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1.
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
2.
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
3.
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
4.
Ann Epidemiol ; 46: 20-23, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32532369

RESUMO

PURPOSE: This study investigates the predictive effects of body mass index (BMI) and waist circumference (WC) for all-cause mortality in old age over 27 years of follow-up. METHODS: Participants were from the Berlin Aging Study (n = 444, M ± SD = 84.55 ± 8.38 years). Reported significance values for hazard ratios were adjusted for age, sex, socioeconomic status, smokers, depressive illness, functional status, cholesterol, and objectively assessed physical diseases. RESULTS: BMI emerged as a significant predictor of all-cause mortality after adjustment. WC was not a significant predictor of mortality either within the unadjusted model or when fully adjusted, including BMI. After the introduction of WC alongside all covariates, the effect for BMI remained significant. A significant quadratic effect for BMI and mortality within the fully adjusted model also emerged. CONCLUSIONS: Our results suggest that lower BMI in the oldest old is associated with increased mortality hazards, and risks were particularly elevated for people who are underweight. This study found no evidence that higher BMI in old age is associated with increased mortality hazards relative to normal weight ranges.


Assuntos
Envelhecimento/fisiologia , Índice de Massa Corporal , Circunferência da Cintura/fisiologia , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Feminino , Seguimentos , Alemanha/epidemiologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Obesidade/mortalidade , Relação Cintura-Quadril
5.
PLoS One ; 15(6): e0234316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520942

RESUMO

Handgrip strength (HGS) is a well-established indicator of muscle strength and can help to identify risk of sarcopenic obesity in children. This study explores the relationship between adiposity and muscular strength in healthy Chilean adolescents. Adolescents (n = 491) aged 10-17 were selected from five schools in Santiago, Chile. HGS was determined by dynamometry. Anthropometry (weight, height, waist and mid arm circumference), physical activity and socioeconomic status were also measured. Relative HGS (RHGS) was calculated by dividing maximum HGS of the dominant hand by body-mass index (BMI) and low RHGS was categorized as <25th percentile by sex. Logistic regression was used to determine the relationship between two markers of adiposity (abdominal obesity category by waist circumference and nutritional status measured by BMI category) and low RHGS, adjusting for possible confounding variables. Participants were on average 13.6y (2.4), 32.8% were overweight or obese and 37.5% were at risk of or had abdominal obesity. RHGS was 1.25 kg/kg/m2 overall, with a significant difference by sex (1.51 for boys versus 1.14 for girls). In adjusted analyses, boys and girls with risk of abdominal obesity, had 3.3 (1.6-6.6) and 4.1 (1.8-9.3) increased odds of low RHGS, respectively, compared to boys and girls with normal waist circumference. Those with abdominal obesity compared to normal WC, had 8.5 (3.4-21.4) and 6.5 (2.0-21.3) increased odds of low RHGS for boys and girls, respectively. We observed similar associations for BMI category. In our sample of healthy adolescents, higher adiposity related to greater odds of low muscle strength measured by dynamometry. Considering the demographic shift from a young to an aging population in many countries, along with the increasing prevalence of obesity beginning in childhood, understanding how adiposity relates to low muscle strength is of growing importance.


Assuntos
Força da Mão/fisiologia , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Adiposidade/fisiologia , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Avaliação Nutricional , Estado Nutricional , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/metabolismo , Obesidade Pediátrica/fisiopatologia , Prevalência , Fatores de Risco , Circunferência da Cintura/fisiologia
6.
Int J Behav Nutr Phys Act ; 17(1): 41, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32345327

