Abdominal Waist Circumference Research Articles

The paradox of obesity with normal weight; a cross-sectional study.

To evaluate the prevalence of excessive adiposity among normal-weight individuals, and their cardiometabolic risk. This cross-sectional study included 3,001 participants (ages 20-95, 52% men, BMI 28.0 ± 5.5 kg/m2) who completed an anthropometric evaluation, dual x-ray absorptiometry (DXA) scan to measure body composition, and cardiometabolic blood markers. Excess adiposity was defined as ≥25% for men and ≥ 35% for women. Of the entire study participants, 967 were in normal BMI (18.5-24.9 kg/m2) with a wide body fat distribution (4-49%). Of them, 26% of men and 38% of women were classified with excess adiposity. As compared to normal-weight lean participants, normal-weight obese men and women had higher triglycerides (76.5 ± 37.3 vs. 101.2 ± 50.3 mg/dL, p = 0.004 and 84 ± 44.2 vs. 101.4 ± 91.1 mg/dL, p = 0.030; respectively) and elevated low-density lipoprotein cholesterol (103.3 ± 31.7 vs. 119.6 ± 45.5 mg/dL, p = 0.011) and total cholesterol (171.5 ± 40.3 vs. 190.2 ± 39 mg/dL, p = 0.007) for men only. Among NWO, abdominal circumference was prevalent in 60% of the females with NWO (≥88 cm), but only in 4% of males (≥102 cm). Higher adiposity, even within normal weight, increases cardiometabolic risk, and abdominal waist circumference misclassified obesity in normal-weight individuals. This study highlights the need for a body composition evaluation to determine cardiometabolic risk for adults with normal body weight.

Evaluation of glomerular hyper filtration in obesity: Which formula to use?

Introduction: Obesity is a progressive chronic disease that is a renal risk factor. Renal hyperfiltration is an early stage in the development of chronic kidney disease (CKD). The objective of our study is to determine the prevalence of glomerular hyperfiltration in obese patients. Materials and Methods: This is a prospective and descriptive study conducted over a period of 4 months. All patients with BMI over 30 kg/m2 who do not have diabetes, hypertension or another apparent cause of CKD. Results: A total of 85 patients were included, the mean age was 41.96 years, with a female majority. The mean BMI was 38.24kg/m2 and the mean abdominal waist circumference was 114.57cm. Obesity was common in 55.88% and secondary in 44.11%. The prevalence of glomerular hyperfiltration was 85.18% by Cockcroft formula and 48.33% by MDRD formula. Discussion: Obesity is a risk factor for CKD, which promotes increased renal blood flow by vasodilation of the afferent glomerular arteriole, resulting in glomerular hyperfiltration that leads to a change in the glomerular barrier, increasing the risk of developing CKD. According to several studies, the Cockcroft formula is a better predictor of renal function in obese patients. A 51% increase in GFR in obese patients has been observed. In our study, the prevalence of glomerular hyperfiltration is 85.18% according to the Cockcroft formula. Conclusion: Obesity is a risk factor for CKD that needs to be carefully considered.

COMPARISON OF HYPERTENSION PREVALENCE AND ASSOCIATED RISK FACTORS IN MONKS AND COMMON RESIDENTS FROM ZHEJIANG PROVINCE, SOUTHEAST CHINA

Objective: The prevalence of hypertension changes with the level of progress of the economy, society, and civilization. There is a lack of relevant studies on monks populations. This study investigated and compared the prevalence and influencing factors of hypertension among monks and common residents in Zhejiang province. Design and method: A cross-sectional survey was conducted by using a stratified multistage random sampling method. Using the probability proportional to size method, 12 districts were selected. A given number of participants from each of the 14 gender/age strata (male/female and aged 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75) were chosen also using the SRS method according to the national demographic composition, from communities or villages using the lists compiled from the local government registers of households (Figure 1). Recruitment included a total of 19254 participants aged 15 or older in 12 districts in Zhejiang province. Socio-demographic profiles, examinations were administrated on each subject. Multilevel logistic regression models were used to identify the risk factors of hypertension. Results: The prevalence of hypertension among monks in Zhoushan was relatively lower than that among common residents of Zhejiang province (11.2% VS. 22.5%). Men (vs. women), 40–79 / 50–59 / 60 years and above (vs. 15–39 years), less than middle school (vs. college or higher), large abdominal waist circumference (vs. normal), family history of hypertension (vs. none), salt use 5 gram or above (ref: < 5 gram), large visceral adipose index (VAI) (vs. normal), large body fat percentage (BFP) (vs. normal) and overweight/obesity (vs. normal weight) were the main risk factors for hypertension development among common residents. Men (vs. women), 60 years and above (vs. 15–39 years), obesity (vs. normal weight), large abdominal waist circumference (vs. normal), large VAI (vs. normal) were the main risk factors for hypertension development among monks. Conclusions: Zhoushan monks had lower hypertension prevalence, that maybe because they had more healthy lifestyles including of no tobacco and alcohol consumption, more vegetables intake, less anxiety and stress.

