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1.
Adv Exp Med Biol ; 1216: 39-50, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31894545

RESUMEN

Cardiovascular disease burden increases with the increasing age of populations. Also, with increasing longevity, some individuals are ageing along an unfavourable path developing frailty syndrome. Epidemiologic studies indicate that frailty is overrepresented among the persons with cardiovascular disease. On the other hand, frail subjects tend to be burdened with cardiovascular disease to a greater degree than their biologically better-off peers. Hypertension, diabetes, and obesity, especially abdominal, and at least some other risk factors appear to be shared between frailty and cardiovascular disease. The probable common underlying pathophysiologic feature is inflammation and associated phenomena, possibly having its root in the inflammageing. We discuss these issues based on the results of original studies, comprehensive literature reviews, and metaanalyses, by hundreds of dedicated researchers worldwide.


Asunto(s)
Enfermedades Cardiovasculares , Fragilidad , Anciano , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Anciano Frágil/estadística & datos numéricos , Fragilidad/complicaciones , Fragilidad/epidemiología , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Obesidad Abdominal/complicaciones , Obesidad Abdominal/epidemiología , Factores de Riesgo
2.
Kardiologiia ; 59(11): 21-30, 2019 Dec 11.
Artículo en Ruso | MEDLINE | ID: mdl-31849296

RESUMEN

Background Long-term secondary preventive programs in coronary heart disease (CHD) are of highest efficacy but numerous logistical problems often compromise their implementation. Contemporary remote technologies have a potential to overcome these barriers. AIM: To assess  the impact of 2 preventive counselling programs with subsequent remote support in CHD patients with concomitant obesity. METHODS: A prospective randomized parallel-group study in 120 stable CHD patients hospitalized for elective coronary revascularization who were from 40 to 65 years old and had concomitant obesity. Patients were randomized (1:1:1) into 3 groups (n=40 each). Before discharge, Groups 1 and 2 received a single-session comprehensive counselling with focus on diet followed by remote counselling by phone (Group 1) or via text messages (Group 2). Remote counselling was delivered weekly (Months 1-3) and then monthly (Months 4-6). Group 3 received only standard advice from their attending physicians. The patients were followed for 12 months with assessment of adiposity measures, self-reported dietary patterns, physical activity (IPAQ questionnaire), smoking status, blood pressure (BP), fasting blood glucose, lipids and C-reactive protein (CRP) levels, as well as of clinical events. RESULTS: At 1 year of follow-up, the patients from both intervention groups showed a marked improvement of several risk factors including obesity: the body mass index was reduced by 1.48±0.13 kg/m² in Group 1 and by 1.53±0.18 kg/m² in Group 2; the waist circumference went down by 7.62±0.49 and by 7.41±0.74 cm, respectively; the height-normalized fat mass decreased by 4.66±0.40 kg and 5.98±0.63 kg, respectively (all P values are <0.01 vs corresponding changes in the control group). These changes were coupled with more healthy dietary patterns and less sedentary lifestyles in both intervention groups: the proportion of patients with low activity level fell from 87.5% to 2.5% in Group 1 and from 80% to 10% in Group 2 (both p values <0.01 vs control). In Group 1, BP decreased by 18.08±2.20 mmHg (systolic) and 8.56±1.61 mmHg (diastolic); both р values <0.01 vs Group 3. In Group 2 systolic BP dropped by only 11.95±2.50 mmHg (non-significant) and diastolic BP by 6.33±1.52 mmHg (р<0.05 vs control). The proportion of smokers went down from 30% to 5% in Group 1 and from 22.5% to 0% in Group 2 (both p values <0.01 vs control). The fasting glucose levels decreased by 0.21±0.20 mmol/L in Group 1 and by 0.48±0.25 mmol/L in Group 2 (<0.01 vs control, both), but there were no meaningful improvements in blood lipids or CRP. CONCLUSION: Long-term (6 months) secondary prevention programs incorporating remote support technologies result into sustained improvement of key secondary prevention indicators in obese CHD patients, irrespective of the support modality (by phone or via electronic messaging).


Asunto(s)
Enfermedad Coronaria , Obesidad Abdominal , Adulto , Anciano , Enfermedad Coronaria/complicaciones , Humanos , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Estudios Prospectivos , Factores de Riesgo , Prevención Secundaria
3.
Kardiologiia ; 59(12): 11-19, 2019 Dec 11.
Artículo en Ruso | MEDLINE | ID: mdl-31849306

