Anthropometric Measures Of Adiposity Research Articles

Adiposity Phenotypes and Associated Cardiometabolic Risk Profile in the Inuit Population of Nunavik.

The Inuit population of Nunavik is faced with a significant rise in the prevalence of obesity [body mass index (BMI) ≥ 30 kg/m2], but the impact on cardiometabolic health is unclear. The aim of this study was to characterize adiposity phenotypes and explore their associations with cardiometabolic risk factors among Nunavimmiut men and women. We used data obtained from 1296 Inuit who participated in the Qanuilirpitaa? 2017 Nunavik Inuit Health survey. Collected information included demographics, anthropometric measurements including visceral fat level (VFL) measured using electrical bioimpedance, biomarkers, hemodynamics, medical history and medication list. Adjusted population-weighted linear regressions were conducted to assess associations between body fat distribution and cardiometabolic risk factors. The accuracy and cut-off points of anthropometric indices to detect cardiometabolic abnormalities was evaluated by area under the receiver operator characteristic curve (AUROC) and a maximum Youden index analysis. Among Nunavimmiut (mean age 38.8 years [95%CI: 38.4 to 39.3]), obesity was observed in 42.8% of women and 25.6% of men. Compared to men, women presented a higher prevalence of abdominal obesity (78.8% vs. 46.4% in men, p < 0.05) and elevated VFL (54.4% vs. 20.1% with an InBody level ≥ 13, p < 0.05). Indices of global fat distribution and abdominal adiposity including VFL provided poor to moderate ability to detect cardiometabolic abnormalities (AUROC between 0.64 and 0.79). This analysis revealed that despite a high prevalence of abdominal obesity, particularly among women, anthropometric measurements of adiposity are inconsistently associated cardio-metabolic risk factors in Inuit adults of Nunavik.

Anthropometric Measures of Adiposity as Markers of Kidney Dysfunction: A Cross-Sectional Study.

The present study was designed to provide information on the ability of several different anthropometric markers to reflect the renal impairment associated with body weight increase and to predict the development of renal alterations linked to overweight and obesity. In 574 subjects representative of the general population of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, with an age range between 57 and 73 years, we investigated the association between different anthropometric markers of body fat, as alternative to body mass index, and renal failure, to obtain information useful for determining their potential predictive value. Renal dysfunction was significantly associated with almost all anthropometric markers of adiposity related to body weight and body shape. After adjustment for confounders, such as age, sex, office blood pressure, serum glucose, antihypertensive drugs and smoking habit, association remained significant only for waist-to-hip ratio (WHR), lipid accumulation product (LAP) and visceral adiposity index (VAI). These 3 markers also displayed at the receiver operating curves (ROC) analysis the best ability to detect subjects with or without kidney dysfunction. The results of the present study provide evidence that WHR, LAP and VAI represent the best markers of renal dysfunction associated with visceral body fat accumulation.

Assessment of correlation between conventional anthropometric and imaging-derived measures of body fat composition: a systematic literature review and meta-analysis of observational studies