RESUMO

OBJECTIVES: While studies exist on the association between screen time and cardiometabolic risk among adolescents, research examining the effect of screen time on cardiometabolic risk in young children is lacking. The primary objective of this study was to examine the association between daily screen time and cardiometabolic risk (CMR) [sum of age- and sex-standardized z-scores of systolic blood pressure (SBP), glucose, log-triglycerides, waist circumference (WC), and negative high-density lipoprotein (HDL) cholesterol divided by the square root of five] in young children. Secondary objectives included examining individual CMR risk factors, including waist-to-height ratio and non high-density lipoprotein (non-HDL) cholesterol, as well as the individual cut-offs of these risk factors. Additional analyses include examining the association between screen time and CMR by handheld/non-handheld devices. METHODS: A study was conducted among young children 3 to 6 years from the TARGet Kids! practice-based research network in Toronto and Montreal, Canada. Children with one or more measures of screen time and CMR were included in this study. Generalized estimating equation (GEE) multivariable linear regressions and multivariable logistic regressions, using published cut-offs, were conducted to evaluate these associations. RESULTS: Data from 1317 children [mean age 52 months (SD = 13.36), 44.34% female] were included for analyses. There was no evidence of associations between screen time and total CMR score or individual risk factors (p > 0.05) after adjusting for confounders. A statistically significant, but small association between daily screen time and non-HDL cholesterol was found (B = 0.046; CI = [0.017 to 0.075]; p = 0.002. CONCLUSIONS: Though no relationship was reported between daily screen time and the majority of CMR factors in early childhood, there was an association between daily screen time and non-HDL cholesterol. As the relationship between daily screen time and CMR factors may not be apparent in early childhood, studies to evaluate longer-term cardiometabolic effects of screen time are needed. Although there is an evidence-based rationale to reduce screen time in early childhood, prevention of cardiometabolic risk may not be the primary driver.


Assuntos
Doenças Cardiovasculares/epidemiologia , Tempo de Tela , Pressão Sanguínea/fisiologia , Criança , Pré-Escolar , HDL-Colesterol/sangue , Humanos , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura/fisiologia
7.
Obes Facts ; 13(2): 245-255, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32213776

RESUMO

OBJECTIVE: We aimed to investigate the relationships of body mass index (BMI), waist circumference (WC), and obesity defined using a combination of both indexes, with the incidence of hypertension in a Chinese community-based population. METHODS: A total of 1,927 Chinese participants (57.2 ± 8.9 years old) with normal blood pressure at baseline were recruited from the Shijingshan community in Beijing. Incident hypertension was defined as blood pressure ≥140/90 mm Hg, self-reported hypertension, or the use of any antihypertensive medication at the follow-up visit. RESULTS: During 2.3 years of follow-up, 19.1% (n = 97) of the men and 13.6% (n = 158) of the women developed incident hypertension. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for obesity (BMI ≥30) were 3.49 (1.59-7.66) and 2.60 (1.48-4.55) for men and women, respectively. A 1-point increase in BMI was associated with 8% (OR = 1.08, 95% CI: 1.00-1.17) and 10% (OR = 1.10, 95% CI: 1.05-1.16) increases in the incidence of hypertension in men and women, respectively. Abdominal obesity (WC ≥90 cm in men and ≥85 cm in women) was positively associated with incident hypertension in both men (adjusted OR = 1.79, 95% CI: 1.10-2.91) and women (adjusted OR = 1.61, 95% CI: 1.09-2.40). A 1-cm increase in WC was associated with 4% (adjusted OR = 1.04, 95% CI: 1.01-1.07) and 4% (adjusted OR = 1.04, 95% CI: 1.02-1.07) increases in the incidence of hypertension in men and women, respectively. The combination of abnormal BMI and WC has the highest risk for hypertension in both men (adjusted OR = 3.10, 95% CI: 1.48-6.50) and women (adjusted OR = 2.51, 95% CI: 1.43-4.40). CONCLUSIONS: This study shows that BMI, WC, and an index that combined the two are independently associated with incident hypertension in a Chinese community-based population.


Assuntos
Índice de Massa Corporal , Hipertensão/epidemiologia , Circunferência da Cintura/fisiologia , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , China/epidemiologia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Características de Residência/estatística & dados numéricos , Fatores de Risco
8.
PLoS One ; 15(3): e0229576, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134933

