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1.
Environ Sci Pollut Res Int ; 28(2): 1966-1972, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32862346

RESUMO

This study aimed to assess the association between urinary concentrations of chlorophenols and childhood central obesity. The study subjects were 165 girls (91 with central obesity and 74 with non-central obesity) aged 7-8 years who visited a hospital for regular health check-ups. The urinary concentrations of chlorophenols including 2,4-dichlorophenol (2,4-DCP), 2,5-dichlorophenol (2,5-DCP), 2,4,5-trichlorophenol (2,4,5-TCP), and 2,4,6-trichlorophenol (2,4,6-TCP) were analyzed using liquid chromatography-tandem mass spectrometry. The central obesity group showed significantly higher urinary concentrations of 2,5-DCP (0.56 vs. 0.28 ng/mL) and 2,4,5-TCP (0.06 vs. 0.03 ng/mL) than the non-central obesity group. The sum of molar concentrations of urinary chlorophenols was also significantly higher in the central obesity group than in the non-central obesity group (9.83 vs. 5.26 nmol/L). Girls in the highest quartile of the molar sum of chlorophenols showed significantly higher body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) compared with the lowest quartile after adjusting for covariates. WC and WHtR, but not BMI, were significantly associated with higher quartiles of the molar sum of chlorophenols (P-for-trend = 0.025 and 0.028, respectively). We found a positive association between chlorophenol exposure and central obesity in Korean girls. Large-scale prospective studies are needed to confirm our findings.


Assuntos
Clorofenóis , Obesidade Abdominal , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Obesidade Abdominal/epidemiologia , Estudos Prospectivos , República da Coreia , Circunferência da Cintura
3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(12): 1402-1407, 2020 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-33333658

RESUMO

Objective: To examine the association of abdominal obesity assessed by waist circumference (WC) with carotid intima-media thickness (cIMT) in children. Methods: The study participants were from the "Huantai Childhood Cardiovascular Health Cohort Study" conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County to conduct the baseline survey from November 2017 to January 2018. A total of 1 515 children aged 6-11 years old were included. The first follow-up survey was conducted from November to December 2019, and a total of 981 children aged 8-13 years old were finally included after exclusion of those with high cIMT at baseline. Questionnaire survey, physical examination and ultrasonic examination were used to collect general demographic characteristics, WC and cIMT information. According to the status of WC at baseline, the participants were divided into normal WC group and abdominal obesity group. Covariance analysis was used to compare the cIMT levels of children between normal WC group and abdominal obesity group. Multivariable logistic regression models were used to evaluate the association between baseline abdominal obesity and high cIMT during the follow-up. Results: The age of 981 children was (8.5±1.5) years at the baseline. The follow-up age was (10.5±1.5) years, and 520 boys accounted for 53.0%. The cIMT of children in the abdominal obesity group was 0.54 mm, which was higher than that in the normal WC group (0.51 mm) (P<0.001). Similarly, the prevalence of high cIMT in children with abdominal obesity (23.9%) was higher than that of normal WC group (3.9%) (P<0.001). After adjusting for potential covariates at the baseline and during the follow-up period, compared with the normal WC group, abdominal obesity was significantly associated with high cIMT (OR=5.78, 95%CI:3.43-9.74). Conclusion: The abdominal obesity in children could increase the risk of high cIMT.


Assuntos
Obesidade Abdominal , Obesidade Pediátrica , Adolescente , Espessura Intima-Media Carotídea , Criança , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia , Fatores de Risco
4.
PLoS One ; 15(11): e0242557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33232343

