Proposed cut-off points for anthropometric and bioelectrical measures based on overweight and obesity criteria in Spanish institutionalised elderly people.

The increasing prevalence of obesity among the institutionalised elderly population and its severe consequences on health requires an early and accurate diagnosis that can be easily achieved in any clinical setting. This study aimed to determine new cut-off values for anthropometric and bioelectrical impedance measures that are superior to body mass index criteria for overweight and obesity status in a sample of Spanish institutionalised elderly population. A total of 211 institutionalised older adults (132 women, aged 84.3±7.3 years; 79 men, aged 81.5±7.3 years) were enrolled in the current cross-sectional study. Anthropometric and bioelectrical impedance measures included the body mass index, waist circumference, gluteal circumference, waist-hip ratio, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio. In women, the waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat index presented strongly significant specificity and sensitivity (area under the curve [AUC], p<0.0001) and elevated discriminative values (receiver operating characteristic [ROC] curves: 0.827 to 0.867) for overweight and obesity status. In men, the waist-hip ratio, waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio were strongly significant AUC (p<0.0001), with moderate-to-high values (ROC curves: 0.757-0.871). In conclusion, our findings suggest that gluteal circumference, waist circumference, and sagittal-abdominal diameter in women and trunk fat, visceral-fat ratio, and waist circumference in men may represent more suitable cut-off values superior to body mass index criteria for overweight and obesity in the Spanish institutionalised elderly population.

Sex differences for predicting metabolic syndrome by adipose dysfunction markers in institutionalized elderly.

AIMS: Recent studies have emphasized that metabolic syndrome (MetS) was the most important modifiable risk factor for cardiovascular and cerebrovascular diseases in the institutionalized elderly. In addition, the occurrence of MetS was higher in those with longer age-adjusted institutionalization time. The present study was conducted to assess predictive value of markers of adipose tissue dysfunction for the early screening of MetS in this population. METHODS AND RESULTS: Two hundred and eleven institutionalized older adults (132 women, aged 74.3 ± 7.3 years; 79 men, aged 71.5 ± 7.3 years) were enrolled in the current cross-sectional study. Lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), and triglycerides (TG)/high-density lipoprotein (HDL)-cholesterol ratio were determined. The receiver operating characteristic curve was calculated to compare the area under the curve of each index. The total prevalence of MetS was 23.8%. In female group, VAI and TG/HDL ratio presented moderate-high sensitivity (77.78% and 78.38%, respectively) and specificity (77.62% and 73.49%, respectively). In males group, LAP presented moderate-high sensitivity (75%) and specificity (76.9%). CONCLUSION: Gender played a key role on the prediction of MetS by adipose dysfunction markers in institutionalized elderly. Accordingly, VAI and TG/HDL-cholesterol ratio showed the highest predictive value for MetS in female elderly. LAP was the strongest predictor of MetS in male elderly.

Sensibilidad y especificidad de la adiposidad abdominal con el síndrome metabólico en ancianos / Sensitivity and specificity of abdominal adiposity with metabolic syndrome in the elderly

Objetivo. Se ha reconocido que la adiposidad abdominal está asociada a factores de riesgo cardiovascular, intolerancia a la glucosa, hipertensión y dislipidemia. El objetivo ha sido evaluar la relación de la grasa de tronco y del índice de grasa visceral, con el síndrome metabólico (SM) en sujetos ancianos. Métodos. Participaron, 208 sujetos (130 mujeres y 78 varones) con una edad media de 82,5 años. Se tomaron medidas de obesidad abdominal por antropometría y bioimpedancia. Se realizaron curvas ROC para evaluar la capacidad diagnóstica con respecto al SM. Resultados. Existen diferencias entre sexos en el índice de masa corporal, índice cintura cadera, perímetro abdominal, grasa de tronco y grasa visceral (p<0,05). También se encuentran diferencias de los parámetros antropométricos y de bioimpedancia entre sujetos con y sin SM (p<0,05) y solo existen diferencias en la glucosa, los triglicéridos y colesterol HDL (p<0,05). Se encuentran correlaciones significativas entre la mayor parte de medidas antropométricas y de bioimpedancia abdominal (p<0,05). Las áreas bajo la curva (ABC) del índice cintura altura, perímetro abdominal, diámetro sagital abdominal y grasa de tronco son mayores a 0,8 (todas, p< 0,01) y en mujeres no superan valores de 0,65. Los puntos de corte obtenidos son 26,81 y 23,53kg/m2 para índice de masa corporal, 102 y 91cm para el perímetro abdominal, 22,1 y 20,7cm de diámetro sagital abdominal, 34 y 43,7% de grasa de tronco y 17 y 11,5 de índice de grasa visceral en hombres y mujeres respectivamente. Conclusiones. Existen diferentes niveles de capacidad predictiva del SM, según el género. La grasa de tronco y el índice de grasa visceral presentan una mayor capacidad predictiva del SM en hombres que en mujeres (AU)

