Waist-based anthropometric measures and central adiposity-related comorbidities in children.

BACKGROUND:  Waist-related measures are commonly used to classify central adiposity and related comorbidities. This classification may be essential among children, as it may identify the risk of future non-communicable diseases. METHODS:  A cross-sectional study was conducted in the Eastern Cape province, South Africa, among 459 primary school learners aged 9-14 years. Height, weight and waist circumference (WC) were measured using standardised techniques recommended by World Health Organization (WHO). The anthropometric measurements, including body mass index (BMI), WC, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were computed and evaluated. RESULTS:  Most participants were girls (57.70%) with an average age of 11.20 ± 1.60 years. The average weight was 38.81 kg ± 10.49 kg with an average height of 144.16 (standard deviation [s.d.] = 10.37) cm. The sample had a BMI of 18.41 kg/m2 (s.d. = 3.19). The results showed, on average, WC of 62.10 cm ± 8.12 cm, WHR of 0.82 ± 0.15 and WHtR of 0.44 ± 0.05. Girls reported significantly higher BMI, WC and WHtR. Based on WHtR, the results showed the acceptable ability to classify children according to abdominal obesity, thus identifying their risk for comorbidities. CONCLUSION:  Overall body fat indicated by BMI and central obesity shown by waist-related anthropometric measures can play a significant role in classifying children in terms of their risk of comorbidities.Contribution: To prevent the risks of metabolic diseases in childhood, it is necessary to detect abdominal obesity early using WC-based anthropometric measurements, especially WHtR, to identify those at risk.

Association between triglyceride-glucose related indices and all-cause and cause-specific mortality in the general population: a cohort study.

BACKGROUND: Although triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance and cardiometabolic disease, its effectiveness in predicting mortality risk has not been adequately validated. We aimed to investigate the association between the TyG-related indices and all-cause and cause-specific mortality in the general population. METHODS: A total of 27,642 individuals were included from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Three indicators were constructed, including the TyG index, TyG combined with waist-to-height ratio (TyG-WHtR), and TyG combined with waist circumference (TyG-WC). Mortality data was acquired through the linkage of NHANES data with National Death Index records. Weighted Cox proportional hazards models were used to estimate the independent association between the TyG-related indices and mortality. Nonlinear associations were explored using restricted cubic splines. RESULTS: Multivariable adjusted models showed a progressive increase in all-cause and cause-specific mortality across quartiles of the TyG-related indices. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios of 1.26 (95% CI 1.04-1.52) for all-cause mortality, 1.38 (1.04-1.74) for cardiovascular mortality, and 1.23 (1.01-1.50) for non-cardiovascular mortality, respectively. For the TyG-WHtR index, the corresponding hazard ratios were 1.60 (1.25-2.05), 1.86 (1.26-2.50), and 1.48 (1.10-1.99), respectively. For the TyG-WC index, the corresponding hazard ratios were 1.42 (1.11-1.75), 1.48 (1.04-1.96), and 1.38 (1.05-1.72), respectively. The associations between the three TyG-related indices and all-cause, cardiovascular and non-cardiovascular mortality were J-shaped. Interaction tests revealed significant effect modification by age, low-density lipoprotein cholesterol (LDL-C) level, and statin use (all P values < 0.05). CONCLUSIONS: The TyG-related indices were independent predictors of all-cause and cause-specific mortality in the general population. Young individuals should be particularly vigilant, whereas low LDL-C levels and statin use are potentially protective.

The association between anthropometric indices and ischemic heart disease: a large-scale cross-sectional study on the Iranian population.

This study aimed to evaluate the superiority of anthropometric indices compared to others for predicting ischemic heart disease (IHD) or cardiometabolic risk factors. This study was a cross-sectional analysis of the Pars Cohort Study data. In total, 9229 Valashahr inhabitants aged 40-75 were included in the analysis. The area under the receiver operating characteristic curve (AUC) analyses was used to compare the predictive accuracy of four anthropometric measures, including body mass index, waist to height ratio (WHtR), waist to hip ratio (WHR), and waist circumference (WC). IHD prevalence was 10.4% in our sample. The prevalence of diabetes mellitus (DM), hypertension, dyslipidemia, and metabolic syndrome was 12.7%, 29.2%, 58.4%, and 22.3%, respectively. All anthropometric indices had poor to good accuracy in predicting IHD risk factors, with AUCs ranging between 0.580 and 0.818. WHR was the most accurate measure for predicting IHD in both genders. All indexes had a better accuracy for predicting DM, dyslipidemia, and metabolic syndrome (MetS) in males than in females. To conclude, anthropometric measures, especially WC and WHtR, are recommended for predicting metabolic syndrome in primary prevention settings. These simple indices could help physicians find those who need further evaluation for MetS.

