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1.
J Frailty Aging ; 12(1): 37-42, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36629082

RESUMO

BACKGROUND: Obesity and low muscle strength (dynapenia) are independently associated with greater falls risk. It remains unclear whether dynapenia and obesity have an additive effect on falls risk, greater than either phenotype alone. OBJECTIVES: To determine whether a combination of abdominal obesity with dynapenia, dynapenic abdominal obesity (DAO), confers a greater risk of falls than either obesity or dynapenia alone in both men and women. DESIGN: An observational cohort study was conducted. SETTING AND PARTICIPANTS: Data from English adults (n=4239, 60-87 years) who took part in the English Longitudinal Study of Ageing were included. MEASUREMENTS: Dynapenia, was defined as hand-grip strength <20kg (female), <30kg (male). Abdominal obesity was defined as waist circumference >88cm (female), >102cm (male). Data on falls and fall-related injuries over a 2-year follow-up were collected. Multiple logistic regression analyses were performed adjusting for age and sex, with results expressed as odds ratios (OR) and areas under the receiver operating characteristic curve (AUC). RESULTS: Falls occurred in 1049 participants, with 284 reporting a related injury during follow-up. DAO was associated with greater OR of falls in men (OR 2.1, 95% Confidence Intervals (CI) 1.3-3.2). Dynapenia rather than obesity was associated with falls in women, with greatest OR observed in those with low hand-grip strength (OR 1.4, 95% CI 1.1-1.7). Individual discrimination was low for measures of obesity or dynapenia either alone or in combination (AUC 0.51-0.58). There was no relationship between fall-related injuries and obesity or dynapenia. CONCLUSION: Our findings suggest a synergistic effect of obesity with dynapenia on falls risk in men but not women.


Assuntos
Acidentes por Quedas , Obesidade Abdominal , Masculino , Humanos , Feminino , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Estudos Longitudinais , Obesidade/epidemiologia , Obesidade/complicações , Fatores de Risco , Força Muscular/fisiologia , Força da Mão/fisiologia
2.
PLoS One ; 18(1): e0279734, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36603004

RESUMO

OBJECTIVE: Previous studies have reported different opinions regarding the association between abdominal obesity and diabetic retinopathy (DR) in patients with diabetes mellitus (DM). In this study, we aimed to investigate this problem through a systematic review and meta-analysis to provide a basis for clinical interventions. METHODS: A comprehensive search was conducted in the PubMed, Embase, and Web of Science databases up to May 1, 2022, for all eligible observational studies. Standardized mean differences (SMD) and 95% confidence intervals (CI) were evaluated using a random-effects model in the Stata software. We then conducted, publication bias assessment, heterogeneity, subgroup and sensitivity analyses. RESULTS: A total of 5596 DR patients and 17907 non-DR patients were included from 24 studies. The results of the meta-analysis of abdominal obesity parameters showed statistically significant differences between DR and non-DR patients in both type 1 and type 2 diabetes. Waist circumference (WC) was higher in patients with DR than in the non-DR patients. In the waist-hip ratio (WHR) subgroup, the level of WHR was higher in patients with DR than that in non-DR patients. The association between abdominal obesity and mild to moderate nonproliferative DR or vision-threatening DR groups did not show any statistical difference. Subgroup analysis according to ethnicity showed that Caucasians had higher levels of combined abdominal obesity parameters than Asians. CONCLUSION: We found that abdominal obesity measured by WC and WHR is associated with DR in patients with type 1 and type 2 diabetes. This association is stronger in Caucasians than in Asians, where isolated abdominal obesity might be more related to DR. However, no correlation was found between abdominal obesity and varying degrees of diabetic retinopathy. Further prospective cohort studies with larger sample sizes are yet to be conducted to clarify our findings.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Humanos , Retinopatia Diabética/complicações , Diabetes Mellitus Tipo 2/complicações , Obesidade Abdominal/complicações , Fatores de Risco , Estudos Prospectivos , Obesidade/complicações
3.
Age Ageing ; 52(1)2023 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-36626317

RESUMO

BACKGROUND: Dynapenic abdominal obesity has been shown as a risk factor for all-cause mortality in older adults. However, there is no evidence on the association between this condition and cardiovascular mortality. OBJECTIVE: We aimed to investigate whether dynapenic abdominal obesity is associated with cardiovascular mortality in individuals aged 50 and older. METHODS: A longitudinal study with an 8-year follow-up was conducted involving 7,030 participants of the English Longitudinal Study of Ageing study. Abdominal obesity and dynapenia were respectively defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). The outcome was cardiovascular mortality. The Fine-Grey regression model was used to estimate the risk of cardiovascular mortality as a function of abdominal obesity and dynapenia status in the presence of competing events controlled by socio-demographic, behavioural and clinical variables. RESULTS: The risk of cardiovascular mortality was significantly higher in individuals with D/AO compared with ND/NAO (SHR 1.85; 95% CI: 1.15-2.97). D/NAO was also associated with cardiovascular mortality (SHR: 1.62; 95% CI: 1.08-2.44). CONCLUSION: Dynapenic abdominal obesity is associated with cardiovascular mortality, with a larger effect size compared to dynapenia alone in individuals older than 50 years. Thus, prevention strategies and clinical interventions that enable mitigating the harmful effects of these conditions should be adopted to diminish such risk.


