Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study

ABSTRACT BACKGROUND: Research on the economic burden of sedentary behavior and abdominal obesity on health expenses associated with cardiovascular diseases is scarce. OBJECTIVE: The objective of this study was to verify whether sedentary behavior, isolated and combined with abdominal obesity, influences the medication expenditure among adults with cardiovascular diseases. DESIGN AND SETTING: This cross-sectional study was conducted in the city of President Prudente, State of São Paulo, Brazil in 2018. METHODS: The study included adults with cardiovascular diseases, aged 30-65 years, who were treated by the Brazilian National Health Services. Sedentary behavior was assessed using a questionnaire. Abdominal obesity was defined by waist circumference. Medication expenditures were verified using the medical records of each patient. RESULTS: The study included a total of 307 adults. Individuals classified in the group with risk factor obesity combined (median [IQ] USD$ 29.39 [45.77]) or isolated (median [IQ] USD$ 27.17 [59.76]) to sedentary behavior had higher medication expenditures than those belonging to the non-obese with low sedentary behavior group (median [IQ] USD$ 13.51 [31.42]) (P = 0.01). The group with combined obesity and sedentary behavior was 2.4 (95%CI = 1.00; 5.79) times more likely to be hypertensive. CONCLUSION: Abdominal obesity was a determining factor for medication expenses, regardless of sedentary behavior, among adults with cardiovascular diseases.

Cut-off points of neck and waist circumference as predictors of obstructive sleep apnea in the Colombian population: a comparison with polysomnography

ABSTRACT BACKGROUND: Neck circumference (NC) is a useful anthropometric measure for predicting obstructive sleep apnea (OSA). Ethnicity and sex also influence obesity phenotypes. NC cut-offs for defining OSA have not been established for the Latin American population. OBJECTIVES: To evaluate NC, waist circumference (WC), and body mass index (BMI) as predictors of OSA in the Colombian population and to determine optimal cut-off points. DESIGN AND SETTING: Diagnostic tests were conducted at the Javeriana University, Bogota. METHODS: Adults from three cities in Colombia were included. NC, WC, and BMI were measured, and a polysomnogram provided the reference standard. The discrimination capacity and best cut-off points for diagnosing OSA were calculated. RESULTS: 964 patients were included (57.7% men; median age, 58 years) and 43.4% had OSA. The discrimination capacity of NC was similar for men and women (area under curve, AUC 0.63 versus 0.66, P = 0.39) but better for women under 60 years old (AUC 0.69 versus 0.57, P < 0.05). WC had better discrimination capacity for women (AUC 0.69 versus 0.57, P < 0.001). There were no significant differences in BMI. Optimal NC cut-off points were 36.5 cm for women (sensitivity [S]: 71.7%, specificity [E]: 55.3%) and 41 cm for men (S: 56%, E: 62%); and for WC, 97 cm for women (S: 65%, E: 69%) and 99 cm for men (S: 53%, E: 58%). CONCLUSIONS: NC and WC have moderate discrimination capacities for diagnosing OSA. The cut-off values suggest differences between Latin- and North American as well as Asian populations.

Relación entre Índices Antropométricos de Obesidad y Condición Física en Escolares de 9 a 14 Años de la Región de Valparaíso, Chile / Relationship Between Anthropometric Indices of Obesity and Physical Condition in Schoolchildren Aged 9 to 14 Years From the Valparaíso Region, Chile

Los objetivos de este estudio fueron 1) describir factores antropométricos asociados a la obesidad y pruebas de condición física junto con 2) determinar la correlación entre estas variables en un grupo de escolares provenientes de la región de Valparaíso. Participaron un total de 109 escolares divididos por sexo y por grupos de edad. Los escolares fueron divididos en dos grupos entre 9 a 11 años (24 hombres= 47,98 ± 10,4 kg; 145,73 ± 7,3 cm; 25 mujeres= 45,06 ± 11,1 kg; 145,30 ± 6,6 cm) y entre 12 a 14 años (24 hombres= 54,85 ± 13,2 kg; 158,42 ± 8,8 cm; 36 mujeres= 52,21 ± 9,1 kg; 155,36 ± 6,1 cm). Se realizaron evaluaciones de la condición física utilizadas en el proceso de evaluación del Sistema de Medición de la Calidad de la Educación (SIMCE) de educación física para escolares chilenos. Estas evaluaciones incluyeron parámetros de flexibilidad, carrera, salto horizontal, y resistencia muscular. Junto con esto, se evaluaron variables antropométricas como peso, estatura y perímetro de cintura para establecer índices antropométricos de obesidad como el índice de masa corporal (IMC), el perímetro de cintura (PC) y el índice de cintura estatura (ICE). Se encontraron diferencias significativas entre los grupos de hombres de los diferentes grupos de edad en las pruebas de condición física, resistencia muscular abdominal (p = 0,001), salto horizontal (p = 0,002) y prueba de carrera (p = 0,003). Entre los grupos de mujeres se encontraron diferencias significativas en las variables de condición física, salto horizontal (p = 0,002) y carrera (p = 0,003). Tanto en hombres como en mujeres del grupo de 9 a 11 años se encontraron correlaciones significativas entre las variables antropométricas con pruebas de salto horizontal y capacidad de carrera (p = 0,03, r = -0,42 - 0,83, moderado a muy fuerte). En este mismo grupo solo las mujeres presentaron una correlación significativa entre parámetros antropométricos y la prueba de resistencia muscular en flexo extensiones de codo (p < 0,05, r = -0,42 - -0,52, moderado a fuerte) y abdominales (p < 0,05, r = -0,57 - -0,60, fuerte). Para el grupo entre 12 y 14 años se obtuvieron correlaciones negativas entre el ICE y la prueba de carrera en hombres (p < 0,016, r = -0,48, moderado), PC y la prueba de carrera en mujeres (p < 0,011, r = -0,41, moderado). Sólo en mujeres fue posible encontrar correlaciones significativas entre PC, IMC e ICE con salto horizontal (p < 0,05, r = 0,38 - 0,48, moderado). Los resultados sugieren una correlación negativa entre parámetros antropométricos de exceso de peso corporal y el rendimiento en pruebas físicas, siendo en el grupo de mayor edad las mujeres quienes presentan mayor cantidad de correlaciones significativas entre variables. Estos datos refuerzan la importancia de incluir abordajes integrales en las clases de educación física considerando estilos de vida activos y saludables en conjunto con la promoción de la actividad física.

