|
1
|
Dimas-Benedicto C, Albasanz JL, Bermejo LM, Castro-Vázquez L, Sánchez-Melgar A, Martín M, Martínez-García RM. Impact of Iron Intake and Reserves on Cognitive Function in Young University Students. Nutrients 2024; 16:2808. [PMID: 39203944 PMCID: PMC11356983 DOI: 10.3390/nu16162808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024] Open
Abstract
Iron is a key nutrient for cognitive function. During periods of high academic demand, brain and cognitive activity increase, potentially affecting iron intake and reserves. The present study aimed to investigate the impact of iron levels on cognitive function in a university sample, considering the influence of gender. A cross-sectional study was conducted with 132 university students (18-29 years) from the University of Castilla-La Mancha (Spain). A dietary record was formed through a questionnaire to analyze iron consumption, and blood and anthropometric parameters were measured. The Wechsler Adult Intelligence Scale-IV was used to determine the Intelligence Quotient (IQ), as well as the Verbal Comprehension Index (VCI), Working Memory Index (WMI), Processing Speed Index (PSI), and Perceptual Reasoning Index (PRI), to assess cognitive abilities. Among women, the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) was 21% and 4.2%, respectively. No ID or IDA was found in men. The impact of iron intake on IQ and cognitive abilities was mainly associated with the female population, where a positive association between iron intake, serum ferritin, and total IQ was revealed. In conclusion, low iron intake is related to poorer intellectual ability, suggesting that an iron-rich diet is necessary to maintain the academic level of university students.
Collapse
Affiliation(s)
- Carmen Dimas-Benedicto
- NUTRI-SAF Research Group, Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Enfermería, University of Castilla-La Mancha, 16071 Cuenca, Spain; (C.D.-B.); (R.M.M.-G.)
| | - José Luis Albasanz
- GNCR Research Group, Departamento de Química Inorgánica, Orgánica y Bioquímica, Facultad de Medicina de Ciudad Real, Instituto de Biomedicina de la UCLM, IDISCAM, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Laura M. Bermejo
- VALORNUT Research Group, Departamento de Nutrición y Ciencias de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain
| | - Lucía Castro-Vázquez
- NUTRI-SAF Research Group, Departamento de Química Analítica y Tecnología de los Alimentos, Facultad de Farmacia, University of Castilla-La Mancha, 02071 Albacete, Spain;
| | - Alejandro Sánchez-Melgar
- GNCR Research Group, Departamento de Química Inorgánica, Orgánica y Bioquímica, Facultad de Enfermeria de Ciudad Real, Instituto de Biomedicina de la UCLM, IDISCAM, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Mairena Martín
- GNCR Research Group, Departamento de Química Inorgánica, Orgánica y Bioquímica, Facultad de Medicina de Ciudad Real, Instituto de Biomedicina de la UCLM, IDISCAM, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
- GNCR Research Group, Departamento de Química Inorgánica, Orgánica y Bioquímica, Facultad de Enfermeria de Ciudad Real, Instituto de Biomedicina de la UCLM, IDISCAM, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Rosa M. Martínez-García
- NUTRI-SAF Research Group, Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Enfermería, University of Castilla-La Mancha, 16071 Cuenca, Spain; (C.D.-B.); (R.M.M.-G.)
| |
Collapse
|
|
2
|
Low NY, Chan CY, Subramaniam S, Chin KY, Ima Nirwana S, Muhammad N, Fairus A, Ng PY, Jamil NA, Abd Aziz N, Mohamed N. Comparing the performance of body mass index, waist circumference and waist-to-height ratio in predicting Malaysians with excess adiposity. Ann Hum Biol 2022; 49:299-304. [PMID: 36373795 DOI: 10.1080/03014460.2022.2147585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Body mass index (BMI) is a widely used surrogate tool to screen for obesity/adiposity, but it cannot differentiate between lean and fat mass. Thus, alternative tools to detect excess adiposity should be identified. AIM This study aimed to compare the performance of BMI, waist circumference (WC) and waist-to-height ratio (WtHR) in predicting Malaysians with excess body fat defined by dual-energy X-ray absorptiometry (DXA). SUBJECTS AND METHODS A total of 399 men and women aged ≥40 years were recruited from Klang Valley, Malaysia. The body composition of the subjects, including body fat percentage, was measured by DXA. The weight, height, WC and WHtR of the subjects were also determined. RESULTS BMI [sensitivity = 55.7%, specificity = 86.1%, area under curve (AUC) = 0.709] and WC (sensitivity = 62.7%, specificity = 90.3%, AUC = 0.765) performed moderately in predicting excess adiposity. Their performance and sensitivity improved with lower cut-off values. The performance of WHtR (sensitivity = 96.6%, specificity = 36.1, AUC = 0.664) was optimal at the standard cut-off value and no modification was required. CONCLUSION The performance of WC in identifying excess adiposity was greater than BMI and WHtR based on AUC values. Modification of cut-off values for BMI and WC could improve their performance and should be considered by healthcare providers in screening individuals with excess adiposity.
Collapse
Affiliation(s)
- Nie Yen Low
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Chin Yi Chan
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Soelaiman Ima Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Ahmad Fairus
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Pei Yuen Ng
- Centre of Drug Delivery Research, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- School of Healthcare Sciences, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noorazah Abd Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| |
Collapse
|
|
3
|
Lucas RWDC, Nassif PAN, Tabushi FI, Nassif DSB, Ariede BL, Brites-Neto J, Malafaia O. CAN STATURE, ABDOMINAL PERIMETER AND BMI INDEX PREDICT POSSIBLE CARDIOMETABOLIC RISKS IN FUTURE OBESITY? ACTA ACUST UNITED AC 2020; 33:e1529. [PMID: 33237167 PMCID: PMC7682149 DOI: 10.1590/0102-672020200002e1529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/29/2020] [Indexed: 01/26/2023]
Abstract
Background:
Obesity changes the anatomy of the patient. In addition to the aesthetic
change, the high percentage of fat determines evident functional changes.
Anthropometric normality in measuring abdominal circumference and height can
serve as a basis for measuring cardiometabolic risks of obesity.
Aim:
To verify if it is possible to determine parameters of normality between
waist and height in people with normal BMI and fat percentages, to serve as
a basis for assessing risks for obesity comorbidities.
Methods:
A sample of 454 individuals with BMI and percentages of fat considered within
the normal range was extracted. It was divided into age groups for both men
and women between 18 and 25; 26 to 35; 36 to 45; 46 to 55; 56 to 65. A total
of 249 men and 205 women were included.
Results:
Regarding the percentage of height as a measure of the abdominal perimeter,
the total female sample had an average of 44.2±1.1% and the male 45.3%+1.5.
For women, this percentage determined the equation of the waist-height ratio
represented by X=(age+217) / 5.875, and for men X=(age+190.89) / 5.2222. “X”
represents the percentage of the height measurement so that the individual
falls into the category of adequate percentage of fat and BMI.
Conclusion:
Between the stature of adult men and women with normal fat percentage and
BMI, there is a common numerical relationship, with is on average 44% for
women and 45% for men.
Collapse
Affiliation(s)
- Ricardo Wallace das Chagas Lucas
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil
| | - Paulo Afonso Nunes Nassif
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Paulo Nassif Institute, Curitiba, PR, Brazil.,Bariatric and Metabolic Surgery Service, University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil
| | | | - Denise Serpa Bopp Nassif
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Paulo Nassif Institute, Curitiba, PR, Brazil
| | | | | | - Osvaldo Malafaia
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Bariatric and Metabolic Surgery Service, University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil
| |
Collapse
|
|
4
|
Lawal Y, Bello F, Anumah FE, Bakari AG. Waist-height ratio: How well does it predict glucose intolerance and systemic hypertension? Diabetes Res Clin Pract 2019; 158:107925. [PMID: 31715203 DOI: 10.1016/j.diabres.2019.107925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 02/05/2023]
Abstract
AIM The aim of this study is to assess whether WHtR is a better predictor of glucose intolerance and systemic hypertension than some other obesity indices. METHODS This is a cross-sectional observational study among four hundred (4 0 0) participants in a Northern Nigerian population. Four (4) participants were eventually excluded due to incomplete data, therefore data from three hundred and ninety six (3 9 6) participants were used in the final analysis. The study assessed whether WHtR is a better predictor of glucose intolerance and systemic hypertension compared to some other obesity indices. Participants were recruited after due consent, then bio-data, blood pressure levels, and some anthropometric measurements were obtained. Subsequently, plasma glucose levels (fasting [FPG] and 2-hour post 75 g glucose load [2HrPPG]) were measured. Data was entered into Microsoft Excel, then analyzed using IBM SPSS version 23. RESULTS Data from three hundred and ninety six (3 9 6) participants (4 excluded due to incomplete details) were analyzed. Logistic regression of obesity indices showed that WHtR was the best predictor of glucose intolerance with odds ratio (OD) of 20.74 (CI 2.80-155, p < 0.001), followed by WC with OD of 1.89 (CI 1.83-3.94, p < 0.001), then WHR with OD of 1.69 (CI 1.06-8.22, p = 0.009). The least but significant predictor of glucose intolerance was BMI with odds ratio of 1.12 (CI 1.06-3.18, p < 0.001). Furthermore, logistic regression of obesity indices showed that WHtR was the strongest predictor of systemic hypertension with OD of 2.32 (CI 4.85-14.96, p < 0.001), followed by BMI (OD 1.99, CI 1.96-2.05, p = 0.031), then WC (OD 1.95, CI 1.90-1.99, p = 0.020). The weakest predictor of systemic hypertension was WHR (OD 1.26, CI 0.04-1.88, p = 0.181). CONCLUSION WHtR had the highest predictive power for both glucose intolerance and systemic hypertension compared to BMI, WC, and WHR.
Collapse
Affiliation(s)
- Yakubu Lawal
- Consultant Physician and Endocrinologist, Federal Medical Centre, Azare, Bauchi state, Nigeria.
| | - Fatima Bello
- Consultant Physician and Endocrinologist, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - F E Anumah
- Consultant Physician and Endocrinologist, College of Health Sciences, University of Abuja, Nigeria
| | - A G Bakari
- Consultant Physician and Endocrinologist, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| |
Collapse
|
|
5
|
Rajput R, Garg K, Rajput M. Prediabetes Risk Evaluation Scoring System [PRESS]: A simplified scoring system for detecting undiagnosed Prediabetes. Prim Care Diabetes 2019; 13:11-15. [PMID: 30545792 DOI: 10.1016/j.pcd.2018.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 10/29/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To develop a simplified scoring system for detecting undiagnosed prediabetes among healthy adult population of Haryana, India. MATERIAL & METHODS This cross-sectional study was a household survey which involved 892 healthy adults >18year of age who were subjected to an oral glucose tolerance test. Sensitivity, specificity, positive and negative predictive value and area under the receiver operating characteristic (ROC) curve and the optimal cut off points for identifying undiagnosed prediabetes were calculated. RESULTS Out of 892 subjects studied, 459 were males and 433 were females and 160 were found to be prediabetic (17.93%). At an optimal score of >45 the area under the ROC curve is 0.785 with sensitivity, specificity, positive and negative predictive value of 84.37%, 58.47%, 30.75 and 94.48% respectively. CONCLUSIONS Prediabetes Risk Evaluation Scoring System (PRESS) a simple and non-invasive screening tool to identify adult individuals having undiagnosed prediabetes.
