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1.
Medicine (Baltimore) ; 99(38): e22243, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957370

RESUMO

Although obesity is an established risk factor of primary stroke, the association between obesity and post-stroke mortality remains unclear. The aim of this study was to investigate the association between dynamic obesity status and mortality in survivors of their first stroke in China.Of 775 patients with first-ever ischemic stroke included in a longitudinal study, 754 patients were included in this study and categorized into 4 categories of body mass index (BMI) (underweight, normal weight, overweight, and obese) and 2 categories of waist circumference (WC) (normal WC and abdominal obesity) according to standard Chinese criteria. The mortality information and obesity status were obtained via telephone follow-up every 3 months, beginning in 2010 through 2016. Time-dependent Cox proportional hazards models were used to estimate the unadjusted and adjusted hazard ratios (HRs) for the relationship between all-cause mortality and dynamic obesity status.Of 754 patients, 60.87% were male, and the overall mean age was 61.45 years. After adjusting for possible confounders, significant inverse associations were identified between BMI and WC and all-cause mortality. Compared with those with normal BMI or WC, those with abdominal obesity or overweight had a significantly lower risk of all-cause mortality (HR and 95% confidence intervals [CIs]: .521 [.303-.897] and 0.545 [.352-.845], respectively), whereas patients with underweight had the highest risk and those with obesity had lower risk of mortality, though it was not statistically significant (1.241 [.691-2.226] and .486 [.192-1.231], respectively).Overweight and abdominal obesity were paradoxically associated with reduced risk of mortality in patients who survived their first-ever ischemic stroke in China. Future prospective studies must look at evaluating the role of obesity in different stroke subtypes and devise appropriate weight-management strategies for optimal prognoses in secondary prevention in these survivors.


Assuntos
Isquemia Encefálica/mortalidade , Obesidade/epidemiologia , Acidente Vascular Cerebral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Isquemia Encefálica/epidemiologia , Isquemia Encefálica/prevenção & controle , China/epidemiologia , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Prevalência , Estudos Prospectivos , Fatores de Risco , Prevenção Secundária , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/prevenção & controle , Sobreviventes , Circunferência da Cintura , Adulto Jovem
2.
BMJ ; 370: m3324, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967840

RESUMO

OBJECTIVE: To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included. DATA SYNTHESIS: A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves. RESULTS: Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index. CONCLUSIONS: Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.


Assuntos
Obesidade Abdominal/mortalidade , Índice de Massa Corporal , Humanos , Obesidade Abdominal/diagnóstico , Circunferência da Cintura , Relação Cintura-Quadril
3.
Maturitas ; 140: 34-40, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32972633

RESUMO

OBJECTIVE: To evaluate the impact of individual components of unfavorable body composition and their combinations on quality of life (QoL) among middle-aged and older adults. METHODS: Data from 1779 participants (53.1 % female; mean age 63.9 ± 9.2 years) from the I-Lan Longitudinal Aging Study were analyzed in this study. Demographic characteristics of all participants and data from anthropometric measurements, functional assessments, dual-energy X-ray absorptiometry scans, and surveys of QoL were obtained. Low skeletal muscle mass was defined by the Asian Working Group of Sarcopenia consensus, and obesity was defined by waist circumference (WC), body fat percentage, or body mass index (BMI). QoL was assessed by the 12-Item Short Form Health Survey version 2, which was divided into the physical component summary (PCS) and mental component summary (MCS). The composite score was determined based on the items of unfavorable body composition. Independent associations between unfavorable body composition components and QoL were evaluated by the multivariate linear regression model. Z transformation was performed to facilitate evaluation between different components of body composition and their relationship with QoL. RESULTS: All definitions of obesity were significantly associated with a lower PCS score (WC: ß=-1.2, SE = 0.3, p < 0.001; body fat percentage: ß=-1.0, SE = 0.3, p < 0.001; BMI: ß=-0.9, SE = 0.3, p = 0.002 in the fully adjusted model). The PCS score decreased linearly as the composite score of unfavorable body composition increased, especially when obesity was defined by WC (score = 1: ß=-0.7, SE = 0.4, p = 0.053, score = 2: ß=-1.1, SE = 0.4, p = 0.008; score = 3: ß=-2.4, SE = 1.0, p = 0.013). After Z transformation, obesity was significantly negatively associated with the PCS score (ß=-0.9∼-0.2, SE = 0.1∼0.2, p values all less than 0.01). In contrast, a one-standard-deviation increase in WC was associated with a significantly higher MCS score (ß = 0.3, SE = 0.1, p = 0.019). CONCLUSIONS: Community-dwelling middle-aged and older people with obesity had significantly lower PCS scores, and the effect was enhanced when low skeletal muscle mass or osteopenia/osteoporosis was present. Central obesity was the only unfavorable body composition parameter with negative effects on both the physical and the mental domains of QoL. Further longitudinal or intervention studies are needed to evaluate the impact on QoL of changes in body composition that occur with aging.