SUMMARY: The objectives of this study were 1) to describe anthropometric factors associated with obesity and physical fitness tests and 2) to determine the correlation between these variables in a group of schoolchildren from the Valparaíso region. A total of 109 schoolchildren divided by sex and age groups participated. The schoolchildren were divided into two groups between 9 to 11 years (24 males = 47,98 ± 10,4 kg; 145,73 ± 7,3 cm; 25 females = 45,06 ± 11,1 kg; 145,30 ± 6,6 cm) and between 12 to 14 years (24 males = 54,85 ± 13,2 kg; 158,42 ± 8,8 cm; 36 females = 52,21 ± 9,1 kg; 155,36 ± 6,1 cm). Physical fitness assessments used by the Sistema de Medición de la Calidad de la Educación (SIMCE) evaluation process for physical education for Chilean schoolchildren were performed. These assessments included flexibility, sprint capacity, horizontal jump, and muscular endurance parameters. In addition, anthropometric variables such as weight, height and waist circumference were evaluated to establish anthropometric indices of obesity such as body mass index (BMI), waist circumference (WC) and waist-height index (WHI). Significant differences were found between the groups of men in the different age groups in the physical fitness tests, abdominal muscular endurance (p = 0.001), horizontal jump (p = 0.002), sprint test (p = 0.003) and the anthropometric index BMI (p = 0.048). Among the female groups, significant differences were only found in the physical condition variables, horizontal jump (p = 0.002) and sprint (p = 0.003). In both males and females in the 9- to 11- year-old group, significant correlations were found between anthropometric variables and tests of horizontal jumping and sprint ability (p = 0.03, r = -0.42 - 0.83, moderate to very high). In this same group, only females presented a significant correlation between anthropometric parameters and muscular endurance tests in elbow flexion (p < 0.05, r = -0.42 - -0.52, moderate to high) and abdominals (p < 0.05, r = -0.57 - -0.60, high). For the group between 12 and 14 years, negative correlations were obtained between WHI and the sprint test in males (p < 0.016, r = -0.48, moderate), WC and the sprint test in females (p < 0.011, r = -0.41, moderate). Only in women was it possible to find significant correlations between WC, BMI and ICE with a horizontal jump (p < 0.05, r = 0.38 - 0.48, moderate). The results suggest a negative correlation between anthropometric parameters of excess body weight and performance on physical tests, with women in the older age group presenting the highest number of significant correlations between variables. These data reinforce the importance of including integral approaches in physical education classes that consider active and healthy lifestyles together with the promotion of physical activity.

Valores del perímetro abdominal e índice cintura-cadera en pacientes con hipertensión arterial / Values of abdominal perimeter and waist-hip ratio in patients with hypertension i: en

Introducción: La hipertensión arterial constituye un problema de salud pública en casi todo el mundo. Entre los factores de riesgo vinculados a ella se destaca la acumulación de grasa, que puede, a su vez, establecer los riesgos, las comorbilidades y la mortalidad asociados a esta entidad nosológica. Objetivo: Determinar las variaciones de los valores del perímetro abdominal y el índice cintura-cadera en pacientes con hipertensión arterial, según variables epidemiológicas y clínicas seleccionadas. Métodos: Se realizó un estudio descriptivo, prospectivo y transversal de 221 pacientes con hipertensión arterial, pertenecientes al Consultorio 19 del Policlínico Docente Josué País García del municipio de Santiago de Cuba, desde junio del 2019 hasta diciembre del 2020. Resultados: Predominó el sexo femenino y el grupo etario de 65-74 años (28,5 %). Los indicadores antropométricos perímetro abdominal e índice cintura-cadera tuvieron valores que superaron los parámetros normales establecidos para ambos sexos. El cálculo del perímetro abdominal reveló un predominio de la obesidad en el sexo femenino, en tanto se clasificó como aumentado en el sexo masculino. Conclusiones: Los valores del índice cintura-cadera y del perímetro abdominal en ambos sexos estuvieron por encima de los clasificados por la Organización Mundial de la Salud como de alto riesgo de presentar la enfermedad.

Introduction: Hypertension constitutes a problem of public health in almost all over the world. Among the risk factors associated with it, the accumulation of fat is notable, which can, in turn, establish risks and determine comorbidities and mortality associated with this nosological entity. Objective: To determine the variations in the values of the abdominal perimeter and waist-hip ratio in patients with hypertension, according to selected epidemiological and clinical variables. Methods: A descriptive, prospective and cross-sectional study was carried out on 221 patients with hypertension, belonging to doctor's office 19 of Josué País García Teaching Polyclinic in Santiago de Cuba municipality, from June, 2019 to December, 2020. Results: There was a prevalence of the female sex and the 65-74 age group (28.5%). The anthropometric indicators, abdominal perimeter and waist-hip ratio, had values that exceeded the established normal parameters for both sexes. The calculation of the abdominal perimeter revealed a predominance of obesity in the female sex, while it was classified as increased in the male sex. Conclusions: The values of the waist-hip ratio and abdominal perimeter exceeded those classified by the World Health Organization as high risk of presenting the disease in both sexes.