Electroacupuncture reduces weight, skinfold thickness and waist circumference and increases skin temperature of the abdominal region in women: a randomized controlled trial.

Acupuncture, as a complementary and alternative medical treatment, has shown some promise as a therapeutic option for obesity and weight control. The aim of the current study was to investigate the effects of electroacupuncture (EA) on body weight, body mass index (BMI), skin fold thickness, waist circumference and skin temperature of the abdominal region in non-obese women with excessive abdominal subcutaneous fat. A total of 50 women with excessive abdominal subcutaneous fat (and average BMI of 22) were randomly assigned to one of two groups: an EA group (n = 25) receiving 10 EA sessions (insertion of needles connected to an electrical stimulator at a frequency of 40 Hz for 40 min) and a control group (n = 25) that received no treatment. Outcome measures evaluated included waist circumference, supra-iliac and abdominal skinfolds, body composition and superficial skin temperature (measured by cutaneous thermography) before and after treatment. Compared with the untreated group, women in the EA group exhibited decreased supra-iliac and abdominal skin folds (p < 0.001), waist circumference (p < 0.001), percentage body fat (p = 0.001) and percentage abdominal fat (p < 0.001). In addition, the EA group showed an elevated skin temperature at the site of the treatment. However, EA did not significantly impact body weight (p = 0.01) or BMI (p = 0.2). EA promoted a reduction in abdominal waist circumference, supra-iliac and abdominal skin folds, and percentage body and abdominal fat in women of normal BMI with excessive abdominal subcutaneous fat, as well as an increase in the superficial skin temperature of the abdominal region. RBR-9tsmpp (Brazilian Registry of Clinical Trials).

Association between combat-related traumatic injury and cardiovascular risk

ObjectiveThe association between combat-related traumatic injury (CRTI) and cardiovascular risk is uncertain. This study aimed to investigate the association between CRTI and both metabolic syndrome (MetS) and arterial stiffness.MethodsThis was...

Abstract 9349: The Relationship Between Combat-related Traumatic Injury and Cardiometabolic Risk

Introduction: The relationship between combat-related traumatic injury (CRTI) and cardiovascular risk is uncertain. Available data are largely derived from small retrospective or cross sectional studies. Hypothesis: This study was designed to investigate, prospectively, the link between CRTI and both metabolic syndrome (MetS) and arterial stiffness Methods: From March 2016 to August 2020, 1144 male combat veterans (UK-Afghanistan War 2003-14) were recruited into the ADVANCE cohort; they comprised 579 men with CRTI and 565 uninjured participants frequency-matched for age, service, rank, regiment, deployment period and role-in-theatre. Investigations included quantification of injury severity (New Injury Severity Scale [NISS]), whole body composition (dual-energy X-ray absorptiometry), arterial stiffness (heart rate-adjusted central augmentation index [cAIx] and pulse wave velocity [PWV]), fasting venous blood glucose, lipids and high sensitivity C-reactive protein (hs-CRP). Insulin resistance was quantified using the estimated glucose disposal rate. The relationships of CRTI to MetS and cAIx were examined using modified Poisson and multiple linear regression analyses respectively. Results: The participants were aged 34·1±5·4 years, which was similar in the CRTI and uninjured groups; the mean time from injury or relevant deployment was 8·3±2·1 years. MetS prevalence (18·0% vs 11·8%; adjusted IRR 1·46; 1·10, 1·94) and cAIx (17·61±8·79 vs 15·23±8·19: p&lt;0·0001) were higher among the CRTI than uninjured group. Abdominal waist circumference, visceral fat area, triglycerides, insulin resistance and hs-CRP were higher and HDL-cholesterol lower with CRTI. There were no significant between-group differences in blood glucose, blood pressure or PWV. CRTI, its severity (↑NISS), lower age and socioeconomic status (SEC) were independently associated with both MetS and cAIx. Conclusions: CTRI is associated with an increased prevalence of MetS and arterial stiffness which are also influenced by age, injury severity and SEC. The longitudinal impact of CRTI on clinical cardiovascular events needs further examination

