A Defining Moment: A Consensus on the Diagnostic Criteria for Clinical Obesity.

To determine the critical value for the standard deviation score (SDS) of waist-hip ratio (WHR)/height (Ht), as an age-adjusted measure of body fat distribution, in relation to occurrence of biochemical complications in obese girls. Cross-sectional, clinical study. The (WHR/Ht)-SDS was calculated as described previously. Obese girls were classified into two groups according to the occurrence of abnormal values in either serum triglyceride, alanine aminotransferase or insulin level. The criteria for obesity were subjected to the receiver operating characteristic (ROC) analysis. One-hundred and twenty-four outpatient Japanese obese girls, ranging in age from 9 to 15 y. Height, body weight, waist girth and hip girth as anthropometric measures. Percentage overweight, waist girth, WHR and (WHR/Ht)-SDS as criteria for obesity. Clinical laboratory analysis for fasting blood samples of obese children. Fifty-nine girls were classified into the no complication group, and 65 girls into the complication group. Those with complications were older, more obese, and their waist girth and WHR were larger, than the girls without complications. The (WHR/Ht)-SDS was >2-fold higher and lipoprotein profile was more atherogenic in the complication group than in the no complication group. Among the four criteria of obesity, (WHR/Ht)-SDS gave the ROC curve skewed furthest into the top left corner of the diagram. Both sensitivity and specificity for (WHR/Ht)-SDS were >80% at the critical value of 2.00. The sensitivity for waist girth was as high as that for specificity for the rest of the criteria were <80%. Only (WHR/Ht)-SDS showed high enough sensitivity and specificity to predict metabolic derangement in the present obese girls. (WHR/Ht)-SDS can serve as the diagnostic criterion that classifies obesity in Japanese adolescent girls into two types.

Performance of different diagnostic criteria of overweight and obesity as predictors of metabolic syndrome in adolescents

Performance of different diagnostic criteria of overweight and obesity as predictors of metabolic syndrome in adolescents

The global increase in the prevalence of overweight and obesity is associated with several chronic diseases. Obesity is characterized by systemic low-grade inflammation and oxidative stress caused by excessive fat accumulation. This study aimed to establish diagnostic criteria for pathological obesity in cats using a highly sensitive serum amyloid A (SAA) assay. In this study, 29 client-owned cats (3-14 years old) with varying body condition scores (BCS) were included. These cats underwent medical checkups and were not treated for any specific diseases. They were divided into three groups: healthy control, simple obesity, and obesity disease. The plasma levels of metabolites, hormones, and enzymes were measured. In the simple obesity cats, body weight, BCS, and plasma triglyceride (TG) and malondialdehyde (MDA) concentrations were significantly higher than those in the healthy control cats. In the obesity disease cats, BCS was significantly higher than that in the simple obesity cats, and plasma TG and SAA concentrations and alanine aminotransferase (ALT) activities increased significantly compared to those in the simple obesity cats. Adiponectin concentrations in the obesity disease cats were significantly lower than those in the healthy control cats. The novel criteria for feline obesity (overweight cats exhibiting two or more of the following symptoms: hyperlipidemia and high ALT and SAA levels) were based on biomarker values that were significantly higher than those in the simple obesity cats. These novel criteria may help detect pathological obesity at an early stage. Early and accurate diagnosis can prevent age-related diseases including obesity.

Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review.