Assuntos
Composição Corporal , Doenças Ósseas Metabólicas , Obesidade , Qualidade de Vida , Sarcopenia , Absorciometria de Fóton , Idoso , Envelhecimento , Índice de Massa Corporal , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Circunferência da Cintura
4.
PLoS Biol ; 18(9): e3000870, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32986697

RESUMO

Obesity and related metabolic diseases show clear sex-related differences. The growing burden of these diseases calls for better understanding of the age- and sex-related metabolic consequences. High-throughput lipidomic analyses of population-based cohorts offer an opportunity to identify disease-risk-associated biomarkers and to improve our understanding of lipid metabolism and biology at a population level. Here, we comprehensively examined the relationship between lipid classes/subclasses and molecular species with age, sex, and body mass index (BMI). Furthermore, we evaluated sex specificity in the association of the plasma lipidome with age and BMI. Some 747 targeted lipid measures, representing 706 molecular lipid species across 36 classes/subclasses, were measured using a high-performance liquid chromatography coupled mass spectrometer on a total of 10,339 participants from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), with 563 lipid species being validated externally on 4,207 participants of the Busselton Health Study (BHS). Heat maps were constructed to visualise the relative differences in lipidomic profile between men and women. Multivariable linear regression analyses, including sex-interaction terms, were performed to assess the associations of lipid species with cardiometabolic phenotypes. Associations with age and sex were found for 472 (66.9%) and 583 (82.6%) lipid species, respectively. We further demonstrated that age-associated lipidomic fingerprints differed by sex. Specific classes of ether-phospholipids and lysophospholipids (calculated as the sum composition of the species within the class) were inversely associated with age in men only. In analyses with women alone, higher triacylglycerol and lower lysoalkylphosphatidylcholine species were observed among postmenopausal women compared with premenopausal women. We also identified sex-specific associations of lipid species with obesity. Lysophospholipids were negatively associated with BMI in both sexes (with a larger effect size in men), whilst acylcarnitine species showed opposing associations based on sex (positive association in women and negative association in men). Finally, by utilising specific lipid ratios as a proxy for enzymatic activity, we identified stearoyl CoA desaturase (SCD-1), fatty acid desaturase 3 (FADS3), and plasmanylethanolamine Δ1-desaturase activities, as well as the sphingolipid metabolic pathway, as constituent perturbations of cardiometabolic phenotypes. Our analyses elucidate the effect of age and sex on lipid metabolism by offering a comprehensive view of the lipidomic profiles associated with common cardiometabolic risk factors. These findings have implications for age- and sex-dependent lipid metabolism in health and disease and suggest the need for sex stratification during lipid biomarker discovery, establishing biological reference intervals for assessment of disease risk.


Assuntos
Envelhecimento/sangue , Lipidômica , Lipídeos/sangue , Obesidade/metabolismo , Caracteres Sexuais , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Metabolismo dos Lipídeos , Masculino , Menopausa/sangue , Pessoa de Meia-Idade , Circunferência da Cintura
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1286-1290, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867437

RESUMO

Objective: To study and establish the percentile reference values of waist circumference (WC) for Chinese children aged 3-7 years. Methods: A total of 26 480 children aged 3-7 years were collected as part of the National Survey on Physical Growth and Development of Children in nine cities (Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou and Kunming) in China from June to November 2015. Sex- and age-specific smoothed percentile reference values of WC were established using the Lambda Mu Sigma method. The P(75) and P(90) curves of WC for children aged 3-7 years in this study were linked with the published P(75) and P(90) cut-off points for Chinese children and adolescents aged 7-18 years. The P(50) percentile of WC in this study was compared with the corresponding percentiles of several foreign studies. Results: The P(5), P(10), P(15), P(20), P(25), P(50), P(75), P(80), P(85), P(90) and P(95) reference values of WC were obtained for boys and girls aged 3-7 years biannually, at the interval of every six months. Results showed that WC at the P(50) had significantly increased from 47.5 cm at the age of 3 to 54.2 cm at the age of 7 for boys and from 47.0 cm at the age of 3 to 52.2 cm for girls at the age of 7. The corresponding WC percentile values appeared a bit higher in boys than those in girls at the same age, with the differences from 0.4 to 3.6 cm. The differences between measured and fitted WC at each empirical percentile ranged from -0.3 to 0.5 cm for both boys and girls aged 3-7 years. The P(75) and P(90) values of WC for boys and girls aged 3-7 years in this study presented a consistent, continuous tendency on age with the published WC cut-off points (P(75) and P(90)) for Chinese children and adolescent aged 7-18. The increasing trend of WC by age in Chinese children aged 3-7 years was consistent with those of foreign studies, at the middle level for boys and lower middle level for girls. Conclusions: Through this study, we established the WC percentile values for Chinese children aged 3-7 years and achieved the continuity in age with the published WC cut-off points for Chinese children and adolescents aged 7-18. These established WC percentile values can be used as reference for clinical practice, health care and scientific research.