The abdominal waist circumference and 4-year outcomes following peripheral bypass grafting.

Current literature evaluating the relationship between obesity, utilizing measures other than the Body Mass Index (BMI), and postoperative outcomes following vascular surgery are sparse. This study aimed to investigate any association between abdominal waist circumference (AWC) and waist-hip ratio (WHR) in relation to postoperative morbidity and mortality following peripheral artery bypass graft (PABG) surgery. AWC and hip circumference (HC) were measured from pre-intervention magnetic resonance (MR) and computed tomography (CT) scans of patients undergoing elective and nonelective PABG. The AWC and WHR were assessed in relation to: the need for higher level care (i.e. level 2/3), the duration of higher level care, postoperative limb ischemia, postoperative hospital stay, graft patency on discharge and 30 day readmission, using logistic and linear regression analysis. Mortality was assessed using cox-regression analysis with calculation of hazard ratios at 30 days and 4 years. In total, 177 patient images performed between January 2014 to January 2017 were analyzed. There were no significant intra-observer and interobserver differences in measurements of AWC and HC. Pre-intervention AWC was predictive of the need for higher level care following non-elective PABG (adjusted OR 1.1 [95% CI: 1.0-1.1, P=0.026]). An inverse relationship between AWC and mortality at 4 years was also observed (adjusted HR=0.9, 95% CI: 0.9-1.0, P=0.028). However, pre-intervention WHR failed to predict mortality and morbidity. AWC may potentially be a suitable risk stratification tool in patients undergoing non-elective PABG. The association of AWC with long-term mortality outcomes require further investigation so that suitable cut-off values may be determined.

Impact of bariatric surgery in patients with stress urinary incontinence.

ABSTRACTObjective:To examine epidemiologic, anthropometric and clinical variables associated with stress urinary incontinence in obese women, before and after bariatric surgery, and to identify predictive factors of stress urinary incontinence resolution.Methods:Prospective observational study with women enrolled in a bariatric surgery program between 2015 and 2016. Patients were assessed prior to and 6 months after bariatric surgery using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale. Patient assessment also included physical examination and bladder stress tests.Results:A total of 43 women completed the study. There was a 72.7% reduction in stress urinary incontinence (p=0.021). Predictive factors for preoperative diagnosis of stress urinary incontinence included age (p=0.024) and abdominal waist circumference (p=0.048). Urinary symptoms improved after weight loss, especially nocturia (p=0.001) and stress urinary incontinence (p=0.026). Menopause was the most significant predictive factor for persistence of stress urinary incontinence within six months of bariatric surgery (p=0.046). Self-reported outcomes and scores obtained in the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale were associated with significant improvement (p=0.012, p=0.025, and p=0.002 respectively).Conclusion:Older women with larger waist circumference have a higher risk of developing stress urinary incontinence prior to bariatric surgery. Menopausal women are highly prone to persistent stress urinary incontinence, even after weight loss. Weight loss achieved through bariatric surgery improved stress urinary incontinence symptoms and mitigated related impacts on quality of life in the vast majority of women.

Metabolic Syndrome in Female Police Officers and Female Office Workers: A Cross-Sectional Study in Occupations with Different Physical Activities.