Ingesta de alimentos ultraprocesados y circunferencia de cintura según área de residencia en adultos peruanos / Ultra-processed food consumption and waist circumference by residence setting in Peruvian adults

Introducción. La circunferencia de cintura (CC) es indicador de obesidad abdominal y riesgo cardiovascular en adultos. En Perú, la obesidad ha aumentado a diferente magnitud por área de residencia y poco se sabe de la influencia del consumo de alimentos ultraprocesados (AUP) sobre este fenómeno en población adulta. Objetivo. Evaluar la asociación entre ingesta de AUP y circunferencia de cintura en adultos peruanos por área de residencia. Materiales y métodos. Estudio transversal de datos secundarios de 745 adultos con información de ingesta dietaria (un recordatorio de 24 horas) de la Encuesta Nacional Vigilancia Alimentaria y Nutricional por Etapas de Vida 2017-2018. Los AUP fueron caracterizados según la clasificación NOVA. La ingesta AUP como el porcentaje relativo de la ingesta energética total (%), dividida en terciles. La CC medida como punto medio entre última costilla y cresta iliaca. Se usó regresión lineal múltiple ponderada y análisis estratificado según área de residencia. Resultados. La edad promedio fue 37,2 años. La ingesta de AUP promedio fue 14,7% (IC95%: 14,2 ­ 15,3). Comparado con adultos en el menor tercil de ingesta de AUP, aquellos en tercil medio tuvieron mayor CC ( 0,73; IC95%: 0,22 ­ 1,24; valor p= 0,007). Al estratificar por área de residencia, adultos rurales del tercil medio tuvieron mayor CC en comparación con primer tercil ( : 1,85; IC95%: 1,17 ­ 2,53, valor p < 0,001). Conclusiones. En adultos peruanos, la ingesta de AUP se asoció a CC en áreas rurales, aunque no de forma lineal. Más estudios son necesarios para entender la naturaleza de esta asociación(AU)

Introduction. Waist circumference (WC) is an abdominal obesity and cardiovascular risk indicator among adults. In Peru, obesity prevalence has been increasing unequally between residence areas, and the influence of ultra- processed food (UPF) consumption on WC in Peruvian adults remains unclear. Objective. Evaluate the association between UPF consumption and waist circumference by residence setting among Peruvian adults. Materials and methods. A cross-sectional secondary analysis of dietary intake data (single 24-hour recall) from 745 adults aged 18 and 59 years old from the "Vigilancia Alimentaria y Nutricional por Etapas de Vida 2017-2018" National Surveys was performed. The NOVA system was used to characterize the UPFs, and the exposure was the percentage of total energy consumed from UPF per day (%), in quantiles. WC (cm) was assessed at the middle point between the last rib and the iliac crest. Weighted linear regression analysis stratified by residence areas were conducted. Results. The mean age was 37.2 years. The mean percent of total energy consumed from UPF was 14.7% (95%CI: 14.2 ­ 15.3). Those in the middle tertile of UPF consumption, had higher WC ( 0.73; 95%CI: 0.22 ­ 1.24; p-value = 0.007) compared with those in the lower tertile. In the stratified analysis, those in the second tertile in rural areas have more WC compared with the first tertile ( 1.85; 95%CI: 1.17 ­ 2.53, p-value< 0.001). Conclusions. In rural areas, UPF consumption was associated with waist circumference, but it does not follow a linear association. Further studies are needed to understand the rationale behind these results(AU)

Dyslipidemia as a risk factor for acute myocardial infarction in postmenopausal women: An observational study

Objective: This study has evaluated risk factors, especially dyslipidemia, for an acute myocardial infarction (AMI) in postmenopausal women. Materials and Methods: This was a hospital-based, observational, single-center study among 100 postmenopausal women admitted to the medicine ward with AMI. They were categorized based on lipid profile groups, viz., dyslipidemic group and non-dyslipidemic group. All clinical parameters were studied between the groups. Results: Among anthropometric profiles, in the comparison of mean height (cm), weight (kg), body mass index (BMI) (kg/m2 ), and waist circumference (WC) (cm) for the dyslipidemic group and non-dyslipidemic group, only WC was statistically significant (P < 0.001). Most patients were hospitalized between 6 and 12 h after the onset of symptoms. At the time of hospitalization, most patients from both groups were observed to have diabetes and hypertension with poor control of postprandial blood sugar, glycated hemoglobin, and diastolic blood pressure (DBP) (P < 0.05). The dyslipidemic group’s mean C-reactive protein was higher (P < 0.05). The comparison of mean total cholesterol, triglyceride (TG), low density lipoprotein-cholesterol in mg/dL, and TG: high density lipoprotein was significantly increased (P < 0.001), while high density lipoprotein-cholesterol (mg/ dL) was significantly decreased (P < 0.001) in the dyslipidemic group. ST-segment elevation myocardial infarction is standard in both groups. The maximum patient has regional wall motion abnormality in echocardiography after day 3 of admission. Among the dyslipidemic group, ejection fraction was on the lower side, and the predominant complication was in the left ventricular failure (LVF) (P < 0.05). Conclusion: WC has a positive association with patients with AMI who have dyslipidemia and can be used as an indicator of the risk of AMI when BMI is normal. WC is a surrogate marker of abdominal fat mass (subcutaneous and intra-abdominal); increased WC is a significant component marker of metabolic syndrome and insulin resistance related to cardiovascular mortality. There was poor glycemic control and blood pressure (mainly DBP) among the dyslipidemic patients. Hypertriglyceridemia is the most common lipid abnormality, followed by hypercholesterolemia among the dyslipidemic group. LVF is the most common complication in dyslipidemic patients.

