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Colonnello E, Libotte F, Masi D, Curreli M, Massetti C, Gandini O, Gangitano E, Watanabe M, Mariani S, Gnessi L, Lubrano C. Eating behavior patterns, metabolic parameters and circulating oxytocin levels in patients with obesity: an exploratory study. Eat Weight Disord 2025; 30:6. [PMID: 39820758 PMCID: PMC11742293 DOI: 10.1007/s40519-024-01698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 10/20/2024] [Indexed: 01/19/2025] Open
Abstract
PURPOSE Obesity is a complex heterogeneous disease often associated with dysfunctional eating behavior patterns. Oxytocin (OT) is a neurohormone involved in the regulation of energy metabolism and eating behavior. The aim of the present study was to evaluate in a population of patients with obesity circulating levels of OT and dysfunctional eating behaviors in relation to anthropometric, hormonal and metabolic parameters. METHODS A prospective, observational, single-center study was conducted at the Center of High Specialization for the Care of Obesity of Sapienza University of Rome. Adult subjects with body mass index (BMI) ≥ 30 kg/m2 were recruited. Body impedance assessment (BIA), biochemical and hormonal parameters, plasma OT concentration analysis and the Eating Behaviors Assessment for Obesity (EBA-O) questionnaire were evaluated. RESULTS A total of 21 patients, 16 females and 5 males, with a mean age of 45.7 ± 15.1 years, mean BMI of 40.89 ± 8.02 kg/m2 and plasma OT concentration of 1365.61 ± 438.03 pg/mL were recruited. The dysfunctional eating behavior traits investigated by the EBA-O appear significantly associated with metabolic derangements. In particular, night eating is associated with alterations in lipid metabolism (p < 0.01). Circulating OT correlates positively with BMI (r = 0,43; p < 0.05), and Hepatic Steatosis Index (HIS) (r = 0.46; p < 0.05), while its role in subjects with obesity and alterations in glucose metabolism is less clear. Interestingly, circulating OT levels < 1312.55 pg/mL may be predictive of food addiction (100% sensitivity; 62.5% specificity). CONCLUSIONS Despite the need for larger studies to confirm their validity, the clinical utility of the EBA-O and circulating OT in identifying dysfunctional eating behaviors appears promising.
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Affiliation(s)
- Elena Colonnello
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy.
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Flavia Libotte
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Davide Masi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Mariaignazia Curreli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Chandra Massetti
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Orietta Gandini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Elena Gangitano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Stefania Mariani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy
| | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome "La Sapienza", Policlinico Umberto Viale del Policlinico 155 - 00161, Rome, Italy.
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Zhou X, Zou Z, Liu Y, Yan Y, Wu J, Zhou G, Li M. Association of anthropometric and obesity indices with abnormal blood lipid levels in young and middle-aged adults. Heliyon 2025; 11:e41310. [PMID: 39845003 PMCID: PMC11750461 DOI: 10.1016/j.heliyon.2024.e41310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 12/15/2024] [Accepted: 12/16/2024] [Indexed: 01/24/2025] Open
Abstract
Introduction Obesity is a known risk factor for dyslipidemia. We aimed to evaluate the association between nine obesity indices and various types of abnormal lipid levels in the young and middle-aged. Methods From July to November 2022, we distributed health survey questionnaires to the target population in the hospital and collected their biochemical and anthropometric data. Multivariate regression models and Receiver operating characteristic (ROC) curve analysis were used for data analyzing. Results We collected a total of 1174 complete samples. Among the five blood lipid indexes tested in this study, TG (triglyceride) is most closely related to various body measurements (P < 0.05). WC (Waist circumference) has the greatest risk for abnormal TG levels (OR, 2.61; P < 0.001) and high-density lipoprotein cholesterol (HDL-C) levels(OR, 1.96; P < 0.001).WHR has the greatest risk of abnormal low-density lipoprotein cholesterol (LDL-C) levels (OR, 1.35; P < 0.05) and non-high-density lipoprotein cholesterol levels(OR, 1.59; P < 0.001). ROC curve analyses revealed that all the tested variables gave the highest area under the curve (AUC) values for predicting high TG in comparison to other plasma lipid abnormalities. The AUC of WC, AVI and BMI were 0.81, 0.80 and 0.79 respectively. Conclusion Specific obesity-related anthropometric measurements, including WC, AVI, and WHR, show improved predictive accuracy in identifying abnormal lipid levels across diverse types. This study supports their effectiveness in early dyslipidemia screening among young and middle-aged individuals.
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Affiliation(s)
- Xiaoling Zhou
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 561113, China
- Editorial Department of Guizhou Medical Journal, Guizhou Provincial Medical Association, Guiyang, 550004, China
| | - Zuoli Zou
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 561113, China
- Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Ying Liu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuzhong Yan
- Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jing Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Geyao Zhou
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 561113, China
| | - Ming Li
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 561113, China
- Shanghai Dongfang Hospital, Shanghai, China
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Dos Santos Sousa AJ, Mattiello SM, Driusso P. Relationship of female pelvic floor muscle function and body composition: cross-sectional study. Arch Gynecol Obstet 2024; 310:3297-3303. [PMID: 39601813 DOI: 10.1007/s00404-024-07848-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 11/14/2024] [Indexed: 11/29/2024]
Abstract
PURPOSE Investigate the relationship between female pelvic floor muscle (PFM) function and body composition. METHODS Cross-sectional study-participants answered sociodemographic and urogynecological questions. The amount of fat mass was measured by dual-emission X-ray densitometry (DXA), and subcutaneous fat thickness was assessed by abdominal ultrasound. PFM assessment was performed using the Modified Oxford Scale and vaginal manometry. Descriptive analysis, independent t test, spearman correlation, and univariate regression were performed. RESULTS Ninety-nine women were included. All body composition variables evaluated, except subcutaneous fat thickness, indicated that women with a higher concentration of fat in the pelvic, android, and visceral region have lower maximum voluntary PFM contraction strength assessed by Modified Oxford Scale and manometry. The univariate model pointed out that the fat concentration increases the chances of reduced PFM strength in the entire body (0.6%), android (5.4%), visceral region (25.3%), and pelvic (89.9%). There was a correlation between the concentration of total, pelvic, and android fat with MVC/average peak. CONCLUSION The accumulation of "total", "pelvic", "android", and "visceral" fat mass is correlated with reduction in PFM strength, and there is an association between MVC and the variables of total and segmented fat. However, pelvic fat concentration is predictive in 89.9% of cases.
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Affiliation(s)
- Ana Jéssica Dos Santos Sousa
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, Washington Luiz Road, Km 235, SP310, São Carlos, SP, 13565-905, Brazil
| | - Stela Márcia Mattiello
- Joint Function Analysis Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, Washington Luiz Road, Km 235, SP310, São Carlos, SP, 13565-905, Brazil.
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Chaudhary I, Prasad S V, Y P G, K N, P R M, Selvan C, Kalra P. A Comparative Analysis of Serum Irisin Levels and Body Composition Indices in Women With and Without Polycystic Ovary Syndrome (PCOS). Cureus 2024; 16:e71426. [PMID: 39539896 PMCID: PMC11558769 DOI: 10.7759/cureus.71426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2024] [Indexed: 11/16/2024] Open
Abstract
Introduction Polycystic ovarian syndrome (PCOS) is a prevalent endocrine-metabolic disorder impacting women of reproductive age, often manifesting during adolescence. This study aimed to determine serum irisin levels in subjects with PCOS compared to healthy controls and explore the correlation between irisin levels and body composition indices. Methods A cross-sectional study was conducted at a tertiary care hospital. Thirty-three women with PCOS and 32 healthy, age-matched controls were recruited. Relevant socio-demographic and clinical data were collected, and body composition was analyzed using bioelectrical impedance analysis (BIA). Serum irisin levels were measured using enzyme-linked immunosorbent assay (ELISA), and statistical analysis was performed using CoGuide software (Evidencian Research Associates, Bengaluru, India). Results PCOS subjects exhibited significantly higher levels of clinical features associated with hyperandrogenism, including elevated systolic (SBP) and diastolic blood pressure (DBP), body mass index, waist-hip ratio, total cholesterol, low-density lipoproteins (LDL), serum testosterone, body fat percentage, subcutaneous fat percentage, visceral fat percentage, and fat mass index, along with lower high-density lipoprotein levels and lean mass percentage, compared to controls. Serum irisin levels were significantly higher in PCOS cases (10.82 (8.5-14.31) ng/mL) than in controls (2.57 (2.19-4.65) ng/mL). There was a moderate positive correlation between serum irisin and SBP, DBP, hirsutism, total cholesterol, LDL, visceral fat, and serum testosterone levels. Weak correlations were observed between serum irisin and other body fat indices. Subjects with metabolic syndrome exhibited higher irisin levels and significantly elevated body composition indices, including body fat percentage, visceral fat percentage, fat mass index, and fat-free mass index, compared to those without metabolic syndrome. Conclusions PCOS subjects have elevated serum irisin levels, which correlate positively with clinical and biochemical hyperandrogenism, total cholesterol, LDL, and visceral fat. These findings suggest that irisin may play a role in the metabolic and hormonal dysregulation observed in PCOS.
