not with DR. CHG was elevated in both DN and DR (P < 0.05), and was the only independent predictor of DN (P = 0.005). Notably, CHG was significantly higher in proliferative vs non-proliferative DR (P = 0.009), unlike the other indices.

While VAI, LAP, and TyG were associated only with nephropathy, CHG was linked to both DN and DR. Its integration of glycemic and lipid parameters may offer greater sensitivity for microvascular risk stratification in T2DM.

Using cross-sectional data from the 2009-2018 National Health and Nutrition Examination Survey, the purpose of this study was to investigate the potential link between lipid accumulation product and gout/hyperuricemia.

The data from 10,871 individuals who participated in the National Health and Nutrition Examination Survey spanning the years 2009-2018 were utilized for additional scrutiny. Participants self-reported gout and hyperuricemia as measured by laboratory test data, and other relevant variables and information for LAP were included. Multivariate logistic regression, restricted cubic spline and p-trend test were employed to determine the association between LAP and gout/hyperuricemia.

The study included 10,871 adults. The prevalence of hyperuricemia and gout was 20.9% and 5.57%, respectively. Compared with the first quartile, the fourth quartile of lipid accumulation product was associated with a 271% higher risk of hyperuricemia (OR = 3.711, 95% CI 2.732-5.042, p < 0.001) in a fully adjusted model. A similar association was found between continuous increase in lipid accumulation product and hyperuricemia (OR = 2.441, 95%CI = 1.348-4.42, p = 0.005), with p trends showing both < 0.001. The RCS model suggests a significant non-linear relationship between lipid accumulation product and the risk of gout/hyperuricemia. There was an inverted U-shaped relationship between lipid accumulation product and gout/hyperuricemia.

This study confirmed that lipid accumulation product has a high potential to predict the risk of gout/hyperuricemia. These findings suggested that the adjustment of the degree of fat accumulation may be a potential way to prevent and control the onset of gout/hyperuricemia.

The association of lipid accumulation product (LAP) and the likelihood of endometriosis prevalence has not been previously mentioned. The research aimed to assess the possible potential association between LAP and endometriosis in nationwide research. This cross-sectional analysis was conducted on 2,216 participants selected from the National Health and Nutrition Examination Survey (NHANES) in the 1999-2006 cycles. Logistic regression and stratified analysis by age, race, level of education, BMI, marital status, PIR, glycohemoglobin, drinking, and smoking status were used to analyze the association of the LAP index and odds of endometriosis prevalence. Moreover, smoothed curve fitting was used to evaluate the relevancy of LAP and endometriosis. The multivariate logistic regression model showed a positive association between ln LAP and endometriosis. This trend remained after a full adjustment (odds ratio = 1.37, 95% confidence interval:1.08-1.75, P = 0.010). Compared to the minimum ln LAP quartile, participants in the highest ln LAP had a 93% higher chance of endometriosis incidence (odds ratio = 1.93, 95% confidence interval: 1.08-3.46, P = 0.027). After conducting subgroup analysis and interaction testing, it was found that this positive association was most prominent among women aged 35 years and above and participants with glycohemoglobin≥6%. This nationwide study suggested that an elevated ln LAP was related to an increased endometriosis prevalence. Therefore, LAP may be a valuable tool for predicting the occurrence of endometriosis. Follow-up studies are critical to assess the association between LAP and odds of endometriosis prevalence and explain the potential mechanisms of this relationship.

Despite the accumulating evidence from cellular and animal studies, the role of circulating Sestrin2, a stress-inducible antioxidant protein, in human cardiometabolic health remains largely unexplored. Hence, the current study aimed to investigate the association between circulating Sestrin2 and cardiometabolic risk factors in healthy and diabetic individuals.

This cross-sectional study leveraging data and plasma samples from the Qatar Biobank investigated the relationship between plasma Sestrin2 levels and various cardiometabolic indices in 326 healthy and 518 diabetic subjects.

The study found that Sestrin2 levels were significantly lower in diabetic individuals compared to healthy controls (5.49 ng/mL vs 8.25 ng/mL, p < 0.001). In the healthy cohort, higher Sestrin2 levels were associated with a favorable metabolic profile, indicated by lower odd ratios (OR) of high glycated hemoglobin (OR: 0.33), Homeostatic Model Assessment for Insulin Resistance score (OR: 0.58), visceral adiposity index (OR: 0.46), lipid accumulation product (OR: 0.49), atherogenic index of plasma (OR: 0.42) and metabolic syndrome (OR: 0.23). Conversely, in the diabetic cohort, higher Sestrin2 levels were paradoxically linked to increased triglycerides (OR: 1.57), the product of triglyceride glucose and waist circumference (OR: 1.8), body fat (OR: 1.72), waist circumference (OR: 1.82), waist-to-hip ratio (OR: 1.96) and metabolic syndrome (OR: 1.48).

These findings suggest that Sestrin2 may play a complex and context-dependent role in metabolic regulation, potentially serving as a protective factor in healthy individuals but contributing to metabolic dysfunction in the context of established diabetes. Further research is needed to elucidate the underlying mechanisms and implications for targeted interventions.

LAP (lipid accumulation products) is a new indicator that estimates lipid overaccumulation and central obesity in our bodies. Nevertheless, the relationship of LAP with bone mineral density (BMD) has not been well established. This study aims to assess the association of LAP with BMD in U.S. adults. Multivariate linear regression was employed to detect the relationship of LAP with lumbar BMD in adult Americans. Subgroup and interaction tests were employed to detect the robustness of our findings. Restricted cubic spline (RCS) and threshold effect analysis were used to assess the nonlinear correlation of LAP with lumbar BMD. A total of 3883 participants consisted of 2117 (54.52%) men and 1766 (45.48%) women. The mean age of participants was 39.33 ± 11.53 years. After adjusting all covariates, we found a negative association of ln-LAP with lumbar BMD (β= -0.011, 95% CI: -0.019, -0.004). Threshold effect analysis identified the inflection points of 2.846. The results showed no correlation to the left of the saturation point but a significant negative correlation to the right. Interaction analyses indicated that all subgroups have no effect on this association (P > 0.05). Our study reported a nonlinear negative association of LAP with lumbar BMD. A large LAP may be associated with reduced BMD in American adults. These findings support the clinical utility of LAP as a predictor of osteoporosis and provide valuable insights into developing early intervention strategies for osteoporosis populations.