Correlation between waist circumference and psychological sub health of middle school students in Xinjiang / 中国学校卫生

Objective@#To understand the association between waist circumference with psychological sub health among middle school students in Xinjiang, and to provide evidence for the management of waist circumference and effective prevention of mental health problems.@*Methods@#By using the stratified cluster sampling, 6 191 middle school students aged 13-15 in Urumqi, Karamay, Yining, and Kashgar of Xinjiang were surveyed on demographic information, lifestyle, waist circumference, and psychological sub health symptoms. Chi square test, one way ANOVA, and Logistic regression analysis were used to analyze the association between waist circumference and mental sub health.@*Results@#The detection rate of psychological subhealth among secondary school students in Xinjiang was 21.4%. The detection rates of emotional problems, behavioral problems, and social adjustment difficulties were 28.4 %, 28.1%, and 17.7%, respectively. Significant differences in the detection rate of emotional problems, social adjustment difficulties, and psychological sub health scores were observed among students with different waist circumference levels ( F= 4.03 , 10.90 , 5.81, P <0.05). Logistic regression analysis showed that secondary school students with high waist circumference had a higher risk of social adjustment difficulties ( OR=1.45, 95%CI =1.20-1.75) and psychological sub health problems ( OR=1.46, 95%CI =1.22-1.74) compared to those with normal waist circumference ( P <0.01).@*Conclusion@#Psychological sub health problems of middle school students in Xinjiang are prominent, and the waist circumference is positively related to the psychological sub health problems. Schools should pay attention to the mental health education of middle school students, ensure reasonable diet, sleep and living habits, and promote their physical and mental health development.

Influence of core strength training on pelvic girdle strength in table tennis players / Influência do treinamento de força do core sobre a força da cintura pélvica nos jogadores de tênis de mesa / Influencia del entrenamiento de la fuerza del core en la fuerza de la cintura pélvica en jugadores de tenis de mesa

ABSTRACT Introduction Core strength training has attracted much attention in modern competitive sports. Objective Study the effect of core strength training on pelvic girdle strength in table tennis players. Methods 50 students aged 12-14 from the table tennis club of an elementary school affiliated with a normal university were divided into a control group and an experimental group. They performed a one-week training of core strength exercises. Through a series of technical index tests, the data before and after using these strength training methods were obtained for comparative analysis. Results After the core strength training, there was no significant difference between the other four indices in the experimental group and the control group, except for the fact that there was a significant difference in the performance of running around the platform (P < 0.05). Conclusion After the experiment, the four indexes reflecting the strength of the core muscle group in the experimental group were significantly optimized, while the four indexes in the control group were not significant, showing that core strength training has a more significant effect on improving the strength of the core muscle group. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O treinamento de força do core atraiu muita atenção no campo dos esportes competitivos modernos. Objetivo Estudar o efeito do treinamento da força do core sobre a força da cintura pélvica dos jogadores de tênis de mesa. Métodos 50 estudantes de 12-14 anos de idade do clube de tênis de mesa da escola primária afiliada à universidade normal foram divididos em grupo de controle e grupo experimental. Executaram um treinamento de uma semana de exercícios de força do core. Através de uma série de testes de índice técnico, os dados antes e depois do uso desses métodos de treinamento de força foram obtidos para análise comparativa. Resultados Após o treinamento de força do core, não houve diferença significativa entre os outros quatro índices do grupo experimental e do grupo controle, exceto pelo fato de que há uma diferença significativa no desempenho da corrida ao redor da plataforma (P < 0,05). Conclusão Após o experimento, os quatro índices que refletem a força do grupo muscular do core no grupo experimental foram significativamente otimizados, enquanto que os mesmos índices no grupo controle não foram significativos, evidenciando que o treinamento de força do core tem um efeito significativo no aprimoramento da força sobre o grupo muscular do core. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El entrenamiento de la fuerza del core ha atraído mucha atención en el campo de los deportes de competición modernos. Objetivo Estudiar el efecto del entrenamiento de la fuerza del core sobre la fuerza de la cintura pélvica en jugadores de tenis de mesa. Métodos 50 estudiantes de entre 12 y 14 años del club de tenis de mesa de la escuela primaria afiliada a la universidad normal fueron divididos en grupo de control y grupo experimental. Realizaron un entrenamiento de una semana de ejercicios de fuerza del core. Mediante una serie de pruebas de índice técnico, se obtuvieron los datos antes y después del uso de estos métodos de entrenamiento de la fuerza para su análisis comparativo. Resultados Después del entrenamiento de la fuerza del core, no hubo diferencias significativas entre los otros cuatro índices del grupo experimental y el grupo de control, excepto por el hecho de que hay una diferencia significativa en el rendimiento de correr alrededor de la plataforma (P < 0,05). Conclusión Tras el experimento, los cuatro índices que reflejan la fuerza del grupo de músculos centrales en el grupo experimental se optimizaron significativamente, mientras que los cuatro índices del grupo de control no fueron significativos, lo que demuestra que el entrenamiento de la fuerza central tiene un efecto más significativo en la mejora de la fuerza del grupo de músculos del core. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Panorama da saúde de um grupo de servidores de uma universidade pública de São Paulo: síndrome metabólica, índices antropométricos e adequação da dieta / Health overview of a group of public university employees in São Paulo: metabolic syndrome, anthropometric indices, and dietary adequacy