RESUMO

BACKGROUND AND OBJECTIVE: Sarcopenic obesity is associated with a higher risk of cardiometabolic disease and mortality than either sarcopenia or obesity alone. However, no study has investigated body shape indices for the assessment of sarcopenia in obese populations. Thus, this study aimed to evaluate the accuracy of body shape indices to assess sarcopenia in nationally representative populations with abdominal obesity. METHODS: Data from the U.S. National Health and Nutrition Examination Survey (U.S. NHANES) 1999-2006 and Korea NHANES (KNHANES) 2008-2011 were assessed. The association between Body Shape Index and sarcopenia was analyzed using a receiver operating characteristic curve. The Z-score of the log-transformed A Body Shape Index (LBSIZ) cut-off value was defined as that with the highest score of the Youden's index. Changes in odds ratios (OR) for sarcopenia were investigated using restricted cubic spline (RCS) plots. RESULTS: This study included 8,013 American and 4,859 Korean adults with abdominal obesity. The overall area under the curve (AUC) of LBSIZ for sarcopenia was 0.816 (95% CI: 0.794-0.838) in U.S. NHANES and 0.822 (95% CI: 0.799-0.844) in KNHANES, which was higher than that of the body roundness index, conicity index, and waist to height ratio (p with DeLong's test <0.001). The cut-off values for the LBSIZ were 1.05 (sensitivity, 88.0%; specificity, 81.5%) for American men, 0.45 (sensitivity, 77.1%; specificity, 70.6%) for American women, 1.15 (sensitivity, 77.5%; specificity, 77.1%) for Korean men and 0.95 (sensitivity, 74.3%; specificity, 69.3%) for Korean women in the development groups. Comparable results were verified in validation groups. The RCS plot indicated that ORs for sarcopenia rapidly increased with an increase in the LBSIZ cut-off value. CONCLUSION: The increased LBSIZ could function as a reliable and cost-effective screening tool for assessing low muscle mass in populations with abdominal obesity.


Assuntos
Músculo Esquelético/patologia , Obesidade Abdominal/complicações , Sarcopenia/etiologia , Distribuições Estatísticas , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Composição Corporal , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/patologia , Tamanho do Órgão , República da Coreia/epidemiologia , Sarcopenia/epidemiologia , Sarcopenia/patologia , Sensibilidade e Especificidade , Estados Unidos/epidemiologia , Circunferência da Cintura
5.
PLoS One ; 15(11): e0241121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33147251

RESUMO

BACKGROUND: Central obesity is known to be associated with diabetes. Increasing lower extremity circumference was hypothesized in association with lower risk of diabetes. OBJECTIVE: This study determined which anthropometric patterns correlates the best with pre-diabetic and diabetic status among healthy adults. DESIGN: Cross-sectional study with nationwide population sampling of participants was designed. PARTICIPANTS: In total, 1,358 ethnic Chinese adult participants were recruited from the Nutrition and Health Survey in Taiwan 2013-2016; the whole-body composition was measured through dual-energy X-ray absorptiometry. MAIN OUTCOME MEASURES: Fat and lean mass in whole and specific parts of body among heathy Asian adults with normal glycemic, pre-diabetic, and diabetic states were measured, separately. STATISTICAL ANALYSES PERFORMED: The generalized linear model was used to investigate the association between body composition (lean and fat mass) and hyperglycemic status. The reduced rank regression (RRR) was used to confirm the correlation between glycemic status and predicting factors (body composition parameters). RESULTS: Trunk fat positively correlated with the fasting glucose level (r = 0.327, P < 0.001) and HbA1c (r = 0.329, P < 0.001), whereas limb fat negatively correlated with the fasting glucose level (r = -0.325, P < 0.001) and HbA1c (ρ = -0.342, P < 0.001), respectively. In RRR analyses, fasting glucose and HbA1c exhibited a high positive association on fat amount per lean mass of the trunk (factor loading = 0.5319 and 0.5599, respectively) and of android area (0.6422 and 0.6104) and a high negative association fat amount per lean mass of the legs (-0.3863 and -0.3083) and gynoid area (-0.3414 and -0.3725). CONCLUSIONS: For healthy community participants, increasing trunk fat had a greater risk of hyperglycemic status. Increasing lower extremity mass may confer lower risk of diabetes.


Assuntos
Distribuição da Gordura Corporal , Diabetes Mellitus/epidemiologia , Obesidade Abdominal/epidemiologia , Estado Pré-Diabético/epidemiologia , Absorciometria de Fóton , Adulto , Idoso , Glicemia/análise , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/metabolismo , Estado Pré-Diabético/sangue , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/metabolismo , Fatores de Risco , Taiwan/epidemiologia
6.
PLoS One ; 15(11): e0242417, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33206709