BackgroundIn studies of the association of adiposity with disease risk, widely used anthropometric measures of adiposity (e.g. body-mass-index [BMI], waist circumference [WC], waist-hip ratio [WHR]) are simple and inexpensive to implement at scale. In contrast, imaging-based techniques (e.g. magnetic resonance imaging [MRI] and dual x-ray absorptiometry [DXA]) are expensive and labour intensive, but can provide more accurate quantification of body fat composition. There is, however, limited evidence about the relationship between conventional and imaging-derived measures of adiposity.MethodsWe searched Scopus and Web of Science for published reports in English of conventional versus imaging-derived measurements of adiposity. We identified 42 articles (MRI = 22; DXA = 20) that met selection criteria, involving 42,556 (MRI = 15,130; DXA = 27,426) individuals recruited from community or hospital settings. Study-specific correlation coefficients (r) were transformed using Fisher’s Z transformation, and meta-analysed to yield weighted average correlations, both overall and by ancestry, sex and age, where feasible. Publication bias was investigated using funnel plots and Egger’s test.ResultsOverall, 98% of participants were 18 + years old, 85% male and 95% White. BMI and WC were most strongly correlated with imaging-derived total abdominal (MRI-derived: r = 0.88-; DXA-derived: 0.50–0.86) and subcutaneous abdominal fat (MRI-derived: 0.83–0.85), but were less strongly correlated with visceral abdominal fat (MRI-derived: 0.76-0.79; DXA-derived: 0.80) and with DXA-derived %body fat (0.76). WHR was, at best, strongly correlated with imaging-derived total abdominal (MRI-derived: 0.60; DXA-derived: 0.13), and visceral abdominal fat (MRI-derived: 0.67; DXA-derived: 0.65), and moderately with subcutaneous abdominal (MRI-derived: 0.54), and with DXA-derived %body fat (0.58). All conventional adiposity measures were at best moderately correlated with hepatic fat (MRI-derived: 0.36–0.43). In general, correlations were stronger in women than in men, in Whites than in non-Whites, and in those aged 18 + years.ConclusionsIn this meta-analysis, BMI and WC, but not WHR, were very strongly correlated with imaging-derived total and subcutaneous abdominal fat. By comparison, all three measures were moderately or strongly correlated with imaging-based visceral abdominal fat, with WC showing the greatest correlation. No anthropometric measure was substantially correlated with hepatic fat. Further larger studies are needed to compare these measures within the same study population, and to assess their relevance for disease risks in diverse populations.

Effects of low-versus high-volume high-intensity interval training on glycemic control and quality of life in obese women with type 2 diabetes: A randomized controlled trial

Background/objectiveComparison between different training volumes of high-intensity interval training (HIIT) is understudied in type 2 diabetes. This study aimed to compare the effects of low- and high-volume HIIT on glycemic control, blood lipids, blood pressure, anthropometric adiposity measures, cardiorespiratory fitness, and health-related quality of life (HRQoL) in women with type 2 diabetes. MethodsSeventy-two obese women with type 2 diabetes aged 36–55 were randomly assigned to a low-volume HIIT group (i.e., 2 × 4-min high-intensity treadmill exercise at 85%–90% of peak heart rate, with a 3-min active recovery interval in between), a high-volume HIIT group (i.e., 4 × 4-min high-intensity treadmill exercise at 85%–90% of peak heart rate, with three 3-min active recovery intervals in between), and a non-exercising control group. Patients in HIIT groups exercised three days a week for 12 weeks. All patients received oral hypoglycemic medications with no calorie restrictions. The outcome measures were glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2-hr PPBG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC), waist-to-hip ratio, time to maximal exhaustion determined from a maximal treadmill exercise test (i.e., a measure of cardiorespiratory fitness), and HRQoL assessed by the 12-item Short Form (SF-12) Health Survey. ResultsThe low- and high-volume HIIT groups showed significant improvements in all outcome measures compared to the baseline and the non-exercising group (P < 0.05), except for DBP in the low-volume HIIT group (p > 0.05). Also, both low- and high-volume HIIT groups showed similar improvements in TC, HDL, SBP, DBP, BMI, WC, waist-to-hip ratio, and the SF-12 scores, with no significant between-groups difference (p > 0.05). The high-volume HIIT group, however, showed more significant improvements in HbA1c, FBG, 2-hr PPBG, TG, LDL, and treadmill time to maximal exhaustion than the low-volume HIIT group (p < 0.05). The non-exercising group showed non-significant changes in all outcome measures (p > 0.05). ConclusionLow-volume HIIT could be equally effective as high-volume HIIT for improving TC, HDL, blood pressure, anthropometric adiposity measures, and HRQoL in obese women with type 2 diabetes. Nevertheless, high-volume HIIT could have a greater impact on glycemic control, TG, LDL, and cardiorespiratory fitness in these patients. Trial registrationClinicalTrials.gov, NCT05110404.