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Affiliation(s)
| | - Vinay Prasad S
- Endocrinology and Diabetes, Ramaiah Medical College, Bengaluru, IND
| | - Ganavi Y P
- Endocrinology, Ramaiah Medical College, Bengaluru, IND
| | - Navikala K
- Biochemistry, Ramaiah Medical College, Bengaluru, IND
| | - Manjunath P R
- Endocrinology, Ramaiah Medical College, Bengaluru, IND
| | - Chitra Selvan
- Endocrinology, Ramaiah Medical College, Bengaluru, IND
| | - Pramila Kalra
- Endocrinology and Metabolism, Ramaiah Medical College, Bengaluru, IND
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Greenblatt DJ, Bruno CD, Harmatz JS, Dawson-Hughes B, Zhang Q, Li C, Chow CR. Estimation of Absolute and Relative Body Fat Content Using Noninvasive Surrogates: Can DXA Be Bypassed? J Clin Pharmacol 2023; 63 Suppl 2:S35-S47. [PMID: 37942909 PMCID: PMC10651165 DOI: 10.1002/jcph.2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/01/2023] [Indexed: 11/10/2023]
Abstract
Dual-energy x-ray absorptiometry (DXA) scanning is used for objective determination of body composition, but instrumentation is expensive and not generally available in customary clinical practice. Anthropometric surrogates are often substituted as anticipated correlates of absolute and relative body fat content in the clinical management of obesity and its associated medical risks. DXA and anthropometric data from a cohort of 9230 randomly selected American subjects, available through the ongoing National Health and Nutrition Examination Survey, was used to evaluate combinations of surrogates (age, height, total weight, waist circumference) as predictors of DXA-determined absolute and relative body fat content. Multiple regression analysis yielded linear combinations of the 4 surrogates that were closely predictive of DXA-determined absolute fat content (R2 = 0.93 and 0.96 for male and female subjects). Accuracy of the new algorithm was improved over customary surrogate-based predictors such as body mass index. However prediction of relative body fat was less robust (R2 less than 0.75), probably due to the nonlinear relation between degree of obesity (based on body mass index) and relative body fat. The paradigm was validated using an independent cohort from the National Health and Nutrition Examination Survey, as well as two independent external subject groups. The described regression-based algorithm is likely to be a sufficiently accurate predictor of absolute body fat (but not relative body fat) to substitute for DXA scanning in many clinical situations. Further work is needed to assess algorithm validity for subgroups of individuals with "atypical" body construction.
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Affiliation(s)
- David J Greenblatt
- Program in Pharmacology and Drug Development, Tufts University School of Medicine, Boston, MA, USA
- Clinical and Translational Science Institute, Tufts Medical Center, Boston, MA, USA
| | - Christopher D Bruno
- Program in Pharmacology and Drug Development, Tufts University School of Medicine, Boston, MA, USA
- Emerald Lake Safety, LLC, Newport Beach, CA, USA
| | - Jerold S Harmatz
- Program in Pharmacology and Drug Development, Tufts University School of Medicine, Boston, MA, USA
| | - Bess Dawson-Hughes
- Jean Mayer Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Qingchen Zhang
- Program in Pharmacology and Drug Development, Tufts University School of Medicine, Boston, MA, USA
| | - Chunhui Li
- Program in Pharmacology and Drug Development, Tufts University School of Medicine, Boston, MA, USA
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Yun J, Kwon RJ, Kim T. Prevalence and clinical characteristics of low skeletal muscle index among adults visiting a health promotion center: Cross-sectional study. Medicine (Baltimore) 2023; 102:e34404. [PMID: 37478219 PMCID: PMC10662807 DOI: 10.1097/md.0000000000034404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023] Open
Abstract
Sarcopenia causes a variety of functional impairments and is associated with all-cause mortality, but once it occurs, it is difficult to treat and reverse. However, the prevalence of sarcopenia in healthy people has never been investigated due to the low awareness of sarcopenia in healthy people. This cross-sectional study was conducted in a single health promotion center from the January 1st 2020 to the December 31st 2021. Adults aged 18 years and older with an Inbody as part of their health checkup were included, and all data was collected from the EMR. Obesity was defined as a body mass index (BMI) of 23 (kg/m2) or more by Korean standards, and low skeletal muscle mass was defined as a skeletal muscle index (SMI) of <0.789 for men and <0.512 for women. 60.5% of the total participants (n = 5993) had low skeletal muscle mass. The low SMI group had lower BMI, waist circumference, and abdominal skinfold than the normal SMI group (low SMI group vs normal SMI: BMI; 25.47 ± 2.96 vs 22.98 ± 3.05, P < .001, waist circumference; 90.31 ± 8.80 cm vs 82.69 ± 9.71 cm, P < .001, abdominal skinfold; 18.78 ± 2.44 mm vs 15.99 ± 2.12 mm, P < .001). The body fat percentage was higher in the low SMI group than in the normal SMI group 25.30 ± 6.23% versus 29.82 ± 7.07%, P < .001. Triglyceride and uric acid levels were low in the low SMI group (TG; 147.69 ± 97.27 vs 115.86 ± 68.31, P < .001, uric acid level; 6.30 ± 1.38 vs 5.23 ± 1.30, P < .001) and high-density lipid (HDL) was high (HDL; 53.17 ± 11.41 vs 59.89 ± 14.72, P < .001). The odds ratio of low SMI prevalence for age, sex, BMI, fat body percent, and triglycerides relative to normal SMI was 1.05 (P = .031), 0.14 (P < .001), 0.12 (P < .001), 2.05 (P < .001), and 0.99 (P = .003), respectively. Of those who visited the Health Promotion Center, more than 60% had low SMI identified through Inbody. Low BMI and high body fat percentage increase the risk of low SMI. Compared to normal and low SMI based on obesity, Sex, height, BW, abdominal skinfold, and waist circumflex showed significant P values in both groups. The factors related to low SMI were TG, HDL, and uric acid levels.
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Affiliation(s)
- Jungmi Yun
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| | - Ryuk Jun Kwon
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Taehwa Kim
- Division of Pulmonology, Allergy, and Critical Care Medicine, Research Institute for Convergence of Biomedical Science and Technology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
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Tian X, Chen S, Xu Q, Zhang Y, Wu S, Wang A, Luo Y. Cumulative burden of abnormal visceral adiposity index and its components on the risk of hyperuricemia. Nutr Metab Cardiovasc Dis 2023; 33:340-349. [PMID: 36641317 DOI: 10.1016/j.numecd.2022.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/04/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The visceral adiposity index (VAI), a gender-specific surrogate maker of adipose tissue distribution and function, is associated with risk of hyperuricemia. However, the impact of time-burden of abnormal VAI and its components on the risk of hyperuricemia remains unknown. METHODS AND RESULTS We included 56,537 participants without hyperuricemia and underwent two health examinations during 2006-2008 from the Kailuan study. Abnormal VAI burdens were evaluated as follows: (1) cumulative number of abnormal VAI presented at each examination (0-2 times); (2) cumulative number of each abnormal VAI component presented at each examination (0-2 times per component); (3) cumulative number of total abnormal VAI components presented at each examination (0-8 times). During a median follow-up of 8.81 years, 10,762 participants were diagnosed with hyperuricemia. The risk of hyperuricemia showed a positive association with cumulative number of abnormal VAI, the adjusted hazard ratio (HR) with 95% confidence interval (CI) of 2 times compared to 0 times was 1.69 (1.58-1.81). All four components of abnormal VAI, when diagnosed repeatedly, were independently associated with an increased risk of hyperuricemia, adjusted HR (95% CI) from 1.15 (1.02-1.28) for low high-density lipoprotein to 1.68 (1.58-1.79) for elevated triglyceride. The risk of hyperuricemia also gradually as abnormal components was accumulated from 0 to 8 counts, reaching an adjusted HR (95% CI) of 3.72 (2.64-5.23). Furthermore, the effect of cumulative abnormal VAI was more pronounced in females than males (P-interaction < 0.0001). CONCLUSIONS Cumulative abnormal VAI burdens were positively associated with the risk of hyperuricemia, especially in females.
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Affiliation(s)
- Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Qin Xu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yijun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Sex Difference in Cutoff and Prevalence of Sarcopenia among 300,090 Urban Korean Population: Association with Metabolic Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101361. [PMID: 36295523 PMCID: PMC9611231 DOI: 10.3390/medicina58101361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 12/18/2022]
Abstract
Background and Objectives: The study aimed to establish the threshold values and prevalence of sarcopenia and to investigate the association of sarcopenia with metabolic syndrome in an urban Korean population. Materials and Methods: The study included 300,090 adults who underwent anthropometric analyses by bioelectrical impedance analyzer. Sarcopenia was defined as: (1) class I, skeletal muscle mass index (SMI) within −1 to −2 standard deviations (SDs); (2) or class II, <−2 SD of SMI in a young population. Results: Low SMI threshold levels for class I and class II sarcopenia were 39.8 and 36.7% in men, and 35.5 and 32.3% in women. Among all age groups, the prevalence rates of sarcopenia were highest in the age group 80−89 years. Following adjustment for possible confounders including age, sex, height, metabolic and health behavioral factors, adjusted odds ratios (95% confidence intervals) for the risk of metabolic syndrome were 2.43 (2.33−2.54) for class I and 2.69 (2.49−2.91) for class II sarcopenia, compared with the normal reference. Sarcopenia was more strongly associated with metabolic syndrome in women than men (p for interaction < 0.01). The threshold values and prevalence of sarcopenia were demonstrated in a large Korean urban population. Conclusions: This study identified that sarcopenia was associated with increased risk of metabolic syndrome, showing itself to be significantly higher in women than men.
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Rosberg V, Vishram-Nielsen JKK, Kristensen AMD, Pareek M, Sehested TS, Nilsson PM, Linneberg A, Palmieri L, Giampaoli S, Donfrancesco C, Kee F, Mancia G, Cesana G, Veronesi G, Grassi G, Kuulasmaa K, Salomaa V, Palosaari T, Sans S, Ferrieres J, Dallongeville J, Söderberg S, Moitry M, Drygas W, Tamosiunas A, Peters A, Brenner H, Schöttker B, Grimsgaard S, Biering-Sørensen T, Olsen MH. Simple cardiovascular risk stratification by replacing total serum cholesterol with anthropometric measures: The MORGAM prospective cohort project. Prev Med Rep 2022; 26:101700. [PMID: 35141116 PMCID: PMC8814644 DOI: 10.1016/j.pmedr.2022.101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/15/2022] [Indexed: 11/29/2022] Open
Abstract
To assess whether anthropometric measures (body mass index [BMI], waist-hip ratio [WHR], and estimated fat mass [EFM]) are independently associated with major adverse cardiovascular events (MACE), and to assess their added prognostic value compared with serum total-cholesterol. The study population comprised 109,509 individuals (53% men) from the MORGAM-Project, aged 19-97 years, without established cardiovascular disease, and not on antihypertensive treatment. While BMI was reported in all, WHR and EFM were reported in ∼52,000 participants. Prognostic importance of anthropometric measurements and total-cholesterol was evaluated using adjusted Cox proportional-hazards regression, logistic regression, area under the receiver-operating-characteristic curve (AUCROC), and net reclassification improvement (NRI). The primary endpoint was MACE, a composite of stroke, myocardial infarction, or death from coronary heart disease. Age interacted significantly with anthropometric measures and total-cholesterol on MACE (P ≤ 0.003), and therefore age-stratified analyses (<50 versus ≥ 50 years) were performed. BMI, WHR, EFM, and total-cholesterol were independently associated with MACE (P ≤ 0.003) and resulted in significantly positive NRI when added to age, sex, smoking status, and systolic blood pressure. Only total-cholesterol increased discrimination ability (AUCROC difference; P < 0.001). In subjects < 50 years, the prediction model with total-cholesterol was superior to the model including BMI, but not superior to models containing WHR or EFM, while in those ≥ 50 years, the model with total-cholesterol was superior to all models containing anthropometric variables, whether assessed individually or combined. We found a potential role for replacing total-cholesterol with anthropometric measures for MACE-prediction among individuals < 50 years when laboratory measurements are unavailable, but not among those ≥ 50 years.
