Abnormal Waist Circumference Research Articles

Fatty Liver as a Potential Surrogate for Waist Circumference in the Diagnosis of Metabolic Syndrome: A Population-Based Study among Chinese Adults.

Increased waist circumference (WC) is an essential component of metabolic syndrome (MetS). Asians have been found to have more intra-abdominal adipose tissue than Caucasians, in spite of having smaller WC. The purpose of this study was to explore whether NAFLD could be used as a surrogate for MetS diagnosis in the normal WC population. A total of 9694 Chinese residents were selected from SPECT-China, a population-based survey of Chinese adults aged ≥ 18 years in East China. Insulin resistance was calculated by the homeostatic model assessment for insulin resistance (HOMA-IR). MetS z-score was used to evaluate the degree of total metabolic disorder. Logistic regression models were used to obtain the associations between different categories and metabolic syndrome (MetS) components. The prevalence of NAFLD was 27.6%, in which 35.2% were without abnormal WC. Subjects with only NAFLD had similarly severe insulin resistance and OR for clustering of MetS components compared with those with only abnormal WC. A considerable number of NAFLD cases, although had severe metabolic disorder, would not be detected by the current MetS definition. NAFLD could be used as a potential surrogate marker for the diagnosis of MetS in normal WC population.

Prevalence of Metabolic Syndrome among Patients with Hypothyroidism

Background: hypothyroidism is of concern in our society; it has an effect on metabolic parameters. Objective: this study aimed to predict the prevalence of metabolic syndrome (MetS) among patients with hypothyroidism in Jeddah, Saudi Arabia and to determine the effect of treating hypothyroidism on MetS. Methods: we conducted this cross-sectional study, in which MetS was defined by presence of at least three of the five AHA/NHLBI criteria. We included patients with hypothyroidism that were managed in an outpatient department or admitted in King Abdulaziz University Hospital from 1 March to 30 April 2016. We measured lipid parameters, blood pressure (BP), waist circumference (WC) and serum fasting blood glucose (FBG). Results: in total 57 patients were included in our study, of which 47 (82%) were females. the majority of patients were greater than 50 years of age (n=35, 60%). We found that 36.8% of patients uncontrolled for hypothyroidism had high levels of TSH (serum level of TSH >5 mlu/L) , while 64.9% of patients who were controlled for hypothyroidism had normal levels of TSH (serum level of TSH 0.5 - 5 mlu/L). Overall, 71.9% (n=41) of hypothyroidism patients had MetS. However, we found that 51.8% (n=21) uncontrolled hypothyroidism patients suffered from MetS and 48.2% (n= 20) patients controlled for hypothyroidism suffered from MetS. However, 70.68 %, 31.03%, 34.48%, 79.31% and 70.6% of participants had abnormal waist circumference (WC), hypertriglyceridemia, abnormal high-density lipoprotein (HDL), hypertension and elevated serum levels of fasting blood sugar, respectively Conclusion: hypothyroidism plays an important role in MetS. Future advanced studies including larger numbers of patients are needed to test the effect of treating hypothyroidism on MetS. Routine screening for cardiovascular risk factors in patients with hypothyroidism may unmask MetS.

Prevalence and risk factors of diabetes among young students of a medical college in central India

Background: India is home to 69.2 million diabetics and is second only to China in these numbers. There has been a rapid increase in the prevalence of diabetes worldwide, developing countries being the worst hit. Recent studies have revealed a trend of occurrence of diabetes mellitus at a younger age.This implies morbidity and mortality due to diabetes will occur at an early age among large proportion of individuals. We aimed to determine the prevalence of diabetes mellitus among young medical students of MGIMS Sevagram and risk factors associated with diabetes.Methods: This cross-sectional study was conducted between August 2010 and December 2012 in MGIMS Sevagram, a medical college located in central India. Total of 700 students, aged 17-35 years, were studied using a modified STEPs questionnaire.After an overnight fast, blood samples for fasting blood glucose and lipid profile were collected. Statistical analysis was done using STATA 13 software.Results: The prevalence of diabetes mellitus was found to be 2.36%. Impaired fasting glucose or prediabetes was present in 17.57%. Control of diabetes was very poor among study subjects as only 33.3% of diabetics had their fasting blood sugar under control. .After multivariate logistic regression analysis diabetesrisk was significantly higher among those aged >30 years {OR-11.32 (95% CI 3.43-37.32)}, those with low physical activity level {6.99 (95% CI 1.52-32.08))}, those with abnormal waist circumference {OR-3.70 (95% CI 1.07-12.81)} and those who had hypertriglyceridemia {OR-3.12 (95% CI 1.02-9.51)}.Conclusion: A significant proportion of young medical students havediabetes and prediabetes. This study is an eye-opener, as a large proportion of young medical students having diabetes are not able to control their diabetes, despite adequate knowledge and treatment opportunity. One factor which can be responsible for this problem is stressful routine through which a medical student has to go through during the training, especially during residency.