The impact of avocado intake on anthropometric measures among Hispanic/Latino children and adolescents: A cluster randomized controlled trial

While the association between avocado consumption and low metabolic risk has been shown in some studies conducted in adults, little is known about the potential effects of avocado consumption on health outcomes in children and adolescents. Thus, we investigated the impact of two levels of avocado allotment, plus a standard nutrition education, on measures of adiposity in children and adolescents (<18 years old). Children (aged 5-12, n=58) and adolescents (aged 13-17, n=32) in seventy-two families that self-identified as Hispanic, with at least 3 members over the age of 5 that resided in the same home, were free of severe chronic disease, and not on specific diets, were randomized to one of two levels of avocado allotment plus bi-weekly nutrition education sessions. Low allotment families received 3 avocados per week, while high allotment families received 14 avocados per week for 6 months. We performed an intention-to-treat analysis, using unpaired, 2-sided t-tests to test the mean changes in anthropometric measures of adiposity (body mass index (BMI), waist circumference, hip circumference, and weight) between children and adolescents from high and low allotment families after the 6-month intervention. At six months, there were no significant differences in body mass index, waist circumference, hip circumference, or waist circumference to weight ratio by avocado allotment group. In children, there was a significant difference in weight (difference in means: 1.10, 95% CI: 0.09, 2.10, p-value=0.03) and waist circumference to height ratio (difference in means: 0.27, 95% CI: 0.12, 0.41, p-value <0.01) between the avocado allotment groups at six months, but these did not remain significant after sensitivity analyses including per-protocol analyses. In adolescents only, there was a significant reduction in waist to hip circumference ratio in the high allotment group compared to the low allotment group after 6 months (difference in means:-0.05, 95% CI:-0.08, 0.00, p-value=0.04) that persisted after multiple sensitivity analyses. Different levels of avocado availability among children and adolescents does not appear to result in significant changes in anthropometric measures. Further study is needed to determine whether avocado consumption promotes metabolic health in this age group.

Gestational diabetes in women with obesity; an analysis of clinical history and simple clinical/anthropometric measures.

We assessed clinical risk factors, anthropometric measures of adiposity and weight gain to determine associations with development of GDM in a cohort of pregnant women with obesity. This was a secondary analysis of the UPBEAT trial of a complex lifestyle intervention in pregnant women with obesity (ISRCTN89971375). Clinical risk factors, and measures of adiposity and weight were assessed in the early 2nd trimester (mean 17 +0 weeks), and adiposity and weight repeated in the early 3rd trimester (mean 27 +5 weeks'). Of the 1117 women (median BMI 35.0 kg/m2) with complete data, 25.8% (n = 304) developed GDM (IADPSG criteria, OGTT 24-28weeks). Using multivariable analysis, early clinical risk factors associated with later development of GDM included age (adj OR 1.06 per year; 95% CI 1.04-1.09), previous GDM (3.27; 1.34-7.93) and systolic blood pressure (per 10mmHg, 1.34; 1.18-1.53). Anthropometric measures positively associated with GDM included second trimester (mean 17+0 weeks) subscapular skinfold thickness, (per 5mm, 1.12; 1.05-1.21), and neck circumference (per cm, 1.11; 1.05-1.18). GDM was not associated with gestational weight gain, or changes in skinfolds thicknesses or circumferences between visits. In this cohort of women with obesity, we confirmed clinical risk factors for GDM, (age, systolic blood pressure) previously identified in heterogeneous weight women but add to these indices of adiposity which may provide a discriminatory approach to GDM risk assessment in this group. This study also underscores the need to focus on modifiable factors pre-pregnancy as an opportunity for GDM prevention, as targeting gestational weight gain and adiposity during pregnancy is likely to be less effective.