Collapse
Affiliation(s)
- Rajesh Rajput
- Department of Endocrinology & Medicine Unit V, India.
| | - Keshav Garg
- Department of Endocrinology & Medicine Unit V, India
| | - Meena Rajput
- Department of Community Medicine, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| |
Collapse
|
|
6
|
Pantoja-Torres B, Toro-Huamanchumo CJ, Urrunaga-Pastor D, Guarnizo-Poma M, Lazaro-Alcantara H, Paico-Palacios S, Del Carmen Ranilla-Seguin V, Benites-Zapata VA. High triglycerides to HDL-cholesterol ratio is associated with insulin resistance in normal-weight healthy adults. Diabetes Metab Syndr 2019; 13:382-388. [PMID: 30641729 DOI: 10.1016/j.dsx.2018.10.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the association between high triglyceride/HDL-cholesterol (TG/HDL-C) ratio and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in normal-weight healthy adults. METHODS We carried out an analytical cross-sectional study in euthyroid non-diabetic adults, who attended the outpatient service of a private clinic in Lima-Peru from 2012 to 2016. Participants were divided in two groups according to the presence or absence of high TG/HDL-C ratio, IR or hyperinsulinemia after OGTT. TG/HDL-C ratio values ≥ 3 were considered as high. IR was defined as a Homeostasis Model Assessment (HOMA-IR) value ≥ 2.28 and hyperinsulinemia after OGTT as a serum insulin value ≥ 80μU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson generalized linear models to evaluate the association between high TG/HDL-C ratio and IR or hyperinsulinemia after OGTT and reported the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed the data of 118 individuals. Prevalence of high TG/HDL-C ratio was 17.8% (n = 21) while the prevalence of IR and hyperinsulinemia after OGTT was 24.6% (n = 29) and 17.0% (n = 20), respectively. TG/HDL-C-ratio values were positively correlated with HOMA-IR (r = 0.498; p < 0.01) and serum insulin after OGTT (r = 0.326; p < 0.001). In the adjusted model, high TG/HDL-C ratio was associated with both IR (aPR = 3.16; 95%CI: 1.80-5.77) and hyperinsulinemia after OGTT (aPR = 2.36; 95%CI: 1.20-4.63). CONCLUSIONS High TG/HDL-C ratio was associated with both IR markers used in our study, appearing to be a clinically useful tool to assess IR in euthyroid normal-weight adults without type 2 diabetes mellitus.
Collapse
Affiliation(s)
| | - Carlos J Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | | | | | | | | | - Vicente A Benites-Zapata
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| |
Collapse
|
|
7
|
Thapliyal V, Singh K, Joshi A. Prevalence and Associated Factors of Hypertension among Adults in Rural Uttarakhand: A Community Based Cross Sectional Study. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2018. [DOI: 10.12944/crnfsj.6.2.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
India is in a state of transition epidemiological, economic, and demographic and nutrition transition. And all these transitions are leading to non communicable diseases like obesity, hypertension and insulin resistance. The study was aimed to estimate the Prevalence of hypertension and its associated risk factors among adults of rural Uttrakhand.
It is a cross sectional community based study. Survey was conducted in rural areas of Uttrakhand, to make a sample size of 300 adults (18-45yr), using WHO STEPS questionnaire. Waist Circumference, Blood pressure, Body Mass Index of the participants was calculated. P value < 0.05 was considered significant.
In the sample population based on systolic BP, 61.3% were non-hypertensive, 29.7% were pre-hypertensive and 9% were hypertensive. Based on diastolic BP, 43.3% were non-hypertensive, 32.7% were pre-hypertensive and 24% were hypertensive. Subjects with hypertension and pre-hypertension have higher BMI and waist circumference.
A high prevalence rate of pre-hypertension and hypertension was depicted in rural areas of Uttrakhand region.4.8% of the female participants had systolic high blood pressure compared to the 11.9% of the male participants. On the other hand, 21.8% of the female participants had diastolic high blood pressure compared to the over 25% of the male participants.
Collapse
Affiliation(s)
| | - Karuna Singh
- Amity Institute of Food Technology, Amity University, Noida
| | - Anil Joshi
- Himalayan Environmental Studies and Conservation Organization (HESCO)
| |
Collapse
|
|
8
|
Abstract
AbstractObjectiveTo retrospectively investigate the association between short stature and increased sitting height ratio (SHR) – indicators of stunting – and obesity markers in adults.DesignCross-sectional evaluation of the EPIPorto cohort. Weight, height, sitting height and waist circumference were measured. Obesity was assessed for men and women through BMI and waist-to-height ratio (WHtR). Short stature (women, <152 cm; men, <164 cm) and high SHR (women, ≥54·05 %; men, ≥53·25 %) were taken as stunting measures. OR with 95 % CI were computed using logistic regression models.SettingRepresentative sample of adults from EPIPorto, an adult cohort study from Porto, Portugal.SubjectsA sample of 1682 adults, aged 18–86 years, was analysed.ResultsHigher obesity prevalence was found among women (BMI≥30·0 kg/m2: 25·5v.13·3 %,P<0·001) and a higher proportion of men presented abdominal obesity (WHtR≥0·5: 80·1v.71·1 %,P<0·001). A positive association was found between short stature and obesity measures for women (multivariate-adjusted OR; 95 % CI: 1·75; 1·17, 2·62 for BMI≥30·0 kg/m2; 1·89; 1·24, 2·87 for WHtR≥0·5). Increased SHR was associated with higher likelihood of having BMI≥30·0 kg/m2in both sexes (multivariate-adjusted OR; 95 % CI: 2·10; 1·40, 3·16 for women; 1·92; 1·07, 3·43 for men) but not with WHtR≥0·5.ConclusionsDifferent growth markers are associated with obesity in adults. However, this association depends on the population and anthropometric measures used: short stature is associated with a higher risk of presenting excessive weight in women but not in men; SHR is more sensitive to detect this effect in both sexes.
Collapse
|
|
9
|
The relationship between visceral obesity and hepatic steatosis measured by controlled attenuation parameter. PLoS One 2017; 12:e0187066. [PMID: 29077769 PMCID: PMC5659780 DOI: 10.1371/journal.pone.0187066] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is closely related with obesity. However, obese subjects, generally represented by high BMI, do not always develop NAFLD. A number of possible causes of NAFLD have been studied, but the exact mechanism has not yet been elucidated. Methods A total of 304 consecutive subjects who underwent general health examinations including abdominal ultrasonography, transient elastography and abdominal fat computed tomography were prospectively enrolled. Significant steatosis was diagnosed by ultrasonography and controlled attenuation parameter (CAP) assessed by transient elastography. Results Visceral fat area (VFA) was significantly related to hepatic steatosis assessed by CAP, whereas body mass index (BMI) was related to CAP only in univariate analysis. In multiple logistic regression analysis, VFA (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.001–1.019; P = 0.028) and triglycerides (TG) (OR, 1.006; 95% CI, 1.001–1.011; P = 0.022) were independent risk factors for significant hepatic steatosis. The risk of significant hepatic steatosis was higher in patients with higher VFA: the OR was 4.838 (P<0.001; 95% CI, 2.912–8.039) for 100<VFA≤200 cm2 and 7.474 (P<0.001; 95% CI, 2.462–22.693) for VFA >200 cm2, compared to patients with a VFA ≤100 cm2. Conclusions Our data demonstrated that VFA and TG is significantly related to hepatic steatosis assessed by CAP not BMI. This finding suggests that surveillance for subjects with NAFLD should incorporate an indicator of visceral obesity, and not simply rely on BMI.
Collapse
|
|
10
|
Hadaegh F, Esmaillzadeh A, Azizi F. Metabolic risks in individuals with normal body mass index and normal waist circumference. ACTA ACUST UNITED AC 2016; 14:200-7. [PMID: 17446797 DOI: 10.1097/01.hjr.0000230096.73579.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Risk of cardiovascular diseases increases in Asian adults within the normal limits of body mass index and waist circumference. OBJECTIVE To determine a point of body mass index and waist circumference above which the chances of having cardiovascular risk factors increased. METHODS Data on anthropometric indices, blood pressure and biochemical measures were collected in a cross-sectional study of 3447 participants (1781 males and 1666 females) with normal body mass index (19 to <25 kg/m for both sexes) and normal waist circumference (<102 cm for men and <88 cm for women). Metabolic abnormalities were defined on the basis of the standard published criteria. RESULTS Individuals at the highest category of body mass index (24 to <25 kg/m) had significantly higher odds for having metabolic risk factors (odds ratios ranging from 1.3 to 1.6 for men and 1.36 to 2.0 for women for different risk factors) compared with those at first category (19 to <20 kg/m). Furthermore, individuals at the top category of waist circumference (95 to <102 cm for men and 85-88 cm for women) had significantly higher chances of having metabolic abnormalities (odds ratios ranging from 2.6 to 4.5 for men and 2.1 to 2.6 for women for different risk factors) compared with those in the first category (62 to <70 cm for men and 60 to <65 cm for women) in both sexes. CONCLUSION We concluded that the cut-off points of body mass index and waist circumference suggested by the World Health Organization are inappropriate for the Tehranian urban population.
Collapse
Affiliation(s)
- Farzad Hadaegh
- Endocrine Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | | | | |
Collapse
|
|
11
|
Abstract
Taiwan's indigenous population exhibits a higher mortality of cardiovascular disease, but current research has not reported any associations among ethnicities on the blood pressure (BP). We randomly selected representative samples in this population-based study. We measured height, weight, hip and waist circumferences, and blood pressure in a screening survey. Systolic BP and diastolic BP were significantly higher in the indigenous population. Among women, prevalence rates of DBP > 90 mmHg among indigenes (32.9 %) were significantly high than those in Han Chinese (17.4 %). Based on multivariate analysis adjusted for covariates, the results showed gender and ethnicity to be significantly correlated with systolic and diastolic BP. Gender was a modifier between ethnicity and BP. Furthermore, we found an additive effect between ethnicity and age on systolic and diastolic BP by gender. Our study showed independent additive effects on systolic BP and diastolic BP between ethnicity and age by gender.
