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1.
BMC Pregnancy Childbirth ; 21(1): 646, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556074

RESUMO

BACKGROUND: High rates of adverse pregnancy outcomes globally raise the need to understand risk factors and develop preventative interventions. The Pregnancy Outcomes in the Era of Universal Antiretroviral Treatment in Sub-Saharan Africa (POISE Study) was a prospective, observational cohort study conducted from 2016 to 2017 in Blantyre, Malawi. We examine the associations between indicators of nutritional status, specifically mid-thigh circumference (MTC) and body-mass index (BMI), and adverse pregnancy outcomes, low birth weight (LBW), preterm birth (PTB), and small-for-gestational age (SGA), in a cohort of HIV-infected and HIV-uninfected women. METHODS: Sociodemographic, clinical, laboratory, and maternal height, weight and MTC data were collected immediately before or after delivery at the Queen Elizabeth Central Hospital (QEHC) and 4 affiliated health centers in Blantyre, Malawi. LBW was defined as birth weight < 2.5 kg; PTB as gestational age < 37 weeks using Ballard score; and SGA as birth weight < 10th percentile for gestational age. Descriptive, stratified, and multivariable logistic regression were conducted using R. RESULTS: Data from 1298 women were analyzed: 614 HIV-infected and 684 HIV-uninfected. MTC was inversely associated with LBW (adjusted odds ratio [aOR] = 0.95, p = 0.03) and PTB (aOR 0.92, p < 0.001), after controlling for HIV status, age, socioeconomic status and hemoglobin. The association between MTC and SGA was (aOR 0.99, p = 0.53). Similarly, higher BMI was significantly associated with lower odds of PTB (aOR 0.90, p < 0.001), LBW (aOR 0.93, p = 0.05), and SGA (aOR 0.95, p = 0.04). CONCLUSIONS: We observed an inverse relationship between MTC and adverse pregnancy outcomes in Malawi irrespective of HIV infection. MTC performs comparably to BMI; the ease of measuring MTC could make it a practical tool in resource-constrained settings for identification of women at risk of adverse pregnancy outcomes.


Assuntos
Tamanho Corporal/fisiologia , Estado Nutricional/fisiologia , Complicações na Gravidez/epidemiologia , Coxa da Perna , Adulto , Feminino , Idade Gestacional , Infecções por HIV , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Malaui/epidemiologia , Masculino , Gravidez , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Estudos Prospectivos , Coxa da Perna/fisiologia , Adulto Jovem
2.
J Obstet Gynaecol Res ; 47(12): 4210-4215, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34601765

RESUMO

AIM: We aimed to evaluate the addition of fetal thigh circumference (TC) to other ultrasound parameters to predict fetal weight compared to two standard formulae (Hadlock's and Vintzileos methods). METHODS: We conducted this prospective study on pregnant women between November 2018 and September 2019. The actual fetal weight was estimated within 48 h of delivery; then, it was compared to the estimated fetal weight by ultrasound. We used the Statistical Package for the Social Sciences (SPSS) software version 20.0 to perform the statistical analysis. RESULTS: A total of 123 pregnant women, with a mean age of 26.68 (5.24) years and a mean gestational age of 38.78 (0.85) weeks, were included in our study. We detected a significant positive correlation between different ultrasound parameters and actual weight (all p ≤ 0.001). The highest correlation was observed between TC and actual fetal weight (r = 0.685). Regarding both formulae, the correlation coefficient was higher in the Vintzileos formula than the Handlock formula (0.976 vs. 0.823). Our linear regression analysis showed that fetal TC could be an indicator for estimating fetal weight (p < 0.001). There was a statistically significant difference between the actual weight and the weight estimated by the Hadlock formula (p < 0.001). We detected no statistically significant difference between the estimated TC by ultrasound and the actual TC (p = 0.0602). CONCLUSION: Fetal TC can help accurately measure fetal birth weight when incorporated with other fetal parameters. The inclusion of fetal TC assessment in routine ultrasound examination is suggested to improve the birth estimates.