Common obesity-related anthropometric indices and the risk of gestational diabetes mellitus in a Chinese population: a prospective cohort study.

OBJECTIVE: Anthropometric measurement provides a simple, noninvasive approach to evaluate obesity in pregnant women. We aimed to develop a predictive model utilizing anthropometric index for gestational diabetes mellitus (GDM), the most common obesity-related complications during pregnancy. METHODS: A prospective cohort of 4709 women was enrolled in Qingdao, China. Logistic regression model was constructed to determine the association of body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) in the first trimester (<14 weeks' gestation) with GDM. The discrimination ability for GDM was assessed using areas under the receiver operating characteristic (ROC) curve (AUC). Delong tests were performed to compare AUC values between different measures. RESULTS: The GDM incidence was 19.50%. GDM risk increased with VAT during early pregnancy, and the risk increased by 117% (OR = 2.17, 95% CI: 1.23-2.83) to 326% (OR = 4.26, 95% CI: 2.29-7.91) in pregnant women with the second quartile or above after adjusting for confounders (all p<.05). Combined index using VAT and BMI demonstrated superior predictive power for GDM compared with BMI alone (p<.05), but didn't differ from VAT (p>.05). Overall, VAT was positively correlated with GDM occurrence, outperforming BMI, WHR, WHtR and SAT in the predicative model. A first-trimester VAT cutoff of 27.05 mm might be promising for GDM risk stratification. CONCLUSIONS: First-trimester routine ultrasound screening may facilitate earlier identification and intervention of GDM. Pregnant women with VAT above the optimal threshold (27.05 mm) might benefit from targeted GDM monitoring.

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants.

BACKGROUND: Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. METHODS: We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20-64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). FINDINGS: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31-3·28) lower for women and 1·28 kg/m2 (1·02-1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. INTERPRETATION: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. FUNDING: UK Medical Research Council and UK Research and Innovation (Innovate UK).

Path analysis model to identify the effect of poor diet quality on NAFLD among Iranian adults from Amol Cohort Study.

Nonalcoholic fatty liver disease (NAFLD) is expanding as a global health problem with approximately 25% of the world's population affected by it. Dietary modification is one of the most important strategies for preventing NAFLD. The association between nutrient density and the Healthy Eating Index 2015 (HEI2015) with NAFLD demonstrates that nutrient density is an independent predictor of NAFLD in Iranian adults [fully adjusted model: OR (95% CI)tertile3vs.1: 0.68 (0.54-0.85), P for trend = 0.001]. However, a favorable association between NAFDL and diet quality (HEI 2015) is more pronounced in participants with abdominal obesity [fully adjusted model: OR (95% CI)tertile3vs.1: 0.63 (0.41-0.98), P for trend = 0.03]. Based on the gender-stratified path analysis, diet quality indirectly through Waist-to-Height Ratio (WHtR), C-reactive protein (CRP), and metabolic syndrome in women, and men through WHtR, hemoglobin A1c (HBA1c), CRP, and metabolic syndrome affects NAFLD. Nutrient density directly and indirectly in women through WHtR, CRP, and metabolic syndrome, and in men indirectly through WHtR, hemoglobin A1c, and metabolic syndrome negatively affect NAFLD. Hence, in these subjects; we can provide early dietary intervention and education to prevent progression to NAFLD.

Anthropometric indicators and cardiovascular diseases risk in pre-diabetic and diabetic adults: NHANES 1999-2018 cross-sectional analysis.