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Key Words
- ACM, all-cause mortality
- ASCVD, atherosclerotic cardiovascular disease
- AUCROC, area under the receiver-operating-characteristic curve
- Adipose tissue
- Assessment, risk
- BMI, body mass index
- BP, blood pressure
- Body mass index
- CEP, composite cardiovascular endpoint
- CI, confidence interval
- CV, cardiovascular
- CVD, cardiovascular disease
- CVM, cardiovascular mortality
- Cardiovascular diseases
- Chol, serum total cholesterol
- Cholesterol
- DBP, diastolic blood pressure
- EFM, estimated fat mass
- HDL-cholesterol, high density lipoprotein cholesterol
- HR, hazard ratio
- IQR, interquartile range
- MACE, major adverse cardiovascular events
- MBP, mean blood pressure
- MONICA, Multi-national MONItoring of Trends and Determinants in CArdiovascular Disease
- MORGAM, MOnica, Risk, Genetics, Archiving and Monograph
- NRI, net reclassification improvement
- NS, non-significant
- PP, pulse pressure
- SBP, systolic blood pressure
- SCORE, Systematic COronary Risk Evaluation
- WHR, waist-hip ratio
- Waist-hip ratio
- cNRI, continuous net reclassification improvement
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Affiliation(s)
- Victoria Rosberg
- Department of Cardiology, North Zealand Hospital, Hillerød, Denmark
| | - Julie KK Vishram-Nielsen
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Frederiksberg, Denmark
| | | | - Manan Pareek
- Department of Cardiology, North Zealand Hospital, Hillerød, Denmark
- Department of Internal Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA
| | | | - Peter M Nilsson
- Department for Clinical Sciences Medicine, Lund University, Skane University Hospital, Malmö, Sweden
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Frederiksberg, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Simona Giampaoli
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Frank Kee
- Centre for Public Health, The Queeńs University of Belfast, Northern Ireland
| | - Giuseppe Mancia
- University of Milano-Bicocca and Policlinico di Monza, Monza, Italy
| | - Giancarlo Cesana
- Research Centre on Public Health, University of Milano Bicocca, Villa Serena, Monza, Italy
| | - Giovanni Veronesi
- Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Italy
| | - Guido Grassi
- Clinica Medica, University Milano Bicocca, Monza, Italy
| | - Kari Kuulasmaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tarja Palosaari
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Susana Sans
- Catalan Department of Health, Barcelona, Spain
| | - Jean Ferrieres
- Department of Cardiology, Toulouse University School of Medicine, Rangueil Hospital, Toulouse Cedex 9, France
| | | | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Cardiology and Heart Centre, Umeå University, Umeå, Sweden
| | - Marie Moitry
- Department of Epidemiology and Public Health, University of Strasbourg and University Hospital of Strasbourg, Strasbourg, France
| | - Wojciech Drygas
- Department of Epidemiology, CVD Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - Abdonas Tamosiunas
- Lithuanian University of Health Sciences, Institute of Cardiology, Kaunas, Lithuania
| | - Annette Peters
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Hermann Brenner
- German Cancer Research Center (DKFZ), Heidelberg, Germany, Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen, Denmark
- Institute of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael H Olsen
- Department of Internal Medicine, Steno Diabetes Center Zealand, Holbaek Hospital, Holbaek, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
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Relative Lean Body Mass and Waist Circumference for the Identification of Metabolic Syndrome in the Korean General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413186. [PMID: 34948793 PMCID: PMC8700886 DOI: 10.3390/ijerph182413186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022]
Abstract
Lean body mass (LBM) comprises organs and muscle, which are the primary determinants of energy expenditure and regulation of glucose and lipid metabolism. Excessive abdominal fat is associated with metabolic abnormality. Little is known about the relationship between metabolic abnormality and LBM and waist circumference (WC), especially in the Asian general population. The aim of this study was to clarify this relationship. We performed a cross-sectional study with 499,648 subjects who received health check-ups at 16 health promotion centers in 13 Korean cities between January 2018 and October 2019. The subjects were categorized into four groups: (a) High (H)-RLBM (relative lean body mass)/Normal (N)-WC, (b) High-RLBM/Abnormal (A)-WC, (c) Low (L)-RLBM/Normal-WC, and (d) Low-RLBM/Abnormal-WC. RLBM was calculated using fat mass data that were estimated via bioelectrical impedance analysis. L-RLBM/A-WC was significantly associated with metabolically unhealthy status (OR: 4.40, 95% CI: 4.326–4.475) compared to H-RLBM/N-WC. L-RLBM/N-WC (OR: 2.170, 95% CI: 2.122–2.218) and H-RLBM/A-WC (OR: 2.713, 95% CI: 2.659–2.769) were also significantly related to metabolic unhealthy status. The cut-offs of RLBM for predicting metabolic syndrome (MetS) were 74.9 in males and 66.4 in females (p < 0.001). L-RLBM and A-WC are associated with metabolic abnormality in the Korean general population. RLBM is an anthropometric index that can be used to predict MetS in primary health care.
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11
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Does Physical Activity Level Affect Homocysteine and Obesity Variables in Women with Cardiovascular Disease? MEDICAL LABORATORY JOURNAL 2021. [DOI: 10.52547/mlj.15.4.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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12
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Buscemi C, Ferro Y, Pujia R, Mazza E, Boragina G, Sciacqua A, Piro S, Pujia A, Sesti G, Buscemi S, Montalcini T. Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women. Nutrients 2021; 13:nu13061909. [PMID: 34199375 PMCID: PMC8227668 DOI: 10.3390/nu13061909] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 12/18/2022] Open
Abstract
Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.
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Affiliation(s)
- Carola Buscemi
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giada Boragina
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Angela Sciacqua
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Salvatore Piro
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giorgio Sesti
- Dipartimento di Medicina clinica e molecolare, Università la Sapienza, 00185 Roma, Italy;
| | - Silvio Buscemi
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
- Correspondence:
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da Silva JSM, Biesek S, Vojciechowski AS, Borba VZC, Rabito EI, Gomes ARS, Oliveira LA. Estimations of body fat by anthropometry or bioelectrical impedance differ from those by dual-energy X-ray absorptiometry in prefrail community-dwelling older women. Nutr Res 2021; 86:1-9. [PMID: 33444993 DOI: 10.1016/j.nutres.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022]
Abstract
This study aimed to compare different methods to assess body fat (BF). We hypothesized that bioelectrical impedance analysis (BIA) or anthropometry may be used to estimate BF in prefrail older women, equivalently to dual-energy X-ray absorptiometry (DXA). The cross-sectional study included 72 prefrail community-dwelling older women (71.13 ± 4.65 years old; body mass index [BMI] 28.89 ± 4.23 kg/m2). The BF percentage (%BF) was estimated using anthropometry with the Durnin & Womersley (D&W) and Petroski's predictive equations, BIA with 2 Baumgartner predictive equations (BIA 1 and BIA 2), and DXA. All methods differed significantly from DXA according to assessments using repeated measures ANOVA and pairwise comparisons. The mean %BF varied between 39.99 ± 3.42% (D&W) and 43.93 ± 5.06% (DXA). Multiple regression analysis with age and BMI as covariates showed positive correlations (R2 = 0.91) in models with D&W equation and BMI, and with BIA 2 and BMI; however, BMI explained more of the model (71%) than the equations. Furthermore, Bland-Altman test revealed a proportional bias for D&W and for BIA 2, with underestimation of BF varying across different %BF values. Petroski's skinfold equation showed a positive correlation on linear regression (R2 = 0.74) and no proportional bias; however, Bland-Altman analysis revealed high limits of agreement (-13.6 to -0.05), thus compromising clinical application. To conclude, compared with DXA, all the equations tested showed a high disagreement and wide limits of agreement, restricting their use in clinical practice to estimate the BF in prefrail older women.
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Affiliation(s)
- Jessica S M da Silva
- Centro Universitário Autônomo do Brasil (UniBrasil), R. Konrad Adenauer, 442 - Tarumã, Curitiba - PR, 82820-540, Brazil
| | - Simone Biesek
- Federal University of Paraná, - Campus Centro Politécnico - Jardim das Américas - Curitiba, PR, Brazil.
