Urinary prostaglandin D2 and E2 metabolites associate with abdominal obesity, glucose metabolism, and triglycerides in obese subjects.

Obesity is associated with low-grade chronic inflammation, which contributes to the development of the metabolic syndrome and its associated complications, such as insulin resistance and type-2 diabetes. Limited data from animal and human studies support local generation of pro-inflammatory prostanoid lipid mediators in white adipose tissue. However, the link between systemic prostanoid levels and parameters characterizing the metabolic syndrome is missing in human obesity. Therefore, we performed a targeted lipidomic analysis using urine samples from obese human subjects (n = 45) and show for the first time in humans that urinary prostanoid levels correlate with metabolic parameters that indicate a dysregulated glucose and triglyceride metabolism. We identified tetranor-PGDM and tetranor-PGEM as the two major urinary prostanoid metabolites in obese subjects with levels of 247 ±â€¯31 and 23.3 ±â€¯4.0 pmol/mg creatinine, respectively. Tetranor-PGDM was significantly associated with serum triglycerides, while tetranor-PGEM was associated with abdominal obesity as defined by an increased waist-to-hip ratio (WHR), with glycated hemoglobin (HbA1c), and with impaired oral glucose tolerance. These results confirm the previously established notion of low-grade chronic inflammation in obesity and further identify an association of the prostanoid pathway with obesity-associated dyslipidemia, abdominal obesity, and insulin resistance.

24-h urinary sodium to potassium ratio and its association with obesity in children and adolescents.

PURPOSE: There are epidemiologic studies indicating a positive correlation between high sodium and low potassium intake and body mass index. Therefore, this study was conducted in a cross-sectional sample of Iranian children and adolescents to evaluate the link between 24-h urinary Na:K ratio and risk of obesity. METHODS: In this cross-sectional study, 374 participants aged 11-18 years were included. One 24-h urine sample was collected by each participant to estimate Na:K ratio. Anthropometric measurements were carried out and overweight/obesity was defined as a BMI ≥ 85th percentile and abdominal obesity as a waist:height ratio (WHtR) of more than 0.5. RESULTS: As expected, 24-h urinary Na:K ratio showed significant associations with risk of overweight/obesity. Risk of adiposity assessed by WC and PBF was significantly associated with Na:K ratio after adjusting for SSBs consumption and calorie intake. Urinary Na:K ratio showed significant association with risk of adiposity assessed by WC only in girls in the highest tertile group with OR of 2.71 (95% CI 1.14-6.43), only after the addition of calorie intake. Adiposity assessed by PBF was only associated with Na:K ratio among boys with OR of 4.47 (95% CI 1.44-9.87) and 3.87 (95% CI 1.20-8.48), after adjusting for SSBs consumption and calorie intake, respectively. CONCLUSION: Our findings suggest that reducing Na and increasing K intake could be used as a useful approach to lower the risk of obesity and associated burden of disease in Iran. However, more studies are warranted.

Computerized Tomography Based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH.

PURPOSE: Uric acid nephrolithiasis is associated with an elevated visceral fat area in kidney stone formers. Hepatic steatosis has also been linked to visceral obesity and nephrolithiasis. We evaluated the association of noncontrast computerized tomography based diagnosis of visceral obesity and hepatic steatosis with 24-hour urine parameters and stone composition in kidney stone formers. MATERIALS AND METHODS: A total of 98 kidney stone formers were included in study who had computerized tomography imaging and 24-hour urine studies available. For each patient a single computerized tomography axial area measurement was obtained of the visceral fat area. Hepatic steatosis was diagnosed by comparing the HU of regions from the liver and spleen. Univariate analysis was performed to compare patients with or without an elevated visceral fat area and hepatic steatosis. Multivariate linear and logistic regression was done to assess for variables associated with 24-hour urine parameters and stone composition. RESULTS: An elevated visceral fat area was associated with higher 24-hour urine sodium (175 vs 157 mg per day, p <0.036) and lower 24-hour urine pH (5.724 vs 6.478, <0.0001). Urine pH less than 6 (OR 2.52) was associated with hepatic steatosis. Low urine pH less than 6 (OR 11.1, p = 0.004) and stone volume greater than 65 mm3 (OR 5.12, p = 0.023) were associated with an elevated visceral fat area. Low urine pH less than 6 (OR 5.87) and visceral fat area greater than 48% (OR 5.33) were associated with uric acid stones. Linear regression demonstrated that the percent of visceral fat area was associated with lower 24-hour urine pH (ß-coefficient -0.438, p <0.0001). CONCLUSIONS: Noncontrast computerized tomography based diagnosis of visceral obesity is associated with low urine pH, high urinary sodium and uric acid stone formation. Hepatic steatosis is associated with low urine pH.