Abstract 21345: Diastolic Blood Pressure is the Predictors of Left Ventricular Myocardial Relaxation in Healthy Postmenopausal Women

Introduction: Previous studies that indicate metabolic syndrome (MetS) might be at risk for left ventricular (LV) diastolic dysfunction. However, little is known about which metabolic factors contribute to the development of LV dysfunction in postmenopausal women without obesity or overweight, diabetes mellitus, and/or cardiovascular disease. Methods: Participants without diabetes mellitus, systolic dysfunction, or other heart diseases underwent a thorough physical examination including tissue Doppler echocardiography. A peak early mitral annular velocity (e′) of <5.0 was designated as indicating abnormal LV myocardial relaxation (LVMR). We performed single and multiple logistic regression analyses of e′ and cardiovascular risk factors, including MetS factors and indicators of major organ dysfunction. Normal-weight subjects (body mass index <25 kg/m2) were also analyzed. Results: A total of 269 postmenopausal women (mean age, 70 ± 7 years) participated, of which 29 (10.8%) had MetS and 67 (23.8%) had abnormal LVMR. Multiple logistic regression analysis revealed high diastolic blood pressure: DBP (odds ratio [OR] 5.3, 95% confidential interval [CI] 1.89 - 15.0, P < 0.01), abnormal waist circumference (OR 2.4, CI 1.15 - 5.01, P < 0.01) and age (OR 1.1, CI 1.05 - 1.16, P < 0.01) to be predictors of abnormal LVMR. In normal-weight subjects (n = 232), high DBP (OR 5.1, CI 1.65 - 15.89, P < 0.01), and aging (OR 1.1, CI 1.06 - 1.17, P < 0.01) were predictors of abnormal LVMR. Conclusions: In postmenopausal women, only diastolic blood pressure was the independent risk factors for abnormal LVMR in both normal-weight and over-weight individuals, and therefore might be useful for predicting diastolic heart failure during routine physical checkups.

FATORES ASSOCIADOS AO CONHECIMENTO E À ATITUDE EM RELAÇÃO AO DIABETES MELLITUS

O objetivo deste estudo foi identificar fatores associados ao conhecimento e à atitude diante da doença em indivíduos com diabetes. Estudo transversal com 288 indivíduos, mediante entrevista, entre março e setembro de 2014, em seis unidades básicas de saúde no estado do Paraná. O conhecimento insatisfatório sobre a doença (n=194, 67,4%) e a atitude negativa (n=211, 73,4%) foram predominantes. Os fatores associados ao conhecimento insatisfatório foram sexo feminino (p=0,004), baixa escolaridade, ausência de complicações (p=0,011), sem consulta com endocrinologista nos últimos doze meses (p=0,009). Renda maior que dois salários mínimos (p=0,002), circunferência abdominal alterada (p=0,001) e sem realização de exames de sangue nos últimos seis meses (p=0,005) estiveram associados à atitude negativa diante da doença. Evidencia-se a necessidade de intervenções que melhorem o conhecimento dos indivíduos sobre a doença, e que reforcem e estimulem o desenvolvimento e a adoção de comportamentos adequados para o enfrentamento dessa condição crônica.

Association of change in waist circumference and dyslipidaemia risk: The rural Chinese cohort study.

