Association of anthropometric measures with all-cause and cause-specific mortality in US adults: revisiting the obesity paradox.

OBJECTIVE: Previous studies have shown that the obesity paradox exists in a variety of clinical settings, whereby obese individuals have lower mortality than their normal-weight counterparts. It remains unclear whether the association between obesity and mortality risk varies by anthropometric measures. The purpose of this study is to examine the association between various anthropometric measures and all-cause and cause-specific mortality in US adults. METHODS: This cohort study included data from the National Health and Nutrition Examination Survey between 2009 and 2018, with a sample size of 28,353 individuals weighted to represent 231 million US adults. Anthropometric measurements were obtained by trained technicians using standardized methods. Mortality data were collected from the date of enrollment through December 31, 2019. Weighted Cox proportional hazards models, restricted cubic spline curves, and cumulative incidence analyses were performed. RESULTS: A total of 2091 all-cause deaths, 606 cardiovascular deaths, 519 cancer deaths, and 966 other-cause deaths occurred during a median follow-up of 5.9 years. The association between body mass index (BMI) and mortality risk was inversely J-shaped, whereas the association between waist-to-height ratio (WHtR) and mortality risk was positively J-shaped. There was a progressive increase in the association between the WHtR category and mortality risk. Compared with the reference category of WHtR < 0.5, the estimated hazard ratio (HR) for all-cause mortality was 1.004 (95% confidence interval [CI] 1.001-1.006) for WHtR 0.50-0.59, 1.123 (95% CI 1.120-1.127) for WHtR 0.60-0.69, 1.591 (95% CI 1.584-1.598) for WHtR 0.70-0.79, and 2.214 (95% CI 2.200-2.228) for WHtR ≥ 0.8, respectively. Other anthropometric indices reflecting central obesity also showed that greater adiposity was associated with higher mortality. CONCLUSIONS: Anthropometric measures reflecting central obesity were independently and positively associated with mortality risk, eliminating the possibility of an obesity paradox.

Predictive Ability of Hypertriglyceridemic Waist, Hypertriglyceridemic Waist-to-Height Ratio, and Waist-to-Hip Ratio for Cardiometabolic Risk Factors Clustering Screening among Chinese Children and Adolescents.

Objective: Hypertriglyceridemic waist (HW), hypertriglyceridemic waist-to-height ratio (HWHtR), and waist-to-hip ratio (WHR) have been shown to be indicators of cardiometabolic risk factors. However, it is not clear which indicator is more suitable for children and adolescents. We aimed to investigate the relationship between HW, HWHtR, WHR, and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents. Methods: This was a national cross-sectional study. Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6-18 years from seven provinces in China. Demographics, physical activity, dietary intake, and family history of chronic diseases were obtained through questionnaires. ANOVA, χ 2 and logistic regression analysis was conducted. Results: A significant sex difference was observed for HWHtR and WHR, but not for HW phenotype. The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents (HW: OR = 12.22, 95% CI: 9.54-15.67; HWHtR: OR = 9.70, 95% CI: 6.93-13.58). Compared with the HW and HWHtR phenotypes, the association between risk of cardiometabolic health risk factors (CHRF) clustering and high WHR was much weaker and not significant (WHR: OR = 1.14, 95% CI: 0.97-1.34). Conclusion: Compared with HWHtR and WHR, the HW phenotype is a more convenient indicator withhigher applicability to screen children and adolescents for cardiovascular risk factors.

Adiposity indices and their higher predictive value for new-onset hypertension in metabolically healthy young women: findings from a population-based prospective cohort study.

BACKGROUND AND AIMS: The present study aimed to investigate the predictive ability of selected adiposity indices, such as body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and waist-to-height ratio (WHtR), for new-onset hypertension in metabolically healthy Taiwanese adults. The study also sought to establish sex-specific cutoff points for these indices and to analyze the risk of new-onset hypertension, taking into account sex and age. METHODS: This prospective cohort study utilized the Taiwan Biobank database to examine metabolically healthy participants aged between 20 and 65 at baseline. Four adiposity indices, namely BMI, WHR, WC, and WHtR, were calculated and used to predict new-onset hypertension over 4 years. Receiver operating characteristics (ROCs) and areas under the curve (AUCs) were used to evaluate the effectiveness of the parameters in predicting new-onset hypertension over 4 years. Sex-specific cutoff points were identified and used to assess the risk of new-onset hypertension. RESULTS: This study analyzed 13,375 participants over 4.28 years. The incidence of new-onset hypertension was 17.65%. The new-onset rate of hypertension was 34.39% in men and 65.61% in women. Adiposity indices effectively predict new-onset hypertension, with WHtR having the highest predictive value (i.e., AUC) for both sexes. The classification of participants into low and high categories for each adiposity index was based on sex-specific cutoff points, and the risk of new-onset hypertension was assessed according to sex and age. This study found that high adiposity indices predicted a significantly higher risk of new-onset hypertension in metabolically healthy adults. The risk was equal for both sexes. Young women had a higher risk of new-onset hypertension than middle-aged women when they were further categorized. All risk ratios of the indices in young women were over two-fold and significant. CONCLUSION: According to the sex-specific cutoff point, high adiposity indices had a higher predictive value for new-onset hypertension in metabolically healthy Taiwanese young women.