RESUMO

BACKGROUND: Waist circumference (WC) measurement is practical to define central obesity. However, WC cut-off point might be differ based on different race or ethnicity. This study aims to analyze the optimal WC cut-off point to identify T2DM risk among Indonesian population. METHOD: We analyzed the secondary data of national based cross-sectional study of the Indonesian Basic National Health Research 2013, comprising 24,660 adults aged ≥ 18 years who were assessed for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). The new proposed cut-off point for WC was calculated using ROC curve analysis and Youden index. The odds ratio of having T2DM was calculated using logistic regression analysis. RESULTS: Increased WC was associated with worsening dysglycemia status among men and women (p<0.001). The optimal cut-off point of WC for detecting T2DM from ROC analysis was 76 for men and 80 for women. Based on this WC cut-off point, the odds ratio for having T2DM was 1.64 [95% CI 1.45-1.86, p<0.01] for men and 1.90 [95% CI 1.71-2.11 p<0.01] for women. CONCLUSION: The newly proposed WC cut-off point of 76 for men and 80 women can be used to screen the risk of T2DM among Indonesian population.


Assuntos
Diabetes Mellitus/etnologia , Obesidade Abdominal/etnologia , Circunferência da Cintura/etnologia , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Diabetes Mellitus/fisiopatologia , Glucose/metabolismo , Teste de Tolerância a Glucose , Inquéritos Epidemiológicos , Hipertensão/epidemiologia , Indonésia/etnologia , Obesidade/complicações , Obesidade/metabolismo , Obesidade Abdominal/epidemiologia , Razão de Chances , Curva ROC , Fatores de Risco , Circunferência da Cintura/fisiologia
7.
Medicine (Baltimore) ; 99(43): e22855, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120822

RESUMO

BACKGROUND: Abdominal obesity occurs when excessive visceral and subcutaneous fat is built up around the abdomen and stomach, which negatively impacts human health. Moxibustion, arose from Traditional Chinese Medicine (TCM), has been widely applied in the treatment of abdominal obesity. Several studies have shown the positive effects of moxibustion in prevention and treatment of endocrine issues and excess body weight. In this context, our study aims to examine the safety and efficacy of the combination of moxibustion and characteristic lifestyle intervention of TCM in the treatment of abdominal obesity. METHODS/DESIGN: This study will be a multicenter, randomized, controlled trial conducted from September 2020 to January 2022 that includes 150 participants who have abdominal obesity and meet the eligibility criteria. The participants will be randomly divided into 3 groups in a 2:2:1 allocation ratio. The intervention group will receive moxibustion combined with characteristic lifestyle intervention of TCM; the other group will receive moxibustion combined with lifestyle intervention; the control group will receive lifestyle intervention only. Eight-week moxibustion sessions will be provided to participants assigned to the 2 intervention groups. The characteristic lifestyle intervention of TCM will also last 8 weeks, whereas the lifestyle intervention will last 12 weeks including 8-week treatment period, 4-week follow-up period. The primary outcome is the waist circumference measured by a tape measure. The secondary outcomes include obesity-related indicators, serum biochemical indexs, blood pressure, conversion score of physical symptoms, and measurement of the scale. Adverse events will be recorded during the treatment and follow-up period. DISCUSSION: The results are expected to provide clinical evidence for the application of the combination of moxibustion and characteristic lifestyle intervention of TCM in patients with abdominal obesity. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04501198, Registered on 9 June 2020.


Assuntos
Moxibustão/métodos , Obesidade Abdominal/terapia , Feminino , Estilo de Vida Saudável , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
High Blood Press Cardiovasc Prev ; 27(6): 579-586, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33098553

