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1.
Int Heart J ; 61(1): 103-108, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-31956154

RESUMO

Waist circumference (WC) is measured for the assessment of abdominal obesity, whereas carotid intima-media thickness (IMT) is a marker of preclinical atherosclerosis. The relationship between WC and carotid IMT in the general population is not fully understood. In this study, we examined 1,182 subjects (658 men and 524 women, 62.3 ± 11.7 years on average) who underwent voluntary health check-ups and sought to determine the optimal cut-off value of WC for predicting carotid IMT thickness. Receiver operating characteristic curve analysis of WC was utilized to predict high carotid IMT (defined as carotid IMT ≥ 1.1 mm). We determined that the appropriate WC cut-off value was a WC ≥ 79 cm for men and women. There was a statistically significant difference in the prevalence of high carotid IMT between WC ≥ 79 cm and WC < 79 cm in both men and women. However, multivariable logistic regression analysis demonstrated that the WC category was independently associated with high carotid IMT in men, but not in women. Our study indicates that the optimal cut-off value of WC to identify preclinical atherosclerosis may be lower than the current Japanese diagnostic criteria for metabolic syndrome (MetS) in both men and women. Compared to women, the association between WC and preclinical atherosclerosis may be more pronounced in men.


Assuntos
Aterosclerose/diagnóstico , Obesidade Abdominal/diagnóstico , Idoso , Aterosclerose/epidemiologia , Espessura Intima-Media Carotídea , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Prevalência , Curva ROC , Fatores Sexuais , Circunferência da Cintura
2.
High Blood Press Cardiovasc Prev ; 27(1): 61-82, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31981085

RESUMO

INTRODUCTION: Metabolic syndrome (MetS) is a risk factor for cardiovascular-related morbidity and mortality. Although the risk factors for MetS are well documented, differences in gender-based demographics among Kenyan adults with central obesity are lacking. AIM: Determine gender differences in the pattern of socio-demographics relevant to metabolic syndrome among Kenyan adults with central obesity at a mission hospital, Nairobi. METHODS: A cross-sectional baseline survey involving adults (N = 404) with central obesity aged 18-64 years, as part of a community-based lifestyle intervention study. Respondents were systematically sampled using the International Diabetes Federation definition for MetS. Lifestyle characteristics, anthropometric, clinical and biochemical markers were measured and analyzed using SPSS. RESULTS: High (87.2%) MetS prevalence associated with advanced age in males (p < 0.001) and females (p = 0.002) was observed. MetS was likely among divorced/separated/widowed (p = 0.021) and high income males (p = 0.002) and females (p = 0.017) with high income. Unemployed males (p = 0.008) and females with tertiary education (p = 0.019) were less likely to have MetS. Advanced age was likely to lead to high blood pressure, fasting blood glucose and triglycerides (p < 0.05). Males were more likely (p = 0.026) to have raised triglycerides, while females (p < 0.001) had low high density lipoproteins. CONCLUSION: A high prevalence of MetS associated with social and gender differences among Kenyan adults with central obesity. These underscore the need to look beyond the behavioral and biological risks and focus on every nuance of gender differences in addressing MetS and CVDs.


Assuntos
Disparidades nos Níveis de Saúde , Hospitais , Estilo de Vida , Síndrome Metabólica/epidemiologia , Obesidade Abdominal/epidemiologia , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Escolaridade , Emprego , Feminino , Humanos , Renda , Quênia/epidemiologia , Masculino , Estado Civil , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Prevalência , Fatores de Risco , Fatores Sexuais , Adulto Jovem
3.
Nutr Metab Cardiovasc Dis ; 29(12): 1353-1360, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31668457

RESUMO

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


Assuntos
Ácido Glutâmico/sangue , Síndrome Metabólica/sangue , Obesidade Abdominal/sangue , Adiposidade , Adolescente , Adulto , Biomarcadores/sangue , HDL-Colesterol/sangue , Estudos Transversais , Jejum/sangue , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Obesidade Abdominal/complicações , Obesidade Abdominal/diagnóstico , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangue , Regulação para Cima , Circunferência da Cintura , Adulto Jovem
4.
Transplant Proc ; 51(7): 2334-2338, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31402244

RESUMO

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


Assuntos
Antropometria/métodos , Resistência à Insulina , Transplante de Rim , Síndrome Metabólica , Obesidade Abdominal/diagnóstico , Adulto , Estudos Transversais , Feminino , Humanos , Resistência à Insulina/fisiologia , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Obesidade Abdominal/complicações , Prevalência , Fatores de Risco , Caracteres Sexuais , Circunferência da Cintura
5.
Biomed Res Int ; 2019: 9047324, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467918