Assuntos
Peso Fetal , Coxa da Perna , Adulto , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Lactente , Gravidez , Estudos Prospectivos , Coxa da Perna/diagnóstico por imagem , Ultrassonografia Pré-Natal
3.
Knee Surg Sports Traumatol Arthrosc ; 29(4): 1045-1051, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32476036

RESUMO

PURPOSE: This study aimed to evaluate the differences in clinical outcome and donor site morbidity between the Peroneus Longus Tendon (PLT) and Hamstring Tendon (HT) in single-bundle Posterior Cruciate Ligament (PCL) reconstruction. METHODS: Patients with an isolated PCL injury underwent single-bundle PCL reconstruction using consecutive sampling. Patients were allocated into two groups (PLT and HT) and prospectively observed. The tendon graft diameter was measured intraoperatively. Functional scores (IKDC, Lysholm, and modified Cincinnati scores) were recorded preoperatively and 2 years postoperatively. The thigh circumference and functional score according to the Foot and Ankle Disability Index (FADI) and American Orthopedic Foot and Ankle Society (AOFAS) were recorded to evaluate the morbidities in the ankle. RESULTS: Fifty-five patients (hamstring n = 27, peroneus n = 28) met the inclusion criteria. The diameter of the PLT graft (8.2 ± 0.6 mm) was comparable to that of the HT graft (8.3 ± 0.5 mm). Both groups had excellent postoperative knee functional outcome scores. The mean AOFAS and FADI scores were excellent, with no difference in thigh circumference between the groups. CONCLUSION: PLT is a good choice as a graft in PCL reconstruction at the 2-year follow-up, with minimal donor site morbidity. LEVEL OF EVIDENCE: II.


Assuntos
Tendões dos Músculos Isquiotibiais/transplante , Reconstrução do Ligamento Cruzado Posterior/métodos , Ligamento Cruzado Posterior/lesões , Ligamento Cruzado Posterior/cirurgia , Tendões/transplante , Adolescente , Adulto , Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Feminino , Pé/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Coxa da Perna/cirurgia , Sítio Doador de Transplante/patologia , Resultado do Tratamento , Adulto Jovem
4.
Acta Med Indones ; 51(2): 117-127, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31383826

RESUMO

BACKGROUND: sarcopenia is one of many geriatric problems that may lead to major clinical outcomes. Calf and thigh circumference have good correlation with muscle mass, whereas SARC-F questionnaire is very predictive of muscle function. There has not been a study that evaluates the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire in detecting sarcopenia. The aim of this study was to investigate the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire compared to standard diagnostic methods of sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) to predict sarcopenia in patient aged 60 years or older. METHODS: this cross-sectional study was conducted in Geriatric Clinic Cipto Mangunkusumo Hospital, Jakarta, Indonesia during April-June 2018. Analysis was performed using receiver operating characteristic (ROC) curve to determine the cut-off point as well as sensitivity (Sn), specificity (Sp), positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (LR+ and LR-) of calf and thigh circumference as an indicator of low muscle mass, and SARC-F questionnaire score to detect decreased muscle function. RESULTS: from 120 participants, there were 46 men (38.3%) and 74 women (61.7%). The combination of calf circumference with cut-off point below 34 cm in men and below 29 cm in women, thigh circumference below 49 cm in men and below 44 cm in women with SARC-F questionnaire score of ≥4 have Sn, Sp, PPV, NPV, LR+, and LR- of 15.79%; 99.01%; 75.00%; 86.21%; 15.95; and 0.85 respectively. CONCLUSION: combination of calf and thigh circumference with SARC-F questionnaire showed good diagnostic accuracy in predicting sarcopenia in elderly outpatients.


Assuntos
Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Indonésia , Perna (Membro)/anatomia & histologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Força Muscular , Desempenho Físico Funcional , Valor Preditivo dos Testes , Curva ROC , Coxa da Perna/anatomia & histologia
5.
J Sport Rehabil ; 28(5): 398-401, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29252077

RESUMO

Context: Periodic assessment of knee extensor muscle strength and size is important for all ages to evaluate the functional status of individuals and to identify and treat those at risk for mobility problems and frailty; however, it is not fully understood whether these field-based simplified approaches correspond to evaluation in knee extensor muscle strength or size. Objective: To examine the relationship between field-based simplified evaluation approaches and knee extensor muscle strength or size in young women. Design: Experimental. Setting: University research laboratory. Subjects: A total of 62 university freshmen women volunteered to participate in this study. Main Outcome Measures: Knee extensor muscle thickness was measured at the anterior half of thigh length; muscle strength was measured when subjects performed knee extension. Field-based simplified approaches (sit-to-stand, standing long jump, handgrip, and upper leg 50% [thigh] girth) were also measured. Results: Maximal strength was correlated with thigh girth, handgrip, and standing long jump, but not with the sit-to-stand test. Muscle thickness was correlated with thigh girth and handgrip, but not with standing long jump or the sit-to-stand test. A stepwise multiple-regression analysis was calculated using the predictor thigh girth and standing long jump to predict knee extensor maximal strength (R2 = .295). To predict knee extensor muscle thickness, the predictor thigh girth was calculated (R2 = .202). Conclusions: Knee extensor muscle strength and size could be evaluated by the field-based simplified approaches, in particular by the thigh girth measurement, which may be a major determinant to maintain activities of daily living for healthy young women. However, the 4 field-based simplified approaches appear to be still not of high impact.