24-h urinary sodium excretion is associated with obesity in a cross-sectional sample of Australian schoolchildren.

Emerging evidence indicates that dietary Na may be linked to obesity; however it is unclear whether this relationship is independent of energy intake (EI). The aim of this study was to assess the association between Na intake and measures of adiposity, including BMI z score, weight category and waist:height ratio (WHtR), in a sample of Australian schoolchildren. This was a cross-sectional study of schoolchildren aged 4-12 years. Na intake was assessed via one 24-h urine collection. BMI was converted to age- and sex-specific z scores, and WHtR was used to define abdominal obesity. In children aged ≥8 years, EI was determined via one 24-h dietary recall. Of the 666 children with valid urine samples 55 % were male (average age 9·3 (sd 1·8) years). In adjusted models an additional 17 mmol/d of Na was associated with a 0·10 higher BMI z score (95 % CI 0·07, 0·13), a 23 % (OR 1·23; 95 % CI 1·16, 1·31) greater risk of being overweight/obese and a 15 % (OR 1·15; 95 % CI 1·09, 1·23) greater risk of being centrally obese. In the subsample of 8-12-year-old children (n 458), adjustment for EI did not markedly alter the associations between Na and adiposity outcomes. Using a robust measure of daily Na intake we found a positive association between Na intake and obesity risk in Australian schoolchildren, which could not be explained by total energy consumption. To determine whether this is a causal relationship, longitudinal studies, with high-quality measures of Na and EI, are required.

Are 24 h urinary sodium excretion and sodium:potassium independently associated with obesity in Chinese adults?

OBJECTIVE: To examine the association of 24 h urinary Na excretion and Na:K with obesity in Chinese adults. DESIGN: Population-based cross-sectional study using a four-stage stratified sampling strategy. SETTING: Shandong Province, China. SUBJECTS: Chinese adults (n 1906) aged 18-69 years who provided complete 24 h urine samples. RESULTS: Odds of obesity increased significantly across increasing quartiles of urinary Na excretion (1·00, 1·54, 1·69 and 2·52, respectively, for overweight; 1·00, 1·20, 1·50, and 2·03, respectively, for obesity; 1·00, 1·44, 1·85 and 2·53, respectively, for abdominal obesity (assessed by waist circumference); and 1·00, 1·28, 1·44 and 1·75, respectively, for abdominal obesity (assessed by waist-to-height ratio); P for linear trend <0·001 for all). In addition, odds of abdominal obesity, but not odds of overweight and obesity, increased significantly with successive Na:K quartiles. Additionally, for each increment in urinary Na excretion of 100 mmol, odds of overweight, obesity, abdominal obesity (by waist circumference) and abdominal obesity (by waist-to-height ratio) increased significantly by 46 %, 39 %, 55 % and 33 %, respectively. Similarly, with a 1 sd increase in Na:K, odds of abdominal obesity (by waist circumference) and abdominal obesity (by waist-to-height ratio) increased significantly by 12 % and 15 %, respectively. CONCLUSIONS: These findings suggest that 24 h urinary Na excretion and Na:K might be important risk factors for obesity in Chinese adults.