Assuntos
Doenças Cardiovasculares , Obesidade , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Estudos Longitudinais , Obesidade/complicações , Fatores de Risco , Obesidade Abdominal/diagnóstico , Medição de Risco , Força da Mão , Doenças Cardiovasculares/diagnóstico
4.
PLoS One ; 18(1): e0280672, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36662845

RESUMO

BACKGROUND: Dyslipidemia is one of the modifiable risk factors for cardiovascular disease and a leading cause of morbidity and mortality worldwide. This study was designed to estimate the prevalence and factors associated with dyslipidemia in Bangladeshi adults. METHODS: A total of 603 participants aged ≥ 18 years were recruited in the study. Serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were analyzed using enzymatic colorimetric methods. Dyslipidemia was defined based on serum lipids levels following the standard guidelines by National Cholesterol Education Program Adult Treatment Panel III. Multivariate logistic regression analysis was applied to evaluate risk factors associated with dyslipidemia. RESULTS: The overall prevalence of dyslipidemia was 89% with no significant difference between male (90.1%) and female (85.7) subjects. The prevalence of hypertriglyceridemia was 51.7%, hypercholesterolemia 41.6%, high LDL 43.9% and low HDL 78.8%. When participants were classified into healthy control, hypertensive and diabetic groups, the lipid levels and prevalence of lipid abnormalities were higher in hypertensive and diabetic groups compared to the control group. Low HDL level was the main prevalent dyslipidemia among study subjects. The prevalence of isolated hypertriglyceridemia, isolated hypercholesterolemia, and isolated low HDL-C was 24.7%, 14.7%, and 25.5%, respectively. Mixed hyperlipidemia was prevalent in 26.9% of the participants. According to the logistic regression analysis, significant associated factors of dyslipidemia were increased age, overweight, general and abdominal obesity, hypertension, diabetes and inadequate physical activity. CONCLUSIONS: This study shows a high prevalence of dyslipidemia in Bangladeshi adults. Important risk factors of dyslipidemia are increased age, overweight, general and abdominal obesity, diabetes, hypertension and low physical activity. Our results suggest that awareness-raising programs are required to prevent and control dyslipidemia among Bangladeshi adults.


Assuntos
Diabetes Mellitus , Dislipidemias , Hipercolesterolemia , Hiperlipidemias , Hipertensão , Hipertrigliceridemia , Adulto , Humanos , Masculino , Feminino , Hipercolesterolemia/epidemiologia , Sobrepeso , Prevalência , Obesidade Abdominal , Dislipidemias/epidemiologia , Obesidade/epidemiologia , Fatores de Risco , Triglicerídeos , Colesterol , Diabetes Mellitus/epidemiologia , Lipoproteínas HDL , Hipertensão/epidemiologia , Lipoproteínas LDL , HDL-Colesterol
5.
PLoS One ; 18(1): e0280033, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36607904

RESUMO

The diagnosing of central obesity requires ethnic-specific cut-offs of waist circumference (WC) and body mass index (BMI). This study aims to develop formulas to predict visceral adipose tissue (VAT) area based on WC and BMI to determine the cut-off points of central obesity in Indonesia. We conducted a cross-sectional study among 32 middle-aged Indonesian men. VAT area was measured using an abdominal CT scan, whereas WC and BMI were assessed through anthropometric measurements. Linear regression analysis was performed to define the formulas to predict VAT area using WC and BMI. Next, the optimal cut-off values of WC and BMI were determined using ROC curve analysis. Strong positive correlations were found between WC and VAT as well as BMI and VAT (r = 0.78; r = 0.67, p <0.001). The formula to predict VAT area from WC was -182.65 + (3.35 × WC), whereas the formula to predict VAT area from BMI was -57.22 + (6.95 × BMI). These formulas predicted WC of 88.5 cm and BMI of 23.9 kg/m2 as the optimal cut-off values for central obesity in middle-aged Indonesian men.


Assuntos
Gordura Intra-Abdominal , Obesidade Abdominal , Pessoa de Meia-Idade , Masculino , Humanos , Indonésia , Obesidade Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/diagnóstico por imagem , Estudos Transversais , Obesidade/diagnóstico , Índice de Massa Corporal , Circunferência da Cintura , Curva ROC , Tecido Adiposo
6.
Environ Health Perspect ; 131(1): 17001, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36598238

RESUMO

BACKGROUND: Metabolic syndrome (MetS), a major contributor to cardiovascular and metabolic diseases, has been linked with exposure to air pollution. However, the relationship between air pollutants and the five components of MetS [abdominal obesity, elevated triglyceride, decreased high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, and elevated fasting blood glucose levels], has not been clearly described. OBJECTIVE: We examined the association between long-term exposure to air pollutants and the occurrence of MetS and its components by using a longitudinal cohort in Taiwan. METHODS: The MJ Health Research Foundation is a medical institute that conducts regular physical examinations. The development of MetS, based on a health examination and the medical history of an MJ cohort of 93,771 participants who were enrolled between 2006 and 2016 and had two or more examinations, was compared with estimated exposure to air pollutants in the year prior to health examination. The exposure levels to fine particulate matter [PM with an aerodynamic diameter of ≤2.5µm (PM2.5)] and nitrogen dioxide (NO2) in the participants' residential areas were estimated using a hybrid Kriging/land-use regression (LUR) model executed using the XGBoost algorithm and a hybrid Kriging/LUR model, respectively. Cox regression with time-dependent covariates was conducted to estimate the effects of annual air pollutant exposure on the risk of MetS and its components. RESULTS: During the average follow-up period of 3.4 y, the incidence of MetS was 38.1/1,000 person-years. After mutual adjustment and adjustments for potential covariates, the results indicated that every 10-µg/m3 increase in annual PM2.5 concentration was associated with an increased risk of abdominal obesity [adjusted hazard ratio (aHR)=1.07; 95% confidence interval (CI): 1.01, 1.14], hypertriglyceridemia (aHR=1.17; 95% CI: 1.11, 1.23), low HDL-C (aHR=1.09; 95% CI: 1.02, 1.17), hypertension (aHR=1.15; 95% CI: 1.09, 1.21), and elevated fasting blood glucose (aHR=1.15; 95% CI: 1.10, 1.20). Furthermore, PM2.5 and NO2 may increase the risk of developing MetS among people who already "have" some components of MetS. DISCUSSION: Our findings suggest that in apparently healthy adults undergoing physical examination, exposure to PM2.5 and NO2 might be associated with the occurrence of MetS and its components. https://doi.org/10.1289/EHP10611.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Hipertensão , Síndrome Metabólica , Adulto , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/induzido quimicamente , Taiwan/epidemiologia , Obesidade Abdominal/induzido quimicamente , Glicemia , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Poluentes Atmosféricos/análise , Material Particulado/análise , Obesidade/induzido quimicamente , Hipertensão/induzido quimicamente , Dióxido de Nitrogênio/análise
7.
JMIR Public Health Surveill ; 9: e39459, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36630180