RESUMEN

BACKGROUND: Quality of life, which is determined both by the physical symptoms and by psychosocial risk factors, is among the primary treatment goals in coronary heart disease (CHD). Therefore, it is reasonable to assess the impact of any therapeutic interventions in CHD on these measures. AIM: To assess the changes of psychological status and quality of life in patients with CHD and abdominal obesity (AO) over time during 2 secondary prevention programs using two different modalities of remote support. METHODS: An open-label randomized study with 3 parallel groups enrolling hospitalized patients with stable CHD and AO (most hospitalizations were due to elective revascularization procedures). The patients were randomized into 2 intervention groups (Group I and Group II) and into Group III (control). Both intervention groups received secondary prevention programs including one in-hospital preventive counselling session with focus on healthy eating habits and subsequent remote support for 6 months (Month 1 to 3: once a week; Month 4 to 6: once a month). Group I received this subsequent counselling via phone calls and Group II received text messages via different platforms according to patient preferences. Group III received standard advice at discharge only. During 1 year of follow-up motivation for lifestyle changes and continued participation in secondary prevention programs, anxiety and depression symptoms (HADS), stress levels (10-point VAS) and quality of life (HeartQol) were assessed. RESULTS: A total of 120 patients were enrolled (mean age±SD, 57.75±6.25 years; men, 83.4%) who had a high baseline motivation to participate in preventive programs. At 1 year of follow-up there was a substantial improvement in anxiety and depression symptoms in Groups I and II which was absent in Group III. As a result, the proportion of patients with HADS-A score ≥8 dropped from 45.0% to 10.0% in Group I and from 40.0% to 7.5% in Group II (both р values <0.01 vs control), and the proportion of participants with HADS-D ≥8 decreased from 30.0% to 10.0% (р<0.01 vs control) and from  12.5% to 0% (р<0.05 vs control), respectively. Stress level decreased in Groups I and II by 3.95±0.38 and 3.56±0.39 баллов, respectively (both р values <0.01 vs control). The HeartQol global score increased by 1.07±0.08 points in Group I and by 0.98±0.13 points in Group (both р values <0.01 vs control). CONCLUSION: Both secondary prevention programs with long-term remote support targeting obese CHD patients resulted in improvement of pivotal measures of their psychological status i.e. into a decline of anxiety and depression symptomatology, stress reduction and into a better quality of life.


Asunto(s)
Enfermedad Coronaria , Obesidad Abdominal , Anciano , Enfermedad Coronaria/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad , Obesidad Abdominal/complicaciones , Calidad de Vida , Prevención Secundaria
4.
Nutr Metab Cardiovasc Dis ; 29(12): 1353-1360, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31668457

RESUMEN

BACKGROUND AND AIM: Circulating level of glutamate, a by-product of the catabolism of branched-chain amino acids, has been positively correlated with visceral adipose tissue accumulation and waist circumference (WC). The aim of the present study was to assess the potential of using glutamate level to identify individuals with abdominal obesity and a high cardiometabolic risk. METHODS AND RESULTS: The study sample included 99 men and 99 women. Fasting serum glutamate was measured using the Biocrates p180 kit. Anthropometric and metabolic variables were used to identify individuals with abdominal obesity (WC ≥ 95 cm in both sexes), the hypertriglyceridemic waist (HTW) phenotype and the metabolic syndrome (MetS). Mean (±SD) age was 34.1 ± 10.1 years, mean BMI was 29.0 ± 6.2 kg/m2 and mean WC was 92.7 ± 16.5 cm. Glutamate was strongly correlated with WC (r = 0.66 for men; r = 0.76 for women, both p < 0.0001) and multiple markers of metabolic dysfunction, particularly fasting triglyceride level (r = 0.59 for men; r = 0.57 for women, both p < 0.0001), HDL-cholesterol level (r = -0.45, p < 0.0001 in both sexes) and the HOMA-IR index (r = 0.65 for men; r = 0.60 for women, both p < 0.0001). Logistic regressions showed that glutamate had an excellent accuracy to identify individuals with abdominal obesity (ROC_AUC: 0.90 for both sexes), a good accuracy to identify those with the HTW phenotype (ROC_AUC: 0.82 for men; 0.85 for women) and fair-to-good accuracy for the MetS (ROC_AUC: 0.78 for men; 0.89 for women). CONCLUSION: Glutamate level may represent an interesting potential biomarker of abdominal obesity and metabolic risk.


Asunto(s)
Ácido Glutámico/sangre , Síndrome Metabólico/sangre , Obesidad Abdominal/sangre , Adiposidad , Adolescente , Adulto , Biomarcadores/sangre , HDL-Colesterol/sangre , Estudios Transversales , Ayuno/sangre , Femenino , Humanos , Masculino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/etiología , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Obesidad Abdominal/diagnóstico , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Triglicéridos/sangre , Regulación hacia Arriba , Circunferencia de la Cintura , Adulto Joven
5.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(5): 725-730, 2019 Sep.
Artículo en Chino | MEDLINE | ID: mdl-31762245