Urinary Malondialdehyde Is Associated with Visceral Abdominal Obesity in Middle-Aged Men.

The purpose of the present study was to investigate multiple anthropometric parameters used to evaluate obesity, particularly visceral abdominal fat area, and various metabolic parameters including malondialdehyde (MDA) as an oxidative stress marker. We evaluated various measures of obesity, including body mass index (BMI), waist circumference (WC), sagittal abdominal diameter, fat percentages using dual-energy X-ray absorptiometry, visceral fat area (VFA), subcutaneous fat area, multiple biomarkers related to metabolic disease, and urinary MDA, in 73 asymptomatic middle-aged men who were not severely obese. We examined relationships between multiple measures of obesity, metabolic markers, and urinary MDA levels and evaluated associations between VFA and urinary MDA. In the visceral obesity group, γ-glutamyl transferase (GGT), uric acid, and urinary MDA levels were significantly higher than in the nonvisceral obesity group (P = 0.008, P = 0.002, and P = 0.018). Urinary MDA (r = 0.357, P = 0.002) and uric acid (r = 0.263, P = 0.027) levels were only significantly positively correlated with VFA among measures of obesity. Urinary MDA, serum GGT, and serum CRP were significantly positively associated with VFA (P = 0.001, P = 0.046, and P = 0.023, resp.), even after adjusting for BMI and WC.

Urinary eicosanoid metabolites in HIV-infected women with central obesity switching to raltegravir: an analysis from the women, integrase, and fat accumulation trial.

Chronic inflammation is a hallmark of HIV infection. Eicosanoids reflect inflammation, oxidant stress, and vascular health and vary by sex and metabolic parameters. Raltegravir (RAL) is an HIV-1 integrase inhibitor that may have limited metabolic effects. We assessed urinary F2-isoprostanes (F2-IsoPs), prostaglandin E2 (PGE-M), prostacyclin (PGI-M), and thromboxane B2 (TxB2) in HIV-infected women switching to RAL-containing antiretroviral therapy (ART). Thirty-seven women (RAL = 17; PI/NNRTI = 20) with a median age of 43 years and BMI 32 kg/m(2) completed week 24. TxB2 increased in the RAL versus PI/NNRTI arm (+0.09 versus -0.02; P = 0.06). Baseline PGI-M was lower in the RAL arm (P = 0.005); no other between-arm cross-sectional differences were observed. In the PI/NNRTI arm, 24-week visceral adipose tissue change correlated with PGI-M (rho = 0.45; P = 0.04) and TxB2 (rho = 0.44; P = 0.005) changes, with a trend seen for PGE-M (rho = 0.41; P = 0.07). In an adjusted model, age ≥ 50 years (N = 8) was associated with increased PGE-M (P = 0.04). In this randomized trial, a switch to RAL did not significantly affect urinary eicosanoids over 24 weeks. In women continuing PI/NNRTI, increased visceral adipose tissue correlated with increased PGI-M and PGE-M. Older age (≥ 50) was associated with increased PGE-M. Relationships between aging, adiposity, ART, and eicosanoids during HIV-infection require further study.

[The influence of physiobalneotherapy on the hormonal status of men suffering from obesity].

The objective of the present work was to study the efficacy of the combined treatment of the patients suffering from obesity and erectile dysfunction with the use of contrast baths, electrical stimulation, and cryomassage. Dynamics of the following anthropometric characteristics was evaluated: bodyweight and height, body mass index, waist and hip circumference, waist-to-hip ratio. In addition, general clinical studies were carried out including total blood count, urinalysis, estimation of lipid and carbohydrate metabolism, blood rheologic properties, general hormonal status, and psychological testing. The most pronounced statistically significant dynamics of the above characteristics was documented in the patients treated with the use of general contrast baths, remedial gymnastics, electrical stimulation and cryomassage of the anterior abdominal wall.