RESUMO

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


Assuntos
Hepatopatia Gordurosa não Alcoólica/diagnóstico , Obesidade Abdominal/diagnóstico , Síndrome do Ovário Policístico/diagnóstico , Ultrassonografia , Adulto , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Resistência à Insulina , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/patologia , Obesidade Abdominal/complicações , Obesidade Abdominal/diagnóstico por imagem , Obesidade Abdominal/patologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/diagnóstico por imagem , Síndrome do Ovário Policístico/patologia , Prognóstico , Circunferência da Cintura , Saúde da Mulher , Adulto Jovem
6.
Nutrients ; 11(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31443303

RESUMO

Despite a global increase in childhood obesity over the past decades, several countries, including Switzerland, have recently reported stabilizing trends. Using national data from school-aged children in Switzerland over the past 16 years, our study aim was to assess changes in the prevalence of overweight and obesity, central adiposity and predictors of obesity related to lifestyle and parental factors. Nationally representative samples of children aged 6-12 years were studied in 2002 (n = 2493), 2007 (n = 2218), 2012 (n = 2963), and 2017/18 (n = 2279). Height and weight, waist circumference, and multiple skinfold thicknesses were measured. Potential risk factors for overweight and obesity were determined using a self-administered questionnaire in 2017/18, collecting data on diet, physical activity, and parental factors. Prevalence (95% CI) of overweight (incl. obesity) and obesity in 2017/18 was 15.9% (14.4-17.4) and 5.3% (4.5-6.3), respectively. Binary logistic regression revealed a small but significant decrease in the prevalence of overweight (including obesity) since 2002 (OR (95% CI) = 0.988 (0.978-0.997)), while the change in obesity alone was not significant. The most important risk factors for childhood overweight/obesity in 2017/18 were low parental education, non-Swiss origin of the parents, low physical activity of the child, and male sex. In conclusion, we have shown a small but significant declining trend in the childhood overweight/obesity prevalence over the past 15 years in Switzerland. Based on the risk factor analysis, preventive action in schoolchildren might be most effective in boys, migrant populations, and families with lower education, and should emphasize physical activity.


Assuntos
Adiposidade , Estilo de Vida Saudável , Obesidade Abdominal/prevenção & controle , Obesidade Pediátrica/prevenção & controle , Comportamento de Redução do Risco , Circunferência da Cintura , Fatores Etários , Criança , Estudos Transversais , Escolaridade , Emigrantes e Imigrantes , Exercício , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/fisiopatologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/fisiopatologia , Prevalência , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento Sedentário , Fatores Sexuais , Suíça/epidemiologia , Fatores de Tempo
7.
Diab Vasc Dis Res ; 16(6): 530-538, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31280604

RESUMO

OBJECTIVES: A recent experimental study revealed that family with sequence similarity 19 [chemokine (C-C motif)-like] member A5 (FAM19A5), a novel secreted adipokine, has inhibitory effects on vascular smooth muscle cell proliferation and migration, and on neointima formation in injured arteries. We investigated the associations between serum FAM19A5 concentration and cardio-metabolic risk factors for the first time in human subjects. METHODS: Circulating FAM19A5 concentrations and their associations with cardio-metabolic risk factors were explored in 223 individuals (45 without diabetes and 178 with type 2 diabetes). RESULTS: Serum FAM19A5 concentrations (pg/mL) were greater in patients with type 2 diabetes [median (interquartile range), 172.70 (116.19, 286.42)] compared with non-diabetic subjects [92.09 (70.32, 147.24)] (p < 0.001). Increasing serum FAM19A5 tertile was associated with trends of increasing waist-to-hip ratio, fasting plasma glucose, glycated haemoglobin and mean brachial-ankle pulse wave velocity. Serum FAM19A5 was positively correlated with waist circumference, waist-to-hip ratio, alanine aminotransferase, fasting plasma glucose, glycated haemoglobin and mean brachial-ankle pulse wave velocity. Multiple stepwise regression analyses identified waist-to-hip ratio, low-density lipoprotein cholesterol and brachial-ankle pulse wave velocity as determining factors for log-transformed serum FAM19A5 concentration (R2 = 0.0689). CONCLUSION: A novel adipokine FAM19A5 was related to various metabolic and vascular risk factors in humans, suggesting its potential as a biomarker of cardio-metabolic disease.