Insulin resistance and central obesity are major risk factors for cardiometabolic diseases. The triglyceride-glucose index (TyG) and lipid accumulation product (LAP) are markers that independently predict cardiometabolic risk. However, their combined long-term trajectories and impact on cardiometabolic multimorbidity (CMM) development remain unclear.

This cohort study utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which tracked 3467 participants at baseline. Dual-trajectory of TyG and LAP were identified using a group-based dual-trajectory model. Cox proportional hazards models were employed to assess the relationships between dual-trajectory groups and primary cardiometabolic outcomes, including first cardiometabolic disease (FCMD), CMM (two or more conditions such as type 2 diabetes, coronary heart disease, or stroke), and all-cause mortality. Multi-state models were performed to assess the associations of dual-trajectory with CMM development.

The study included 3467 participants with a mean age of 25.08 years (SD = 3.59). Of these, 43.4% (n = 1505) were male, and 53.2% (n = 1561) were White. Three distinct dual-trajectory groups were identified: low-increasing (61.5%), high-amplitude fluctuation (7.6%), and high-increasing (30.9%). After multivariate adjustment, compared with the low-increasing group, the high-amplitude fluctuation group exhibited significantly higher risks for FCMD (hazard ratio [HR] 1.38, 95% confidence interval [CI]: 1.08-1.77), CMM (HR 2.63, 95% CI 1.21-5.71), and all-cause mortality (HR 2.16, 95% CI 1.30-3.56), as well as elevated risks for transitions from baseline to FCMD (HR 1.41, 95% CI 1.17-1.63), FCMD to CMM (HR 2.07, 95% CI 1.53-3.96), CMM to death (HR 2.87, 95% CI 1.19-7.62). The high-increasing group showed similar results.

Elevated and fluctuating trajectories of TyG and LAP from early adulthood are associated with increased risks of CMM development in midlife.

AMY1 gene copy number (GCN) variations and the satiety hormone Nesfatin-1 have recently emerged as potential contributors to obesity and related metabolic disturbances. This study evaluated the relationship between AMY1 GCN, Nesfatin-1 level, and nutritional status in obese/overweight and normal-weight women. Participants included 40 normal-weight and 45 overweight/obese women aged 19-50. Data were collected through a demographic and dietary habits questionnaire, a 3-day food recall, anthropometric measurements, and body composition analysis via bioelectrical impedance. Saliva samples were used to measure AMY1 GCN and Nesfatin-1 levels. The AMY1 GCN was significantly lower in overweight/obese participants compared to normal-weight participants. Increased AMY1 GCN was associated with a decrease in BMI (-0.154 units), while increased Nesfatin-1 level was linked to a rise in BMI (0.196 units) (p < 0.05). Women with low AMY1 GCN had higher daily intakes of energy, carbohydrate, protein, and fat (p < 0.05). This study highlights the significant roles of AMY1 GCN and Nesfatin-1 in the development of obesity. The findings suggest that lower AMY1 GCN and higher Nesfatin-1 levels are associated with unfavorable nutritional and metabolic profiles. Further comprehensive studies on genetic and hormonal factors, including AMY1 GCN and Nesfatin-1, are recommended to guide obesity prevention and treatment strategies.

This study aimed to investigate the association of novel obesity indicators (lipid accumulation product [LAP] and cardiometabolic index [CMI]) with asymptomatic intracranial arterial stenosis (aICAS), particularly in different obesity statuses.

The study included 1994 participants (aged ≥ 40 years) from the Rose Asymptomatic Intracranial Artery Stenosis (RICAS) study, free of stroke or transient ischemic attack. Participants with aICAS were screened using transcranial Doppler ultrasound and diagnosed via magnetic resonance angiography. Multivariate logistic regression and receiver operating characteristic (ROC) curves were used to explore the association of LAP or CMI with aICAS.

A total of 146 participants were diagnosed with aICAS. Higher levels of LAP and CMI were associated with aICAS, particularly with moderate-to-severe aICAS. Notably, LAP was significantly associated with aICAS (OR 1.58; 95 % CI, 1.00-2.49; P = 0.048), and was showed the highest area under the curve (AUC, 0.654) among the three indicators (LAP, CMI, and BMI) in underweight and normal weight participants (Body mass index [BMI] ≤23.9 kg/m²). In the obesity population (BMI ≥28.0 kg/m2), CMI was significantly associated with aICAS (OR 1.40; 95 % CI, 1.11-1.77; P = 0.005), and was showed the highest AUC (0.610).

This study found a positive association between elevated levels of LAP or CMI and aICAS. Furthermore, LAP was significantly correlated with aICAS in underweight and normal weight individuals, while CMI was associated with aICAS in obesity individuals. Our findings may provide additional risk stratification information for aICAS.

Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide.

We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain).

We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO's) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM.

Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life.

