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1.
Cardiovasc Diabetol ; 23(1): 192, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844974

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is closely associated with the triglyceride glucose (TyG) index and its related indicators, particularly its combination with obesity indices. However, there is limited research on the relationship between changes in TyG-related indices and CVD, as most studies have focused on baseline TyG-related indices. METHODS: The data for this prospective cohort study were obtained from the China Health and Retirement Longitudinal Study. The exposures were changes in TyG-related indices and cumulative TyG-related indices from 2012 to 2015. The K-means algorithm was used to classify changes in each TyG-related index into four classes (Class 1 to Class 4). Multivariate logistic regressions were used to evaluate the associations between the changes in TyG-related indices and the incidence of CVD. RESULTS: In total, 3243 participants were included in this study, of whom 1761 (54.4%) were female, with a mean age of 57.62 years at baseline. Over a 5-year follow-up, 637 (19.6%) participants developed CVD. Fully adjusted logistic regression analyses revealed significant positive associations between changes in TyG-related indices, cumulative TyG-related indices and the incidence of CVD. Among these changes in TyG-related indices, changes in TyG-waist circumference (WC) showed the strongest association with incident CVD. Compared to the participants in Class 1 of changes in TyG-WC, the odds ratio (OR) for participants in Class 2 was 1.41 (95% confidence interval (CI) 1.08-1.84), the OR for participants in Class 3 was 1.54 (95% CI 1.15-2.07), and the OR for participants in Class 4 was 1.94 (95% CI 1.34-2.80). Moreover, cumulative TyG-WC exhibited the strongest association with incident CVD among cumulative TyG-related indices. Compared to the participants in Quartile 1 of cumulative TyG-WC, the OR for participants in Quartile 2 was 1.33 (95% CI 1.00-1.76), the OR for participants in Quartile 3 was 1.46 (95% CI 1.09-1.96), and the OR for participants in Quartile 4 was 1.79 (95% CI 1.30-2.47). CONCLUSIONS: Changes in TyG-related indices are independently associated with the risk of CVD. Changes in TyG-WC are expected to become more effective indicators for identifying individuals at a heightened risk of CVD.


Assuntos
Biomarcadores , Glicemia , Doenças Cardiovasculares , Obesidade , Triglicerídeos , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/sangue , Estudos Prospectivos , Triglicerídeos/sangue , Incidência , Medição de Risco , China/epidemiologia , Glicemia/metabolismo , Obesidade/epidemiologia , Obesidade/diagnóstico , Obesidade/sangue , Idoso , Biomarcadores/sangue , Estudos Longitudinais , Fatores de Tempo , Prognóstico , Fatores de Risco de Doenças Cardíacas , Valor Preditivo dos Testes , Fatores de Risco
2.
Cardiovasc Diabetol ; 22(1): 345, 2023 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-38093333

RESUMO

BACKGROUND: The association between obesity indicators and mortality in individuals with diabetes remains unclear, and data on cardiovascular mortality are scarce. Therefore, we investigated the associations between the five adiposity indices and both all-cause and cardiovascular mortality in patients with diabetes. METHODS: This cohort study included 34,686 adults with diabetes who underwent a standard health-screening program between 1996 and 2017 in Taiwan. The dates and causes of death till January 2022 were retrieved from the National Death Registry. Cox proportional hazards models were used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cardiovascular mortality in relation to body mass index (BMI), waist circumference, waist-hip ratio (WHR), body fat percentage (BF%), and A Body Shape Index (ABSI), using the third quintile as the reference group. RESULTS: During a median follow-up of 15 years, there were 8,324 deaths, of which 1,748 were attributed to cardiovascular disease. After adjusting for demographics, lifestyle factors and comorbidities, ABSI was associated with all-cause mortality in an exposure-response manner; the HR (95% CI) for first and fifth vs. third quintile was 0.78 (0.69-0.89) and 1.24 (1.14-1.35), respectively. A similar but weaker exposure-response relationship was found between WHR and mortality. People with a lower BMI and BF% had an increased risk of mortality (HR [95% CI] for the first vs. third quintiles, 1.33 [1.22, 1.44] and 1.42 [1.30, 1.56], respectively). No association was observed between waist circumference categories and risk of mortality. Similar results were observed for the association of BF%, waist circumference, and ABSI with cardiovascular mortality. However, no significant association was observed between BMI and cardiovascular mortality. The association between WHR and cardiovascular mortality was stronger than that between WHR and all-cause mortality. CONCLUSIONS: ABSI demonstrated a consistent exposure-response relationship with both all-cause and cardiovascular mortality in this Asian cohort with diabetes. Our findings highlight the importance of monitoring ABSI, a surrogate index of central adiposity, in patients with diabetes.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Adulto , Humanos , Seguimentos , Estudos de Coortes , Taiwan/epidemiologia , Fatores de Risco , Obesidade/complicações , Relação Cintura-Quadril , Circunferência da Cintura , Índice de Massa Corporal , Diabetes Mellitus/diagnóstico
3.
Ecotoxicol Environ Saf ; 247: 114211, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36306623