Assuntos
Doenças das Artérias Carótidas/sangue , Citocinas/sangue , Diabetes Mellitus Tipo 2/sangue , Obesidade Abdominal/sangue , Idoso , Índice Tornozelo-Braço , Biomarcadores/sangue , Glicemia/metabolismo , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Prevalência , Prognóstico , Análise de Onda de Pulso , República da Coreia/epidemiologia , Fatores de Risco , Regulação para Cima , Relação Cintura-Quadril
8.
Nutrients ; 11(6)2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31234393

RESUMO

There are discrepancies in the reports on the association of metabolic syndrome (MetS) and its components with bone mineral density (BMD) and hence more population-based studies on this subject are needed. In this context, this observational study was aimed to investigate the association between T-scores of BMD at lumbar L1-L4 and full MetS and its individual components. A total of 1587 participants (84.7% females), >35 years and with risk factors associated with bone loss were recruited from February 2013 to August 2016. BMD was done at L1-L4 using dual-energy X-ray absorptiometry (DXA). T-Scores were calculated. Fasting blood samples and anthropometrics were done at recruitment. Fasting lipid profile and glucose were measured. Screening for full MetS and its components was done according to the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. Logistic regression analysis revealed that the odds of having full MetS increased significantly from the lowest T-score tertile to the highest one in both sexes (OR, odd ratio (95% CI, confidence interval) of tertile 2 and 3 at 1.49 (0.8 to 2.8) and 2.46 (1.3 to 4.7), p = 0.02 in males and 1.35 (1.0 to 1.7) and 1.45 (1.1 to1.9), p < 0.01 in females). The odds remained significant even after adjustments with age, body mass index (BMI), and other risk factors associated with bone loss. Among the components of MetS, only central obesity showed a significant positive association with T-score. The study suggests a significant positive association of T-score (spine) with full MetS irrespective of sex, and among the components of MetS this positive association was seen specifically with central obesity.


Assuntos
Árabes , Densidade Óssea , Síndrome Metabólica/etnologia , Obesidade Abdominal/etnologia , Osteoporose/etnologia , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Feminino , Humanos , Lipídeos/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Obesidade Abdominal/diagnóstico , Osteoporose/diagnóstico por imagem , Prevalência , Medição de Risco , Fatores de Risco , Arábia Saudita/epidemiologia
9.
J Dermatol ; 46(8): 695-701, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31149744

RESUMO

Psoriasis is a chronic inflammatory skin disease known to be associated with a variety of systemic comorbidities, such as metabolic syndrome and obesity. Obesity represents a major comorbidity and has been suggested to be related to psoriasis. This nationwide population-based prospective cohort study was performed to investigate the impacts of body mass index (BMI) and waist circumference (WC) on psoriasis. We used the health check-up database and the study population consisted of subjects who had undergone health screening between January 2009 and December 2012. This study investigated patients newly diagnosed with psoriasis (International Classification of Disease, Tenth Revision, code L40) by dermatologists during the follow-up period (5.32 years), based on claims data. The total population consisted of 22 633 536 subjects, among whom 399 461 had newly developed psoriasis. Subjects with BMI of more than 30 had a higher risk of psoriasis (hazards ratio [HR], 1.118; 95% confidence interval [CI], 1.100-1.137) compared with the BMI 18.5-23 group. WC showed a dose-dependent association with psoriatic risk. Subjects with WC over 105 cm showed the highest risk of psoriasis (HR, 1.305; 95% CI, 1.261-1.349) compared with subjects with WC lower than 80/75 after adjusting for confounding factors, including BMI. The risk of psoriasis was highest in males with normal BMI and abdominal obesity (HR, 1.175; 95% CI, 1.150-1.200). Our study indicates that WC is a specific factor affecting psoriatic risk and highlights the association between abdominal obesity and psoriasis, thus increasing awareness of the role of abdominal obesity in the pathogenesis and comorbidities of psoriasis.


Assuntos
Obesidade Abdominal/complicações , Psoríase/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Estudos Prospectivos , Psoríase/etiologia , República da Coreia/epidemiologia , Fatores de Risco , Fatores Sexuais , Circunferência da Cintura , Relação Cintura-Quadril
10.
Nutr Metab Cardiovasc Dis ; 29(5): 474-480, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954417

RESUMO

BACKGROUND AND AIMS: The results of studies on the effect of trans-fatty acids (TFAs) and added sugars on obesity are not consistent. This study aimed to investigate whether the association of changes in general and central obesity with added sugar and TFA intakes is modified by common fat mass and obesity-associated gene (FTO) polymorphisms, in isolation or in a combined-form genetic risk score (GRS). METHODS AND RESULTS: Subjects of this cohort study were selected from among adult participants of the Tehran Lipid and Glucose Study (n = 4292, 43.2% male). Dietary data were collected using a valid and reliable food frequency questionnaire. The genotypes of selected polymorphisms (rs1421085, rs1121980, and rs8050136) were determined. Genetic risk score (GRS) was calculated using the dominant weighted method. The mean age of participants was 42.6 ± 14 and 40.4 ± 13 years in men and women, respectively. FTO rs8050136 polymorphisms and TFAs have a significant interaction in changing body mass index (BMI) (P interaction = 0.01). There were no changes in waist circumference (WC) and BMI among FTO risk allele carriers, across quartiles of added sugar intake. GRS and TFA intakes significantly interacted in altering the BMI and WC; thus, a higher intake of TFAs was associated with higher changes of BMI and WC in subjects with high GRS (P trend<0.05) compared to individuals with low GRS. CONCLUSION: Our findings suggest that TFA intake can increase the genetic susceptibility of FTO SNPs to BMI or WC change.