A obesidade constatada como um problema de saúde pública está relacionada ao maior risco por doenças cardiovasculares, hipertensão arterial, resistência à insulina, diabetes tipo II, dislipidemia e síndrome metabólica. Aliados ao estilo de vida sedentário e a uma dieta inadequada, elevados índices de massa corporal circunferência cintura e relação cintura e estatura foram constatados. O objetivo desse trabalho foi caracterizar o quadro de Síndrome Metabólica, em adultos (mulheres 89 e 46 homens) pelos índices antropométricos, dados bioquímicos e a adequação da dieta. Trata-se de um estudo epidemiológico descritivo realizado com 135 servidores não docentes, categoria funcional básico, técnico e superior, de uma universidade pública no Estado de São Paulo. Foram coletados dados sóciodemográficos, inquérito alimentar, de peso, estatura, circunferência da cintura, medidas de pressão arterial e exames bioquímicos: glicemia, triglicérides e HDL-c (High-density lipoprotein-c). Resultados: 36 % dos participantes apresentou sobrepeso e 28% obesidade e 62,0% da amostra apresentou algum dos parâmetros bioquímicos alterados. O percentual de Síndrome Metabólica foi de 13,3% nos homens e 19,2% nas mulheres. Na relação cintura estatura, 81 % apresentaram índices no padrão de risco de doenças cardiovasculares ou metabólicas, a dieta inadequada nos três macronutrientes foi constatada nos participantes em 34,9% com Indice de massa corporal alterado e 37,0% com Circunferência da cintura alterado. Os resultados mostraram que a caracterização da síndrome metabólica com os parâmetros avaliados aliados à análise da dieta estabelece um quadro com informações que direcionam ações para programas até mesmo dentro de Instituições universitárias e ligadas a área da Saúde.

Obesity, recognized as a public health issue, is associated with an increased risk of cardiovascular diseases, high blood pressure, insulin resistance, type II diabetes, dyslipidemia, and metabolic syndrome. Coupled with a sedentary lifestyle and inadequate diet, elevated body mass index, waist circumference, and waist-to-height ratio have been observed. This study aimed to characterize the Metabolic Syndrome profile in adults (89 women and 46 men) using anthropometric indices, biochemical data, and dietary adequacy. This descriptive epidemiological study was conducted with 135 non-teaching staff members, including basic, technical, and higher categories, at a public university in Sao Paulo. Sociodemographic data, dietary surveys, weight, height, waist circumference, blood pressure measurements, and biochemical tests (glucose, triglycerides, and High-density lipoprotein-c) were collected. Results: 36% of participants were overweight, 28% were obese, with 62.0% of the sample showing altered biochemical parameters. The prevalence of Metabolic Syndrome was 13.3% in men and 19.2% in women. In the waist-to-height ratio, 81% had cardiovascular or metabolic disease risk range indices. An inadequate diet across all three macronutrients was observed in 34.9% of participants with altered body mass index and 37.0% with altered waist circumference. The results revealed that characterizing metabolic syndrome with the evaluated parameters and dietary analysis provides insights that guide actions for programs, even within university institutions and those connected to the health field.

Dietary amino acids and anthropometric indices: Tehran Lipid and Glucose Study

ABSTRACT Objective: Recent studies investigated the role of amino acids (AAs) in weight management. We aimed to determine the association between AAs and three-year change of anthropometric indices and incident obesity. Materials and methods: Height, weight, hip, and waist circumference (WC) were collected at baseline and follow up. Three-year changes in anthropometric indices and obesity incident according to body mass index (BMI) (overweight & obesity) and WC cutoffs (obesity-WC) were ascertained. Dietary intakes of AAs were collected at baseline, using a food frequency questionnaire. Data analyses were conducted on 4976 adult participants and two subsamples, including 1,570 and 2,918 subjects, for assessing the AAs relationship with 3-year changes on anthropometric indices and obesity incident. Results: Lysine and aspartic acid were positively associated with higher weight change, whereas acidic AAs, cysteine, and glutamic acid showed a negative correlation with weight change. Furthermore, a weak positive correlation was shown for alkaline AAs, lysine, and valine with WC; however, acidic AAs, tryptophan, cysteine, and glutamic acid were negatively associated with WC. Aromatic and acidic AAs also demonstrated a weak negative relation with changes in BAI. Phenylalanine and Aromatic AAs showed a negative association with overweight &obesity incidence adjusting for potential confounders. Each quartile increases the dietary lysine, arginine, alanine, methionine, aspartic acid, and alkaline AAs related to a greater risk of obesity-WC, while tryptophan, glutamic acid, proline, and acidic AAs associated with lower obesity-WC risk. Conclusion: Our results suggested that certain dietary AAs may potentially change anthropometric indices and risk of obesity incident.