RESUMEN

OBJECTIVE: To understand the relationship between obesity and depression in the elderly in China, and to explore whether there are differences between the genders. METHODS: The data were collected from the 2015 China Health and Retirement National Investigation (China Health and Retirement Longitudinal Study, CHARLS). The respondents were grouped according to depressive status. The difference of depressive status between the elderly male and female groups was examined by Chi-square test. The relationship between depression, obesity and the other sociological factors was analyzed by binary logistic regression. RESULTS: There were 4 019 valid cases, including 2 109 males (52.48%) and 1 910 females (47.52%). All the respondents were aged 60 years and over. There were 474 cases of central obesity (11.79%) and 2 418 cases of abdominal obesity (60.16%). There were significant differences in central obesity and abdominal obesity between the elderly male and female groups (P < 0.001). 1 304 cases suffered from depression, accounting for 32.45%, of which 539 cases were male (41.33%) and 765 cases were female (58.67%). Different groups of gender, central obesity and abdominal obesity had significant differences in depressive status (P < 0.001). The results of univariate analysis indicated that the characteristics of female, divorced/widowed/unmarried, in rural areas, having chronic diseases and functional loss were the risk factors for depression. The results of multivariate logistic regression analysis indicated that, in terms of the total sample, after adjustment for the confounding factors, both central obesity and abdominal obesity groups were less likely to suffer from depression. After stratified by gender, both central obesity and abdominal obesity were negatively correlated with depression. CONCLUSIONS: The elderly with central obesity or abdominal obesity are less likely to suffer from depression, regardless of gender.


Asunto(s)
Depresión/complicaciones , Obesidad Abdominal/complicaciones , Anciano , China/epidemiología , Femenino , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad
6.
BMC Public Health ; 19(1): 1533, 2019 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-31730482

RESUMEN

BACKGROUND: The prevalence of abdominal obesity is increasing worldwide. Adults with abdominal obesity have been reported to have increased risk of cardiometabolic disorders. The aim of this study was to examine whether non-obese subjects (body mass index (BMI) < 25 kg/m2) with abdominal obesity examined in the framework of the Swiss-Hungarian Cooperation Programme had increased metabolic risk compared to participants without abdominal obesity. METHODS: A cross-sectional study was carried out in 5228 non-obese individuals. Data were collected between July 2012 and February 2016. Descriptive statistics, Pearson's correlation analysis and multiple logistic regression models were applied, odds ratios (OR) with 95% confidence interval (CI) being the outcomes. RESULTS: 607 (11.6%) out of the 5228 non-obese individuals had abdominal obesity. The correlation analysis indicated that the correlation coefficients between BMI and waist circumference (WC) were 0.610 in males and 0.526 in females. In this subgroup, the prevalence of high systolic blood pressure, high fasting blood glucose, and high total cholesterol and triglyceride levels were significantly higher. The logistic regression model based on these data showed significantly higher risk for developing high systolic blood pressure (OR = 1.53; 95% CI = 1.20-1.94), low HDL cholesterol (OR = 2.06; 95% CI = 1.09-3.89), and high trygliceride level (OR = 1.65; 95% CI = 1.27-2.16). CONCLUSIONS: There was a very high, significant, positive correlation between WC and BMI. Abdominal obesity was found to be strongly related to certain metabolic risk factors among non-obese subjects. Hence, measuring waist circumference could be recommended as a simple and efficient tool for screening abdominal obesity and related metabolic risk even in non-obese individuals.


Asunto(s)
Enfermedades Metabólicas/etiología , Obesidad Abdominal/fisiopatología , Adulto , Glucemia/análisis , Presión Sanguínea , Índice de Masa Corporal , HDL-Colesterol/sangre , Estudios Transversales , Ayuno/sangre , Femenino , Humanos , Hungría/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Obesidad Abdominal/epidemiología , Oportunidad Relativa , Prevalencia , Factores de Riesgo , Triglicéridos/sangre , Circunferencia de la Cintura
7.
BMC Endocr Disord ; 19(1): 95, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477078

RESUMEN

BACKGROUND: Cholecystectomy, central obesity, and insulin resistance (IR) are established risk factors for nonalcoholic fatty liver disease (NAFLD). We aimed to examine the relative contributions and combined association of cholecystectomy and central obesity/IR with NAFLD risk. METHODS: We conducted a cross-sectional analysis of data from the third National Health and Nutrition Examination Survey (NHANES III), in which ultrasonography was performed. Odds ratios (ORs) and 95% confidence intervals for NAFLD were estimated using logistic regression. RESULTS: Cholecystectomy associated with a higher prevalence of NAFLD compared with gallstones among both centrally obese and non-centrally-obese subjects. Gallstones associated with a higher prevalence of NAFLD only in the presence of central obesity. In centrally obese participants, the OR increased from 2.67 (2.15-3.32) for participants without gallstone disease to 6.73 (4.40-10.29) for participants with cholecystectomy. In participants with cholecystectomy, the OR increased from 2.57 (1.35-4.89) for participants without central obesity to 6.73 (4.40-10.29) for centrally obese counterparts. We observed a modest increase in the risk of NAFLD with cholecystectomy compared with a large increase in the risk with IR or metabolic syndrome. CONCLUSION: The magnitude of the NAFLD risk contributed by cholecystectomy was similar to central obesity in combined analyses. The magnitude of the association with IR or metabolic syndrome was greater than with cholecystectomy.