| | - Audrin S Vojciechowski
- Federal University of Paraná, - Campus Centro Politécnico - Jardim das Américas - Curitiba, PR, Brazil
| | - Victoria Z C Borba
- Endocrine Center of UFPR, Federal University of Paraná, Rua Gen. Carneiro, 181, Prédio Central, 11 andar, sala 1136 - Alto da Glória - Curitiba - PR, Brazil
| | - Estela I Rabito
- Nutrition Department - Federal University of Paraná, Curitiba, PR, Brazil
| | - Anna Raquel S Gomes
- Federal University of Paraná, - Campus Centro Politécnico - Jardim das Américas - Curitiba, PR, Brazil; Prevention and Rehabilitation in Physiotherapy Department, Federal University of Paraná, Avenida Coronel Francisco H. dos Santos, 100, Centro Politécnico - Jardim das Américas, Curitiba - PR, 81531-980, Brazil
| | - Liana A Oliveira
- Centro Universitário Autônomo do Brasil (UniBrasil), R. Konrad Adenauer, 442 - Tarumã, Curitiba - PR, 82820-540, Brazil
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Associations of vitamin D with novel and traditional anthropometric indices according to age and sex: a cross-sectional study in central southern China. Eat Weight Disord 2020; 25:1651-1661. [PMID: 31728924 DOI: 10.1007/s40519-019-00803-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Vitamin D insufficiency and obesity are recognized as worldwide concerns and have been linked with each other. New anthropometric indices reflect visceral obesity better than traditional anthropometric indices. Our aim was to identify the specific correlations of novel and traditional anthropometric indices with 25-hydroxyvitamin D (25(OH)D) concentrations by sex and age. METHODS Cross-sectional data on sociodemographic characteristics, lifestyle factors, clinical characteristics and biochemical measurements were collected for 12,617 Chinese adults. Four traditional anthropometric indices, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and two novel anthropometric indices, body roundness index (BRI) and body shape index (ABSI), were calculated. RESULTS In both sexes, the mean values of BMI, WC, WHtR and BRI tended to increase with 25(OH)D insufficiency, regardless of adjustment (all P < 0.05). Males with insufficient 25(OH)D had increased odds of obesity (assessed by BMI, WC, WHtR, BRI and ABSI) compared to the odds of males with sufficient 25(OH)D. Females with insufficient 25(OH)D had a higher chance of general obesity (assessed by BMI). Low 25(OH)D status was associated with indicators of obesity only in participants aged 45-64 years in both sexes. CONCLUSION A inverse association between obesity and lower vitamin D levels was found. Moreover, in addition to BMI, novel indicators of visceral adiposity, such as BRI and ABSI, were associated with lower 25(OH)D serum concentrations in males. The effects of optimizing vitamin D levels in obese Chinese adults need further examination, particularly in middle-aged males. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Sommer I, Teufer B, Szelag M, Nussbaumer-Streit B, Titscher V, Klerings I, Gartlehner G. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Sci Rep 2020; 10:12699. [PMID: 32728050 PMCID: PMC7391719 DOI: 10.1038/s41598-020-69498-7] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of this systematic review was to assess the performance of anthropometric tools to determine obesity in the general population (CRD42018086888). Our review included 32 studies. To detect obesity with body mass index (BMI), the meta-analyses rendered a sensitivity of 51.4% (95% CI 38.5-64.2%) and a specificity of 95.4% (95% CI 90.7-97.8%) in women, and 49.6% (95% CI 34.8-64.5%) and 97.3% (95% CI 92.1-99.1%), respectively, in men. For waist circumference (WC), the summary estimates for the sensitivity were 62.4% (95% CI 49.2-73.9%) and 88.1% for the specificity (95% CI 77.0-94.2%) in men, and 57.0% (95% CI 32.2-79.0%) and 94.8% (95% CI 85.8-98.2%), respectively, in women. The data were insufficient to pool the results for waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) but were similar to BMI and WC. In conclusion, BMI and WC have serious limitations for use as obesity screening tools in clinical practice despite their widespread use. No evidence supports that WHR and WHtR are more suitable than BMI or WC to assess body fat. However, due to the lack of more accurate and feasible alternatives, BMI and WC might still have a role as initial tools for assessing individuals for excess adiposity until new evidence emerges.
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Affiliation(s)
- Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria.
| | - Birgit Teufer
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Monika Szelag
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Barbara Nussbaumer-Streit
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Viktoria Titscher
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Irma Klerings
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Gerald Gartlehner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
- RTI-UNC Evidence-Based Practice Center, Research Triangle Institute International, East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
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Shams-White MM, Chui K, Deuster PA, McKeown NM, Must A. Comparison of Anthropometric Measures in US Military Personnel in the Classification of Overweight and Obesity. Obesity (Silver Spring) 2020; 28:362-370. [PMID: 31904192 DOI: 10.1002/oby.22675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/17/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study aimed to determine (1) the level of agreement between BMI, circumference-based equation (CBE) measures, waist circumference (WC), and bioelectrical impedance analysis (BIA) measures and (2) whether BMI, CBE measures, or WC alone or in combination adequately reflects adiposity in military personnel compared with BIA. METHODS BMI from measured height and weight (using military overweight cutoffs in men [BMI ≥ 27.5 kg/m2 ] and World Health Organization overweight cutoffs [BMI ≥ 25.0 kg/m2 ]), BMI body fat percentage (BF%), WC, CBE BF%, and BIA BF% were collected. Respondents (N = 389, 78% men) were categorized with normal fat versus overweight, obesity, or overfat. Levels of agreement and standard screening performance measures were compared between anthropometric measures and BIA. RESULTS World Health Organization BMI and BIA BF% classified the most men and women with overweight/obesity; WC with BMI (BMI + WC) and WC alone classified the fewest men and women with overweight/obesity. Levels of agreement were all statistically significant and highest for BMI (men: Cohen's κ = 0.711; women: Cohen's κ = 0.814) and lowest for WC and BMI + WC (all Cohen's κ ≤ 0.270). BMI + CBE performed best overall (sensitivity = 50.9%, false discovery rate = 5.4%). CONCLUSIONS Our findings support BMI + CBE as an easy-to-implement combination to assess adiposity in the military.
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Affiliation(s)
- Marissa M Shams-White
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kenneth Chui
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Patricia A Deuster
- Department of Military and Emergency Medicine, Consortium for Health and Military Performance, Department of Defense Center of Excellence, Uniformed Services University, Bethesda, Maryland, USA
| | - Nicola M McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Aviva Must
- Department of Public Health and Community Medicine, School of Medicine, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
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Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study. ACTA ACUST UNITED AC 2019; 55:medicina55070334. [PMID: 31277306 PMCID: PMC6681323 DOI: 10.3390/medicina55070334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/31/2022]
Abstract
Background and objectives: Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. Materials and Methods: This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Results: Neck circumference (in the anthropometric model; R2: 0.889; β: age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; R2: 0.891; β: age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (R2: 0.894; β: age = 0.882, FFMI = 0.126, neck = 0.093). Conclusion: It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.
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Moraes AB, Cavalari EMR, de Paula MP, Arruda M, Curi DSC, Leitão RA, de Mendonça LMC, Farias MLF, Madeira M, Vieira Neto L. Evaluation of body composition using dual-energy X-ray absorptiometry in patients with non-functioning adrenal incidentalomas and an intermediate phenotype: Is there an association with metabolic syndrome? J Endocrinol Invest 2019; 42:797-807. [PMID: 30465247 DOI: 10.1007/s40618-018-0985-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Metabolic syndrome (MS) and sarcopenia are associated with increased cardiovascular risk. No studies using dual-energy x-ray absorptiometry (DXA) have evaluated association between body composition (BC) changes and MS in adrenal incidentaloma (AI). Our aim was to analyse BC in non-functioning AI (NFAI) and intermediate phenotype (IP) relative to controls and to correlate with cortisol levels. METHODS Cross-sectional study with 44 NFAI (serum cortisol ≤ 50 nmol/L after the overnight 1 mg dexamethasone suppression test), 27 IP (cortisol 51-138 nmol/L), and 41 controls (normal adrenal on imaging examination) using DXA. Autonomic cortisol secretion (cortisol > 138 nmol/L) was excluded from the study. BC data were compared using criteria for MS (World Health Organization, National Cholesterol Education Program-Adult Treatment Panel-III, American Association of Clinical Endocrinologists (AACE), and International Diabetes Federation). RESULTS There was no significant difference in clinical data and body mass index (BMI) among the three groups. Waist circumference (WC) was larger in AI vs. controls (p < 0.01). Waist-to-hip ratio was higher in NFAI vs. controls and waist-to-height ratio was higher in IP vs. controls (p = 0.03 and p = 0.02, respectively). The frequency of MS was higher in AI vs. controls. BC was not different among the groups. Patients with AI there was a significant association of MS with both an increase in total fat and body fat index (all criteria), and a significant difference between MS and smaller BMI-adjusted lean mass (AACE, p = 0.036). No correlation of cortisol after 1 mg dexamethasone test with BC or MS. AI and WC were independently associated with MS. CONCLUSIONS AI presented high frequency of MS and was independently associated with MS. Possible deleterious effects of cortisol secretion seem to initially affect the muscular system.
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Affiliation(s)
- A B Moraes
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - E M R Cavalari
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - M P de Paula
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - M Arruda
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - D S C Curi
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - R A Leitão
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - L M C de Mendonça
- Department of Internal Medicine and Rheumatology Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rio De Janeiro, RJ, Brazil
| | - M L F Farias
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
| | - M Madeira
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil
- Endocrinology Unit, Bonsucesso Federal Hospital, Rio de Janeiro, RJ, Brazil
| | - L Vieira Neto
- Department of Internal Medicine and Endocrine Unit, Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rua Professor Rodolpho Paulo Rocco, 255. 9 Floor - Endocrine Unit, Rio De Janeiro, RJ, 21941-913, Brazil.
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Park CH, Do JG, Lee YT, Yoon KJ. Sarcopenic obesity associated with high-sensitivity C-reactive protein in age and sex comparison: a two-center study in South Korea. BMJ Open 2018; 8:e021232. [PMID: 30232104 PMCID: PMC6150137 DOI: 10.1136/bmjopen-2017-021232] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To evaluate the association between high-sensitivity C-reactive protein (hs-CRP) and sarcopenic obesity, and to determine age or sex differences underlying the relationship between hs-CRP and sarcopenic obesity. DESIGN Observational study. PARTICIPANTS The study included 237 838 participants whose body composition and hs-CRP were analysed at the two health promotion centres in South Korea. Participants were divided into four groups based on body composition: normal, obesity only, sarcopenia only and sarcopenic obesity. PRIMARY MEASURES The levels of hs-CRP and proportion of participants with high (≥1.0 mg/L) hs-CRP. Sarcopenic obesity was defined as subjects fulfilling the criteria for sarcopenia (below 2 SD of mean of Skeletal Muscle Mass Index for young adults) and obesity (waist circumference ≥90 cm for men and ≥85 cm for women). RESULTS The level of hs-CRP was highest in the sarcopenic obesity group. Following adjustment for various confounders including age, sex, comorbidities, metabolic, health-related behaviour and demographic factors, the adjusted ORs (95% CI) for subjects with high hs-CRP associated with obesity, sarcopenia and sarcopenic obesity compared with normal group (reference) were 1.17 (1.05 to 1.31), 2.23 (1.21 to 4.07) and 3.23 (2.71 to 3.83), respectively. In age subgroup analyses, multivariate logistic regression analysis revealed that the association of high hs-CRP with sarcopenic obesity was stronger in younger (<60 years) participants than in older (≥60 years) participants (p for interaction <0.001). In subgroup analyses for sex, the association of high hs-CRP with sarcopenic obesity was higher in female participants than in males (p for interaction <0.001). CONCLUSIONS This study demonstrated that high level of hs-CRP was independently associated with sarcopenic obesity in Korean population. We found for the first time that there was a strong association between increased hs-CRP and sarcopenic obesity in female and younger (<60 years) subjects.