Collapse
|
|
12
|
Kshatriya GK, Acharya SK. Triple Burden of Obesity, Undernutrition, and Cardiovascular Disease Risk among Indian Tribes. PLoS One 2016; 11:e0147934. [PMID: 26808418 PMCID: PMC4726542 DOI: 10.1371/journal.pone.0147934] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 01/11/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Socio-cultural transitions among individuals from vulnerable groups introduce epidemiological transition, with a concomitant increase in the prevalence of undernutrition, obesity, and cardiovascular disease risks. An accepted conventional wisdom exists for Indian tribes that they are undernourished and away from lifestyle-related diseases. However, the extent of this triple burden affecting them is unknown. In this study, we assessed this triple burden among the 9 major tribes of India. METHODS AND FINDINGS During January 2011 to December 2013, we conducted a cross-sectional study among 1066 men and 1090 women constituting a total of 2156 adults belonging to the 9 major tribal groups: Santals, Oraons, and Koras (West Bengal); Santals, Bhumijs, and Bathudis (Odisha); and Dhodias, Kuknas, and Chaudharis (Gujarat) to estimate the prevalence of the triple burden (undernutrition, overweight or obesity, and hypertension). A high prevalence of undernutrition and hypertension was observed among the Koras (51.9%and 10.6%, respectively), Bathudis (51.3% and 12.1%, respectively), and Oraons (49.6% and 16.5%, respectively). However, the prevalence of overweight and hypertension among the Bhumijs (17.7% and 14.7%, respectively), Dhodias (23.8% and 12.9%, respectively), Kuknas (15.8% and 11.3%, respectively), and Santals of West Bengal (12.2% and 11.8%, respectively) and Odisha (15% and 9.6%, respectively) was most alarming. The prevalence of overweight or obesity among the women was 10.9% and 1.5%, respectively, with 14.0% hypertensive women. The prevalence of overweight and obesity among the men was 14.8% and 1.7%, respectively, with 9.2% hypertensive men. Undernutrition was highly prevalent among men and women. However, data from the past 30 years on systolic blood pressure (SBP) and body mass index (BMI) revealed that the studied tribes were at a higher risk than the general Indian population. In addition, a vast gender disparity with relation to the disease and risk prevalence was observed. CONCLUSION The alarming trend of an increasing prevalence of overweight/obesity, undernutrition, and hypertension is observed among indigenous populations of India, emphasizing the incorporation of a specific health management policy.
Collapse
|
|
13
|
Lee IJ, Jang BK, Lee JW, Son BS, Cheong HK, Ha M, Choi YH, Park M. Association between Metabolic Syndrome and Participation in Clean-up Work at the Hebei Spirit Oil Spill. ACTA ACUST UNITED AC 2015. [DOI: 10.5668/jehs.2015.41.5.335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
|
14
|
Moges B, Amare B, Fantahun B, Kassu A. High prevalence of overweight, obesity, and hypertension with increased risk to cardiovascular disorders among adults in northwest Ethiopia: a cross sectional study. BMC Cardiovasc Disord 2014; 14:155. [PMID: 25373922 PMCID: PMC4228065 DOI: 10.1186/1471-2261-14-155] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 10/27/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Overweight and obesity are components of a defined cluster of risk factors for non-communicable diseases, once problems for only the high-income countries, in recent days became rampant in developing countries. Despite the lack of extensive data on metabolic and cardio vascular disorders in Ethiopia, the prevalence of obesity among young adults (15-24 years), in a cross sectional study conducted in 1997, was 0.7% for men and 6% for women. The prevalence of hypertension (HTN) was found to be 7.1% of the population. The objective of this study was to see the prevalence and association of overweight, obesity and HTN and to check if there was any agreement among the various anthropometric measurements in detecting overweight and obesity. METHODS This cross-sectional study was conducted in Gondar city, Northwest Ethiopia. A total of 68 participants with age >18 year were randomly selected and included. Data were collected using questionnaires and through physical measurements of weight, height and blood pressure, using the WHO recommendations. RESULT The prevalence of hypertension was 13.3% (9/68). The prevalence of overweight based on calculated body mass index (BMI) was 32.4% (22/68) while the prevalence of obesity was 16.2% (11/68). Body fat percentage (BFP) effectively classified all of the 'overweight' and 'obese' values according to the BMI as 'overweight/obese' (P = 0.016). Risk level classification with waist circumference enabled to correctly classify most (90.9%) and all of the 'overweight' and 'obese' BMI values as 'increased risk/substantially increased risk' (P < 0.001). Similarly, waist-to-height ratio (WHtR) was able to classify all 'overweight' and 'obese' BMI values as 'increased risk/substantially increased risk' (P < 0.001). CONCLUSION In conclusion, the current study was able to detect a high prevalence of overweight, obesity, and HTN among adult population in Gondar town. There is a prevalent high level of general adiposity and central obesity. WHtR and BFP were the most efficient measurements to identify all 'high risk' groups of individuals as 'high risk' irrespective of their gender. Further study is recommended to elucidate the risk factors and complications of obesity and overweight in the study area and beyond.
Collapse
Affiliation(s)
- Beyene Moges
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | | | | | | |
Collapse
|
|
15
|
Cho JY, Chung TH, Lim KM, Park HJ, Jang JM. The impact of weight changes on nonalcoholic Fatty liver disease in adult men with normal weight. Korean J Fam Med 2014; 35:243-50. [PMID: 25309705 PMCID: PMC4192788 DOI: 10.4082/kjfm.2014.35.5.243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 06/16/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although it is known that losing weight has an effect on the treatment of non-alcoholic fatty liver disease, the studies that show how losing weight affects the non-alcoholic fatty liver disease for the normal weight male adults are limited so far. In this study, we set body mass index as criteria and investigated how the weight changes for 4 years makes an impact on the risk of non-alcoholic fatty liver disease for the male adults who have the normal body mass index. METHODS From January to December of 2004, among the normal weight male adults who had general check-up at the Health Promotion Center of Ulsan University Hospital, 180 people (average age, 47.4 ± 4.61 years) who were diagnosed with fatty liver through abdominal ultrasonography were included in this study and were observed according to the variety of data and ultrasonography after 4 years (2008). People who had a history of drinking more than 140 g of alcohol per week or who had a past medical history were excluded from the analysis. The weight change of subjects was calculated using the formula 'weight change = weight of 2008 (kg) - weight of 2004 (kg)' and classified into three groups, loss group (≤-3.0 kg), stable group (-2.9 to 2.9 kg), and gain group (≥3.0 kg). The odds for disappearance of non-alcoholic fatty liver disease in those three different groups were compared. RESULTS Among 180 subjects, compared with stable group (67.2%, 121 subjects), loss group (11.7%, 21 subjects) showed 18.37-fold increase in the odds of disappearance of non-alcoholic fatty liver disease (95% confidence interval [CI], 4.34 to 77.80) and gain group (21.1%, 38 subjects) showed 0.28-fold decrease in the odds of disappearance of non-alcoholic fatty liver disease (95% CI, 0.10 to 0.83). CONCLUSION Even for the normal weight people, losing weight has an effect on the improvement of non-alcoholic fatty liver disease.
Collapse
Affiliation(s)
- Ji-Young Cho
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Tae-Heum Chung
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyoung-Mo Lim
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hee-Jin Park
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jung-Mi Jang
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| |
Collapse
|
|
16
|
Midha T, Krishna V, Nath B, Kumari R, Rao YK, Pandey U, Kaur S. Cut-off of body mass index and waist circumference to predict hypertension in Indian adults. World J Clin Cases 2014; 2:272-278. [PMID: 25032202 PMCID: PMC4097154 DOI: 10.12998/wjcc.v2.i7.272] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 06/12/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the cut-off values of body mass index (BMI) and waist circumference to predict hypertension in adults in north India.
METHODS: A community based cross-sectional study was conducted in 801 subjects in Kanpur, aged 20 years and above, using multistage stratified random sampling technique. A pre-tested structured questionnaire was used to elicit the required information from the study participants and the diagnostic criteria for hypertension were taken according to the Seventh Joint National Committee Report on Hypertension (JNC-7). Receiver operating characteristic (ROC) analysis was used to estimate the cut-off values of BMI and waist circumference to predict hypertension.
RESULTS: The ROC analysis revealed that BMI is a good predictor of hypertension for both men (area under the ROC curve 0.714) and women (area under the ROC curve 0.821). The cut-off values of BMI for predicting hypertension were identified as ≥ 24.5 kg/m2 in men and ≥ 24.9 kg/m2 in women. Similarly, the ROC analysis for waist circumference showed that it is a good predictor of hypertension both for men (area under the ROC curve 0.784) and women (area under the ROC curve 0.815). The cut-offs for waist circumference for predicting hypertension were estimated as ≥ 83 cm for men and ≥ 78 cm for women. Adults with high BMI or high waist circumference had a higher prevalence of hypertension, respectively.
CONCLUSION: Simple anthropometric measurements such as BMI and waist circumference can be used for screening people at increased risk of hypertension in order to refer them for more careful and early diagnostic evaluation. Policies and programs are required for primary and secondary prevention of hypertension.
Collapse
|
|
17
|
Rajput R, Rajput M, Bairwa M, Singh J, Saini O, Shankar V. Waist height ratio: A universal screening tool for prediction of metabolic syndrome in urban and rural population of Haryana. Indian J Endocrinol Metab 2014; 18:394-399. [PMID: 24944937 PMCID: PMC4056141 DOI: 10.4103/2230-8210.131201] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
AIMS To compare waist circumference (WC), body mass index (BMI), waist hip ratio (WHR), and waist-to-height ratio (WHtR) and define an appropriate cut-off, which is most closely predictive of the non-adipose components of the IDF metabolic syndrome (MetS) definition. METHODS AND RESULTS A total of 3,042 adults (1,693 in rural area and 1,349 in urban area) were screened for the presence of MetS according to the IDF definition. Among 3,042 adults selected as subjects, 1,518 were male and 1,524 were female. The receiver operating curve (ROC) analysis was done to determine the optimal cut-off value and the best discriminatory value of each of these anthropometric parameters to predict two or more non-obese components of metabolic syndrome. The area under ROC (AURC) for WC was superior to that for other anthropometric variables. The optimal cut-off value of WC in urban and rural males was >89 cm, which is higher than that in urban and rural females at 83 cm and 79 cm, respectively; the optimal cut-off for WHtR was >0.51 in rural females, 0.52 in rural males, and 0.53 in both urban males and females. Both parameters were found to be better than BMI and WHR. ROC and AURC values for WC were better than those for WHtR in men and women in both urban and rural areas (P = 0.0054); however, when the entire study cohort was analyzed together, irrespective of gender and place of residence, then at a value of 0.52, WHtR scored over WC as a predictor of metabolic syndrome (P = 0.001). CONCLUSION Although the predictive value of different gender-specific WC values is clearly superior to other anthropometric measures for predicting two or more non-adipose components of MetS, a single value of WHtR irrespective of gender and the area of residence can be used as a universal screening tool for the identification of individuals at high risk of development of metabolic complications.