Assuntos
Circunferência da Cintura , Criança , Pré-Escolar , China , Cidades , Feminino , Humanos , Masculino , Valores de Referência
6.
PLoS One ; 15(9): e0236693, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870909

RESUMO

The prevalence of metabolic syndrome (MetS) is increasing worldwide, and diet therapy plays a key role in treating this disease. Since most patients show difficulties in adhering to nutritional interventions, research on the association of positive psychological characteristics with greater engagement in physical health is relevant to this field. The present study aimed to evaluate the association between positive psychology attributes (optimism, hope, self-esteem, positive/negative affect and life satisfaction) and changes in diet quality and anthropometric parameters of individuals with MetS who received nutritional counseling. The study assessed 63 patients at a nutrition outpatient clinic. Anthropometric parameters and 24-hour food recall data (for evaluation of the Brazilian Healthy Eating Index-Revised-BHEI-R) were collected at the first visit and subsequent return visit (on average five months later). Psychological data were collected at the first visit using validated and standardized scales. The results were adjusted in relation to the depression scores of the patients, which were evaluated using the Beck Depression Inventory-II (BDI-II). Changes in anthropometric factors and in the BHEI-R were assessed, and their associations with the psychological attributes were investigated. The results indicated that positive affect and hope were associated with improvement in the BHEI-R scores (Cohen effect sizes -0.65 and -0.58; p = 0.012 and 0.025, respectively). A significant association was also observed between optimism and a reduction in abdominal circumference (Cohen effect size 0.56; p = 0.031). The associations remained significant even after adjusting for the BDI-II scores (p = 0.022, p = 0.037 and p = 0.05, respectively). No statistically significant associations were observed for the other attributes assessed.The study suggests that some attributes may have a greater influence on the nutritional treatment of MetS and that future studies should be conducted in order to enable effective multidisciplinary interventions to treat MetS.


Assuntos
Síndrome Metabólica/dietoterapia , Síndrome Metabólica/psicologia , Otimismo , Adulto , Idoso , Atitude Frente a Saúde , Brasil/epidemiologia , Dieta , Dieta Saudável , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Estado Nutricional , Circunferência da Cintura
7.
Medicine (Baltimore) ; 99(37): e22202, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925796

RESUMO

Metabolic syndrome (MetS), mainly caused by intra-abdominal fat (IAF) accumulation, is an important risk factor for cardiovascular disease. The prevalence of MetS increases rapidly after the age of 40 years, and it is presumed that there is a substantial proportion of MetS in younger age groups. However, the association of IAF with MetS in adults aged 20 to 30 years has not been fully investigated.This study aimed to determine the prevalence of MetS and to verify whether IAF accumulation is associated with other MetS-related metabolic disorders including dyslipidemia, high blood pressure, and high blood glucose among the Japanese population in their 20s.In this cross-sectional study, IAF area (IAFA) and MetS-related metabolic parameters were evaluated in university students in their 20s (n = 1822, 21.5 ±â€Š1.5 years). IAFA was measured using a non-invasive device, DUALSCAN, which can be readily measured through the dual impedance method. The participants were divided into four groups according to IAFA: 0-49.9, 50-74.9, 75-99.9, and ≥100 cm.MetS was prevalent in 3.3% and 0.0% of the males and females, respectively, according to the Japanese criteria of MetS. The sex- and lifestyle-adjusted odds ratios (ORs) for the three metabolic component levels of Mets were elevated in the larger IAFA groups compared to the smallest IAFA group, according to the level of IAFA. The levels particularly increased in participants with abdominal obesity, defined by both, IAFA and waist circumference rather than by waist circumference alone.IAF accumulation was significantly associated with MetS-related metabolic disorders in young adults. An evaluation of IAFA may contribute to the early prediction of the risk of developing MetS in the future.


Assuntos
Síndrome Metabólica/epidemiologia , Obesidade Abdominal/epidemiologia , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Pesos e Medidas Corporais , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Gordura Intra-Abdominal/fisiopatologia , Estilo de Vida , Lipídeos/sangue , Masculino , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
8.
J Assoc Physicians India ; 68(10): 29-33, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32978922

RESUMO

Introduction: Obesity is associated with insulin resistance and measuring it in an apparently healthy population and correlating them with established risk parameters may identify predisposed individuals who may later develop diabetes or cardiovascular diseases. Material and Methods: 405 participants from a rural area were investigated for various metabolic parameters and indices of insulin resistance. Insulin resistance indices were evaluated in the 3 different groups [Obese Metabolic Syndrome (MetS), Lean MetS and those without MetS]. Various anthropometric and metabolic parameters were compared. Lean MetS is defined as those having waist criteria below the region specific waist criteria and even then satisfying the definition of MetS as per the NCEP ATP-III criteria. Results: The mean fasting insulin level was 7.69+4.38 uIU/ml in normal population, 10.40+5.65 uIU/ml in Lean MetS population and 13.71+6.63 uIU/ml in Obese MetS population (P<0.05). The HOMA-IR2 measured was 2.39+ 1.69 in normal population, while in the Lean MetS and Obese Mets were 3.99+3.40 and 4.04+2.53, respectively (P<0.05). The QUICKI level measured was 0.358+0.041 in normal population and 0.334+0.037 and 0.316+0.026 respectively in the Lean MetS and Obese MetS (P<0.05). McAuley index measured in normal population was 0.49+0.26 and 0.75+0.25 and 0.79+0.17 in the Lean MetS and Obese MetS population (P<0.05).TyG index measured was 8.51+0.46 in normal population and 9.27+0.56 and 9.06+0.49 respectively in the Lean MetS and Obese MetS (P<0.05). Conclusion: Insulin resistance indices are elevated in MetS compared to the normal population but the indices in Lean MetS are not different from Obese MetS. The relevance of ethnicity specific waist circumference may need re-evaluation considering its little impact in influencing the level of insulin resistance.