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Affiliation(s)
- Chul-Hyun Park
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
- Department of Rehabilitation Medicine, Graduate School of Medicine, Chung-Ang University, Seoul, Korea
| | - Jong Geol Do
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
| | - Yong-Taek Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
| | - Kyung Jae Yoon
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
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20
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Park CH, Yi Y, Do JG, Lee YT, Yoon KJ. Relationship between skeletal muscle mass and lung function in Korean adults without clinically apparent lung disease. Medicine (Baltimore) 2018; 97:e12281. [PMID: 30212965 PMCID: PMC6155967 DOI: 10.1097/md.0000000000012281] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Previous studies have demonstrated that low skeletal muscle mass is related to decreased lung function in patients with chronic obstructive pulmonary disease. However, there is little information about the relationship between skeletal muscle mass and lung function in asymptomatic adults without clinically apparent lung disease.This was a cross-sectional study of 240,562 Korean adults without known lung disease. All subjects underwent both pulmonary function test (PFT) and bioelectrical impedance analysis in the health checkup program at Kangbuk Samsung Hospital. Skeletal muscle mass index (SMI) was estimated as skeletal muscle mass/weight×100. We analyzed the relationship between SMI and PFT using multivariate logistic regression models.Of the 240,562 study subjects, values for forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF) were decreased across quartiles (Qs) of decreasing SMI. After adjustments for various confounders including demographic and health behavior-related factors, odds ratios (ORs; 95% confidence interval) for subjects with FVC% <80% for Q1-Q3 compared with Q4 (reference) were 2.97 (2.74-3.17), 2.11 (1.99-2.27), and 1.66 (1.52-1.83), respectively. ORs for subjects with FEV1% <80% for Q1-Q3 compared with Q4 were 2.64 (2.43-2.83), 1.96 (1.83-2.09), and 1.51 (1.43-1.62), respectively. Lastly, OR for subjects with PEF% <80% for Q1-Q3 compared with Q4 were 1.73 (1.58-1.89), 1.35 (1.26-1.45), and 1.23 (1.15-1.30), individually. Subgroup analyses for gender and all age groups showed the associations of decreasing SMI Qs with lower FVC%, FEV1%, and PEF% remained significant.Decreased SMI was independently associated with decline in lung function in apparently healthy adults. This association was sustained in subgroup analyses by gender and all age groups.
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Affiliation(s)
- Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Chung-Ang University
| | - Youbin Yi
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jong Geol Do
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
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21
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van Rassel CR, Bewski NA, O'loughlin EK, Wright A, Scheel DP, Puig L, Kakinami L. Validity of electrical impedance myography to estimate percent body fat: comparison to bio-electrical impedance and dual-energy X-ray absorptiometry. J Sports Med Phys Fitness 2018; 59:632-639. [PMID: 30024123 DOI: 10.23736/s0022-4707.18.08505-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Assessment of percent body fat (%BF) is typically measured with bioelectrical impedance (BIA) as a proxy for dual-energy X-ray absorptiometry (DXA). Notably, poorer agreement between BIA and DXA among persons who are overweight or obese has been reported. The use of electrical impedance myography (EIM) as a proxy for DXA has not been validated. The objective was to evaluate an EIM device and two multi-frequency BIA devices with the reference standard (DXA) stratified by weight status and gender. METHODS In a convenience sample of 82 adults, %BF assessed by EIM and two BIA devices was compared to DXA. Agreement between devices was tested with intra-class correlation coefficients (ICC) and Bland-Altman plots. RESULTS Agreement between DXA and EIM (ICC=0.77) was poorer than the agreement between either BIA device with DXA (ICC>0.87). Stratified by sex, agreement between EIM and DXA was greater for men than women (ICC=0.81 and ICC=0.61, respectively). Stratified by BMI, agreement between EIM and DXA was best for normal-weight individuals (ICC=0.89) and progressively poorer for overweight (ICC=0.80) and obese (ICC=0.67) individuals. Bland-Altman plots revealed wide limits of agreement and an increase in EIM mean difference as average %BF increased. Similar trends were seen in BIA assessments. CONCLUSIONS EIM and BIA substantially underestimate %BF in overweight and obese individuals. Wide limits of agreement coupled with variable ICC limit device interchangeability with one another and limit clinical utility.
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Affiliation(s)
| | - Nicole A Bewski
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Erin K O'loughlin
- INDI Department, Concordia University, Montreal, QC, Canada.,Hospital Research Center of Montreal University (CRCHUM), Montreal, QC, Canada
| | - Alicia Wright
- PERFORM Center, Concordia University, Montreal, QC, Canada
| | - Daniel P Scheel
- Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada
| | - Lucila Puig
- Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada
| | - Lisa Kakinami
- PERFORM Center, Concordia University, Montreal, QC, Canada - .,Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada
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22
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Woods SG, Knehans A, Arnold S, Dionne C, Hoffman L, Turner P, Baldwin J. The associations between diet and physical activity with body composition and walking a timed distance in adults with Prader-Willi syndrome. Food Nutr Res 2018; 62:1343. [PMID: 29942245 PMCID: PMC6010474 DOI: 10.29219/fnr.v62.1343] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/01/2018] [Accepted: 05/07/2018] [Indexed: 12/01/2022] Open
Abstract
Background Research on aging in Prader–Willi syndrome (PWS) is limited, although people with PWS are living longer. Individuals with PWS present with high fat mass, low lean mass, and low levels of physical activity (PA). Previous reports in children and young adults with PWS show inadequate nutrient intake and body fat percentage indicating obesity. Previous studies in PWS rarely included individuals beyond young adulthood, especially studies conducted in the United States. This study includes adults from 18 to 62 years of age, and includes 19 of the estimated 60 adult individuals with PWS in Oklahoma. Because individuals with PWS are living longer, information must be provided on aging with PWS. This study is a report of the initial data for a planned longitudinal study on aging with PWS. Objective Determine associations between body composition, diet, PA, and a timed walk for adults with PWS, and to assess adequacy of dietary intake for those individuals aging with PWS. Design This cross-sectional investigation determined dietary habits, PA, and body composition of adults with PWS, and tested associations between these variables. Results Participants ranged in age from 18 to 62 years. They had healthier body composition, at 26.8% body fat, than previously reported. Mean body mass index (BMI) was in the overweight range at 26.7. Those who consumed higher amounts of fat (as a percent of total kilocalories) had statistically significant lower body fat percentage, but this may simply reflect that individuals with lower body fat percentages felt freer to consume fat. Mean steps taken per day was 7631.7 steps but only 16% of participants met healthy PA recommendations despite participating in daily structured exercise. All participants’ diets met Dietary Guidelines for macronutrient distribution, but 80% were deficient in calcium, 100% were deficient in dietary vitamin D, and 87% were deficient in fiber. Sample size was small, so it was difficult to reach statistical significance, despite seeing clinical significance. Conclusions Recommend working toward healthy PA recommendations for all age groups by decreasing time in sedentary activity. Recommend increasing vitamin A and D fortified dairy products and high-fiber foods, and consider dietary supplementation, especially for calcium, vitamin D, and fiber.
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Affiliation(s)
- Susan G Woods
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Allen Knehans
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sandra Arnold
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carol Dionne
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Leah Hoffman
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Peggy Turner
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jonathan Baldwin
- Department of Medical Imaging and Radiation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Kurniawan LB, Bahrun U, Hatta M, Arif M. Body Mass, Total Body Fat Percentage, and Visceral Fat Level Predict Insulin Resistance Better Than Waist Circumference and Body Mass Index in Healthy Young Male Adults in Indonesia. J Clin Med 2018; 7:96. [PMID: 29723977 PMCID: PMC5977135 DOI: 10.3390/jcm7050096] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 04/17/2018] [Accepted: 04/20/2018] [Indexed: 12/19/2022] Open
Abstract
The incidence of obesity which leads to insulin resistance (IR) and metabolic disorder is increasing in developing countries, including Indonesia. Male adults have a higher risk of abdominal obesity than females. This is associated with cardiometabolic disorders. Several anthropometric measurements have been proposed to predict IR. The aim of this study was to investigate whether body mass, body mass index (BMI), waist circumference (WC), body fat percentage (BF) or visceral fat level (VF) could become a better predictor of IR in healthy young male adults. A total of 140 healthy young male adults ranging from 18⁻25 years were recruited in the study. Insulin resistance was measured by calculating their Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Subjects with a HOMA-IR value ≥75th percentile, with cut off 3.75, were defined as IR. Anthropometric measurements including body weight, BMI, and WC were performed, whereas BF and VC were measured using bioelectrical impedance analysis (BIA). IR had a strong correlation with body weight, BMI, WC, BF, and VF. In the area under the curve of body mass, BF and VF were slightly greater than WC and BMI. Anthropometric measurements correlated strongly with IR but body weight, BF, VF had a stronger correlation than WC and BMI in healthy young male adults.
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Affiliation(s)
- Liong Boy Kurniawan
- Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia.
| | - Uleng Bahrun
- Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia.
| | - Mochammad Hatta
- Department of Immunology and Biomolecular, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia.
| | - Mansyur Arif
- Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia.
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Dong H, Xu Y, Zhang X, Tian S. Visceral adiposity index is strongly associated with hyperuricemia independently of metabolic health and obesity phenotypes. Sci Rep 2017; 7:8822. [PMID: 28821853 PMCID: PMC5562916 DOI: 10.1038/s41598-017-09455-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/25/2017] [Indexed: 12/22/2022] Open
Abstract
Visceral adiposity index (VAI) is a novel sex-specific index for visceral adipose function; however the association between VAI and hyperuricemia in China is unknown. We aimed to investigate this association, also whether it was independent of metabolic health and obesity phenotypes. 7632 adult subjects from the China Health and Nutrition Survey 2009 were retained. Subjects were categorized into four obesity phenotypes based on a cross-classification of BMI and metabolic health status by two representative criteria. VAI was the best predictors for hyperuricemia irrespective of obesity phenotypes, with area under curve (AUC) ranging 0.665–0.719. The odd ratio (OR) for hyperuricemia in the highest quartile of the VAI were 6.93 (95% CI 5.79–8.29) after adjusting for age and gender. Following further adjustments for metabolic obesity phenotypes and lifestyle confounders, the ORs were 4.88 (3.92–6.09) and 5.65 (4.68–6.82) according to these two criteria, respectively. A similar significant pattern was still found even after adjustment for blood pressure and other cardiovascular risks. Within each metabolic obesity phenotype, the significant association between VAI and hyperuricemia was consistently evident. In conclusion, the association of the VAI with hyperuricemia was significant, especially this association was independent of metabolic health and obesity phenotypes in the Chinese population.