BACKGROUND: Since cardiovascular disease (CVD) stands as the primary cause of death in those with diabetes, and given the substantial influence of obesity as a common risk factor for both diabetes and atherosclerotic conditions, this investigation sought to find the relationship between anthropometric indicators and CVD risk within these populations. METHODS: Our study examined 36,329 adults, including those with diagnosed diabetes, pre-diabetes, and without diabetes from National Health and Nutrition Examination Survey (NHANES) data spanning 1999 to 2018. Various anthropometric indicators such as body mass index (BMI), waist circumference, weight-adjusted waist index (WWI), waist-to-height ratio (WHtR), weight, and height were assessed. Baseline characteristics were compared among the three groups after weighting. Participants were then grouped based on anthropometric indicators, and logistic regression models were used to analyze the association between these indicators and CVD risk in the total diabetes group (including diabetic and pre-diabetic individuals). Threshold effect analysis was conducted to explore nonlinear relationships, and mediation analyses assessed whether serum parameters influenced these relationships. RESULTS: This cross-sectional study involved 36,329 participants, weighted to a count of approximately 160.9 million, including over 45.9 million pre-diabetic individuals and around 16.6 million diabetic individuals. Baseline analysis showed significant associations between all six anthropometric indicators and CVD risk across patients with different diabetes statuses. Weighted restricted cubic spline (RCS) curve analysis highlighted increased CVD risk among the total diabetes group for each anthropometric indicator compared to the non-diabetic group. Anthropometric indicators were then divided into quartiles, and after adjusting for confounders, Model 3 revealed that the highest BMI group had a heightened risk of CVD compared to the lowest BMI group. Similar trends were observed in the WWI and WHtR subgroups. Threshold effect analysis of anthropometric indicators unveiled nonlinear associations between waist circumference, height, WWI and CVD risk. Mediation analysis suggested that lipid parameters, especially HDL, significantly mediated these relationships. CONCLUSION: In individuals with diabetes and pre-diabetes, BMI, weight, and WHtR displayed a consistent, linear increase correlation with CVD risk. Conversely, the link between waist circumference, height, and WWI and CVD risk showcased a more complex, nonlinear pattern. Moreover, HDL level emerged as notable mediator in the association between anthropometric indicators and the risk of CVD.

Strengths and Limitations of BMI in the Diagnosis of Obesity: What is the Path Forward?

PURPOSE OF REVIEW: This review aims to discuss strengths and limitations of body mass index (BMI) in diagnosing obesity, the use of alternative anthropometric measurements, and potential new technology that may change the future of obesity diagnosis and management. RECENT FINDINGS: The diagnosis of obesity requires the anthropometric assessment of adiposity. In clinical settings, this should include BMI with confirmation that elevated BMI represents excess adiposity and a measure of fat distribution (i.e., waist circumference (WC), waist to height ratio (WHtR), or WC divided by height0.5 (WHR.5R). Digital anthropometry and bioelectric impedance (BIA) can estimate fat distribution and be feasibly employed in the clinic. In addition, the diagnosis should include a clinical component assessing the presence and severity of weight-related complications. As anthropometric measures used in the diagnosis of obesity, BMI is generally sufficient if confirmed to represent excess adiposity, and there are advantages to the use of WHtR over WC to assess fat distribution. BIA and digital anthropometry have the potential to provide accurate measures of fat mass and distribution in clinical settings. There should also be a clinical evaluation for the presence and severity of obesity complications that can be used to stage the disease.

Imaging-based body fat distribution and diabetic retinopathy in general US population with diabetes: an NHANES analysis (2003-2006 and 2011-2018).