Prevalence of prediabetes in Indonesia is increasing Type 2 Diabetes prevalence and its complications. Its complications is causing economic burden since one third of the costs of Indonesia national health insurance’s claim. Based on this problem, prediabetes is the right strategy to do but in practice it is an effective and efficient method for high-risk groups, namely obesity. The current assessment is the Body Mass Index (BMI) but has limitation for those with big muscle . Waist circumference is debated. Similarly, waist to height ratio is shown to have corellation to prediabetes. But, studies that explain which are the best anthropometry indicator that have strongest corellation to prediabetes is still limited. This study aims to determine the greatest association among these anthropometry indicators to predict prediabetes in the obese group. Methods: The study used a cross sectional study design for 166 adult respondents 21-65 years who met one of the criteria for obesity: BMI> 25 kg / m2; waist circumference> 80 cm in women or> 90 cm in men; weight to height ratio 0,5. Respondents had fasting for 8-10 hours before checking sugar with a glucometer. Analysis using SPSS 18.00 program, univariate analysis to describe characteristic respondents in the Pejagalan area, then performed linear regression analysis to see the difference between BMI, waist circumference, or the waist to height ratio with most related to prediabetes. Results: The prevalence of prediabetes in obesity was 81 people (48.2%). Different age, BMI, and behavior in male and female respondents. Regression analysis showed that weight-to-height ratio is has strongest corellation in increasing risk of prediabetes. Conclusion: Waist to heigt ratio can be a measure of nutritional anthropometry that is most associated with prediabetes. Keywords: BMI, waist circumference, waist circumference - height, prediabetes

PurposeThe aim of this study was to study the appropriate cut-off value of visceral fat area (VFA) and waist-to-height ratio (WTHR) which increase the risk of obesity-related disorders and to validate the diagnostic criteria of abdominal obesity and metabolic syndrome in Korean children and adolescents.Materials and MethodsA total 314 subjects (131 boys and 183 girls) were included in this study. The subjects were selected from Korean children and adolescents who visited three University hospitals in Seoul and Uijeongbu from January 1999 to December 2009. All patients underwent computed tomography to measure VFA.ResultsThe cut-off value of VFA associated with an increase risk of obesity-related disorder, according to the receiver operating characteristics curve, was 68.57 cm2 (sensitivity 59.8%, specificity 76.6%, p=0.01) for age between 10 to 15 years, and 71.10 cm2 (sensitivity 72.3%, specificity 76.5%, p<0.001) for age between 16 to 18 years. By simple regression analysis, the WTHR corresponding to a VFA of 68.57 cm2 was 0.54 for boys and 0.61 for girls, and the WTHR corresponding to a VFA of 71.10 cm2 was 0.51 for boys and 0.56 for girls (p=0.004 for boys, p<0.001 for girls).ConclusionBased on the results of this study, VFA which increases the risk of obesity-related disorders was 68.57 cm2 and the WTHR corresponding to this VFA was 0.54 for boys and 0.61 for girls age between 10-15 years, 71.70 cm2 and the WTHR 0.51 for boys and 0.56 for girls age between 16-18 years. For appropriate diagnostic criteria of abdominal obesity and obesity-related disorders in Korean children and adolescents, further studies are required.

The Asia-Oceania consensus: Definitions and diagnostic criteria for sarcopenic obesity.

Leptin is an adipocyte-derived hormone that decreases food intake and increases energy expenditure through the activation of the sympathetic nervous system (SNS). Notwithstanding recent intensive research, the underlying physiological mechanism of leptin as well as the etiology of obesity in humans remains elusive. The present study attempted to investigate the potential association between endogenous circulating leptin and sympatho-vagal activities in age- and height-matched obese and nonobese healthy young women. Plasma leptin concentrations were measured by radioimmunoassay. The autonomic nervous system activity was assessed during the resting condition by means of a recently devised power spectral analysis of heart rate variability, which serves to identify three separate frequency components, very low (VLO), low (LO), and high (HI). Plasma leptin concentrations were greater in the obese than in the control group (45.7 +/- 5.89 vs. 11.2 +/- 1.10 ng. ml(-1), P < 0.01). As to the contribution of endogenous leptin to SNS activity, both the ratios of the VLO frequency component reflecting thermoregulatory sympathetic function and the global SNS index [(VLO + LO)/HI] to plasma leptin concentration were markedly reduced in the obese compared to the control group (VLO per leptin: 5.9 +/- 1.39 vs. 37.8 +/- 8.1 ms(2). ml. ng(-1), P < 0.01; SNS index per leptin: 0.04 +/- 0.008 vs. 0.33 +/- 0.01 ml c. ng(-1), P < 0.01). Additionally, a nonlinear regression analysis revealed that these ratios exponentially decreased as a function of body fat content (VLO per leptin r(2) = 0.57, P < 0.01; SNS index per leptin r(2) = 0.53, P < 0.01). Our data suggest that reduced sympathetic responsiveness to endogenous leptin production, implying peripheral leptin resistance, might be a pathophysiological feature of obesity in otherwise healthy young women. The findings regarding the association of leptin, body fat content, and SNS activity further indicate that the 30% of total body fat, which has been used as a criterion of obesity, might be a critical point at which leptin resistance is induced.