Asunto(s)
Colecistectomía/efectos adversos , Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico/etiología , Obesidad Abdominal/complicaciones , Anciano , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/patología , Encuestas Nutricionales , Prevalencia , Pronóstico , Factores de Riesgo , Estados Unidos/epidemiología
8.
BJOG ; 126(12): 1424-1433, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31376211

RESUMEN

BACKGROUND: Adiposity has been associated with elevated risk of urinary incontinence in epidemiological studies; however, the strength of the association has differed between studies. OBJECTIVES: To conduct a systematic literature review and dose-response meta-analysis of prospective studies on adiposity and risk of urinary incontinence. SEARCH STRATEGY: We searched PubMed and Embase databases up to 19 July 2017. SELECTION CRITERIA: Prospective cohort studies were included. DATA COLLECTION AND ANALYSIS: Data were extracted by one reviewer and checked for accuracy by a second reviewer. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. MAIN RESULTS: Twenty-four prospective studies were included. The summary RR per 5 kg/m2 increment in body mass index (BMI) was 1.20 (95% CI 1.16-1.25, I2  = 62%, n = 11) for population-based studies and 1.19 (95% CI 1.08-1.30, I2  = 87.1%, n = 8) for pregnancy-based studies, 1.18 (95% CI 1.14-1.22, I2  = 0%, n = 2) per 10 cm increase in waist circumference and 1.34 (95% CI 1.11-1.62, I2  = 90%, n = 2) per 10 kg of weight gain. Although the test for nonlinearity was significant for BMI, P = 0.04, the association was approximately linear. For subtypes of urinary incontinence the summary RR per 5 BMI units was 1.45 (95% CI 1.25-1.68, I2  = 85%, n = 3) for frequent incontinence, 1.52 (95% CI 1.37-1.68, I2  = 34%, n = 4) for severe incontinence, 1.33 (95% CI 1.26-1.41, I2  = 0%, n = 8) for stress incontinence, 1.26 (95% CI 1.14-1.40, I2  = 70%, n = 7) for urge incontinence, and 1.52 (95% CI 1.36-1.69, I2  = 0%, n = 3) for mixed incontinence. CONCLUSION: These results suggest excess weight may increase risk of urinary incontinence. TWEETABLE ABSTRACT: Overweight and obesity increase the risk of urinary incontinence.


Asunto(s)
Obesidad Abdominal/complicaciones , Incontinencia Urinaria/etiología , Índice de Masa Corporal , Femenino , Humanos , Estudios Prospectivos , Factores de Riesgo , Aumento de Peso
9.
Nutrients ; 11(8)2019 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-31408930

RESUMEN

Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was performed in a group of 542 women, 197 who were diagnosed with breast cancer and 344 control individuals. The groups were matched by age, body mass index, and menopausal status. Participants were evaluated for level of physical activity, alcohol consumption, smoking habit, weight, height, and waist circumference (WC). A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals (95% CI). Regular consumption of alcoholic beverages (2.91, 95% CI 1.58-5.38 and 1.86, 95% CI 1.15-3.03) and sedentary behavior (2.08; 95% CI 1.12-3.85 and 1.81; 95% CI 1.12-2.94) were associated with breast cancer risk in pre- and postmenopausal women, respectively. High WC (3.31, 95% CI 1.45-7.55) was associated with an increased risk of developing breast cancer in premenopausal women. While in postmenopausal women, current smoking (2.43, 95% CI 1.01-5.83) or previous history of smoking (1.90; 95% CI 1.14-3.14) increased the chances of developing breast cancer. Sedentary behavior and current consumption of alcoholic beverages were more likely to increase the risk of developing breast cancer regardless of menopausal status.


Asunto(s)
Consumo de Bebidas Alcohólicas , Neoplasias de la Mama/etiología , Ejercicio , Menopausia , Conducta Sedentaria , Adulto , Anciano , Bebidas Alcohólicas , Índice de Masa Corporal , Femenino , Humanos , Estilo de Vida , Modelos Logísticos , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Posmenopausia , Premenopausia , Fumar , Circunferencia de la Cintura
10.
Transplant Proc ; 51(7): 2334-2338, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31402244

RESUMEN

Obesity is one of the most important metabolic diseases around the world. There are no reliable and inexpensive methods to evaluate obesity. All of the anthropometric measurements used have some limitations. In 2012, Krakauer et al developed a new method, called A Body Shape Index (ABSI), to identify abdominal obesity that is derived from weight, height, and waist circumference. In this study, we aimed to investigate the clinical usefulness of the ABSI to predict the presence of insulin resistance (IR) and metabolic syndrome (MetS) in renal transplant recipients. A total of 155 patients were included in the study. Prevalence of IR was 17.4%, and MetS was 62.6%. ROC results demonstrated the power of all anthropometric indices to discriminate patients with and without MetS and IR in the renal transplant populations. ROC curves showed that waist-to-height ratio (WHtR) had the optimal power to discriminate MetS and IR in women. WC had higher area under curve than all other anthropometric indices to predict MetS and IR in men. WC in men and WHtR in women has higher discriminatory capacity to predict MetS and IR in renal transplant recipients. An obvious difference was observed in the optimal anthropometric measures between the 2 sexes, suggesting that sex-specific measures should be used in practice. In order to evaluate the value of ABSI in determining metabolic risk factors, studies with larger, randomized, controlled body fat ratios are needed.