RESUMO

BACKGROUND: General obesity and abdominal obesity, typically measured by BMI and waist circumference (WC), respectively, are associated with an increased risk of type 2 diabetes mellitus (T2DM). However, the magnitude of the association of these two obesity indicators and their joint association with the onset of T2DM remain controversial. OBJECTIVE: The aim of this study was to investigate the associations between these two obesity indicators and T2DM among the Chinese population to contribute scientific evidence for appropriate T2DM interventions. METHODS: A cohort of 3001 eligible participants was selected from the Ningbo Adult Chronic Disease Surveillance Project running since 2015. Based on BMI, individuals were categorized into groups of underweight or normal, overweight, and obesity. Based on WC, individuals were categorized in groups of normal, precentral obesity, and central obesity. Follow-up was performed by linking data of the baseline data set with the diabetes registry data set and the vital registry data set (both from the Ningbo Municipal Integrated Noncommunicable Disease Collaborative Management System), mainly using the participants' identity numbers. Follow-up was completed when a participant was diagnosed with T2DM. The associations were estimated with multivariate Cox proportional hazard regression. RESULTS: In the cohort, 90 of 3001 participants developed T2DM (incidence density: 6.483/1000 person-years) with a median 4.72 years of follow-up. After controlling for age, sex, hypertension, dyslipidemia, smoking status, and family history of diabetes, the multivariate adjusted hazard ratios (HRs) across underweight/normal, overweight, and obesity BMI categories were 1.000, 1.653 (95% CI 1.030-2.654), and 2.375 (95% CI 1.261-4.473), respectively. The multivariate adjusted HRs across the normal, precentral obesity, and central obesity WC categories were 1.000, 1.215 (95% CI 0.689-2.142), and 1.663 (95% CI 1.016-2.723), respectively. Compared with the reference group (normal WC with an underweight/normal BMI), the multivariate adjusted HR for participants with both central obesity according to WC and obesity according to BMI was 2.489 (95% CI 1.284-4.825). CONCLUSIONS: Both elevated BMI and WC at baseline increased the risk of T2DM. Compared with WC, BMI as an obesity indicator was more strongly associated with the onset of T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Adulto , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Circunferência da Cintura , Estudos Prospectivos , Fatores de Risco , Índice de Massa Corporal , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Sobrepeso/complicações , Magreza/complicações , Obesidade/epidemiologia
8.
JMIR Public Health Surveill ; 9: e41973, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36630179

RESUMO

BACKGROUND: According to previous reports, obesity especially visceral fat has become an important public health problem, causing an estimation of 20.5 disability-adjusted life years per 1000 inhabitants. Those who exercised for 1 or 2 days per week and reached the recommended 150 minutes of moderate physical activity (PA) per week have been defined as "weekend warriors" (WWs). Although the benefits of PA in suppressing obesity have been widely studied, the association of WWs with the Visceral Adiposity Index (VAI) and the difference between WW activity and regular PA are yet to be explored. OBJECTIVE: This study aims to explore the association between WW activity and other PA patterns with VAI in US adults. METHODS: The National Health and Nutrition Examination Survey 2007-2016 data set was used, and the analytic sample was limited to adults 20 years and older who had complete information about VAI, PA patterns, and other covariates, including demographic characteristics, behavioral factors, and disease conditions. Participants' characteristics in different PA pattern groups were tested using the Rao and Scott adjusted χ2 test and ANOVA. Univariate and multivariate stepped linear regression models were then used to explore the association between the PA pattern and VAI. Finally, stratified analyses and interaction effects were conducted to investigate whether the association was stable among subgroups. RESULTS: The final sample included 9642 adults 20 years or older, which is representative of 158.1 million noninstitutionalized US adults, with 52.15% (n=5169) being male and 70.8% (n=4443) being non-Hispanic White. Gender, age group, race, education level, income level, marital status, smoking status, alcoholism, VAI, cardiovascular disease, and diabetes were all correlated with the PA pattern, but no relationship between hypertension and PA pattern was observed. After adjusting for demographic covariates, smoking status, alcoholism, cardiovascular disease, diabetes, and hypertension, WW and regularly active adults had a ß of .307 (95% CI -0.611 to -0.003) and .354 (95% CI -0.467 to -0.241), respectively, for reduced VAI when compared with inactive adults, but no significant effect of lowering VAI (ß=-.132, 95% CI -0.282 to 0.018) was observed in insufficiently active adults when compared with inactive adults. Besides, no significant difference was exhibited between WW adults and regularly active adults (ß=.047, 95% CI -0.258 to 0.352), suggesting WW adults had the same benefit of decreasing VAI as regularly active adults. Stratified analyses results exhibited that WW activity was related to reduced VAI in female adults aged 20-44 years who were non-Hispanic Black, other, or multiracial; high school or General Educational Development education; and never married, and the association between PA pattern and VAI remained stable in all demographic subgroups. CONCLUSIONS: Compared with inactive adults, WWs could reduce VAI, and there was no significant difference between WWs and regular active adults in decreasing VAI. Our study provides compelling evidence of the beneficial effect of WW activity on visceral obesity.