Collapse
Affiliation(s)
- Rajesh Rajput
- Department of Endocrinology and Medicine Unit VI, Pt. B.D.S. PGIMS, Rohtak, Haryana, India
| | - Meena Rajput
- Department of Community Medicine, Pt. B.D.S. PGIMS, Rohtak, Haryana, India
| | - Mohan Bairwa
- Department of Community Medicine, Pt. B.D.S. PGIMS, Rohtak, Haryana, India
| | - Jasminder Singh
- Department of Endocrinology and Medicine Unit VI, Pt. B.D.S. PGIMS, Rohtak, Haryana, India
| | - Ompal Saini
- Department of Endocrinology and Medicine Unit VI, Pt. B.D.S. PGIMS, Rohtak, Haryana, India
| | - Vijay Shankar
- Department of Biochemistry, Pt. B.D.S. PGIMS, Rohtak, Haryana, India
| |
Collapse
|
|
18
|
Sarry El Din AM, Zaki ME, Kandeel WA, Mohamed SK, El Wakeel KH. Cut-Off Values of Anthropometric Indices for the Prediction of Hypertension in a Sample of Egyptian Adults. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Obesity, particularly abdominal adiposity, is closely associated with premature atherosclerosis and many metabolic modifications including insulin resistance dyslipidemia hypertension and diabetes. Cut-off values for abdominal obesity predicting future cardiovascular disease are known to be population specific.Objective: To identify cut-off points of some anthropometric measurements (BMI, WC, WHR and WHtR) that associated with hypertension in a sample of Egyptian adults.Subjects and Methods: This is a cross-sectional analysis. The blood pressure of 5550 Egyptian adults was measured (2670 females – 2880 males).The subjects represented different geographic localities and different social classes. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured by practitioners.Results: The cut-off values to detect hypertension in females were 30.08 for BMI, 87.75 for WC , 0.81 for WHR and 0.65 for WHtR, and the corresponding sensitivity and specificity were 69.1; 60.7- 80.9; 48.6 -65.3; 53.4 and 61.4; 58.9, respectively. The cut-off values to detect hypertension in males were 27.98 for BMI, 95.75 for WC, 0.92 for WHR, and 0.57 for WHtR and the corresponding sensitivity and specificity were 62.8; 59.9 -71.9; 51.9 -64.6; 55.8 and 59.7; 55.8, respectively.Conclusion: The BMI, Waist circumference, WHR and WHtR values can predict the presence of hypertension risk in adult Egyptians.
Collapse
|
|
19
|
Ren Y, Wang B, Liu X, Li Z, Yuan W, Sun Y, Miao M. Association between body fat distribution and androgen deficiency in middle-aged and elderly men in China. Int J Impot Res 2013; 26:116-9. [PMID: 24352246 DOI: 10.1038/ijir.2013.48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 08/17/2013] [Accepted: 11/06/2013] [Indexed: 11/09/2022]
Abstract
The objective of the present study was to examine the association between body fat distribution and total testosterone (TT) and free testosterone (FT) levels among middle-aged and elderly men. A total of 922 male residents aged 40-70 years from a community in Shanghai, China, participated in the study. Their waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), and TT and FT concentrations were measured. Logistic regression models were used to estimate testosterone deficiency risk on the basis of anthropometric indices. BMI, WC and WHtR were all associated with TT deficiency. The participants in the highest quartiles of above-mentioned anthropometric indices had the highest risk of TT deficiency (BMI: odds ratio (OR)=4.40, 95% confidence interval (CI)=2.69-7.19; WC: OR=3.47, 95% CI=2.14-5.60; WHtR: OR=2.89, 95% CI=1.76-4.76). WC and WHtR were associated with FT deficiency. The participants in the highest quartiles had the highest risk of FT deficiency (WC: OR=1.87, 95% CI=1.18-2.97; WHtR: OR=1.67, 95% CI=1.04-2.66). The association between BMI and FT deficiency was not statistically significant (OR=1.21 for the highest quartile, 95% CI=0.78-1.87). Our study demonstrated that both general and abdominal obesity were associated with TT deficiency, whereas only abdominal obesity was found to be associated with FT deficiency.
Collapse
Affiliation(s)
- Y Ren
- Weifang Medical University, Weifang, China
| | - B Wang
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - X Liu
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Z Li
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - W Yuan
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Y Sun
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - M Miao
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| |
Collapse
|
|
20
|
Abstract
The nonalcoholic fatty liver disease (NAFLD) is defined as the presence of hepatic steatosis, determined by either imaging or histology, in the absence of secondary causes of hepatic fat accumulation. Nonalcoholic fatty liver is defined as the presence of hepatic steatosis with no evidence of hepatocellular injury in the form of ballooning of the hepatocytes or fibrosis. NASH is defined as the presence of hepatic steatosis and inflammation with hepatocyte injury (ballooning) with or without fibrosis. Although initial epidemiological studies have focused on its prevalence in the Western countries, it is becoming increasingly clear that NAFLD is highly prevalent in the Asia Pacific region, and there may be important distinctions in its phenotype between Asia Pacific and Western countries. Of particular interest are "lean NAFLD" and the "urban-rural divide," which will be discussed in this review article. Obesity, dyslipidemia, type 2 diabetes and metabolic syndrome are established risk factors for developing NAFLD. Many other risk factors (e.g., hypothyroidism, polycystic ovary syndrome, obstructive sleep apnea, hypopituitarism and hypogonadism) for NAFLD have been described in the Western countries, but these associations are yet to be investigated adequately in the Asia Pacific region.
Collapse
|
|
21
|
Buduneli N, Bıyıkoğlu B, Ilgenli T, Buduneli E, Nalbantsoy A, Saraç F, Kinane DF. Is obesity a possible modifier of periodontal disease as a chronic inflammatory process? A case-control study. J Periodontal Res 2013; 49:465-71. [PMID: 23919737 DOI: 10.1111/jre.12125] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE This cross-sectional case-control study was conducted to provide a comparative evaluation of clinical periodontal measurements, together with serum levels of certain bioactive peptides and inflammatory cytokines, in relation to obesity. For this purpose, clinical periodontal measurements and the levels of serum leptin, adiponectin, interleukin-6 (IL-6), C-reactive protein and soluble intercellular adhesion molecule-1 of obese female individuals and their nonobese counterparts were compared. MATERIAL AND METHODS Sixty obese (body mass index (BMI) > 30) and 31 nonobese (BMI < 30) female subjects were recruited for the present study. Before any periodontal intervention, serum samples were obtained and full-mouth clinical periodontal measurements were recorded at six sites per tooth. ELISA was used for the biochemical analysis. Data were tested statistically. RESULTS Clinical attachment level was significantly higher in the obese group compared with the nonobese control group (p < 0.05). Serum levels of leptin and IL-6 were significantly higher in the obese group (p < 0.05). BMI correlated with the serum levels of inflammatory molecules (p < 0.05), but not with clinical periodontal parameters, in the obese group. CONCLUSION In conclusion, obesity does not seem to have a prominent effect on clinical periodontal parameters but it does have many correlations with circulating inflammatory molecules. As suggested in the literature, increased levels of leptin and IL-6 in the obese group might be one explanation for a possible relationship between obesity and periodontal disease. A prospective study is warranted to clarify, in greater detail, the effects of obesity on periodontal health.
Collapse
Affiliation(s)
- N Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | | | | | | | | | | | | |
Collapse
|
|
22
|
Ju DY, Choe YG, Cho YK, Shin DS, Yoo SH, Yim SH, Lee JY, Park JH, Kim HJ, Park DI, Sohn CI, Jeon WK, Kim BI. The influence of waist circumference on insulin resistance and nonalcoholic fatty liver disease in apparently healthy Korean adults. Clin Mol Hepatol 2013; 19:140-7. [PMID: 23837138 PMCID: PMC3701846 DOI: 10.3350/cmh.2013.19.2.140] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 04/21/2013] [Accepted: 05/07/2013] [Indexed: 12/21/2022] Open
Abstract
Background/Aims Waist circumference (WC) is a risk factor for metabolic syndrome and is related to insulin resistance (IR) and nonalcoholic fatty liver disease (NAFLD). The purpose of this study was to determine the association between WC and IR and NAFLD in apparently healthy Korean adults. Methods The volunteers included in this cross-sectional study comprised 9,159 adults (5,052 men, 4,107 women) who participated in a comprehensive health checkup program. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR) and was considered to be present when the HOMA-IR score was >2. NAFLD was evaluated by ultrasound examination. Elevated alanine aminotransferase (ALT) was defined as >40 IU/L in men and >35 IU/L in women. Logistic regression was performed to determine the odds ratios (ORs) and 95% confidence intervals (95% CIs) for NAFLD, IR, and ALT according to categorized levels of WC. Results NAFLD was found in 2,553 (27.9%) of the participants (82.6% men, 17.4% women), while IR and elevated ALT were found in 17.2% (68.1% men, 31.9% women) and 10% (83% men, 17% women), respectively. After adjusting for confounding factors, the prevalence of NAFLD, IR, and elevated ALT was significantly associated with increases in WC quartile: highest quartile for NAFLD in men, OR=15.539, 95% CI=12.687-19.033; highest quartile for NAFLD in women, OR=48.732, 95% CI=23.918-99.288 (P<0.001); and highest quartile for IR in men, OR=17.576, 95% CI=13.283-23.255; highest quartile for IR in women, OR=11.078, 95% CI=7.813-15.708 (P<0.001); highest quartile for elevated ALT in men, OR=7.952, 95% CI=6.046-10.459; and highest quartile for elevated ALT in women, OR=8.487, 95% CI=4.679-15.395 (P<0.001). Conclusions WC contributes to IR and NAFLD in apparently healthy Korean adults, and thus may be an important factor in the development of IR and NAFLD.
Collapse
Affiliation(s)
- Deok Yun Ju
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
23
|
Waist to height ratio for recording the risks of overweight in schoolchildren in Kerala. Indian Pediatr 2013; 50:493-5. [DOI: 10.1007/s13312-013-0150-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 09/21/2012] [Indexed: 10/26/2022]
|
|
24
|
Park YS, Kim JS. Association between waist-to-height ratio and metabolic risk factors in Korean adults with normal body mass index and waist circumference. TOHOKU J EXP MED 2013; 228:1-8. [PMID: 22864013 DOI: 10.1620/tjem.228.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is little consensus on the best obesity index associated with metabolic risk factors among the population with normal both body mass index (BMI) and waist circumference (WC). We therefore evaluated the association between anthropometric indices and metabolic risk factors in a Korean population with normal BMI and WC. This cross-sectional study involved 2,952 participants aged 20-79 years who had normal BMI and WC, based on the Fourth Korea National Health and Nutrition Examination Surveys conducted in 2008. The receiver operating characteristic (ROC) curves were generated to identify the optimal measurement of obesity for the prediction of metabolic risk factors in this population. The area under the ROC curve value for waist-to-height ratio (WHtR) in prediction of metabolic syndrome (MetS) and its components was higher than that for BMI and WC. Among individuals with normal BMI and WC, prevalence of all metabolic risk factors and MetS significantly increased across the quartiles of WHtR in both men and women. After adjustment for potential confounders, the Odds Ratios (95% confidence intervals) for MetS in the second, third, and fourth quartiles of WHtR compared to the first quartile of WHtR were 3.53 (2.12-5.89), 6.06 (3.52-10.43), and 7.11 (4.08-12.38) in men, and 1.66 (1.01-2.72), 2.79 (1.81-4.30), and 2.82 (1.76-4.52) in women, respectively. In conclusion, WHtR has the best predictive value for evaluating the metabolic risk factors compared to BMI or WC alone among subjects with normal BMI and WC.