RESUMO

AIMS: To explore the association between decreased levels of particulate matter (≤2.5 µm; PM2.5) due to the implementation of environmental protection policies and the incidence of obesity in adolescents in Chongqing, China through a prospective cohort study. METHODS: A total of 2105 children (52.02% male; aged 7.33 ± 0.60 years at baseline) were enrolled from the Chongqing Children's Health Cohort. A mixed linear regression model was used to analyse the relationships of PM2.5 levels with obesity indicators after adjusting for covariates. Additionally, a Poisson regression model was used to determine the relationship between PM2.5 exposure and the incidence of overweight/obesity. RESULTS: The average PM2.5 exposure levels from participant conception to 2014, from 2015 to 2017, and from 2018 to 2019 were 66.64 ± 5.33 µg/m3, 55.49 ± 3.78 µg/m3, and 42.50 ± 1.87 µg/m3, respectively; these levels significantly decreased over time (P < 0.001). Throughout the entire follow-up period, the incidence of overweight/obesity after a ≥ 25 µg/m3 decrease in the PM2.5 level was 4.57% among females; this incidence was the lowest among females who experienced remarkable decreases in PM2.5 exposure. A 1-µg/m3 decrease in the PM2.5 level significantly decreased the body mass index (BMI), BMI z score (BMIz), and weight of adolescents (all P < 0.001). Compared with a < 20-µg/m3 decrease in the PM2.5 level, a ≥ 25-µg/m3 decrease protected against increased BMI (net difference= -0.93; 95% confidence interval [CI]: (-1.23,-0.63) kg/m2), BMIz (-0.28 (-0.39, -0.17)), weight (-1.59 (-2.44, -0.74) kg), and incidence of overweight/obesity (0.48 (0.37, 0.62), P < 0.001). Moreover, compared with a < 20-µg/m3 decrease in the PM2.5 level, a ≥ 25-µg/m3 decrease resulted in significant absolute differences in BMI (-1.26 (-1.56, -0.96) kg/m2), BMIz (-0.53 (-0.65, -0.40)) and weight (-3.01 (-3.8, -2.19) kg) (all P < 0.001). CONCLUSIONS: This study showed the etiological relevance of declining PM2.5 concentrations for the incidence of obesity in children and adolescents, suggesting that controlling ambient air pollutants may prevent the development of obesity in this age group. Continuous implementation of environmental protection policies in China has led to substantial health benefits.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Obesidade Infantil , Humanos , Criança , Adolescente , Feminino , Masculino , Obesidade Infantil/epidemiologia , Obesidade Infantil/prevenção & controle , Incidência , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Sobrepeso/epidemiologia , Estudos Prospectivos , Conservação dos Recursos Naturais , Material Particulado/análise , Poluentes Atmosféricos/análise , Estudos de Coortes , China/epidemiologia , Políticas , Poluição do Ar/efeitos adversos , Poluição do Ar/prevenção & controle , Poluição do Ar/análise
4.
Wei Sheng Yan Jiu ; 51(5): 746-752, 2022 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-36222036

