Identification of Hepatic Steatosis in Premenopausal and Postmenopausal Women Based on Phenotypes Combining Triglyceride Levels and Anthropometric Indices: A Cross-Sectional Study.

BACKGROUND: The hypertriglyceridemic waist phenotype (HWP) has exhibited a strong association with metabolic syndrome, a condition closely linked with nonalcoholic fatty liver disease (NAFLD). However, no study has investigated whether the HWP can accurately predict NAFLD among premenopausal and postmenopausal women or whether alternative anthropometric indexes could replace waist circumference (WC) in the HWP. We examined the power of phenotypes combining triglyceride (TG) levels with anthropometric indexes such as body mass index (BMI), WC, waist-to-hip ratio, waist-to-height ratio, and percent body fat, to detect NAFLD among premenopausal and postmenopausal women. METHODS: We conducted a cross-sectional study of 1125 premenopausal women and 654 postmenopausal women who had received an annual health checkup. For all the participating women, we measured both anthropometric and biochemical indexes, such as serum lipid levels. NAFLD diagnoses were made on the basis of abdominal ultrasonography findings. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the indicators' ability to detect NAFLD. RESULTS: Among the indicators of hepatic steatosis, the combined phenotypes of TG level (≥1.50 mmol/L) and BMI (≥24.0 kg/m2) exhibited the largest AUC (0.841, 95%confidence interval [CI] 0.812-0.871, P< 0.001) for premenopausal women, whereas WC alone exhibited the highest predictive potential (0.765, 95% CI 0.729-0.801, P< 0.001) for postmenopausal women. CONCLUSION: Out of all the phenotypes combining a single anthropometric index with TG level or WC and TG level, the combination of TG level and BMI was the best indicator of NAFLD for premenopausal women. For screening NAFLD in postmenopausal women, WC alone was superior to all other indicators.

Screening for Metabolic Syndrome Using an Integrated Continuous Index Consisting of Waist Circumference and Triglyceride: A Preliminary Cross-sectional Study.

BACKGROUND: It has been suggested that hypertriglyceridemic waist (HW) phenotype is strongly associated with metabolic syndrome (MetS); however, there are very limited studies integrating triglyceride (TG) and waist circumference (WC) into a continuous variable to investigate the predictive power of this phenotype. Inspired from the triglyceride glucose index (TyG), we developed an integrated continuous index termed waist-triglyceride index (WTI) which was calculated as Ln [TG (mg/dl) WC (cm)/2]. OBJECTIVE: We aimed to examine the potential of WTI in screening for MetS by comparing this quantitative index with the qualitative HW phenotype and other frequently used indices. METHODS: A cross-sectional study was conducted in a total of 3460 non-diabetic adults who participated in an annual health checkup. MetS was defined by the update National Cholesterol Education Program/Adult Treatment Panel ш criteria for Asian Americans. Receiving operating characteristic (ROC) curve and areas under the curve (AUC) were employed to evaluate the performance of the involved indices in screening for MetS. Statistical differences among the AUC values of the indices were compared. RESULTS: In both genders, the AUC value of WTI, TyG or HW phenotype was markedly larger than that of each anthropometric index alone. In men, there were no statistical differences in the AUC values among WTI, TyG and HW phenotype, whereas in women, the AUC value of WTI was significantly larger than that of HW phenotype [difference between area (DBA): 0.042, 95% CI: 0.0224-0.0617, P < 0.0001] and was nominally and significantly smaller than that of TyG (DBA: 0.00646, 95% CI: 0.000903-0.012, P = 0.0227). CONCLUSION: Our results suggest that there are discriminatory performance between the WTI and HW phenotype in the detection of MetS in women rather than in men. Appropriate markers for screening MetS in population study should be considered according to the genders.

Utility of different indices in screening Chinese postmenopausal women for hepatic steatosis.

BACKGROUND AND OBJECTIVES: To analyze the potential of fatty liver index (FLI) and several obesity indices and to explore which index is best for predicting nonalcoholic fatty liver disease (NAFLD) in Chinese postmenopausal women. METHODS AND STUDY DESIGN: A cross-sectional study was conducted in 680 Chinese postmenopausal women. NAFLD was defined as a hepatic steatosis observed on liver ultrasonography in the absence of a second cause. Odds ratio and corresponding 95% confidence interval (CI) between hepatic steatosis and FLI as well as different obesity indices were evaluated by Binary Logistic regression model. Receiver operating characteristic curve and area under curve (AUC) were used to compare the ability of predicting hepatic steatosis between FLI and obesity indices. RESULTS: The upper values of all indices were significantly associated with the presence of hepatic steatosis (all p<0.01) after the adjustment for potential confounders. The largest AUC [0.85 (0.82-0.88), 95% CI, p<0.01] was observed for FLI, followed by the frequently used obesity indices. CONCLUSIONS: FLI is closely associated with the presence of hepatic steatosis in Chinese postmenopausal women. Compared to the obesity indices frequently used, FLI is a better surrogate marker for predicting the presence of hepatic steatosis in Chinese postmenopausal women.