Collapse
Affiliation(s)
- Yong Soon Park
- Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Suwon, Korea
| | | |
Collapse
|
|
25
|
Liu CJ. Prevalence and risk factors for non-alcoholic fatty liver disease in Asian people who are not obese. J Gastroenterol Hepatol 2012; 27:1555-60. [PMID: 22741595 DOI: 10.1111/j.1440-1746.2012.07222.x] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Fatty liver (hepatic steatosis) is prevalent in industrialized countries. It is typically linked to obesity, central obesity and the presence of metabolic syndrome. With the introduction of a Westernized lifestyle and the increasing frequency of obesity in the Asia-Pacific region, the prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing over the past two decades. The risk factors are similar to those in other ethnic populations; but it is important to adopt the regional (ethnic-specific) anthropometric criteria to define overweight, obesity (including central obesity) and metabolic syndrome. To be noted, even using strict ethnic-specific criteria, a high percentage (15-21%) of Asia-Pacific NAFLD subjects in some series have been found to be non-obese, i.e. to have a normal body mass index (BMI) (17.5-22.4 kg/m(2)) or to be overweight (BMI 22.5-24.9 kg/m(2)). Differential distribution of visceral adipose tissue, recent increase in body weight, intake of high cholesterol diet and genetic background are factors likely associated with the development of NAFLD in these non-obese (but often overweight) Asia-Pacific subjects. Furthermore, insulin resistance may be the underlying key mechanism. In addition, since NAFLD may be the hepatic manifestation of metabolic syndrome, the presence of NAFLD is a predictor of future type 2 diabetes, metabolic syndrome and cardiovascular disease. Therefore, interventions at the public health level are indicated to halt the trend of overweight as well as obesity in Asia-Pacific region, particularly among those with relevant family history. Since the pathophysiology of NAFLD is closely related to metabolic derangement, lifestyle modification remains the cornerstone of management.
Collapse
Affiliation(s)
- Chun-Jen Liu
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
|
26
|
García OP, Ronquillo D, Caamaño MDC, Camacho M, Long KZ, Rosado JL. Zinc, vitamin A, and vitamin C status are associated with leptin concentrations and obesity in Mexican women: results from a cross-sectional study. Nutr Metab (Lond) 2012; 9:59. [PMID: 22703731 PMCID: PMC3406981 DOI: 10.1186/1743-7075-9-59] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 06/15/2012] [Indexed: 02/06/2023] Open
Abstract
Background The prevalence of obesity among Mexican women is high and it could be related to micronutrient status. We evaluated in a cross-sectional study the associations of zinc and vitamins A, C and E concentrations with BMI, central adiposity, body fat and leptin concentration. Methods Women aged 37 ± 7.5 years (n = 580) from 6 rural communities in Mexico were evaluated. Anthropometric measurements included weight, height, waist and hip circumference. A fasting blood sample was taken for the analysis of glucose, lipid profile, leptin, zinc, and vitamins A, C and E. Body composition was determined by DEXA (Hologic Mod Explorer). Results The prevalence of overweight and obesity was 36% (BMI > 25 Kg/m2) and 44% (BMI > 30 Kg/m2), respectively. Prevalence of zinc and vitamins C and E deficiencies were similar in obese, overweight and normal weight women. No vitamin A deficiency was found. Vitamin C was negatively associated with BMI, waist-to-height ratio, and leptin concentrations (p < 0.05). Vitamin A was positively associated with leptin (p < 0.05). When stratifying by BMI, % body fat and waist circumference, high leptin concentrations were associated with lower zinc and lower vitamin C concentrations in women with obesity (p < 0.05) and higher vitamin A concentrations in women without obesity (p < 0.01). Vitamin E status was not associated with any markers of obesity. Conclusion Zinc and vitamins A and C are associated with obesity, adiposity and leptin concentration in women from rural Mexico, and may play an important role in fat deposition. The causality of these associations needs to be confirmed.
Collapse
Affiliation(s)
- Olga Patricia García
- School of Natural Sciences, Universidad Autónoma de Querétaro, Av, De la Ciencia S/N, Juriquilla, Querétaro, 76230, Mexico.
| | | | | | | | | | | |
Collapse
|
|
27
|
Maniwa R, Iwamoto M, Nogi A, Yamasaki M, Yang JJ, Hanaoka H, Shiwaku K. Behavioral intervention in the overweight and obese employee: the challenge of promoting weight loss and physical activity. J Rural Med 2012; 7:25-32. [PMID: 25648082 PMCID: PMC4309326 DOI: 10.2185/jrm.7.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 04/12/2012] [Indexed: 11/27/2022] Open
Abstract
Effects of gender and employment situation on weight loss and lifestyle modification were
assessed in a 3-month intervention study done for overweight and obesity. A total of 384
individuals in Izumo City Japan, participated from 2000 to 2006. Lifestyle modifications
were quantitatively evaluated by calculating calories of energy intake and expenditure.
Eleven men and 15 women failed to complete the intervention; they were significantly
younger in both genders, and the women had a higher rate of employment than the completing
group (91 men and 267 women). Intervention induced a weight loss of 1.9 kg for men and 1.6
kg for women, with no significant differences by gender. Significant differences were
found in changes in energy intake and expenditure in both genders, but these disappeared
after adjusting for weight. There were significant decreases in weight (1.6 kg in
unemployed, 2.5 kg in employed) in men. Increases in walking and exercise for the employed
were smaller than those for the unemployed. The relationship between changes in weight and
energy balance by employment status was independently significant using multiple
regression analysis. Employment is associated with difficulty in losing weight due to
limited exercise time in behavioral intervention.
Collapse
Affiliation(s)
- Rumi Maniwa
- Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Japan
| | - Mamiko Iwamoto
- Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Japan
| | - Akiko Nogi
- Department of Human Nutrition, Faculty of Nursing and Human Nutrition, Yamaguchi Prefectural University, Japan
| | - Masayuki Yamasaki
- Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Japan ; Research Project Promotion Institute, Shimane University, Japan
| | - Jian-Jun Yang
- Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Japan ; School of Public Health, Ningxia Medical University, China
| | - Hideaki Hanaoka
- Department of Physical Therapy and Occupational Therapy Sciences, Graduate School of Health Science, Hiroshima University, Japan
| | - Kuninori Shiwaku
- Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Japan ; Research Project Promotion Institute, Shimane University, Japan
| |
Collapse
|
|
28
|
Li WC, Chen IC, Chang YC, Loke SS, Wang SH, Hsiao KY. Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36,642 Taiwanese adults. Eur J Nutr 2011; 52:57-65. [PMID: 22160169 PMCID: PMC3549404 DOI: 10.1007/s00394-011-0286-0] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 11/18/2011] [Indexed: 01/13/2023]
Abstract
PURPOSE We aimed to investigate the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cardiometabolic risk. METHODS In this cross-sectional study, 21,038 men and 15,604 women who participated in a health check-up were included. RESULTS In both men and women, the area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of diabetes, hypertension, high total cholesterol, high triglycerides, and low HDL-cholesterol (P < 0.05 for all). The AUC for WHtR in the prediction of metabolic syndrome (MS) was also highest in the women (P < 0.05). After adjustment for potential confounders, the odds ratios and 95% confidence intervals for MS for each standard deviation increase in BMI, WHtR, and WC were 1.47 (1.46-1.49), 1.32 (1.31-1.33), and 1.19 (1.18-1.19), respectively. Finally, patients of either sex with a normal BMI or WC level, but with an elevated WHtR, had higher levels of various cardiometabolic risk factors in comparison with their normal BMI or WC, but low WHtR, counterparts (P < 0.05 for all). CONCLUSION Among Taiwanese adults, a WHtR greater than 0.5 is a simple, yet effective indicator of centralized obesity and associated cardiometabolic risk, even among individuals deemed 'healthy' according to BMI and WC.
Collapse
Affiliation(s)
- Wen-Cheng Li
- Department of Occupation Medicine, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Maijin Rd., Keelung, 200, Taiwan.
| | | | | | | | | | | |
Collapse
|
|
29
|
Abstract
OBJECTIVES The purposes of this study were to (1) describe anthropometric measures among Korean immigrants with type 2 diabetes mellitus (T2DM) and (2) examine the relationships between measures of obesity with several forms of dyslipidemia in this group. BACKGROUND Obesity and dyslipidemia are commonly associated with T2DM, and they are risk factors for coronary heart disease (CHD), the leading cause of death for people with diabetes. Asians are predisposed to abdominal obesity and experience significant CHD risk at lower body mass index (BMI) levels. Despite high prevalence of diabetes among Korean immigrants, relationships among anthropometric measures and lipid-related CHD risk factors have not been examined. METHODS A convenience sample of 143 adult Korean immigrants with T2DM between the ages of 30 and 80 years participated in the study. Body mass index, waist circumference (WC), and waist-to-hip ratio (WHR) were obtained using standardized procedures. Total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were assessed using a fingerstick blood test. Hierarchical linear regressions were conducted to identify which of the anthropometric measures was significantly related to individuals' cholesterol levels. RESULTS Central obesity measures, not BMI, were significantly associated with dyslipidemia in Korean immigrants with T2DM independent of potential confounds such as hemoglobin A1C, cigarette smoking, age, and cholesterol medication. Different central obesity measures were associated with different cholesterol types for diabetic Korean men and women. In men, WHR was positively associated with low-density lipoprotein cholesterol and total cholesterol levels. In women, WC was negatively associated with high-density lipoprotein cholesterol. CONCLUSIONS Central obesity measures (WC and WHR) are better indicators for assessing lipid-related CHD risk factor among Korean immigrants with T2DM than BMI. Gender difference in the association between central obesity measures and lipid types should be considered in CHD risk assessment of Korean immigrants with T2DM.