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Affiliation(s)
- Huimin Dong
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, NO. 6 Jiefang Street Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Yang Xu
- Department of Scientific Research Project, Affiliated Zhongshan Hospital of Dalian University, NO. 6 Jiefang Street Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Xiuzhi Zhang
- Department of Scientific Research Project, Affiliated Zhongshan Hospital of Dalian University, NO. 6 Jiefang Street Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Simiao Tian
- Department of Scientific Research Project, Affiliated Zhongshan Hospital of Dalian University, NO. 6 Jiefang Street Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.
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25
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Zhang J, Fang L, Qiu L, Huang L, Zhu W, Yu Y. Comparison of the ability to identify arterial stiffness between two new anthropometric indices and classical obesity indices in Chinese adults. Atherosclerosis 2017; 263:263-271. [PMID: 28704699 DOI: 10.1016/j.atherosclerosis.2017.06.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/11/2017] [Accepted: 06/15/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The association between anthropometric indices of body composition and arterial stiffness is inconclusive. The objective of this study was to examine the predictive ability of two new obesity indices: a body shape index (ABSI), and a body roundness index (BRI), for the identification of arterial stiffness among Chinese adults, as well as to compare the relative strength of association between the anthropometric indices and arterial stiffness. METHODS A total of 10,197 subjects were recruited in this cross-sectional study. We tested the association between anthropometric indices (body mass index [BMI], waist circumference [WC], waist-height-ratio [WHtR], ABSI and BRI) and brachial-ankle pulse wave velocity (PWV). Receiver operating characteristic curve and area under curve (AUC) were employed to evaluate the predictive value of the anthropometric indices for identification of arterial stiffness. RESULTS After adjusting for confounding variables, BRI (linear regression: 0.112; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.173 for male) exhibited a more powerful predictive ability of arterial stiffness than ABSI (linear regression: 0.110; AUC: 0.674; OR: 1.315 for female and linear regression: 0.058; AUC: 0.610; OR: 1.150 for male) and WC (linear regression: 0.078; AUC: 0.699; logistic regression: negative for female and linear regression: negative; AUC: 0.593; logistic regression: negative for male) while having a similar predictive value to that of WHtR (linear regression: 0.113; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.185 for male) among both sexes. BMI (linear and logistic regression: negative; AUC: 0.660 for female and 0.568 for male) had the lowest predictive power in both sex categories. The optimal cut-off of WHtR for detecting arterial stiffness was 0.49 in females and 0.53 in males, that of BRI was 3.19 in females and 3.89 in males. CONCLUSIONS WHtR, ABSI and BRI were significantly associated with arterial stiffness. BRI and WHtR, rather than ABSI, showed superior predictive abilities for arterial stiffness in both sexes.
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Affiliation(s)
- Jia Zhang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lizheng Fang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lifeng Qiu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Huang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenhua Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yunsong Yu
- Department of Infectious Disease and Hepatopathy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Comparison of the ability to identify cardiometabolic risk factors between two new body indices and waist-to-height ratio among Chinese adults with normal BMI and waist circumference. Public Health Nutr 2016; 20:984-991. [PMID: 27989263 DOI: 10.1017/s1368980016003281] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Waist-to-height ratio (WHtR) has been reported to be more strongly associated with cardiometabolic risk factors among non-obese individuals than BMI and waist circumference (WC). A body shape index (ABSI) and body roundness index (BRI) have been proposed recently to assess obesity-related disorders or mortalities. Our aim was to compare the ability of ABSI and BRI with that of WHtR to identify cardiometabolic risk factors in Chinese adults with normal BMI and WC. DESIGN Receiver-operating characteristic curves and areas under the curve (AUC) were employed to evaluate the ability of the indices (WHtR, BRI, ABSI) to identify metabolic risk factors and to determine the indices' optimal cut-off values. The value of each index that resulted in maximization of the Youden index (sensitivity + specificity - 1) was defined as optimal. Differences in the AUC values between the indices were also evaluated. SETTING Individuals attending a voluntary health check-up in Beijing, China, July-December 2015, were recruited to the study. SUBJECTS Non-obese adults (n 1596). RESULTS Among both genders, ABSI exhibited the lowest AUC value for identifying each risk factor among the three indices; the AUC value of BRI for identifying each risk factor was very close to that of WHtR, and no significant differences were observed between the AUC values of the two new indices. CONCLUSIONS When evaluating cardiometabolic risk factors among non-obese adults, WHtR was a simple and effective index in the assessment of cardiometabolic risk factors, BRI could be used as an alternative body index to WHtR, while ABSI could not.
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27
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Corbasson I, Hankinson SE, Stanek EJ, Reeves KW. Urinary bisphenol-A, phthalate metabolites and body composition in US adults, NHANES 1999-2006. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2016; 26:606-617. [PMID: 27643383 DOI: 10.1080/09603123.2016.1233524] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 08/28/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Exposure to bisphenol-A (BPA) and phthalates is highly prevalent. Prior studies have not assessed associations between urinary levels of BPA and phthalate metabolites and body composition. METHODS National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2006 on adults aged ≥20 were analyzed by linear regression for associations between urinary BPA, monoethyl phthalate, monobutyl phthalate (MBP), monoethylhexyl phthalate (MEHP), and monobenzyl phthalate (MBzP) and lean mass, fat mass, and percent body fat. RESULTS BPA and phthalate metabolites were not independently associated with fat mass or percent body fat. Significant inverse associations were observed with lean mass, with the strongest association observed for BPA in men (mean lean mass 1.39 kg lower for quartile 4 vs. quartile 1, p trend = 0.02). CONCLUSIONS BPA and some phthalates could have important, negative effects on muscle and may affect conditions related to deficits in lean mass, though additional research is needed.
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Affiliation(s)
- Iris Corbasson
- a Department of Biostatistics and Epidemiology , University of Massachusetts Amherst , Amherst , MA , USA
| | - Susan E Hankinson
- a Department of Biostatistics and Epidemiology , University of Massachusetts Amherst , Amherst , MA , USA
| | - Edward J Stanek
- a Department of Biostatistics and Epidemiology , University of Massachusetts Amherst , Amherst , MA , USA
| | - Katherine W Reeves
- a Department of Biostatistics and Epidemiology , University of Massachusetts Amherst , Amherst , MA , USA
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Hsieh MH, Lee CTC, Tsai PJ, Tsai CJ, Liao YT, Chen VCH, Stewart R. Chronic obstructive pulmonary disease and anxiety disorders: a nationwide population-based study in Taiwan. Gen Hosp Psychiatry 2016; 42:1-6. [PMID: 27638963 DOI: 10.1016/j.genhosppsych.2016.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 05/20/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Few studies have investigated the relationship between chronic obstructive pulmonary disease (COPD) and anxiety disorder outcomes. We sought to investigate the association in a large national sample. METHODS Cases were identified from Taiwan's National Health Insurance Research Database who were aged 15 years and above, with a new primary diagnosis of COPD (International Classification of Diseases, Ninth Revision codes: 491, 492, 494 and 496) between 2000 and 2007. The 29,951 cases identified were compared to 29,951 controls matched on sex, age, urban/rural residence and socioeconomic status based on insurance premium. Both groups were followed until the end of 2008 for instances of anxiety disorders. Competing risk-adjusted Cox regression analyses were applied, adjusting for matching variables, Charlson comorbidity index, hospital admission days and daily dose of prednisone. RESULTS Of the 59,902 subjects, 3951 were found to have anxiety disorders during a mean (SD) follow-up period of 5.5 (2.5) years. COPD, female, urban residence, lower dose of prednisone use, depressive disorders and higher outpatient visits were independent predictors of incident anxiety disorder. CONCLUSIONS COPD was associated with increased risk of an anxiety disorder diagnosis, independent of a number of potential confounding factors.
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Affiliation(s)
- Ming-Han Hsieh
- Department of Psychiatry, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan
| | - Charles Tzu-Chi Lee
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Jung Tsai
- Department of Psychiatry, Lutung Christian Hospital, Lukang, Taiwan
| | - Chia-Jui Tsai
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yin-To Liao
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan; Chang Gung University, Taoyuan, Taiwan.