To investigate the association of change in waist circumference (WC) and incidence of dyslipidaemia in a cohort study of a rural Chinese population. Change in WC (ΔWC) was defined as the value at follow-up minus the corresponding value at baseline. Risk of dyslipidaemia associated with ΔWC was assessed by odds ratios and 95% confidence intervals in a logistic regression model, and the odds ratios were transformed to relative risks (RRs). Among 7691 participants without dyslipidaemia at baseline, 3213 (41.78%) showed dyslipidaemia at 6year follow-up. Risk of dyslipidaemia was decreased for participants with the first quartile of ΔWC and normal baseline WC (adjusted RR [aRR]=0.79 [95% confidence interval: 0.64-0.98]) and was increased with the fourth quartile of ΔWC and male gender, age 18 to 30years, age 31 to 50years, or normal baseline WC (aRR=1.55 [1.19-2.03], 2.40 [1.16-4.95], 1.32 [1.06-1.64], and 1.66 [1.35-2.04], respectively). The risk of dyslipidaemia increased with change in WC from normal at baseline to abnormal at follow-up for both genders (aRR=1.88 [1.39-2.55] for men and 1.60 [1.30-1.97] for women) and decreased with abnormal baseline WC changed to normal WC for women (aRR=0.61 [0.45-0.83]). Dynamic change in waist circumference was closely related to the incidence of dyslipidaemia in a rural Chinese population. Waist circumference reduction could decrease dyslipidaemia risk, whereas WC increase may increase the risk. Interventions to control or reduce WC to within the normal range are important for early prevention of dyslipidaemia.

Health status of traffic police personnel in Chennai city

Background: The work environment constitutes an important part of man’s total environment, so health to a large extent is affected by work conditions. These personnel have to undergo physical strain in an environment polluted by fumes, exhaust of vehicles, use of blowing horns, blow of dust in the air by the speeding vehicle, under hot sun, etc. Objective: To assess the health status of the traffic police personnel in Chennai city. Methodology: Cross sectional study was conducted among 139 traffic police personnel in Chennai city. Afterobtaining informed consent,information regarding socio-demographic profile, job experience and physical health profile was collected using a pre-structured proforma. Results: Among the study population, 134 (96.4%) were males and 5 (3.6%) were females. Thirty two (23%) were diabetic, 32 (23%) were hypertensive, 17 (12.2%) had respiratory problems, 26 (18.7%) had skin problems, 70(50.4%) complained of low back pain, 34 (24.5%) reported eye problems, 20 (14.4%) had low PEFR, and 18 (12.9%) were found to have varicose veins by Trendelenberg’s test. Significant association (p<0.05) was found between years of service with diabetes, hypertension, abnormal waist circumference and usage of personal protective equipment (maskand sunglasses). Conclusion: Regularscreening and health education programs need to be implemented. Lifestyle modification, smoking and alcohol control and stress alleviation should be an integral component of these health-related activities.

New-onset diabetes in HIV-treated adults: predictors, long-term renal and cardiovascular outcomes.

To determine the incidence and risk factors for developing diabetes mellitus in a cohort of Thai HIV-infected patients on long-term combination antiretroviral therapy (cART). Prospective study conducted between July 1996 and 30 April 2015. A total of 1748 patients (60% men) who did not have diabetes mellitus prior to ART were assessed twice a year. Incident diabetes mellitus was defined as either having two consecutive fasting glucose levels more than 126 mg/dl, or reporting antidiabetes mellitus medication/diabetes mellitus diagnosis after starting cART. Incidence rates were calculated per 1000 person-year follow-up. Multivariate Cox regression was used to determine risk factors for the development of diabetes mellitus. During a median follow-up of 9 years (16 274 person-year of follow-up), 123 patients developed new-onset diabetes mellitus, resulting in an incidence rate of 7.6 (95% confidence interval 6.3-9) per 1000 person-year of follow-up. From the multivariate models, age more than 35 years, male sex, BMI at least 25 kg/m, family history of diabetes, abnormal waist circumference, lipodystrophy and exposure to didanosine were significantly associated with incident diabetes mellitus. The diabetes mellitus group had higher mortality rate (8.1 vs. 4.1%, P = 0.04). A significantly higher proportion diabetes vs. nondiabetes patients developed cardiovascular and cerebrovascular complications (8.9 vs. 3.6%, P = 0.008) or chronic kidney disease stage III (estimated glomerular filtration rate <60 ml/min/1.73 m) (15.3 vs. 1.9%, P < 0.001) over total follow-up. In addition to traditional risk factors, lipodystrophy and use of didanosine were strongly associated with development of incident diabetes. Given the higher rate of cardiovascular-cerebrovascular complications and chronic kidney disease among patients with diabetes mellitus, careful assessment and appropriate management of diabetes mellitus are essential.