Assuntos
Joelho/diagnóstico por imagem , Joelho/fisiologia , Força Muscular/fisiologia , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Coxa da Perna/diagnóstico por imagem , Coxa da Perna/fisiologia , Ultrassonografia , Adolescente , Adulto , Povo Asiático , Teste de Esforço , Feminino , Força da Mão/fisiologia , Humanos , Contração Muscular/fisiologia , Dinamômetro de Força Muscular , Universidades
6.
Int J Geriatr Psychiatry ; 33(8): 1019-1027, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29726588

RESUMO

OBJECTIVE: Few studies have investigated the relationship between specific body measures and dementia. METHODS: Three-dimensional anthropometric body surface scanning data containing 38 body measures were collected from 6831 participants from the health examination department of a medical center in Taiwan during 2000 to 2008, and 236 dementia cases were identified during the 10-year follow-up. A multiple Cox regression analysis was performed. RESULTS: Specific body measures, namely chest width (hazard ratio [HR] = 0.90; 95% confidence interval [CI] = 0.83-0.98), and right thigh circumference (HR = 0.93; 95% CI = 0.90-0.96), were protective predictors to dementia occurrence. Waist circumference (HR = 1.03; 95% CI = 1.02-1.05) was a risk factor in dementia occurrence. Among the combinations, dementia risk was higher in participants with a larger waist circumference and a smaller right thigh circumference, with the highest HR of 2.49 (95% CI = 1.54-4.03). CONCLUSION: The body measures provide clues for future applications and scientific merits in both clinical and preventive medicine.


Assuntos
Demência/diagnóstico , Coxa da Perna/anatomia & histologia , Tórax/anatomia & histologia , Circunferência da Cintura , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Fatores de Risco , Taiwan
7.
Wei Sheng Yan Jiu ; 47(6): 875-882, 2018 Nov.
Artigo em Zh | MEDLINE | ID: mdl-30593325

RESUMO

OBJECTIVE: To explore the association of obesity indicators with hypertension and dyslipidemia in adults. METHODS: The study used anthropometric data of 1022 adults aged 18-69 years in Liaoning, Henan and Hunan Provinces in 2012 to describe the overweight and obesity rate of body mass index( BMI), waist circumference( WC), waist to height ratio( WHtR), waist hip ratio( WHR) and body fat percentage( BF%). The ability of indicators to predict the risk of hypertension and dyslipidemia was evaluated by receiver operating characteristic( ROC) curve analysis. RESULTS: In comparison of anthropometric measurements, male WC was significantly higher than female, thigh circumference( ThC) was no gender differences and thigh height ratio( THtR) lower in men than in women. The obesity index was used to determine the overweight and obesity rate of Chinese adults: WHtR > WHR > BMI > BF% > WC was58. 7%, 50. 4%, 49. 1%, 35. 7% and 35. 3%, respectively. The obesity rate of BMI was13. 2%, significantly lower than other indicators. The ROC curve illustrated area under curve( AUC) of WHtR was the largest in predicting the risk of hypertension, and the cutoff values were 0. 53 and 0. 56 in male and female. AUC of WHR were the largest with hypercholesterolemia as dependent variables in male and female and as the only significant indicator in men. The value of BMI, WC, WHtR, WHR and BF% to predict the risk of hypertriglyceridemia was similar. ThC and THtR had a better prognosis value than BMI, WC, WHtR and other common indicators in low high-density lipoprotein cholesterolemia, especially in male residents. The cut-off values of ThC were 52. 50 and 55. 40, and the cut-off values of THtR were 0. 31 and 0. 35 in male and female. CONCLUSION: Men are more likely to hoard fat in the abdomen, female fat easily in the thigh accumulation. WHtR is the best index in predicting the risk of hypertension. The association between obesity indexes and different clinical classification of dyslipidemia are not the same: WHR shows the best effect in predicting the risk of hypercholesterolemia, BMI, WC, WHtR, WHR and BF% have the same value in predicting the risk of hypertriglyceridemia, ThC and THtR are better than BMI, WC, WHtR and other common indicators in predicting the risk of low high-density lipoprotein cholesterolemia, especially in male residents.