Assuntos
Resistência à Insulina , Síndrome Metabólica/epidemiologia , Índice de Massa Corporal , Jejum , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Circunferência da Cintura
9.
Revista Digital de Postgrado ; 9(2): 225, ago. 2020. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1103378

RESUMO

Las medidas antropométricas resultan de utilidad para evaluar el estado nutricional, son fáciles de obtener cuando se aplican a poblaciones de ancianos ambulantes. Objetivo: evaluar antropométricamente un grupo de adultos mayores; para ello se midieron las variables: edad, peso, talla, Circunferencia de cintura (CC), perímetro de pantorrilla (PP) y se calcularon IMC, ICT, IPCC y %GC. Métodos: Se seleccionó un grupo de adultos mayores, quienes asistieron a la consulta en una clinica privada, del área metropolitana de Caracas, durante los mese de junio y octubre de 2015. Se determinaron los indicadores IMC, CC, PP, ICT, IPCC y %GC, para clasificar, según las categorías de cada uno, a los adultos, y evaluar su estado nutricional. Resultados: Los resultados indican edad 71,9±7,9 años, peso 67,1±13,9, talla 157,6±9,2 cm, CC 93,7±12,2, PP 33,7±4,1, IMC 26,9±4,7, ICT 0,60±0,08, IPCC 0,71±0,10 y %GC 40,4±7,7. Desnutrición según el PP 42,3%(M) y 15,6%(F); Sobrepeso según IMC 69,1%(M) y 62,9% (F); obesidad 30,8% (M) y 37.1%(F). Riesgo elevado y riesgo muy elevado, según la CC, 42,1% (M) y 20,6% (F), y 58,9% (M) y 77,4% (F), respectivamente. ICT revela obesidad 20,7% (M) y 62,2% (F); IPCC riesgo 78,2% (M) y 49,6% (F); %GC obesida 95,5% (M) y 98,3% (F). Correlaciones altas entre CC-ICT, Peso-IMC, Peso-CC, Peso-IPCC (r ≥ 0,80 y p<0,001). Conclusión: los indicadores son muy útiles para evaluar el estado nutricional, y disponer de varios de ellos, permite complementar la evaluación nutricional en el adulto mayor(AU)


Anthropometric measurements are useful for evaluating nutritional status, they are easy to obtain when applied to ambulatory elderly populations. Objective: to anthropometrically evaluate a group of older adults; For this, the variables: age, weight, height, waist circumference (CC), calf circumference (PP) were measured and BMI, ICT, IPCC and% GC were calculated. Methods: A group of older adults was selected, who attended the consultation in a private clinic, in the Caracas metropolitan area, during the months of June and October 2015. The indicators BMI, CC, PP, ICT, IPCC and% GC were determined. To classify, according to the categories of each, adults, and assess their nutritional status. Results: The results indicate age 71.9 ± 7.9 years, weight 67.1 ± 13.9, height 157.6 ± 9.2 cm, CC 93.7 ± 12.2, PP 33.7 ± 4.1, BMI 26.9 ± 4.7, ICT 0.60 ± 0.08, IPCC 0.71 ± 0.10 and% GC 40.4 ± 7.7. Malnutrition according to the PP 42.3% (M) and 15.6% (F); Overweight according to BMI 69.1% (M) and 62.9% (F); obesity 30.8% (M) and 37.1% (F). According to the CC, high risk and very high risk, 42.1% (M) and 20.6% (F), and 58.9% (M) and 77.4% (F), respectively. ICT reveals obesity 20.7% (M) and 62.2% (F); IPCC risk 78.2% (M) and 49.6% (F); % GC obesity 95.5% (M) and 98.3% (F). High correlations between CC-ICT, Weight-BMI, Weight-CC, Weight-IPCC (r ≥ 0.80 and p <0.001). Conclusion: the indicators are very useful to assess nutritional status, and having several of them, allows to complement the nutritional evaluation in the elderly(AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Idoso , Índice de Massa Corporal , Estado Nutricional , Circunferência da Cintura , Composição Corporal , Antropometria
10.
Medicine (Baltimore) ; 99(30): e20923, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791673