RESUMO

INTRODUCTION: Sex-difference in types of cardiac organ damage has been reported in subjects with increased body mass index (BMI). However less is known about sex-differences in left ventricular (LV) myocardial function assessed by global longitudinal strain (GLS) in these subjects. METHODS: 493 subjects (mean age 47 ± 9 years, 61% women) with BMI > 27.0 kg/m2 and without known cardiac disease underwent 24-hour (24h) ambulatory blood pressure (BP) recording, body composition analysis, carotid-femoral pulse wave velocity (PWV) measurement and echocardiography. LV peak systolic GLS was measured by two-dimensional speckle tracking echocardiography and LV ejection fraction (EF) by biplane Simpson's method. Insulin sensitivity was assessed by homeostatic model of insulin resistance (HOMA-IR). RESULTS: Women had higher prevalence of increased waist circumference (99% vs. 82%), lower prevalence of hypertension (59 vs. 74%), and lower serum triglycerides (1.3 ± 0.7 vs. 1.7 ± 0.9 mmol/L) and carotid-femoral PWV (7.3 ± 1.6 vs. 7.7 ± 1.6 m/s) compared to men (all p < 0.05). Women also had higher (more negative) GLS compared to men (- 19.9 ± 3.0 vs. - 18.6 ± 3.0%, p < 0.001), while EF did not differ between sexes. In multivariable linear regression analyses, lower GLS in women was associated with higher waist circumference and PWV and with lower EF (all p < 0.05). In men, lower GLS was associated with higher waist circumference and HOMA-IR, and with lower EF (all p < 0.05). CONCLUSIONS: Among subjects with increased BMI, GLS was higher in women than men. Lower GLS was associated with abdominal obesity in both sexes, and with impaired glucose metabolism in men, and with higher arterial stiffness in women. TRIAL REGISTRATION: https://www.clinicaltrials.gov NCT02805478, first registered 20.06.16.


Assuntos
Índice de Massa Corporal , Disparidades nos Níveis de Saúde , Obesidade Abdominal/fisiopatologia , Volume Sistólico , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Estudos Transversais , Feminino , Transtornos do Metabolismo de Glucose/sangue , Transtornos do Metabolismo de Glucose/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Prevalência , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/epidemiologia , Circunferência da Cintura
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(9): 1450-1454, 2020 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-33076597

RESUMO

Objective: To evaluate the association of abdominal obesity and obesity types with carotid intima-media thickness (cIMT) in children and provide scientific evidence for the prevention of abnormal vascular structure. Methods: Based on the "Children's Cardiovascular Health Cohort" conducted in Huantai county of Zibo, Shandong province from November 2017 to January 2018, a total of 1 240 children, including 657 boys (53.0%), who had completed data of sex, age, physical examinations, blood biochemical indices and lifestyle variables (collected by questionnaires) were included for the analysis. Covariance analysis was used to compare the levels of cIMT in groups with normal waist circumference, pre-abdominal obesity and abdominal obesity. Logistic regression analysis was used to evaluate the association of pre-abdominal obesity and abdominal obesity with high cIMT, and the association of combined effect of general overweight or obesity and abdominal obesity or pre-abdominal obesity with high cIMT. Results: The levels of cIMT in children with pre-abdominal obesity (0.47±0.03) mm and abdominal obesity (0.50±0.04) mm were higher than that in children with normal waist circumference (0.45±0.05) mm, the difference was significant (P<0.001). The detection rates of high cIMT in children with pre-abdominal obesity(20.8%) and abdominal obesity (49.5%) were higher than that in children with normal waist circumference (8.8%), the difference was significant (P<0.001). Compared with normal waist circumference, pre-abdominal obesity and abdominal obesity were significantly associated with high cIMT (pre-abdominal obesity: OR=2.53, 95%CI: 1.67-3.84; abdominal obesity: OR=8.56, 95%CI: 5.97-12.29) after adjustment for potential covariates. Compared with normal body mass index and normal waist circumference, abdominal obesity or pre-abdominal obesity alone (OR=2.24, 95%CI: 1.36-3.69), and mixed overweight and obesity (OR=6.94, 95%CI: 4.87-9.90) were significantly associated with high cIMT. Conclusions: The association between abdominal obesity and high cIMT was significant in children, and the association was stronger between mixed overweight or obesity and high cIMT, suggesting that we should consider mixed overweight and obesity in the prevention of abnormal vascular structure.


Assuntos
Espessura Intima-Media Carotídea , Obesidade Abdominal , Obesidade Pediátrica , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia
10.
PLoS One ; 15(10): e0241242, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33104712