Assuntos
Dislipidemias , Hipertensão , Obesidade , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Dislipidemias/complicações , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Curva ROC , Fatores de Risco , Circunferência da Cintura , Relação Cintura-Quadril , Adulto Jovem
8.
J Phys Ther Sci ; 28(3): 718-21, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27134346

RESUMO

[Purpose] Our aim was to evaluate the relationships between waist and mid-thigh circumference, used as proxy measures of trunk and lower limb strengths, respectively, and selected parameters of driver and putting performance in Korean college golfers. [Subjects and Methods] The participants were 103 college golfers (81 male, 20 to 27 years old). Measurements of body composition, waist and mid-thigh circumference, and grip strength, as well as assessment of golf performance, including driver distance, driver swing speed, putting accuracy, and putting consistency, were performed at the golf performance laboratory at Konkuk University in Chungju-si, Republic of Korea. Average round score was obtained from 10 rounds of golf completed during the study period. The relationships between strength measures and golf performance were evaluated by partial correlation analysis, with adjustment for age, golf experience, and body mass index. [Results] Waist circumference did not correlate with any of the performance variables in both males and females. Mid-thigh circumference correlated with putting consistency (r = 0.364) in males and with putting consistency (r = 0.490) and accuracy (r = 0.547) in females. No other significant correlations between waist and mid-thigh circumference and golf performance were identified. [Conclusion] Lower limb strength may be an important component of putting performance. Further studies are needed to fully characterize the contributions of trunk strength to performance.

9.
J Phys Ther Sci ; 27(9): 3019-21, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26504348

RESUMO

[Purpose] We investigated whether waist and mid-thigh circumference correlated with cardiovascular fitness (VO2max) in a selected sample of Korean college students. [Subjects and Methods] The subjects were 41 college students (25 males, 16 females; age, > 19 years) who visited the sports medicine laboratory at the Korea National University of Transportation in Chungju-si, Republic of Korea, to undergo measurements of body composition, cardiovascular fitness, and waist and mid-thigh circumference. [Results] VO2max did not correlate with waist circumference or mid-thigh circumference in males, whereas VO2max was negatively correlated with mid-thigh circumference, but not waist circumference, in females. [Conclusion] Mid-thigh circumference was not associated with cardiovascular fitness or waist in male college students. However, it was associated with cardiovascular fitness in female college students. Well-designed studies are needed to investigate this further.

10.
Front Physiol ; 15: 1446963, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39189031

RESUMO

Background: Arterial occlusion pressure (AOP) is a relevant measurement for individualized prescription of exercise with blood flow restriction (BFRE). Therefore, it is important to consider factors that may influence this measure. Purpose: This study aimed to compare lower limb AOP (LL-AOP) measured with 11 cm (medium) and 18 cm (large) cuffs, in different body positions, and explore the predictors for each of the LL-AOP measurements performed. This information may be useful for future studies that seek to develop approaches to improve the standardization of pressure adopted in BFRE, including proposals for equations to estimate LL-AOP. Methods: This is a cross-sectional study. Fifty-one healthy volunteers (males, n = 25, females, n = 26; Age: 18-40 years old) underwent measurement of thigh circumference (TC), brachial blood pressure, followed by assessments of LL-AOP with medium and large cuffs in positions supine, sitting and standing positions. Results: The large cuff required less external pressure (mmHg) to elicit arterial occlusion in all three-body positions when compared to the medium cuff (p < 0.001). The LL-AOP was significantly lower in the supine position, regardless of the cuff used (p < 0.001). Systolic blood pressure was the main predictor of LL-AOP in the large cuff, while TC was the main predictor of LL-AOP with the medium cuff. Body position influenced strength of the LL-AOP predictors. Conclusion: Our results indicate that LL-AOP and its predictors are substantially influenced by body position and cuff width. Therefore, these variables should be considered when standardizing the pressure prescribed in BFRE.