This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized in inflammatory bowel disease (IBD) patients due to chronic inflammation and metabolic disturbances. However, reliable non-invasive biomarkers for MASLD prediction in this population are lacking. This study evaluated the predictive value of metabolic scores and lipid ratios for MASLD onset in IBD patients. Methods: An observational retrospective study was conducted on 358 IBD patients at the "Renato Dulbecco" Teaching Hospital in Catanzaro, Italy, in a period between 1 January 2021 and 31 December 2024. Clinical and laboratory data, including metabolic scores and lipid ratios, were analyzed using the chi-square and Kruskal-Wallis tests as appropriate. Post hoc comparisons were conducted using Dunn's test. Receiver operating characteristic analysis assessed their predictive accuracy for MASLD. p < 0.05 was considered significant. Results: IBD-MASLD patients had a significantly higher body mass index (BMI, 27 ± 4 vs. 22 ± 2 kg/m2; p < 0.001), waist circumference (100 ± 11 vs. 85 ± 4 cm; p < 0.001), other anthropometric parameters, metabolic scores, and lipid ratios than IBD-only patients. The metabolic score for insulin resistance [METS-IR, area under curve (AUC = 0.754)] and waist circumference (AUC = 0.754) exhibited the highest predictive accuracy, followed by the lipid accumulation product (LAP, AUC = 0.737), BMI (AUC = 0.709), and triglyceride/high-density lipoprotein (TG/HDL, AUC = 0.701). Insulin resistance scores, including the homeostasis model assessment of insulin resistance (AUC = 0.680) and triglyceride-glucose index (AUC = 0.674), were of moderate predictive use. The visceral adiposity index (AUC = 0.664) and low-density lipoprotein/high-density lipoprotein (AUC = 0.656) showed lower discriminative ability, while the fibrosis-4 index (AUC = 0.562) had the weakest diagnostic performance. Conclusions: Our findings suggest that MASLD in IBD is primarily driven by cardiometabolic dysfunction. The introduction of the METS-IR, LAP, and TG/HDL into clinical assessments of IBD patients could prove useful in preventing liver and cardiovascular complications in this setting.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant cause of chronic liver disease globally, and the rising prevalence of MASLD is occurring in parallel with the global aging population. The use of non-invasive biomarker tools to rule-in or rule-out hepatic steatosis is important in large epidemiological studies in this field. While the Fatty Liver Index (FLI) is the best validated tool in older adults, not all studies will have the necessary parameters for steatosis identification. This retrospective post-hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) study involved 16,703 Australian adults aged ≥70 years. Using the FLI as the 'gold standard' index, we evaluated the correlation with other indices: the Dallas Steatosis Index (DSI), Framingham Steatosis Index, ZJU index (ZJU), Hepatic Steatosis Index (HSI), Lipid Accumulation Product (LAP), and Visceral Adiposity Index (VAI), as well as age- and sex-adjusted outcome measures including mortality, major adverse cardiovascular events (MACE), atrial fibrillation (AF), and persistent physical disability. Of the non-FLI indices, the DSI and FSI had the highest percentage of participants correctly classified as having MASLD (97.7% and 93.8% respectively). The FSI, LAP, and VAI were associated with MACE. The FSI and FLI were predictive of incident AF. The FLI, DSI, FSI, LAP and VAI were associated with physical disability. No MASLD score was associated with increased mortality. Indeed, MASLD defined by the ZJU and HSI were both inversely associated with mortality. As such, we've demonstrated that the FSI and DSI are the most accurate scores for identifying MASLD in older adults when compared to the FLI as the gold standard. The FSI is associated with MACE, AF, and persistent physical disability, lending support to its use in identifying older persons with MASLD when the FLI is unable to be calculated.

Objective: Various insulin resistance (IR) indices have been developed to assess cardiovascular (CVS) risk. We compared the association between ten IR indices and cardiac, renal, and vascular end-organ measures in a predominantly young (age 45.0 ± 18.3 years) South African Black population. Methods: We assessed the relationships between ten IR indices (homeostatic model assessment for IR [HOMA-IR], quantitative insulin sensitivity check index [QUICKI], metabolic score for IR [METS-IR], triglyceride-glucose index [TyG], TyG-body mass index [TyG-BMI], TyG-waist circumference [TyG-WC], TyG-waist-to-height ratio [TyG-WHtR], triglyceride to high-density cholesterol concentration [TyG-HDL], lipid accumulation product [LAP], visceral adiposity index [VAI]) and end-organ measures in 779 community participants of African ancestry. Results: HOMA-IR and QUICKI were the only IR indices consistently associated with end-organ measures (left ventricular [LV] mass index, p ≤ 0.005; LV relative wall thickness, p < 0.0001; early-to-late mitral velocity, p ≤ 0.01; E/e', p ≤ 0.002; e', p < 0.0001; pulse wave velocity, p = 0.036 (HOMA-IR only); glomerular filtration rate [GFR], p < 0.0001), independent of confounders. Furthermore, HOMA-IR was consistently higher, and QUICKI lower, in those with compared to those without end-organ damage (LV hypertrophy [p ≤ 0.03], concentric LV [p < 0.03], and reduced GFR [p ≤ 0.008]), independent of confounders. Importantly, the associations between HOMA-IR or QUICKI and end-organ measures were independent of additional CVS risk factors, including adiposity measures, and were replicated in the participants without diabetes mellitus (n = 669) and in the participants without high blood pressure (n = 505). Conclusions: In a predominantly young community of African ancestry, of ten recommended IR indices, only HOMA-IR and QUICKI were consistently associated with end-organ damage independent of CVS risk factors.

Background: Recent evidence has shown that insulin resistance (IR), a hallmark of nonalcoholic fatty liver disease, predicts bladder cancer (BC) presence. However, the best surrogate marker of IR in predicting BC is still unclear. This study examined the relationships among ten surrogate markers of IR and the presence of BC. Methods: Data from 209 patients admitted to two urology departments from September 2021 to October 2024 were retrospectively analyzed. Individuals (median age 70 years) were divided into two groups (123 and 86 patients, respectively) based on the presence/absence after cystoscopy/TURB of non-metastatic BC. Univariate logistic regression was used to determine the relationships between groups, and the following IR parameters: Triglyceride-Glucose (TyG) index, TyG-BMI, HOMA-IR HOMAB, MetS-IR, Single Point Insulin Sensitivity Estimator, Disposition Index, non-HDL/HDL, TG/HDL-C ratio and Lipoprotein Combine Index. Stepwise logistic regressions were carried out to evaluate the significant predictions and LASSO regression to confirm any significant variable(s). The predictive value of the index test for coexistent BC was evaluated using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). Results: The univariate analysis revealed that the TyG index and MetS-IR were associated with the BC presence. Specifically, the associations of the TyG index and MetS-IR were more significant in participants =/> 65 years old. In multivariate analysis, the stepwise logistic regression, evaluating the most representative variables at univariate analysis, revealed a prediction of BC by only TyG index (OR 2.51, p = 0.012), confirmed by LASSO regression, with an OR of 3.13, p = 0.004). Assessing the diagnostic reliability of TyG, it showed an interesting predictive value for the existence of BC (AUC = 0.60; 95% CI, 0.51-0.68, cut-off 8.50). Additionally, a restricted cubic spline model to fit the dose-response relationship between the values of the index text (TyG) and the BC evidenced the presence of a non-linear association, with a high predictive value of the first knot, corresponding to its 10th percentile. The decision curve analysis confirmed that the model (TyG) has utility in supporting clinical decisions. Conclusions: Compared to other surrogate markers of IR, the TyG index is effective in identifying individuals at risk for BC. A TyG threshold of 8.5 was highly sensitive for detecting BC subjects and may be suitable as an auxiliary diagnostic criterion for BC in adults, mainly if less than 65 years old.