Objectives. It is recognised that abdominal adiposity is associated with cardiovascular risk factors, such as intolerance to glucose, hypertension and dyslipidaemia. The objective of the present study was to assess the relationship of trunk fat and visceral fat index, obtained by anthropometric and bioelectrical impedance, with metabolic syndrome (SM) in an elderly population. Methods. The study included 208 subjects (78 men and 130 women) with a mean age of 82.5 years. Abdominal obesity was assessed by anthropometry and bioelectrical impedance. ROC curves were calculated in order to assess the ability of these variables to diagnose metabolic syndrome. Results. There are differences between men and women in body mass index, waist to height ratio, waist circumference, and bioelectrical impedance measurements as trunk fat and visceral fat (p<.05). Also, found differences in anthropometric indices and variables and abdominal bioelectrical impedance between subjects with and without SM (p<.05) and only exist differences in blood glucose, triglycerides and HDL cholesterol (p<.05). There are significant correlations between anthropometric variables and abdominal bioelectrical impedance (p<.05). Areas under the curve (AUC) of waist to height index, waist circumference, sagittal abdominal diameter, and trunk fat were greater than 0.8 (all p<.01), and in women did not exceed values of 0.65. The cut-off points obtained for BMI were 26.81 and 23.53kg/m2, 102 and 91cm for waist circumference, 22.1 and 20.7cm for sagittal abdominal diameter, 34% and 43.7% for trunk fat, and 17 and 11.5 for visceral fat ratio in men and women, respectively. Conclusions. There are different levels of predictive ability for metabolic syndrome according to gender. Trunk fat and visceral fat index and anthropometric measures have higher predictive ability for metabolic syndrome in men than in women (AU)

[Sensitivity and specificity of abdominal adiposity with metabolic syndrome in the elderly]. / Sensibilidad y especificidad de la adiposidad abdominal con el síndrome metabólico en ancianos.

OBJECTIVES: It is recognised that abdominal adiposity is associated with cardiovascular risk factors, such as intolerance to glucose, hypertension and dyslipidaemia. The objective of the present study was to assess the relationship of trunk fat and visceral fat index, obtained by anthropometric and bioelectrical impedance, with metabolic syndrome (SM) in an elderly population. METHODS: The study included 208 subjects (78 men and 130 women) with a mean age of 82.5 years. Abdominal obesity was assessed by anthropometry and bioelectrical impedance. ROC curves were calculated in order to assess the ability of these variables to diagnose metabolic syndrome. RESULTS: There are differences between men and women in body mass index, waist to height ratio, waist circumference, and bioelectrical impedance measurements as trunk fat and visceral fat (p<.05). Also, found differences in anthropometric indices and variables and abdominal bioelectrical impedance between subjects with and without SM (p<.05) and only exist differences in blood glucose, triglycerides and HDL cholesterol (p<.05). There are significant correlations between anthropometric variables and abdominal bioelectrical impedance (p<.05). Areas under the curve (AUC) of waist to height index, waist circumference, sagittal abdominal diameter, and trunk fat were greater than 0.8 (all p<.01), and in women did not exceed values of 0.65. The cut-off points obtained for BMI were 26.81 and 23.53kg/m2, 102 and 91cm for waist circumference, 22.1 and 20.7cm for sagittal abdominal diameter, 34% and 43.7% for trunk fat, and 17 and 11.5 for visceral fat ratio in men and women, respectively. CONCLUSIONS: There are different levels of predictive ability for metabolic syndrome according to gender. Trunk fat and visceral fat index and anthropometric measures have higher predictive ability for metabolic syndrome in men than in women.