[Impact of Anthropometric Indices of Obesity on the Risk of Incident Hypertension in Adults with Prehypertension: A Secondary Analysis of a Cohort Study].

PURPOSE: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. METHODS: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. RESULTS: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. CONCLUSION: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

Sex-specific associations of childhood maltreatment with obesity-related traits - The Study of Health in Pomerania (SHIP).

BACKGROUND: Child maltreatment (CM) is linked to obesity in adulthood. However, sex-differences and direct measurements of body fat have previously been insufficiently considered in this context. OBJECTIVE: To assess sex-specific associations of CM with anthropometric markers of overweight/obesity and direct measures of body fat. PARTICIPANTS AND SETTING: Analyses were conducted in 4006 adults from a population-based cohort in Northeastern Germany (SHIP-TREND-0). METHODS: CM was assessed using the Childhood Trauma Questionnaire (CTQ). Obesity-related traits included anthropometric indicators (i.e., height, weight, body mass index [BMI], waist [WC] and hip circumference [HC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), fat mass (FM) and fat-free mass (FFM) derived from bioelectrical impedance analysis (BIA), and subcutaneous (SAT) and visceral adipose tissue (VAT) ascertained using magnetic resonance imaging (MRI). Sex-stratified linear regression models predicting obesity-related traits from total CTQ scores were adjusted for age and education. Exploratory analyses investigated effects of CTQ subscales on obesity-related traits. RESULTS: In men, CM was positively associated with WHtR (ß = 0.04; p = .030) and VAT (ß = 0.02; p = .031) and inversely with body height (ß = -0.05; p = .010). In women, CM-exposure was positively associated with body weight (ß = 0.07; p = .018), BMI (ß = 0.03; p = .013), WC (ß = 0.07; p = .005), HC (ß = 0.05; p = .046), WHR (ß = 0.03; p = .015), WHtR (ß = 0.04; p = .006), FM (ß = 0.04; p = .006), and SAT (ß = 0.06; p = .041). In both sexes, effects were mainly driven by exposure to emotional and physical abuse. CONCLUSIONS: Results suggest that associations between CM-exposure and obesity-related traits in adulthood are primarily present in women. This may have implications for sex-specific obesity-related cardiometabolic risk after CM.

Correlation of serum uric acid levels with certain anthropometric parameters in prediabetic and drug-naive diabetic subjects.

Introduction: Uric acid is produced during the metabolism of nucleotide and adenosine triphosphate and contains the final product of human purine metabolism. It acts both as an antioxidant and pro-inflammatory marker and has a positive association with visceral fat in overweight subjects. The aim of the present study is to find an association of uric acid level with certain anthropometric parameters in subjects having type 2 diabetes. Materials and Methods: The study included 124 urban drug-naive diabetic Indian subjects above 18 years of age from the general population of the city of North India. Uric acid concentrations were estimated by the uricase method. Fasting plasma glucose (FPG) concentrations were estimated by the glucose oxidase-peroxidase method. Anthropometric measurements and information on lifestyle factors and disease history were collected through in-person meeting. Results: All participants of the study subjects had a body mass index (BMI) of more than 23.5. BMI, waist-to-hip ratio (WHR), waist-to-height ratio, waist circumference, neck circumference, weight, age, sagittal abdominal diameter (SAD), skinfold thickness, and body roundness index were positively correlated with the serum uric acid level. The correlation of weight, BMI, SAD, and WHR was statistically significant. Conclusion: We found that serum uric acid level increases as body fat content increases. Statistical data show remarkable results for a significant correlation of uric acid level with BMI, WHR, SAD, and FPG. Hypertrophy occurs as a result of inflammatory processes and oxidative stress when the supply of energy starts to exceed the storage capacity of adipocytes, as a result, adipokines such as interleukin (IL)-1, IL-6, and tumor-necrosis factor-alpha are released more frequently which lead to low-grade chronic inflammation. Uric acid levels are much lean toward visceral obesity than overall body fat content.