RESUMO

OBJECTIVE: To investigate the relationship between obesity indicators and dyslipidemia and hypertension in the Yao population of Guangxi. METHODS: In 2015, we examined the body composition data of 784 Yao residents aged 18 years or older in Guangxi using a multi-stage whole-group random sampling method, analyzed the association between 10 indicators responding to the degree of obesity and dyslipidemia and hypertension, and analyzed the predictive value of each obesity indicator for dyslipidemia and hypertension by receiver operating characteristic(ROC) curves. RESULTS: There were 58.80% of Yao adults with dyslipidemia, with no difference between men and women(χ~2=0.24, P>0.05); 15.94% of Yao adults had hypertension, with a higher prevalence in men than in women(χ~2=4.76, P<0.05). ROC curves plotted with dyslipidemia as the dependent variable showed that the best predictor of risk of dyslipidemia prevalence in the Yao adult population was waist-to-hip ratio(WHR)(AUC=0.62, 95% CI 0.56-0.68) with a cut point of 0.86 in men and waist circumference(AUC=0.64, 95% CI 0.59-0.69) with a cut point of 75.50 cm in women. The ROC curves were plotted with hypertension as the dependent variable, and the result showed that the best predictor of risk of hypertension in the Yao adult population was: visceral fat content(AUC=0.62, 95% CI 0.56-0.68) with a cut point of 0.65 kg in men and WHR(AUC=0.67, 95% CI 0.62-0.72) with a cut point of 0.82 in women. CONCLUSION: Compared with indicators reflecting general obesity such as body mass index and percentage of body fat, indicators reflecting abdominal obesity such as waist circumference, WHR and visceral fat content are more closely related to two metabolic diseases such as dyslipidemia and hypertension in the Yao population.


Assuntos
Dislipidemias , Hipertensão , Adulto , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Dislipidemias/epidemiologia , Etnicidade , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Obesidade/epidemiologia , Curva ROC , Fatores de Risco , Circunferência da Cintura , Relação Cintura-Quadril
5.
Diabetes Metab Res Rev ; 37(5): e3380, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32596997

RESUMO

BACKGROUND: Adiposity is an established risk factor for diabetes. The different measurements of adiposity for predicting diabetes have been compared in recent studies in Western countries. However, similar researches among Chinese adults are limited. METHODS: Data were collected from a national survey conducted during September 2014 and May 2015 Among Chinese adults aged 40 years and older across 30 China's provinces. Multilevel model analysis was performed to examine the impacts of different obesity indices [body mass index (BMI), waist circumference (WC), lipid accumulation product index (LAP), visceral adiposity index (VAI), and body adiposity index (BAI)] on the risk of diabetes. RESULTS: A total of 162 880 participants were included in this study. Of them, 54.47% were female. With an increase in BMI, WC, LAP, VAI, and BAI, the prevalence of diabetes significantly grew (P < 0.001). The multilevel model analysis showed that WC has the strongest impact on diabetes prevalence, while BAI was the weakest. For one SD increment in BMI, WC, LAP, VAI, and BAI, the prevalence of diabetes increased by 27.0% (Odds Ratio (OR) = 1.270, 95% Confidence interval (CI) = 1.251-1.289), 37.4% (OR = 1.374, 95% CI = 1.346-1.401), 28.1% (OR = 1.281, 95% CI = 1.266-1.297), 22.0% (OR = 1.220, 95% CI = 1.204-1.236), and 17.4% (OR = 1.174, 95% CI = 1.151-1.192), respectively. CONCLUSION: Obesity indicators of BMI, WC, LAP, VAI, and BAI have significant positive relationships with the risk of diabetes. WC has the strongest impact on diabetes, while BAI has the weakest.


Assuntos
Adiposidade , Diabetes Mellitus , Adulto , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Circunferência da Cintura
6.
Ann Nutr Metab ; 77(2): 100-108, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34139697

RESUMO

OBJECTIVES: The objective of this study was to demonstrate the association between changes in different obesity indicators and the risk of incident hypertension by the age-group among community-dwelling residents in southern China. METHODS: A total of 6,959 non-hypertensive participants aged ≥18 years old were enrolled in this cohort study and completed questionnaire interviews and anthropometric measurements at baseline (2010) and follow-up (2017). A time-dependent covariate Cox proportional hazard model considered the changes in obesity indicators during the follow-up period and calculated the hazard ratios (HRs) to analyze the risk of incident hypertension according to different obesity indicators. RESULTS: During a mean follow-up of 7.1 years, 1,904 participants were newly diagnosed with hypertension. The body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were significantly positively associated with an increased future risk of incident hypertension, and BMI was the best predictive indicator of hypertension (obesity in men: HR = 2.65, 95% confidence interval (CI) = 2.20-3.20; obesity in women: HR = 2.80, 95% CI = 2.27-3.45). Compared with the middle-aged and older group, the risk of incident hypertension was highest in the younger group which had the highest baseline obesity indicators. CONCLUSIONS: Changes in obesity indicators were significantly associated with the risk of incident hypertension in all age-groups, and the risk of future incident hypertension increased with the increase in baseline obesity indicators.