IntroductionIncrease in the prevalence of metabolic syndrome (MetS) has become a worldwide major health problem. So far, there are limited data about the impact of occupation types and the development of metabolic risks in females. This study aimed to compare the metabolic risk profiles and in two extremely different female occupational groups: police officers (PO) and office workers (OW).MethodsThe prospective study included a total number of 97 female subjects (37 POs and 60 OWs) from Germany. Anthropometric characteristics, metabolic risk parameters as well as laboratory parameters were taken. The diagnosis of MetS was based on the criteria of the International Diabetes Federation (IDF).ResultsFemale OWs presented a high prevalence of obesity, shown in average abdominal waist circumference (85.3 ± 14.5 cm) above the threshold of ≥80 cm recommended by the IDF to define abdominal obesity. Sixty percent of OWs versus 25% of POs had an abnormal abdominal waist circumference. Concerning other metabolic risk factors (HDL, triglycerides, body mass index, blood pressure) no significant differences were found, but a tendency toward a higher prevalence of abnormal values is presented in OWs than POs. MetS was detected in almost 8% of OWs as compared with 5% in POs (p = 0.705).ConclusionIn an international comparison, German female POs showed one of the lowest prevalence of MetS, whereas the prevalence in OWs is equal to results in other countries. In conclusion, especially the occupational type of female OWs presented elevated factors, that are associated with increased metabolic risk. There is a relevant need for further prospective studies with larger sample sizes in female workers to determine the influence between occupational type and metabolic system.

Study protocol for the use of photobiomodulation with red or infrared LED on waist circumference reduction: a randomised, double-blind clinical trial

IntroductionThe search for non-invasive procedures to reduce localised adiposity in aesthetics clinics has recently been increasing. In this context, procedures, such as cryolipolysis, ultracavitation, photobiomodulation (PBM) and other techniques have...

Association Between Abdominal Waist Circumference and Blood Pressure In Brazilian Adolescents With Normal Body Mass Index: Waist circumference and blood pressure in Adolescents.

Obesity is the most common chronic disease in adolescents. In adults, waist circumference (WC) is associated with the presence of cardiovascular risk factors and is also a better predictor of cardiovascular (CV) risk than body mass index (BMI). The association between WC and CV risk factors in adolescents has been poorly explored so far, mainly in those within the normal BMI range.Objective:To evaluate the association between WC and elevated blood pressure (BP) in adolescents with a normal BMI.Methods:Cross-sectional analysis of 73,399 scholars between 12 and 17 years old from the ERICA study, a school-based, national representative study with Brazilian adolescents. Only those within the normal range of BMI were included. The WC was categorized into quartiles for sex and age (Q1 to Q4). For the analysis, BP values ≥ 90th percentile were considered to indicate elevated BP, what includes hypertension and pre-hypertension. The Poisson Regression model was used and the prevalence ratio was estimated.Results:A total of 53,308 adolescents with normal BMI were included. Prevalence of elevated BP in the overall group was 18.0%. In female adolescents with WC in the lowest quartile for their age, the prevalence of elevated BP was 7.3% (12–14 years) and 6.9% (15–17 years), increasing in the upper quartile to 15.2% and 19.5% respectively, with a prevalence ratio (PR) indicating chance at least two times higher for elevated BP in Q4 (p < 0.001). Similarly, this was observed in boys, with a prevalence of elevated BP of 10.0% and 18.9% in Q1, increasing to 21.4% and 49.6% in Q4 (p < 0.001).Conclusion:In adolescents, there is a strong association of increased WC with BP elevation, even when the BMI is adequate.

Metabolic Syndrome: An Indicator of Complicated Gall Stone Disease?

BackgroundGallstone disease is a common surgical entity worldwide and accounts for a major portion of hospital admissions and surgeries. Metabolic syndrome is diagnosed when three of the following medical conditions are positive: central obesity, high blood pressure, increased fasting glucose levels, low high-density lipoprotein (HDL) levels and high serum triglycerides.ObjectiveTo compare the frequency of metabolic syndrome in patients with uncomplicated gallstone disease and complicated gallstone disease.Study designObservational, cross-sectional study.MethodologyA total of 104 patients, above age 18 years, visiting the outpatient department (OPD) or the emergency department, diagnosed as having gallstone disease. The study was conducted in surgical unit VI, civil hospital Karachi from June 2014 to June 2015. Patients’ demographics, abdominal waist circumference, blood pressure, serum fasting blood sugar, triglyceride level and HDL levels were recorded. Final outcome was labeled as presence or absence of metabolic syndrome. Presence of metabolic syndrome was compared in patients with complicated gallstone disease as well as in patients with uncomplicated gallstone disease. Chi square test was used to detect statistical significance and a p-value of <0.05 was taken as significant.ResultsThe ages were comparable between the two groups, that is, the complicated and uncomplicated gallstone disease at 42.42 +/- 12.15 years in the former and 39.24 +/- 10.41 years in the latter group. Metabolic syndrome was more predominant in the complicated arm 40.38% when compared to uncomplicated arm 25% but it was not significant statistically with a p-value of 0.2.ConclusionMetabolic syndrome is associated with complicated gallstone disease though this study failed to reach statistical significance due to small sample size, it re-enforces the findings of previous studies. It is an easily assessable and useful measure to predict complications associated with gall stone disease.