BACKGROUND: Limited studies have investigated the correlation between fat distribution and the risk of diabetic retinopathy (DR) in the general population with diabetes. The relationship between obesity and DR remains inconclusive, possibly due to using simple anthropometric measures to define obesity. This study investigates the relationships between the android-to-gynoid fat ratio (A/G ratio, measured using dual-energy X-ray absorptiometry) and DR within the US population with diabetes. METHODS: The study used a population-based, cross-sectional approach based on the 2003-2006 and 2011-2018 data of the National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression analyses were performed on participants with diabetes to evaluate the contribution of body mass index (BMI), waist-to-height ratio (WHtR), and A/G ratio to the prevalence of DR. RESULTS: The prevalence of DR was 22.2, 21.2, and 17.6% among participants with A/G ratios <1.0, 1.0-1.2, and ≥1.2, respectively. After adjusting sex, age, ethnicity, diabetes duration, hemoglobin A1c level, blood pressure level, and non-high-density lipoprotein cholesterol level, a higher A/G ratio (≥1.2) was independently associated with decreased odds of DR (odds ratio [OR], 0.565; 95% CI: 0.372-0.858) compared with the A/G ratio of 1.0-1.2. Associations between a higher A/G ratio and DR remained statistically significant after adjusting for BMI (OR, 0.567; 95% CI: 0.373-0.861) and WHtR (OR, 0.586; 95% CI: 0.379-0.907). Moreover, these associations remained statistically significant in analyses using the ethnic-specific tertiles for the A/G ratio. In sex-stratified models, these correlations remained in males. There was a significant inverse association between the A/G ratio and diabetes duration in males, which persisted after multivariable adjustments (p < 0.05). CONCLUSIONS: A novel finding indicates that a higher A/G ratio is associated with a reduced likelihood of DR in males with diabetes. The results from NHANES underscore the importance of considering imaging-based fat distribution as a critical indicator in clinical practice.

Normoglycemia and type 2 diabetes: exploring secreted frizzled-4, insulin resistance, and waist-height ratio.

The current study was planned to compare serum levels of secreted frizzled related protein-4, insulin resistance and waist-to-height ratio in individuals with and without a diabetic background, and to assess the correlation of these markers with family history of diabetes. The cross-sectional comparative study comprised 80 subjects with confirmed normal glucose tolerance values. Parameters assessed included secreted frizzled related protein-4, fasting glucose, random glucose, fasting insulin, homeostasis model of assessment of insulin resistance and waist-toheight ratio values. Those without a diabetic background had significantly higher frizzled related protein-4 levels (p=0.02). Although subjects with family history of diabetes showed higher mean fasting glucose, waist circumference and waist-to-height ratio, these differences were not statistically significant (p>0.05). However, there was a strong positive correlation with waist circumference, waistto- height ratio, fasting insulin and homeostasis model of assessment of insulin resistance (p=0.0001). There was no significant correlation of diabetic background with frizzled related protein-4 SFRP-4, homeostasis model of assessment of insulin resistance and waist-to-height ratio (p>0.05).

Associations between different triglyceride glucose index-related obesity indices and periodontitis: results from NHANES 2009-2014.

BACKGROUND: This study aimed to explore the associations between triglyceride glucose (TyG) index-related obesity indices and periodontitis within the American population. METHODS: This cross-sectional investigation utilized data from the National Health and Nutrition Examination Survey (NHANES) for 2009-2014. The association between the TyG-waist-to-height ratio (TyG-WHtR), TyG-weight-adjusted-waist index (TyG-WWI), TyG-waist circumference (TyG-WC), or TyG-body mass index (TyG-BMI) and periodontitis was investigated utilizing multivariable logistic regression model, subgroup, and dose-response curve analyses. RESULTS: This study enrolled 4,808 adult participants. Except for TyG-BMI, which did not exhibit a relationship with periodontitis, TyG-WHtR, [odds ratio (OR) (95% confidence interval (CI))] = 2.83 [1.58-5.10], P = 0.002], TyG-WWI [OR (95% CI) = 7.50 (3.06-18.34), P < 0.001], and TyG-WC [OR (95% CI) = 2.12 (1.23-3.64), P = 0.011] were all associated with periodontitis. Participants in the highest quartile displayed an elevated risk of periodontitis relative to their counterparts in the lowest quartile, as evidenced for TyG-WWI [OR (95% CI) = 1.72 (1.26-2.33), P = 0.001] and TyG-WC [OR (95% CI) = 1.50 (1.13-1.99), P = 0.009] in the full adjustment model. Subgroup analyses suggested more pronounced positive associations between these indices and periodontitis in participants who were < 60 years old, had a BMI ≥ 25, and did not have diabetes. The dose-response curve indicated linear responses in these associations. CONCLUSIONS: This investigation identified a significant and stable association between TyG-WHtR, TyG-WWI, or TyG-WC and periodontitis, which implies a robust correlation between high insulin resistance and susceptibility to periodontitis in the American population.