Assuntos
Índice de Massa Corporal , Hipertensão/epidemiologia , Obesidade/epidemiologia , Razão Cintura-Estatura , Relação Cintura-Quadril , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Fatores de Risco , Inquéritos e Questionários , Circunferência da Cintura , Adulto Jovem
7.
J Biosoc Sci ; 51(4): 624-626, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30944046

RESUMO

Obesity indicators are useful clinical tools in the measurement of obesity, but it is important for clinicians to appropriately interpret their values in individuals with different ethnicities. Future research is needed to identify optimal cut-offs that can predict the occurrence of cardio-metabolic comorbidities in individuals of different ethnic descent. Assessment of more recently developed indicators like the Edmonton Obesity Staging System and visceral adipose tissue are able to appropriately identify metabolically at-risk individuals.


Assuntos
Adiposidade , Etnicidade , Povo Asiático , Índice de Massa Corporal , Humanos , Obesidade
8.
Nutrients ; 15(14)2023 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-37513586

RESUMO

The purpose of this research was to evaluate the lipid accumulation product (LAP)'s accuracy and predictive value for identifying metabolic syndrome (MS) in the general Chinese population compared with other obesity indicators. Baseline survey information from a population-based cohort study carried out in Shanghai's Songjiang District was used in this research. Odds ratios (OR) and a 95% confidence interval (CI) were obtained by logistic regression. The ability of each variable to detect MS was assessed using the receiver operating characteristic curve (ROC). The optimum cut-off point for each indicator was selected using Youden's index. The survey involved 35,446 participants in total. In both genders, the prevalence of MS rose as the LAP increased (p < 0.001). The LAP's AUC was 0.901 (95%CI: 0.895-0.906) in males and 0.898 (95%CI: 0.893-0.902) in females, making it substantially more predictive of MS than other variables (BMI, WC, WHR, WHtR). The optimal cutoff point of the LAP for men and women was 36.04 (Se: 81.91%, Sp: 81.06%) and 34.95 (Se: 80.93%, Sp: 83.04%). The Youden index of the LAP was 0.64 for both sexes. Our findings imply that the LAP, compared to other obesity markers in China, is a more accurate predictor of MS.


Assuntos
Produto da Acumulação Lipídica , Síndrome Metabólica , Obesidade , Humanos , Valor Preditivo dos Testes , Síndrome Metabólica/diagnóstico , China/epidemiologia , Obesidade/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso
9.
Healthcare (Basel) ; 11(8)2023 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-37107955

RESUMO

BACKGROUND: Nutritional interventions such as the planetary health diet, which the EAT-Lancet commission proposed, may be an effective strategy for reducing type 2 diabetes risks and its associated complications. The planetary health diet demonstrates the significant role of diet in associating human health with environmental sustainability and the significance of transforming food systems in order to ensure that the UN's Sustainable Development Goals and the Paris Agreement are achieved. Therefore, the aim of this review is to examine the association of the planetary health diet (PHD) with the risk of type 2 diabetes and its related complications. METHOD: The systematic review was conducted in line with established guidelines. The searches were carried out in health sciences research databases through EBSCOHost. The population, intervention, comparator and outcomes framework was used in order to define the research question and the search terms. The searches were carried out from the inception of the databases to 15 November 2022. Search terms including synonyms and medical subject headings were combined using Boolean operators (OR/AND). RESULTS: Seven studies were included in the review and four themes were identified, including incidence of diabetes; cardiovascular risk factors and other disease risks; indicators of obesity and indicators of environmental sustainability. Two studies examined the association between the PHD and the incidence of type 2 diabetes and found that high adherence to the reference diet (EAT-Lancet reference diet) was correlated with a lower incidence of type 2 diabetes. High adherence to the PHD was also associated with some cardiovascular risk factors and environmental sustainability. CONCLUSION: This systematic review has shown that high adherence to the PHD is associated with a reduced risk of type 2 diabetes and may be associated with a lower risk of subarachnoid stroke. In addition, an inverse relationship was found between adherence to the PHD and markers of obesity and environmental sustainability. Adherence to the reference diet was also associated with lower values of some markers of cardiovascular risk. More studies are needed to fully examine the relationship between the planetary health diet, type 2 diabetes and its related conditions.