RESUMO

Overweight and obesity in childhood are associated with early cardiovascular dysfunction and promote heightened risk of cardiovascular morbidity and mortality in adulthood. Waist circumference (WC) correlates with visceral obesity, which is why obese children with elevated WC need to be carefully monitored to prevent long-term cardio-metabolic complications. The purpose of our study was to establish if WC could be a predictor of cardiovascular complications in children.The authors conducted a retrospective study that included 160 overweight and obese children and adolescents, aged 6 to 18 years. Patients were evaluated completely anthropometrically, biologically, and imagistic. The anthropometric data tracked were height, weight, WC, and body mass index. Echocardiography evaluated the following parameters: the interventricular septum, left ventricular mass, the relative thickness of the ventricular wall, the pathological epicardial fat.Our results confirm that the presence of visceral obesity was significantly associated (χ = 11.72, P = .0006) with pathological epicardial fat. In children, visceral obesity is not a risk factor for vascular or cardiac impairment, but in adolescents, the results showed that visceral obesity is an important predictive factor for the occurrence of vascular (AUC = 0.669, P = .021) and cardiac (AUC = 0.697, P = .037) impairment. Concentric left ventricular (LV) hypertrophy is significantly influenced by the presence of visceral obesity (AUC = 0.664, P = .013 children; AUC = 0.716, P = .026 adolescents).WC above the 90th percentile is a predictive factor for increased LVM index and concentric hypertrophy in both children and adolescents.


Assuntos
Doenças Cardiovasculares/etiologia , Obesidade Abdominal/complicações , Obesidade Pediátrica/complicações , Circunferência da Cintura , Adolescente , Doenças Cardiovasculares/diagnóstico por imagem , Criança , Ecocardiografia , Feminino , Humanos , Masculino , Estudos Retrospectivos
11.
PLoS One ; 15(8): e0237336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790774

RESUMO

This study aims to investigate the prevalence and factors associated with abdominal obesity in climacteric women assisted at Family Health Strategy units of the city of Montes Claros, State of Minas Gerais, Brazil. It is a cross-sectional analytical study. The women were selected by probabilistic sampling from August 2014 to August 2015. A questionnaire containing information referring to sociodemographic and economic characteristics, behavioral characteristics and clinical data was used. To estimate abdominal obesity, the measure of circumference ≥ 88 cm was considered. To analyze the association between abdominal obesity and the independent variables, a bivariate analysis was performed by means of Pearson's chi-square test (p≤0.25). Subsequently, a multiple Poisson regression analysis with robust variance was performed, through which prevalence ratios with level of significance of 5% (p<0.05) were obtained. A total of 805 women were evaluated, aged 40 to 65 years, and the prevalence of women with abdominal obesity was 62.4%. The mean and median of abdominal circumference were 93.0 cm. The associated variables were being sedentary (PR = 1.44) or irregularly active (PR = 1.39), presenting altered total cholesterol (PR = 1.21), and being hypertensive (PR = 1.31). The abdominal obesity in climacteric women was associated with physical inactivity, total cholesterol and arterial hypertension. The measurement of abdominal circumference must be valued and adopted in the routine of professionals who work in Primary Care.


Assuntos
Obesidade Abdominal/epidemiologia , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Hipertensão/sangue , Hipertensão/complicações , Menopausa , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Prevalência , Fatores de Risco , Comportamento Sedentário , Fatores Socioeconômicos , Circunferência da Cintura
12.
J Assoc Physicians India ; 68(8): 51-54, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32738842

RESUMO

Background and objective: Nonalcoholic fatty liver disease (NAFLD) is conventionally considered to be a disease of obese subjects. Recent data suggests increasing incidence of NAFLD among lean subjects also. The aim of this study was to evaluate the metabolic profile of lean subjects with NAFLD and compare it with obese subjects with NAFLD. We also aimed to compare the same with lean subjects without NAFLD. Methods: This study included 250 subjects with NAFLD and 500 non-NAFLD controls. Clinical, anthropological and biochemical data were collected. Subjects with body mass index (BMI) >= 25 kg/m2 were taken as obese and subjects with BMI <25 kg/m2 were taken as lean. Study population was divided into four groups i.e. lean subjects with NAFLD (LN), obese subjects with NAFLD (ON), lean subjects without NAFLD (LNN) and obese subjects without NAFLD (ONN). Results: Out of 250 NAFLD subjects, 69 (27.6%) were lean. Out of 69 lean subjects with NAFLD, 54 (78.3%) were having diabetes mellitus. Metabolic profile (including lipid profile, diabetic profile) of lean subjects with NAFLD was significantly abnormal in comparison to lean non-NAFLD subjects. Proportion of subjects with metabolic syndrome was also comparable in both lean and obese NAFLD groups. Despite having comparable BMI, LN groups had significantly higher waist circumference (WC) than LNN. Mean total cholesterol, triglyceride, LDL were significantly higher in obese NAFLD in comparison to lean NAFLD. Mean HDL and VLDL were comparable among both groups. Mean FBS, HbA1c, fasting insulin and HOMA-IR were significantly higher among lean NAFLD group in comparison to obese NAFLD group. Obese NAFLD group had significantly higher levels of SGPT and SGOT as compared to lean NAFLD group. Conclusion: Lean NAFLD has significantly higher WC in comparison to non-NAFLD counterparts suggesting possible association with central adiposity. Lean and obese NAFLD share common set of metabolic abnormalities, albeit with varying intensity. Lean NAFLD has more severe insulin resistance in comparison to obese NAFLD. Lean NAFLD subjects appeared to have less severe transaminasemia.