Development of an ‘At Risk for Metabolic Syndrome’ Score

Develop a score that evaluates individuals ‘at risk of metabolic syndrome (metS)’ in college-age students using risk factors in addition to the five components of metS (abnormal waist circumference, dyslipidemia, elevated blood pressure, and insulin resistance). MetS affects more than 20% of U.S. adults and was reported in 10% of male and 3% of female college students. Health and nutrition research professionals developed the scoring tool in September 2014. In addition to the five components, the tool considered nutritional status, physical inactivity, ethnicity, and family history. Thirty-seven young adults at West Virginia University (WVU) were evaluated using the 12 point scale. Correlations were assessed between our tool and two validated tools of disease severity: West Virginia University School of Public Health MetS Severity Score (Gurka et al 2014) and the American Heart Association Score (AHA My Life Check® 2016). Pearson’s correlation showed a significant association between our score and WVU’s Public Health Z-score (R = 0.049 CI (0.19, 0.70) p=0.0024) and the AHA Score (R = -0.35, CI (-0.60, -0.03) p=0.03). To our knowledge, no instrument has been developed to assess ‘at risk of developing metS’. Our instrument strongly correlates to the most validated tools that currently assess disease severity. Future analysis is being undertaken to evaluate our tool using a larger sample size. Development of this tool helps improve primary prevention intervention strategies on individuals at risk of MetS.

Abstract P151: Comparison of Standard Definitions and Sagittal Abdominal Diameter as a Measure of Excess Adiposity When Defining Metabolic Syndrome in Adolescents

Introduction: Metabolic syndrome (MetS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MetS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MetS for this age group. It is important to estimate MetS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MetS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MetS when utilizing sagittal abdominal diameter (SAD) as a component of MetS. Methods: Data from U.S. adolescents ages 12-19 years (N=970) in the NHANES (2011-2014) were analyzed. MetS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MetS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MetS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MetS components. For both sexes, estimated prevalence of components varied greatly by definition (e.g., boys’ prevalence of high fasting blood glucose: IDF-27.2% vs. Cook and deFerranti-both 2.7%). MetS prevalence in boys using standard and SAD-modified definitions were 4.5% and 5.0%; 10.6% and 9.4%; and 4.6% and 3.3% for the Cook, deFerranti, and IDF definitions, respectively. Among girls, the standard-defined and SAD-modified MetS prevalence were 2.4% and 2.4%; 8.5% and 8.2%; and 4.3% and 2.8% for the Cook, deFerranti, and IDF definitions, respectively. Conclusions: Though the most prevalent MetS components were similar, the estimated prevalence values of individual components varied greatly across MetS definitions. With the risk of false positives, the deFerranti definition of MetS may identify the greatest number of adolescents at potential risk for MetS. Cook and deFerranti definitions may miss the identification of adolescents who could benefit from additional health promotion programs. Compared to WC, use of SAD resulted in similar yet slightly attenuated estimated MetS prevalence.

Sarcopenia in rheumatoid arthritis: prevalence, influence of disease activity and associated factors.

Evaluate the prevalence of sarcopenia on patients with rheumatoid arthritis (RA), the influence of sarcopenia on disease activity and factors associated with sarcopenia. One hundred and twenty-three patients aged over 18years with RA based on the 1987 ACR/EULAR classification criteria were enrolled. We performed a whole body DXA scan using a dual-energy X-ray absorptiometry (DXA) scanner lunar prodigy to measure fat mass, lean mass, and bone mass in the whole body and body parts. According to the anthropometric equation by Baumgartner et al., sarcopenia was defined as Relative skeletal mass index (RSMI) <5.5kg/m2 on women and <7.26kg/m2 on men. Body mass index (BMI) and waist circumference were measured and patients were classified according to World Health Organization. Disease activity was evaluated by: disease activity score 28 ESR (DAS28 ESR), disease activity score 28 CRP (DAS28 CRP), clinical disease activity index (CDAI), simplify disease activity index (SDAI). We measured functional disability by Health assessment questionnaire (HAQ). History and previous medication use including steroids were also checked, and comorbidities were recorded. We analyzed the relation between disease parameters and sarcopenia with the r of Pearson and Spearman. Factors associated and related to sarcopenia were assessed using multiple regression analysis and t independent test. We included 123 patients (107 women). 49 subjects (39.8%) where suffering from sarcopenia, of which 40 women. Most of the sarcopenic patients were between 41 and 50years old. Sarcopenia on female subjects was not related to parameters of disease activity evaluated by DAS 28, CDAI and SDAI. Most of the sarcopenic patients had normal BMI and abnormal waist circumference. In simple regression analysis sarcopenia was related to BMI, DAS 28 ESR, bone erosion, waist circumference and HAQ. In multiple regression analysis, sarcopenia was positively related to an increase cardiometabolic risk [p = 0.025, OR 0.176, CI (0.038-0.980)], normal BMI [p = 0.004, OR 12.3, CI (2.27-67.6)], over fat BMI [p = 0.004, OR 12.3, CI (2.27-67.6)] and bone erosion [p = 0.012, OR 0.057 CI (0.006-0.532)]. No statistical difference was found according to disease duration and steroids use between sarcopenic and non sarcopenic patients. Sarcopenia is prevalent and related to age, bone erosion, normal/over fat BMI and high cardiometabolic risk according to waist circumference but not with disease activity.