Collapse
Affiliation(s)
- Sarah Choi
- Program in Nursing Science, College of Health Sciences, University of California-Irvine, CA 92697, USA.
| |
Collapse
|
|
30
|
Inability of waist-to-height ratio to predict new onset diabetes mellitus among older adults in Taiwan: A five-year observational cohort study. Arch Gerontol Geriatr 2011; 53:e1-4. [DOI: 10.1016/j.archger.2010.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 04/28/2010] [Accepted: 04/30/2010] [Indexed: 11/23/2022]
|
|
31
|
Impact of cigarette smoking on onset of nonalcoholic fatty liver disease over a 10-year period. J Gastroenterol 2011; 46:769-78. [PMID: 21302121 DOI: 10.1007/s00535-011-0376-z] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 01/11/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND Metabolic syndrome, which includes obesity, hyperglycemia, dyslipidemia, and hypertension, is a major risk factor for the development of nonalcoholic fatty liver disease (NAFLD). Cigarette smoking is a well-known risk factor for metabolic syndrome, but the epidemiological impact of cigarette smoking on development of NAFLD is unclear. METHODS In this retrospective study, 2,029 subjects underwent a complete medical health checkup in 1998 and again in 2008. Those who were positive for hepatitis B surface antigen or hepatitis C virus antibody, or had an alcohol intake of > 20 g/day as assessed by questionnaire, were excluded. Fatty liver was diagnosed by abdominal ultrasonography. Independent risk factors associated with the development of NAFLD were determined by multiple logistic regression analysis. Smoking status was expressed using the Brinkman index (BI), which was calculated as the number of cigarettes smoked per day multiplied by the number of years of smoking. RESULTS Of 1,560 subjects without NAFLD in 1998, 266 (17.1%) were newly diagnosed with NAFLD in 2008. Multiple logistic analysis identified age [adjusted odds ratio (AOR) 0.95, 95% confidence interval (95% CI) 0.94-0.97], male sex (AOR 1.46, 95% CI 1.01-2.10), body mass index ≥ 25 (AOR 3.08, 95% CI 2.20-4.32), dyslipidemia (AOR 1.79, 95% CI 1.25-2.58) and cigarette smoking (AOR 1.91, 95% CI 1.34-2.72) as risk factors associated with the development of NAFLD. Smoking status at baseline was also associated with the development of NAFLD (BI 1-399: AOR 1.77, 95% CI 1.02-3.07, BI ≥ 400: AOR 2.04, 95% CI 1.37-3.03). CONCLUSION Cigarette smoking is an independent risk factor for onset of NAFLD.
Collapse
|
|
32
|
Hsu HS, Liu CS, Pi-Sunyer FX, Lin CH, Li CI, Lin CC, Li TC, Lin WY. The associations of different measurements of obesity with cardiovascular risk factors in Chinese. Eur J Clin Invest 2011; 41:393-404. [PMID: 21114491 DOI: 10.1111/j.1365-2362.2010.02421.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Obesity increases the risks of cardiovascular diseases (CVD). This study examined the optimal cut-off values for overweight and obesity for CVD risks using different anthropometric indices in middle-aged Taiwanese. MATERIALS AND METHODS A total of 2359 subjects aged 40 and over were recruited in 2004 in Taiwan. Body mass index (BMI) was divided into four groups using three different definitions. Waist circumference (WC), waist-to-hip ratio (WC/HC) and waist-to-height ratio (WC/H) were divided into quartiles. The receiver operating characteristic analysis was used to compare their predictive validity and to find out their optimal cut-off values. RESULTS Men were older and had greater height, weight, BMI, WC, WC/HC, WC/H, blood pressure (BP), fasting glucose, uric acid and triglycerides than women. In all BMI definitions, subjects in higher BMI groups had higher BP, fasting glucose, triglycerides, uric acid and WC than subjects in lower BMI groups. Compared to quartile I of WC, WC/HC and WC/H, the odds ratios of having CVD risk factors increased in higher quartiles of WC, WC/HC and WC/H. The optimal cut-off values for overweight/obesity in middle-aged Taiwanese in men and women were as follows: BMI of 23·7 and 22·4 kg m(-2), WC of 82·5 and 72·5 cm, WC/HC of 0·87 and 0·79 and WC/H of 0·50 and 0·46. WC/H is the best indicator for predicting CVD risks. CONCLUSIONS Obesity, presenting with higher BMI, WC, WC/HC and WC/H, is closely related to CVD risk factors. WC/H is the best predictor of CVD risk factors in middle-aged Taiwanese.
Collapse
Affiliation(s)
- Hua-Shui Hsu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
|
33
|
Kawada T, Otsuka T, Inagaki H, Wakayama Y, Li Q, Li YJ, Katsumata M. Optimal cut-off levels of body mass index and waist circumference in relation to each component of metabolic syndrome (MetS) and the number of MetS component. Diabetes Metab Syndr 2011; 5:25-28. [PMID: 22814837 DOI: 10.1016/j.dsx.2010.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS There is an ethnic difference of obesity index to diagnose metabolic syndrome. The authors explored the optimal cut-off levels for body mass index (BMI) and waist circumference (WC) in relation to each component of metabolic syndrome. MATERIALS AND METHODS Receiver operating characteristics (ROC) analysis was used to determine the optimal cut-off levels for each component of metabolic syndrome. This study included 4572 workers aged 42.5±9.9 years. RESULTS The optimal BMI cut-off values for diabetes mellitus, hypertension or dyslipidemia varied from 23.0 to 24.3 kg/m(2). As for WC, the optimal cut-off values varied from 83.0 to 83.7 cm. The optimal BMI cut-off values relating with one to three components of metabolic syndrome varied from 23.2 to 25.3 kg/m(2). As for WC, the optimal cut-off values varied from 83.0 to 85.0 cm. Pair-wise comparison of ROC curves showed that WC has an advantage in relation to metabolic syndrome and its components compared with BMI. By logistic regression analysis, odds ratios of obesity indices for hypertension, dyslipidemia or the number of metabolic component were all significantly increased. As for diabetes mellitus, odds ratios of BMI ≥25 and WC ≥85 significantly increased, respectively. CONCLUSIONS Japanese criteria of obesity in metabolic syndrome in man may be appropriate for diabetes mellitus. Ethnic difference in criteria of obesity in Asian metabolic syndrome exists, and mutual comparisons in the prevalence of metabolic syndrome have a difficulty to conduct.
Collapse
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Tokyo 113-8602, Japan.
| | | | | | | | | | | | | |
Collapse
|
|
34
|
Karadag B, Ozturk AO, Sener N, Altuntas Y. Use of knee height for the estimation of stature in elderly Turkish people and their relationship with cardiometabolic risk factors. Arch Gerontol Geriatr 2010; 54:82-9. [PMID: 21185093 DOI: 10.1016/j.archger.2010.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 11/29/2010] [Accepted: 11/30/2010] [Indexed: 11/30/2022]
Abstract
The determination of the approximately truest value in height measurement is important in many fields, but it is difficult to perform true measurements, especially in the elderly individuals. We planned to investigate the following items in geriatric Turkish population: to calculate the decrease in height with advancing age by using the standing height measurement and estimated height derived from the knee height; to evaluate the significance of difference between the two measurement methods in the calculation of body mass index (BMI) and waist/height ratio (WHtR); to determine the cut-off value of WHtR according to estimated height in elderly individuals. We studied 551 cases aged between 19 and 97 years. Knee height was measured using a sliding caliper in a sitting position. Linear regression analysis was carried out to derive predictive equations for the estimation of stature with adults (≤ 50 years of age) according to the gender. This equation was then used to estimate height among elderly subjects. Of the cases, 60.3% were <60 years (mean: 48.75 ± 7.50); 39.7% of the cases were >60 years (mean: 69.51 ± 7.12). Estimated BMI (EBMI) measurements in the females and males >60 years were in average 1.23 kg/m(2) and 0.92 kg/m(2) higher than their real BMIs, respectively. EBMI measurements in the females <60 years were 0.32 kg/m(2) higher than their real BMIs (p<0.01). There is a statistically significant difference between WHtR in the females of both age groups, and in the males >60 years, as compared to our estimated WHtR (EWHtR) measurements (p<0.01). The cut-off point of WHtR was 0.61 and 0.58 in the female and male cases of >60 years in our study, respectively. WHtR seemed to be a better anthropometric index that could predict most cardiometabolic risk factors in our study. EWHtR emerged to be a better cardiometabolic risk index especially in the elderly group.
Collapse
Affiliation(s)
- Berrin Karadag
- Sisli Etfal Education and Research Hospital, Internal Medicine/Endocrinology and Metabolism Clinics, 34377 Sisli, Istanbul, Turkey.
| | | | | | | |
Collapse
|
|
35
|
Pavlica T, Bozic-Krstic V, Rakic R. Body mass index, waist-to-hip ratio and waist/height in adult population from Backa and Banat - the Republic of Serbia. Ann Hum Biol 2010; 37:562-73. [PMID: 20141483 DOI: 10.3109/03014460903512829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Nutritional status is vital in the assessment of physical fitness and health status of populations. AIM This study aimed to describe relationships between BMI, waist-to-hip ratio (WHR) and waist/height (W/Ht) and factors such as education, residence, origin and ethnic belonging among adults in Backa and Banat. SUBJECTS AND METHODS The study was conducted in 47 villages in the north of Serbia. The tested group consisted of 4247 individuals, aged 20+. RESULTS The problem of overweight and obesity was more common among men (66%) than women (49.71%). In the group with normal BMI, the majority of men and women were characterized by normal WHR and W/Ht values, but among them there were also groups with incorrect WHR (males >or= 0.95, females >or= 0.8) and W/Ht (>or= 0.5). Socio-demographic factors had a little impact on BMI, WHR and W/Ht in men in certain age groups while their impact was higher in women. These factors, especially education and origin, had a significant impact on nutritional status in young and middle-aged women, whereas they were not significant in older female participants (> 60). CONCLUSION Despite the fact that this part of the country has undergone intensive social changes since the last decade of 20th century, the nutritional status of the population has not significantly changed.
Collapse
Affiliation(s)
- Tatjana Pavlica
- Laboratory for Human Biology, Department for Biology and Ecology, University of Novi Sad, 21000 Novi Sad, Serbia.
| | | | | |
Collapse
|
|
36
|
A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev 2010; 23:247-69. [PMID: 20819243 DOI: 10.1017/s0954422410000144] [Citation(s) in RCA: 868] [Impact Index Per Article: 57.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This systematic review collated seventy-eight studies exploring waist-to-height ratio (WHtR) and waist circumference (WC) or BMI as predictors of diabetes and CVD, published in English between 1950 and 2008. Twenty-two prospective analyses showed that WHtR and WC were significant predictors of these cardiometabolic outcomes more often than BMI, with similar OR, sometimes being significant predictors after adjustment for BMI. Observations from cross-sectional analyses, forty-four in adults, thirteen in children, supported these predictions. Receiver operator characteristic (ROC) analysis revealed mean area under ROC (AUROC) values of 0·704, 0·693 and 0·671 for WHtR, WC and BMI, respectively. Mean boundary values for WHtR, covering all cardiometabolic outcomes, from studies in fourteen different countries and including Caucasian, Asian and Central American subjects, were 0·50 for men and 0·50 for women. WHtR and WC are therefore similar predictors of diabetes and CVD, both being stronger than, and independent of, BMI. To make firmer statistical comparison, a meta-analysis is required. The AUROC analyses indicate that WHtR may be a more useful global clinical screening tool than WC, with a weighted mean boundary value of 0·5, supporting the simple public health message 'keep your waist circumference to less than half your height'.