Assuntos
Alcoolismo , Doenças Cardiovasculares , Diabetes Mellitus , Hipertensão , Adulto , Humanos , Masculino , Feminino , Obesidade Abdominal/complicações , Obesidade Abdominal/diagnóstico , Estudos Transversais , Inquéritos Nutricionais , Adiposidade , Alcoolismo/complicações , Hipertensão/complicações
9.
PLoS One ; 18(1): e0266637, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36693111

RESUMO

BACKGROUND: Chronic non-communicable disease comorbidities are a major problem faced by people living with HIV (PLHIV). Obesity is an important factor contributing to such comorbidities and PLHIV face an elevated risk of obesity. However, there is data paucity on the intersection of obesity and HIV in adolescents and youth living with HIV (AYLHIV) in sub-Saharan Africa. We therefore aimed to investigate the prevalence of abdominal obesity and associated multilevel factors in AYLHIV in peri-urban Cape Town, South Africa. METHODS: We conducted a cross-sectional study enrolling AYLHIV aged 15-24 years attending primary healthcare facilities in peri-urban Cape Town in 2019. All measures, except for physical examination measures, were obtained via self-report using a self-administered electronic form. Our outcome of interest was abdominal obesity (waist-to-height ratio ≥ 0.5). We collected individual-level data and data on community, built and food environment factors. Data was summarized using descriptive statistics, stratified by obesity status. Multilevel logistic regression was conducted to investigate factors associated with abdominal obesity, adjusted for sex and age. FINDINGS: A total of 87 participants were interviewed, 76% were female and the median age was 20.7 (IQR 18.9-23.0) years. More than two fifths had abdominal obesity (41%; 95% CI: 31.0-51.7%), compared to published rates for young people in the general population (13.7-22.1%). In multilevel models, skipping breakfast (aOR = 5.42; 95% CI: 1.32-22.25) was associated with higher odds of abdominal obesity, while daily wholegrain consumption (aOR = 0.20; 95% CI: 0.05-0.71) and weekly physical activity (aOR = 0.24; 95% CI: 0.06-0.92) were associated with lower odds of abdominal obesity. Higher anticipated stigma was associated with reduced odds of obesity (aOR = 0.58; 95% CI: 0.33-1.00). Land-use mix diversity (aOR = 0.52; 95% CI: 0.27-0.97), access to recreational places (aOR = 0.37; 95% CI: 0.18-0.74), higher perceived pedestrian and traffic safety (aOR = 0.20; 95% CI: 0.05-0.80) and having a non-fast-food restaurant within walking distance (aOR = 0.30; 95% CI: 0.10-0.93) were associated with reduced odds of abdominal obesity. The main limitations of the study were low statistical power and possible reporting bias from self-report measures. CONCLUSIONS: Our findings demonstrate a high prevalence of abdominal obesity and highlight multilevel correlates of obesity in AYLHIV in South Africa. An intersectoral approach to obesity prevention, intervening at multiple levels is necessary to intervene at this critical life stage.


Assuntos
Infecções por HIV , Obesidade Pediátrica , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Masculino , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , África do Sul/epidemiologia , Estudos Transversais , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Prevalência
10.
Nutrients ; 15(2)2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36678331

RESUMO

There were three objectives: (1) evaluate the relationship between legume intake and weight change across the previous 10 years, (2) examine the cross-sectional associations between legume consumption, BMI, and abdominal adiposity, and (3) determine if the relationship between legume intake and the outcomes were influenced by multiple covariates, particularly fiber intake. The sample included 15,185 randomly selected adults representative of the U.S. population. Percent change in weight was used as the outcome measure for the 10-year analysis. BMI, and waist circumference, corrected for height, were employed as the outcomes for the cross-sectional analyses. Legume, fiber, and energy intakes were measured using the average of two 24-h dietary recalls. Legume intake was divided into three categories. Five demographic and five lifestyle covariates were controlled statistically. There was an inverse dose-response relationship between legume intake and percent weight change over the previous 10 years after adjusting for 9 of the covariates (F = 6.5, p = 0.0028). However, after controlling for fiber with the other covariates, there were no differences across the three legume intake groups (F = 1.9, p = 0.1626). The cross-sectional findings showed similar inverse dose-response results until fiber intake was controlled. Then the associations became non-significant. In conclusion, legume intake is a good predictor of percent weight change over the previous 10 years, and it is also a significant predictor of BMI and abdominal adiposity cross-sectionally. These relationships are strongly influenced by fiber consumption. Evidently, legumes have dietary advantages, especially high fiber levels, that seem to be valuable in the battle against weight gain and obesity.


Assuntos
Adiposidade , Fabaceae , Adulto , Humanos , Estudos Transversais , Índice de Massa Corporal , Obesidade/epidemiologia , Obesidade Abdominal/epidemiologia , Ingestão de Energia , Verduras , Circunferência da Cintura , Peso Corporal
11.
Chemosphere ; 315: 137738, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36608892

RESUMO

BACKGROUND: Increasing evidence have been provided that the exposure to environment pollutants was associated obesity, while whether the exposure to volatile organic chemicals (VOC) was associated with obesity or abdominal obesity is yet to be clarified. METHOD: A cross-sectional study using data from the 6 survey cycles (2005-2006, 2011-2018, 2017-2020) of NHANES program was performed. Obesity and abdominal obesity were identified as a BMI >30 and a waist circumference >102 cm for men or >88 cm for women respectively. The quantile logistic regression method was used to analyze the association between VOC metabolites (VOCs) in urine and obesity, and the quantile regression method was used for the association analysis between VOCs in urine and BMI, as well as waist circumference. RESULTS: A total of 17 524 participants (4965 obesity, 7317 abdominal obesity) were included, and participants in the obesity or abdominal obesity groups showed higher VOCs in urine than that in the control group. The CEMA was identified as the risk factor for obesity and abdominal obesity in all the 4 models, and its detected OR for obesity in the Q2 to Q4 of model 3 was 1.169 (Q2, p < 0.05), 1.306 (Q3, p < 0.001) and 1.217 (Q4, p < 0.01) respectively. And its OR for abdominal obesity in the Q2 to Q4 of model 3 was 1.222 (Q2, p < 0.01), 1.448 (Q3, p < 0.001) and 1.208 (Q4, p < 0.05) respectively. A significantly positive association between CEMA and BMI, as well as waist circumference, was also detected. CONCLUSION: In this study, we found that the exposure to VOC (Acrolein, Acrylamide, Acrylonitrile, 1,3-Butadiene, Crotonaldehyde, Cyanide, N,N-Dimethylformamide, Ethylbenzene, styrene, Propylene oxide, Toluene and Xylene) was significantly associated with obesity or abdominal obesity. And also, more prospective studies and related experimental researches should be carried out to further demonstrate the conclusion of this study.