10.
Front Endocrinol (Lausanne) ; 13: 965890, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36072930

RESUMO

Background: There is still controversy surrounding the precise characterization of prediabetic population. We aim to identify and examine factors of demographic, behavioral, clinical, and biochemical characteristics, and obesity indicators (anthropometric characteristics and anthropometric prediction equation) for prediabetes according to different definition criteria of the American Diabetes Association (ADA) in the Chinese population. Methods: A longitudinal study consisted of baseline survey and two follow-ups was conducted, and a pooled data were analyzed. Prediabetes was defined as either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or elevated glycosylated hemoglobin (HbA1c) according to the ADA criteria. Robust generalized estimating equation models were used. Results: A total of 5,713 (58.42%) observations were prediabetes (IGT, 38.07%; IGT, 26.51%; elevated HbA1c, 23.45%); 9.66% prediabetes fulfilled all the three ADA criteria. Among demographic characteristics, higher age was more evident in elevated HbA1c [adjusted OR (aOR)=2.85]. Female individuals were less likely to have IFG (aOR=0.70) and more likely to suffer from IGT than male individuals (aOR=1.41). Several inconsistency correlations of biochemical characteristics and obesity indicators were detected by prediabetes criteria. Body adiposity estimator exhibited strong association with prediabetes (D10: aOR=4.05). For IFG and elevated HbA1c, the odds of predicted lean body mass exceed other indicators (D10: aOR=3.34; aOR=3.64). For IGT, predicted percent fat presented the highest odds (D10: aOR=6.58). Conclusion: Some correlated factors of prediabetes under different criteria differed, and obesity indicators were easily measured for target identification. Our findings could be used for targeted intervention to optimize preventions to mitigate the obviously increased prevalence of diabetes.


Assuntos
Diabetes Mellitus , Intolerância à Glucose , Estado Pré-Diabético , Glicemia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , Jejum , Feminino , Intolerância à Glucose/epidemiologia , Hemoglobinas Glicadas/análise , Humanos , Estudos Longitudinais , Masculino , Obesidade/epidemiologia , Estado Pré-Diabético/epidemiologia
11.
Front Public Health ; 10: 843622, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35392463

RESUMO

Aims: To explore the effect of long-term exposure to particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5) on childhood obesity based on a cohort study in Chongqing. Methods: A total of 4,284 children aged 6-8 years at baseline were enrolled from the Chongqing Children Health Cohort in 2014-2015 and were followed up in 2019. A stratified cluster sampling was applied to select the participants. A Mixed-effects linear regression model was used to examine the effect of long-term exposure to PM2.5 on the growth curve of obesity indicators [including body mass index (BMI), BMI Z-score (BMIz), and waist-to-height ratio (WHtR)]. A mixed-effects logistic regression model was used to study the dose relationship between PM2.5 exposure and the risk of obesity indicators. Results: A higher level of accumulating exposure to PM2.5 was associated with an increased childhood obesity index, and the effect was the most significant for WHtR than BMI and BMIz. This effect was more pronounced in boys than in girls except for WHtR, and it was the most significant under the PM2.5 exposure period from pregnancy to 6 years old. Compared the annual average PM2.5 exposure level of <60 µg/m3, the WHtR and BMI were increased by 0.019 [(95% CIs): 0.014, 0.024] and 0.326 [(95% CIs): 0.037, 0.616] Kg/m2 for participants living with the PM2.5 exposure level of 70-75 µg/m3, respectively. For every 5 µg/m3 increase in PM2.5 levels (from pregnancy to 6 years old), the risk of central obesity was increased by 1.26 {odds ratio [OR] (95% CIs): 1.26 (1.16, 1.37), p < 0.001} times. Conclusions: This study confirmed a dose-response relationship between PM2.5 exposure and childhood obesity, especially central obesity, suggesting that controlling ambient air pollution can prevent the occurrence of obesity in children and adolescents.