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women worldwide. The cardiovascular risk profile deteriorates after women enter menopause. By definition, women diagnosed with premature ovarian insufficiency (POI) experience menopause before 40 years of age, which may render these women even more susceptible to develop CVD later in life. However, prospective long-term follow up data of well phenotyped women with POI are scarce. In the current study we compare the CVD profile and risk of middle aged women previously diagnosed with POI, to a population based reference group matched for age and BMI. METHODS AND FINDINGS: We compared 123 women (age 49.0 (± 4.3) years) and diagnosed with POI 8.1 (IQR: 6.8-9.6) years earlier, with 123 population controls (age 49.4 (± 3.9) years). All women underwent an extensive standardized cardiovascular screening. We assessed CVD risk factors including waist circumference, BMI, blood pressure, lipid profile, pulse wave velocity (PWV), and the prevalence of diabetes mellitus, metabolic syndrome (MetS) and carotid intima media thickness (cIMT), in both women with POI and controls. We calculated the 10-year CVD Framingham Risk Score (FRS) and the American Heart Association's suggested cardiovascular health score (CHS). Waist circumference (90.0 (IQR: 83.0-98.0) versus 80.7 (IQR: 75.1-86.8), p < 0.01), waist-to-hip ratio (0.90 (IQR: 0.85-0.93) versus 0.79 (IQR: 0.75-0.83), p < 0.01), systolic blood pressure (124 (IQR 112-135) versus 120 (IQR109-131), p < 0.04) and diastolic blood pressure (81 (IQR: 76-89) versus 78 (IQR: 71-86), p < 0.01), prevalence of hypertension (45 (37%) versus 21 (17%), p < 0.01) and MetS (19 (16%) versus 4 (3%), p < 0.01) were all significantly increased in women with POI compared to healthy controls. Other risk factors, however, such as lipids, glucose levels and prevalence of diabetes were similar comparing women with POI versus controls. The arterial stiffness assessed by PWV was also similar in both populations (8.1 (IQR: 7.1-9.4) versus 7.9 (IQR: 7.1-8.4), p = 0.21). In addition, cIMT was lower in women with POI compared to controls (550 µm (500-615) versus 684 µm (618-737), p < 0.01). The calculated 10-year CVD risk was 5.9% (IQR: 3.7-10.6) versus 6.0% (IQR: 3.9-9.0) (p = 0.31) and current CHS was 6.1 (1.9) versus 6.5 (1.6) (p = 0.07), respectively in POI versus controls. CONCLUSIONS: Middle age women with POI presented with more unfavorable cardiovascular risk factors (increased waist circumference and a higher prevalence of hypertension and MetS) compared to age and BMI matched population controls. In contrast, the current study reveals a lower cIMT and similar 10-year cardiovascular disease risk and cardiovascular health score. In summary, neither signs of premature atherosclerosis nor a worse cardiovascular disease risk or health score were observed among middle age women with POI compared to population controls. Longer-term follow-up studies of women of more advanced age are warranted to establish whether women with POI are truly at increased risk of developing CVD events later in life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02616510.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Sistema Cardiovascular/fisiopatologia , Insuficiência Ovariana Primária/fisiopatologia , Aterosclerose/sangue , Aterosclerose/metabolismo , Aterosclerose/fisiopatologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/metabolismo , Sistema Cardiovascular/metabolismo , Estudos de Casos e Controles , Diabetes Mellitus/fisiopatologia , Feminino , Glucose/metabolismo , Humanos , Hipertensão/sangue , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Lipídeos/sangue , Menopausa/sangue , Menopausa/metabolismo , Menopausa/fisiologia , Menopausa Precoce/sangue , Menopausa Precoce/metabolismo , Menopausa Precoce/fisiologia , Pessoa de Meia-Idade , Insuficiência Ovariana Primária/sangue , Insuficiência Ovariana Primária/metabolismo , Estudos Prospectivos , Análise de Onda de Pulso/métodos , Fatores de Risco , Rigidez Vascular/fisiologia , Circunferência da Cintura/fisiologia , Relação Cintura-Quadril/métodos
9.
Sci Rep ; 10(1): 4183, 2020 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-32144319