Assuntos
Compostos Orgânicos Voláteis , Masculino , Humanos , Feminino , Compostos Orgânicos Voláteis/metabolismo , Estudos Transversais , Obesidade Abdominal/epidemiologia , Inquéritos Nutricionais , Estudos Prospectivos , Obesidade/epidemiologia
12.
Eur J Gastroenterol Hepatol ; 35(2): 181-190, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36574309

RESUMO

BACKGROUND: Serrate d polyps (SP) is associated with an increased risk of colorectal cancer. Patients with SP history tend to have SP recurrence. However, the risk factors for metachronous polyps (MP) in those patients are not well established. METHODS: Data of colonoscopy were retrospectively reviewed from October 2012 to October 2021. The pathology database, electronic medical records and telephone follow-up data were also observed. RESULTS: A total of 906 patients were studied including 278 patients with MPs and 628 patients without. The multiplicity of polyps (OR, 13.63; 95% CI, 8.80-21.75), older age (OR, 5.71; 95% CI, 1.87-20.63), abdominal obesity (OR, 2.46; 95% CI, 0.98-6.42), current smoker (OR, 2.93; 95% CI, 1.15-7.83) and sedentary lifestyle (OR, 1.41; 95% CI, 1.22-1.65) are significantly associated with the risk of MPs. Patients with baseline SP < 10 mm were more likely to develop higher or same risk-grade polyps (HSRGP) ( P = 0.0014). Patients with non-clinically significant SPs whether coexisted with adenoma or not were more likely to develop HSRGPs when compared to others ( P < 0.001). CONCLUSION: Total number of polyps, older age, sedentary behavior, abdominal obesity and smoking status contributed to the risk of MPs at surveillance colonoscopy. Patients with grade 1 SPs might require closer surveillance. SPs coexisting with conventional adenoma did not increase the risk of MPs but may increase the risk of developing HSRGPs.


Assuntos
Adenoma , Pólipos do Colo , Neoplasias Colorretais , Humanos , Pólipos do Colo/epidemiologia , Pólipos do Colo/patologia , Estudos Retrospectivos , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Colonoscopia/efeitos adversos , Adenoma/diagnóstico , Adenoma/epidemiologia , Adenoma/complicações , Obesidade/complicações , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia
13.
J Hypertens ; 41(2): 326-335, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36583358

RESUMO

OBJECTIVE: Central (abdominal) obesity is associated with elevated adrenergic activity and arterial blood pressure (BP). Therefore, we tested the hypothesis that transduction of spontaneous muscle sympathetic nerve activity (MSNA) to BP, that is, sympathetic transduction, is augmented in abdominal obesity (increased waist circumference) and positively related to prevailing BP. METHODS: Young/middle-aged obese (32 ±â€Š7 years; BMI: 36 ±â€Š5 kg/m2, n = 14) and nonobese (29 ±â€Š10 years; BMI: 23 ±â€Š4 kg/m2, n = 14) without hypertension (24-h ambulatory average BP < 130/80 mmHg) were included. MSNA (microneurography) and beat-to-beat BP (finger cuff) were measured continuously and the increase in mean arterial pressure (MAP) during 15 cardiac cycles following MSNA bursts of different patterns (single, multiples) and amplitude (quartiles) was signal-averaged over a 10 min baseline period. RESULTS: MSNA burst frequency was not significantly higher in obese vs. nonobese (21 ±â€Š3 vs. 17 ±â€Š3 bursts/min, P = 0.34). However, resting supine BP was significantly higher in obese compared with nonobese (systolic: 127 ±â€Š3 vs. 114 ±â€Š3; diastolic: 76 ±â€Š2 vs. 64 ±â€Š1 mmHg, both P < 0.01). Importantly, obese showed greater increases in MAP following multiple MSNA bursts (P = 0.02) and MSNA bursts of higher amplitude (P = 0.02), but not single MSNA bursts (P = 0.24), compared with nonobese when adjusting for MSNA burst frequency. The increase in MAP following higher amplitude bursts among all participants was associated with higher resting supine systolic (R = 0.48; P = 0.01) and diastolic (R = 0.48; P = 0.01) BP when controlling for MSNA burst frequency, but not when also controlling for waist circumference (P > 0.05). In contrast, sympathetic transduction was not correlated with 24-h ambulatory average BP. CONCLUSION: Sympathetic transduction to BP is augmented in abdominal obesity and positively related to higher resting supine BP but not 24-h ambulatory average BP.