Differences in the treatment and control of hypertension in urban and rural residents of the northeastern region of the People’s Republic of China: a cross-sectional study

ABSTRACTBackground: Hypertension is a significant global public health problem and an important risk factor for cardiovascular diseases. We aimed to determine treatment and control rates of hypertension and to explore related risk factors by urban and rural areas.Methods: A cross-sectional survey of 14,956 participants (≥ 15 years) was conducted in Jilin Province, China from July 2014 to December 2015 using questionnaire forms and physical measurements.Results: Total rates of hypertension treatment, control, and controlled blood pressure among treated subjects were 31.7%, 8.8%, and 27.9% in the Jilin Province. Rates of hypertension treatment, control, and controlled blood pressure among treated subjects were 35.9%, 13.7%, and 38.3% in urban areas and 28.4%, 5.0%, and 17.5% in rural areas, respectively. Higher treatment of hypertension was associated with older age, female sex, other races (except Han), and higher body fat percentage in both areas. Among urban residents, higher education was additionally associated with higher treatment of hypertension; among rural residents, a family history of coronary artery disease and unemployment were associated with higher treatment of hypertension. Higher control of hypertension was associated with unemployment, married status, higher education, healthy body mass index, lower abdominal waist circumference, non-smoking status, and lower visceral adiposity index in urban residents; higher control of hypertension was associated with younger age in rural residents.Conclusion: Treatment and control rates of hypertension in urban and rural areas were lower than the national average; blood pressure control in patients taking antihypertensive drugs needs further improvement.

Influences of clinical experience in the quantification of morphometric sarcopaenia: a cohort study.

Influences of clinical experience in the quantification of morphometric sarcopaenia: a cohort study.

Differences in prevalence of hypertension and associated risk factors in urban and rural residents of the northeastern region of the People's Republic of China: A cross-sectional study.

BackgroundHypertension is a significant global public health problem and recognized as an important risk factor for cardiovascular diseases. This study was designed to assess the current prevalence of hypertension and to explore risk factors associated with hypertension by urban and rural status to guide the prevention and control of hypertension in Jilin province.MethodsA multi-stage stratified random cluster sampling method was used to obtain data on hypertension, which was investigated by physical examination and face-to-face questionnaire in July 2014-December 2015. Sample data were analyzed by complex weighted statistical analysis to estimate blood pressure levels and prevalence of hypertension in the province. Multivariable logistic regression analysis was used to identify factors influencing hypertension rates.ResultsThe prevalence of hypertension was significantly higher in rural areas than urban areas (25.93% versus 22.73%, respectively). The rates of hypertension known (46.7% versus 38.1%, respectively), control (13.7% versus 5.0%, respectively), and controlled among treated subjects (38.3% versus 17.5%, respectively) were higher in urban areas than in rural areas (all p < 0.001), while the treatment rate was not statistically significantly different between urban and rural areas (35.9% versus 28.4%, respectively). After adjusting for demographic covariates, hypertension prevalence in rural areas was still significantly greater than in urban areas (adjusted OR = 1.22; 95%CI: 1.10, 1.36; p < 0.001). Common risk factors for hypertension among urban and rural residents included older age; male; married; employed; less education; overweight/obese; greater abdominal waist circumference; family history of hypertension, stroke, or coronary heart disease; current smoker; alcohol consumption; higher visceral adiposity index; and higher body fat percentage.ConclusionsThis study identified an increased risk for hypertension in rural regions of Jilin province, suggesting that rural hypertension screening and treatment guidelines should receive greater attention.