Prevalence of Diet Atherogenicity and Coexistence of Lipid Disorders and Arterial Hypertension among 50-year-old Inhabitants of Wroclaw, Poland.

The incorrect composition of a diet, its atherogenicity, is conducive to the occurrence of lipid disorders, arterial hypertension (HTN), diabetes, and metabolic syndrome (MetS). The aim of the study was to evaluate the prevalence of incorrect anthropometric and biochemical parameters as well as diet atherogenicity. The study group included 1,520 adults (880 women, 640 men). The nutritional status evaluation was based on respondents' BMI and waist circumference. The diet atherogenicity was estimated using Keys Index (KI) and P/S ratio. Total cholesterol (TCh), LDL cholesterol as well as triglycerides (TG) concentration in blood serum were also evaluated. In 56.8% of women and 60.8% of men waist circumference exceeded referential values. The diets of 71.4% of women and 87.3% of men were atherogenic. HTN was observed in 64.1% of the study population. Hypercholesterolaemia was found in approximately 72% of the respondents. The increased LDL cholesterol concentration were found in 57.5% of women and 64.5% of men. Abnormal concentration of HDL cholesterol occurred among approximately 20% of respondents. Hypertriglyceridaemia was recognised in 26% of women and 44% of men. In the group of women and men with HTN, mean values, i.e. BMI, waist circumference and TG (with TCh concentration additionally noted in men) were found as significant. Normal lipid profile and arterial pressure values were observed in 6.6% of the population. In the diets of men with HTN were observed higher values of KI compared to group without HTN. No significant differences were found in the frequency of occurrence of the analysed parameters either among the group of women with HTN or without it. In the group of men with HTN, the abnormal BMI, waist circumference and TG occurred more frequently.

The Effect of Obesity and Increased Waist Circumference on the Outcome of Laparoscopic Nephrectomy.

Introduction. The prevalence of obesity is increasing worldwide. Obesity can be determined by body mass index (BMI); however waist circumference (WC) is a better measure of central obesity. This study evaluates the outcome of laparoscopic nephrectomy on patients with an abnormal WC. Methods. A WC of >88 cm for women and >102 cm for men was defined as obese. Data collected included age, gender, American Society of Anaesthesiologists (ASA) score, renal function, anaesthetic duration, surgery duration, blood loss, complications, and duration of hospital stay. Results. 144 patients were assessed; 73 (50.7%) of the patients had abnormal WC for their gender. There was no difference between the groups for conversion to open surgery, number of ports used, blood loss, and complications. Abnormal WC was associated with a longer median anaesthetic duration, 233 min, IQR (215–265) versus 204 min, IQR (190–210), p = 0.0022, and operative duration, 178 min, IQR (160–190) versus 137 min, IQR (128–162), p < 0.0001. Patients with an abnormal WC also had a longer inpatient stay, p = 0.0436. Conclusion. Laparoscopic nephrectomy is safe in obese patients. However, obese patients should be informed that their obesity prolongs the anaesthetic duration and duration of the surgery and is associated with a prolonged recovery.

The Impacts of Albuminuria and eGFR on Cardiovascular Disease

Albuminuria is often used as a surrogate marker for the risk of fatal and non-fatal events in clinical trials of antihyperglycemic medications or in antihypertensive therapy. Similarly, low estimated glomerular filtration rate (eGFR), which is a common manifestation of progressed diabetic nephropathy, has also been demonstrated to be an independent risk factor for cardiovascular events and death. Recent evidence suggests that both high albuminuria and low eGFR are independent risk factors for progressive kidney failure and cardiovascular disease. The purpose of this study was to investigate the impacts of albuminuria and low eGFR on the risk of cardiovascular disease. A cross-sectional design was used. Data were collected through adults’ health examinations by a hospital in a certain area in Pingtung County between 2011 and 2015. The health data base included participants’ basic information, physical examination and blood examination results. Use abbreviated modification of diet in renal disease, aMDRD (Abbreviated modification of diet in renal disease) formula to estimate eGFR. Use metabolic syndrome to define the criteria of rising blood pressure, blood sugar, blood lipids as an important cardiovascular disease (CVD) indicator and then calculation of the 10-year risk for CVD was completed using data from the Framingham Heart Study and a computer was used to determine risk values. In this study, ≤ 10% was defined as low risk, 11-20% was defined as moderate risk, and > 20% was defined as high risk. As albuminuria and eGFR approached critically high values, initially moderate and high 10-year risk levels for CVD tended to increase. Logistic regression analysis showed that patients with severe albuminuria and severe eGFR had higher risks of metabolic syndrome, abnormal waist circumference, hyperglycemia, reduced high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia, and elevated blood pressure. The study concluded that albuminuria and eGFR are risk factors for CVD and can increase a patient’s 10-year risk of CVD.