11.
Sci Rep ; 14(1): 21407, 2024 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-39271702

RESUMO

Anthropometric parameters are widely used in the clinical assessment of hypertension, type 2 diabetes, and cardiovascular disease. However, few studies have compared the association between different anthropometric parameters and insulin resistance (IR). This study was aimed at investigating the relationship between 6 indicators, including body mass index (BMI), calf circumference (CC), arm circumference (AC), thigh circumference (TC), waist circumference (WC), waist-height ratio (WHtR), and IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to measure IR. Weighted linear regression was used to assess the relationship between different parameters and IR. The receiver operating characteristic curve (ROC) was employed to compare the strength of the relationship between different anthropometric parameters and IR. A total of 8069 participants were enrolled in our study, including 4873 without IR and 3196 with IR. The weighted linear regression results showed that BMI, CC, AC, TC and WC were significantly correlated with IR, except WHtR. After adjusting for multiple confounding factors, we found that BMI, AC and WC were significantly positively correlated with IR, while TC was significantly negatively correlated with IR. Logistic regression results showed that a larger TC was associated with a decreased risk of IR. In addition, BMI and WC had similar areas under the curve (AUC: 0.780, 95% CI 0.770-0.790; AUC: 0.774, 95% CI 0.763-0.784, respectively), which were higher than TC and AC (AUC: 0.698, 95% CI 0.687-0.710, AUC: 0.746, 95% CI 0.735-0.757, respectively). To our knowledge, this is the first study to report a negative correlation between TC and IR among patients without diabetes mellitus. Therefore, TC may be a new tool to guide public health and a clinical predictor of IR in non-diabetic patients.


Assuntos
Antropometria , Índice de Massa Corporal , Resistência à Insulina , Circunferência da Cintura , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Curva ROC , Razão Cintura-Estatura , Diabetes Mellitus Tipo 2
12.
Indian J Orthop ; 58(7): 971-978, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38948377

RESUMO

Background: This study aims to systematically compare the efficacy of two distinct approaches that is limb occlusion pressure (LOP) and systolic blood pressure (SBP) in determining the optimal tourniquet pressure for primary total knee arthroplasty. The overarching goal is to identify the method that yields superior outcomes in minimizing post-operative thigh pain while simultaneously reducing complications in our patient population. Methods: 311 patients scheduled for primary total knee replacement (TKR) were randomized in two groups. Group A (LOP) had 154 patients and group B had 157 patients. In group A, LOP was determined for all patients. After adding the safety margin, the tourniquet pressure was determined which was kept during the procedure. By adding 150 mm Hg to SBP in group B, the tourniquet inflation pressure was ascertained. Postoperatively, thigh pain was evaluated from day 1 to day 3 and at 6 weeks. Results: The average tourniquet pressure in group A patients having thigh circumference between 40 and 50 cm was 223.8 mm + - 19.8 mm Hg and in group B it was 262.1 + - 15.9 mm Hg (P < .01). Patients having thigh circumference between 51 and 60 cm had average tourniquet pressure of 240.07 + - 20.1 mm Hg in group A and 264.5 + - 17.4 mm Hg in group B (P < .01). The average tourniquet pressure for patients with thigh circumference more than 60 cm was 296 + /15.3 mm Hg in group A and 267.3 + /19.2 mm Hg in group B (P < 0.01). Conclusion: Tourniquet pressure determination based on the limb occlusion pressure (LOP) method provide less postoperative thigh pain and better range of motion. Graphical Abstract: Optimizing Tourniquet Pressure in Primary Total Knee Replacement: Limb Occlusion Pressure vs Systolic blood pressure method to minimize thigh pain.

13.
Front Cardiovasc Med ; 10: 1251619, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37719982

RESUMO

Background: Central obesity increases the risk of several diseases, including diabetes, cardiovascular disease (CVD), and cancer. However, the association between extremity obesity and mortality has not been extensively evaluated. The objective of this study was to investigate the quantitative effects of waist circumference (WC), arm circumference (AC), calf circumference (CC), and thigh circumference (TC) on all-cause mortality and CVD mortality. Methods: The study used data from the National Health and Nutrition Examination Survey (NHANES) sample survey from 1999 to 2006. A total of 19,735 participants were included in the study. We divided the participants into four groups (Q1-Q4) and used Q1 as a reference to compare the risk of all-cause mortality and CVD mortality in Q2-Q4. COX proportional hazard regression model was used to analyze the relationship between WC, AC, CC and TC on all-cause and CVD mortality. In addition, we conducted a stratified analysis of gender. Results: After a mean follow-up of 11.8 years, we observed a total of 3,446 deaths, of which 591 were due to cardiovascular disease. The results showed that for both men and women, compared to the first group, the risk of all-cause mortality was significantly higher in the other three groups of WC and significantly lower in the other three groups of AC, CC, and TC. Similar results were observed after adjusting for confounding factors such as demographics. Conclusions: Our results show that all-cause and CVD mortality are positively associated with measures of central obesity and negatively associated with measures of extremity obesity, and that AC, CC, and TC can be used as potential tools to measure prognosis in the general population.