Résumé Introduction: L'acide urique est produit lors du métabolisme des nucléotides et de l'adénosine triphosphate, et il représente le produit final du métabolisme des purines chez l'homme. Il agit à la fois comme un antioxydant et un marqueur pro-inflammatoire, et il est positivement associé à la graisse viscérale chez les sujets en surpoids. L'objectif de la présente étude est de rechercher une association entre le taux d'acide urique et certains paramètres anthropométriques chez des sujets atteints de diabète de type 2. Matériels et méthodes: L'étude a inclus 124 sujets diabétiques urbains indiens, naïfs aux médicaments, âgés de plus de 18 ans, issus de la population générale de la ville du nord de l'Inde. Les concentrations d'acide urique ont été estimées par la méthode de l'uricase. Les concentrations de glucose plasmatique à jeun (FPG) ont été estimées par la méthode glucose oxydase-peroxydase. Les mesures anthropométriques et les informations sur les facteurs de mode de vie et les antécédents médicaux ont été recueillies lors de rencontres en personne. Résultats: Tous les participants de l'étude présentaient un indice de masse corporelle (IMC) supérieur à 23,5. L'IMC, le rapport taille-hanche (WHR), le rapport taille-hauteur, la circonférence de taille, la circonférence du cou, le poids, l'âge, le diamètre abdominal sagittal (SAD), l'épaisseur des plis cutanés et l'indice de rondeur corporelle étaient corrélés positivement avec le taux d'acide urique sérique. La corrélation du poids, de l'IMC, du SAD et du WHR était statistiquement significative. Conclusion: Nous avons constaté que le taux d'acide urique sérique augmente avec l'augmentation de la teneur en graisse corporelle. Les données statistiques montrent des résultats remarquables pour une corrélation significative du taux d'acide urique avec l'IMC, le WHR, le SAD et le FPG. L'hypertrophie se produit en raison de processus inflammatoires et de stress oxydatif lorsque l'apport d'énergie dépasse la capacité de stockage des adipocytes. Par conséquent, des adipokines telles que l'interleukine (IL)-1, l'IL-6 et le facteur alpha de nécrose tumorale sont libérées plus fréquemment, ce qui entraîne une inflammation chronique de bas grade. Les niveaux d'acide urique sont davantage associés à l'obésité viscérale qu'à la teneur globale en graisse corporelle. Mots-clés: Anthropométrique, syndrome métabolique, microalbuminurie, acide urique sérique.

Exploring the Role of Adult Wrist Circumference as a Potential Indicator of Obesity.

OBJECTIVE: To explore the correlation of wrist circumference (WrC) with various obesity indices and to determine gender-specific optimal cut-off points of WrC for obesity. STUDY DESIGN: Cross-sectional study. Place and Duration of the Study: Dow University of Health Sciences, Karachi, Pakistan, from December 2021 to December 2022. METHODOLOGY: Two hundred and eighty residents of Karachi, aged 30-60 years, participated in this research. Established methods were used to measure body mass index (BMI), waist circumference, hip circumference, neck circumference, WrC, visceral fat level, waist-hip ratio, abdominal volume index, and body roundness index. Correlation of WrC with all obesity markers was done and scatterplots were obtained. Receiver Operating Characteristic curves were plotted to find the gender-specific cut-off value of WrC. RESULTS: Of the total 280 subjects, 191 (68%) were females and 89 (32%) were males. The overall mean age was 42.04 ± 9.12 years (range: 28-65 years). The mean WrC in males and females were 16.32 ± 1.01 cm and 14.82 ± 1.03 cm, respectively. The WrC correlated best with neck circumference in males (r = 0.758; p<0.001) and BMI in females (r=0.615; p<0.001). The scatterplots obtained showed positive linear relationships between WrC and anthropometric variables. The cut-off values of WrC for adult males and females when compared to waist circumference were 15.45 cm and 13.95 cm, respectively. CONCLUSION: Measurement of the WrC can be a helpful indicator to identify excess weight in the general population. Its ease of measurement makes it applicable in both routine clinical practice and extensive epidemiological research. KEY WORDS: Wrist circumference, BMI, Waist circumference, Obesity.

Is There a Relationship between Anthropometric Indices and Muscular, Motor, and Cardiorespiratory Components of Health-Related Fitness in Active European Older Adults?