RESUMO

In an exploratory, block-randomised, parallel, double-blind, single-centre, placebo-controlled superiority study (ISRCTN12562026, funded by Cultech Ltd), 220 Bulgarian participants (30 to 65 years old) with BMI 25-34.9 kg/m2 received Lab4P probiotic (50 billion/day) or a matched placebo for 6 months. Participants maintained their normal diet and lifestyle. Primary outcomes were changes in body weight, BMI, waist circumference (WC), waist-to-height ratio (WtHR), blood pressure and plasma lipids. Secondary outcomes were changes in plasma C-reactive protein (CRP), the diversity of the faecal microbiota, quality of life (QoL) assessments and the incidence of upper respiratory tract infection (URTI). Significant between group decreases in body weight (1.3 kg, p < 0.0001), BMI (0.045 kg/m2, p < 0.0001), WC (0.94 cm, p < 0.0001) and WtHR (0.006, p < 0.0001) were in favour of the probiotic. Stratification identified greater body weight reductions in overweight subjects (1.88%, p < 0.0001) and in females (1.62%, p = 0.0005). Greatest weight losses were among probiotic hypercholesterolaemic participants (-2.5%, p < 0.0001) alongside a significant between group reduction in small dense LDL-cholesterol (0.2 mmol/L, p = 0.0241). Improvements in QoL and the incidence rate ratio of URTI (0.60, p < 0.0001) were recorded for the probiotic group. No adverse events were recorded. Six months supplementation with Lab4P probiotic resulted in significant weight reduction and improved small dense low-density lipoprotein-cholesterol (sdLDL-C) profiles, QoL and URTI incidence outcomes in overweight/obese individuals.


Assuntos
Bifidobacterium/fisiologia , Lactobacillus/fisiologia , Obesidade/tratamento farmacológico , Obesidade/microbiologia , Sobrepeso/tratamento farmacológico , Sobrepeso/microbiologia , Probióticos/uso terapêutico , Peso Corporal/fisiologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções Respiratórias , Circunferência da Cintura/fisiologia , Perda de Peso/fisiologia
10.
Prostate ; 80(6): 481-490, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32104919

RESUMO

OBJECTIVE: To investigate the potential mechanism of the effect of metabolic syndrome (MetS) on prostate volume (PV) and the risk of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and the relationships of MetS and the major pathogenic factors of MetS with the clinical progression of BPH/LUTS in older Chinese men. SUBJECTS AND METHODS: We analyzed clinical data obtained from 506 ostensibly healthy men who underwent routine health check-ups and recruited 415 subjects from a group of previously studied men after 4 years. We evaluated the associations of major pathological factors of MetS, including insulin resistance, subclinical inflammatory state, and sex hormone changes, with PV, the risk of BPH and the clinical progression of BPH/LUTS by using multiple linear regression and logistic regression. RESULTS: After adjustment for age, insulin, HOMA (homeostatic model assessment) index, leptin, resistin, adiponectin, C-reactive protein, tumor necrosis factor-α (TNF-α), sex hormone-binding globulin, and testosterone levels were significantly associated with PV (all P < .05), and in the age-adjusted logistic regression model, positive associations of resistin and TNF-α with BPH/LUTS were found (OR, 1.662, P = .007 and OR, 1.044, P < .001, respectively). Predictors of BPH/LUTS clinical progression were significantly correlated with MetS and TNF-α. The group with higher TNF-α levels had a higher rate of newly diagnosed BPH (9.5% vs 19.1%, P = .006) and a greater increase in PV levels (0.61 ± 0.08 vs 1.09 ± 0.35 cm3 , P <.001) after 4 years. CONCLUSIONS: MetS and its pathological factors were associated with an increased PV and an increased risk of BPH/LUTS that is more prone to clinical progression. TNF-α may serve as an early biological indicator to identify which patients with BPH/LUTS are at higher risk of unfavorable outcomes.


Assuntos
Síndrome Metabólica/metabolismo , Síndrome Metabólica/patologia , Hiperplasia Prostática/metabolismo , Hiperplasia Prostática/patologia , Idoso , Pressão Sanguínea/fisiologia , Humanos , Modelos Logísticos , Masculino , Próstata/metabolismo , Próstata/patologia , Circunferência da Cintura/fisiologia
11.
Nat Rev Endocrinol ; 16(3): 177-189, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32020062

RESUMO

Despite decades of unequivocal evidence that waist circumference provides both independent and additive information to BMI for predicting morbidity and risk of death, this measurement is not routinely obtained in clinical practice. This Consensus Statement proposes that measurements of waist circumference afford practitioners with an important opportunity to improve the management and health of patients. We argue that BMI alone is not sufficient to properly assess or manage the cardiometabolic risk associated with increased adiposity in adults and provide a thorough review of the evidence that will empower health practitioners and professional societies to routinely include waist circumference in the evaluation and management of patients with overweight or obesity. We recommend that decreases in waist circumference are a critically important treatment target for reducing adverse health risks for both men and women. Moreover, we describe evidence that clinically relevant reductions in waist circumference can be achieved by routine, moderate-intensity exercise and/or dietary interventions. We identify gaps in the knowledge, including the refinement of waist circumference threshold values for a given BMI category, to optimize obesity risk stratification across age, sex and ethnicity. We recommend that health professionals are trained to properly perform this simple measurement and consider it as an important 'vital sign' in clinical practice.