The new definition of obesity: an analysis of a population-based survey in an Andean country

BACKGROUND: Sarcopenic obesity has been observed in people with neuromuscular impairment and is linked to adverse health outcomes; it is unclear, however, if adults with facioscapulohumeral muscular dystrophy (FSHD) develop this condition. PURPOSE: Determine if adults with FSHD meet criteria for sarcopenic obesity (appendicular lean mass index (ALMI) scores of <7.26 kg/m2 or 5.45 kg/m2; % body fat of ≥27% or 38% in men/women). METHODS: Ten FSHD patients (50±11.4 years, 2 females) and ten age/sex-matched controls (47±13.6 years, 2 females) completed one visit, which included a full-body DXA scan. Regional and whole body total mass (g), fat mass (FM, (g, %)), and lean mass (LM, (g, %)) were collected; body mass index (BMI, kg/m2) and sarcopenia measures (appendicular lean mass (sum of arm/leg lean mass, ALM (kg)) and ALM index (ALMI, kg/m2)) were computed. RESULTS: Whole body total mass was similar between cohorts (FSHD: 84.5±12.9 vs. control: 81.8±13.5 kg; p=0.65). A decrease in ALM volume was found in the FSHD group (FSHD: 20.5±4.4 vs. control: 26.5±5.9 kg; p=0.02); similarly, ALMI scores were different between FSHD and controls (FSHD: 6.3±1.2 vs. control: 8.6±1.4 kg/m2; p=0.001). An increase in the proportion of whole body FM to whole body total mass (% body fat) in the FSHD group was observed (FSHD: 40.8±7.0 vs. control: 27.9±7.5%; p=0.001). While mean alterations in ALMI (6.3 ±1.3 kg/m2) and % body fat (40.0 ± 6.4%) among men with FSHD met diagnostic criteria for sarcopenic obesity, this finding was not mirrored among female FSHD counterparts (ALMI: 6.2 ±1.0 kg/m2, % body fat: 44.1 ±11.4%). Whole body LM was 15% lower in FSHD (p=0.05), furthermore, the FSHD group had a reduced proportion of whole body LM to whole body total mass vs. controls (p=0.001), along with lower total arm (p<0.01) and total leg lean mass (p=0.03). Study participants with FSHD did exhibit an increase in total body FM (p<0.01), along with greater total leg fat mass (p<0.001) but not total arm fat mass (p=0.09). CONCLUSIONS: A loss in ALM and increase in FM may lead to sarcopenic obesity in men with FSHD, resulting in a reduced quality of life and longevity.

Sarcopenic obesity research perspectives outlined by the sarcopenic obesity global leadership initiative (SOGLI) – Proceedings from the SOGLI consortium meeting in Rome November 2022