Association of urine acidification with visceral obesity and the metabolic syndrome.

Urine acidification is induced by metabolic acidosis which is associated with a high intake of protein-rich diet. The purpose of this study was to investigate the relationship of urine acidification with visceral obesity and the metabolic syndrome. We recruited 1,051 male subjects who underwent health examinations at the Health Care Center in Kinki Central Hospital. Subjects who were treated for hypertension, dyslipidemia, diabetes mellitus, and hyperuricemia and had the past history of chronic liver disease, chronic kidney disease and cancer, were excluded in this study. All subjects were administered to urine pH, blood and physical examinations. Lower urine pH was associated with higher serum urea nitrogen which reflects high intake of protein-rich diet, whereas it had no relation to serum creatinine. Lower urine pH was also associated with an increase in waist circumference, homeostasis model assessment-R, fasting plasma glucose, HbA1c, serum triglyceride, serum uric acid and with a decrease in high density lipoprotein cholesterol. Urine pH was not associated with mean blood pressure. Urine acidification is a characteristic of visceral obesity and the metabolic syndrome. High intake of protein-rich diet may contribute urine acidification, which is associated with various metabolic abnormalities in visceral obesity.

Association of urinary polycyclic aromatic hydrocarbons and obesity in children aged 3-18: Canadian Health Measures Survey 2009-2015.

Polycyclic aromatic hydrocarbons (PAHs) may contribute to obesity. Childhood obesity is a strong predictor of adult obesity and morbidity; however, the relationship between PAHs and obesity in young children (e.g., aged 3-5) has not been studied. We examined the association between urinary PAH metabolites and measures of obesity in children. We analyzed data from 3667 children aged 3-18 years who participated in the Canadian Health Measures Survey (CHMS, 2009-2015). We ran separate multivariable linear models to estimate the association between quartiles of PAH metabolites and each of body mass index (BMI) percentile, waist circumference (WC), and waist-to-height ratio (WHtR) in the total population, as well as in the age subgroups 3-5, 6-11, and 12-18, adjusting for age, sex, ethnicity, education, income quintile, diet, creatinine, and exposure to environmental tobacco smoke. A multinomial logistic regression model estimated adjusted odds ratios for risk of central obesity. BMI, WC, and WHtR were positively associated with total PAH and naphthalene metabolites in the total population aged 3-18 and in age groups 6-11 and 12-18. In 3-5 year olds, WHtR, but not BMI, was significantly associated with total PAH, naphthalene, and phenanthrene metabolites. Overall, those in the highest quartile for naphthalene or total PAH metabolites had three times greater odds of having central obesity compared with those in the lowest quartile. Urinary PAH metabolites are associated with WHtR, an indicator of central obesity and predictor of health risks associated with obesity, in children as young as 3-5.

Increased waist-to-hip ratio is associated with decreased urine glucose excretion in adults with no history of diabetes.

PURPOSE: Promoting urine glucose excretion (UGE) is an attractive approach for the treatment of diabetes. Obesity is associated with increased risk for type 2 diabetes. This study was aimed to investigate the association of waist-to-hip ratio (WHR), a simple measure of abdominal obesity, with UGE determined in subjects without previous history of diabetes. METHODS: We studied the correlation of WHR with UGE in 7485 participants without previous history of diabetes. All participants were given a standard 75 g glucose solution. Clinical parameters and demographic characteristics were assessed. Multiple linear regression analysis and multivariate logistic regression analysis were performed to determine the association of WHR with UGE. RESULTS: Individuals with high WHR (H-WHR) exhibited significantly lower UGE compared to those with low WHR (L-WHR), in either normal glucose tolerance group or pre-diabetes group. In newly diagnosed diabetes group, individuals with H-WHR also showed lower UGE than those with L-WHR; however, no statistical significance was observed. After adjustment for potential confounding factors, including age, genders, and blood glucose level, WHR was negatively associated with UGE (ß = -250.901, 95% CI: -471.891 to -29.911, p = 0.026). However, no significant association was observed between BMI and UGE. Furthermore, multivariable logistic regression model showed that individuals with H-WHR were more likely to have low UGE (OR = 0.83, 95% CI: 0.71-0.97, p = 0.018). CONCLUSIONS: Individuals with H-WHR were at risk for decreased UGE. This study suggests that WHR, but not BMI, might be an important determinant of UGE.