Assuntos
Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Açúcares da Dieta/efeitos adversos , Obesidade Abdominal/genética , Polimorfismo de Nucleotídeo Único , Ácidos Graxos Trans/efeitos adversos , Adulto , Feminino , Interação Gene-Ambiente , Predisposição Genética para Doença , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Fenótipo , Estudos Prospectivos , Fatores de Risco
11.
Lipids Health Dis ; 18(1): 93, 2019 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-30961653

RESUMO

BACKGROUND: The aim of this study was to evaluate the effect of a simple visceral obesity phenotype, known as the hypertriglyceridemic waist phenotype and its quantitative indicator waist circumference index on the severity of acute pancreatitis. MATERIALS AND METHODS: Diagnosis and severity analysis of acute pancreatitis were determined according to the Atlanta classification guidelines, revised in 2012. We considered the hypertriglyceridemic waist phenotype as characterized by increased waist circumference and elevated triglyceride concentrations. We investigated the association between the acute pancreatitis severity and hypertriglyceridemic waist phenotype, including waist circumference index. RESULTS: The hypertriglyceridemic waist phenotype was significantly associated with systemic inflammatory response syndrome, organ failure, and severe acute pancreatitis. The median waist circumference index and demonstration of hypertriglyceridemic waist phenotype were positively correlated with acute pancreatitis severity. In addition, multivariate logistic analysis showed that patients with the hypertriglyceridemic waist phenotype had 1.664 times the risk of organ failure and 1.891 times the risk of systemic inflammatory response syndrome, compared with the other groups. CONCLUSION: Upon admission, the hypertriglyceridemic waist phenotype was strongly associated with acute pancreatitis in patients. This phenotype, including waist circumference index, might be a simple method for evaluating individuals at high risk of severe acute pancreatitis.


Assuntos
Cintura Hipertrigliceridêmica/diagnóstico , Obesidade Abdominal/diagnóstico , Pancreatite Necrosante Aguda/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Triglicerídeos/sangue , Adulto , Índice de Massa Corporal , Feminino , Humanos , Cintura Hipertrigliceridêmica/sangue , Cintura Hipertrigliceridêmica/complicações , Cintura Hipertrigliceridêmica/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade Abdominal/sangue , Obesidade Abdominal/complicações , Obesidade Abdominal/patologia , Escores de Disfunção Orgânica , Pancreatite Necrosante Aguda/sangue , Pancreatite Necrosante Aguda/complicações , Pancreatite Necrosante Aguda/patologia , Fenótipo , Estudos Retrospectivos , Risco , Síndrome de Resposta Inflamatória Sistêmica/sangue , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Síndrome de Resposta Inflamatória Sistêmica/patologia , Circunferência da Cintura
12.
BMC Cardiovasc Disord ; 19(1): 88, 2019 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-30961530

RESUMO

BACKGROUND: Studies from Saudi Arabia have reported a continued increase in the prevalence of cardiovascular diseases and their associated risk factors. The objective of this study was to measure the gender differences in the cardiovascular disease (CVD) risk based on Framingham risk scores (FRS) and to explore the association of FRS with sedentary life style including physical inactivity, sitting time and central obesity among Saudi adults. METHODS: A cross-sectional survey was conducted on 2997 Saudi adults (males = 968, females = 2029) selected from 18 primary health care centres in Riyadh city, from December 2014 to August 2015. A detailed interview that evaluated lifestyle and past medical history was conducted; furthermore, anthropometric measurements and blood samples were collected for lipid profiling. The FRS were calculated based on the age, gender, systolic blood pressure, treatment for hypertension, diabetes, smoking status, total blood cholesterol and high-density lipoprotein levels. These scores were categorized into low risk (FRS < 10) and high/intermediate risk (≥10). A multivariable logistic regression analysis was performed. RESULTS: The mean (±SD) age of the males and females was 43.1(±11.7) vs 43.8(±10.9) years (p = 0.07), respectively. The number of Saudi male participants with intermediate-to-high FRS scores (≥10) was almost twice that of females (males 33% vs 17%). The multivariable logistic regression model after adjusting for education level and housing type, found that low physical activity (aOR & 95%CI for males 2.91 (1.45, 5.80); females 1.38 (1.06, 1.81); prolonged sitting time (aOR &95%CI for males 1.36 (0.98, 1.90) females 1.58 (1.20, 2.07), high central obesity (defined as waist circumference in males > 102 cms, and females > 88 cms) (aOR & 95%CI for males 2.38 (1.67, 3.41); females 3.35 (1.92, 5.87) were associated with high/ intermediate risk for CVD. CONCLUSIONS: A significant percentage of Saudi population revealed FRS ≥10. Females beyond the age of 50 were found to have a higher prevalence for CVD risk compared with males of the same age group. Modifiable risk factors like low physical activity, prolonged sitting time and central obesity have strong implications for primary prevention and management services that can change the risk profile of the Saudi population.