EFFECTS OF FOOD AND DRINK INGESTION ON BODY COMPOSITION VARIABLES OF ABDOMINAL BIOELECTRICAL IMPEDANCE.

OBJECTIVE: to know the changes in trunk fat and visceral fat level determined by abdominal bioelectrical impedance (BIA) as well as other anthropometric measures related to the central or abdominal fat after the ingestion of a lunch. METHODS: the experimental study was conducted to assess a longitudinal intervention descriptive study. PARTICIPANTS: 21 subjects (10 male and 11 female), volunteers who have access to a medical assessment, with an age of 74 ± 13.43 years. MEASUREMENTS: Maximal waist circumference in standing position, waist circumference at navel level in supine position and sagittal abdominal diameter (SAD). In the same position trunk fat and visceral fat level by abdominal bioelectrical impedance analysis with Tanita AB-140 (ViScan) were obtained before and after meal. RESULTS: anthropometric measures as waist circumference in supine position and SAD did not show significant differences (P > 0.05), after food ingestion, except for a significant increase of the maximal waist circumference in standing position (P < 0.05). In addition trunk fat and visceral fat ratio did not change (P > 0.05). The percentage changes of the measures were less than 2% for waist circumference in standing position, waist circumference by Viscan, sagittal abdominal diameter and trunk fat and 5.9% for visceral fat ratio. CONCLUSIONS: the effects on trunk fat and visceral fat ratio by abdominal bioelectrical impedance are minimal after the ingestion of a portion of food and drink, although it is always recommended to do it in fasting conditions.

Objetivo: conocer los cambios en la grasa del tronco y el nivel de grasa visceral determinado por BIA abdominal, así como otras medidas antropométricas relacionadas con la grasa abdominal o central después de la ingestión de una comida. Métodos: se realizó un protocolo experimental para evaluar un estudio descriptivo de intervención longitudinal. Los participantes fueron 21 sujetos (10 hombres y 11 mujeres), voluntarios que tuvieron acceso a una evaluación médica, con una edad de 74 años ± 13,43. Las mediciones antropométricas fueron: circunferencia de la cintura máxima en posición de pie, circunferencia de la cintura a nivel del ombligo en posición de decúbito supino y diámetro sagital abdominal (SAD). Además se obtuvo la grasa del tronco y el nivel de grasa visceral, por análisis de impedancia bioeléctrica abdominal, con un dispositivo Tanita AB-140 (ViScan), todo ello antes y después de una ración de comida. Resultados: las medidas antropométricas, como la circunferencia de la cintura en posición supina y SAD, no mostraron diferencias significativas (P > 0,05), después de la ingestión de alimentos, a excepción de un aumento significativo de la circunferencia de la cintura máxima en posición de pie (P < 0,05). Además, la relación entre la grasa visceral y en tronco no cambió (P > 0,05). Los cambios porcentuales de las medidas fueron menores del 2% para la circunferencia de la cintura en posición de pie, para la circunferencia de cintura por Viscan, para el diámetro sagital abdominal y la grasa del tronco, y un 5,9% para el nivel de grasa visceral. Conclusiones: los efectos de una comida y bebida sobre la grasa del tronco y el nivel de grasa visceral, medidas por impedancia bioeléctrica abdominal, son mínimas, aunque siempre es recomendable hacerlo en condiciones de ayuno.

Effects of food and drink ingestion on body composition variables of abdominal bioelectrical impedance / Efectos de la comida y la bebida sobre las variables de composición corporal en la bioimpedancia abdominal