The association between body roundness index (BRI) and all-cause mortality and the occurrence of cardiovascular disease (CVD) in patients with diabetes is unknown. This study aimed to determine the association between BRI and all-cause/CVD mortality in a diabetic cohort.

A total of 8227 individuals with diabetes from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) database were included. Multifactorial Cox regression models were used to analyze the association between BRI and mortality in patients with diabetes. Multivariate-adjusted restricted cubic spline (RCS) regression was used to test for nonlinearity.

During a median follow-up of 7.25 years, a total of 27.22% died, with 9.18% of these deaths due to CVD. After fully adjusting for potential confounders, BRI remained significantly associated with all-cause/CVD mortality in the diabetic population. The restricted cubic splines revealed no significant nonlinear relationship between BRI and all-cause mortality (P = 0.29) or CVD mortality (P = 0.73). BRI was better associated with all-cause/CVD mortality in patients with diabetes compared to other body metabolic indices.

In patients with diabetes, we found an association between BRI and all-cause/CVD mortality.

Background and Aims: Visceral adipose tissue (VAT) is a key cardiometabolic risk factor. This study evaluates the association between VAT and adiposity indices and identifies reliable predictors of increased VAT. Methods: This cross-sectional study utilized data from 4696 participants in the National Health and Nutrition Examination Survey 2011-2018. VAT was measured via dual-energy X-ray absorptiometry. Adiposity indices included body mass index (BMI), waist circumference (WC), lipid accumulation product, visceral adiposity index, body shape index, body roundness index, and metabolic score for visceral fat (METS-VF). Correlation analysis, receiver operating characteristic curve analysis, and multivariate adaptive regression splines (MARS) modeling evaluated the performance of indices and identified key predictors of VAT. Results: All adiposity indices were significantly correlated with VAT (P < 0.001). Among them, METS-VF demonstrated the highest predictive performance for increased VAT (>130 cm2) followed by WC. Optimal cutoff values for METS-VF were 7.1 [areas under the curve (AUC): 0.887, 95% confidence interval (CI): 0.873-0.899] in men and 7.5 (AUC: 0.904, 95% CI: 0.891-0.916) in women. For WC, the cutoff values were 99.5 cm (AUC: 0.866, 95% CI: 0.851-0.879) in men and 96 cm (AUC: 0.883, 95% CI: 0.869-0.896) in women. MARS modeling identified race, age, WC, BMI, glucose, high-density lipoprotein cholesterol, and triglycerides as significant predictors of VAT, achieving an R2 of 75.2%. Conclusion: METS-VF demonstrated the highest predictive value among the indices evaluated for predicting increased VAT. It may serve as a valuable tool in assessing visceral obesity and associated cardiometabolic risks.

Various anthropometric indices have been proposed to assess central obesity and predict metabolic syndrome (MetS). However, their ability to predict MetS has not been evaluated in the Nepali adult population. This study compared the predictive potential of 12 novel and traditional anthropometric indices for MetS and its components among Nepali adults.

This cross-sectional study, conducted between January 2022 and June 2023, involved 1,116 adult participants (424 females, 692 males) aged 30-86 years from Gandaki Province, Nepal. Twelve anthropometric indices were calculated from the primary anthropometric and metabolic parameters. MetS was defined according to the modified NCEP-ATP III criteria. Logistic regression models were used to assess the strength of associations between these indices and MetS. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive potential of these indices for MetS and its components. AUC differences between various index pairs were also calculated.

The overall prevalence of MetS in our study participants was 52.7%. The VAI demonstrated the best performance in predicting MetS (AUC: 0.865 for females, 0.882 for males), followed by LAP (AUC: 0.848 for females, 0.866 for males). The WHR showed good performance (AUC: 0.749 for females, 0.722 for males). BMI, the well-known traditional measure of body adiposity, demonstrated lower predictive ability (AUC: 0.586 for females, 0.571 for males). The optimal cutoffs were as follows: VAI > 2.37 for females, > 1.71 for males; LAP > 37.21 for females, > 47.74 for males; WHR > 0.97 for females, > 0.98 for males; and BMI > 23.10 for females, > 23.90 for males. BAI exhibited the poorest diagnostic performance for MetS prediction in both sexes (AUC < 0.555). Both the VAI and LAP were strongly positively associated (p < 0.001) with increased odds of MetS in both females (OR: 16.03, 95% CI: 9.77-26.31) and males (OR: 24.88, 95% CI: 16.51-37.48).

Among Nepali adults, the VAI and LAP outperform traditional anthropometric indices in predicting MetS and its components, suggesting their potential as effective screening tools for early detection. These findings contribute to the development of population-specific screening strategies for MetS in resource-limited settings such as Nepal, potentially enhancing early detection and prevention of cardiometabolic disorders.

The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD.

We obtained participant-related data from the National Health and Nutrition Examination Survey (NHANES), including complete information on DKD, CMI, and other covariates. We employed weighted multivariable logistic regression models, restricted cubic spline (RCS) regression analysis, subgroup analyses, and interaction tests to explore the relationship between CMI and DKD. Additionally, we utilized receiver operating characteristic (ROC) curves to compare the performance of CMI in identifying DKD relative to a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), and lipid accumulation product (LAP) indices.

According to the logistic regression analysis, a positive correlation between CMI and DKD was observed among the 2371 participants included in the study (OR: 1.40, 95% CI: 1.19-1.66). RCS analysis indicated that this relationship is nonlinear. When CMI was converted from a continuous variable to quartiles, the prevalence of DKD in the highest quartile group showed a significant 84% increase compared to the lowest quartile group (OR: 1.84, 95% CI: 1.24-2.72). The area under the ROC curve of CMI for identifying DKD was 0.67, outperforming other indices. The results of subgroup analyses and interaction tests were stable.

Elevated CMI is associated with an increased risk of DKD and can serve as a low-cost screening tool, allowing physicians to potentially identify high-risk diabetic patients early and implement timely interventions to slow the progression of DKD.