Asunto(s)
Antropometría/métodos , Resistencia a la Insulina , Trasplante de Riñón , Síndrome Metabólico , Obesidad Abdominal/diagnóstico , Adulto , Estudios Transversales , Femenino , Humanos , Resistencia a la Insulina/fisiología , Masculino , Síndrome Metabólico/epidemiología , Síndrome Metabólico/etiología , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Prevalencia , Factores de Riesgo , Caracteres Sexuales , Circunferencia de la Cintura
11.
J Altern Complement Med ; 25(10): 1005-1008, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31448950

RESUMEN

Objectives: The aim of this pilot study was to assess the effects of a t'ai chi program on health-related quality of life (HR-QOL) in centrally obese adults with depression. Methods: Two hundred thirteen participants were randomly allocated to either a t'ai chi intervention group (n = 106) or a usual medical care control group (n = 107). The t'ai chi group involved 3 × 1.5 h supervised and group-based training sessions per week for 24 weeks. Indicators of HR-QOL were assessed by questionnaire at baseline, 12 weeks, and 24 weeks. Results: There were significant improvements in favor of the t'ai chi group for the SF-36 subscales of physical functioning (p < 0.01), role physical (p < 0.01), and role emotional (p < 0.01) at 12 and 24 weeks. Scores for bodily pain were improved in the control group at 12 weeks (p < 0.01) and 24 weeks (p < 0.05), but not in the t'ai chi group. There was also a significant improvement in favor of the control group in general health (p < 0.05) at 12 weeks, but not at 24 weeks. A further analysis showed clinically significant changes in favor of the t'ai chi group in physical functioning (p < 0.05 or p = 0.05), role physical (p < 0.05), and role emotional (p < 0.05), and in favor of the control group in bodily pain (p < 0.05) at 12 and 24 weeks. Conclusions: The findings show that t'ai chi exercise improved indicators of HR-QOL including physical functioning, role physical, and role emotional in centrally obese adults with depression.


Asunto(s)
Depresión , Obesidad Abdominal , Calidad de Vida , Tai Ji , Adulto , Anciano , Depresión/complicaciones , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Obesidad Abdominal/terapia , Encuestas y Cuestionarios , Adulto Joven
12.
Biomed Res Int ; 2019: 9047324, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31467918

RESUMEN

Polycystic ovary syndrome (PCOS) and nonalcoholic fatty liver (NAFLD) share similar clinical presentations including obesity, insulin resistance (IR), and metabolic abnormality. The predictive factors of NAFLD in women with PCOS and specifically in Asian women are not well established. Associated factors for NAFLD assessed by ultrasound (US) among a group of PCOS and healthy women were determined and diagnostic accuracy between US and transient elastography (TE) for NAFLD was compared and correlated. Sixty-three women with ages ranging from 20 to 40 years participated in the present cross-sectional study. Forty-two women with PCOS as diagnosed by the Rotterdam criteria and 21 healthy women were recruited into the study. Women with underlying hepatic diseases and history of alcohol consumption >20 g/day were excluded. Biochemical and hormonal testing, anthropometrics, liver US, and TE were assessed. Waist circumference (WC) greater than 80 cm was the only predictive factor for NAFLD as assessed by US in the whole group (adjusted odds ratio [aOR] 5.49, 95% confidence interval [CI]: 1.85-16.26, p <0.001). The value of the TE-based controlled attenuation parameter (CAP) was significantly correlated with stage of steatosis as assessed by US (correlation coefficient = 0.696, p <0.001). The diagnostic accuracies of dichotomized CAP ≥236 dB/m assessed for NAFLD using US as the gold standard were 84% and 78% sensitivity and specificity, respectively, with the area under the curve at 0.81 (p <0.001). Abdominal obesity, rather than the presence of PCOS, was shown to be the independently associated factor for NAFLD. WC could be used as the primary screening tool before performing complicated intervention for detection of steatosis. TE is an alternative noninvasive detection tool in women with PCOS for NAFLD and hepatic fibrosis identification.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Obesidad Abdominal/diagnóstico , Síndrome del Ovario Poliquístico/diagnóstico , Ultrasonografía , Adulto , Diagnóstico por Imagen de Elasticidad , Femenino , Humanos , Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/diagnóstico por imagen , Enfermedad del Hígado Graso no Alcohólico/patología , Obesidad Abdominal/complicaciones , Obesidad Abdominal/diagnóstico por imagen , Obesidad Abdominal/patología , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/diagnóstico por imagen , Síndrome del Ovario Poliquístico/patología , Pronóstico , Circunferencia de la Cintura , Salud de la Mujer , Adulto Joven
13.
Diagn Interv Radiol ; 25(5): 338-345, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31287430