Normal-weight central obesity is associated with metabolic disorders in Chinese postmenopausal women.

BACKGROUND AND OBJECTIVES: This cross-sectional study examined whether normal-weight central obesity, defined as a high waist-to-height ratio (WHtR), is associated with metabolic disorders in Chinese postmenopausal women. METHODS AND STUDY DESIGN: We recruited 634 community-dwelling postmenopausal women with a normal body mass index (BMI) who participated in an annual health checkup. Normal-weight obesity (NWO) was defined as a normal BMI and WHtR in the highest tertile of the study population. The updated National Cholesterol Education Program/Adult Treatment Panel III criteria were used to assess metabolic abnormalities, and binary logistic regression models were employed to estimate the associations between NWO and metabolic disorders. RESULTS: The prevalence of each metabolic disorder showed a graded increase (p<0.05) across the WHtR tertiles in the study population. NWO was significantly associated with some non-adipose components of metabolic syndrome (MetS) (p<0.05) after adjusting for age, smoking status, drinking status, inflammatory markers, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), body fat percentage (BF%), and the remaining non-adipose MetS components. Participants in the highest WHtR tertile had a higher odds ratio [2.00 (1.19- 3.33), p<0.01] for the presence of at least two non-adipose MetS components than those in the lowest tertile after adjusting for age, lifestyle factors, inflammatory markers, TC, LDL-c, and BF%. CONCLUSIONS: NWO is significantly associated with metabolic disorders, suggesting that a clinical assessment of abdominal obesity indices should be conducted in postmenopausal women, even in those with a normal BMI.

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.

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.

Visceral Adiposity Index Is Associated with Pre-Diabetes and Type 2 Diabetes Mellitus in Chinese Adults Aged 20-50.

BACKGROUND/AIMS: Diabetes mellitus and pre-diabetes are closely associated with visceral obesity. Visceral adiposity index (VAI) is a novel sex-specific index, indirectly expressing visceral adipose function. Our aim was to determine the associations of VAI with dysglycemia (the combination of diabetes and pre-diabetes) and to compare the predictive ability for dysglycemia between VAI and traditional obesity indices. METHODS: We performed a cross-sectional analysis of the data of 2,754 Chinese community-dwelling people who participated in the health checkup. Sex-specific VAI tertile cut-off points were used as follows: 1.70, 2.77 in males and 0.98, 1.75 in females. Binary logistic regression models were performed to estimate the association of the higher values of all the obesity indices with pre-diabetes and diabetes. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was applied to compare the predictive potential for dysglycemia among the obesity indices. RESULTS: VAI was the only index significantly associated with both pre-diabetes and diabetes in both sexes after adjusting for potential confounders. The results of ROC analysis and AUC showed that VAI possessed the largest AUC, followed by other obesity indices. CONCLUSIONS: Higher VAI values are positively associated with the presence of pre-diabetes and diabetes in Chinese adults.

[Prevalence and risk factors of retinal arterial atherosclerosis in urban subjects participating in routine physical examinations].

OBJECTIVE: To determine the prevalence and risk factors of atherosclerotic lesions in retinal arteries of an urban population undergoing routine physical examinations. METHODS: Demographic and clinical information of subjects participating in annual routine physical examinations at Peking Union Medical Center from January to October of 2010 were collected and summarized. Univariate and multivariate Logistic regression analyses were conducted to evaluate the demographic and clinical factors associated with retinal arterial atherosclerosis. RESULTS: Among a total of 17 886 non-diabetic adults evaluated during the study period, retinal arterial atherosclerosis was diagnosed in 1721 (9.6%). There were predominantly grade 1 (88%) and grade 2 (11%) lesions. Prevalence of retinal arterial atherosclerosis increased with age. And traditional risk factors for cardiovascular diseases included overweight or obesity, hypertension, dyslipidemia and elevated fasting serum glucose. In a multivariate Logistic regression model, advanced age, male gender, obesity or overweight, hypertension and dyslipidemia were independently associated with a higher risk of retinal arterial atherosclerosis. Hypertension was prevalent in subjects above 40 years old while overweight or obesity had a high prevalence in all age groups. CONCLUSION: Retinal arterial atherosclerosis is common in this urban population. And aging, overweight/obesity and hypertension are the dominant risk factors. Routine physical examination is valuable for both the prevention and an early diagnosis of this disease.