The aging process induces alterations in the body, resulting in changes in both health-related fitness and specific anthropometric measures. These changes often pose health risks for older adults. The aim of the present study was to investigate whether there is an association between anthropometric indices and muscular, motor, and cardiorespiratory components of health-related fitness in active European older adults. This study included 2687 European older adults, comprising 1999 women and 688 men, with an average age of 70.05 ± 5.5 years. The assessment included health-related fitness using the Senior Fitness Test and anthropometric indices, such as the body adiposity index, body mass index, conicity index, waist-to-hip ratio, and waist-to-height ratio, among others. The results indicated that gender significantly influences the values of physical performance and anthropometric parameters, making them incomparable. The degree of correlation between anthropometric indices and muscular, motor, and cardiorespiratory components of fitness depends on each anthropometric index analysed. The anthropometric index most correlated with physical fitness performance parameters is the waist-to-height ratio (WHR), followed by the body mass index (BMI). Cardiorespiratory endurance and balance are the two physical parameters most correlated with anthropometric indices.

Roles of general and central adiposity in cardiometabolic multimorbidity: revisiting the obesity paradox using a multistate model.

OBJECTIVE: The objective of this study was to evaluate the associations of general and central obesity with risk of first cardiometabolic disease (FCMD), cardiometabolic multimorbidity (CMM), and death. METHODS: A total of 86,169 participants who were CMD-free were included from the Kailuan cohort and categorized into four groups by quartiles of BMI, waist to hip ratio (WHR), weight-adjusted waist index, and waist to height ratio. We defined FCMD as the first onset of diabetes, stroke, or myocardial infarction and CMM as co-occurrence of at least two CMDs. Multistate models were used to estimate hazard ratios and 95% CI. RESULTS: A total of 18,461 participants developed FCMD, of whom 1476 progressed to CMM, and 10,009 died during follow-ups. Both general and central adiposity indices increased the risk of transition from baseline to FCMD and from FCMD to CMM. However, compared with the first quartile, the hazard ratio (95% CI) of the fourth quartile of BMI was 0.86 (95% CI: 0.80-0.91) for transition from health to death and 0.66 (95% CI: 0.59-0.74) from FCMD to death, whereas the corresponding estimates of WHR were 1.22 (95% CI: 1.14-1.31) and 1.16 (95% CI: 1.02-1.32), respectively. CONCLUSIONS: Central adiposity indices such as WHR were associated with an increased risk of CMD and mortality, showing no evidence for the obesity paradox and thereby supporting a shift of public focus from BMI only to both general obesity and adiposity distribution.

Evaluating the performance of a novel anthropometric index: weight adjusted for waist-to-height ratio (W-WHR) - for predicting cardiometabolic risk among adults in Addis Ababa.

OBJECTIVE: Various anthropometric indices had been proposed to predict cardiometabolic risk, yet few were validated in the African population. We evaluated the diagnostic accuracy of a novel anthropometric index-weight adjusted for waist-to-height ratio (W-WHR)-as a predictor of cardiometabolic risk among adults 18-64 years in Addis Ababa, Ethiopia; and compared its performance with other indices commonly used in the literature. DESIGN: Cross-sectional study. SETTING: Community-based study in Addis Ababa, Ethiopia. PARTICIPANTS: Randomly selected adults (n=600) completed serum lipid, blood pressure, blood glucose and anthropometric measurements. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes of interest were dyslipidaemia, hypertension and hyperglycaemia. Having at least one of the three outcomes was considered as a secondary outcome. Receiver-operating characteristic curve (ROC) used to measure the diagnostic accuracy of W-WHR and another 13 indices for predicting the primary and secondary outcomes. Optimal thresholds were determined using Youden's index. RESULTS: W-WHR demonstrated an acceptable diagnostic accuracy (area under the curve (AUC), 95% CI) for correctly classifying dyslipidaemia (0.80, 0.76 to 0.84), hypertension (0.74, 0.70 to 0.78), hyperglycaemia (0.76, 0.70 to 0.82) and the secondary outcome of interest (0.79, 0.75 to 0.83). Depending on the outcomes, thresholds between 32.6 and 36.7 concurrently maximised sensitivity and specificity of the index. ROC analysis indicated, W-WHR (AUC=0.80), abdominal volume index (AVI) (AUC=0.78) and waist circumference (WC) (AUC=0.78) for dyslipidaemia; W-WHR (AUC=0.74) and WC (AUC=0.74) for hypertension; and waist-to-height ratio (AUC=0.80) and body roundness index (AUC=0.80) for hyperglycaemia, had the highest diagnostic accuracy. Likewise, W-WHR (AUC=0.79), AVI (AUC=0.78) and WC (AUC=0.78) had better performance for the secondary outcome. Most indices have better utility among younger than older adults, and per cent body fat had the highest diagnostic accuracy among women (AUC 0.74-0.83). CONCLUSION: W-WHR is a useful index for predicting cardiometabolic risk, especially among young adults.