RESUMO

BACKGROUND: Frailty and obesity contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients, but the interaction between frailty and obesity remains uncertain. OBJECTIVE: To examine the interaction between frailty and obesity on the clinical outcome of PD patients. DESIGN: Single centre prospective observational cohort study. PATIENTS: 267 prevalent Chinese PD patients were recruited. MEASUREMENTS: Frailty was identified by a standard score. General and central obesity were determined by body mass index (BMI) and waist-hip ratio (WHR), respectively. Body composition was assessed by bioimpedance spectroscopy. All patients were followed for two years. Outcome measures included all-cause as well as cardiovascular mortality and hospitalization. RESULTS: Of the 267 patients, 120 (44.9%) were frail. Frail individuals were more likely to have central obesity (p < 0.001) but not general obesity. Although WHR did not predict patient survival, there was a significant interaction between WHR and frailty on patient survival and cardiovascular survival (p = 0.002 and p = 0.038, respectively). For patients without frailty, the two-year cardiovascular survival was 91.3% and 74.4% for those with and without central obesity, respectively (p = 0.002). For patients with frailty, however, the two-year cardiovascular survival was 64.6% and 66.7% for those with and without central obesity, respectively (p = 0.6). For patients without frailty, the number of hospital admission for cardiovascular disease over 2 years were 0.12 ± 0.37 and 0.34 ± 0.72 for those with and without central obesity, respectively (p = 0.03). For frail patients, however, the number of hospital admission was similar between those with and without central obesity. CONCLUSION: There is a significant interaction between frailty and central obesity on the outcome of PD patients. The protective role of central obesity is only apparent in PD patients without frailty but not the frail ones, and there is a little prognostic value of general (non-central) obesity.


Assuntos
Fragilidade/complicações , Obesidade Abdominal/complicações , Diálise Peritoneal , Espectroscopia Dielétrica , Feminino , Hospitalização , Humanos , Estimativa de Kaplan-Meier , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Modelos de Riscos Proporcionais , Análise de Sobrevida , Resultado do Tratamento , Relação Cintura-Quadril
11.
Medicine (Baltimore) ; 99(35): e21327, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871862

RESUMO

The prevalence of type 2 diabetes (T2D) has increased recently in Qatar. Body mass index (BMI) is a predictor of T2D in many populations. However, BMI is based on height and weight measurements and not on body adiposity. Therefore, the utility of BMI for predicting the risk of T2D has been questioned. Visceral adiposity appears to be a better predictor of T2D.This study aimed to assess the relative effectiveness of visceral adiposity index (VAI) and body adiposity index (BAI), in comparison with BMI, for T2D among Qatari adults.A random sample of 1103 adult Qatari nationals and long term residents over 20 years old were included in this study. This data were obtained from the Qatar Biobank (QBB). We performed a multivariate logistic regression to examine the association between VAI, BAI, BMI, and T2D, and computed z-scores for VAI, BAI and BMI.VAI z-scores showed the strongest association with the risk of T2D (OR, 1.44; 95% CI: 1.24-1.68) compared with the z-scores for BAI (OR, 1.15; 95% CI: 0.93-1.43) and BMI (OR, 1.33; 95% CI: 1.11-1.59). ROC curve analysis showed that VAI was a stronger predictor than BAI and BMI (P < .0001). Subgroup analysis indicated that the association was stronger between VAI and T2D in Qatari women than in men.VAI was a stronger and an independent predictor of T2D compared to BAI and BMI among the Qatari adult population. Therefore, VAI could be a useful tool for predicting the risk of T2D among Qatari adults.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Gordura Intra-Abdominal/patologia , Obesidade Abdominal/complicações , Adiposidade , Adulto , Algoritmos , Antropometria/métodos , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Gordura Intra-Abdominal/crescimento & desenvolvimento , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Catar/epidemiologia
12.
Medicine (Baltimore) ; 99(37): e22202, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925796

RESUMO

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


Assuntos
Síndrome Metabólica/epidemiologia , Obesidade Abdominal/epidemiologia , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Pesos e Medidas Corporais , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Gordura Intra-Abdominal/fisiopatologia , Estilo de Vida , Lipídeos/sangue , Masculino , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
13.
BMJ ; 370: m3324, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967840

RESUMO

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


Assuntos
Obesidade Abdominal/mortalidade , Índice de Massa Corporal , Humanos , Obesidade Abdominal/diagnóstico , Circunferência da Cintura , Relação Cintura-Quadril
14.
Sci Rep ; 10(1): 13734, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32792565