Sex-related differential prevalence of central obesity in diabetes mellitus: a multi-centred survey in North-Central Nigeria

Contrary to the old dictum that central obesity is more common among men than women, recent reports have shown a gradual reversal of this trend, as suggested by some studies. Objective: To compare the prevalence of central obesity among men and women with Diabetes mellitus in NorthCentral Nigeria. Methods: This multi-centred, cross-sectional study was conducted across 20 hospitals in Abuja, Nasarawa State, and Niger State, involving 1040 participants. Some obesity indices (body mass index, waist circumference and waist-toheight ratio) were measured. Results: The prevalence of central obesity (waist circumference criterion) was significantly higher in the females compared to male participants (89.6% vs 51.6%, χ2 = 1231.37, p<0.001), similar to the prevalence determined by waistheight ratio criterion (female vs male, 88.8% vs 71.5%, χ2 = 58.83, p<0.001). Following correction for age, duration of diabetes mellitus, blood pressure, blood glucose, and glycated haemoglobin using logistic regression, female gender remained a significant determinant of central obesity (OR = 2.76, 95% CI 1.81-3.83, p = 0.004). Conclusion: The prevalence of central obesity was higher among women than men in a cross-section of patients with diabetes mellitus in North-Central Nigeria

Association between anthropometry and cardiovascular risk in patients attending a diabetic clinic

Background Obesity is a well-documented risk factor for cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM), with increasing evidence to suggest visceral adiposity as a greater risk factor for CVD than body mass index (BMI). Objectives To determine a relationship between hypertension (HPT) and anthropometry in people living with diabetes (PLWD) in an HIV endemic area. Methods This was a retrospective study analysing data captured from standardised clinic sheets from the DM clinic at the Harry Gwala Regional Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Results Data from 957 PLWD were used for the study, the majority of whom had T2DM (811; 86.2%). Approximately one-sixth of the cohort had HIV infection (146; 15.3%). There was no significant difference in HPT prevalence between the HIV-uninfected (77.9%) and PLWD who had HIV (PLWDHIV) (78.1%). Multivariate analysis revealed females with increased waist circumference (WC) and waist-to-height ratio (WTHR) were 57.8 (95% CI 3.04­1096.33) (p = 0.007) and 87.2 (95% CI 4.88­1558.28) (p = 0.002) times more likely to be hypertensive respectively. By contrast, only BMI in males was associated with HPT with a AOR 5.294 (95% CI 1.54 - 18.22) (p = 0.008). HIV status was non-contributory to anthropometry in predicting HPT in PLWD. Conclusion Our study found that anthropometric indices are not all equal predictors of HPT. The authors advocate for local guidance on gender-specific cut-offs on anthropometry in PLWD.

Effects of Body Weight and Waist Circumference on Balance Function in Overweight and Obese Adults / 中山大学学报(医学科学版)

ObjectiveTo explore the effects of body weight and waist circumference on static and dynamic balance function in overweight and obese adults. MethodsParticipants （n=103） were selected by cluster random sampling from the Hypoglycemic Weight Loss Clinic of the Endocrinology Department of the Third Affiliated Hospital of Sun Yat-sen University. All participants were assessed for basic data collection， biochemical test， body weight， waist circumference and height measurement， static balance function assessed by balance error scoring system （BESS） and dynamic balance function assessed by functional reach test （FRT）. The BESS score and FRT distance of all participants were compared among groups according to different BMI grades and WC grades. Multivariate linear regression was used to analyze the influencing factors of participants' dynamic and static balance functions. Results① With the increase of BMI grading， the BESS score showed an upward trend， and the difference between groups was statistically significant （P = 0.004）. The BESS score of normal WC patients was lower than that of central obesity patients （P < 0.001）， which indicated that compared with normal BMI， overweight and obese people had poor dynamic and static balance ability； ② With the BMI grading， the FRT distance increased， showing a downward trend （P < 0.001）. The FRT distance in normal WC patients was significantly higher than that in central obesity patients （P < 0.001）， which indicated that the static and dynamic balance ability of central obesity patients was worse than that of normal WC patients； ③ In BMI overweight group， the FRT distance decreased significantly with the increase of WC （P = 0.02）. The results showed that under the condition of no difference in BMI， Compared with normal WC， the dynamic and static balance ability of central obese patients was worse； ④ The influence of BESS score on BMI（B=4.12，P =0.027， 95% CI=0.48-7.75）and WC（B = 3.47，P = 0.046， 95% CI = 0.07 - 6.88）was significant. The influence of FRT distance on BMI（B = -5.68，P = 0.001， 95% CI = -8.95 - 2.41）and WC（B = -4.71，P = 0.003， 95% CI = -7.83 to -1.61）was significant， which indicated that the static and dynamic balance ability of obese people was worse with the increase of BMI， and the ability of dynamic and static balance of central obesity was worse than that of normal WC. ConclusionWaist circumference is an independent factor affecting the dynamic and static balance function of overweight and obese people. Under similar BMI， the dynamic balance function of central obese people is worse than that of people with normal waist circumference， leading to higher risk of falling.

Correlation between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus / 中国基层医药

Objectives:To investigate the relationship between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus.Methods:A total of 1 036 patients with type 2 diabetes mellitus who received treatment in The Second Affiliated Hospital of Xi'an Jiaotong University from May 2017 to May 2018 were included in this study. The visceral adipose index was detected using a bioresistance assay. These patients were divided into four groups using the quartile method: Visceral adipose index < 8.10 (q1 group, n = 246), 9.60 > visceral adipose index ≥ 8.10 (q2 group, n = 64), 11.10 > visceral adipose index ≥ 9.60 (q3 group, n = 423), visceral adipose index ≥ 11.10 (q4 group, n = 233). One-way analysis of variance was performed to compare the differences among groups. Partial correlation and multiple regression were used to analyze the correlation between body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, body fat content, visceral adipose index, and urinary microalbumin and glomerular filtration rate. Results:With the increase in the visceral adipose index, the glomerular filtration rate gradually decreased. The glomerular filtration rate in the q1, q2, q3, q4 groups was (112.19 ± 31.74) mL·min -1·1.73 m -2, (106.14 ± 28.26) mL·min -1·1.73 m -2, (104.73 ± 23.63) mL·min -1·1.73 m -2, (103.40 ± 27.51) mL·min -1·1.73 m -2, respectively. In the female group, with the increase in visceral adipose index, the glomerular filtration rate decreased gradually. After controlling for age, sex, diabetes, and hypertension, the visceral adipose index was significantly correlated with the glomerular filtration rate ( r = -0.10, P < 0.001). Multiple regression analysis showed that visceral adipose index and waist-to-height ratio were closely related to glomerular filtration rate ( F = 6.00, P < 0.001). Conclusion:With the increase of visceral adipose index, body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, body fat content, and urinary microalbumin increased gradually. When the visceral adipose index is greater than 9.60, the glomerular filtration rate is significantly decreased. Therefore, it is suggested to adopt various methods to evaluate obesity in clinical work, and visceral fat index should be paid more attention, especially when the visceral fat index is greater than 9.60.