| | - Robert Stewart
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Nduka CU, Uthman OA, Kimani PK, Malu AO, Stranges S. Impact of body fat changes in mediating the effects of antiretroviral therapy on blood pressure in HIV-infected persons in a sub-Saharan African setting. Infect Dis Poverty 2016; 5:55. [PMID: 27245216 PMCID: PMC4888205 DOI: 10.1186/s40249-016-0152-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 05/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies of HIV-infected patients have shown significant associations between highly active antiretroviral therapy (HAART) and increased blood pressure; however, the mechanisms involved are less clear. Therefore, we sought to investigate the potential impact of body fat changes in mediating the effects of HAART on blood pressure changes among people living with HIV. Methods Four hundred six consenting patients (≥18 years of age) attending a tertiary HIV clinic in semi-urban Nigeria were recruited between August and November 2014 as part of a cross-sectional study. We performed bias-corrected bootstrap tests of mediation using 95 % confidence intervals (CI) to determine the mediating effects of body mass index and waist circumference (mediators) on the total effects of HAART exposure (primary predictor) on blood pressure (outcome), while controlling for age, sex and other potential confounders. Results Waist circumference remained a significant partial mediator of the total effects of HAART exposure on increasing systolic blood pressure (coefficient: 1.01, 95 % CI: 0.33 to 2.52, 11 % mediated) and diastolic blood pressure (coefficient: 0.68, 95 % CI: 0.26 to 1.89, 9 % mediated) after adjusting for age, sex, smoking status, CD4 count and duration of HIV infection. No significant mediating effect was observed with body mass index alone or in combination with waist circumference after adjusting for all potential confounders. Conclusion Waist circumference significantly mediates the effects of HAART on blood pressure in persons living with HIV, independent of the role of traditional risk factors. The use of waist circumference as a complementary body fat measure to body mass index may improve the clinical prediction of hypertension in HIV-infected patients on antiretroviral therapy. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0152-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chidozie U Nduka
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Olalekan A Uthman
- Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Centre for Applied Health Research and Delivery (CAHRD), Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Peter K Kimani
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Abraham O Malu
- Department of Internal Medicine, Benue State University Teaching Hospital, Makurdi, Nigeria
| | - Saverio Stranges
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, L-1445, Luxembourg
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Jung HJ, Jung H, Lee T, Kim J, Park J, Kim H, Cho J, Lee WY, Park SW, Rhee EJ, Oh HG. Decreased muscle mass in Korean subjects with intracranial arterial stenosis: The Kangbuk Samsung Health Study. Atherosclerosis 2016; 256:89-93. [PMID: 27211479 DOI: 10.1016/j.atherosclerosis.2016.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/28/2016] [Accepted: 05/03/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUNDS AND AIMS Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians. Decreased muscle mass is one of the major causes of chronic disease in adults. The purpose of this study was to analyze the relationship between muscle mass and ICAS in Korean adults. METHODS For this study, we selected a total of 10,530 participants (mean age, 43.3 years; 8558 men) in a health screening program, for whom transcranial Doppler (TCD) ultrasound was used to detect >50% ICAS based on criteria modified from the stroke outcomes and neuroimaging of intracranial atherosclerosis trial. Body composition was evaluated by bioelectrical impedance analysis (BIA). Skeletal muscle index (SMI) was calculated with muscle mass/weight (kg) * 100. RESULTS Among the total patient population, 322 (3.1%) subjects had ICAS. Subjects with ICAS were older, and had higher mean values for fasting glucose, body mass index and blood pressure compared with those without ICAS. Subjects with ICAS had significantly lower muscle mass, SMI and higher percent body fat compared with those without ICAS. In logistic regression analysis, the subjects in the highest tertile of muscle mass had the lowest odds ratio for ICAS with the lowest tertile group of muscle mass as the reference group even after adjusting for age, systolic blood pressure, fasting blood glucose, sex, smoking and exercise (OR 0.650, 95% CI 0.442-0.955). CONCLUSIONS Subjects with ICAS had significantly decreased muscle mass compared with those without ICAS in Korean adults. The risk for ICAS was lower in subjects with higher muscle mass.
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Affiliation(s)
- Ho-Jung Jung
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hwanseok Jung
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Taeyoung Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jongho Kim
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jongsin Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hacsoo Kim
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Junghwan Cho
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Young Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Woo Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun-Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Hyung-Geun Oh
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan, South Korea.
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Zhang N, Chang Y, Guo X, Chen Y, Ye N, Sun Y. A Body Shape Index and Body Roundness Index: Two new body indices for detecting association between obesity and hyperuricemia in rural area of China. Eur J Intern Med 2016; 29:32-6. [PMID: 26895753 DOI: 10.1016/j.ejim.2016.01.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 01/03/2016] [Accepted: 01/23/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The first objective was to examine whether A Body Shape Index (ABSI) and Body Roundness Index (BRI) can identify hyperuricemia in rural China. The second aim was to compare the relative strength of association between anthropometric indices and hyperuricemia. METHODS A total of 11,345 participants were involved in this cross-sectional study. Obesity measurements included BMI, WC, WHtR, ABSI and BRI. According to the statistical distribution of serum uric acid (SUA), we split our study population in sex-specific tertiles of SUA. RESULTS After adjusting for confounding variables, BRI (linear regression: 0.170; AUC: 0.641; OR: 1.459) showed more powerful predictive ability for hyperuricemia than BMI (linear regression: 0.151; AUC: 0.630; OR: 1.108), while having a similar predictive power for hyperuricemia as WHtR (linear regression: 0.191; AUC: 0.656; OR: 1.067) and WC (linear regression: 0.209; AUC: 0.658; OR: 1.047) in the female group, but not in the male group. However, ABSI (A) (linear regression: 0.089 for women, 0.121 for men; AUC: 0.589 for women, 0.578 for men; OR: 1.027 for women, 1.034 for men) and ABSI (B) (linear regression: 0.118 for women, 0.121 for men; AUC: 0.607 for women, 0.578 for men; OR: 1.049 for women, 1.034 for men) had the lowest predictive power for hyperuricemia in both sex categories. CONCLUSIONS ABSI, BRI, BMI, WC and WHtR were all significantly associated with hyperuricemia in both sexes. In addition, BRI rather than ABSI showed a superior predictive ability for identifying hyperuricemia than BMI in female and similar capabilities as those of WC and WHtR in the female, but not in the male gender.
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Affiliation(s)
- Naijin Zhang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Ye Chang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Ning Ye
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
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Validation study of multi-frequency bioelectrical impedance with dual-energy X-ray absorptiometry among obese patients. Obes Surg 2015; 24:1476-80. [PMID: 24464546 DOI: 10.1007/s11695-014-1190-5] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Body mass index (BMI) is the most common parameter for classifying nutritional status. However, body composition (BC) may vary considerably among individuals with identical BMIs; consequently, we need to assess BC efficiently. Bariatric surgery is the most effective method for treating obesity. To improve quality assessment of postoperative weight loss, it is essential to assess BC. Multi-frequency bioelectrical impedance analysis (BIA) is a practical assessment instrument, though limited when applied among the obese population. Despite dual-energy X-ray absorptiometry (DXA) being the current reference standard, it has physical limitations which restrict its practical application. This study, therefore, sought to correlate the results of BC assessments of same patient population using BIA and DXA. METHODS This was a cross-sectional validation study with patients invited to undergo a multi-frequency BIA (Inbody 720®) and afterwards a DXA examination Statistical analyses were done using the intraclass correlation coefficient (ICC), paired t-test and the Bland-Altman plot analysis. RESULTS A total of 108 patients were randomly selected, with 73 meeting the criteria for study inclusion. Most were female (89%) and had an average BMI of 40.17 ± 4.08 kg/m(2). An almost perfect correlation of fat (kg) and fat-free mass (kg) was found in results from the BIA and DXA examination (ICC = 0.832 and ICC = 0.899, respectively). A substantial correlation was also found between the percentage of body fat (%BF) and the percentage of fat-free mass (%FFM). The comparison made between the BIA and DXA using the t-test showed significant differences between all parameters. The Bland-Altman plot showed that the BIA method tends to underestimate the FM and overestimate the LM measurements when compared with DXA. CONCLUSION BIA proved to be a safe alternative for assessing BC in clinically severely obese patients and thus provides a more accessible evaluation tool for this population. But, consideration should be given to the formula added to the BIA measurement, adjusting the values to differences observed in order to reduce errors when compared with the DXA measurements.
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Lubrano C, Tenuta M, Costantini D, Specchia P, Barbaro G, Basciani S, Mariani S, Pontecorvi A, Lenzi A, Gnessi L. Severe growth hormone deficiency and empty sella in obesity: a cross-sectional study. Endocrine 2015; 49:503-11. [PMID: 25614038 DOI: 10.1007/s12020-015-0530-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/10/2015] [Indexed: 12/29/2022]
Abstract
Obesity is associated with blunted growth hormone (GH) secretion. In some individuals, hypothalamic-pituitary (HP) structural lesions may contribute to GH deficiency (GHD). We explored pituitary morphology in obese patients with suspected GHD and its association with cardiovascular risk factors, body composition, and cardiac morphology. One hundred and eighty-four adults obese patients with symptoms and signs of GHD (147 females and 37 males; mean age 46.31 ± 12.11 years), out of 906 consecutive white obese outpatients, were evaluated. The main measures were anthropometric data, blood pressure, lipid profile, glycemic parameters, pituitary hormones, and insulin-like growth factor-1 values, echocardiography, magnetic resonance imaging (MRI) of the HP region, body composition, and growth hormone-releasing hormone plus arginine test. Seventy patients had GHD (GH peak values <4.2 μg/mL). GHD patients showed significantly higher body mass index and fat mass, lower lumbar bone mineral density, increased left ventricular mass index, and epicardial fat thickness. The MRI of the HP region showed empty sella (ES) in 69 and normal pituitary in one of the 70 GHD patients; the 114 patients with normal GH response had ES (n = 62, 54 %), normal pituitary (n = 37, 32 %), microadenomas (n = 10, 8 %), and other pituitary abnormalities (n = 5, 4 %). ES was a significant independent predictor of GH secretory capacity as determined by multiple regression analysis. The close relationship between ES and GH secretory capacity points out to the possibility of the organic nature of GHD in a portion of obese individuals and opens a new scenario with regard to the potential of GH treatment on metabolic consequences of obesity.
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Affiliation(s)
- Carla Lubrano
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, University of Rome "La Sapienza", Policlinico Umberto I, 00161, Rome, Italy
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Lubrano C, Valacchi G, Specchia P, Gnessi L, Rubanenko EP, Shuginina EA, Trukhanov AI, Korkina LG, De Luca C. Integrated Haematological Profiles of Redox Status, Lipid, and Inflammatory Protein Biomarkers in Benign Obesity and Unhealthy Obesity with Metabolic Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:490613. [PMID: 26090072 PMCID: PMC4451994 DOI: 10.1155/2015/490613] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/11/2015] [Accepted: 04/20/2015] [Indexed: 12/24/2022]
Abstract
The pathogenesis of obesity (OB) and metabolic syndrome (MetS) implies free radical-, oxidized lipid- (LOOH-), and inflammatory cytokine-mediated altered pathways in target organs. Key elements of the transition from benign OB to unhealthy OB+MetS remain unclear. Here, we measured a panel of redox, antioxidant, and inflammation markers in the groups of OB patients (67 with, 45 without MetS) and 90 controls. Both OB groups displayed elevated levels of adipokines and heavy oxidative stress (OS) evidenced by reduced levels of glutathione, downregulated glutathione-S-transferase, increased 4-hydroxynonenal-protein adducts, reactive oxygen species, and membrane-bound monounsaturated fatty acids (MUFA). Exclusively in OB+MetS, higher-than-normal glutathione peroxidase activity, tumor necrosis factor-α, and other proinflammatory cytokines/chemokines/growth factors were observed; a combination of high adipokine plasminogen activator inhibitor-1 and MUFA was consistent with increased cardiovascular risk. The uncomplicated OB group showed features of adaptation to OS such as decreased levels of vitamin E, activated superoxide dismutase, and inhibited catalase, suggesting H2O2 hyperproduction. Proinflammatory cytokine pattern was normal, except few markers like RANTES, a suitable candidate for therapeutic approaches to prevent a setting of MetS by inhibition of LOOH-primed leukocyte chemotaxis/recruitment to target tissues.