Objective: to know the changes in trunk fat and visceral fat level determined by abdominal bioelectrical impedance (BIA) as well as other anthropometric measures related to the central or abdominal fat after the ingestion of a lunch. Methods: the experimental study was conducted to assess a longitudinal intervention descriptive study. Participants: 21 subjects (10 male and 11 female), volunteers who have access to a medical assessment, with an age of 74±13.43 years. Measurements: Maximal waist circumference in standing position, waist circumference at navel level in supine position and sagittal abdominal diameter (SAD). In the same position trunk fat and visceral fat level by abdominal bioelectrical impedance analysis with Tanita AB-140 (ViScan) were obtained before and after meal. Results: anthropometric measures as waist circumference in supine position and SAD did not show significant differences (P>0.05), after food ingestion, except for a significant increase of the maximal waist circumference in standing position (P0.05). The percentage changes of the measures were less than 2% for waist circumference in standing position, waist circumference by Viscan, sagittal abdominal diameter and trunk fat and 5.9% for visceral fat ratio. Conclusions: the effects on trunk fat and visceral fat ratio by abdominal bioelectrical impedance are minimal after the ingestion of a portion of food and drink, although it is always recommended to do it in fasting conditions (AU)

Objetivo: conocer los cambios en la grasa del tronco y el nivel de grasa visceral determinado por BIA abdominal, así como otras medidas antropométricas relacionadas con la grasa abdominal o central después de la ingestión de una comida. Métodos: se realizó un protocolo experimental para evaluar un estudio descriptivo de intervención longitudinal. Los participantes fueron 21 sujetos (10 hombres y 11 mujeres), voluntarios que tuvieron acceso a una evaluación médica, con una edad de 74 años ± 13,43. Las mediciones antropométricas fueron: circunferencia de la cintura máxima en posición de pie, circunferencia de la cintura a nivel del ombligo en posición de decúbito supino y diámetro sagital abdominal (SAD). Además se obtuvo la grasa del tronco y el nivel de grasa visceral, por análisis de impedancia bioeléctrica abdominal, con un dispositivo Tanita AB-140 (ViScan), todo ello antes y después de una ración de comida. Resultados: las medidas antropométricas, como la circunferencia de la cintura en posición supina y SAD, no mostraron diferencias significativas (P > 0,05), después de la ingestión de alimentos, a excepción de un aumento significativo de la circunferencia de la cintura máxima en posición de pie (P < 0,05). Además, la relación entre la grasa visceral y en tronco no cambió (P > 0,05). Los cambios porcentuales de las medidas fueron menores del 2% para la circunferencia de la cintura en posición de pie, para la circunferencia de cintura por Viscan, para el diámetro sagital abdominal y la grasa del tronco, y un 5,9% para el nivel de grasa visceral. Conclusiones: los efectos de una comida y bebida sobre la grasa del tronco y el nivel de grasa visceral, medidas por impedancia bioeléctrica abdominal, son mínimas, aunque siempre es recomendable hacerlo en condiciones de ayuno (AU)

Predicción del síndrome metabólico por bioimpedancia abdominal y antropometría en hombres de mediana edad / Abdominal bioelectrical impedance analysis and anthropometry for predicting metabolic syndrome in middle aged men

Objetivo: la obesidad central tiene una gran relación con el síndrome metabólico. Estudiar la relación de la grasa del tronco, el índice de grasa visceral y las medidas antropométricas con el síndrome metabólico. Métodos: diseño: transversal descriptivo y correlacional. Participaron 75 varones, voluntarios, de distintas profesiones, que accedieron a un reconocimiento médico-laboral, con un rango de edad de 21 a 59 años. Mediciones de peso, talla, índice de masa corporal, perímetro abdominal, perímetro glúteo, índice cintura-cadera y grasa de tronco y nivel de grasa visceral mediante bioimpedanciometría (Tanita AB-140-ViScan) y parámetros bioquímicos: glucosa, colesterol total y triglicéridos. Así mismo, se midió la presión arterial sistólica y diastólica. Se comparan los estados de síndrome metabólico, sobrepeso y obesidad. Resultados: existen correlaciones de las medidas antropométricas con la de grasa de tronco y el nivel de grasa visceral, así como con los parámetros bioquímicos (p < 0,001). Un análisis de curvas ROC muestra que los puntos de corte a partir de los cuales se puede presentar el síndrome metabólico son de 32,7% de grasa de tronco y de 13 para el nivel de grasa visceral, con una alta sensibilidad y especificidad. Se obtienen los mismos puntos de corte para el estado de obesidad y síndrome metabólico. Conclusiones: la grasa de tronco y los niveles de grasa visceral son muy sensibles y específicos para la detección del síndrome metabólico y la obesidad, aunque no superan a las variables e índices antropométricos. En la condición de sobrepeso, la grasa de tronco y visceral son medidas algo más predictivas que las variables antropométricas (AU)