RESUMO

The prevalence of diabetes mellitus is increasing worldwide, including the nation of Poland. The aim of this prospective and observational study was to determine risk factors and the predictors of diabetes incidence in elderly women, and to calculate the diabetes incidence ratio in this population. Two-hundred women, aged 65-74, who were non-diabetic at baseline in 2012 were followed for 6.5 years. All women were checked for incident diabetes. In non-diabetic subjects, diagnostic procedures for diabetes were performed according to Poland's Diabetes recommendations. Between April 2012 and September 2018, 25 women developed diabetes and the next 11 cases were diagnosed based on FPG or oral glucose tolerance test. Women with incident diabetes had significantly higher baseline FPG, triglycerides (TG), TG/HDL cholesterol ratio and visceral adiposity index (VAI) score, and lower abdominal aorta diameter (AAD), HDL cholesterol and eGFR. In the Cox proportional hazard regression analysis, only AAD < 18 mm and VAI score ≥ 3.8 were independently associated with diabetes risk, hazard ratio (HR) 2.47 (95% confidence interval 1.21-5.02), P = 0.013 and HR 2.83 (1.35-5.94), P = 0.006 respectively. In the backward stepwise regression analysis including all variables, diabetes incidence could be predicted from a linear combination of the independent variables: AAD < 18 mm (P = 0.002), VAI score ≥ 3.8 (P < 0.001) and FPG ≥ 5.6 mmol/L (P = 0.011). The calculated incidence of diabetes was 2769.2 new cases/100,000 persons per year. AAD below 18 mm seem to be a novel, independent marker of diabetes risk in elderly women, and AAD assessment during routine abdomen ultrasound may be helpful in identifying females at early elderliness with high risk of diabetes incidence.


Assuntos
Aorta Abdominal/fisiologia , Diabetes Mellitus Tipo 2/etiologia , Obesidade Abdominal/fisiopatologia , Abdome/fisiologia , Adiposidade/fisiologia , Idoso , Aorta Abdominal/metabolismo , HDL-Colesterol/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Teste de Tolerância a Glucose/métodos , Humanos , Incidência , Gordura Intra-Abdominal/metabolismo , Gordura Intra-Abdominal/fisiologia , Obesidade Abdominal/metabolismo , Polônia , Prevalência , Estudos Prospectivos , Fatores de Risco , Triglicerídeos/metabolismo , Mulheres
15.
J Steroid Biochem Mol Biol ; 203: 105737, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32818561

RESUMO

Abdominal obesity may be defined as excess deposits of fat in the abdominal region. It is a common health condition seen in South Asians and is positively related to non-communicable diseases (NCDs). It is independent of body mass index and measured by raised waist circumference for men≥90 cm and women≥80 cm. The reason for its prevalence being common in Indians finds its root from pregnancy, during fetal period and has emerged as a concept of 'Thin Fat Indian'. Malnutrition in such a critical period of growth has consequences in the form of reduced basal metabolic rate (BMR), reduced blood flow to growing tissues, reduced functional ability of vital organs, endocrine changes and reduced capacity of primary adipose tissue. However, excess of visceral fat facilitates high dosage of adipokines in the portal vein to liver and other body tissues having serious implications seen in the form NCDs like diabetes, hypertension, heart diseases, non-alcoholic fatty liver diseases, kidney disorders, cancer and other health problems. Abdominal obesity should be addressed before it has progressed further to defined health issues by exercise and diet, so that people can live a quality life.


Assuntos
Doenças não Transmissíveis/epidemiologia , Obesidade Abdominal/epidemiologia , Adipocinas/metabolismo , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu , Humanos , Doenças não Transmissíveis/etnologia , Obesidade Abdominal/etnologia , Grupo com Ancestrais Oceânicos
16.
Pan Afr Med J ; 36: 52, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774627

RESUMO

Truncal obesity and its associated health risk is an enormous burden. The traditional surgical treatment modality is liposuction or lipoabdominoplasty. An uncommon mode of the treatment is the use of abdominoplasty alone or as a surgical component. The aim of this report is to show a satisfactory outcome of abdominoplasty as the only surgical component in the management of severe truncal obesity in elderly male patient. We report a 75 year old Nigerian trader who had truncal obesity with gross abdominal asymmetry and cardiovascular and diabetes mellitus co-morbidities as well as bilateral knee osteoarthritis and social isolation due to truncal disfigurement. He was offered abdominoplasty as a sole surgical option for correction of anterior abdominal wall asymmetry. Apart from post operative wound complications and blood transfusion reactions, the patient had a good recovery and improved quality of life. Abdominoplasty is a rewarding treatment when used as a sole surgical option in centrally obese patients with anterior abdominal wall asymmetry and significant subcutaneous fat thickness.