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Affiliation(s)
- Carla Lubrano
- Section of Medical Pathophysiology, Endocrinology and Food Science, Department of Experimental Medicine, “Sapienza” University, “Umberto I” Polyclinic, Viale Regina Elena 324, 00161 Rome, Italy
| | - Giuseppe Valacchi
- Department of Life Sciences and Biotechnology, University of Ferrara, Via Luigi Borsari 46, 44100 Ferrara, Italy
- Department of Food and Nutrition, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Republic of Korea
| | - Palma Specchia
- Section of Medical Pathophysiology, Endocrinology and Food Science, Department of Experimental Medicine, “Sapienza” University, “Umberto I” Polyclinic, Viale Regina Elena 324, 00161 Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Endocrinology and Food Science, Department of Experimental Medicine, “Sapienza” University, “Umberto I” Polyclinic, Viale Regina Elena 324, 00161 Rome, Italy
| | - Elizaveta P. Rubanenko
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
| | - Elena A. Shuginina
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
| | - Arseny I. Trukhanov
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
| | - Liudmila G. Korkina
- Active Longevity Clinic “Institut Krasoty na Arbate”, 8 Maly Nikolopeskovsky Lane, Moscow 119002, Russia
- Centre of Innovative Biotechnological Investigations (Cibi-NanoLab), 197 Vernadskogo Prospekt, Moscow 119571, Russia
| | - Chiara De Luca
- Centre of Innovative Biotechnological Investigations (Cibi-NanoLab), 197 Vernadskogo Prospekt, Moscow 119571, Russia
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Rotella CM, Dicembrini I. Measurement of body composition as a surrogate evaluation of energy balance in obese patients. World J Methodol 2015; 5:1-9. [PMID: 25825693 PMCID: PMC4374088 DOI: 10.5662/wjm.v5.i1.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/18/2015] [Accepted: 03/16/2015] [Indexed: 02/06/2023] Open
Abstract
In clinical practice obesity is primarily diagnosed through the body mass index. In order to characterize patients affected by obesity the use of traditional anthropometric measures appears misleading. Beyond the body mass index, there are overwhelming evidences towards the relevance of a more detailed description of the individual phenotype by characterizing the main body components as free-fat mass, muscle mass, and fat mass. Among the numerous techniques actually available, bioelectrical impedance analysis seems to be the most suitable in a clinical setting because it is simple, inexpensive, noninvasive, and highly reproducible. To date, there is no consensus concerning the use of one preferred equation for the resting energy expenditure in overweight and/or obese population. Energy restriction alone is an effective strategy to achieve an early and significant weight loss, however it results in a reduction of both fat and lean mass therefore promoting or aggravating an unfavourable body composition (as sarcobesity) in terms of mortality and comorbidities. Therefore the implementation of daily levels of physical activity should be simultaneously promoted. The major role of muscle mass in the energy balance has been recently established by the rising prevalence of the combination of two condition as sarcopenia and obesity. Physical exercise stimulates energy expenditure, thereby directly improving energy balance, and also promotes adaptations such as fiber type, mitochondrial biogenesis, improvement of insulin resistance, and release of myokines, which may influence different tissues, including muscle.
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Wang S, Liu Y, Li F, Jia H, Liu L, Xue F. A novel quantitative body shape score for detecting association between obesity and hypertension in China. BMC Public Health 2015; 15:7. [PMID: 25595192 PMCID: PMC4308906 DOI: 10.1186/s12889-014-1334-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 12/22/2014] [Indexed: 12/31/2022] Open
Abstract
Background Obesity is a major independent risk factor for chronic diseases such as hypertension and coronary diseases, it might not be only related to the amount of body fat but its distribution. The single body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) or waist to stature ratio (WSR) provides limited information on fat distribution, and the debate about which one is the best remained. On the other hand, the current classification of body shape is qualitative rather than quantitative, and only crudely measure fat distribution. Therefore, a synthetical index is highly desirable to quantify body shape. Methods Based on the China Health and Nutrition Survey (CHNS) data, using Lohmäller PLSPM algorithm, six Partial Least Squares Path Models (PLSPMs) between the different obesity measurements and hypertension as well as two synthetical body shape scores (BSS1 by BMI/WC/Hip circumference, BSS2 by BMI/WC/WHR/WSR) were created. Simulation and real data analysis were conducted to assess their performance. Results Statistical simulation showed the proposed model was stable and powerful. Totally 15,172 (6,939 male and 8,233 female) participants aged from 18 to 87 years old were included. It indicated that age, height, weight, WC, WHR, WSR, SBP, DBP, the prevalence of hypertension and obesity were significantly sex-different. BMI, WC, WHR, WSR, Hip, BSS1 and BSS2 between hypertension and normotensive group are significantly different (p < 0.05). PLSPM method illustrated the biggest path coefficients (95% confidence interval, CI) were 0.220(0.196, 0.244) for male and 0.205(0.182, 0.228) for female in model of BSS1. The area under receiver-operating characteristic curve (AUC(95% CI)) of BSS1(0.839(0.831,0.847)) was significantly larger than that of BSS2(0.834(0.825,0.842)) as well as the four single indices for female, and similar trend can be found for male. Conclusions BSS1 was an excellent measurement for quantifying body shape and detecting the association between body shape and hypertension.
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Affiliation(s)
- Shukang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, PO Box 100, Jinan, 250012, China.
| | - Yanxun Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, PO Box 100, Jinan, 250012, China.
| | - Fangyu Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
| | - Hongying Jia
- The Second Hospital of Shandong University, Jinan, China.
| | - Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
| | - Fuzhong Xue
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, PO Box 100, Jinan, 250012, China.
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Yusen RD. Body composition, lung transplant candidacy, and patient outcomes. Am J Respir Crit Care Med 2014; 190:971-3. [PMID: 25360725 DOI: 10.1164/rccm.201410-1767ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Roger D Yusen
- 1 Division of Pulmonary and Critical Care Medicine Washington University School of Medicine St. Louis, Missouri
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De Rosa E, Santarpia L, Marra M, Sammarco R, Amato V, Onufrio M, De Simone G, Contaldo F, Pasanisi F. Preliminary evaluation of the prevalence of sarcopenia in obese patients from Southern Italy. Nutrition 2014; 31:79-83. [PMID: 25441590 DOI: 10.1016/j.nut.2014.04.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 03/31/2014] [Accepted: 04/27/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Sarcopenic obesity has not yet been widely defined. The aim of this study was to evaluate the prevalence of sarcopenia in a group of severely obese adults from southern Italy by using two different indexes: percentage of skeletal muscle mass (SMP) and skeletal muscle mass normalized for height (SMI); and to determine SMP and SMI cutoff points in a southern Italy reference population. METHODS Skeletal muscle mass of 131 consecutive obese adult outpatients (51 men and 80 women; ages 45-67 y; body mass index 44.6 ± 7.7 kg/m(2)), was assessed by bioimpedance analysis. SMP and SMI cutoff points to identify moderate and severe sarcopenia were calculated in a reference group of 500 young southern Italy adults (100 men and 400 women; ages 18-40 y; body mass index 25.2 ± 5.6 kg/m(2)) and applied to assess the prevalence of sarcopenia in the study population. RESULTS SMP cutoff points to identify moderate and severe sarcopenia were, 28.8% to 35.6% and ≤ 28.7% in men and 23.1% to 28.4% and ≤ 23% in women, respectively. The corresponding values for SMI were 8.44 to 9.53 kg/m(2) and ≤ 8.43 kg/m(2) in men, 6.49 to 7.32 kg/m(2) and ≤ 6.48 kg/m(2) in women. According to SMP, 23 of 51 (45.1%) men and 19 of 80 (23.8%) women were moderately sarcopenic; 28 of 51 (54.9%) men and 61 of 80 (76.3%) women met the definition of severe sarcopenia. Based on SMI, only 2 of 51 (3.9%) men were moderately sarcopenic. CONCLUSIONS This study confirms that sarcopenia rates vary widely in obese patients depending on the criteria used. SMP as a screening tool to identify a sarcopenia at-risk population.
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Affiliation(s)
- Eliana De Rosa
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Lidia Santarpia
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Maurizio Marra
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Rosa Sammarco
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Valeria Amato
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Michele Onufrio
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni De Simone
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Franco Contaldo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Fabrizio Pasanisi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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From simplicity towards complexity: the Italian multidimensional approach to obesity. Eat Weight Disord 2014; 19:387-94. [PMID: 24448995 DOI: 10.1007/s40519-013-0097-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/27/2013] [Indexed: 01/09/2023] Open
Abstract
Obesity is the result of a complex interplay among several factors leading to medical, functional and psychosocial consequences that markedly reduce life expectancy and impair quality of life. Is obesity itself a disease? Is obesity a brain disease? Who should treat obesity? This paper is a narrative review aimed to describe and to argue the prevalent position of some major Italian scientific and academic institutions dealing with obesity. According to the recent statements and recommendations published by the Italian Society for Obesity (SIO) and the Italian Society for the Study of Eating Disorders (SISDCA), the management of obese patients should include five main levels of care: (1) primary care, (2) outpatient treatment, (3) intensive outpatient treatment, (4) residential rehabilitative treatment, and (5) hospitalization. Ideally, patients suffering from obesity need a multidimensional evaluation intended to design an individualized treatment plan applying different procedures and therapeutic strategies (diet, physical activity and functional rehabilitation, educational therapy, cognitive-behavior therapy, drug therapy, and bariatric surgery). This thorough approach should address not only weight loss but also quality of weight loss, medical and psychiatric comorbidity, psychosocial problems, and physical disability. Such management of obesity requires an effective multiprofessional team, while health services have to overcome a number of administrative and organizational barriers that do not account for diseases requiring resources and professionals from different areas of medicine. Integrating several competences in a team-based approach demands specific education, skills and expertise. As for other diseases, the principles of complexity theory may offer a model useful to implement both teamwork and care delivery for patients with obesity.
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