The association between body weight indices, behavioral factors, and type 2 diabetes mellitus in Africa: A systematic review and meta-analysis of population-based epidemiological studies.

BACKGROUND AND AIM: Type 2 diabetes mellitus (T2DM) is a significant public health concern in Africa. While the associations between modifiable risk factors and T2DM are likely to be Africa-specific, their overall estimations have not been published. This study aimed to use systematic and meta-analytic methods to examine the strength of associations between modifiable risk factors and T2DM in Africa. METHODS AND RESULTS: A systematic search of literature published between January 2000 to March 2022 was conducted. The review included only population-based studies and data extracted from 57 studies. Of these, unadjusted data from 50 studies were included in meta-analysis. With considerable heterogeneity between studies, random-effect models were calculated to ascertain the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity (OB) and overweight (OV), defined by BMI; central obesity (waist circumference (OB-WC), waist-to-hip-ratio (OB-WHR)), alcohol, fruit and vegetable consumption, smoking, physical activity (PA) and T2DM. Moderator effects of age, African regions, and urban/rural location were assessed. Risk factors associated with T2DM include BMI-OB [OR = 3.05, 95% CI: (2.58, 3.61)], BMI-OV [OR = 2.38, 95% CI: (1.51, 3.75)], and BMI-OV/OB [OR = 2.07, 95% CI: (1.82, 2.34)]; OB-WC [OR = 2.58, 95% CI: (2.09, 3.18)] and OB-WHR [OR = 2.22, 95% CI: (1.69, 2.92)]; PA [OR = 1.85, 95% CI: (1.50, 2.30)]. Significant moderator effects were not observed. CONCLUSION: Obesity defined by BMI and central obesity, but not behavioral risk factors were most strongly associated with T2DM in African populations, emphasizing the need for obesity prevention to limit the rise of T2DM. REGISTRATION: The PROSPERO registration number is CRD42016043027.

Metabolic syndrome prediction using non-invasive and dietary parameters based on a support vector machine.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is a widely used index for finding people at risk for chronic diseases, including cardiovascular disease and diabetes. Early detection of MetS is especially important in prevention programs. Relying on previous studies that suggest machine learning methods as a valuable approach for diagnosing MetS, this study aimed to develop MetS prediction models based on support vector machine (SVM) algorithms, applying non-invasive and low-cost (NI&LC), and also dietary parameters. METHODS AND RESULTS: This population-based research was conducted on a large dataset of 4596 participants within the framework of the Shahedieh cohort study. An Extremely Randomized Trees Classifier was used to select the most effective features among NI&LC and dietary data. The prediction models were developed based on SVM algorithms, and their performance was assessed by accuracy, sensitivity, specificity, positive prediction value, negative prediction value, f1-score, and receiver operating characteristic curve. MetS was diagnosed in 14% of men and 22% of women. Among NI&LC features, waist circumference, body mass index, waist-to-height ratio, waist-to-hip ratio, systolic blood pressure, and diastolic blood pressure were the most predictive variables. By using NI&LC features, models with 78.4% and 63.5% accuracy and 81.2% and 75.3% sensitivity were yielded for men and women, respectively. By incorporating NI&LC and dietary features, the accuracy of the model in women improved by 3.7%. CONCLUSIONS: SVM algorithms had promising potential for early detection of MetS relying on NI&LC parameters. These models can be used in prevention programs, clinical practice, and personal applications.

Risk of Sleep Apnea Is Associated with Abdominal Obesity Among Asian Americans: Comparing Waist-to-Hip Ratio and Body Mass Index.