To identify reliable indicators to predict the occurrence of metabolic syndrome (MetS) and to provide an effective way to prevent it in polycystic ovary syndrome (PCOS), we explored the relationships between triglyceride-glucose index (Ty-G), lipid accumulation product (LAP), lipid accumulation product ratio, and MetS.

We detected the relationship between the Ty-G index, LAP, lipid ratio, and incidence of MetS. In addition, we classified the Ty-G index and LAP into tertiles to determine the efficacy of these indicators in predicting the risk of MetS. Finally, the effects of the Ty-G index, LAP, and lipid ratio on the prediction of MetS were evaluated with the receiver operating characteristic (ROC) curve.

Our results indicate that the incidence of MetS was 38% in 134 patients with PCOS, and that the Ty-G index, LAP, and lipid ratio were independent risk factors for MetS. In addition, the incidence of MetS significantly increased with Ty-G index and LAP. The ROC curve showed that the Ty-G index, LAP, and lipid ratio all showed good performance in predicting the occurrence of MetS in PCOS patients, but the Ty-G index had the highest predictive value, with a cut-off value of 8.70.

Our study revealed that the Ty-G index plays an important role in predicting the occurrence of MetS in PCOS patients. In addition, monitoring blood glucose and lipid levels is an effective approach for preventing MetS in PCOS patients clinically regardless of age, and weight management should be strictly implemented in overweight and obese patients to prevent MetS.

The goal of our study was to investigate the potential relationship between Lipid Accumulation Product (LAP) and prevalence of asthma.

Cross-sectional study.

The National Health and Nutrition Examination Survey (2003-2018).

The study included a total of 13,993 participants, all of whom had complete data on both asthma and LAP.

The Lipid accumulation product (LAP) index is a potential estimator of visceral fat accumulation. Overweight and obesity are the risk factors for asthma. However, no research investigated the possible correlation between LAP and the incidence of asthma.

We undertook a cross-sectional analysis to investigate the link between LAP and asthma, utilizing data from the National Health and Nutrition Examination Surveys (NHANES 2003-2018). To address the complex, multistage, and clustered survey design, sample weights were incorporated into all the statistical analyses. The association between LAP and the prevalence of asthma was examined through multivariable logistic regression. Additionally, the linear correlation between these variables was assessed via smoothed curve fitting and threshold effect analyses. Subgroup analysis was conducted to identify any vulnerable populations.

The study included 13,993 participants, of whom 1965 (14.0 %) were diagnosed with asthma. Following adjustment for all covariates, a notable positive correlation emerged between the LAP index and asthma according to a multivariate logistic regression analysis. A heightened prevalence of asthma was observed with each unit increase in LnLAP (OR = 1.17, 95 % CI = 1.09-1.27, P < 0.001). Compared to individuals in the lowest LAP quartile, those in the highest quartile had a 34 % increased probability of developing asthma. (OR 1.34, 95 % CI 1.13-1.60, P = 0.001). Additionally, smoothed curve-fitting analysis revealed a nonlinear correlation between the LAP index and asthma. Through threshold effect analysis, the inflection point was established at 114.495.

The study found a positive association between the LAP index and asthma in adults, suggesting that LAP may serve as a potential biomarker for early detection of asthma and assessment of treatment efficacy.

Insulin resistance (IR) is a complex abnormality and associated with hypertension. We aimed to assess the associations of six alternate IR measures and risk of hypertension, and to compare the predictive values for hypertension. We assessed 11,223 non-hypertensive Chinese adults enrolled in The Rural Chinese Cohort Study during 2007-2008. Six surrogate IR indexes were new visceral adiposity index (NVAI), Chinese visceral adiposity index (CVAI), weight-adjusted waist index (WWI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and visceral adiposity index (VAI). The relative risks (RR) and 95% confidence intervals (95% CI) of the six IR indicators and hypertension were estimated by using modified Poisson regression models with three adjusted models. During a median follow-up of 11.1 years, 3373 (30.05%) study participants developed hypertension. The cumulative incidence of hypertension showed an increasing trend with higher levels of all six IR surrogates. Significant associations of all the IR measures with incident hypertension were found in fully adjusted model, and the highest quartile group RRs (95% CIs) for hypertension were, 2.19 (1.88-2.55), 1.60 (1.42-1.81), 1.38 (1.25-1.53), 1.47 (1.31-1.65), 1.18 (1.04-1.34) and 1.25 (1.08-1.44) for NVAI, CVAI, WWI, LAP, TyG index and VAI, respectively, compared with lowest quartile group. Further, NVAI had the maximum predictive power for hypertension among six IR measures with the largest AUC of 0.706 (0.697-0.714). NVAI, CVAI, WWI, LAP, and TyG index were all independently associated with greater risk of incident hypertension, among which NVAI is the most powerful predictor for hypertension in rural Chinese adults. Association of the surrogate insulin resistance indexes with the risk of hypertension.

A new disease name, "Steatotic Liver Disease (SLD)" was proposed in 2023. Within this algorithm, combined metabolic and alcoholic liver disease (MetALD) was named as a new specific subgroup. The clinical profiles and outcomes of MetALD patients are unknown.

Participants from Taiwan Biobank database after exclusion those with positive for HBsAg, anti-HCV, and former drinkers were selected. MASLD was diagnosed if having hepatic steatosis on ultrasound plus at least one of cardiometabolic criteria. Increased or moderate alcohol intake was defined as continuous drinkers with alcohol consumption exceeding 210 g for men and 140 g for women weekly or below the levels, respectively. The fibrosis 4 (FIB-4) score was used to assess the severity of liver fibrosis, and carotid plaques on duplex ultrasound were employed to diagnose atherosclerosis.

In a total of 18,160 (mean age 55.28 ± 10.41; 33.2 % males) participants, there were 7316 (40.3 %) MASLD patients and 209 (1.2 %) MetALD patients. The participants with MetALD were younger and male predominant. After propensity score matching for age and gender, MetALD patients had higher AST, GGT, fatty liver index (FLI), and FIB-4 score and tended to have a higher proportion of carotid plaques than MASLD patients. Among MASLD patients, those with moderate alcohol intake had higher values of GGT, FLI, and FIB-4 score and a higher proportion of carotid plaques than those with no or social alcohol intake.