Currently there are no unified diagnostic criteria for the sarcopenic obesity, the prevalence of which is growing along with an increase in the number of obese people worldwide. The bioimpedance analysis of body composition is widely used to assess the body composition. In 2021, M.Sc. Isabel Gätjens (Christian-Albrechts-Universität zu Kiel) et al. proposed to use the ratio of fat mass to lean body mass as a new criterion for the sarcopenic obesity in children aged 5 to 17 years old. The purpose of the study was to determine the prevalence of sarcopenic obesity in children with constitutional-exogenous obesity (CEO) according to the proposed criterion. Materials and methods: 557 children were included in a single-center retrospective cohort study, of which 266 (47%) boys and 291 (53%) girls, aged 7 to 17 years old (age 14.3 [12.7; 15.5] years) with CEO who underwent inpatient examination at the Endocrinology Research Centre of the Ministry of Healthcare of Russia (Moscow, Russia) in Feb. 2018 - Feb. 2022. All of the children were assessed for the body composition using the bioimpedance analysis. The value of the ratio of fat mass to lean mass &gt;90th percentile for the corresponding gender and age (according to M.Sc. Isabel Gätjens et al..) is defined as a criterion for sarcopenic obesity in children. Results: the sarcopenic obesity was determined in 88.68% of children with CEO without statistically significant difference between boys and girls (86.06% and 91.06%, respectively, p=0.54). Conclusion: an extremely high prevalence of sarcopenic obesity in children and adolescents with CEO was revealed. Further studies needed to assess the contribution of sarcopenic obesity to the development of metabolic disorders and obesity-associated diseases in childhood.

The aim of this study was to determine the appropriate cut-off values for visceral fat area and waist circumference (WC) associated with an increase in risk for obesity-related disorder, and to validate diagnostic criteria for abdominal obesity and the metabolic syndrome in a Korean adult population. We included 413 subjects (174 men and 239 women) for this study. Subjects were selected among Korean adults who visited the obesity clinic at St. Mary's Hospital and Kangnam St. Mary's Hospital from January 1999 to August 2005. All patients had computed tomography performed. The cut-off value, of visceral fat area associated with an increase risk of obesity-related disorder, according to the receiver operating characteristics curve, was 103.8 cm2 (sensitivity 74.5%, specificity 64.7%, p<0.001). The cut-off value for the WC was 89.8 cm in men (sensitivity 84.7%, specificity 91.7%, p<0.005) and 86.1 cm in women (sensitivity 83.9%, specificity 62.9%, p<0.001). Based on the results of this study, the visceral fat area associated with an increased risk of obesity-related disorder in Korea was 103.8 cm2 and the WC was 89.8 cm in men and 86.1 cm in women.

AimsAlthough there are population‐level estimates of the prevalence of overweight and obesity (OAO), there are few direct epidemiological surveys of OAO prevalence at scale.Materials and MethodsThis was a cross‐sectional, multi‐centre, population‐based study of all adults aged >18 years attending the Dubai Academic Health Corporation (DAHC) between January 2018 and August 2023. OAO was defined according to WHO standards or modified WHO cut points for individuals from WHO South‐East Asian Region (SEAR) countries. Clinical obesity, defined according to new Lancet Commission diagnostic criteria, was estimated using ICD‐10 codes corresponding to end‐organ dysfunction.ResultsOf 440 590 participants, 48.5% were female, 52% were aged 19–39 years and 37.1% were UAE nationals. 63.4% of the population were living with OAO. Significantly more UAE nationals (68.3%) were living with OAO than nationals from SEAR countries (59.7%, p < 0.001) or elsewhere (63.6%, respectively, p < 0.001). Significantly more females than males were living with obesity (30.4% vs. 25.9%, p < 0.001). About a half of female UAE nationals aged ≥40 years were living with obesity, about one in five of whom had class 2 or class 3 obesity. Using modified ethnicity‐specific thresholds increased the overall proportion of people living with obesity in the UAE from 28.0% to 35.8%. About a third of individuals with a body mass index ≥40 kg/m2 also had signs or symptoms of ongoing organ dysfunction classifiable as clinical obesity.ConclusionsThis is the largest epidemiological study to provide direct prevalence data on OAO at this scale in the region and one of the largest globally. Using standard WHO cut points to define OAO may severely underestimate the prevalence of clinically actionable obesity in individuals of Southeast Asian ethnicity. This first application of new diagnostic criteria of clinical obesity suggests that some individuals may be disqualified from therapy who might otherwise benefit from a patient‐centric approach.