Association between triglyceride glucose-waist height ratio index and cardiovascular disease in middle-aged and older Chinese individuals: a nationwide cohort study.

BACKGROUND: The triglyceride-glucose (TyG) index and its combination with obesity indicators can predict cardiovascular diseases (CVD). However, there is limited research on the relationship between changes in the triglyceride glucose-waist height ratio (TyG-WHtR) and CVD. Our study aims to investigate the relationship between the change in the TyG-WHtR and the risk of CVD. METHODS: Participants were from the China Health and Retirement Longitudinal Study (CHARLS). CVD was defined as self-reporting heart disease and stroke. Participants were divided into three groups based on changes in TyG-WHtR using K-means cluster analysis. Multivariable binary logistic regression analysis was used to examine the association between different groups (based on the change of TyG-WHtR) and CVD. A restricted cubic spline (RCS) regression model was used to explore the potential nonlinear association of the cumulative TyG-WHtR and CVD events. RESULTS: During follow-up between 2015 and 2020, 623 (18.8%) of 3312 participants developed CVD. After adjusting for various potential confounders, compared to the participants with consistently low and stable TyG-WHtR, the risk of CVD was significantly higher in participants with moderate and increasing TyG-WHtR (OR 1.28, 95%CI 1.01-1.63) and participants with high TyG-WHtR with a slowly increasing trend (OR 1.58, 95%CI 1.16-2.15). Higher levels of cumulative TyG-WHtR were independently associated with a higher risk of CVD events (per SD, OR 1.27, 95%CI 1.12-1.43). CONCLUSIONS: For middle-aged and older adults, changes in the TyG-WHtR are independently associated with the risk of CVD. Maintaining a favorable TyG index, effective weight management, and a reasonable waist circumference contribute to preventing CVD.

Associations between waist-to-height ratio and abdominal aortic calcification: A cross-sectional study.

Waist-to-height ratio (WtHR) is a validated biomarker of central obesity that appears to be preferable to other body composition measurements in the evaluation of cardiovascular disease. The goal of this research was to explore the connection between WtHR and abdominal aortic calcification (AAC) among adults. On the basis of data from the 2013 to 2014 National Health and Nutrition Examination Survey, multivariate logistic regression, sensitivity analysis, as well as smoothed curve fitting were used to evaluate the connection between WtHR and AAC. Subgroup analyses along with interaction tests were done to see if this link was consistent across populations. Among 3079 participants aged >40 years, there was a negative association between WtHR and ACC. Each 1-unit emergence of WtHR was related to a 2% reduction in the probability of severe AAC in the entirely adjusted model (odds ratio = 0.02, 95% confidence interval: [0.00-0.12]). Participants in the highest WtHR quartile were 39% less likely to acquire severe AAC compared with those in the lowest quartile. (odds ratio = 0.61, 95% confidence interval: [0.37-1.00]). This negative association was more pronounced in the diabetes subgroup. We discovered a reversed U-shaped association between WtHR as well as AAC score utilizing a 2-stage linear regression model, with an intersection point of 0.56. WtHR was negatively associated with AAC among US adults.

Waist-to-height ratio and body fat percentage as risk factors for ischemic cardiovascular disease: a prospective cohort study from UK Biobank.