Assuntos
Abdominoplastia/métodos , Obesidade Abdominal/cirurgia , Qualidade de Vida , Parede Abdominal/cirurgia , Idoso , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia
17.
Rev. cuba. endocrinol ; 31(2): e215, tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1138893

RESUMO

RESUMEN Introducción: Existen discrepancias en relación con el aumento de la adiposidad abdominal de los pacientes con hiperplasia suprarrenal congénita (HSC) y la influencia sobre ella de factores clínicos, hormonales y relacionados con la dosis y el tiempo de uso del tratamiento esteroideo. Objetivo: Describir la relación entre la obesidad abdominal, la dosis, el tiempo de tratamiento esteroideo los niveles de andrógenos circulantes y el perfil lipídico en los pacientes tratados por este padecimiento. Métodos: Estudio descriptivo, transversal, que incluyó a todos los niños y adolescentes con hiperplasia suprarrenal congénita por déficit de 21 hidroxilasa que recibían tratamiento esteroideo sustitutivo, atendidos en el departamento de endocrinología pediátrica del Instituto Nacional de Endocrinología durante el periodo 2000-2015. Se estudiaron variables clínicas, bioquímicas y hormonales. Para las variables cualitativas se calcularon frecuencias absolutas y porcentajes, media y desviación estándar para las variables cuantitativas. Se evaluaron asociaciones utilizando el coeficiente de correlación de Spearman y la prueba chi cuadrado para evaluar la significación estadística de la posible asociación, considerada cuando p < 0,05. Resultados: Fueron estudiados 29 pacientes, 24 (82,8 por ciento) con sexo social femenino, una edad promedio de 10,9 ± 6,27 años, edad al diagnóstico de 1,9 años ± 2,7 años y edad de inicio del tratamiento 2,03 ± 2,7 años. Las formas clásicas predominaron con 23 pacientes (79,3 por ciento), 11 perdedoras de sal (47,8 por ciento) y 12 formas virilizantes simples, solo 6 correspondieron a las formas no clásicas (20,7 por ciento). En los tres grupos se comprobó adiposidad abdominal incrementada según el índice abdomen/talla (0,52 vs. 0,51 vs. 0,51). La utilización de mayores dosis de esteroides se correlacionó de manera positiva con mayor circunferencia de cintura (p < 0,05) y abdomen (p < 0.01). En 13 (44,8 por ciento) pacientes se comprobó obesidad abdominal y el perfil lipídico mostró valores normales en todos los casos estudiados. Conclusiones: La obesidad abdominal constituye un signo frecuente en los pacientes con HSC. Es preciso monitorear con precisión las dosis de esteroides empleadas, establecer estrategias de seguimiento más completas y estimular estilos de vida saludables, lo que redundará a largo plazo en menores consecuencias cardiometabólicas(AU)


ABSTRACT Introduction: Some disagreement exists concerning the increase in abdominal adiposity in patients with congenital adrenal hyperplasia and the influence of clinical, hormonal and dose-related factors and the time of steroid treatment use. Objective: To identify the presence of abdominal obesity and its relationship with the dose and time of steroid treatment, as well as with the levels of circulating androgens, and describe the lipid profile of these patients. Methods: Cross-sectional and descriptive study that included all the children and adolescents with 21-hydroxylase-deficient congenital adrenal hyperplasia and who received steroid replacement treatment, treated at the pediatric endocrinology department of the National Institute of Endocrinology, in the period 2000-2015. Clinical, biochemical and hormonal variables were studied. For the qualitative variables, absolute frequencies and percentages; mean and standard deviations were calculated for the quantitative variables. Associations were evaluated using the Spearman correlation coefficient. The chi-square test was used to evaluate the statistical significance of the possible association, considered when p < 0.05. Results: Twenty-nine patients were studied: 24 (82.8 percent) with female social sex, an average age of 10.9 ± 6.27 years, age of diagnosis at 1.9 ± 2.7 years, and age of treatment beginning at 2.03 ± 2.7 years. The classical forms predominated in 23 patients (79.3 percent): 11 salt losers (47.8 percent) and 12 simple virializing forms; only six corresponded to non-classical forms (20.7 percent). In the three groups, increased abdominal adiposity was found, according to abdomen/height index (0.52 vs. 0.51 vs. 0.51). The use of higher doses of steroids was correlated positively with greater circumference of waist (p < 0.05) and abdomen (p < 0.01). In 13 (44.8 percent) patients, abdominal obesity was found, while the lipid profile showed normal values in all the cases studied. Conclusions: Abdominal obesity is a frequent sign in patients with congenital adrenal hyperplasia. It is necessary to monitor accurately the doses of steroids used, establish more comprehensive follow-up strategies, and encourage healthy lifestyles, which will result in fewer long-term cardiometabolic consequences(AU)