Assuntos
Pressão Arterial , Hipertensão , Pessoa de Meia-Idade , Humanos , Pressão Sanguínea/fisiologia , Obesidade Abdominal , Frequência Cardíaca/fisiologia , Sistema Nervoso Simpático , Músculo Esquelético/inervação , Obesidade/complicações
14.
Obesity (Silver Spring) ; 31(1): 279-289, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36507560

RESUMO

OBJECTIVE: The aim of this study was to investigate the transgenerational associations between exposure to famine in early life and obesity. METHODS: This study used the longitudinal data from the China Health and Nutrition Survey from 1989 to 2015. A total of 1113 fathers and 1207 mothers (946 mother-father pairs) born in 1955 to 1966 and 1895 adult offspring were included. Offspring were classified into subgroups according to the famine exposure of their parents (unexposed, maternal exposed, paternal exposed, parental exposed) and exposure timing (during fetal development, childhood). RESULTS: Maternal exposure to famine in early life was associated with elevated levels of BMI, waist circumference, overweight, and central obesity of their children, whereas paternal exposure was inversely associated with these measurements. Compared with children of unexposed parents (P0M0), the maternal exposed group (P0M1) had higher mean BMI, by 1.3 kg/m2 (95% CI: 0.3 to 2.4); waist circumference, by 1.5 cm (-1.0 to 3.9); overweight (odds ratio [OR] [95% CI]: 3.1 [1.6 to 6.1]); and central obesity (OR [95% CI]: 1.9 [1.02 to 3.7]). No significant heterogeneity was observed in the associations by sex of offspring. CONCLUSIONS: Fetal and early childhood exposure to famine in parents may be associated with their children's risk of obesity during adulthood. A better understanding of the transgenerational associations is important for developing strategies to reduce obesity risk in future generations.


Assuntos
Efeitos Tardios da Exposição Pré-Natal , Inanição , Masculino , Feminino , Criança , Adulto , Humanos , Pré-Escolar , Idoso , Fome Epidêmica , Fatores de Risco , Sobrepeso/epidemiologia , Obesidade Abdominal , Obesidade/epidemiologia , Pais , China/epidemiologia , Inanição/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
15.
Lancet Gastroenterol Hepatol ; 8(2): 120-132, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36521501

RESUMO

BACKGROUND: Management strategies for non-alcoholic steatohepatitis (NASH) are based predominantly on lifestyle modification, with no approved disease-modifying drugs yet available. We aimed to evaluate the safety, pharmacokinetics, and pharmacodynamics of pegozafermin (BIO89-100), a glycoPEGylated FGF21 analogue, in participants with NASH. METHODS: This randomised, double-blind, placebo-controlled, phase 1b/2a multiple-ascending-dose study enrolled adults (aged 21-75 years) who had NASH with stage F1-F3 fibrosis, or non-alcoholic fatty liver disease and a high risk of NASH (referred to in this study as phenotypic NASH) due to central obesity with type 2 diabetes, or central obesity with increased alanine aminotransferase (ALT) or a Fibroscan score of 7 kPa or greater, across 12 specialist centres and clinics in the USA. Patients were centrally randomised by use of an interactive web response system to receive subcutaneously administered pegozafermin (3, 9, 18, or 27 mg once weekly; 18 or 36 mg once every 2 weeks) or placebo for 12 weeks. The primary endpoints were the safety, tolerability, and pharmacokinetics of pegozafermin. This trial is registered with ClinicalTrials.gov (NCT04048135). FINDINGS: Between July 29, 2019, and Aug 3, 2020, 275 participants were screened and 81 (15 [19%] with biopsy-confirmed NASH) were randomly assigned: 62 to pegozafermin (six to 3 mg once weekly, 12 to 9 mg once weekly, 11 to 18 mg once weekly, ten to 27 mg once weekly, 14 to 18 mg once every 2 weeks, and nine to 36 mg once every 2 weeks) and 19 to placebo; 63 received pegozafermin and 18 received placebo, as one participant in the placebo group inadvertently received 3 mg pegozafermin once weekly. Adverse events were reported in eight (44%) of 18 participants in the pooled placebo group, six (86%) of seven in the 3 mg once weekly pegozafermin group, four (33%) of 12 in the 9 mg once weekly group, seven (64%) of 11 in the 18 mg once weekly group, seven (70%) of ten in the 27 mg once weekly group, eight (57%) of 14 in the 18 mg once every 2 weeks group, and eight (89%) of nine in the 36 mg once every 2 weeks group. The most common treatment-related adverse event was mild increased appetite (in ten [16%] of 63 participants in the pooled pegozafermin group vs none of 18 in the pooled placebo group), which was not associated with bodyweight gain. Two patients discontinued treatment due to an adverse event (one each in the 27 mg once weekly and 18 mg once every 2 weeks groups). No treatment-related serious adverse events or deaths occurred. Dose-proportional pharmacokinetics were observed. Anti-drug antibodies were detected in 41 (65%) of 63 participants treated with pegozafermin. By week 13, pegozafermin significantly reduced the least squares mean (LSM) absolute differences in hepatic fat fraction versus pooled placebo (-8·9% [95% CI -14·8 to -3·1; p=0·0032] for 3 mg once weekly, -11·5% [-16·1 to -6·9; p<0·0001] for 9 mg once weekly, -8·9% [-13·7 to -4·2; p=0·0004] for 18 mg once weekly, -14·9% [-20·1 to -9·7; p<0·0001] for 27 mg once weekly, -10·4% [-14·7 to -6·1; p<0·0001] for 18 mg once every 2 weeks, and -11·1% [-16·2 to -6·0; p<0·0001] for 36 mg once every 2 weeks). At week 13, significant LSM relative reductions versus pooled placebo in ALT were observed for pegozafermin 9 mg once weekly, 18 mg once weekly, 27 mg once weekly, and 36 mg once every 2 weeks. At week 13, significant LSM relative reductions versus pooled placebo in aspartate aminotransferase were observed for pegozafermin 3 mg once weekly, 27 mg once weekly, and 36 mg once every 2 weeks. Significant improvements were also observed with pegozafermin treatment for triglycerides (9 mg once weekly, 27 mg once weekly, and 18 mg once every 2 weeks), LDL-C (9 mg once weekly and 27 mg once weekly), HDL-C (3 mg once weekly and 18 mg once every 2 weeks), non-HDL-C (9 mg once weekly and 27 mg once weekly), adiponectin (all doses except for 36 mg once every 2 weeks), PRO-C3 (27 mg once weekly), and bodyweight (27 mg once weekly). Changes in insulin resistance and HbA1c were not significant. INTERPRETATION: Pegozafermin was generally well tolerated and associated with clinically meaningful reductions in liver fat, measures of liver function, and circulating lipids. Further evaluation of pegozafermin in individuals with NASH is warranted. FUNDING: 89bio.


Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica , Adulto , Humanos , Diabetes Mellitus Tipo 2/complicações , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações , Obesidade Abdominal/complicações , Adulto Jovem , Pessoa de Meia-Idade , Idoso
16.
J Clin Hypertens (Greenwich) ; 25(1): 78-85, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36573350

RESUMO

Previous studies focused on the relationships between Serum Uric Acid (SUA) and lipids have found an association mainly with triglycerides. Furthermore, previous studies on adiposity indices have been focused on the evaluation of the Visceral Adiposity Index (VAI). The present study was aimed at providing within the same population a systematic evaluation of lipids and adiposity indices with SUA, employing both the classic cutoff for hyperuricemia and the newly one identified by the Uric Acid Right for Heart Health (URRAH) study. We analyzed data collected in 1892 subjects of the Pressioni Arteriose Monitorate E loro Associazioni (PAMELA) study with available SUA, lipid profile and variables necessary to calculate VAI, Cardio-Metabolic Index (CMI) and Lipid Accumulation Product (LAP). At linear regression model (corrected for confounders) SUA correlated with all the lipids values (with the strongest ß for triglycerides) and adiposity indices. When the two different cutoffs were compared, the URRAH one was significantly related to atherogenic lipids profile (OR 1.207 for LDL and 1.33 for non-HDL, P < 0.001) while this was not the case for the classic one. Regarding adiposity indices the classic cutoff displays highest OR as compared to the URRAH one. In conclusions, newly reported URRAH cutoff for hyperuricemia better relate to atherogenic lipoprotein (LDL and non-HDL) when compared to the classic one. The opposite has been found for adiposity indexes where the classic cut-off seems to present highest performance. Among adiposity indexes, LAP present the highest OR for the relationship with hyperuricemia.


Assuntos
Hipertensão , Hiperuricemia , Humanos , Adiposidade , Ácido Úrico , Hiperuricemia/complicações , Hipertensão/complicações , Obesidade/complicações , Triglicerídeos , Obesidade Abdominal/epidemiologia , Índice de Massa Corporal
17.
Crit Rev Food Sci Nutr ; 63(2): 249-260, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34190668

RESUMO

We performed this systematic review and meta-analysis to evaluate observational studies assessing the association between ultra-processed food (UPF) consumption and the risk of overweight, obesity, and abdominal obesity in the general population. We searched the databases PubMed/MEDLINE, Scopus, Embase, and ISI Web of Science from inception until December 2020. Data were extracted from 12 studies (nine cross-sectional and three cohort studies). Odds ratio (OR) were pooled using a random-effects model. UPF consumption was associated with an increased risk of obesity (OR = 1.55; 95% CI: 1.36, 1.77; I2 = 55%), overweight (OR = 1.36; 95% CI: 1.14, 1.63; I2 = 73%), and abdominal obesity (OR = 1.41; 95% CI: 1.18, 1.68; I2 = 62%). Furthermore, every 10% increase of UPF consumption in daily calorie intake was associated with a 7%, a 6%, and a 5% higher risk of overweight, obesity, and abdominal obesity, respectively. Dose-response meta-analysis of cross-sectional studies showed a positive linear association between UPF consumption and abdominal obesity. There was also a positive linear association between UPF consumption and risk of overweight/obesity in the analysis of cross-sectional studies and a positive monotonic association in the analysis of cohort studies. Our study suggests that UPF consumption is associated with an increased risk of excess weight or abdominal obesity.


Assuntos
Obesidade Abdominal , Humanos , Adulto , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etiologia , Estudos Transversais , Estudos Observacionais como Assunto
19.
Cardiovasc Diabetol ; 21(1): 266, 2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36461034

RESUMO

BACKGROUND: An "obesity paradox" for mortality has been shown in chronic disorders such as diabetes, and attributed to methodological bias, including the use of body mass index (BMI) for obesity definition. This analysis investigated the independent association of BMI versus surrogate measures of central adiposity with all-cause mortality in individuals with type 2 diabetes. METHODS: The Renal Insufficiency And Cardiovascular Events Italian Multicentre Study is a prospective cohort study that enrolled 15,773 patients in 19 Italian centres in 2006-2008. Exposures were BMI and the surrogate measures of central adiposity waist circumference (WC), waist-to-height ratio (WHtR), and A Body Shape Index (ABSI). Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%), RESULTS: Age- and sex-adjusted hazard ratios and 95% confidence intervals were significantly higher in BMI-based underweight (1.729 [1.193-2.505), P = 0.004), moderately obese (1.214 [1.058-1.392), P = 0.006) and severely obese (1.703 [1.402-2.068), P < 0.0001), lower in overweight (0.842 [0.775-0.915), P < 0.0001) and similar in mildly obese (0.950 [0.864-1.045), P = 0.292), compared to normal-weight individuals. When further adjusting for smoking, physical activity (PA), and comorbidities, risk was lower also in mildly obese versus normal-weight patients. The BMI-mortality relationship did not change after sequentially excluding ever smokers, individuals with comorbidities, and those died within two years from enrollment and when analyzing separately participants below and above the median age. Conversely, a paradox relationship was observed among inactive/moderately inactive, but not moderately/highly active patients. Mortality risk adjusted for age, gender, smoking, PA and comorbidities was significantly higher in the highest tertile of WC (1.279 [1.089-1.501], P = 0.003), WHtR (1.372 [1.165-1.615], P < 0.0001), and ABSI (1.263 [1.067-1.495], P = 0.007) versus the lowest tertile. However, risk was lower in the intermediate versus lowest tertile for WC (0.823 [0.693-0.979], P = 0.028), similar for WHtR, and higher, though not significantly, for ABSI. CONCLUSIONS: An "overweight paradox" remained after controlling for age, smoking, and comorbidities, arguing against a collider bias or reverse causation. However, it could be partly explained by confounding from PA level, possibly through its impact on lean mass and cardiorespiratory fitness. No obesity paradox was observed with WHtR and especially ABSI, which predicted mortality risk associated with central adiposity better than WC. Trial registration ClinicalTrials.gov, NCT00715481, 15 July, 2008.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/diagnóstico , Sobrepeso , Adiposidade , Estudos Prospectivos , Obesidade Abdominal/diagnóstico , Obesidade/diagnóstico
20.
West Afr J Med ; 39(11): 1141-1147, 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36453473