Collapse
|
|
37
|
Hsieh SD, Muto T, Tsuji H, Arase Y, Murase T. Clustering of other metabolic risk factors in subjects with metabolic syndrome. Metabolism 2010; 59:697-702. [PMID: 19913845 DOI: 10.1016/j.metabol.2009.08.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Accepted: 08/20/2009] [Indexed: 12/31/2022]
Abstract
Various anthropometric indices have been proposed for metabolic syndrome. We investigated the clustering of metabolic risk factors other than components of metabolic syndrome and physical activity in subjects with and without metabolic syndrome as defined by different anthropometric indices. The subjects comprised 6141 men and 2137 women who underwent routine health examinations in Tokyo. We compared metabolic risk factors (high low-density lipoprotein cholesterol, hyperuricemia, high gamma-glutamyltransferase, fatty liver) and sedentary history in subjects with and without metabolic syndrome as defined by the American Heart Association by substituting various proposed anthropometric indices of abdominal obesity (waist circumference >or=85, >or=90, or >or=102 cm for men and >or=90, >or=80, or >or=88 cm for women; waist-to-height ratio >or=0.5 for both men and women). Irrespective of the anthropometric index or sex, the age-adjusted odds ratios for risk factors and sedentary history were all significantly greater in subjects with metabolic syndrome (men and women: 1.26 approximately 1.35 and 2.06 approximately 2.63 for high low-density lipoprotein cholesterol, 2.36 approximately 2.60 and 3.88 approximately 7.20 for hyperuricemia, 2.54 approximately 3.02 and 2.92 approximately 4.05 for high gamma-glutamyltransferase, 4.42 approximately 4.87 and 9.43 approximately 12.27 for fatty liver, and 1.37 approximately 1.50 and 1.43 approximately 1.72 for sedentary history). Findings still persisted in those not receiving medication for diabetes mellitus or coronary heart disease. Therefore, attention should be paid to other metabolic risk factors in subjects with metabolic syndrome, irrespective of the anthropometric index or sex. Further study is also needed to clarify the most appropriate definition of metabolic syndrome so as to include the spectrum of risk factors that best represents the future risk of cardiovascular and other diseases.
Collapse
Affiliation(s)
- Shiun Dong Hsieh
- Medical Center of Health Science, Toranomon Hospital, Tokyo, Japan.
| | | | | | | | | |
Collapse
|
|
38
|
Lewis JR, Mohanty SR. Nonalcoholic fatty liver disease: a review and update. Dig Dis Sci 2010; 55:560-78. [PMID: 20101463 DOI: 10.1007/s10620-009-1081-0] [Citation(s) in RCA: 227] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 12/01/2009] [Indexed: 12/13/2022]
Abstract
The spectrum of nonalcoholic fatty liver disease (NAFLD) ranges from asymptomatic steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Hepatic steatosis occurs when free fatty acids, released in the setting of insulin resistance and the metabolic syndrome, are taken up by the liver. Additional biochemical insults, including oxidative stress, upregulation of inflammatory mediators, and dysregulated apoptosis, can result in inflammation (producing NASH) and fibrosis. Noninvasive methods (e.g., abdominal ultrasonography) are safe ways to support a diagnosis of hepatic steatosis, but advanced liver histopathologic findings including NASH and fibrosis cannot be identified without pursuing liver biopsy. Recent advances in serologic and imaging methods aim to determine severity of inflammation and fibrosis noninvasively. Currently, therapeutic options for NAFLD are limited to medications that reduce risk factors, but the future holds promise for therapies that might slow the progression of this increasingly prevalent disorder.
Collapse
Affiliation(s)
- Jeffrey R Lewis
- Department of Medicine, Center for Liver Diseases, University of Chicago, Chicago, IL 60637, USA.
| | | |
Collapse
|
|
39
|
Jia WP, Wang C, Jiang S, Pan JM. Characteristics of obesity and its related disorders in China. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2010; 23:4-11. [PMID: 20486430 DOI: 10.1016/s0895-3988(10)60025-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Obesity is a medical condition with excess body fat accumulation to the extent which leads to serious health consequences. Abdominal obesity, also known as central obesity, refers to the presence of excess fat in the abdominal area. Obesity, especially abdominal obesity, contributes to many metabolic disorders including metabolic syndrome (MetS), type 2 diabetes (T2DM) and cardiovascular diseases (CVD). The incidence of obesity has increased dramatically in recent years worldwide. In China, more than one-third of adults are overweight or obese and 10%-20% of all adults are affected by MetS. The pathogenesis underlying the abdominal obesity remains unclear. The ultimate health outcome of obesity and its related metabolic disorders haveprompted physicians to take aggressive treatments (lifestyle changes, pharmacological interventions and surgical therapies) before a serious consequence becomes clinically apparent. In this review, we discuss the prevalence, pathogenesis and clinic features of obesity in China.
Collapse
Affiliation(s)
- Wei-Ping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai 200233, China.
| | | | | | | |
Collapse
|
|
40
|
Gil JH, Lee MN, Lee HA, Park H, Seo JW. Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity in Korean Children and Adolescents. ACTA ACUST UNITED AC 2010. [DOI: 10.5223/kjpgn.2010.13.2.180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Joo Hyun Gil
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Mi Na Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hye Ah Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jeong Wan Seo
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| |
Collapse
|
|
41
|
Mohanty SR, Troy TN, Huo D, O'Brien BL, Jensen DM, Hart J. Influence of ethnicity on histological differences in non-alcoholic fatty liver disease. J Hepatol 2009; 50:797-804. [PMID: 19231016 DOI: 10.1016/j.jhep.2008.11.017] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 11/11/2008] [Accepted: 11/30/2008] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS Previous studies examining ethnic differences in non-alcoholic fatty liver disease (NAFLD) are limited by small sample sizes and the lack of liver biopsy as a diagnostic modality. METHODS We retrospectively examined the influence of ethnicity on the biochemical and liver histological differences in NAFLD patients. RESULTS The proportion of African Americans (AA) in the NAFLD sample (total 238 patients; 15.1% AA) was lower than in the base population (68.2%). Median ALT (47 IU/L; p=0.05) and triglyceride (134mg/dL, p=0.002) levels were lower in AA than other ethnicities. AA showed lower degrees of steatosis [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.22-0.89; p=0.02] than Whites. In contrast, Asians showed higher grades of ballooning than Whites (OR 2.67, 95% CI 1.03-6.93; p=0.04) and other ethnicities combined (OR 2.71, 95% CI 1.06-6.92; p=0.04). Hispanics showed a higher rate of Mallory bodies than Whites (OR 2.38, 95% CI 1.05-5.39; p=0.04) and other ethnicities combined (OR 2.41, 95% CI 1.09-5.34; p=0.03). CONCLUSIONS African Americans showed a lower degree of steatosis than Whites. In contrast, Asians and Hispanics showed higher grades of ballooning and Mallory bodies, respectively, than Whites and other ethnicities combined. These findings highlight the need for prospective studies to evaluate ethnic differences in NAFLD.
Collapse
Affiliation(s)
- Smruti R Mohanty
- Department of Medicine, Center for Liver Diseases, University of Chicago, 5841 S. Maryland Avenue, MC 7120, Chicago, IL 60637-1463, USA.
| | | | | | | | | | | |
Collapse
|
|
42
|
Rocha R, Cotrim HP, Bitencourt AGV, Barbosa DBV, Santos AS, Almeida ADM, Cunha B, Guimarães I. Nonalcoholic fatty liver disease in asymptomatic Brazilian adolescents. World J Gastroenterol 2009; 15:473-477. [PMID: 19152453 PMCID: PMC2653370 DOI: 10.3748/wjg.15.473] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Revised: 10/20/2008] [Accepted: 10/27/2008] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the prevalence and clinical characteristics of Nonalcoholic fatty liver disease (NAFLD) among asymptomatic Brazilian adolescents. METHODS Transversal observational study included asymptomatic adolescents with central obesity from private and public schools in Salvador-Bahia, northeastern Brazil. The children answered a questionnaire that included age, gender, race, and medical history, and were submitted to a complete physical exam and abdominal ultrasound. Biochemical exams included: ALT, AST, GGT, C reactive protein (CRP), fasting glucose, insulin, cholesterol and triglycerides. Criteria for NAFLD included: the presence of steatosis in ultrasound and/or high level of ALT, negative or occasional historic of intake of alcohol ( RESULTS From October, 2005 to October, 2006, the study included 1801 subjects between 11 and 18 years of age and a mean age of 13.7+/-2.0 years. One hundred ninety-nine had central obesity. The prevalence of NAFLD was 2.3%, most of whom were male and white. Insulin resistance (IR) was observed in 22.9% of them and had positive correlations with ALT and GGT (P<0.05). Elevated CRP was observed in 6.9% of the cases; however, it was not associated with WC, IR or liver enzymes. CONCLUSION The prevalence of NAFLD in Brazilian adolescents was low. The ethnicity may have influence this frequency in the population studied, which had a large proportion of African descendents.
Collapse
Affiliation(s)
- Raquel Rocha
- Federal University of Bahia, School of Medicine, Bahia 40110-150, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
|
43
|
Sato M, Hamano T, Yamasaki M, Shiwaku K. Ten-year Follow-up of Obesity and Obesity-related Metabolic Disorders in Male Rural Japanese Workers. J Rural Med 2009. [DOI: 10.2185/jrm.4.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
|
44
|
Ashwell M, Gibson S. Waist to height ratio is a simple and effective obesity screening tool for cardiovascular risk factors: Analysis of data from the British National Diet And Nutrition Survey of adults aged 19-64 years. Obes Facts 2009; 2:97-103. [PMID: 20054212 PMCID: PMC6444829 DOI: 10.1159/000203363] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE AND METHOD To analyse data from the nationally representative National Diet and Nutrition Survey (NDNS) collected in 2000/2001 and to investigate how the BMI and two proxy indicators of central fat distribution, namely the waist circumference and the waist to height ratio (WHtR), are associated with each other and with cardiovascular disease (CVD) risk factors. RESULTS Screening health risk by BMI alone would 'miss' 35% of men and 14% of women who are within the normal BMI range (18.5-25 kg/m(2)) but have central fat distribution, defined by WHtR > 0.5. In the total population this equates to 17% of all men and 6% of all women who would be inadequately screened by BMI alone. Compared to BMI, WHtR was more closely associated with CVD risk factors among both men and women. Furthermore, in a combined analysis of men and women, central fat distribution with a normal BMI was associated with higher levels of CVD risk factors than being overweight without central fat distribution. CONCLUSION WHtR is a simple and effective, non-invasive screening tool for CVD risk factors. Our proposed boundary value of 0.5 translates into a simple public health message: 'Keep your waist circumference to less than half your height'.