MetALD patients have a higher risk of liver injury than those with MASLD. Moreover, moderatet alcohol intake also increases the risk of liver injury and atherosclerotic in MASLD patients, suggesting MASLD patients should refrain from alcohol intake.

Despite the established link between obesity and cardiovascular disease (CVD), the optimal anthropometric index for risk prediction remains uncertain.

This prospective cohort study aimed to compare various anthropometric indices for their association with 20-year atherosclerotic cardiovascular disease (ASCVD) risk in a healthy adult population and to assess their incremental predictive value.

In 2002, n = 3,042 adults free of CVD, residing in Athens metropolitan area, in Greece, were recruited. A 20-year follow-up was conducted in 2022, comprising n = 2,169 participants, of which n = 1,845 had complete data on both CVD occurrence and anthropometric measures.

Almost all the studied anthropometric measures were significantly associated with 20-year ASCVD incidence. However, after full adjustment, none of these measures retained a significant association. The inclusion of any individual obesity index within the SCORE2 model enhanced the model's discriminatory power, while the continuous NRI exhibited positive values, suggesting improved risk reclassification. The indices linked to adipose tissue dysfunction exhibited greater efficacy in distinguishing and reclassifying CVD risk beyond SCORE2. Stratified analysis according to obesity and metabolic health status revealed that the optimal obesity index varies according to individual obesity and metabolic health profiles.

Obesity indices are strongly associated with long-term risk of ASCVD, underscoring the major role of excessive body fat in the pathogenesis of this condition. The inclusion of an obesity index in a CVD risk model significantly enhances its predictive accuracy and reclassification of risk, emphasizing the importance of these indices in refining CVD risk assessment among the general population.

Deleterious adiposity (e.g., obesity) is considered an inflammatory condition that increases risk for cardiovascular diseases. Lower heart rate variability (HRV), an independent predictor of cardiovascular disease risk, is linked with higher levels of adiposity and inflammation. However, indices of adiposity vary in their strength of association with disease risk. Body mass index (BMI) is a modest predictor of disease, while the lipid accumulation product (LAP) better predicts disease risk. The current investigation used cross-sectional and prospective designs to probe the differential associations between HRV and multiple measures of adiposity (e.g., LAP and BMI) and examine if inflammation (measured via C-reactive protein; CRP) mediated these associations. Study 1 showed that HRV was more strongly linked with LAP relative to other adiposity measures and that this link was mediated by CRP. Study 2 replicated Study 1 results and showed that this association remained significant 4 years later. Our novel findings are consistent with studies suggesting LAP may be a superior measure of cardiovascular disease risk relative to other measures of adiposity. Importantly, the strong link between HRV and LAP was mediated by inflammation, highlighting the key role of the cholinergic anti-inflammatory pathway in regulating obesity and associated health consequences.

Osteoporosis and osteopenia pose substantial public health challenges, particularly among postmenopausal women. Although various anthropometric measures have been proposed for risk assessment, their predictive performance and nonlinear relationships with bone outcomes remain unclear. We analyzed data from six consecutive cycles (2007-2018) of the National Health and Nutrition Examination Survey (NHANES). A total of 4473 postmenopausal women aged ≥ 50 years were included, each classified as having normal bone density, osteopenia, or osteoporosis based on dual-energy X-ray absorptiometry measurements. Ten anthropometric indices-waist-to-height ratio (WTHR), conicity index (CI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product, visceral adiposity index, cardiometabolic index, atherogenic index of plasma, weight-adjusted-waist index (WWI), and triglyceride-glucose (TyG) index-were examined using multiple logistic regression, restricted cubic spline curves, threshold-effect analyses, and SHAP (SHapley Additive exPlanations) analysis to assess their associations with osteoporosis and osteopenia. In fully adjusted models, individuals with higher WTHR, CI, BRI, WWI, and TyG tended to have a lower likelihood of osteoporosis or osteopenia (p < 0.01), whereas those with elevated ABSI were more likely to be diagnosed with these conditions (p < 0.01). Notably, several indices showed nonlinear effects on bone outcomes. Receiver operating characteristic (ROC) analyses indicated that WTHR and BRI had the highest discriminative capacity for differentiating osteoporosis from osteopenia. SHAP analysis further highlighted WTHR and BRI as the most influential predictors. WTHR and BRI demonstrated strong predictive utility for osteoporosis and osteopenia, suggesting their potential as noninvasive, cost-effective screening metrics for postmenopausal bone health. These findings provide insight into the varying roles of central and general obesity indicators in bone density and underscore the importance of incorporating novel anthropometric indices into early-stage risk assessment.

To compare anthropometric, endocrine, and metabolic parameters among White, Black, and Mixed-race women who have polycystic ovary syndrome (PCOS).

This cross-sectional study enrolled 392 Brazilian women of different races, 308 women with PCOS and 84 without PCOS. The proportions of differences in races/ethnicities between groups were compared using a chi-squared test with Bonferroni adjustment for the number of comparisons. Comparisons between PCOS and control in each race group were performed using Student t test or Z test where appropriate. Differences among more than two Gaussian variables were determined using one-way analysis of variance followed by a Tukey post hoc test. Age and body mass index as possible confounders of the found results were controlled using a multinominal logistic regression.

The proportions of ages and races were not different between women with PCOS and the control group (p = 0.099 and p = 0.978, respectively). Diastolic blood pressure was higher among Black women with PCOS (p < 0.001) and not different among Mixed-race (p = 0.667) or White (p = 0.133) races in the control group. Body weight, body mass index, waist circumference, waist-to-hip ratio, and fat mass were higher in Black women than in White women with PCOS (p < 0.05 for all comparisons). Free testosterone levels were higher among Black women than White women (p < 0.001) and Mixed-race women (p < 0.001) with PCOS, but the levels were not different in the control group. HbA1C was also higher among Black women with PCOS (p = 0.041).

Black women with PCOS presented higher concentrations of carbohydrate and lipid than White women. Regarding hormones, free testosterone levels and free androgen index were higher among Black women than among White and Mixed-race women with PCOS. The control group did not present anthropometric, metabolic, and endocrine differences among races. The findings of the current study strongly suggest that ethnic background has a wide implication in the development of comorbidities, diagnosis, or for the clinical assistance of women with PCOS. The analysis of race/ethnicity is recommended in future studies with focus on pathophysiological, biochemical, and clinical characteristics.