Central obesity transition increased urinary levels of 8-hydroxydeoxyguanosine in male adults: A 3-year follow up study.

OBJECTIVE: Association of oxidative DNA damage with gain in anthropometric indices has not been fully elucidated. METHODS: In this study, participants (n = 1151) were derived from the baseline visit of Wuhan residents in the Wuhan-Zhuhai Cohort Study. The participants finished the physical examinations at both baseline and 3-year follow up. Urinary levels of 8-hydroxydeoxyguanosine (8-OHdG) were measured by gradient-elution high performance liquid chromatography method and then calibrated by urinary creatinine (Cr) values. RESULTS: Generalized linear models showed that after adjusted for confounding factors, baseline central obesity individuals with a ≥2.5% hip circumference (HC) loss or >5% HC gain had a 0.290 µmol/mol Cr (95% confidence interval (CI): 0.108, 0.472) or 0.553 µmol/mol Cr (95% CI: 0.273, 0.833) increase in urinary 8-OHdG levels compared with those with a -2.5%-2.5% HC gain (both P < 0.05). Moreover, compared with non-central obesity at both baseline and 3-year follow-up, we observed that central obese men at both baseline and 3-year follow-up had a 0.46 µmol/mol Cr (95% CI: 0.16, 0.75) increased in urinary 8-OHdG levels. CONCLUSIONS: HC gain showed dose-dependent associations with urinary 8-OHdG levels. Moreover, male central obesity at both baseline and 3-year follow-up had an increased risk for urinary 8-OHdG levels.

Association of plasma and urine viscosity with cardiometabolic risk factors and oxidative status. A pilot study in subjects with abdominal obesity.

There is increasing interest in the search for accurate, repeatable and widely applicable clinical biomarkers for the early detection of cardiometabolic alterations and oxidative status. Viscosity is a promising tool in that sense, although most studies have used simple viscosimeters, providing limited information, and have not considered oxidative status. The aim of this study was to assess whether viscosity determinations were associated with cardiometabolic and oxidative status in subjects at a primary stage of cardiometabolic risk. A pilot study (n = 20) was conducted in subjects with abdominal obesity, determining urine and plasma viscosity with a rotational rheometer at different shear rates (10000-1000 s-1 in plasma and 1000-50 s-1 in urine). Simple regression showed that urine viscosity was significantly (p< 0.05) associated with markers of oxidative status, and plasma viscosity with blood glucose. Categorical Principal Component Analysis plots showed that urine viscosity measurements at different shear rates clustered in three groups (low, intermediate and high shear rates) were selectively associated with uric acid, polyphenols and antioxidant capacity respectively. Plasma viscosity did not seem to be a relevant clinical marker in subjects with abdominal obesity. Therefore, urine viscosity could potentially serve as a complimentary marker in the evaluation of oxidative status.

Urinary bisphenol A concentration and the risk of central obesity in Chinese adults: A prospective study.