OBJECTIVE: This study examines associations between the risk of sleep apnea and abdominal obesity (assessed by waist-to-hip ratio (WHR)) and general obesity (assessed by body mass index (BMI)) in a sample of Chinese and Korean American immigrants. METHODS: The dataset included Chinese and Korean participants aged 50-75 who were recruited from primary care physicians' clinics from April 2018 to June 2020 in the Baltimore-Washington D.C. Metropolitan area (n = 394). Abdominal obesity was determined if WHR ≥ 0.9 in men and WHR ≥ 0.85 in women. General obesity was determined if BMI ≥ 30. The risk of sleep apnea was determined by using the Berlin questionnaire. Poisson regression models examined associations between sleep apnea risk and obesity. Models controlled for socio-demographic risk factors. RESULTS: Twelve percent of the study participants were classified as a high risk for sleep apnea, and 75% had abdominal obesity whereas 6.4% had general obesity. High risk of sleep apnea was positively associated with abdominal obesity (PR = 1.31, 95% CI: 1.17-1.47) and general obesity (PR = 2.19, 95% CI: 0.90-5.32), marginally significant at p < 0.1). CONCLUSIONS: Chinese and Korean immigrants living in the USA who are at high risk of sleep apnea have higher abdominal obesity, even after accounting for sociodemographic characteristics. Abdominal obesity may be a better indicator than general obesity when examining the risk of sleep apnea among Asian Americans. INFORMATION ON CLINICAL TRIAL: Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296; Date of registration: March 29, 2018 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1.

Gender differences in midlife to later-life cumulative burden and variability of obesity measures and risk of all-cause and cause-specific mortality.

BACKGROUND/OBJECTIVES: Previous studies have reported the gender-specific association between general and central obesity measures, using snapshot assessments, and mortality events. This study seeks to further explore this link by examining how the longitudinal cumulative burden and variability of obesity measures from midlife to later-life impact mortality events in the Atherosclerosis Risk in Communities (ARIC) study population, specifically in relation to gender differences. SUBJECTS/METHODS: Using data from the ARIC study, a total of 7615 (4360 women) participants free of cardiovascular disease, cancer, and early mortality events were included in the data analysis. Longitudinal cumulative burden (estimated by the area under the curve (AUC) using a quadratic mixed-effects method) and variability (calculated according to average successive variability (ASV)) were considered as exposures, separately and all together. Cox proportional hazard regression models were used to estimate multivariable-adjusted standardized hazard ratios. RESULTS: The mean age was 62.4 and the median follow-up was 16.9 years. In men, AUCs of waist-related obesity measures, and also ASVs of all obesity measures were associated with increased all-cause mortality risk. In women, waist circumference and waist-to-height ratio AUCs were associated with increased all-cause mortality risk. Regarding cardiovascular mortality, all adiposity measures ASVs in both genders and waist-related obesity measures AUCs in men were associated with increased risk. Significant gender differences were found for the associations between cumulative and variability of waist-to-hip ratio for all-cause mortality and all adiposity measures ASVs for cardiovascular mortality risk with higher impact among men. CONCLUSIONS: Cumulative burden and variability in general and central obesity measures were associated with higher all-cause and cardiovascular mortalities among men. In women, general obesity measures variability, as well as cumulative and variability of central adiposity measure, increased all-cause mortality risk.

RELATIONSHIP BETWEEN SELECTED TRADITIONAL & NOVEL ANTHROPOMETRIC PARAMETERS AND BLOOD PRESSURE AMONG YOUNG PEOPLE.

Background: Many anthropometric measures have been developed in the last two decades to evaluate cardiovascular health and disease. However, the relationship between these measures and blood pressure is not commonly explored among young population. Objective: This study sought to explore the relationship between selected traditional and novel anthropometric metrics and blood pressure among young people as part of ThE profile of anthRopometRy And psyChosocial issuEs on campus (TERRACE) study. Methods: A total of 375 participants were included in the study. Basic demographic details, standard methods were used to measure blood pressure, and anthropometric measures Height, weight, waist circumference, hip circumference, and neck circumference were measured. Derived waist and hip indices included the waist-hip ratio, waist-to-height ratio, weight-adjusted waist index, abdominal volume index, neck-to-height ratio, and conicity index. The linear relationships between the anthropometric parameters and systolic blood pressure, diastolic blood pressure, and pulse pressure were explored. Those that were strongly correlated, moderately correlated, weakly correlated, and effectively uncorrelated were graded 0.50-1.0, 0.30-0.49, 0.10-0.29, and less than 0.10, respectively. The analysis was done using SPSS version 23. A p-value <0.05 was considered significant. Results: The mean age ±standard deviation(SD) and proportion of females were 21.1±3.5 years and 245 (65.3%), respectively. The mean ±SD systolic blood pressure, diastolic blood pressure, and pulse pressure were 109.2 11.2 mmHg, 67.5±8.8 mmHg, and 41.6±11.1 mmHg, respectively. Most of the variables have a statistically significant relationship with the blood pressure parameters; however, all are neither moderately nor strongly correlated. Conclusion: Most of the anthropometric indicators, including the novel ones, are correlated with BP parameters in this young population. However, further research is needed to unravel newer one with better correlations in this population.