14.
JHEP Rep ; 5(7): 100730, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37425213

RESUMO

Background & Aims: No prospective studies have examined the association between thigh subcutaneous fat distribution and non-alcoholic fatty liver disease (NAFLD). We investigated the associations of thigh subcutaneous fat distribution with incidence and remission of NAFLD in a community-based prospective cohort. Methods: We followed 1,787 subjects, who underwent abdominal ultrasonography, abdominal and femoral magnetic resonance imaging scans, and anthropometric assessments. Associations of thigh subcutaneous fat area/abdominal fat area ratio and thigh circumference/waist circumference ratio with incidence and remission of NAFLD were estimated using the modified Poisson regression model. Results: Over a mean 3.6-year follow-up, 239 incident cases of NAFLD and 207 regressed cases of NAFLD were identified. Increasing thigh subcutaneous fat area/abdominal fat area ratio was associated with a lower risk of incident NAFLD and a higher likelihood of remission of NAFLD [risk ratio (RR) per SD: 0.69, 95% CI 0.59-0.81; 1.20, 95% CI 1.07-1.34, respectively). Each one SD increase in thigh circumference/waist circumference ratio was associated with a 16% lower risk of incident NAFLD (RR 0.84, 95% CI 0.76-0.94) and a 22% higher likelihood of remission of NAFLD (RR 1.22, 95% CI 1.11-1.34). Additionally, the effects of thigh subcutaneous fat area/abdominal fat area ratio on the incidence and remission of NAFLD were mediated through adiponectin (14.9% and 26.6%), homeostasis model assessment of insulin resistance (9.5% and 23.9%), and triglyceride (7.5% and 19.1%). Conclusions: These results demonstrated that a favourable fat distribution, characterised by a greater ratio of thigh subcutaneous fat to abdominal fat, had a protective role against NAFLD. Impact and implications: The associations of thigh subcutaneous fat distribution with NAFLD incidence and remission have not been prospectively examined in a community-based cohort. Our findings suggest that greater thigh subcutaneous fat relative to a given amount of abdominal fat has a protective effect against NAFLD among the middle-aged and older Chinese populations.

15.
Front Endocrinol (Lausanne) ; 13: 937264, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35903270

RESUMO

Introduction: Type 2 diabetes patients have abdominal obesity and low thigh circumference. Previous studies have mainly focused on the role of exercise in reducing body weight and fat mass, improving glucose and lipid metabolism, with a lack of evaluation on the loss of muscle mass, diabetes complications, energy metabolism, and brain health. Moreover, whether the potential physiological benefit of exercise for diabetes mellitus is related to the modulation of the microbiota-gut-brain axis remains unclear. Multi-omics approaches and multidimensional evaluations may help systematically and comprehensively correlate physical exercise and the metabolic benefits. Methods and Analysis: This study is a randomized controlled clinical trial. A total of 100 sedentary patients with type 2 diabetes will be allocated to either an exercise or a control group in a 1:1 ratio. Participants in the exercise group will receive a 16-week combined aerobic and resistance exercise training, while those in the control group will maintain their sedentary lifestyle unchanged. Additionally, all participants will receive a diet administration to control the confounding effects of diet. The primary outcome will be the change in body fat mass measured using bioelectrical impedance analysis. The secondary outcomes will include body fat mass change rate (%), and changes in anthropometric indicators (body weight, waist, hip, and thigh circumference), clinical biochemical indicators (glycated hemoglobin, blood glucose, insulin sensitivity, blood lipid, liver enzyme, and renal function), brain health (appetite, mood, and cognitive function), immunologic function, metagenomics, metabolomics, energy expenditure, cardiopulmonary fitness, exercise-related indicators, fatty liver, cytokines (fibroblast growth factor 21, fibroblast growth factor 19, adiponectin, fatty acid-binding protein 4, and lipocalin 2), vascular endothelial function, autonomic nervous function, and glucose fluctuation. Discussion: This study will evaluate the effect of a 16-week combined aerobic and resistance exercise regimen on patients with diabetes. The results will provide a comprehensive evaluation of the physiological effects of exercise, and reveal the role of the microbiota-gut-brain axis in exercise-induced metabolic benefits to diabetes. Clinical Trial Registration: http://www.chictr.org.cn/searchproj.aspx, identifier ChiCTR2100046148.