[Correlation between retinal artery atherosclerosis and renal dysfunction in non-diabetic urban subjects aged over 40 during routine physical examinations].

OBJECTIVE: To evaluate the correlation between retinal artery atherosclerosis and renal dysfunction and compare their risk factors in an urban population of Beijing. METHODS: The non-diabetic adults > 40 years old undergoing annual physical examinations during June 2010 and February 2011 at one medical center were evaluated. Pearson correlation coefficient was calculated between retinal artery atherosclerosis and renal dysfunction. The analyses of multivariate Logistic regression were performed to compare the risk factors of these two diseases. RESULTS: Among 10 191 subjects included, retinal artery atherosclerosis was diagnosed in 1287 (12.6%) and renal dysfunction in 434 (4.3%). And 1.0% of subjects had both two diseases versus 12.2% with retinal artery atherosclerosis alone and 3.3% with renal dysfunction alone. Correlation coefficient was low between two diseases (r = 0.21; P < 0.01). According to the analyses of multivariate Logistic regression, the strongest predictors of retinal artery atherosclerosis were obesity (OR = 2.5, 95%CI 2.0 - 3.2) and hypertension (OR = 2.2, 95%CI 2.0 - 2.6) while advanced age (OR = 3.1, 95%CI 2.8 - 3.5 per 10 year increment) was the strongest factor for renal dysfunction. CONCLUSION: The low-level correlation and different risk factor profiles between retinal artery atherosclerosis and renal dysfunction indicate different pathogenic mechanisms of two diseases and suggest different preventive strategies.

Identification of a new broad-spectrum CD8+ T cell epitope from over-expressed antigen COX-2 in esophageal carcinoma.

Cyclooxygenase-2 (COX-2) has been found to be over-expressed in esophageal carcinoma (EC) and it could be considered as a potential tumor-associated antigen (TAA). In the present study, six candidate peptides from COX-2 were firstly predicted and synthesized. Among them, P(479) had the highest affinity and stability toward both HLA-A *0201 and HLA-A *03 molecules and it could significantly promote the IFN-gamma release. The cytotoxic T lymphocytes (CTLs) induced by P(479) could specifically lyse COX-2-expressed EC cell lines, EC-1 (HLA-A3 supertype) and EC-9706 (HLA-A2 supertype). These results suggested that P(479) as a novel broad-spectrum T cell epitope would be very useful in immunotherapy against esophageal carcinoma.

[Study on the relationship between intake of nutrients and bone density in middle-aged and old people].

OBJECTIVE: To study the relationship between intake of nutrients and bone density in the middle-aged and the old people. METHODS: Dietary investigation was conducted and bone densities of lumbar 2-4, tuberositas of femur and the neck of femur were measured in 200 healthy subjects who received physical check-up in our hospital. Subjects were distributed into 6 groups including young or middle-aged, pre-old and old groups of men and women. Comparison was conducted within those groups. RESULTS: The average intake of protein, carbohydrate and energy per day in old men-group were (71.4 +/- 11.7) g, (294.2 +/- 54.7) g and (2196.9 +/- 311.3) kcal, respectively, which were significantly lower than those in young or middle-aged groups, and the average amounts of protein, carbohydrate and energy intake per day in old men-group were (91.7 +/- 19.5) g, (81.8 +/- 85.2) g and (2716.0 +/- 451.7) kcal, respectively. The average intake of calcium in women-old group was (362.0 +/- 167.1) mg, the lowest in the groups. The incidence of abnormal bone densities of lumbar 2-4, the tuberositas of femur and the neck of femur in old men group was significantly higher than those in young or middle-aged men groups (P < 0.05) and the pre-old men group. There were significantly different incidence rates of abnormal bone densities between the 3 women groups (P < 0.05), especially between young or middle-aged groups and in the old women-group (P < 0.0001). The incidences of abnormal bone density in pre-old men group and old men group were significantly lower than those in-pre-old and old women groups. CONCLUSION: The decrease of calcium intake seemed to be one of the factors leading to abnormity of bone density in old women. While the increase of calcium intake served as one of the nutritional factors affecting the bones.