Assuntos
Obesidade Abdominal/fisiopatologia , Circunferência da Cintura/fisiologia , Índice de Massa Corporal , Feminino , Humanos , Masculino , Obesidade Abdominal/metabolismo
12.
Obesity (Silver Spring) ; 28(3): 537-543, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32090511

RESUMO

OBJECTIVE: The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and high levels of triglycerides. In a cross-sectional assessment of PREDIMED-Plus trial participants at baseline, HTGW phenotype prevalence was evaluated, associated risk factors were analyzed, and the lifestyle of individuals with metabolic syndrome and HTGW was examined. METHODS: A total of 6,874 individuals aged 55 to 75 with BMI ≥ 27 and < 40 kg/m2 were included and classified by presence (HTGW+ ) or absence (HTGW- ) of HTGW (waist circumference: men ≥ 102 cm, women ≥ 88 cm; fasting plasma triglycerides ≥ 150 mg/dL). Analytical parameters and lifestyle (energy intake and expenditure) were analyzed. RESULTS: A total of 38.2% of the sample met HTGW+ criteria. HTGW+ individuals tended to be younger, have a greater degree of obesity, be sedentary, and be tobacco users. They had higher peripheral glucose, total cholesterol, and low-density lipoprotein cholesterol levels; had lower high-density lipoprotein cholesterol levels; and had increased prevalence of type 2 diabetes mellitus. Mediterranean diet (MedDiet) adherence and physical activity were greater in HTGW- patients. Age, BMI, tobacco use, total energy expenditure, hypertension, type 2 diabetes mellitus, and MedDiet adherence were associated with HTGW+ . CONCLUSIONS: HTGW is a highly prevalent phenotype in this population associated with younger age, higher BMI, tobacco use, and decreased MedDiet adherence. HTGW- individuals were more physically active with greater total physical activity, and fewer had hypertension.


Assuntos
Cintura Hipertrigliceridêmica/epidemiologia , Estilo de Vida , Obesidade Abdominal/complicações , Triglicerídeos/sangue , Circunferência da Cintura/fisiologia , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Fatores de Risco
13.
Int J Med Sci ; 17(2): 182-190, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32038102

RESUMO

Background: Fatty acid-binding protein 1 (FABP1) (also known as liver-type fatty acid-binding protein or LFABP) is a protein that is mainly expressed in the liver, and is associated with hepatocyte injury in acute transplant rejection. Reduced levels of FABP1 in mice livers have been shown to be effective against nonalcoholic fatty liver disease (NAFLD). In this study, we investigated the association between plasma FABP1 levels and NAFLD in patients with type 2 diabetes mellitus (T2DM). Methods: We enrolled 267 T2DM patients. Clinical and biochemical parameters were measured. The severity of NAFLD was assessed by ultrasound. FABP1 levels were determined using by enzyme-linked immunosorbent assays. Results: FABP1 levels were higher in patients with overt NAFLD, defined as more than a moderate degree of fatty liver compared to those without NAFLD. Age- and sex-adjusted analysis of FABP1 showed positive associations with body mass index (BMI), waist circumference, homeostasis model assessment estimate of ß-cell function, creatinine, and fatty liver index, but showed negative associations with albumin and estimated glomerular filtration rate (eGFR). The odds ratio (OR) for the risk of overt NAFLD with increasing levels of sex-specific FABP1 was significantly increased (OR 2.63 [95% CI 1.30-5.73] vs. 4.94 [2.25-11.48]). The OR in the second and third tertiles of FABP1 remained significant after adjustments for BMI, triglycerides, high-density lipoprotein cholesterol, HbA1C, homeostasis model assessment estimate of insulin resistance, white blood cell count, hepatic enzymes, and eGFR. Conclusion: Our results indicate that FABP1 may play a role in the pathogenesis of NAFLD in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Proteínas de Ligação a Ácido Graxo/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Idoso , Índice de Massa Corporal , Creatinina/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Razão de Chances , Circunferência da Cintura/fisiologia
14.
Sci Rep ; 10(1): 1924, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024868