Assuntos
Diabetes Mellitus Tipo 2 , Treinamento Resistido , Glicemia/metabolismo , Peso Corporal , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/terapia , Humanos , Obesidade , Obesidade Abdominal , Ensaios Clínicos Controlados Aleatórios como Assunto , Coxa da Perna
16.
JGH Open ; 6(9): 621-624, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36091320

RESUMO

Background and Aim: Sarcopenia is a problem affecting inflammatory bowel disease (IBD) outcome and should be evaluated by measuring muscle mass (using dual-energy X-ray absorptiometry [DXA]), muscle strength, and physical performance. DXA has drawbacks as it is expensive, not covered by a national program, and requires a technician. Other inexpensive and simple examinations are needed. The objective is to explore cutoff point and diagnostic accuracy of thigh circumference (TC), calf circumference (CC), subjective global assessment (SGA), and handgrip strength (HGS) to identify sarcopenia in IBD patients. Methods: The study was conducted in Cipto Mangunkusumo Hospital during November 2020-June 2021. Analysis was performed to discover the cutoff point and diagnostic accuracy of TC, CC, SGA, and HGS to identify sarcopenia. Results: As assessed by DXA, 7 of 60 women (11.7%) with IBD had sarcopenia. Using CC cutoff ≤31 cm, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ration (PLR), and negative likelihood ratio (NLR) were 100%, 60.38%, 25%, 100%, 2.52, and 0, respectively. Using TC cutoff ≤50 cm, the sensitivity, specificity, PPV, NPV, PLR, and NLR were 100%, 83.02%, 43.75%, 100%, 5.90, and 0, respectively. SGA has sensitivity, specificity, PPV, NPV, PLR, and NLR of 42.86%, 84.91%, 27.27%, 91.84%, 2.84, and 0.67, respectively. The area under curve of HGS was 33.3%. Conclusion: In this survey of Indonesian women with IBD, the frequency of sarcopenia was 11.7%. When compared with DXA, TC and CC values over 50 cm and 31 cm, respectively, were helpful to exclude the diagnosis of sarcopenia. SGA and HGS were of lesser value for the identification of a decrease in muscle mass.

17.
Eur Geriatr Med ; 12(6): 1191-1200, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34027601

RESUMO

PURPOSE: In addition to playing a critical role in cardiovascular health, muscle mass and strength independently impact aging-related health outcomes in adults. There are limited predictive data for all-cause mortality, particularly for community-dwelling persons in Japan. This study examined whether handgrip strength (HGS) and thigh circumference are related to survival prognosis based on a 6-year follow-up period. METHODS: Participants were 787 men (aged 69 ± 11 years) and 963 women (aged 69 ± 9 years) who took part in a Nomura cohort study conducted in 2014 and who continued with follow-ups for the subsequent 6 years (follow-up rate: 95.5%). We obtained adjusted relative hazards of all-cause mortality from the basic resident register. The data were subjected to a Cox regression with age as the time variable and gender, age, anthropometric index, smoking habits, drinking habits, exercise habits, cardiovascular history, blood pressure, lipid levels, diabetes, renal function, and serum uric acid as risk factors. RESULTS: Of the 1750 participants, a total of 97 (5.5%) were confirmed to have died, of which 56 were men (7.1% of all male participants), and 41 were women (4.3% of all female participants). The multivariable Cox regression analysis revealed that smaller thigh circumference and lower HGS in men were found to predict 6-year all-cause mortality, but in women only baseline HGS was associated with all-cause mortality. CONCLUSION: Thigh circumference and HGS are useful predictors of death in Japanese community-dwelling men.