Central obesity, body mass index, metabolic syndrome and mortality in Mediterranean breast cancer patients.

Obesity and metabolic disorders have been associated with poor outcomes in non-Mediterranean breast cancer (BC) patients. The purpose of this study was to investigate the prognostic potential of anthropometric variables in patients with early BC living in Southern Mediterranean region of Italy. We enrolled 955 consecutive early BC patients treated in hospitals in Naples between 2009 and 2013 (median follow-up 11.8-year ending 15/09/2022). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and metabolic syndrome (MetS) were collected. All-cause and BC-specific mortality were calculated. At the last day of contact 208 (22%) patients had died, 131 (14%) from BC. High WC (≥ 88 cm) or WHR (> 0.85) and the MetS were significantly associated with moderately increased risk of all-cause mortality (HR=1.39, 1.62, 1.61, respectively). A significant increased risk of BC-specific mortality was found in obese patients, in those with high WC, high WHR and those with MetS (HR=1.72, 1.71, 1.80, 1.81, respectively). Central obesity significantly increased total and BC-specific mortality particularly in pre-menopausal women and in luminal subtypes, while in post-menopause MetS was a stronger risk factor. Obesity and MetS may impair the effectiveness of BC therapies hence active lifestyle interventions are encouraged.

Degree of association between the body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), body adiposity index (BAI) and conicity index (CI) in physically active older adults.

BACKGROUND: Aging is the main factor in the eventual development of cardiovascular disease (CVD) the prevalence of which is increasing progressively along with life expectancy. Therefore, it is essential to identify the most effective indicators for predicting the possible development of CVD. Anthropometric indices provide useful information for CVD risk evaluation. These are widely used for the simplicity of their estimates and their high correlation in the positive identification of CVD. The most used in the general population are the body mass index (BMI), the waist to hip ratio (WHR) and waist to height ratio (WHtR), body adiposity index (BAI) and conicity index (CI). However, the behavior and association of such indices in physically active people over 65 years of age is not well established. PURPOSE: To analyze the behavior and association of the BMI, WHR, WHtR, BAI and CI in a group of active people over 65 years of age. METHODS: A group of 608 European participants with a mean age of 68.05 ± 5.43yrs, composed of 74.2% female and 28.5% male, was randomly selected and evaluated for anthropometric parameters and body composition by a bio-impedance measuring device with four electrode sensor systems. A descriptive analysis was completed via measures of central tendency (mean and standard deviation) and percentage analysis. As the distribution of the sample was normal (parametric), an association analysis was carried out through the Pearson correlation coefficient (r), in order to determine the relationship between anthropometric and body composition indices. A P value of <0.05 was considered to indicate statistical significance. RESULTS: The results show that BMI, BAI and WHtR are significantly related to % body fat (Fat %), with BMI reaching the highest correlation (r = 0.612), followed by BAI (r = 0.556) and WHtR (r = 0.521). When the association between indices is considered, the WHtR and BAI and WHtR and BMI are those with the highest significant correlation (r = 0.981 and r = 0,789, respectively). As for the effects of gender, good to strong correlations were found between the BMI and the WHtR (r = 0.731 for female, r = 0.568 for male) and between the WHtR and the BAI (r = 0.989 for female, r = 0.985 for male). CONCLUSION: The most accurate anthropometric index for indicating the level of body fat present in an active population of 65 years of age or over seems to be the BMI, followed by the BAI and WHtR. However, the degree of association between body fat and anthropometric parameters seems to be conditioned by gender.

Obesity indices and the risk of total and cardiovascular mortality among people with diabetes: a long-term follow-up study in Taiwan.