Kidney stones (KS) are prevalent and often recur, with obesity, metabolic disorders, and inflammation significantly impacting their pathophysiology. The traditional body mass index (BMI) has limitations, as it cannot effectively differentiate between fat and lean body mass or provide information about fat distribution. In contrast, the lipid accumulation product (LAP), which combines waist circumference and triglyceride levels, serves as a crucial indicator of visceral fat. This study examines the relationship between LAP and KS, including recurrent kidney stones (RKS), using data from the National Health and Nutrition Examination Survey (NHANES). It also investigates whether neutrophils mediate the connection between LAP and KS/RKS, comparing the predictive accuracy of LAP and BMI. Data from 2007 to 2014 covered 9910 KS participants and 880 RKS participants. Weighted logistic regression assessed the LAP-KS/RKS relationship, while mediation analysis explored the role of neutrophils. Receiver Operating Characteristic (ROC) curves evaluated the predictive capabilities of LAP and BMI. Results showed LAP was significantly associated with KS (OR = 1.629; 95% CI 1.296-2.047) and RKS (OR = 1.561; 95% CI 1.145-2.128). Neutrophils partially mediated the LAP-KS relationship (7.6%, p = 0.018), with no effect found for RKS. Moreover, LAP outperformed BMI in diagnostic accuracy. These findings suggest that LAP is an effective marker for assessing KS and RKS, aiding in the early identification of potential patients to reduce the incidence and recurrence of kidney stones.

Effective biomarkers for the diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) remain limited. This study aims to evaluate the potential of advanced glycation end products (AGEs) and their endogenous secretory receptor (esRAGE) as non-invasive biomarkers for diagnosing MASLD, to explore differences between obese and non-obese MASLD patients, and to develop a novel diagnostic model based on these biomarkers.

This study enrolled 341 participants, including 246 MASLD patients (118 non-obese, 128 obese) and 95 healthy controls. Serum AGEs and esRAGE levels were measured by ELISA. Key predictors were identified using the Lasso algorithm, and a diagnostic model was developed with logistic regression and visualized as nomograms. Diagnostic accuracy and utility were evaluated through the area under the curve (AUC), bootstrap validation, calibration curves, and decision curve analysis (DCA).

Serum AGEs and esRAGE levels were significantly higher in MASLD patients compared to controls. Moreover, obese MASLD patients had higher esRAGE levels than non-obese ones, but no significant difference in AGEs levels was found. A diagnostic model incorporating age, WC, BMI, ALT, TG, HDL, AGEs, and esRAGE achieved an AUC of 0.963, with 94.3% sensitivity and 85.3% specificity. The AUC for bootstrap internal validation was 0.963 (95% CI: 0.944-0.982). Calibration curves showed strong predictive accuracy, and DCA demonstrated high net clinical benefit.

Serum AGEs and esRAGE serve as non-invasive biomarkers for distinguishing MASLD patients. We developed and validated diagnostic models for MASLD, offering valuable tools to identify at-risk populations and improve prevention and treatment strategies.

Background and Objectives: Heart failure (HF) among patients with type 2 diabetes (T2DM) is linked to significant morbidity and mortality, despite the increased availability of new drug therapy. This study aims to investigate subclinical changes in patients with HF stage A (at risk for HF) and B (Pre-HF) and T2DM treated with oral semaglutide. Materials and Methods: In a prospective, observational, single-center study, 50 T2DM patients were assessed at baseline and one-year follow-up for changes in spectral Doppler, tissue Doppler, and speckle-tracking (2DST) and metabolic parameters. Results: Correlation and regression analyses identified predictors of Δ GLS. In correlation analysis, Δ GLS showed a negative correlation with Δ VAI (rho = -0.3, p = 0.02), Δ LAP (rho = -0.3, p = 0.04), Δ FPG (rho = -0.3, p = 0.009), Δ TG (rho = -0.4, p = 0.004), and Δ TyG (rho = -0.3, p = 0.02). In linear stepwise regression analysis, the most accurate model, with a p-value < 0.001, was M3, explaining 70% of the variance in Δ GLS (adjusted R2 = 0.7); this model included Δ FPG (beta -0.4, p = 0.001), Δ CRR (beta -1.3, p < 0.001), and Δ LDLc (beta 0.6, p = 0.01). Conclusions: These findings show that improved subclinical left ventricular systolic dysfunction is associated with improved glycemic control, visceral adiposity, and reduced insulin resistance, respectively, with improved lipid profiling.

Increasing studies have indicated that insulin resistance is a risk factor for the development of depression. The lipid accumulation product (LAP) has emerged as a novel biomarker of insulin resistance. This cross-sectional study aimed to explore the relationship between LAP and the risk of depression.

Data of adult participants from the 2005-2018 National Health and Nutrition Examination Survey were obtained. Depression presence and severity were evaluated using the 9-item Patient Health Questionnaire (PHQ-9). The linear and non-linear associations between LAP and PHQ-9 scores were evaluated using multivariable logistic regression analysis, restricted cubic spline analysis, and piecewise regression analysis.

A total of 2073 participants with and 22,714 without depression were included. The association between LAP and risk of depression was L-shaped. Piecewise regression analysis showed that the odds ratio and 95 % confidence interval for the association between LAP and PHQ-9 score were 1.008 (1.004, 1.012) for LAP <140.16 cm × mmol/L and 1.001 (0.999, 1.004) for LAP >140.16 cm × mmol/L. Subgroup analysis indicated that the association between LAP and PHQ-9 score was more pronounced in women than in men, and more pronounced in never smokers than in former and current smokers.

Cross-sectional design that limited interpretation of causal relationships.

LAP was an independent risk factor for depression in US adults when it was <140.16 cm × mmol/L, especially in women and never smokers. Prospective, longitudinal studies are needed to establish a causal relationship between LAP and depression.