RESUMO

Previous studies on Chinese showed mixed results describing the relationship between obesity and mortality. The optimum levels of body mass index (BMI) and waist circumference (WC) are inconsistent. In the Guangzhou Biobank Cohort Study, after excluding ever smokers and those with poor health, 19,405 Chinese (50+ years) recruited from 2003 to 2008 were followed-up until 2017. During an average follow-up of 11.5 (standard deviation = 2.3) years, 1,757 deaths were recorded. All-cause mortality showed a J-shaped association with BMI, with the lowest mortality risks at 22.5 kg/m2 for both men and women. In those with BMI ≥ 22.5 kg/m2, an increase of 5 kg/m2 was associated with 29% higher all-cause mortality (hazard ratio (HR) = 1.29, 95% confidence interval (CI) 1.15-1.46), 30% higher cancer mortality (1.30, 95% CI 1.08-1.57), and 37% higher cardiovascular disease (CVD) mortality (1.37, 95% CI 1.13-1.67) after adjustment for potential confounders. In this first cohort study in one of the most economically developed cities in China, the lowest all-cause mortality was observed for a BMI of 22.5 kg/m2 in all participants, and a WC of 78 cm in men and 72 cm in women.


Assuntos
Adiposidade/fisiologia , Doenças Cardiovasculares/mortalidade , Mortalidade , Neoplasias/mortalidade , Obesidade/epidemiologia , Idoso , Bancos de Espécimes Biológicos , Índice de Massa Corporal , Doenças Cardiovasculares/fisiopatologia , China/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/fisiopatologia , Obesidade/fisiopatologia , Fatores de Risco , Fatores Sexuais , Circunferência da Cintura/fisiologia
15.
Sci Rep ; 10(1): 2294, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-32042008

RESUMO

Cumulating evidence in Caucasian women suggests a positive association between height and premenopausal breast cancer risk and a negative association with overall adiposity; however data from Latin America are scarce. We investigated the associations between excess adiposity, body shape evolution across life, and risk of premenopausal breast cancer among 406 cases (women aged 20-45) and 406 matched population-based controls from Chile, Colombia, Costa Rica, and Mexico. Negative associations between adult adiposity and breast cancer risk were observed in adjusted models (body mass index (BMI): Odds ratio (OR) per 1 kg/m2 = 0.93; 95% confidence interval = 0.89-0.96; waist circumference (WC): OR per 10 cm = 0.81 (0.69-0.96); hip circumference (HC): OR per 10 cm = 0.80 (0.67-0.95)). Height and leg length were not associated with risk. In normal weight women (18.5 ≤ BMI < 25), women with central obesity (WC > 88 cm) had an increased risk compared to women with normal WC (OR = 3.60(1.47-8.79)). Residuals of WC over BMI showed positive associations when adjusted for BMI (OR per 10 cm = 1.38 (0.98-1.94)). Body shape at younger ages and body shape evolution were not associated with risk. No heterogeneity was observed by receptor status. In this population of Latin American premenopausal women, different fat distributions in adulthood were differentially associated with risk of breast cancer.


Assuntos
Adiposidade/fisiologia , Neoplasias da Mama/epidemiologia , Obesidade Abdominal/epidemiologia , Pré-Menopausa , Circunferência da Cintura/fisiologia , Adulto , Índice de Massa Corporal , Neoplasias da Mama/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Incidência , América Latina/epidemiologia , Pessoa de Meia-Idade , Obesidade Abdominal/fisiopatologia , Fatores de Risco , Adulto Jovem
16.
Curr Diab Rep ; 20(1): 1, 2020 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-31970540

RESUMO

PURPOSE OF REVIEW: Our review provides a brief summary of the most recent advances towards the identification of the genetic basis of specific aspects of obesity and the quantification of their consequences on health. We also highlight the most promising avenues to be explored in the future. RECENT FINDINGS: While obesity has been demonstrated to lead to adverse cardio-metabolic consequences, the determinants of inter-individual variability remain largely unknown. The elucidation of the molecular underpinnings of this relationship is hampered by the extremely heterogeneous nature of obesity as a human trait. Recent technological advances have facilitated a more in-depth characterization of body composition at large-scale. At the pace of current data acquisition and resolution, it is realistic to improve characterization of obesity and to advise individuals based on detailed body composition combined with tissue-specific molecular signatures. Individualized predictions of health implications would enable more personalized and effective public health interventions.