BACKGROUND: The independent effect of waist-to-height ratio (WHtR) and body fat percentage (BF%) on ischemic cardiovascular disease (CVD) remains uncertain. OBJECTIVES: This study aimed to investigate the independent associations of WHtR and BF% with ischemic CVD. METHODS: This prospective cohort study used data from the UK Biobank. BF% was calculated as fat mass divided by body weight, measured by bioimpedance. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for overall and sex-specific associations of BF% and WHtR with risks of ischemic CVD and its main subtypes [myocardial infarction (MI) and ischemic stroke (IS)], adjusted for a range of potential confounders, including mutual adjustment for BF% and WHtR. RESULTS: In total, 468,333 participants without existing CVD were included in the analysis. During 12 y of follow-up, 20,151 ischemic CVD events, 13,604 MIs, and 6681 ISs were recorded. WHtR was linearly associated with ischemic CVD, MI, and IS, with an HR per 5% increase of 1.23 (95% CI: 1.20, 1.25), 1.24 (95% CI: 1.21, 1.27), and 1.22 (95% CI: 1.18, 1.26), respectively, independent of BF%. A stronger association between WHtR and MI was seen in females than in males. The association of BF% with these outcomes was substantially attenuated in both sexes after adjustment for WHtR. For example, in females, the HR (highest compared with lowest fifth) was reduced from 1.94 (95% CI: 1.76, 2.15) to 1.04 (95% CI: 0.90, 1.01) for ischemic CVD, from 2.04 (95% CI: 1.79, 2.32) to 0.97 (95% CI: 0.81, 1.16) for MI, and from 1.81 (95% CI: 1.54, 2.13) to 1.07 (95% CI: 0.85, 1.33) for IS. CONCLUSIONS: WHtR, when used as a proxy measure for central obesity, is linearly associated with ischemic CVD in both sexes, which is independent of BF%. In contrast, the relationship of BF% with these health outcomes is predominantly driven by its correlation with WHtR.

Association between triglyceride glucose-waist to height ratio and coronary heart disease: a population-based study.

BACKGROUND: The Triglyceride glucose (TyG) index-related indicators improve risk stratification by identifying individuals prone to atherosclerosis early in life. This study aimed to examine the relation between TyG-waist circumference-to-height ratio (TyG-WHtR) and coronary heart disease. METHODS: Data from four National Health and Nutrition Examination Surveys (NHANES) cycles between 2011 and 2018 were used for a cross-sectional study. The association between TyG-WHtR and coronary heart disease risk was examined using a multifactorial logistic regression model, and corresponding subgroup analyses were performed. Nonlinear correlations were analyzed using smooth curve fitting and threshold effects analysis. When nonlinear connections were discovered, appropriate inflection points were investigated using recursive methods. RESULTS: TyG-WHtR and coronary heart disease were significantly positively correlated in the multifactorial logistic regression analysis. Subgroup analyses and interaction tests revealed that gender, age, smoking status, and cancer were not significantly associated with this correlation (P for interaction > 0.05). Furthermore, utilizing threshold effect analysis and smooth curve fitting, a nonlinear connection with an inflection point of 0.36 was observed between TyG-WHtR and coronary heart disease. CONCLUSIONS: According to this study, the American population is far more likely to have coronary heart disease if they have higher TyG-WHtR levels.

Correlation of anthropometric measurements with body mass index and estimation of the proportion of metabolic syndrome among overweight and obese children: a hospital-based cross-sectional study.

BACKGROUND: Early identification of overweight and obesity with the help of simple anthropometric tests can prevent from development of metabolic complications in these children. Body mass index (BMI) is the most commonly used parameter but, measurements such as waist circumference (WC), waist-to-height ratio (WHtR) and wrist circumference (WrC) have also been studied and found to have a better correlation with visceral fat. OBJECTIVE: To correlate WC, WHtR and WrC with BMI among overweight and obese children. The secondary objective was to estimate the proportion of metabolic syndrome among obese and overweight children. METHODS: A single-centre, cross-sectional study involving 80 overweight and obese children aged 3-15 years. Anthropometric measures such as WC, WHtR and WrC of the study subjects were correlated with BMI and investigated for metabolic syndrome. RESULTS: Statistically significant and moderate positive correlation was found between BMI and WC, r (80)=0.45 and p<0.001 with WC explaining 20% of the variation of BMI. There was a statistically significant, moderate positive correlation between WHtR and BMI r (80)=0.34 and p<0.001 with 11% of the variation in BMI. There was a statistically significant strong positive correlation between WC and WrC (80)=0.61 and p<0.001, and WrC explains 37.2% of the variation in WC. However, there was no statistically significant correlation between BMI and WrC. Metabolic syndrome was found in 13 (16.25%) children. CONCLUSION: Alternative anthropometric measurements such as WC and WHtR have a significant correlation with BMI and may be of help in defining overweight and obesity in children. There was a statistically significant strong positive correlation between WC and WrC among obese children. Metabolic syndrome is common in these children.

Comparison of anthropometric indicators related to overweight and obesity by place of residence in a local community with a high social deprivation rate - a cross-sectional study.