Objective: central obesity has a higher risk of metabolic syndrome. The present work aimed to study the relationship of trunk fat and the visceral fat index, and other anthropometric indices in relation to the metabolic syndrome in middle aged male Methods: design: transversal descriptive and correlational study. Participants: 75 male, volunteers who have access to a medical assessment, with an age range of 21 to 59 years, from different professions. Measurements: Weight, height, body mass index, waist circumference, gluteal circumference, waist-to-hip ratio, waist-to-height ratio, trunk fat and visceral fat level by bioelectrical abdominal impedance analysis with Tanita AB-140 (ViScan) and biochemical markers: fasting glucose, total cholesterol, and triglycerides. Likewise, the systolic and diastolic blood pressure was measured. Results: there are significant correlations of anthropometric measurements with trunk fat and visceral fat level and the same with biochemical variables. Receptor-operator curves (ROC curve) analysis shows that the cutoff points from which arises the metabolic syndrome are 32.7% of trunk fat and a level of visceral fat of 13 with a high sensitivity and specificity, attaining the same cut-off points for the metabolic syndrome and obesity status. Conclusions: trunk fat and visceral fat levels determined by bioelectrical abdominal impedance analysis, values are variables very sensitive and specific for the detection of metabolic syndrome and obesity, though not over the variables and anthropometric indices. In the condition of the overweight, trunk fat and visceral fat level are more predictive than anthropometric measures (AU)

[ABDOMINAL BIOELECTRICAL IMPEDANCE ANALYSIS AND ANTHROPOMETRY FOR PREDICTING METABOLIC SYNDROME IN MIDDLE AGED MEN]. / PREDICCIÓN DEL SÍNDROME METABÓLICO POR BIOIMPEDANCIA ABDOMINAL Y ANTROPOMETRÍA EN HOMBRES DE MEDIANA EDAD.

OBJECTIVE: central obesity has a higher risk of metabolic syndrome. The present work aimed to study the relationship of trunk fat and the visceral fat index, and other anthropometric indices in relation to the metabolic syndrome in middle aged male Methods: design: transversal descriptive and correlational study. PARTICIPANTS: 75 male, volunteers who have access to a medical assessment, with an age range of 21 to 59 years, from different professions. MEASUREMENTS: Weight, height, body mass index, waist circumference, gluteal circumference, waist-to-hip ratio, waist-to-height ratio, trunk fat and visceral fat level by bioelectrical abdominal impedance analysis with Tanita AB-140 (ViScan) and biochemical markers: fasting glucose, total cholesterol, and triglycerides. Likewise, the systolic and diastolic blood pressure was measured. RESULTS: there are significant correlations of anthropometric measurements with trunk fat and visceral fat level and the same with biochemical variables. Receptor-operator curves (ROC curve) analysis shows that the cutoff points from which arises the metabolic syndrome are 32.7% of trunk fat and a level of visceral fat of 13 with a high sensitivity and specificity, attaining the same cut-off points for the metabolic syndrome and obesity status. CONCLUSIONS: trunk fat and visceral fat levels determined by bioelectrical abdominal impedance analysis, values are variables very sensitive and specific for the detection of metabolic syndrome and obesity, though not over the variables and anthropometric indices. In the condition of the overweight, trunk fat and visceral fat level are more predictive than anthropometric measures.