Assuntos
Adiposidade/fisiologia , Obesidade/genética , Obesidade/metabolismo , Adiposidade/genética , Composição Corporal/genética , Composição Corporal/fisiologia , Distribuição da Gordura Corporal , Índice de Massa Corporal , Heterogeneidade Genética , Humanos , Obesidade/complicações , Obesidade/diagnóstico , Fenótipo , Fatores Sexuais , Circunferência da Cintura/genética , Circunferência da Cintura/fisiologia
17.
Int J Cancer ; 146(6): 1541-1552, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31187481

RESUMO

Adiposity increases estrogen receptor (ER)-positive postmenopausal breast cancer risk. While mechanisms underlying this relationship are uncertain, dysregulated sex-steroid hormone production and insulin signaling are likely pathways. Our aim was to quantify mediating effects of fasting insulin and free estradiol in the adiposity and ER-positive postmenopausal breast cancer association. We used data from a case-cohort study of sex hormones and insulin signaling nested within the Melbourne Collaborative Cohort Study. Eligible women, at baseline, were not diagnosed with cancer, were postmenopausal, did not use hormone therapy and had no history of diabetes or diabetes medication use. Women with ER-negative disease or breast cancer diagnosis within the first follow-up year were excluded. We analyzed the study as a cumulative sampling case-control study with 149 cases and 1,029 controls. Missing values for insulin and free estradiol were multiply imputed with chained equations. Interventional direct (IDE) and indirect (IIE) effects were estimated using regression-based multiple-mediator approach. For women with body mass index (BMI) >30 kg/m2 compared to women with BMI 18.5-25 kg/m2 , the risk ratio (RR) of breast cancer was 1.75 (95% confidence interval [CI] 1.05-2.91). The estimated IDE (RR) not through the mediators was 1.03 (95% CI 0.43-2.48). Percentage mediated effect through free estradiol was 72% (IIE-RR 1.56; 95% CI 1.11-2.19). There was no evidence for an indirect effect through insulin (IIE-RR 1.12; 95% CI 0.68-1.84; 28% mediated). Our results suggest that circulating free estradiol plays an important mediating role in the adiposity-breast cancer relationship but does not explain all of the association.


Assuntos
Adiposidade/fisiologia , Neoplasias da Mama/epidemiologia , Estradiol/sangue , Insulina/metabolismo , Pós-Menopausa/metabolismo , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/sangue , Neoplasias da Mama/metabolismo , Estudos de Casos e Controles , Jejum/sangue , Jejum/fisiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Receptores Estrogênicos/metabolismo , Medição de Risco , Vitória/epidemiologia , Circunferência da Cintura/fisiologia
18.
Clin Exp Hypertens ; 42(2): 190-196, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30999775

RESUMO

Backgroud and Purpose: Hypertension has been regarded as one of the most common chronic diseases reported in different studies, and handgrip strength is a good indicatorof anindividual's overall health. However, few studies have concentrated on investigating the relationship between hypertension and handgrip strength, especially for the middle-aged and elderly population in the community. Therefore, the purpose of this study was to explore the association of handgrip strength with the risk of hypertension.Methods: A cross-sectional study was conducted using a multi-instrument questionnaire. A total of 1152 participants aged 45 and older were included in this study. Handgrip strength, social-demographiccharacteristics, behavioral lifestyle and health-related variables were collected. Binary logistic regression was employed to analyse the relationship.Results: Handgrip strength was positively related to the risk of hypertension. Binary logistic regression models revealed that the increase of handgrip strength was significantly associated with the reduction of hypertension risk in female after adjusting forsocial-demographic characteristics, behavioral lifestyle and health-related variables (OR [95%CI] =0.265 [0.089-0.787]). In addition, after stratifying by age groups, the significant association was still existing in 60-74 years and ≥75 years of female groups, respectively(OR [95%CI] =0.158 [0.032-0.779]; (OR [95%CI] =0.009 [0.000-0.409]). No significant associations were observed in male after adjusting variables.Conclusion: stronger handgrip strength was association with the lower risk ofhypertension for the elderly female population.Abbreviations: BMI: body mass index; DBP: diastolic blood pressure; HC: hip circumference; SBP, systolic blood pressure; WC: waist circumference; WHC: hip-waist relation.