Assuntos
Resistência à Insulina , Hepatopatia Gordurosa não Alcoólica , Índice de Massa Corporal , Humanos , Metaboloma , Obesidade , Circunferência da Cintura
13.
Braz J Med Biol Res ; 53(10): e9815, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32813851

RESUMO

Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.


Assuntos
Pescoço , Adulto , Idoso , Índice de Massa Corporal , Brasil , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Fatores de Risco , Circunferência da Cintura
14.
Yonsei Med J ; 61(7): 579-586, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32608201

RESUMO

PURPOSE: The impact of changes in body mass index and waist circumference on the development of metachronous colorectal neoplasia (CRN) after polypectomy has rarely been examined. We evaluated the association between changes in overall/abdominal obesity and metachronous CRN risk. MATERIALS AND METHODS: We studied patients who underwent ≥1 adenoma removal and surveillance colonoscopy. Patients were classified into the following four groups based on the changes in overall obesity from index to follow-up colonoscopy: non-obesity persisted (group 1), obesity to non-obesity (group 2), non-obesity to obesity (group 3), and obesity persisted (group 4). Patients were also divided into another four groups based on similar changes in abdominal obesity (groups 5-8). RESULTS: The number of patients in groups 1, 2, 3, and 4 was 5074, 457, 643, and 3538, respectively, and that in groups 5, 6, 7, and 8 was 4229, 538, 656, and 2189, respectively. Group 4 had a significantly higher risk of metachronous CRN compared to groups 1 and 2. However, metachronous advanced CRN (ACRN) risk was not different among groups 1, 2, 3, and 4. Metachronous CRN risk in group 8 (abdominal obesity persisted) was higher than that in groups 5 (non-abdominal obesity persisted) and 7 (non-abdominal obesity to abdominal obesity), and tended to be higher than that in group 6 (abdominal obesity to non-abdominal obesity). Additionally, group 8 had a significantly higher risk of metachronous ACRN compared to groups 5, 6, and 7. CONCLUSION: Changes in obesity affected the metachronous CRN risk. In particular, changes in abdominal obesity affected the metachronous ACRN risk.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/patologia , Segunda Neoplasia Primária/patologia , Obesidade Abdominal/complicações , Obesidade/complicações , Adulto , Índice de Massa Corporal , Pólipos do Colo/epidemiologia , Pólipos do Colo/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Segunda Neoplasia Primária/cirurgia , Obesidade/epidemiologia , Obesidade Abdominal/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Circunferência da Cintura/fisiologia
15.
PLoS One ; 15(7): e0236451, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32697789

RESUMO

BACKGROUND: Lifestyle habits associate with metabolic health in overall populations. Whether such association is similar among subjects with a different nutritional status has been less studied. We aimed to (i) determine the prevalence of metabolic phenotypes in Chile, and (ii) determine the association between lifestyle habits and metabolic health according to the nutritional status. METHODS: The National Health Survey of Chile 2016-2017 was analyzed. A metabolically unhealthy phenotype was defined as manifesting ≥3 of the following risk factors: elevated blood pressure, elevated triglycerides, elevated glucose, elevated waist circumference, or reduced high-density lipoprotein cholesterol. Individuals manifesting <2 risk factors were considered as healthy. The nutritional status was defined as normal weight (18.5 to <25 kg/m2), overweight (25 to <30 kg/m2) or obesity (≥30 kg/m2). Questionnaires were used to estimate smoking habits, alcohol intake, sedentary behavior, moderate-vigorous physical activity, fruits/vegetables consumption, and fish/seafood consumption. The association (odds ratio [95%CI]) between lifestyle habits and metabolic health was determined within each nutritional status, adjusting for age, sex, BMI (in kg/m2), and education. RESULTS: The prevalence of a metabolically unhealthy phenotype was 36% in the overall sample. Such a prevalence was 7%, 33% and 58% among subjects with normal weight, overweight and obesity, respectively. In subjects with normal weight, the highest quartile of fruits/vegetables consumption was associated with reduced odds of having a metabolically unhealthy phenotype (0.09 [0.01-0.48]). In subjects with obesity, the highest quartile of moderate-vigorous physical activity was associated with reduced odds of having a metabolically unhealthy phenotype (0.29 [0.09-0.91]). CONCLUSION: One third of the Chilean population manifests an unhealthy phenotype. We identified associations between lifestyle habits and metabolic health that are specific to the nutritional status. Thus, emphasizing fruits/vegetables consumption in subjects with normal weight, and physical activity in subjects with obesity, may maximize the benefits of public health interventions.