Assuntos
Doenças Cardiovasculares/epidemiologia , Exercício , Obesidade Abdominal/etnologia , Comportamento Sedentário , Adulto , Fatores Etários , Idoso , Doenças Cardiovasculares/diagnóstico , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Medição de Risco , Fatores de Risco , Arábia Saudita/epidemiologia , Fatores Sexuais , Postura Sentada , Fatores de Tempo
13.
BMJ Open ; 9(2): e024029, 2019 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-30782890

RESUMO

OBJECTIVE: To develop a novel sex independent anthropometric index, termed as angle index, related to type 2 diabetes. DESIGN: Case-control. PARTICIPANTS: The study comprised 121 participants and were divided into two groups. One group had no form of diabetes and served as controls (n=50). The other group had the condition of type 2 diabetes (n=71). 31% (n=37) of the subjects were male and 69% (n=84) were female. 62% (n=75) of the subjects were of East Indian ethnicity, 28% (n=34) were of African ethnicity and 10% (n=12) were of mixed ethnicity. SETTING: Participants of the study were from the island of Trinidad, located in the Caribbean. Patients in the study were selected at random from hospital records. PRIMARY OUTCOME MEASURE: It was hypothesised that the mean angle index of patients with type 2 diabetes would be higher than the mean angle index of patients without type 2 diabetes. RESULTS: Patients with type 2 diabetes had a significantly higher angle index value as compared with controls (p<0.001). Angle index was the superior sex independent anthropometric index in relation to type 2 diabetes (area under the curve=0.72; p<0.001) as compared with other sex independent variables. Angle index correlated with glycated haemoglobin (rs=0.28, p=0.003) and fasting blood glucose (rs=0.31, p=0.001) levels. Patients with type 2 diabetes were four times more likely to have an angle index greater than 184° (OR 4.2, 95% CI 1.8 to 9.9) as compared with controls. CONCLUSION: Angle index was a superior sex independent index for discriminating between patients with and without type 2 diabetes, as compared with waist circumference, abdominal volume index, conicity index, blood pressure readings, triglyceride levels and very low-density lipoprotein levels.


Assuntos
Antropometria/métodos , Diabetes Mellitus Tipo 2/metabolismo , Obesidade Abdominal/diagnóstico , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Pressão Sanguínea , Estudos de Casos e Controles , VLDL-Colesterol , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Medição de Risco , Triglicerídeos , Trinidad e Tobago , Umbigo , Circunferência da Cintura , Relação Cintura-Quadril
14.
Eur J Clin Invest ; 49(4): e13075, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30701542

RESUMO

BACKGROUND: Using telemedicine in the school setting in Greece, we screened a representative adolescent sample for MetS (International Diabetes Federation criteria) and explored its associations with anthropometric, sociodemographic and behavioural parameters. MATERIALS AND METHODS: Cross-sectional data were obtained from 12- to 17-year-old high school students. RESULTS: The prevalence of MetS in 1578 adolescents (mean age ± SD 14.4 ± 1.7 years) was 2.6% (3.4% among males; 2.0% among females), highest (4.3%) at age 13 years and lowest (1.3%) at 16 years. Adolescents with MetS had significantly higher mean body mass index (BMI) ± SD than those without MetS (30.2 ± 4.2 vs 21.3 ± 3.2 kg/m2 , respectively; P < 0.001); among participants with obesity, 31.6% had MetS. Abdominal obesity, elevated triglycerides, low HDL-cholesterol, impaired fasting blood glucose (FBG) and elevated blood pressure (BP) were detected in 9.5%, 2.3%, 10.7%, 25.9% and 21.8% of participants, respectively. Additional analysis (modified NCEP:ATPIII youth criteria) demonstrated similar overall prevalence of MetS (2.9%). Statistically significant correlations were found between most anthropometric and MetS characteristics, with the exception of FBG, which was correlated only with systolic BP. BMI was strongly correlated with waist and hip circumferences (r = 0.818, P < 0.001; r = 0.825, P < 0.001, respectively). Single parenthood and older maternal age (>60 years) were risk factors for MetS. Although counterintuitive, body image distortion, body dissatisfaction and bullying about weight were more prevalent in normal weight girls. CONCLUSIONS: The overall prevalence of MetS was low but 12-fold higher when obesity was taken into account. Impaired FBG and elevated BP were the most prevailing features. Telemedicine services were used effectively in Greek schools for screening youth MetS.