Assuntos
Poluentes Atmosféricos , Obesidade Infantil , Adolescente , Poluentes Atmosféricos/análise , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Obesidade Abdominal , Material Particulado/efeitos adversos , Material Particulado/análise , Obesidade Infantil/epidemiologia , Gravidez , Estudos Prospectivos
12.
Eur Endocrinol ; 16(2): 148-151, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33117447

RESUMO

OBJECTIVE: The global prevalence of obesity is increasing and has nearly doubled in the last decade, disproportionately impacting less-developed countries. The aim of this cross-sectional study was to analyse health-related quality of life (HRQOL) in morbidly obese women attending a bariatric clinic in India, and assess potential obesity indicators that can be utilised in under-resourced settings, to better understand HRQOL of individual patients. METHODS: Anthropometric measurements were collected, including waist circumference, hip circumference, waist-hip ratio, waist-height ratio and body mass index (BMI). HRQOL was assessed using an obesity-related quality-of-life questionnaire focused on the impact of obesity on physical distress, self-esteem, sexual life and work life. RESULTS: The average BMI of study participants was 39.6 kg/m2, with an average HRQOL of 40.2%. The strongest correlation was noted between BMI and HRQOL (R2=0.16). Exploratory analyses demonstrated that patients with higher BMI quartiles had lower scores for physical impact and psychosocial impact, and higher scores for sexual health, comfort with food, and experience with dieting compared to patients in lower quartiles. CONCLUSION: In South Indian, middle-aged, morbidly obese women, HRQOL is lower than average and is highly correlated with BMI, with different BMI levels having higher impacts in different subcategories, supporting the need for an individualised therapeutic focus for each patient.

13.
J Nutr Sci ; 9: e15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32328239

RESUMO

Obesity indicators are known to predict the presence of type 2 diabetes mellitus (T2DM); however, evidence for which indicator best identifies undiagnosed T2DM in the Indian population is still very limited. In the present study we examined the utility of different obesity indicators to identify the presence of undiagnosed T2DM and determined their appropriate cut point for each obesity measure. Individuals were recruited from the large-scale population-based Kerala Diabetes Prevention Program. Oral glucose tolerance tests was performed to diagnose T2DM. Receiver operating characteristic (ROC) curve analyses were used to compare the association of different obesity indicators with T2DM and to determine the optimal cut points for identifying T2DM. A total of 357 new cases of T2DM and 1352 individuals without diabetes were identified. The mean age of the study participants was 46⋅4 (sd 7⋅4) years and 62 % were men. Waist circumference (WC), waist:hip ratio (WHR), waist:height ratio (WHtR), BMI, body fat percentage and fat per square of height were found to be significantly higher (P < 0⋅001) among those with diabetes compared with individuals without diabetes. In addition, ROC for WHR (0⋅67; 95 % 0⋅59, 0⋅75), WHtR (0⋅66; 95 % 0⋅57, 0⋅75) and WC (0⋅64; 95 % 0⋅55, 0⋅73) were shown to better identify patients with T2DM. The proposed cut points with an optimal sensitivity and specificity for WHR, WHtR and WC were 0⋅96, 0⋅56 and 86 cm for men and 0⋅88, 0⋅54 and 83 cm for women, respectively. The present study has shown that WHR, WHtR and WC are better than other anthropometric measures for detecting T2DM in the Indian population. Their utility in clinical practice may better stratify at-risk patients in this population than BMI, which is widely used at present.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Obesidade/diagnóstico , Adulto , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e Especificidade , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril
14.
Auton Neurosci ; 219: 1-4, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31122596