Assuntos
Hábitos , Estilo de Vida , Síndrome Metabólica/epidemiologia , Estado Nutricional/fisiologia , Adolescente , Adulto , Idoso , Glicemia/análise , Chile/epidemiologia , HDL-Colesterol/sangue , Estudos Transversais , Escolaridade , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/metabolismo , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/metabolismo , Sobrepeso/sangue , Sobrepeso/epidemiologia , Sobrepeso/metabolismo , Prevalência , Fatores de Risco , Circunferência da Cintura/fisiologia , Adulto Jovem
16.
Ecotoxicol Environ Saf ; 203: 111009, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32684521

RESUMO

BACKGROUND: Polybrominated diphenyl ethers (PBDEs) exist extensively in the environment. Toxicological studies suggested PBDEs may interfere with adipogenic pathways. However, few human evidence addressed PBDE exposures in utero related to childhood adiposity. OBJECTIVE: We assessed associations between PBDEs concentrations in cord serum and childhood adiposity measures at 7 years. METHODS: Among 318 mother-child pairs from Sheyang Mini Birth Cohort Study (SMBCS) in China, nine PBDE congener concentrations were quantified in umbilical cord serum using gas chromatography-negative chemical ionization mass spectrometry (GC-NCI-MS). Anthropometric indicators of children aged 7 years were measured, including weight, height and waist circumference. Age and sex-specific body mass index (BMI) z scores were calculated based on World Health Organization (WHO)'s child growth standards. Multivariate linear and logistic regression models adjusted for putative confounders were performed to examine associations between PBDE congeners and adiposity parameters. RESULTS: BDE-209 was the most abundant congener of PBDEs with a median value of 19.5 ng/g lipid. The geometric mean values of nine PBDE congeners ranged from below limit of detection (LOD) to 18.1 ng/g lipid, and the detection rates were 46.5%~96.5%. Cord serum BDE-153 and BDE-154 concentrations were associated with lower childhood BMI z score (regression coefficient, ß=-0.15, 95% confidence interval: -0.29, -0.02; p=0.02; ß=-0.23, 95%CI: -0.43, -0.03; p=0.03, respectively) and lower waist circumference (ß=-0.75 cm, 95%CI: -1.43, -0.06; p=0.03; ß=-1.22 cm, 95%CI: -2.23, -0.21; p=0.02, respectively), after controlling for potential confounders. Moreover, prenatal BDE-154 exposure was related to a decreased obesity risk of children aged 7 years (odds ratio, OR=0.46, 95%CI: 0.22, 0.94; p=0.03). These effects were only observed among boys in sex-straitified analyses. CONCLUSIONS: Cord serum BDE-153 and BDE-154 concentrations were related to reduced adiposity measures at 7 years of age. Further evidence regarding the impacts of prenatal PBDE exposures on childhood development is warranted.


Assuntos
Adiposidade , Poluentes Ambientais/sangue , Sangue Fetal/química , Éteres Difenil Halogenados/sangue , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Índice de Massa Corporal , Criança , China/epidemiologia , Estudos de Coortes , Poluentes Ambientais/química , Feminino , Éteres Difenil Halogenados/química , Humanos , Masculino , Gravidez , Circunferência da Cintura
17.
Medicine (Baltimore) ; 99(27): e21140, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629750

RESUMO

INTRODUCTION: Treating blood stasis is effective in treating obesity and metabolic diseases in traditional Korean medicine. The aim of this prospective observational study is to determine the effectiveness of the diagnosis index for metabolic diseases with blood stasis by analyzing clinical data and blood samples. METHODS AND ANALYSIS: We will perform a prospective observational study. Participants who meet the inclusion criteria will be recruited from the Dongguk university Ilsan Oriental hospital. The outcomes are resistin, serum amyloid P component, C-reactive protein, D-dimer, and blood stasis scores. In addition, the blood pressure, ankle-brachial pressure index, brachial-ankle pulse wave velocity, body mass index, waist circumference, and levels of blood lipid will be assessed. DISCUSSION: Through this study, we could collect specific data for diagnosing metabolic diseases with blood stasis. Therefore, the findings of this study will provide a summary of the current state of evidence regarding the effectiveness of the diagnosis index in managing metabolic disease with blood stasis. ETHICS AND DISSEMINATION: The study was approved by the Institutional Review Board of the Dongguk University Ilsan Oriental Hospital (DUIOH-2018-09-001-007). The results will be published in a peer-reviewed journal and will be disseminated electronically and in print. TRIAL REGISTRATION NUMBER: Clinical Research Information Service: KCT0003548.


Assuntos
Medicina Tradicional Coreana/métodos , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/terapia , Língua/irrigação sanguínea , Adulto , Idoso , Índice Tornozelo-Braço/métodos , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Feminino , Humanos , Lipídeos/sangue , Masculino , Doenças Metabólicas/complicações , Doenças Metabólicas/metabolismo , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Onda de Pulso/métodos , República da Coreia/epidemiologia , Língua/patologia , Circunferência da Cintura/fisiologia
18.
PLoS One ; 15(6): e0235049, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603369