This research explored the effects of 2-hydroxyfluorene exposure on the incidence of cardiovascular diseases (CVDs), particularly examining the mediating role of the lipid accumulation product (LAP) index. Utilizing data from the National Health and Nutrition Examination Survey spanning 2005 to 2018, this analysis evaluated the impact of 2-hydroxyfluorene on CVDs prevalence employing a variety of statistical methods. Logistic regression was applied to investigate relationships within polycyclic aromatic hydrocarbon mixtures, complemented by Bayesian Kernel Machine Regression. Additionally, a mediation analysis explored the influence of the LAP index in moderating the effects of 2-hydroxyfluorene on CVDs prevalence. The research also detailed the link between 2-hydroxyfluorene exposure and specific CVDs such as congestive heart failure, myocardial infarction, angina pectoris, and coronary heart disease, including their mediated impacts. Involving 3653 participants, the study detected a robust positive correlation between 2-hydroxyfluorene exposure and overall CVD risk (OR [95%CI] = 393.5173 [23.6978-6534.5979], P < .0001). This association extended to the prevalence of specific types of CVDs. The LAP index served as a mediator in the connection between 2-hydroxyfluorene exposure and the prevalence of total CVD, congestive heart failure, myocardial infarction, coronary heart disease, and stroke, with mediation percentages of 12%, 10%, 100%, 5%, and 9%, respectively. These results underscore a significant link between 2-hydroxyfluorene exposure and increased prevalence of CVDs, with the LAP index playing a crucial mediating role.

The relationship between obesity and mental health has attracted attention. However, large sample studies on the relationship between visceral fat obesity and depression are lacking. This study aimed to explore the relationship between visceral fat obesity and depression by using visceral adiposity index (VAI) and lipid accumulation product (LAP). Additionally, it sought to explore the potential mediating role of sleep duration in these associations.

The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2020, including 19,659 participants. Depression was measured using the nine-item Patient Health Questionnaire. Weighted multivariable regression analysis was used to evaluate the correlation of VAI and LAP with depression. The potential non-linear relationship was determined using smooth curve fitting and threshold effect analysis. Additionally, mediation analysis was performed to investigate the potential mediating role of sleep duration. The stability of the relationship was assessed through sensitivity analysis.

VAI and LAP were closely related to depression. In the fully adjusted model, VAI and LAP in the highest quartile increased the association of depression by 52% (OR = 1.52, 95% CI 1.20-1.92, P < 0.001) and 51% (OR = 1.51, 95% CI 1.19-1.91, P < 0.001), respectively, compared with the lowest quartile. Specific saturation effects for VAI, LAP, and depression were identified by smoothed curve fitting, with inflection points of 3.81 and 98.55, respectively. Additionally, mediation analysis revealed that 5.1% and 2.8% of the associations between VAI and LAP with depression were mediated through sleep duration. The results of the sensitivity analysis showed interactions between hypertension and cardiovascular disease in the associations of VAI, and depression (P < 0.05).

VAI and LAP are associated with depression in US adults. The associations between VAI and LAP with depression are non-linear, which may be mediated through sleep duration. The study highlights the potential of VAI and LAP as valuable tools for the prevention and management of depression.

Left ventricular hypertrophy (LVH), a hallmark of early-stage heart failure (HF), is a common complication in individuals with type 2 diabetes mellitus (T2DM). Metabolic Visceral Fat Score (METS-VF), a novel metric for estimating visceral adiposity, may provide valuable insights into LVH risk. This study explores the association between METS-VF and LVH in T2DM and compare its predictive performance to traditional abdominal obesity indices.

This cross-sectional study included 4,988 adults with T2DM. Participants were stratified into quartiles based on METS-VF. Logistic regression models assessed the association between METS-VF and LVH. Restricted cubic spline analyses evaluated nonlinear relationships, while stratified analyses explored subgroups effects. Receiver operating characteristic (ROC) curves compared the predictive performance of METS-VF with other indices.

LVH prevalence increased across METS-VF quartiles (Quartile 1: 7.9%; Quartile 2: 13.0%; Quartile 3: 20.0%; Quartile 4: 31.0%; P < 0.001). Higher METS-VF was independently associated with LVH (OR: 9.79; 95% CI: 6.16-15.76; P < 0.001). A nonlinear relationship was observed between METS-VF and LVH, with a steeper risk increase above specific thresholds. Stratified analyses showed that the positive association between METS-VF and LVH was consistent. METS-VF outperformed traditional indices in predicting LVH (AUC: 0.68; 95% CI: 0.66-0.70).

METS-VF is strongly associated with LVH in T2DM, demonstrating superior predictive performance compared to traditional indices. METS-VF is a practical, cost-effective tool for early cardiac risk stratification, facilitating timely interventions to mitigate HF risk in T2DM populations.

Obesity, especially abdominal obesity, is more common in patients with heart failure (HF), but body mass index (BMI) cannot accurately describe fat distribution. Several surrogate adiposity markers are available to reflect fat distribution and quantity. The objective of this study was to explore which adiposity marker is most highly correlated with HF prevalence, all-cause mortality and patients' long-term survival.

The National Health and Nutrition Examination Survey (NHANES) database provided all the data for this study. Logistic regression analyses were adopted to compare the association of each surrogate adiposity marker with the prevalence of HF. Cox proportional hazards models and restricted cubic spline (RCS) analysis were employed to assess the association between surrogate adiposity markers and all-cause mortality in HF patients. The ability of surrogate adiposity markers to predict long-term survival in HF patients was assessed using time-dependent receiver operating characteristic (ROC) curves.

46,257 participants (1,366 HF patients) were encompassed in this retrospective study. An area under the receiver operating characteristic curve (AUC) for the prevalence of HF assessed by weight-adjusted-waist index (WWI) was 0.70 (95% CI: 0.69-0.72). During a median follow-up of 70 months, 700 of 1366 HF patients' death were recorded. The hazard ratio (HR) for HF patients' all-cause mortality was 1.33 (95% CI: 1.06-1.66) in the a body shape index (ABSI) quartile 4 group and 1.43 (95% CI: 1.13-1.82) in the WWI quartile 4 group, compared with the lowest quartile group. The AUC for predicting 5-year survival of HF patients using the ABSI was 0.647 (95% CI: 0.61-0.68).

WWI is strongly correlated with the prevalence of HF. In HF patients, those with higher WWI and ABSI tend to higher all-cause mortality. ABSI can predict patients' long-term survival. We recommend the use of WWI and ABSI for assessing obesity in HF patients.