Assuntos
Humanos , Epidemiologia Descritiva , Hiperplasia Suprarrenal Congênita/etiologia , Obesidade Abdominal/epidemiologia
18.
Nutr Metab Cardiovasc Dis ; 30(11): 2001-2007, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-32807634

RESUMO

BACKGROUND AND AIMS: Obesity-related diseases play a significant role in the epidemiology of stroke; however, the exact effects of obesity and transitions in obesity status on stroke risk are still unclear. This study was performed to investigate the association of general and abdominal obesity and their changes with stroke in Chinese adults. METHODS AND RESULTS: A total of 26,815 subjects (13,684 men and 13,131 women) aged ≥35 years participated in the study. The association of general and abdominal obesity and their changes with stroke was estimated by Cox proportional hazards models. During a median follow-up period of 11.8 years, 1507 people developed an incident stroke event. The multivariable-adjusted hazard ratios (HRs) (95% CIs) for stroke comparing the highest vs. lowest quartiles of these measurements were 1.276 (1.068-1.524) for BMI, 1.245 (1.035-1.499) for WC, 0.940 (0.786-1.125) for WHR, and 1.221 (1.019-1.464) for WHtR in men. For women, the corresponding values were 1.368 (1.089-1.718), 1.424 (1.119-1.813), 0.971 (0.765-1.232), and 1.341 (1.059-1.699), respectively. C- statistics showed no difference in the predictive value for stroke among various measures of adiposity. Compared with participants who maintained a normal BMI, the HRs for reversed general obesity was 1.272 (95% CI: 1.044-1.550) among men and 1.240 (95% CI: 0.948-1.623) among women. CONCLUSION: Increasing levels of general or abdominal adiposity consistently predict increased risk of stroke, and maintenance of a normal BMI or WC may aid in stroke prevention.


Assuntos
Adiposidade , Obesidade Abdominal/epidemiologia , Obesidade/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Índice de Massa Corporal , China/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/terapia , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Abdominal/terapia , Prevalência , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Saúde da População Rural , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/prevenção & controle , Fatores de Tempo , Circunferência da Cintura
19.
Artigo em Inglês | MEDLINE | ID: mdl-32764442

RESUMO

BACKGROUND/OBJECTIVES: The longitudinal effect of abdominal weight status (AWS) defined by waist circumference (WC) on healthy aging has not yet been comprehensively examined. Therefore, the purpose of the present study was to examine the temporal association between WC-defined AWS and a comprehensive assessment for healthy aging. SUBJECTS/METHODS: This study utilized data from 5211 respondents aged 65+ who participated in the National Health and Aging Trends Study from 2011 to 2018. Mixed effects regression models were used to examine the association between baseline AWS and the annual change rate in healthy aging score (HAS) via interaction terms (AWS*round) adjusting for confounding effects. Further multiple mixed models examined the relationship of AWS and HAS over an 8-year period. RESULTS: There were no annual change rate differences in HAS by baseline AWS, regardless of sex. However, males with abdominal obesity were more likely to have a lower HAS than males with normal AWS (ß = -0.20, 95% CI: -0.30, -0.10, p < 0.001) but no difference in HAS was observed between males with overweight and normal AWS. A similar pattern was observed among females. CONCLUSIONS: Study results indicate that AWS was associated with HAS but it did not modify annual HAS change rate over time.


Assuntos
Peso Corporal , Envelhecimento Saudável , Obesidade Abdominal , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Masculino , Obesidade , Obesidade Abdominal/epidemiologia , Circunferência da Cintura
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