BACKGROUND: Bisphenol A (BPA) exposure has been associated with diabetes and related metabolic disorders, such as obesity, but studies of the association of urinary BPA concentrations with central obesity risk are limited. The aim of this study was to prospectively investigate the association between urinary BPA and incident central obesity in a Chinese population aged ≥40 years. METHODS: The study followed 888 participants from Shanghai, China, who did not have central obesity at baseline (in 2009) for 4 years. Concentrations of BPA were measured in baseline morning spot urine samples. Central obesity was defined as waist circumference ≥90 cm in men and ≥80 cm in women. RESULTS: During a mean follow-up of 4 years, 124 (14.0%) participants developed central obesity. Each 1-unit increase in log [BPA] was positively associated with a 2.30-fold risk of incident central obesity (95% confidence interval [CI] 1.39-3.78; P < 0.001) after adjustment for confounders. Compared with the lowest tertile of urinary BPA concentration, Tertiles 2 and 3 were associated with a higher risk of incident central obesity (odds ratios 1.73 [95% CI 1.04-2.88] and 1.81 [95% CI 1.08-3.05], respectively). Stratified analysis showed significant associations of BPA with incident central obesity in women and individuals <60 years of age, with normal weight, non-smokers, non-drinkers, or non-hypertensives. CONCLUSIONS: The results indicate that higher urinary BPA concentrations may be associated with a greater risk of incident central obesity in Chinese adults. The study emphasizes the effects of BPA exposure on metabolic risk from a public health perspective.

Association of Body Mass Index, Waist Circumference, and Waist-Stature Ratio With Urine Composition in Patients With Urolithiasis.

INTRODUCTION: This study was aimed to evaluate the correlation of body mass index (BMI), waist circumference (WC), and waist-stature ratio (WSR) with urinary composition in urolithiasis patients. MATERIALS AND METHODS: Medical reports of 1410 urolithiasis patients referred to a tertiary in Tehran, from 2010 to 2015, were reviewed. Collected data included WC, BMI, and WSR, 24-hour urine composition, and the first-morning urine pH. Urinary relative supersaturation of calcium oxalate, calcium phosphate, and uric acid were calculated. Linear correlation and logistic regression models were used for study analyses. RESULTS: A total of 511 records were reviewed. In the women, supersaturation of calcium oxalate significantly correlated with BMI, WC, and WSR. Supersaturation of uric acid significantly correlated with WC. Using regression analyses, BMI and WSR were associated with greater supersaturation of calcium oxalate abnormality, which persisted after adjustment for confounding factors (odds ratio, 1.080; 95% confidence interval, 1.001 to 1.166 for BMI; odds ratio, 1.053; 95% confidence interval, 1.001 to 1.108 for WSR). Larger WC accompanied abnormal values for supersaturation of calcium oxalate; however, the model was marginally significant (odds ratio, 1.032; 95% confidence interval, 1.000 to 1.065; P = .05) in multivariable analysis. In the men on the other hand, none of the obesity indexes were associated with the supersaturation measures. CONCLUSIONS: Although both obesity and abdominal obesity correlated with supersaturation of calcium oxalate, mostly by changes in urine volume and pH in women, none of those indexes showed significant correlation with urine composition in the men population of our study.

The effects of phthalate and nonylphenol exposure on body size and secondary sexual characteristics during puberty.

BACKGROUND: Some phthalic acid esters (PAEs) and nonylphenol (NP) are endocrine-disrupting chemicals (EDCs) that are widely used in consumer products. Consequently, the general population is exposed simultaneously to both groups of chemicals. OBJECTIVE: To investigate the single- and co-exposure effects of PAEs (DMP, DEP, DnBP, DiBP, BBzP, and DEHP) and NP on obesity and pubertal maturity to compare the body sizes of general adolescents with the complainants of the phthalate-tainted foods scandal that occurred in Taiwan. METHODS: This study included 270 general adolescents aged 6.5-15.0 years and 38 complainants aged 6.5-8.5 years. Nine metabolites of the five PAEs and of NP were measured in urine. We used a questionnaire to evaluate pubertal maturity, measured anthropometric indices (APs) to assess body size, and collected urine samples to measure the two groups of chemicals. RESULTS: We found that urinary PAE metabolite concentrations (specifically, metabolites of DEP, DnBP, DiBP, and DEHP) were positively associated with the APs for abdominal obesity (including skinfold thickness, waist circumference, waist-to-height ratio, and waist-to-hip) and indicated a dose-response relationship. Mono-methyl phthalate (MMP) exposure was inversely associated with pubarche among boys. The daily intake of DEHP in general adolescents exceeded the reference doses (RfD-20 µg/kgbw/day) and tolerable daily intake (TDI-50 µg/kgbw/day) by 3.4% and 0.4%, respectively. No associations were observed between NP exposure or co-exposure and the APs or pubertal maturity. No significant differences were observed between general adolescents and the complainants with regard to weight, height, or BMI. CONCLUSIONS: The study suggests that PAE (specifically, DEP, DnBP, DiBP, and DEHP) exposure is associated with abdominal obesity in adolescents and that the APs for abdominal obesity are more sensitive than BMI for measuring obesity among adolescents. We suggest that the RfD and TDI for PAEs should be revised to provide sufficient protection.