RESUMO

OBJECTIVE: This study evaluated the associations between cardiac autonomic nervous system (ANS) activity and cardiometabolic disease (CMD) risk factors among black South African children. DESIGN: The participants included 34 black South African children (11.85 ±â€¯0.89 y). CMD risk factors included waist circumference (WC), hip circumference (HC), body mass index z-score (BMI z-score), blood pressure (SBP, DBP), total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), fasting glucose (FG), fasting insulin (FINS), and vessel stiffness index (SI). Heart rate variability was used to quantify cardiac ANS activity. RESULTS: lnRMSSD, pNN50 and lnSD1 were inversely associated with FINS (r = -0.33, p = 0.05; r = -0.36, p = 0.03; r = -0.41, p = 0.01), WC (r = -0.45, p = 0.01; r = -0.39, p = 0.02; r = -0.45, p = 0.01), and HC (r = -0.41, p = 0.01; r = -0.36, p = 0.03; r = -0.43, p = 0.01). HDL was positively associated with lnRMSSD (r = 0.37; p = 0.03) and lnSD1 (r = 0.37; p = 0.03) while, LDL was negatively associated with HF (r = -0.41; p = 0.01). Regression analysis identified WC as the primary predictor for parasympathetic modulation in time domain (lnRMSSD: r2 = 0.21, p = 0.01; pNN50: r2 = 0.18, p = 0.01) and non-linear domain (lnSD1: r2 = 0.21, p = 0.01). CONCLUSION: Elevated resting parasympathetic activity in children is associated with lower CMD risk factors and an elevation in the protective HDL.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Frequência Cardíaca , População Negra , Glicemia , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Doenças Cardiovasculares/patologia , Criança , Colesterol/sangue , Estudos Transversais , Feminino , Coração/fisiopatologia , Frequência Cardíaca/fisiologia , Humanos , Insulina/sangue , Masculino , Obesidade/epidemiologia , Obesidade/patologia , Obesidade/fisiopatologia , Fatores de Risco , África do Sul , Rigidez Vascular , Circunferência da Cintura
15.
Obes Res Clin Pract ; 9(4): 328-35, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25154649

RESUMO

INTRODUCTION: In previous study, we found that in order to prevent MS in women aged <65 years, the cutoff points of obesity indicators should be lowered. OBJECTIVE: To investigate whether our proposed cutoff points of obesity indicators predict the occurrence of hypertension (HT), diabetes mellitus (DM), and hyperlipidemia in premenopausal women with greater sensitivity and specificity compared to reference cutoff points of obesity that are currently being used. METHODS: Using the database of the "2002 Survey on the Prevalence of Hypertension, Hyperglycemia and Hyperlipidemia in Taiwan" provided by the Bureau of Health Promotion, Taiwan as research material, data from 2270 premenopausal women aged 20-65 years were used for the analyses. The receiver-operating characteristic curves (ROC) of the body-mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were used to predict HT, DM, and hyperlipidemia. RESULTS: Obesity is not a good predictor of the occurrence of hyperlipidemia in premenopausal women aged <65 years. However, our proposed cutoff points had greater sensitivity and specificity than did the reference cutoff points. To prevent the risk of HT and DM in premenopausal women, the cutoff points of obesity indicators should be reduced. The proposed values are as follows: a WHR of 0.79; a WC of 74.7 cm; a WHtR of 0.49; and a BMI of 22.3 kg/m(2).


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hiperlipidemias/etiologia , Hipertensão/etiologia , Obesidade/complicações , Adulto , Área Sob a Curva , Biomarcadores , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/fisiopatologia , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Prevalência , Curva ROC , Valores de Referência , Sensibilidade e Especificidade , Taiwan/epidemiologia , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril , Saúde da Mulher
16.
Iran J Public Health ; 40(3): 33-40, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-23113084

RESUMO

BACKGROUND: Obesity is a significant risk factor for metabolic disorders including increase in blood pressure. Body mass index (BMI), waist circumference (WC) and Waist/Hip ratio (WHR) are simple and effective indicators of obesity. The objectives of this study were to examine the relationships between obesity anthropometric indicators and hypertension and to identify the best anthropometric indicator/s that can predict hypertension risk among youth in the UAE. METHODS: A 110 first year students in a Medical University in Ajman, UAE, during the year 2009-2010 were included in a cross-sectional study. The height, weight, WC, hip circumference and blood pressure were measured and the BMI and WHR were calculated for each student and used in the analyses. RESULTS: The mean values for BMI, WC, hip circumference and WHR, were significantly higher in the Pre/Hypertensive group compared to normal blood pressure group. The risk of Pre/ hypertension was significantly increased by 4.3 times for participants who had general obesity (BMI≥ 30) or abdominal obesity (identified from high WC). Highly significant correlations were noticed between systolic and diastolic blood pressure and all anthropometric indicators except that for Hip circumference and systolic blood pressure. Step-wise linear regression model showed that when all obesity indicators were studied together, the waist circumference was the only indicator which showed significant relationship with both systolic and diastolic blood pressure. CONCLUSION: Waist circumference is the best anthropometric indicator that can predict hypertension risk among youth in the UAE.

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