Inflammatory and metabolic markers in relation to outcome of in vitro fertilization in a cohort of predominantly overweight and obese women

For overweight and obese women undergoing in vitro fertilization (IVF) the pregnancy and live birth rates are compromised while the underlying mechanisms and predictors are unclear. The aim was to explore the association between adipose tissue-related inflammatory and metabolic markers and the pregnancy and live birth outcome of IVF in a cohort of predominantly overweight and obese women. Serum samples, fulfilling standardizing criteria, were identified from 195 women having participated in either the control (n = 131) or intervention (n = 64) group of a randomized controlled trial (RCT), seeking to evaluate the effect of a weight reduction intervention on IVF outcome in obese women. Serum high-sensitivity C-reactive protein (hsCRP) and the adipokines leptin and adipocyte fatty acid-binding protein (AFABP) were analyzed for the whole cohort (n = 195) in samples collected shortly before IVF [at randomization (control group), after intervention (intervention group)]. Information on age, anthropometry [BMI, waist circumference, waist-to-height ratio (WHtR)], pregnancy and live birth rates after IVF, as well as the spontaneous pregnancy rate, was extracted or calculated from collected data. The women of the original intervention group were also characterized at randomization regarding all variables. Eight women [n = 3 original control group (2.3%), n = 5 original intervention group (7.8%)] conceived spontaneously before starting IVF. BMI category proportions in the cohort undergoing IVF (n = 187) were 1.6/20.1/78.3% (normal weight/overweight/obese). The pregnancy and live birth rates after IVF for the cohort were 35.8% (n = 67) and 24.6% (n = 46), respectively. Multivariable logistic regression revealed that none of the variables (age, hsCRP, leptin, AFABP, BMI, waist circumference, WHtR) were predictive factors of pregnancy or live birth after IVF. Women of the original intervention group displayed reductions in hsCRP, leptin, and anthropometric variables after intervention while AFABP was unchanged. In this cohort of predominantly overweight and obese women undergoing IVF, neither low-grade inflammation, in terms of hsCRP, other circulating inflammatory and metabolic markers released from adipose tissue (leptin, AFABP), nor anthropometric measures of adiposity or adipose tissue distribution (BMI, waist, WHtR) were identified as predictive factors of pregnancy or live birth rate.Trial registration: ClinicalTrials.gov number, NCT01566929. Trial registration date 30-03-2012, retrospectively registered.

Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition.

The Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.e., body mass index (BMI), waist circumference (WC), waist-height-ratio (WHtR), and 2) the ability to predict with silhouette showcards anthropometric adiposity measures, i.e., overweight and obesity (BMI ≥ 25 kg/m2), obesity alone (BMI ≥ 30 kg/m2), elevated WC (men ≥ 94 cm; women ≥ 80 cm), and WHtR (> 0.5) across the epidemiological transition. 751 African-origin participants, aged 20-68 years old, from the United States (US), Seychelles, and Ghana, completed anthropometrics and selected silhouettes corresponding to their perceived body size. Silhouette performance to anthropometrics was examined using a least-squares linear regression model. A receiver operator curve (ROC) was used to investigate the showcards ability to predict anthropometric adiposity measures. The relationship between silhouette ranking and BMI were similar between sexes of the same country but differed between countries: 3.65 [95% CI: 3.34-3.97] BMI units/silhouette unit in the US, 3.23 [2.93-3.74] in Seychelles, and 1.99 [1.72-2.26] in Ghana. Different silhouette cutoffs predicted obesity differently in the three countries. For example, a silhouette ≥ five had a sensitivity/specificity of 77.3%/90.6% to predict BMI ≥ 25 kg/m2 in the US, but 77.8%/85.9% in Seychelles and 84.9%/71.4% in Ghana. Ultimately, silhouettes predicted BMI, WC, and WHtR similarly within each country and sex but not across countries. Our data suggest that Pulvers' silhouette showcards may be a helpful tool to predict anthropometric and adiposity measures in different populations when direct measurement cannot be performed. However, no universal silhouette cutoff can be used for detecting overweight or obesity status, and population-specific differences may stress the need to calibrate silhouette showcards when using them as a survey tool in different countries.