Análisis de relevancia clínica aplicado a 3 métodos de reducción de peso en pacientes con sobrepeso u obesidad seguidos durante un año

ObjectiveTo analyse the effect of the use/implementation of 3methods to reduce weight in overweight or obese patients during one year of follow up. Material and methodsThe design corresponds to a double-blind, randomised, controlled clinical trial with 3arms, and 12 months of follow-up.Patients were randomised into 3intervention groups: obesity motivational intervention, with a nurse previously trained in motivational intervention by expert psychologists (G1; n=60); lower intensity consultation, non-motivational group, with digital platform support (G2; N=61), and a third group that received recommendations for weight loss and follow-up in Primary Care Clinic (G3; n=59).Anthropometric variables (weight, height, and abdominal-waist circumference) were measured, and the percentage of patients who managed to reduce their weight ≥5% was considered as the main measurement of treatment effectiveness. ResultsAll groups significantly decreased body weight at the end of the study, with a reduction in G1 (−5.6kg) followed by G2 (−4.3kg), and G3 (−1.7kg), with an overall mean: −3.9kg. The indicators of clinical relevance were in G1/G3: relative risk (RR): 4.99 (95% CI: from 2.71 to 9.18); relative risk reduction (RRR): 399.1% (171.3 to 818.0); Absolute risk reduction (RAR): 65.3% (from 51.5 to 79.1) and NNT: 2 (from 2 to 2). In the G2/G3 groups: RR: 3.01 (from 1.57 to 5.76); RRR: 200.5% (from 57.0 to 475.5); RAR: 32.8% (from 16.9 to 48.7) and NNT: 4 (from 3 to 6). In the G1/G2 groups: RR: 1.66 (from 1.25 to 2.20); RRR: 66.1% (from 25.3 to 120.1); RAR: 32.5% (from 16.6 to 48.4) and NNT: 4 (from 3 to 7). ConclusionsAll 3groups were able to reduce weight. Although the group with motivational intervention achieved the greatest decrease, as well as the most favourable clinical relevance indicators.

Effect of Three Methods of Approaching Obesity in Long- Term Weight Loss

Objective: To analyze the effect on weight reduction in overweight and obese patients through three intervention methods.Material and methods: Prospective, randomized, multicentric intervention study in overweight and obese patients with a 12-month follow-up. Patients were randomized into three intervention groups: Obesity motivational intervention with previously trained nurse (G1), lower intensity consultation, no motivational group, digital platform support (G2), and a third group that received a recommendation to lose Weight and follow-up in primary care consultation (G3). Weight, height, BMI, abdominal waist circumference, Lipid Parameters, Blood Pressure and Blood Glucose were collected.Results: The study enrolled 176 patients, of whom 60 were randomized to Group 1, 61 to Group 2 and 55 to Group 3. 58% of the populations were women and 42% men, being therefore the global ratio between men and women from 1 to 2.65. In all three groups the weight decreased in each visit, with an overall mean reduction at the end of the study of 3.9 kg. It can be seen how the three groups reduce total cholesterol, although the G1 with motivational intervention reduces it significantly more with respect to G2 and G3. On the other hand Triglycerides are significantly reduced by the two study groups. And HDL-C is increased in all three groups.Conclusions: The three groups managed to reduce weight, although the group with motivational intervention and telemedicine showed significant differences.

Occupation and metabolic syndrome: is there correlation? A cross sectional study in different work activity occupations of German firefighters and office workers

BackgroundThe treatment and prevention of the metabolic syndrome (MetS) is currently one of the major challenges in medicine. The impact of working conditions on metabolic risk has not been adequately studied. Our objective was to compare the prevalence of MetS and metabolic risk in two extremely different occupational groups: firefighters and office workers.MethodsA total of 143 male subjects (97 firefighters and 46 office workers) from Germany participated in the study. Anthropometric characteristics, metabolic risk parameters as well as laboratory parameters were collected. MetS was diagnosed according to criteria of the International Diabetes Federation.ResultsSedentary occupation showed a significant tendency towards obesity. Abdominal waist circumference was significantly greater in office workers than in firefighters [5.08 CI (1.44–8.71), p = 0.007]. Concerning metabolic risk factors, abnormal HDL, triglycerides, BMI, blood pressure and waist circumference values were more frequently found in office workers than in firefighters. The MetS was detected in almost 33 % of office workers as compared with only 14 % in firefighters (p = 0.015). Regarding MetS in an international comparison, the prevalence of MetS in German office workers was high and in firefighters it was extremely low.ConclusionsSedentary occupation as an office worker is associated with a high risk of MetS. Both groups need to be made aware of the metabolic risks, and health promoting concepts such as corporate sports activities or education in healthy nutrition need to be implemented to counteract the development of the MetS and cardiovascular risk factors.