RESUMO

INTRODUCTION: The elderly hypertensive patients often have increased prevalence of cardiometabolic risk factors and their attendant co-morbidities. The aim of this study was to determine the prevalence of cardiometabolic risk factors and blood pressure control among elderly hypertensive patients, and to determine the influence of modifiable cardiometabolic risk factors on the control of hypertension among elderly hypertensive patients. SUBJECTS AND METHODS: A case-control comparative and hospitalbased study involving a total of 190 consenting elderly (>65 years), hypertensive patients (subjects) (n=100) and normotensive controls (n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding their lifestyle was obtained. Standard protocols were used to measure blood pressure, weight, height, waist circumference, fasting plasma glucose and fasting lipid profile of the subjects. Body mass index was derived from weight and height. RESULTS: The mean age of the subjects was 71.5 ± 6.3 years and the controls was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% of the subjects and controls were females (p = 0.651). The level of control of hypertension was poor in over two-thirds (68%) of the elderly hypertensive patients. The prevalence of modifiable cardiometabolic risk factors burden was higher in the hypertensive subjects when compared with the controls. Prevalence of Dyslipidaemia was 76% in the subjects and 51% in the controls (p = 0.004). Prevalence of Diabetes Mellitus was 40% among the subjects and 17.8% in the controls (p = 0.0001); prevalence of Obesity was 24% in the subjects and 4.4% in the controls (p=<0.001); prevalence of excess alcohol intake was 49% in the subjects and 14.4% in the controls (p=<0.001). Prevalence of sedentary life style was high in both the subjects (53%) and controls (50%), p=0.679. Poor blood pressure control was predicted by dyslipidaemia and central obesity. CONCLUSION: The level of control of hypertension was poor among the elderly and modifiable cardiometabolic risk factors were relatively prevalent. Central obesity and dyslipidaemia were predictive of poor control of hypertension. Addressing these factors may therefore improve blood pressure control.


INTRODUCTION: Les patients hypertendus âgés présentent souvent une prévalence accrue de facteurs de risque cardiométaboliques et de leurs comorbidités. Le but de cette étude était de déterminer la prévalence des facteurs de risque cardiométabolique et le contrôle de la pression artérielle chez les patients hypertendus âgés, et de déterminer l'influence des facteurs de risque cardiométabolique modifiables sur le contrôle de l'hypertension chez les patients hypertendus âgés. SUJETS ET MÉTHODES: Une étude cas-témoins comparative et hospitalière portant sur un total de 190 patients âgés (e"65 ans) consentants, hypertendus (sujets) (n=100) et témoins normotendus (n=90) a été réalisée sur une période de dix mois. A l'aide d'un questionnaire administré par un enquêteur, des données biographiques et des informations concernant leur mode de vie ont été obtenues. Des protocoles standard ont été utilisés pour mesurer la pression artérielle, le poids, la taille, le tour de taille, la glycémie à jeun et le profil lipidique à jeun des sujets. L'indice de masse corporelle a été calculé à partir du poids et de la taille. RÉSULTATS: L'âge moyen des sujets était de 71,5±6,3 ans et celui des témoins de 72,3±7,2 ans. Quarante-huit pour cent (48 %) et 47,8 % des sujets et des témoins étaient des femmes (p=0,651). Le niveau de contrôle de l'hypertension était faible chez plus de deux tiers (68 %) des patients hypertendus âgés. La prévalence des facteurs de risque cardiométabolique modifiables était plus élevée chez les sujets hypertendus que chez les témoins. La prévalence de la dyslipidémie était de 76 % chez les sujets, 51 % chez les témoins (p=0,004). La prévalence du diabète sucré était de 40% chez les sujets et de 17,8% chez les témoins (p= 0,0001), la prévalence de l'obésité était de 24% chez les sujets et de 4,4% chez les témoins (p=<0,001), la prévalence de la consommation excessive d'alcool était de 49% chez les sujets et de 14,4% chez les témoins (p=<0,001). La prévalence du style de vie sédentaire était élevée chez les sujets (53%) et les témoins (50%), p=0,679. Un mauvais contrôle de la pression artérielle était prédit par la dyslipidémie et l'obésité centrale. CONCLUSION: Le niveau de contrôle de l'hypertension était faible chez les personnes âgées et les facteurs de risque cardiométaboliques modifiables étaient relativement prévalents. L'obésité centrale et la dyslipidémie étaient prédictives d'un mauvais contrôle de l'hypertension. La prise en compte de ces facteurs peut donc améliorer le contrôle de la pression artérielle. Mots clés: Pression artérielle, Facteurs de risque cardiométabolique, Personnes âgées.


Assuntos
Hipertensão , Obesidade Abdominal , Idoso , Feminino , Humanos , Masculino , Pressão Sanguínea , Nigéria/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Morbidade
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