Assuntos
Síndrome Metabólica/diagnóstico , Telemedicina , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Diagnóstico Precoce , Feminino , Grécia/epidemiologia , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Prevalência , Serviços de Saúde Escolar , Inquéritos e Questionários
15.
Vital Health Stat 2 ; (182): 1-20, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30707674

RESUMO

Objective This report compares five methods of waist circumference (WC) measurements: 1) the National Heart, Lung, and Blood Institute (NHLBI-WC); 2) the World Health Organization (WHO-WC); 3) the Multi-Ethnic Study of Atherosclerosis (MESA-WC) using Gulick II Plus tape; 4) the Multi-Ethnic Study of Atherosclerosis (MESA-WC) using Lufkin tape; and 5) assisted self-measurement over clothes (MESA-assisted). Method During 2016, measurements were obtained from 2,297 participants aged 20 and over, who participated in the National Health and Nutrition Examination Survey (NHANES). The mean differences and sensitivity and specificity for abdominal obesity (AO) were calculated between the NHLBI-WC (reference) and the other four WC measurements. Results The mean difference between NHLBI-WC and WHO-WC was 0.81 cm for men and 3.21 cm for women ( p ≤ 0.0125 for both); between NHLBI-WC and MESA-WC (Gulick) was -0.68 cm for men ( p ≤ 0.0125) and -0.89 cm for women; between NHLBI-WC and MESA-WC (Lufkin) was 0.02 cm for men and 0.08 cm for women; and between NHLBI-WC and MESA-assisted was -0.71 cm for men and 1.34 cm for women ( p ≤ 0.0125 for both). Sensitivity and specificity for AO, with NHLBI-WC as a reference, for men were greater than 90% for all methods; for women, sensitivity and specificity for AO for MESA-WC (Lufkin) were greater than 90%; for women, WHO-WC, MESAWC (Gulick), and MESA-assisted methods were greater than 85%.


Assuntos
Antropometria/métodos , Obesidade Abdominal/diagnóstico , Circunferência da Cintura , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Heart, Lung, and Blood Institute (U.S.) , Inquéritos Nutricionais , Sensibilidade e Especificidade , Fatores Sexuais , Estados Unidos , Organização Mundial da Saúde , Adulto Jovem
16.
Mayo Clin Proc ; 94(2): 211-224, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30711119

RESUMO

OBJECTIVE: To assess the effectiveness of exercise and pharmacotherapy interventions in reducing visceral adipose tissue (VAT). PATIENTS AND METHODS: A systematic search of Ovid MEDLINE, Scopus, Web of Science, Cochrane Library, ClinicalTrials.gov, New York Academy of Science Grey Literature Report, and OpenGrey was combined with hand searches of existing literature. A total of 2515 titles and abstracts were reviewed. Only randomized controlled trials evaluating the effectiveness of monitored exercise or pharmacological interventions in reducing VAT by using computed tomography or magnetic resonance imaging during a sustained intervention period (≥6 months) were included. Data were independently extracted by reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed for quality and risk of bias. Separate analyses for each intervention were performed using random effect models, with pooled estimates of the change in VAT area (in centimeters squared) from baseline to follow-up reported as standardized mean difference (SMD; with 95% CI). RESULTS: A total of 3602 participants from 17 randomized controlled trials were included in the final analysis. Both exercise and pharmacological interventions were associated with significant reductions in VAT: small reduction with pharmacological interventions (SMD, -0.27; 95% CI, -0.47 to -0.07; P=.02) and more substantial reductions with exercise interventions (SMD, -0.54; 95% CI, -0.63 to -0.46; P<.001). The mean absolute VAT reduction was greater in pharmacological trials than in exercise trials. Meta-regression exhibited a linear correlation between VAT and weight loss (R2=0.52 for exercise and R2=0.88 for pharmacological interventions), but VAT reduction relative to weight loss differed by intervention type. CONCLUSION: Exercise interventions resulted in greater reduction in VAT relative to weight loss than did pharmacological interventions. A preferential reduction in VAT may be clinically meaningful when monitoring success of interventions because weight loss alone may underestimate benefits.