Objetivo: la obesidad central tiene una gran relación con el síndrome metabólico. Estudiar la relación de la grasa del tronco, el índice de grasa visceral y las medidas antropométricas con el síndrome metabólico. Métodos: diseño: transversal descriptivo y correlacional. Participaron 75 varones, voluntarios, de distintas profesiones, que accedieron a un reconocimiento médico- laboral, con un rango de edad de 21 a 59 años. Mediciones de peso, talla, índice de masa corporal, perímetro abdominal, perímetro glúteo, índice cintura-cadera y grasa de tronco y nivel de grasa visceral mediante bioimpedanciometría (Tanita AB-140-ViScan) y parámetros bioquímicos: glucosa, colesterol total y triglicéridos. Así mismo, se midió la presión arterial sistólica y diastólica. Se comparan los estados de síndrome metabólico, sobrepeso y obesidad. Resultados: existen correlaciones de las medidas antropométricas con la de grasa de tronco y el nivel de grasa visceral, así como con los parámetros bioquímicos (p < 0,001). Un análisis de curvas ROC muestra que los puntos de corte a partir de los cuales se puede presentar el síndrome metabólico son de 32,7% de grasa de tronco y de 13 para el nivel de grasa visceral, con una alta sensibilidad y especificidad. Se obtienen los mismos puntos de corte para el estado de obesidad y síndrome metabólico. Conclusiones: la grasa de tronco y los niveles de grasa visceral son muy sensibles y específicos para la detección del síndrome metabólico y la obesidad, aunque no superan a las variables e índices antropométricos. En la condición de sobrepeso, la grasa de tronco y visceral son medidas algo más predictivas que las variables antropométricas.

Importancia clínica, métodos diagnósticos y efectos del ejercicio físico sobre la grasa visceral / Clinical relevance, diagnostic methods and effects of exercise on visceral fat

El aumento epidémico del sobrepeso y la obesidad repercuten sobre la cantidad de grasa así como en su distribución corporal. En especial son importantes las implicaciones clínicas que pueden producir los depósitos de grasa visceral. El aumento en la cantidad de tejido adiposo visceral, se asocia a enfermedades como el síndrome metabólico, la enfermedad cardiovascular y varias enfermedades neoplásicas como el cáncer de próstata, mama y colorrectal. La evaluación precisa del tejido adiposo visceral es importante para evaluar el riesgo potencial de desarrollo de estas patologías, así como para proporcionar un pronóstico preciso. Esta revisión tiene como objetivo revisar los diferentes métodos de la cuantifi cación de la grasa visceral, como los métodos antropométricos y la bioimpedancia eléctrica (BIA) y la pletismografía, así como los métodos de imagen: ultrasonidos, la absorciometría dual de rayos X, (DXA) la tomografía computerizada (TC) y la resonancia magnética (RM), en la práctica clínica y de investigación y repasar los efectos del ejercicio físico sobre la grasa visceral. Los métodos TC y RM son considerados los métodos patrón en cuanto a la medición de las cortes simples y volúmenes de grasa visceral en los niveles de L2-L3 y L4-L5 dependiendo de los diferentes autores y métodos. Las medidas antropométricas se correlacionan débilmente con las mediciones y volúmenes de grasa visceral, aunque son útiles para el diagnóstico epidemiológico de la obesidad general y central. La BIA suele sobrestimar los valores de grasa de tronco sobre métodoscomo RM y DXA. El ejercicio físico tiene efectos diferentes sobre los depósitos viscerales, dependiendo del fenotipo. Los mayores efectos de reducción dela grasa visceral parecen obtenerse con el ejercicio aeróbico varias veces por semana y a una intensidad moderada-alta

The epidemic increase in overweight and obesity aff ect on the amount of total body fat and body distribution. Clinical implications that can cause visceral fat deposits are especially important. The higher amounts of visceral adipose tissue is associated with several diseases such as metabolic syndrome, cardiovascular disease and various neoplasic diseases such as prostate, breast and colorectal cancer. The accurate assessment of visceral adipose tissue is important to assess the potential risk of development of these pathologies, as well as to provide an accurate prognosis. This work aims to review the diff erent methods of visceral fat quantifi cation as anthropometric methods and bioelectrical impedance analysis and plethysmography, as well as imaging methods: ultrasound, dual X-ray absorptiometry, computed tomography and magnetic resonance in clinical practice and research settings and review the eff ects of physical exercise on visceral fat amounts. CT and MRI methods are considered the gold standard, in terms of measuring the simple cuts and volumes of visceral fat levels in L2-L3 or L4-L5 depending of several authors and methods. Anthropometric measures are weakly correlated with measurements and volumes of visceral fat, even if they are useful for epidemiological diagnosis of total body fat and central obesity. The BIA is often overestimated values of fat trunk on methods such as RM and DXA. Physical exercise has different eff ects on visceral deposits, depending on the phenotype. The greatest eff ects of reduction of the visceral fat seem to get aerobic exercise, several times a week at a moderate intensity