Value of triglyceride-glucose index combined with obesity index in predicting nonalcoholic fatty liver disease in individuals with obstructive sleep apnea / 临床肝胆病杂志

Objective To investigate the value of triglyceride-glucose index (TyG), TyG combined with body mass index (BMI), and TyG combined with waist circumference (WC) in predicting nonalcoholic fatty liver disease (NAFLD) in patients with obstructive sleep apnea (OSA). Methods A retrospective analysis was performed for 190 patients who underwent sleep respiratory monitoring and were diagnosed with OSA in The Second Affiliated Hospital of Kunming Medical University from January 2020 to December 2021, and according to the results of ultrasonography, they were divided into OSA+NAFLD group with 107 patients and control group with 83 patients. The t -test or the Mann Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The binary logistic regression analysis was used to explore the influencing factors for the development of NAFLD in patients with OSA. The receiver operating characteristic (ROC) curve was plotted for TyG, TyG combined with BMI, and TyG combined with WC in predicting NAFLD in the patients with OSA, and the area under the ROC curve (AUC) was calculated. The Z test was used for comparison of AUC. Results Compared with the control group, the OSA+NAFLD group had significantly higher BMI, neck circumference, WC, apnea-hypopnea index, oxygen desaturation index, alanine aminotransferase, gamma-glutamyltransferase, triglyceride, fasting plasma glucose, and TyG and significantly lower age, average SpO 2 , LSaO 2 , and high-density lipoprotein cholesterol (all P < 0.05). The binary logistic regression analysis showed that TyG (odds ratio [ OR ]=1.961, 95% confidence interval [ CI ]: 1.03-3.73, P =0.04), BMI ( OR =1.203, 95% CI : 1.03-1.41, P =0.020), and WC ( OR =1.074, 95% CI : 1.01-1.14, P =0.026) were independent risk factors for NAFLD in patients with OSA. TyG, TyG combined with BMI, and TyG combined with WC had an AUC of 0.696 (95% CI : 0.625-0.760), 0.787 (95% CI : 0.722-0.843), and 0.803 (95% CI : 0.739-0.857), respectively, in predicting NAFLD in OSA patients, with an optimal cut-off value of 8.72, 0.36, and 0.60, respectively. TyG combined with BMI had a significantly higher value than TyG in predicting NAFLD in OSA patients ( Z =2.542, P =0.011), and TyG combined with WC also had a significantly higher predictive value than TyG ( Z =2.976, P =0.002 9). Conclusion TyG, TyG combined with BMI, and TyG combined with WC have a good value in predicting NAFLD in OSA patients, among which TyG combined with WC has the best predictive value and is thus expected to become a predictor for the risk of NAFLD in OSA patients.

Reduced Heart Rate Variability as A Risk Factor for Cardiovascular Disease in Young Healthy Adults with Low and High Body Mass Indexes – A Descriptive Study

Background: Heart rate variability (HRV) is a used to assess autonomic nervous system input to the heart. Studies on the impact of HRV on underweight are limited. Aims/Objectives: To evaluate HRV in age matched young adults of different BMI category. Methodology: This cross-sectional study was done among healthy young adult volunteers between 18 and 25 years of age. Anthropometric variables were measured. ECG was recorded in lead II configuration for 5 minutes. Heart rate variability was analysed with Kubios HRV analyzer. Results: HRV indices were reduced in underweight (UW), overweight (OW) and obese group compared to normal weight (NW) BMI group. Second order polynomial regression between BMI and HF log power in both genders shows an inverted U-shaped relationship with BMI. The association between BMI, waist circumference and body fat (percentage) with HRV indices shows a significant relation to heart rate var-iability among which waist circumference (WC) shows a greater association with HRV indices than BMI. Comparison of HRV parameters among men and women of different BMI group shows female had great-er heart rate variability compared to males across BMI Conclusions: underweight individual also have increased cardiovascular risk like obese group and ab-dominal obesity is better indicator of cardiovascular risk than BMI.

Effect of age and menopause on anthropometric parameters in non-obese and obese South Indian women

Background: Men and women show differences in the distribution of body fat. Women tend to store more fat subcutaneously compared to men. Fat distribution changes in postmenopausal women. Understanding the changes in anthropometry with age and menopausal status is important in the context of deriving population, age, and gender-specific cutoff levels for obesity indices. Aims and Objectives: This study was conducted with the objectives of measuring Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) in South-Indian women and determining the effect of age and menopause on the anthropometric parameters in non-obese and obese women. Materials and Methods: 290 women between the age group of 30 to 70 years participated in this analytical cross-sectional study. Age and menopausal status were recorded. Anthropometric parameters such as weight, height, WC, and hip circumference were measured. Body-mass index, WHR, and WHtR were derived. The data were analyzed to compare mean values of anthropometric parameters between premenopausal and postmenopausal women using unpaired t-test. The difference in anthropometric status was also compared between those with Body mass index (BMI) in the non-obese range and those with BMI in the obese range in relation to menopausal status. Results: A higher proportion of women were classified as having abdominal obesity based on WHtR cutoff compared to classifying using WC cutoff. Postmenopausal women showed higher mean values of all measured anthropometric parameters, but the difference was significant only for WHR. When the study subjects were analyzed based on BMI categories, a significant difference between pre and post-menopausal women was recorded in WHtR values in the non-obese BMI group, but not in the obese BMI group when analyzed by unpaired t-test. Conclusion: Anthropometric parameters show an increasing trend as age advances. There is a difference in mean values of all parameters between pre and post-menopausal women, though statistical significance was seen only for WHR and WHtR in different sub-groups based on BMI. Further studies are needed to decide on the need for separate cutoff values for postmenopausal women.