Assuntos
Força da Mão/fisiologia , Hipertensão/fisiopatologia , Idoso , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , China/etnologia , Estudos Transversais , Feminino , Humanos , Hipertensão/etnologia , Estilo de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Circunferência da Cintura/fisiologia
19.
Clin Exp Hypertens ; 42(2): 146-152, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30964359

RESUMO

Background: Subjects with metabolic syndrome showed increased risk of cardiovascular events. We investigated the relationship between components of metabolic syndrome and arterial stiffness in Chinese hypertensives.Method: 680 subjects (aged 58.44 ± 11.67 years, male 63.53%, hypertension 65.00%) were divided into five groups based on the number of known components of metabolic syndrome (MSCs) according to the criteria of 2010 Chinses Guidelines for Prevention and Management of Hypertension (0MSCs: n= 86; 1MSCs: n= 153; 2MSCs: n= 201; 3MSCs: n= 148; 4/5MSCs: n= 92.). Body weight, height, waist circumference, blood pressure and clinical biochemical tests were measured. Carotid-femoral pulse wave velocity (cfPWV) was measured using a non-invasive automatic device (Complior Analysis, France).Results: The level of cfPWV was significantly increased with the increasing number of MSCs (8.20 ± 1.54 vs 8.72 ± 1.48 vs 9.34 ± 1.77 vs 9.64 ± 1.86 vs 9.91 ± 2.19 m/s, P<0.05). In subjects with hypertension (n= 442), cfPWV was higher than those without hypertension (n= 238) (9.59 ± 1.90 vs 8.49 ± 1.50 m/s, P<0.05) . Stepwise multiple regression analysis revealed that age, gender, the number of MSCs, heart rate as well as serum uric acid level were determinants for cfPWV (P<0.05). In the subgroups stratified by age, systolic blood pressure correlated with cfPWV in hypertensives under 55 years old, while in non-hypertensives the correlation was found after 60 years old.Conclusion: The arterial stiffness became significant with the increasing of the metabolic components numbers, which was independent of age, gender and blood pressure. And the presence of hypertension played the most important role in the progress of arterial stiffness even compared with age.


Assuntos
Hipertensão/fisiopatologia , Síndrome Metabólica/fisiopatologia , Rigidez Vascular/fisiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/etnologia , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Peso Corporal/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Ácido Úrico/metabolismo , Circunferência da Cintura/fisiologia
20.
Ann N Y Acad Sci ; 1468(1): 55-73, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31872895

RESUMO

Rapid development in Latin America has been accompanied by lifestyle shifts, including changes in time use and social environments. Overweight/obesity has also emerged as a public health challenge. We examined whether lifestyle changes and sexual maturity-related indicators (early pubertal development and having a child) predict increases in adiposity among Peruvian youth. Using longitudinal data from Young Lives, we examined changes in adiposity between ages 8 and 15 years old for the younger cohort and ages 15 and 22 years old for the older cohort. Boys and girls in both cohorts demonstrated substantial increases in age-adjusted adiposity measures, but predictors were different for boys versus girls. For boys, increases in time spent in work and domestic chores predicted increases in adiposity body mass index and BMI-for-age Z-score and increases in time spent sleeping were associated with decreases in adiposity (waist circumference and waist-to-height ratio). For girls, sexual maturity-related indicators (early menarche and childbearing) predicted increases in adiposity, regardless of time use. Potential mechanisms for these results may include diet, physical activity, wealth, and urban-rural residence. Time use among youth was associated with diet quality and physical activity, but in different ways for boys versus girls. Strategies for dealing with rising overweight and obesity should incorporate sex-based specificities.


Assuntos
Adiposidade/fisiologia , Índice de Massa Corporal , Dieta , Exercício Físico/fisiologia , Obesidade/etiologia , Sobrepeso/etiologia , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Peru , Saúde Pública , Fatores de Risco , Fatores Sexuais , Circunferência da Cintura/fisiologia , Adulto Jovem
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