INTRODUCTION AND OBJECTIVE: Obesity is considered a major public health concern. The aim of the study is to compare anthropometric indicators related to overweight and obesity by place of residence in a local community with a high social deprivation rate, based on the example of residents of the Janów District in eastern Poland, taking into account gender strata differences. MATERIAL AND METHODS: The cross-sectional epidemiological study was carried out in a study group of 3,752 individuals. The following anthropometric measurements and laboratory tests were performed to identify the anthropometric indicators related to overweight and obesity: body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) and body adiposity index (BAI). RESULTS: Mean age of the study group was 51.92 ± 8.15. Overweight and obesity-related indicators were more prevalent in rural than urban areas among women, and were as follows: BMI (28.77 ± 5.37 vs. 27.62 ± 5.09; p < 0.001), WHR (0.87 ± 0.07 vs. 0.85 ± 0.07; p < 0.001), WHtR (0.57 ± 0.09 vs. 0.57 ± 0.08; p < 0.001) and BAI (33.58 ± 5.48 vs. 32.82 ± 5.4; p = 0.002). Men's mean WHR was higher in rural than in urban areas (0.96 ± 0.07 vs. 0.95 ± 0.62; p < 0.001). CONCLUSIONS: The study shows that women living in rural areas had a mean BMI that was 1.1 higher than that of women living in urban areas, as well as 0.02 higher WHR and WHtR and 0.8 higher BAI. In contrast, men living in rural areas had a 0.001 higher WHtR and WHR than men living in urban areas. In the multivariable models, after having considered potential confounding variables, women living in rural areas had approximately a 60% higher probability of being obese, while men had approximately a 30% higher probability of being obese.

Association of triglyceride-glucose index and its related parameters with atherosclerotic cardiovascular disease: evidence from a 15-year follow-up of Kailuan cohort.

BACKGROUND: Triglyceride glucose (TyG) index and its related parameters have been introduced as cost-effective surrogate indicators of insulin resistance, while prospective evidence of their effects on atherosclerotic cardiovascular disease (ASCVD) remained scattered and inconsistent. We aimed to evaluate the association of TyG and its related parameters with new-onset ASCVD, and the predictive capacity were further compared. METHOD: A total of 95,342 ASCVD-free participants were enrolled from the Kailuan study. TyG and its related parameters were defined by fasting blood glucose, triglyceride, body mass index (BMI), waist circumstance (WC) and waist-to-height ratio (WHtR). The primary outcome was incident ASCVD, comprising myocardial infarction (MI) and ischemic stroke (IS). Cox proportional hazard models and restricted cubic spline (RCS) analyses were adopted to investigate the association between each index and ASCVD. The C-index, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were used for comparison of their predictive value for ASCVD. RESULTS: During a median follow-up of 15.0 years, 8,031 new cases of ASCVD were identified. The incidence rate of ASCVD increased along with elevated levels of each index, and the relationships were found to be nonlinear in the RCS analyses. The hazard ratio (HR) and 95% confidence interval (95% CI) for ASCVD was 1.39 (1.35, 1.43), 1.46 (1.41, 1.50), 1.50 (1.46, 1.55), and 1.52 (1.48, 1.57) per 1 IQR increase of baseline TyG, TyG-BMI, TyG-WC, and TyG-WHtR, respectively, and the association were more pronounced for females and younger individuals aged < 60 years (Pfor interaction<0.05). Using the updated mean or time-varying measurements instead of baseline indicators did not significantly alter the primary findings. Additionally, TyG-WC and TyG-WHtR showed better performance in predicting risk of ASCVD than TyG, with the IDI (95% CI) of 0.004 (0.001, 0.004) and 0.004 (0.001, 0.004) and the category-free NRI (95% CI) of 0.120 (0.025, 0.138) and 0.143 (0.032, 0.166), respectively. Similar findings were observed for MI and IS. CONCLUSIONS: Both the TyG index and its related parameters were significantly and positively associated with ASCVD. TyG-WC and TyG-WHtR had better performance in predicting incident ASCVD than TyG, which might be more suitable indices for risk stratification and enhance the primary prevention of ASCVD.