Impact of Renal Anatomy on Shock Wave Lithotripsy Outcomes for Lower Pole Kidney Stones: Results of a Prospective Multifactorial Analysis Controlled by Computerized Tomography

We evaluated which variables impact fragmentation and clearance of lower pole calculi after shock wave lithotripsy. We prospectively evaluated patients undergoing shock wave lithotripsy for a solitary 5 to 20 mm lower pole kidney stone between June 2012 and August 2014. Patient body mass index and abdominal waist circumference were recorded. One radiologist blinded to shock wave lithotripsy outcomes measured stone size, area and density, stone-to-skin distance, infundibular length, width and height, and infundibulopelvic angle based on baseline noncontrast computerized tomography. Fragmentation, success (defined as residual fragments less than 4 mm in asymptomatic patients) and the stone-free rate were evaluated by noncontrast computerized tomography 12 weeks postoperatively. Univariate and multivariate analysis was performed. A total of 100 patients were enrolled in the study. Mean stone size was 9.1 mm. Overall fragmentation, success and stone-free rates were 76%, 54% and 37%, respectively. On logistic regression body mass index (OR 1.27, 95% CI 1.11-1.49, p = 0.004) and stone density (OR 1.0026, 95% CI 1.0008-1.0046, p = 0.005) significantly impacted fragmentation. Stone size (OR 1.24, 95% CI 1.07-1.48, p = 0.039) and stone density (OR 1.0021, 95% CI 1.0007-1.0037, p = 0.012) impacted the success rate while stone size (OR 1.24, 95% CI 1.04-1.50, p = 0.029), stone density (OR 1.0015, 95% CI 1.0001-1.0032, p = 0.046) and infundibular length (OR 1.1035, 95% CI 1.015-1.217, p = 0.015) impacted the stone-free rate. The best outcomes were found in patients with a body mass index of 30 kg/m(2) or less, stones 10 mm or less and 900 HU or less, and an infundibular length of 25 mm or less. The coexistence of significant unfavorable variables led to a stone-free rate of less than 20%. Obese patients with higher than 10 mm density stones (greater than 900 HU) in the lower pole of the kidney with an infundibular length of greater than 25 mm should be discouraged from undergoing shock wave lithotripsy.

Prevalence of Chronic Kidney Disease in an Adult Population

One strategy to prevent and manage chronic kidney disease (CKD) is to offer screening programs. The aim of this study was to determine the percentage prevalence and risk factors of CKD in a screening program performed in an adult general population. This is a cross-sectional study. Six-hundred ten adults (73% women, age 51± 14 years) without previously known CKD were evaluated. Participants were subjected to a questionnaire, blood pressure measurement and anthropometry. Glomerular filtration rate estimated by CKD-EPI formula and urine tested with albuminuria dipstick. More than 50% of subjects reported family antecedents of diabetes mellitus (DM), hypertension and obesity, and 30% of CKD. DM was self-reported in 19% and hypertension in 29%. During screening, overweight/obesity was found in 75%; women had a higher frequency of obesity (41 vs. 34%) and high-risk abdominal waist circumference (87 vs. 75%) than men. Hypertension (both self-reported and diagnosed in screening) was more frequent in men (49%) than in women (38%). CKD was found in 14.7%: G1, 5.9%; G2, 4.5%; G3a, 2.6%; G3b, 1.1%, G4, 0.3%; and G5, 0.3%. Glomerular filtration rate was mildly/moderately reduced in 2.6%, moderately/severely reduced in 1.1%, and severely reduced in <1%. Abnormal albuminuria was found in 13%. CKD was predicted by DM, hypertension and male gender. A percentage CKD prevalence of 14.7% was found in this sample of an adult population, with most patients at early stages. Screening programs constitute excellent opportunities in the fight against kidney disease, particularly in populations at high risk.