Assuntos
Anticolesterolemiantes/uso terapêutico , Terapia por Exercício/métodos , Exercício/fisiologia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Obesidade Abdominal , Perda de Peso/fisiologia , Adiposidade , Humanos , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Abdominal/reabilitação , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Nutr Metab Cardiovasc Dis ; 29(2): 177-184, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30660687

RESUMO

BACKGROUND AND AIMS: Obesity and insulin resistance development are related to known risk factors (such as diet) that begin in childhood. Among dietary factors, the consumption of ultra-processed foods has received attention. The present study investigated the association between ultra-processed foods consumption at preschool age and changes in anthropometric measurements from preschool to school age and glucose profile at school age. METHODS AND RESULTS: The present study was a follow-up of a randomized controlled trial, conducted with 307 children of low socioeconomic status from São Leopoldo, Brazil. At ages 4 and 8 years, children's anthropometric assessments were collected from preschool to school age including body-mass index (BMI) for-age, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold. At the age 8 years, blood tests were performed to measure glucose profile. Dietary data were collected through 24-h recalls and the children's ultra-processed food intake was assessed. Linear regression analysis was used to assess the relationship between ultra-processed food consumption and the outcomes. The percentage of daily energy provided by ultra-processed foods was 41.8 ± 8.7 (753.8 ± 191.0 kcal) at preschool age and 47.8 ± 8.9 (753.8 ± 191.0 kcal) at school age, on average. The adjusted linear regression analyses showed that ultra-processed food consumption at preschool age was a predictor of an increase in delta WC from preschool to school age (ß = 0.07; 95%CI 0.01-0.14; P = 0.030), but not for glucose metabolism. CONCLUSION: Our data suggest that early ultra-processed food consumption played a role in increasing abdominal obesity in children. These results reinforce the importance of effective strategies to prevent the excessive consumption of ultra-processed foods, especially in early ages.


Assuntos
Antropometria , Glicemia/metabolismo , Fast Foods/efeitos adversos , Manipulação de Alimentos , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia , Fatores Etários , Biomarcadores/sangue , Brasil , Criança , Comportamento Infantil , Desenvolvimento Infantil , Pré-Escolar , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Estudos Longitudinais , Masculino , Valor Nutritivo , Obesidade Abdominal/sangue , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Pediátrica/sangue , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Classe Social
18.
Nutr Metab Cardiovasc Dis ; 29(2): 159-169, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30660688

RESUMO

BACKGROUND AND AIMS: Various lifestyle, anthropometric, socio-demographic and perinatal characteristics have been separately associated with elevated blood pressure in children and adolescents. The aim of this study was to simultaneously evaluate all potential risk factors and to identify the most dominant correlates of early adolescence hypertension in a large group of school children 9-13 years old. METHODS AND RESULTS: A cross-sectional study with 1444 schoolchildren 9-13 years old, having full data on lifestyle, anthropometric, socio-demographic and perinatal indices, as well as blood pressure measurements. Early adolescents born large for their gestational age (LGA) (OR, 95% C.I. 0.49 (0.25-0.97)), those with higher levels of moderate to vigorous physical activity (MVPA) (OR, 95% C.I. 0.71 (0.53-0.96)) and those of a higher socioeconomic status (SES) (OR, 95% C.I. 0.51 (0.33-0.79)), had lower risk of hypertension, compared with their counterparts with appropriate birth weight, low levels of PA and with low SES respectively, independently of the variables used in the multivariate model. On the other hand, overweight and obese early adolescents (OR, 95% C.I. 2.61 (1.88-3.62)), those with central obesity (OR, 95% C.I. 1.75 (1.12-2.73)) and those having a hypertensive father (OR, 95% C.I. 1.93 (1.20-3.12)) had higher risk of hypertension compared with normal weight early adolescents and those without a family history of hypertension. CONCLUSIONS: Among the parameters examined, early adolescence abnormal body weight and central obesity, low PA, non LGA, low SES family and family history of hypertension were found to be independently associated with higher risk of hypertension. The identified correlates of early adolescence hypertension can be used by public health initiatives for early detection and management of this major public health problem, prioritizing early adolescents and families at the highest possible risk for hypertension.


Assuntos
Hipertensão/epidemiologia , Estilo de Vida , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia , Classe Social , Determinantes Sociais da Saúde , Adolescente , Desenvolvimento do Adolescente , Idade de Início , Antropometria , Peso ao Nascer , Criança , Desenvolvimento Infantil , Estudos Transversais , Exercício , Feminino , Grécia/epidemiologia , Inquéritos Epidemiológicos , Estilo de Vida Saudável , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/prevenção & controle , Masculino , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Abdominal/prevenção & controle , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/prevenção & controle , Fatores de Proteção , Fatores de Risco , Comportamento de Redução do Risco
19.
Arthritis Care Res (Hoboken) ; 71(2): 290-299, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30044543