Collapse
|
|
45
|
Adedoyin RA, Mbada CE, Bisiriyu LA, Adebayo RA, Balogun MO, Akintomide AO. Relationship of anthropometric indicators with blood pressure levels and the risk of hypertension in Nigerian adults. Int J Gen Med 2008; 1:33-40. [PMID: 20428404 PMCID: PMC2840543 DOI: 10.2147/ijgm.s3643] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND PURPOSE Studies on cardiovascular risks in relation to anthropometric factors are limited in Sub-Sahara Africa. The aims of this study were to examine the relationship between anthropometric parameters and blood pressure; and to evaluate body mass index (BMI) across the range of underweight and obesity as a primary risk factor of hypertension in adult Nigerians. MATERIAL AND METHODS 2097 adults aged between 20 and 100 years consented and participated in this door-to-door survey. All participants underwent blood pressure and anthropometric measurements using standard procedures. The population study was separated in normotensive and hypertensive males and females and the possible risk for hypertension were categorized into different classes of value based on BMI definition. RESULTS The relative risks (odds ratio [OR] and 95% confidence interval [CI]) of developing hypertension among the obese compared with the underweight, normal weight, and overweight persons were (OR 5.75; CI 5.67-5.83), (OR 1.73; CI 1.65-1.81), and (OR 1.54; CI 1.46-1.62) for all the participants, respectively. Among obese (BMI >/= 30.0 Kg/m(2)) males, the OR for hypertension was three times (OR 2.78; CI 2.76-2.80) that of normal weight (BMI >/= 18.5-24.9 Kg/m(2)) males. Females with obesity had a risk of hypertension three times (OR 3.34; CI 3.33-3.35) that of normal weight females. CONCLUSION Our results indicated that the there was a significant positive correlation of obesity indicator with blood pressure. In Nigeria, we found a strong gradient between higher BMI and increased risk of hypertension among all ages. Approaches to reduce the risk of hypertension may include prevention of overweight and obesity.
Collapse
Affiliation(s)
| | - Chidozie E Mbada
- Physiotherapy Department, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | | | - Rasaaq A Adebayo
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Michael O Balogun
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | |
Collapse
|
|
46
|
Ekuni D, Yamamoto T, Koyama R, Tsuneishi M, Naito K, Tobe K. Relationship between body mass index and periodontitis in young Japanese adults. J Periodontal Res 2008; 43:417-21. [DOI: 10.1111/j.1600-0765.2007.01063.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
|
47
|
Mohan V, Deepa M, Farooq S, Narayan KMV, Datta M, Deepa R. Anthropometric cut points for identification of cardiometabolic risk factors in an urban Asian Indian population. Metabolism 2007; 56:961-8. [PMID: 17570259 DOI: 10.1016/j.metabol.2007.02.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Accepted: 02/12/2007] [Indexed: 12/22/2022]
Abstract
The aim of this study was to determine the anthropometric cut points for risk of cardiometabolic risk factors in an urban Asian Indian population. The Chennai Urban Rural Epidemiology Study representatively sampled 26001 individuals aged 20 years or older and detailed measures were obtained in every 10th subject: 90.4% (2350/2600). An oral glucose tolerance test was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements such as body mass index (BMI) and waist circumference (WC) were obtained and serum lipid estimations were done in all subjects. Sensitivity, specificity, and distance on receiver operating characteristic curve were used to determine the optimal cut points for BMI and WC with cardiometabolic risk factors. Maximum sensitivity and specificity of BMI for all cardiometabolic risk factors such as diabetes mellitus, prediabetes, hypertension, hypertriglyceridemia, hypercholesterolemia, and low high-density lipoprotein cholesterol ranged from 22.7 to 23.2 kg/m(2) for men and 22.7 to 23.8 kg/m(2) for women, and that of WC ranged from 86 to 88.2 cm for men and 81 to 83.8 cm for women. The optimal BMI cut point for identifying any 2 cardiometabolic risk factors was 23 kg/m(2) in both sexes, whereas that of WC was 87 cm for men and 82 cm for women. The study validates the World Health Organization Asia Pacific guidelines of BMI of 23 kg/m(2) for the designation of overweight; WC of 87 cm for men and 82 cm for women appear to be appropriate cut points to identify cardiometabolic risk factors including prediabetes in urban Asian Indians.
Collapse
Affiliation(s)
- Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai 600 086, India.
| | | | | | | | | | | |
Collapse
|
|
48
|
Fan JG, Saibara T, Chitturi S, Kim BI, Sung JJY, Chutaputti A. What are the risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol 2007; 22:794-800. [PMID: 17498218 DOI: 10.1111/j.1440-1746.2007.04952.x] [Citation(s) in RCA: 207] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The risk factors and settings for non-alcoholic fatty liver disease (NAFLD) in Asians are reviewed comprehensively. Based particularly on large community-based studies using ultrasonography, case-control series and prospective longitudinal studies, the prevalence of NAFLD in Asia is between 12% and 24%, depending on age, gender, locality and ethnicity. Further, the prevalence in China and Japan has nearly doubled in the last 10-15 years. A detailed analysis of these data shows that NAFLD risk factors for Asians resemble those in the West for age at presentation, prevalence of type 2 diabetes mellitus (T2DM) and hyperlipidemia. The apparent differences in prevalence of central obesity and overall obesity are related to criteria used to define waist circumference and body mass index (BMI), respectively. The strongest associations are with components of the metabolic syndrome, particularly the combined presence of central obesity and obesity. Non-alcoholic fatty liver disease appears to be associated with long-standing insulin resistance and likely represents the hepatic manifestation of metabolic syndrome. Not surprisingly therefore, Asians with NAFLD are at high risk of developing diabetes and cardiovascular disease. Conversely, metabolic syndrome may precede the diagnosis of NAFLD. The increasing prevalence of obesity, coupled with T2DM, dyslipidemia, hypertension and ultimately metabolic syndrome puts more than half the world's population at risk of developing NAFLD/non-alcoholic steatohepatitis/cirrhosis in the coming decades. Public health initiatives are clearly imperative to halt or reverse the global 'diabesity' pandemic, the underlying basis of NAFLD and metabolic syndrome. In addition, a perspective of NAFLD beyond its hepatic consequences is now warranted; this needs to be considered in relation to management guidelines for affected individuals.
Collapse
Affiliation(s)
- Jian-Gao Fan
- Center for Fatty Liver Disease, Shanghai First People's Hospital, Jiaotong University, Shanghai, China.
| | | | | | | | | | | |
Collapse
|
|
49
|
Yang JJ, Shiwaku K, Nabika T, Masuda J, Kobayashi S. High Frequency of Cardiovascular Risk Factors in Overweight Adult Japanese Subjects. Arch Med Res 2007; 38:337-44. [PMID: 17350486 DOI: 10.1016/j.arcmed.2006.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2006] [Accepted: 10/26/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND It has been suggested that Japanese subjects categorized as having normal weight (body mass index [BMI]<25.0) as defined by WHO (2000) have a tendency toward increased incidence of dyslipidemia and diabetes. Our objective was to assess the suitability for Japanese subjects of the Regional Office for the Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000) by analyzing cardiovascular risk factors relative to gender and age in overweight Japanese with BMI of 23.0-24.9. METHODS There were 3,608 subjects (2,387 men: 42.3+/-0.2 years and 1,221 women: 41.6+/-0.3 years) who participated in a community setting and cross-sectional study and were not using any prescription drugs for obesity-related diseases. BMI and cardiovascular risk factors (blood pressure, plasma levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, Lp(a), glucose, HbA1C, uric acid, white blood cell count, AST, ALT and gamma-GTP) were compared by BMI classes and by gender and age group. RESULTS The subjects were categorized as 21% "overweight" (23.0-24.9 BMI), 17% "obese I" (25.0-29.9 BMI) and 2% "obese II" (over 30.0 BMI), all based on WPRO criteria. Graded increases in BMI classes based on these WPRO criteria were positively associated with frequency and values of cardiovascular risk factors, and the "overweight" had a significantly higher risk of cardiovascular disease than did the "normal" subjects. CONCLUSION While a relationship between BMI and cardiovascular risk factors is gender and age specific, our investigation, highlighting the increasing risks of "overweight" with a BMI of 23.0-24.9, suggests that WPRO criteria are more relevant and therefore suitable for Japanese subjects.
Collapse
Affiliation(s)
- Jian-jun Yang
- Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Izumo, Japan
| | | | | | | | | |
Collapse
|
|
50
|
Kagawa M, Kerr D, Uchida H, Binns CW. Differences in the relationship between BMI and percentage body fat between Japanese and Australian-Caucasian young men. Br J Nutr 2007; 95:1002-7. [PMID: 16611393 DOI: 10.1079/bjn20061745] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This cross-sectional study aimed to determine ethnic and environmental influences on the relationship between BMI and percentage body fat, using a sample of 144 Japanese and 140 Australian-Caucasian men living in Australia, and eighty-eight Japanese men living in Japan. Body composition was assessed by anthropometry using standard international methods (International Society for the Advancement of Kinanthropometry protocol). Body density was predicted using Durnin and Womersley's (1974) equation, and percentage body fat was calculated from Siri's (1961) equation.Significant (P<0·05) ethnic differences in stature, body mass and BMI were observed between Japanese and Australian men, but no ethnic differences were observed in their percentage body fat and height-corrected sum of skinfold thicknesses. No differences were found in the BMI–percentage body fat relationship between the Japanese subjects living in Australia and in Japan. Significant (P<0·05) ethnic differences in the BMI–percentage body fat relationship observed from a comparison between pooled Japanese men(aged 18–40 years, BMI range 16·6–32·8kg/m2) andAustralians (aged 18–39 years, BMI range 16·1–31·4kg/m2) suggest that Japanese men are likely to havea greater percentage body fat than Australian men at any given BMI value.From the analyses, the Japanese men were estimated to have an equivalent amount of body fat to the Australian men at BMI values that were about 1·5 units lower than those of the Australians (23·5kg/m2 and 28·2kg/m2, respectively).It was concluded that Japanese men have greater body fat deposition than Australian-Caucasians at the same BMI value. Japanese men may therefore require lower BMI cut-off points to identify obese individuals compared with Australian-Caucasian men.
Collapse
Affiliation(s)
- Masaharu Kagawa
- School of Public Health, Curtin University of Technology, Perth, Australia
| | | | | | | |
Collapse
|