Metabolic Syndrome After HIV Acquisition in South African Women.

Noncommunicable diseases are common among chronically infected patients with HIV in the developed world, but little is known about these conditions in African cohorts. We assessed the epidemiology of metabolic syndrome among young South African women during the first 3 years after HIV acquisition. A total of 160 women were followed prospectively in the CAPRISA 002 Acute Infection study. Metabolic syndrome was defined as a constellation of hyperlipidemia, hypertension, hyperglycemia/diabetes, and abdominal obesity. Time trends were assessed using generalized estimation equation models. Median age was 24 years and body mass index 27 kg/m. Prevalence of metabolic syndrome at infection was 8.7% increasing to 19.2% over 36 months (P = 0.001). The proportion of women with body mass index >30 kg/m increased from 34.4% to 47.7% (P = 0.004), those with abnormal waist circumference and elevated blood pressure increased from 33.5% to 44.3% (P = 0.060) and 23.8% to 43.9% (P < 0.001), respectively. Incidence of metabolic syndrome was 9.13/100 person-years (95% CI: 6.02 to 13.28). Predictors of metabolic syndrome were age (per year increase odds ratio (OR) = 1.12; 95% CI: 1.07 to 1.16), time postinfection (per year OR = 1.47; 95% CI: 1.12 to 1.92), family history of diabetes (OR = 3.13; 95% CI: 1.71 to 5.72), and the human leukocyte antigen (HLA)-B*81:01 allele (OR = 2.95; 95% CI: 1.21 to 7.17), whereas any HLA-B*57 or B*58:01 alleles were protective (OR = 0.34; 95% CI: 0.15 to 0.77). HIV-1 RNA (OR = 0.89; 95% CI: 0.62 to 1.27) and CD4 count (OR = 1.03; 95% CI: 0.95 to 1.11) did not predict metabolic syndrome. The high burden of metabolic conditions in young South African HIV-infected women highlights the need to integrate noncommunicable disease and HIV care programs. Interventions to prevent cardiovascular disease must start at HIV diagnosis, rather than later during the disease course.

Prevalence and risk factors of dyslipidemia in a rural population of Henan Province, China

Objective: The purpose of this study was to investigate the prevalence and risk factors of dyslipidemia in a rural population of Henan Province, China. Methods: A total of 20 194 participants aged ≥18 years were selected randomly by cluster sampling from two townships(towns)in Henan Province from July to August 2007 and July to August 2008. Investigations included questionnaires, anthropometric measurements, fasting plasma glucose, and lipid profile examination at baseline. A total of 16 155 participants were followed up from July to August 2013 and July to October 2014. Overall, 13 869 participants were included in the study, after excluding 2 286 participants with incomplete dyslipidemia follow-up data. Distributions of the characteristics of dyslipidemia were determined, and prevalence was standardized by age according to data of the 2010 Sixth National Population Census. Risk factors for dyslipidemia were analyzed using a logistic regression model after adjusting for sex, age, education level, marital status, and income status. Results: The prevalence of dyslipidemia was 53.72%(7 450/13 869)for residents aged ≥22 years living in rural areas of Henan Province(59.32%(3 069/5 174)for men and 50.39%(4 381/8 695)for women). The adjusted prevalence of dyslipidemia was 50.50%(59.27% for men and 45.53% for women). The prevalence of hypercholesterolemia, hypertriglyceridemia, low HDL-C, and high LDL-C was 4.34%(602/13 868), 20.42%(2 826/13 837), 42.75%(5 927/13 865), and 3.14%(420/13 375), respectively, and the adjusted prevalence was 2.44%, 18.84%, 41.42%, and 1.86%, respectively. Logistic regression analyses showed that alcohol consumption(OR=1.27, 95% CI: 1.05-1.53), family history of hyperlipidemia(OR=1.29, 95% CI: 1.17-1.43), overweight(OR=1.40, 95% CI: 1.22-1.61), obesity(OR= 1.65, 95% CI: 1.39- 1.96), abnormal waist circumference(OR=1.22, 95% CI: 1.04- 1.43), and abnormal waist-height ratio(OR=1.21, 95% CI: 1.01-1.45)were significant independent risk factors, and high levels of physical activity(OR=0.85, 95% CI: 0.77- 0.95)and underweight(OR=0.52, 95% CI: 0.36- 0.75)were protective factors for dyslipidemia after adjusting for sex, age, education level, marital status, and income status. Conclusion: The prevalence of dyslipidemia was very high for this rural population. Alcohol consumption, family history of hyperlipidemia, overweight, obesity, abnormal waist circumference, and abnormal waist-height ratio were significant independent risk factors for dyslipidemia.