Waist circumference and waist-hip ratio as a predictor of respiratory risk factor

Background: The prevalence of Abdominal Obesity as well as of Generalized Obesity are high in India. Obesity can directly alter respiratory physiology through a variety of processes and can lead to reduction in lung function. The quantity and location of body fat alter the impact of obesity on pulmonary function. Waist circumference (WC) links to intra-abdominal and subcutaneous fat and it is a better scale of intra-abdominal fat. Aim and Objectives: (1) To determine the effect of anthropometric parameters like WC, waist-hip ratio (WHR) on timed vital capacity in adult. (2) To determine the difference in timed vital capacity between males and females. Materials and Methods: 150 apparently healthy adults aged 20� years were selected for the study. WC, Waist-hip ratio were measured. Pulmonary functions such as Forced Vital Capacity, Forced Expiratory Volume in one second, (FEV1/FVC%) were recorded using Computerized Spirometer (RMS HELIOS 401). Data were statistically analyzed by unpaired t-test, Karl Pearson抯 coefficient of correlation test, statistical significance was considered for P < 0.05. Results: FVC, FEV1 were significantly declined in both male and female subjects in the group II compared to group I in terms of both WC and WHR. FVC, FEV1were significantly higher in males when compared with females. Significant negative correlation observed between FVC and FEV1 values with Group II of WC and WHR. Conclusion: To conclude obesity even in the absence of specific pulmonary disease, alters the pulmonary function, that can lead to long-term consequences. Regular exercise, yoga, pranayama help to reduce weight and improve breathing by strengthening respiratory muscles.

Correlação entre a Circunferência de Cintura e Medidas Centrais da Pressão Arterial / Correlation among Waist Circumference and Central Measures of Blood Pressure

Resumo Fundamento: A rigidez arterial é um forte preditor de doença cardiovascular (DCV). Medidas de gordura corporal, como a circunferência da cintura (CC), têm sido associadas à DCV na idade adulta. Objetivos: O objetivo deste estudo foi avaliar a associação da rigidez arterial, medida por tonometria de aplanação-Sphygmocor, com a CC. Métodos: Estudo observacional com 240 participantes que fazem consultas de rotina no ambulatório de clínica médica de um hospital universitário. Os participantes foram entrevistados e tiveram as medidas centrais da pressão arterial (MCPA), parâmetros antropométricos, gordura abdominal e gordura visceral mensurados. Foram u tilizados os testes t pareado e não pareado e qui-quadrado. Foi a dotado nível de significância de 5%. Resultados: Dos 240 participantes, 51,82% era do sexo masculino com idade média de 59,71(±14,81) anos e CC média de 99,87 (±11,54) cm. Os valores médios das MCPA foram: Pressão arterial central (PAC) = 130,23 (91-223) mmHg, velocidade de onda de pulso (VOP) = 9,8 (5,28-19,6)m/s e Augmentation Index [Índice de amplificação (AI)] = 29,45 (-14-60). A VOP e a PAC foram altamente correlacionadas com uma CC com p<0,001 e p=0,02, respectivamente; porém, a mesma correlação positiva não foi encontrada entre a CC e o AI (p=0,06). Conclusão: O presente estudo mostrou uma associação positiva entre a CC e a rigidez arterial, através da velocidade de onda de pulso carotídeo femoral (VOP-cf) e o AI, sendo mais forte com a VOP-cf, sugerindo a avaliação do efeito da CC na saúde vascular como método de auxílio no tratamento precoce das DCV e na prevenção de desfechos clínicos.

Abstract Background: Arterial stiffness is a strong predictor of cardiovascular disease (CVD). Body fat measures such as waist circumference (WC) have been associated with CVD in adulthood. Objectives: The objective of this study was to evaluate the association of arterial stiffness, measured by applanation tonometry-Sphygmocor, with WC. Methods: Observational study with 240 participants who make routine consultations at the outpatient clinic of a university hospital. Participants were interviewed and had central blood pressure measurements (CBPM), anthropometric parameters, abdominal fat and visceral fat measured. Paired and unpaired t and chi-square tests were used. A significance level of 5% was adopted. Results: Of the 240 participants, 51.82% were male with a mean age of 59.71(±14.81) years and a mean WC of 99.87 (11.54) cm. Mean CBPM values were: Central arterial pressure (CAP) = 130.23 (91-223) mmHg, pulse wave velocity (PWV) = 9.8 (5.28-19.6)m/s and Augmentation Index [Amplification Index (AI)] = 29.45 (-14-60). PWV and CAP were highly correlated with WC with p<0.001 and p=0.02, respectively; however, the same positive correlation was not found between WC and AI (p=0.06). Conclusion: The present study showed a positive association between WC and arterial stiffness, through the femoral carotid pulse wave velocity (cf-PWV) and AI, being stronger with cf-PWV, suggesting the evaluation of the effect of WC in vascular health as a method of aid in the early treatment of CVD and in the prevention of clinical outcomes.