Visceral obesity is associated with microalbuminuria in nondiabetic Asians.

Microalbuminuria is an indicator of renal disease and is known to be related to obesity. The aim of this study is to investigate the association between the cross-sectional area of visceral adipose tissue (VAT) and the prevalence of microalbuminuria. We conducted a cross-sectional study of 1154 subjects who underwent routine checkups, including computed tomography (CT) scans of abdominal adipose tissue. We used the lowest tertile as a reference of abdominal fat. The highest tertile of VAT was related to the highest prevalence of microalbuminuria (odds ratio (OR): 1.96; 95% CI: 1.12-3.43). Subcutaneous adipose tissue (SAT) was not associated with microalbuminuria. In men, the highest tertile for VAT was associated with the highest prevalence of microalbuminuria (OR: 2.74; 95% CI: 1.44-5.22). In women, VAT or SAT was not associated with microalbuminuria. In nondiabetic subjects, the highest tertile for VAT was associated with the highest prevalence of microalbuminuria (OR: 2.23; 95% CI: 1.15-4.32). Among subjects without metabolic syndrome or with body mass index <25 kg m(-2), the highest tertile for VAT was associated with microalbuminuria in age- and sex-adjusted model, respectively (OR: 1.62; 95% CI: 1.01-2.31; OR: 2.21; 95% CI: 1.05-4.65). The analysis of the association of VAT and insulin resistance (IR) indicated that a higher VAT was associated with a higher IR (highest tertile for VAT-OR: 2.91; 95% CI: 1.70-4.96). In conclusion, the highest VAT of the current study was significantly correlated with the highest prevalence of microalbuminuria, even in traditionally low-risk subjects without diabetes, and this association is potentially related with a higher IR.

Leukotriene production is increased in abdominal obesity.

Obesity is a major risk factor for insulin resistance and type-2 diabetes. A chronic low grade inflammatory state has been described during obesity and associated with insulin resistance pathogenesis. Results from animal studies are in favor of a role of the leukotriene (LT) pathway in obesity induced-insulin resistance. However, there is a paucity of data regarding this association in human obesity. Therefore, the aim of this study was to investigate whether LT production was associated with insulin resistance and other metabolic parameters in a cohort of obese subjects. Forty-six (70% females) obese subjects (BMI≧30 kg/m2) without known diabetes and without inflammatory disease (CRP<10 mg/l) were included. Median age was 44 years (16-80) with a median BMI of 36.8 kg/m2 (30-51). Insulin resistance was evaluated by HOMA-IR index and glucose tolerance test. Urinary LTE4 (U-LTE4) concentration was measured by enzyme immune assay. Screening for obstructive sleep apnea was performed. There was a positive association of U-LTE4 with waist to hip ratio, systolic blood pressure and HOMA-IR in univariate analysis. Further, waist to hip ratio remained the only parameter significantly correlated with U-LTE4, in adjusted multivariate analysis. Taken together, these results confirm the previously established notion of chronic low grade inflammation in obesity and further suggests a role for the LT pathway in obesity-associated development of insulin resistance in humans.