RESUMEN

PURPOSE: We aimed to examine the possible relationship between abdominal adiposity parameters and the presence of colorectal cancer (CRC) and between these adiposity parameters and various histopathologic findings of the tumor. METHODS: A total of 60 control subjects and 111 CRC patients, 63 with early-stage and 48 with advanced-stage disease, were enrolled. Medical data and abdominopelvic computed tomography (CT) examinations of each study group were retrospectively reviewed. Abdominal adiposity parameters, including visceral adipose tissue (VAT) volume, subcutaneous adipose tissue (SAT) volume, and total adipose tissue (TAT) volume, were calculated on all slices of the CT examinations with specialized software, and results for each study group were compared. Adiposity parameters were also compared with tumor histopathologic findings. RESULTS: We found lower VAT and higher SAT volumes in advanced-stage CRC patients, compared with the early-stage group. However, this relationship was not statistically significant (P = 0.721 for VAT and P = 0.432 for SAT volumes). We detected significantly lower VAT and SAT volumes in the early-stage CRC group compared with the control group (P = 0.014 for both). There was no significant relationship between TAT volumes and the study groups (P = 0.06). No statistically significant relationship was detected between adipose tissue parameters and histopathologic features of the CRC group (P > 0.05). CONCLUSION: We found statistically significant lower VAT and SAT volumes in patients with early-stage CRC compared with the control group. Volumetric adipose tissue measurements may be more accurate than area measurements and can easily be performed on abdominopelvic CT examination, which is the routine imaging modality for CRC patients.


Asunto(s)
Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/diagnóstico por imagen , Obesidad Abdominal/complicaciones , Obesidad Abdominal/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad
14.
Biomed Res Int ; 2019: 4808541, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31281839

RESUMEN

Measurement of waist circumference has substantial variability and some limitations, while neck circumference is a simple and reliable anthropometric measure. This study aimed to assess the association between neck circumference and waist circumference and to identify the best cutoff of neck circumference that could predict central obesity in prediabetic patients. This cross-sectional study included adult patients with prediabetes, defined as having fasting plasma glucose levels ranging from 100 to 125 mg/dL or HbA1c ranging from 5.7 to 6.49%, who visited the outpatient clinic of Family Medicine Department, Ramathibodi Hospital, Thailand, during October 2014 and March 2016. Neck circumference was measured from the level just below the laryngeal prominence perpendicular to the long axis of the neck. Central obesity was defined as having waist circumference measurements greater than 90 and 80 cm for males and females, respectively. The correlation between neck circumference and waist circumference was explored by applying pairwise correlation coefficient. Receiver operating characteristic (ROC) curve analysis was performed and Youden index equal to "sensitivity - (1-specificity)" was calculated. Neck circumference that yielded the maximum Youden index was determined as the optimal cutoff point for prediction of central obesity. There were 1,534 patients eligible for this study. After adjusting for covariables, neck circumference was found to be significantly associated with waist circumference in both females and males, with ß-coefficients of 1.01 (95% CI: 0.83, 1.20) and 0.65 (95% CI: 0.46, 0.85), respectively. After applying the ROC analysis, neck circumferences ≥ 32 cm in females and ≥ 38 cm in males were determined as the best cutoff values to predict central obesity. Neck circumference is strongly correlated with waist circumference in prediabetics and should be considered as an alternative to the waist circumference measurement in screening for central obesity.


Asunto(s)
Antropometría , Cuello/patología , Obesidad Abdominal/complicaciones , Obesidad Abdominal/patología , Estado Prediabético/complicaciones , Estado Prediabético/patología , Estudios Transversales , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Curva ROC , Circunferencia de la Cintura
15.
Sao Paulo Med J ; 137(2): 126-131, 2019 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-31314872

RESUMEN

BACKGROUND: The lipid accumulation product (LAP) index is an abdominal adiposity marker. OBJECTIVE: The aim of this study was to describe the cardiovascular risk of primary healthcare users through the LAP index and correlate it with anthropometric and biochemical indicators. DESIGN AND SETTING: Cross-sectional study in primary care units in a city in northeastern Brazil. METHODS: The subjects responded to a structured questionnaire that contained questions about their sociodemographic condition, and then underwent an anthropometric nutritional assessment. The LAP index values were expressed as three degrees of cardiovascular risk intensity: high risk (above the 75th percentile), moderate risk (between the 25th and 75th percentiles) and low risk (below the 25th percentile). RESULTS: The median LAP index was 52.5 cm.mmol/l (range: 28.2-86.6), and there was no statistically significant difference between the sexes: 57.7 cm.mmol/l (24.5-91.1) and 49.5 cm.mmol/l (29.8-85.2) for females and males, respectively (P = 0.576). Among all the subjects, 67.2% were overweight and there was a statistically significant difference in mean LAP index between those who were and those who were not overweight. Statistically significant differences in anthropometric and biochemical markers for cardiovascular risk were observed among individuals who had higher LAP index values. There were significant correlations between the LAP index and all of the biochemical variables. CONCLUSIONS: These significant correlations between the LAP index and the traditional biochemical risk markers may be useful within conventional clinical practice, for cardiovascular risk screening in primary healthcare.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Producto de la Acumulación de Lípidos , Obesidad Abdominal/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores , Índice de Masa Corporal , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/sangre , Atención Primaria de Salud , Medición de Riesgo , Factores de Riesgo , Factores Socioeconómicos , Circunferencia de la Cintura , Adulto Joven
16.
Diabetes Res Clin Pract ; 155: 107798, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31330161