Assuntos
Força da Mão , Vida Independente , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Força da Mão/fisiologia , Humanos , Japão/epidemiologia , Masculino , Coxa da Perna , Ácido Úrico
18.
Endocr Connect ; 9(4): 271-278, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32247281

RESUMO

OBJECTIVE: A small thigh circumference is associated with an increased risk of diabetes, cardiovascular diseases, and total mortality. The purpose of this study was to evaluate the association between thigh circumference and hypertension in the middle-aged and elderly population. METHODS: A total of 9520 individuals aged 40 years and older with measurement of thigh circumference were available for analysis. The measurement of thigh circumference was performed directly below the gluteal fold of the thigh. The association of thigh circumference with hypertension was tested in logistic regression analyses and reported as odds ratio (OR) with 95% CI. RESULTS: Thigh circumference was negatively correlated with systolic blood pressure, diastolic blood pressure, fasting glucose, and total cholesterol. Compared with the lowest thigh circumference tertile group, the risk of hypertension was significantly lower in the highest tertile group, both in overweight individuals (OR 0.68; 95% CI 0.59-0.79, P < 0.001) and obese individuals (OR 0.51; 95% CI 0.38-0.70, P < 0.001). CONCLUSION: In the present study, large thigh circumference is associated with lower risk of hypertension in overweight and obese Chinese individuals.

19.
Risk Manag Healthc Policy ; 13: 1977-1987, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116978

RESUMO

PURPOSE: The relationship between thigh circumference and all-cause and cause-specific mortality has not been consistent. We aimed to examine how thigh circumference associates with all-cause, cardiovascular, and cerebrovascular mortality among US adults. PATIENTS AND METHODS: This cohort study included 19,885 US adults who participated in the 1999-2006 National Health and Nutrition Examination Survey (NHANES) with thigh circumference being measured at baseline, and survival status was ascertained until 31 December 2015. We used Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for mortality according to thigh circumference in quartiles. Kaplan-Meier survival curve and restricted cubic spline regression were performed to evaluate the prospective association. Finally, subgroup analyses by age, gender, body mass index (BMI), and medical history at baseline were conducted. RESULTS: During a median follow-up of 11.9 years, 3513 cases of death, 432 death cases due to cardiovascular disease, and 143 death cases due to cerebrovascular disease have occurred. Multivariate Cox regression indicated that every 1cm increase in thigh circumference was related to 4% and 6% decreased risk of all-cause mortality and cardiovascular mortality, respectively. Compared to the reference group, the highest quartile of thigh circumference significantly decreased all-cause mortality by 21% (HR 0.79, 95% CI 0.62-1.00, P<0.05). However, the association of thigh circumference with cerebrovascular mortality was not significant. BMI was a significant effect modifier among individuals with a BMI of less than 25 kg/m2 (P<0.0001). CONCLUSION: A low thigh circumference appears to be associated with increased risk of all-cause and cardiovascular mortality, but not cerebrovascular mortality.

20.
J Clin Orthop Trauma ; 11(Suppl 3): S332-S336, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32523289

RESUMO

BACKGROUND: Peroneus longus tendon autograft resembles hamstring tendon's biomechanical strength. Thus, peroneus longus is a potential graft in reconstructive orthopaedic procedures. However, there was few study in evaluation of peroneus longus usage in ACL reconstruction. This study aimed to quantify the clinical outcome and donor site morbidity in ACL reconstruction using peroneus longus tendon autograft. METHODS: Patients who suffered isolated ACL injury were enrolled and underwent isolated single bundle ACL reconstruction using peroneus longus autograft. Functional score (IKDC, Modified Cincinnati, and Tegner-Lysholm score) were assessed at pre-operative and 2-years after surgery. Graft diameter was measured intraoperative. Donor site morbidities were assessed with thigh circumference measurement and ankle scoring using AOFAS and FADI. We also measured serial hop test. RESULTS: Seventy-five patients fulfilled inclusion criteria. Peroneus longus graft diameter was 8.38 ±â€¯0.68 mm. There was significant difference between pre and 2-years post-operative functional score in IKDC, Modified Cincinnati, and Tegner-Lysholm score. Mean of AOFAS was 98.93 ±â€¯3.10 and FADI was 99.79 ±â€¯0.59 with no significant decrease of thigh circumference, and good serial hop test result. CONCLUSION: ACL reconstruction with peroneus longus autograft has excellent functional score in IKDC, Modified Cincinnati, Tegner-Lysholm score at 2-years follow up with the advantages of greater graft diameter, less thigh hypotrophy, good serial hop test result, and excellent ankle function based on AOFAS and FADI score. LEVEL OF EVIDENCE: Level 2, Prospective Cohort Study.

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