Central obesity and albuminuria: both cross-sectional and longitudinal studies in Chinese.

BACKGROUND: Albuminuria is recognized as a marker of vascular dysfunction. Central obesity increases the risk of cardiovascular disease. Little is known about the association between albuminuria and central obesity in Chinese. We aimed to assess the association between central obesity and prevalence and incidence of albuminuria in a middle-aged population-based cohort study. METHODS: This is a cross-sectional and longitudinal cohort study. A total of 2350 subjects aged ≥ 40 years were recruited in 2004 in Taiwan for cross-sectional analysis. Longitudinal analysis included 1432 baseline normoalbuminuria subjects with a mean 2.8 years follow-up, 67 of whom exhibited incident albuminuria. Albuminuria was defined as urinary albumin-to-creatinine ratio ≥ 30 mg/g creatinine. Multiple logistic regression analyses were used to evaluate the relationship between central obesity and prevalence and incidence of albuminuria after adjustment for age, gender, body mass index, blood pressure, renal function, glucose, high sensitivity c-reactive protein, smoking, betel nut chewing, alcohol drinking, and physical activity. RESULTS: At baseline, albuminuria is significantly associated with central obesity. The adjusted odds ratio of having albuminuria among subjects with central obesity was 1.73(95% confidence interval (CI): 1.04-2.85), compared to the subjects without central obesity. In multivariable models, participants with central obesity at baseline had a 112% increase in risk of incident albuminuria (adjusted incidence rate ratio (95% CI): 2.12(1.01-4.44)) compared with participants with non-central obesity. CONCLUSIONS: Abdominal adiposity was independently associated with increased prevalence and incidence of albuminuria in Chinese. The mechanisms linking adiposity and albuminuria need to be addressed.

Adiposidad abdominal, insulino-resistencia, hipertensión y sodio urinarioen adolescentes obesos / Abdominal adiposity, insulin resistance, hypertension and urinary sodium in obese adolescents / Adiposidade abdominal, insulino-resistência, hipertensão e sódio urinário em adolescentes obesos

El objetivo de este estudio fue evaluar la relación entre adiposidad abdominal con insulino-resistencia, hipertensión arterial y excreción urinaria de sodio en adolescentes obesos. Se realizó un estudio transversal descriptivo que incluyó 107 adolescentes obesos, entre 10 y 14 años, sin restricción dietaria, provenientes del Hospital de Pediatría-Posadas, Misiones, durante los años 2011-2012. Se definió obesidad abdominal según: perímetro de cintura ≥p90, hipertensión arterial: presión arterial sistólica y/o diastólica ≥p95 y prehipertensión ≥p90 y

The aim of this study was to assess abdominal adiposity relationship with insulin resistance, high blood pressure and urinary sodium excretion in an obese adolescent population. A descriptive cross sectional study that included 107 obese teenagers from 10 to 14 years of age without any dietary restriction was performed during 2011 and 2012 at the Pediatric Hospital, in Posadas, Misiones. Abdominal obesity was defined as: waist perimeter ≥p90, hypertension: systolic and/or diastolic pressure ≥p95 and prehypertension ≥p90 and

O objetivo deste estudo foi avaliar a relação de adiposidade abdominal com insulino-resistência, hipertensão arterial e excreção urinária de sódio em adolescentes obesos. Foi realizado um estudo transversal descritivo que incluiu 107 adolescentes obesos, entre 10 e 14 anos, sem restrição na dieta, provenientes do Hospital de Pediatría Posadas, Misiones, durante os anos 2011-2012. Definiu-se obesidade abdominal conforme o perímetro de cintura ≥p90, hipertensão arterial: pressão arterial sistólica e/ou diastólica ≥p95 e pré-hipertensão ≥p90 e