RESUMEN

OBJECTIVES: Lipid accumulation product (LAP) index and Visceral Adiposity Index (VAI) are simple calculations to measure fat accumulation and visceral fat respectively. We aim to study the use of LAP index and VAI as diagnostic parameter and predictor of T2DM. METHODS: We analysed the baseline and longitudinal data from the Indonesian Ministry of Health Cohort Study of Non-communicable Diseases Risk Factors in West Java, comprising 846 men and 2437 women aged 25-65 years. At baseline, the odds ratio for the diagnosis of prediabetes and T2DM among subjects with high LAP Index and VAI was analysed using logistic regression analysis. In the longitudinal analysis, LAP index and VAI as predictor of prediabetes and T2DM was analysed with cox regression analysis. RESULT: Worsening glycemia status was associated with an increased LAP index and VAI (p < 0.001). Subjects with high VAI had an increased OR of having T2DM in both men [OR, 95%CI, 2.29(1.15-4.56), p = 0.018] and women [1.95(1.49-2.54), p < 0.001)]. Association of high LAP with T2DM was found only in women [OR, 95%CI, 2.11(1.16-1.52), p < 0.001]. In terms of T2DM prediction, only women [RR, 95% CI, 2.59 (1.05-6.39), p = 0.038)], with high VAI had an increased risk of T2DM in the future. High LAP index was not associated with an in increased risk of T2DM in the future in both sexes. CONCLUSION: High LAP index was associated with an increased risk of T2DM diagnosis in women but it could not predict the development of T2DM. High VAI was associated with an increased risk of T2DM diagnosis in both sexes, however, it could only predict the development of T2DM in women.


Asunto(s)
Adiposidad , Diabetes Mellitus Tipo 2/diagnóstico , Producto de la Acumulación de Lípidos , Enfermedades no Transmisibles/epidemiología , Obesidad Abdominal/complicaciones , Adulto , Anciano , Diabetes Mellitus Tipo 2/etiología , Femenino , Humanos , Indonesia/epidemiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Riesgo
17.
Diabetes Metab Syndr ; 13(2): 1231-1235, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31336469

RESUMEN

BACKGROUND: Visceral Adiposity Index (VAI) is a formula to estimate visceral fat accumulation which has been reported to have a better prediction for type 2 diabetes mellitus (T2DM) in Caucasian population. This systematic review is proposed to inquire whether VAI can be used as a predictor of T2DM in Asian population with different body composition compared to the Caucasian. METHODS: All studies performed in Asia and published in English on VAI prediction on the incidence of T2DM were included. The search keywords used in Pubmed and Cochrane database were visceral adiposity index, VAI and T2DM. RESULTS: Seven included studies, of which six studies were conducted in China and one in Iran. Four studies were prospective cohorts and the other three were cross-sectional. The largest study population were 7639 subjects, while the longest observation period was 15 years. This study found that VAI can be used as a predictor of T2DM in Asian population with better prediction values compared to Caucasian population. The reported odds ratio or hazard ratio ranged from 1.2 to 3.6. CONCLUSIONS: VAI is a practical formula used to estimate the accumulation of visceral fat which can be used as a predictor for T2DM in Asian population.


Asunto(s)
Adiposidad , Diabetes Mellitus Tipo 2/diagnóstico , Grasa Intraabdominal/fisiopatología , Obesidad Abdominal/complicaciones , Asia/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Humanos , Prevalencia
18.
Diabetes Metab Syndr ; 13(2): 1437-1441, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31336503

RESUMEN

BACKGROUND AND OBJECTIVES: Diabetes Mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia, which occurs due to insufficient production of insulin by the pancreas or resistance to insulin produced by the body. The most dangerous and Long-term complications of diabetes include renal failure, heart failure, cardiovascular disease, stroke, diabetic foot ulcers, and diabetic neuropathy. MATERIALS AND METHODS: This longitudinal cohort study was conducted on 1641 non-diabetic people of 2000 participants enrolled in phase I of Yazd Healthy Heart project (YHHP) aged 20-74 year-old resident of the city of Yazd. They were selected randomly through cluster sampling method and included in follow up a project for ten years (2004-2014). In order to analyze the data, Chi-Square, independent t-test and logistic regression statistical models were used through the SPSS Ver20. RESULTS: The incidence rate of DM type II among the people aged 20-74 years in Yazd was 21.4 per 1000 of a population-year. Univariate analysis revealed that the relative risk of DM incidence increased by smoking, increasing BMI, abdominal obesity, hypertension, and increased cholesterol, triglyceride and uric acid levels (p < 0.0001). Variables with a significant p-value < 0.05 using the univariate analysis were included in the logistic regression model. Age, family history of diabetes mellitus in relatives, abdominal obesity, triglyceride values greater than 150 and uric acid more than the 75th percentile were recognized as independent risk factors of diabetes. CONCLUSION: In the present study, Age, family history of DM, abdominal obesity, high triglycerides, and high uric acid are the most important risk factors for diabetes.