RESUMO

OBJECTIVE: To identify risk factors for low back pain (LBP) and lumbar radicular pain and to assess whether obesity and exposure to workload factors modify the effect of leisure-time physical activity on LBP and lumbar radicular pain. METHODS: The population of this 11-year longitudinal study consists of a nationally representative sample of Finns ages ≥30 years (n = 3,505). The outcomes of the study were LBP and lumbar radicular pain for >7 days or for >30 days in the past 12 months at follow-up. RESULTS: LBP and lumbar radicular pain were more common in women than in men. LBP slightly declined with increasing age, while lumbar radicular pain increased with age. Abdominal obesity (defined by waist circumference) increased the risk of LBP (adjusted odds ratio [OR] 1.40 [95% confidence interval (95% CI) 1.16-1.68] for LBP >7 days and adjusted OR 1.41 [95% CI 1.13-1.76] for LBP >30 days) and general obesity (defined by body mass index) increased the risk of lumbar radicular pain (adjusted OR 1.44 [95% CI 1.12-1.85] for pain >7 days and adjusted OR 1.62 [95% CI 1.16-2.26] for pain >30 days). Smoking and strenuous physical work increased the risk of both LBP and lumbar radicular pain. Walking or cycling to work reduced the risk of LBP, particularly LBP for >30 days (adjusted OR 0.75 [95% CI 0.59-0.95]), with the largest reductions among nonabdominally obese individuals and among those not exposed to physical workload factors. Using vibrating tools increased the risk of lumbar radicular pain. CONCLUSION: Lifestyle and physical workload factors increase the risk of LBP and lumbar radicular pain. Walking and cycling may have preventive potential for LBP.


Assuntos
Dor Lombar/epidemiologia , Obesidade Abdominal/epidemiologia , Exposição Ocupacional , Vigilância da População , Ciática/epidemiologia , Fumar/epidemiologia , Adulto , Idoso , Exercício/fisiologia , Feminino , Finlândia/epidemiologia , Seguimentos , Inquéritos Epidemiológicos/métodos , Humanos , Estudos Longitudinais , Dor Lombar/diagnóstico , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/fisiopatologia , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Exposição Ocupacional/efeitos adversos , Fatores de Risco , Ciática/diagnóstico , Ciática/fisiopatologia , Fumar/efeitos adversos , Circunferência da Cintura/fisiologia
20.
Eur Radiol ; 29(5): 2417-2425, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30406311

RESUMO

OBJECTIVE: To evaluate predictive values of sarcopenia and visceral obesity measured from preoperative CT/MRIs for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy in patients with periampullary malignancies. METHODS: From the prospectively constructed surgical registry, we included adult patients treated with pancreaticoduodenectomy. Based on CT/MRIs, body morphometric analysis was performed to evaluate the visceral obesity and sarcopenia, based on the areas of visceral fat and skeletal muscle measured at the L3 vertebrae level. We retrieved various perioperative factors from registry. As outcomes of postoperative complications, we evaluated POPF and major complications based on the Clavien-Dindo classification. Multivariate logistic regression analyses were performed. RESULTS: From a total of 284 patients (163 males, 121 females) who met the inclusion/exclusion criteria, POPF, major complications, and 60-day mortality occurred in 52 (18.3%), 34 (12.0%), and 6 (2.1%), respectively. Sarcopenia and visceral obesity were noted in 123 (75.5%) and 66 (40.5%) of men and 68 (56.2%) and 53 (43.8%) of women, respectively. Combination of sarcopenia and obesity (sarcopenic obesity) was noted in 31.9% (52/163) of men and in 26.4% (32/121) of women. In multivariate logistic regression analyses, sarcopenic obesity was the only independent predictor for POPF (OR 2.65, 95% CI 1.43-4.93), and the vascular resection during pancreaticoduodenectomy was the only independent predictor for severe complications (OR 3.75, 95% CI 1.61-8.70). CONCLUSION: Sarcopenic obesity might be highly predictive for POPF. Body morphometric analysis in preoperative CT/MRI combined with assessment of perioperative clinical features may help to identify high-risk patients and determine perioperative management strategies. KEY POINTS: • Sarcopenic obesity might be predictive for postoperative pancreatic fistula after pancreaticoduodenectomy. • The vascular resection during pancreaticoduodenectomy might be predictive of major complications. • Body morphometric analysis might be helpful for identifying high-risk patients.


Assuntos
Imagem por Ressonância Magnética/métodos , Obesidade Abdominal/complicações , Fístula Pancreática/diagnóstico , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias , Sarcopenia/complicações , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Obesidade Abdominal/diagnóstico , Valor Preditivo dos Testes , Período Pré-Operatório , Fatores de Risco , Sarcopenia/diagnóstico , Sarcopenia/etiologia
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