RESUMO

BACKGROUND: Short sleep duration has been suggested to lead to insulin resistance both directly by altering glucose metabolism and indirectly through obesity. This study aims to investigate associations between nocturnal sleep duration and insulin resistance considering abdominal obesity as a mediator. METHODS: We analysed data of 3 900 children aged 2-15 years participating in the second (2009/10) and third (2013/14) examination wave of the European IDEFICS/I.Family study (hereafter referred to as baseline and follow-up). Information on nocturnal sleep duration was collected by questionnaires and age-standardised (SLEEP z-score). The homeostasis model assessment (HOMA) was calculated from fasting insulin and fasting glucose obtained from blood samples; waist circumference (WAIST) was measured with an inelastic tape. HOMA and WAIST were used as indicators for insulin resistance and abdominal obesity, respectively, and transformed to age- and sex-specific z-scores. Cross-sectional and longitudinal associations between SLEEP z-score and HOMA z-score were investigated based on a path model considering WAIST z-score as a mediator adjusting for relevant confounders. RESULTS: Cross-sectionally, baseline SLEEP z-score was negatively associated with baseline WAIST z-score (unstandardised effect estimate -0.120, 95% confidence interval [-0.167; -0.073]). We observed no direct effect of baseline SLEEP z-score on baseline HOMA z-score but a negative indirect effect through baseline WAIST z-score (-0.042 [-0.058; -0.025]). Longitudinally, there was no direct effect of baseline SLEEP z-score on HOMA z-score at follow-up but a negative indirect effect through both baseline WAIST z-score and WAIST z-score at follow-up (-0.028 [-0.040; -0.016]). CONCLUSIONS: Our results do not support the hypothesis of an association between short sleep duration and insulin resistance independent of abdominal obesity. However, longer sleep duration may exert short and long term beneficial effects on insulin resistance through its beneficial effects on abdominal obesity.


Assuntos
Resistência à Insulina , Obesidade Abdominal/epidemiologia , Sono , Adolescente , Glicemia/análise , Criança , Pré-Escolar , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Insulina/sangue , Estudos Longitudinais , Masculino , Circunferência da Cintura
19.
PLoS One ; 15(7): e0235977, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730260

RESUMO

OBJECTIVES: To quantify the link between four different types of social ties and objective measures of abdominal and general obesity, and to explore their inter-relationships in association with obesity using a gender-sensitive analysis. METHODS: A cross-sectional analysis of 28,238 adults (45-85 years) from the baseline Canadian Longitudinal Study on Aging Comprehensive cohort (2012-15). Social ties (marital status, living arrangement, social network size, and social participation) and measured anthropometry (body mass index, waist circumference) were analyzed using linear and logistic regression models with interaction terms conditioned on known confounders. RESULTS: We found that being single, widowed or divorced/separated was associated with worse anthropometric outcomes in women, including higher odds of both abdominal and general obesity, and that associations were enhanced when combined with limited social participation, lone-living and greater social network size. Few clear associations were observed in men. Limited social participation (no social activities at least once/month) among women was associated with larger waist circumference (+4.19 cm [95% CI: 1.86, 6.52]) and higher odds of both abdominal and general obesity. By contrast, associations appeared to be reversed in men: lone-living and smaller social networks were associated with lower odds of obesity, compared to co-living and larger social networks. We also found that more regular social participation can potentially mitigate the adverse associations between non-partnership (single, divorced) and obesity in women. Overall, the combined influence of two types of social tie deficits on excess weight measures was more pronounced in women than men. CONCLUSIONS: Results highlight the importance of considering how the role of social ties for obesity prevention may differ for women and men. Frequent social participation and number of social contacts may matter for assessing whether divorced, single or lone-living older women are at risk of obesity while living arrangement and social contacts may matter for obesity in men.


Assuntos
Envelhecimento/fisiologia , Índice de Massa Corporal , Relações Interpessoais , Obesidade/epidemiologia , Participação Social , Idoso , Canadá/epidemiologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Circunferência da Cintura
20.
Rev Med Chil ; 148(1): 69-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32730438

RESUMO

BACKGROUND: The functional fitness of older people may be associated with their nutritional status. AIM: To assess the association between of anthropometric measures with functional fitness in older people. MATERIAL AND METHODS: Cross-sectional study conducted in 75 participants aged 65 to 89 years. Body mass index (BMI), waist-to-height ratio (WHtR), fat mass (FM) and skeletal muscle mass index (SMI) were calculated from anthropometric measures. The functional fitness was determined using the Senior Fitness Test battery. RESULTS: BMI and FM indicated obesity, and WHtR indicated cardiometabolic risk in 49%, 55% and 83% of participants, respectively. SMI indicated a low muscle mass in 91% of females. Performance standards of chair stand, arm curl, 2-min step test and 8-foot up-and-go tests were met in 1%, 8%, 1% and 89% of participants, respectively. Significant negative correlations were found between 2-min step test and BMI, WHtR and FM (r = -0.26, -0.31 and -0.48 respectively). Back scratch had a negative correlation with BMI (r = -0.23) and SMI (rho = -0.28). Significant positive correlations were found between 8-foot up-and-go, WHtR (rho = 0.28) and FM (rho = 0.23), and between 2-min step test and SMI (rho = 0.28). The coefficient of determination (R2) between 2-min step test with BMI, WHtR and FM were 0.05, 0.08 and 0.22, respectively, while the R2 between back scratch and BMI was 0.04. Multiple regression models indicated that FM affected the 2-min step test independently of BMI and WHtR (adjusted R2 = 0.22), however age and sex negatively influenced these associations. CONCLUSIONS: Functional fitness of older adults is influenced by nutritional anthropometric measures, particularly BMI, WHtR and FM for aerobic capacity, and BMI for upper limb flexibility.


Assuntos
Estado Nutricional , Razão Cintura-Estatura , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Obesidade , Circunferência da Cintura
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