Asunto(s)
Índice de Masa Corporal , Diabetes Mellitus Tipo 2/epidemiología , Hipertensión/complicaciones , Obesidad Abdominal/complicaciones , Adulto , Anciano , Biomarcadores/análisis , Diabetes Mellitus Tipo 2/etiología , Diabetes Mellitus Tipo 2/patología , Femenino , Estudios de Seguimiento , Humanos , Irán/epidemiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Riesgo , Adulto Joven
19.
Indian J Public Health ; 63(2): 101-106, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31219057

RESUMEN

Background: Prevention of cardiovascular disease (CVD) among postmenopausal women with limited resource is a great challenge for a country like Bangladesh. Objectives: This study aimed to evaluate the level of agreement among different risk prediction tools to find out the cost-effective and suitable one that can be applied in a low-resource setting. Methods: This was a cross-sectional study conducted from February through December 2016 among 265 postmenopausal women of 40-70 years age. Data were collected from the outpatient department of a rural health-care center situated in the village Karamtola of Gazipur district, Bangladesh. The CVD risk was estimated using the World Health Organization/International Society of Hypertension (WHO/ISH) "with" and "without" cholesterol risk charts and the Framingham Risk Score (FRS). Concordance among the tools was evaluated using Cohen's kappa (κ), prevalence-adjusted bias-adjusted kappa (PABAK), and first-order agreement coefficient (AC1). Results: The "without" cholesterol version showed 79% concordance against the "with" cholesterol and 75.4% concordance against the FRS. In between the WHO/ISH risk charts, slight-to-substantial levels of agreement (κ = 0.14, PABAK = 0.58, and AC1 = 0.72; P = 0.023) were observed. With FRS, the "without" cholesterol version showed higher agreement (κ = 0.38, fair; PABAK = 0.50, moderate; and AC1 = 0.60, moderate; P = 0.000) compared to "with" cholesterol version (κ = 0.13, slight; PABAK = 0.30, fair; and AC1 = 0.44, moderate; P = 0.013). Predictability of CVD risk positive (≥10%) cases was similar for both the versions of WHO/ISH risk charts. Conclusion: In a low-resource setting, the "without" cholesterol version of WHO/ISH risk chart is a good option to detect and target the population with high CVD risk.


Asunto(s)
Hipertensión/etiología , Adulto , Anciano , Bangladesh/epidemiología , Enfermedades Cardiovasculares/etiología , Estudios Transversales , Femenino , Humanos , Hipertensión/epidemiología , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Obesidad Abdominal/epidemiología , Prevalencia , Medición de Riesgo , Factores de Riesgo , Población Rural/estadística & datos numéricos , Uso de Tabaco/efectos adversos , Uso de Tabaco/epidemiología
20.
Indian J Public Health ; 63(2): 119-127, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31219060

RESUMEN

Background: The increasing burden of noncommunicable diseases (NCDs) urges continuous survey of risk factors in different population groups. Objectives: The study was conducted to assess the prevalence and determinants of behavioral and biological risk factors of NCDs, in rural tribal population. Methods: A community-based cross-sectional study was conducted from June 2014 to May 2015, in rural Siliguri, among 172 tribal people aged 25-64 years selected by multistage cluster random sampling using WHO-STEPS instrument. Study participants were interviewed for sociodemographic and behavioral risk factors, and biological measurements were taken. Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. Results: Among the study participants, the prevalence of current tobacco use and alcohol use were 69.8% and 40.7%, respectively; 96.5% consumed unhealthy diet and 2.9% were physically inactive. The prevalence of abdominal obesity and overweight were 26.2% and 12.2%, respectively. Odds of tobacco use were significantly raised among men (adjusted odds ratio [AOR]: 47.7 [95% confidence interval (CI) 11.1, 203.9]) and increased age of the participants. Men showed higher odds of alcohol consumption (AOR: 13.4 [95% CI 4.6, 38.9]). Odds of abdominal obesity were higher among older participants, whereas lower odds were found among men (AOR: 95% CI 0.11 [0.0, 0.5]) compared to women. Conclusions: Most of the behavioral and biological risk factors of NCDs were quite high among tribal population of rural Siliguri except physical inactivity. Increasing awareness about NCDs through locally accepted and culturally appropriate strategies need to be implemented in the study area.


Asunto(s)
Grupos Étnicos/psicología , Enfermedades no Transmisibles/epidemiología , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Estudios Transversales , Dieta/efectos adversos , Dieta/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades no Transmisibles/etnología , Enfermedades no Transmisibles/psicología , Obesidad Abdominal/complicaciones , Obesidad Abdominal/epidemiología , Factores de Riesgo , Conducta Sedentaria , Factores Sexuales , Uso de Tabaco/efectos adversos , Uso de Tabaco/epidemiología
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