BACKGROUND: The association between obesity indicators and mortality in individuals with diabetes remains unclear, and data on cardiovascular mortality are scarce. Therefore, we investigated the associations between the five adiposity indices and both all-cause and cardiovascular mortality in patients with diabetes. METHODS: This cohort study included 34,686 adults with diabetes who underwent a standard health-screening program between 1996 and 2017 in Taiwan. The dates and causes of death till January 2022 were retrieved from the National Death Registry. Cox proportional hazards models were used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cardiovascular mortality in relation to body mass index (BMI), waist circumference, waist-hip ratio (WHR), body fat percentage (BF%), and A Body Shape Index (ABSI), using the third quintile as the reference group. RESULTS: During a median follow-up of 15 years, there were 8,324 deaths, of which 1,748 were attributed to cardiovascular disease. After adjusting for demographics, lifestyle factors and comorbidities, ABSI was associated with all-cause mortality in an exposure-response manner; the HR (95% CI) for first and fifth vs. third quintile was 0.78 (0.69-0.89) and 1.24 (1.14-1.35), respectively. A similar but weaker exposure-response relationship was found between WHR and mortality. People with a lower BMI and BF% had an increased risk of mortality (HR [95% CI] for the first vs. third quintiles, 1.33 [1.22, 1.44] and 1.42 [1.30, 1.56], respectively). No association was observed between waist circumference categories and risk of mortality. Similar results were observed for the association of BF%, waist circumference, and ABSI with cardiovascular mortality. However, no significant association was observed between BMI and cardiovascular mortality. The association between WHR and cardiovascular mortality was stronger than that between WHR and all-cause mortality. CONCLUSIONS: ABSI demonstrated a consistent exposure-response relationship with both all-cause and cardiovascular mortality in this Asian cohort with diabetes. Our findings highlight the importance of monitoring ABSI, a surrogate index of central adiposity, in patients with diabetes.

The association of traditional obesity parameters with the length of stay among patients with coronary artery disease: A cross-sectional study.

There is a strong association between obesity and coronary artery disease (CAD). Obesity is measured using traditional obesity parameters, such as body mass index, body adiposity index, waist circumference (WC), and hip circumference. The aim of this study is to explore the association between traditional obesity parameters and the length of stay (LOS) among hospitalized CAD patients. An original correlative descriptive study was carried out using secondary data analysis, in which 220 hospitalized Jordanian CAD patients were recruited from Jordan northern and middle regions. Age, WC, triglycerides, and high- sensitivity C-reactive protein were all positive predictors of the total hospital LOS among hospitalized patients with CAD. The WC, age, triglycerides, and high-sensitivity C-reactive protein levels were significantly positively associated with total LOS. Healthcare providers, including nurses, should take into account these significant positive predictors of LOS to achieve better health outcomes and improve patient satisfaction.

Associations of general and central adiposity with hypertension and cardiovascular disease among South Asian populations: a systematic review and meta-analysis.

BACKGROUND: The relevance of measures of general and central adiposity for cardiovascular disease (CVD) risks in populations of European descent is well established. However, it is less well characterised in South Asian populations, who characteristically manifest larger waist circumferences (WC) for equivalent body mass index (BMI). This systematic review and meta-analysis provide an overview of the literature on the association of different anthropometric measures with CVD risk among South Asians. METHODOLOGY: MEDLINE and Embase were searched from 1990 to the present for studies in South Asian populations investigating associations of two or more adiposity measures with CVD. Random-effects meta-analyses were conducted on the associations of BMI, WC and waist-to-hip ratio (WHR) with blood pressure, hypertension and CVD. Quality assessment was performed using the Newcastle-Ottawa scale. RESULTS: Titles and abstracts were screened for 7327 studies, yielding 147 full-text reviews. The final sample (n=30) included 2 prospective, 5 case-control and 23 cross-sectional studies. Studies reported generally higher risks of hypertension and CVD at higher adiposity levels. The pooled mean difference in systolic blood pressure (SBP) per 5 kg/m2 higher BMI was 3 mmHg (2.90 (95% CI 1.30 to 4.50)) and 6 mmHg (6.31 (95% CI 4.81 to 7.81) per 13 cm larger WC. The odds ratio (OR) of hypertension per 5 kg/m2 higher BMI was 1.33 (95% CI 1.18 to 1.51), 1.45 (95% CI 1.05 to 1.98) per 13 cm larger WC and 1.22 (95% CI 1.04 to 1.41) per 0.1-unit larger WHR. Pooled risk of CVD for BMI-defined overweight versus healthy-weight was 1.65 (95% CI 1.55 to 1.75) and 1.48 (95% CI 1.21 to 1.80) and 2.51 (95% CI 0.94 to 6.69) for normal versus large WC and WHR, respectively. Study quality was average with significant heterogeneity. CONCLUSIONS: Measures of both general and central adiposity had similar, strong positive associations with the risk of CVD in South Asians. Larger prospective studies are required to clarify which measures of body composition are more informative for targeted CVD primary prevention in this population.