OP.6A.05] CARDIOVASCULAR DISEASE RISK FACTORS IN ADOLESCENT STUDENTS FROM A BRAZILIAN STATE CAPITAL

Objective: To determine the prevalence of cardiovascular disease risk factors in adolescents from public and private schools of a Brazilian state capital. Design and method: Cross-sectional study with a representative sample of adolescents aged 14 to 18 years, enrolled in public and private schools in Goiânia, Goiás state, Brazil. The data collection included a standard questionnaire (gender, age, ethnicity, smoking, alcohol consumption in the last 30 days, socioeconomic status, and family history of cardiovascular disease); the International Physical Activity Questionnaire (IPAQ); and a physical assessment (weight, height, waist circumference, and blood pressure). The prevalence ratio was used as the measure of association, estimated by Poisson regression. Results: The sample was composed of 862 adolescents with a mean age of 15.4 ± 1.1 years and with a predominance of females (52.8%). Alcohol consumption in the last 30 days (72.2%) and physical inactivity (66.8%) were the most prevalent cardiovascular risk factors. The most prevalent variables in female adolescents were socioeconomic class C (53.6%; p = 0.022), alcohol consumption in the last 30 days (75.4%; p = 0.025) and physical inactivity (66.8%, p = 0.000). In male adolescents, the most prevalent variables were abnormal blood pressure (24.3%; p = 0.000), abnormal waist circumference (17.2%; p = 0.011), and overweight (24.6%; p = 0.001). The prevalence of a family history of cardiovascular disease was 39.5%. Most adolescents (60.3%) had three or more risk factors, and only 1.1% did not present any cardiovascular risk factor. Conclusions: The prevalence of cardiovascular disease risk factors, particularly the occurrence of multiple risk factors, was high in the population studied.

Is the 90th Percentile Adequate? The Optimal Waist Circumference Cutoff Points for Predicting Cardiovascular Risks in 124,643 15-Year-Old Taiwanese Adolescents.

Adolescent obesity has increased to alarming proportions globally. However, few studies have investigated the optimal waist circumference (WC) of Asian adolescents. This study sought to establish the optimal WC cutoff points that identify a cluster of cardiovascular risk factors (CVRFs) among 15-year-old ethnically Chinese adolescents. This study was a regional population-based study on the CVRFs among adolescents who enrolled in all the senior high schools in Taipei City, Taiwan, between 2011 and 2014. Four cross-sectional health examinations of first-year senior high school (grade 10) students were conducted from September to December of each year. A total of 124,643 adolescents aged 15 (boys: 63,654; girls: 60,989) were recruited. Participants who had at least three of five CVRFs were classified as the high-risk group. We used receiver-operating characteristic curves and the area under the curve (AUC) to determine the optimal WC cutoff points and the accuracy of WC in predicting high cardiovascular risk. WC was a good predictor for high cardiovascular risk for both boys (AUC: 0.845, 95% confidence interval [CI]: 0.833–0.857) and girls (AUC: 0.763, 95% CI: 0.731–0.795). The optimal WC cutoff points were ≥78.9 cm for boys (77th percentile) and ≥70.7 cm for girls (77th percentile). Adolescents with normal weight and an abnormal WC were more likely to be in the high cardiovascular risk group (odds ratio: 3.70, 95% CI: 2.65–5.17) compared to their peers with normal weight and normal WC. The optimal WC cutoff point of 15-year-old Taiwanese adolescents for identifying CVRFs should be the 77th percentile; the 90th percentile of the WC might be inadequate. The high WC criteria can help health professionals identify higher proportion of the adolescents with cardiovascular risks and refer them for further evaluations and interventions. Adolescents’ height, weight and WC should be measured as a standard practice in routine health checkups.

Obesity and lifestyle risk factors among an adult population in Legal Amazon, Mato Grosso, Brazil.

Objective To evaluate the frequency of obesity and lifestyle risk factors in the population of Barra do Garças, Legal Amazon. Methodology A randomized, transversal study with 305 adults of both genders was performed. Weight, height, body mass index (BMI), waist circumference, food dietary habits, frequency of smoking and alcoholic consumption, practice of physical activity, and the physical activity level were evaluated. Results Smoking and alcoholic consumption was higher among men compared to women. Almost 60 % of men engaged in leisure-time physical activities, whereas only 42.4 % of women practiced physical activity. Women were engaged in mostly sedentary behavior activities, such as watching television and using the computer use than men. Dietary daily intake of fruits and vegetables were higher among women compared to men (65.9 % and 51.5 %, respectively). Men were more prone to drink soft drinks than women. However, 39.4 % of men and only 3.4 % of women drank soft drinks three or more days per week. The prevalence of overweight and obesity according to body mass index (BMI) was higher in this study. 34.4 % of men and 33.7 % of women were overweight and 15.10 % and 17.50% of men and women, respectively, were classified as obese. Elevated values of waist circumference were found in 35.35 % of men and 70.73 % of women. Conclusion Women were more sedentary than men and had higher prevalence of abnormal waist circumference values.

Body mass index, waist circumference and waist-to-height ratio associated with the incidence of type 2 diabetes mellitus: a cohort study

To investigate the association between body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and the incidence risk of type 2 diabetes mellitus (T2DM). In total, 20 194 participants ≥18 years old were selected randomly by cluster sampling from two township (town) of the county in Henan province from July to August of 2007 and July to August of 2008 and the investigation included questionnaires, anthropometric measurements, fasting plasma glucose, and lipid profile examination were performed at baseline; 17 236 participants were enrolled in this cohort study. 14 720 (85.4%) were followed up from July to August 2013 and July to October 2014. Finally, 11 643 participants (4 301 males and 7 342 females) were included in this study. Incidence density and Cox proportional hazards regression models were used to evaluate the risk of T2DM associated with baseline BMI, WC, WHtR, and their dynamic changes. After average of 6.01 years following up for 11 643 participants, 613 developed T2DM and the incidence density was 0.89 per 100 person-years. After adjusted for baseline sex, age, smoking, drinking, family history of diabetes, as well as the difference of fasting plasma-glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP) between baseline and follow-up, Cox Proportional-Hazards regression analysis indicated that T2DM risk of baseline BMI overweight group, BMI obesity group, abnormal WC group and abnormal WHtR group were significantly higher than that of the corresponding baseline normal groups , and the incidence risk of T2DM reached the highest for those whose baseline BMI, WC and WHtR were all abnormal, the corresponding HR (95%CI) were 2.05 (1.62-2.59), 3.01 (2.33-3.90), 2.34 (1.89-2.90), 2.88 (2.21-3.74), 3.32 (2.50-4.40), respectively. Whether baseline BMI/WC was normal or not, T2DM risk increased if baseline WHtR was abnormal, and the HR (95%CI) of baseline normal BMI/abnormal WHtR group, baseline abnormal BMI/abnormal WHtR group, baseline normal WC/abnormal WHtR group, baseline abnormal WC/abnormal WHtR group were 1.88 (1.29-2.74), 3.08 (2.34-4.05), 2.15(1.53-3.00), 3.22 (2.45-4.23), respectively. The analysis for dynamic changes of BMI, WC, and WHtR indicated that in baseline normal WC or WHtR group, T2DM risk increased when baseline normal WC or WHtR developed abnormal at follow-up, and the corresponding HR (95%CI) were 1.79 (1.26-2.55), 2.12(1.32-3.39), respectively. In baseline abnormal WC or WHtR group, T2DM risk decresed when baseline abnormal WC or WHtR reversed to normal at follow-up, and the corresponding HR (95%CI) were 2.16 (1.42-3.29), 2.62 (1.63-4.20), respectively. BMI, WC, and WHtR were associated with increased T2DM risk. The more abnormal aggregation of BMI, WC, and WHtR presents, the higher T2DM risk was. T2DM risk could be decreased when abnormal WC or WHtR reversed to normal.