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone

BackgroundAdiposity is a major component of the metabolic syndrome (MetS), low muscle strength has also been identified as a risk factor for MetS and for cardiovascular disease. We describe the prevalence of MetS and evaluate the relationship between muscle strength, anthropometric measures of adiposity, and associations with the cluster of the components of MetS, in a middle-income country.MethodsMetS was defined by the International Diabetes Federation criteria. To assess the association between anthropometric variables (waist circumference (WC), waist-to-hip ratio (W/H), body mass index (BMI)), strength (handgrip/kg bodyweight (HGS/BW)) and the cluster of MetS, we created a MetS score. For each alteration (high triglycerides, low HDLc, dysglycemia, or high blood pressure) one point was conferred. To evaluate the association an index of fat:muscle and MetS score, participants were divided into 9 groups based on combinations of sex-specific tertiles of WC and HGS/BW.ResultsThe overall prevalence of MetS in the 5,026 participants (64% women; mean age 51.2 years) was 42%. Lower HGS/BW, and higher WC, BMI, and W/H were associated with a higher MetS score. Amongst the 9 HGS/BW:WC groups, participants in the lowest tertile of HGS/BW and the highest tertile of WC had a higher MetS score (OR = 4.69 in women and OR = 8.25 in men;p < 0.01) compared to those in the highest tertile of HGS/BW and in the lowest tertile of WC.ConclusionWC was the principal risk factor for a high MetS score and an inverse association between HGS/BW and MetS score was found. Combining these anthropometric measures improved the prediction of metabolic alterations over either alone.

Optimal Cutoff Values for Anthropometric Adiposity Measures of Sri Lankan Adult Women

Anthropometric adiposity measures (AAMs) such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used to evaluate obesity status. Country-specific cutoff values of AAMs would provide more accurate estimation of obesity prevalence. This cross-sectional study was designed to determine the optimal cutoff values for AAMs, BMI, WC, hip circumference (HC), and WHR, of Sri Lankan adult women. The study was conducted in Galle, Sri Lanka, with 350 healthy community-dwelling middle-aged women aged 30–60 years, divided into two groups (Group A, n = 175 and Group B, n = 175). Total body fat percentage (TBFP) (kg) was measured with DXA. Body weight (kg), height (m), and WC and HC (cm) were measured. BMI (kg/m2) and WHR were calculated. Optimal cutoff values were determined by area under curve (AUC) in Receiver-Operating Characteristic (ROC) curve analysis using TBFP as the criterion at the TBFP level of 33% and 35% using the women in Group A. Then, the prevalence of obesity was determined in Group B while comparing the prevalence based on the cutoff values recommended by the World Health Organization (WHO) for Asians and the newly developed cutoff values for Sri Lankan women. Optimal cutoff values of AAMs which correspond to TBFP 33% are BMI, 24.5 kg/m2; WC, 80 cm; HC, 95 cm; and WHR, 0.83. TBFP 35% corresponds to the optimal cutoff values of BMI, 25.0 kg/m2; WC, 85 cm; HC, 100 cm; and WHR, 0.83. Prevalence of obesity (number, %) according to the WHO and newly defined cutoff values that correspond to TBFP 33% and 35% were as follows: BMI = 83 (47.4%), 98 (56.0%), 83 (47.4%); WC = 106 (60.6%), 106 (60.6%), 72 (41.1%); and WHR = 140 (80.0%), 106 (60.6%), 106 (60.6%). The observed cutoff values of BMI and WC in this study were within the ranges of those described by the WHO for Asian populations which correspond to the 33% and 35% TBFP levels, respectively. However, the WHR cutoff value of WHO (Asians) is lower when compared to the newly determined value for Sri Lankan females while overestimating the prevalence. More studies are needed to confirm these values before clinical use.

156-LB: Effect of Maternal Obesity and GDM on Children’s Obesity and Fat Distribution

Background: Women with obesity or gestational diabetes (GDM) and their children are at risk for type 2 diabetes. Given that obesity and fat distribution are correlated with insulin resistance, we examined whether there are differences in total adiposity and fat distribution among women who were lean (NW) or obese (Ob) with no GDM history, verses women with prior GDM, and their children. We hypothesized that dyads in the GDM group would have greater adiposity and more centralized fat distribution compared to dyads in the NW and Ob groups. Methods: Mother-child dyads were enrolled 4-10 years after a pregnancy complicated by GDM (N=73), or without GDM and NW (N=76) or Ob (N=76). Body weight, height, and anthropometric measures of adiposity were collected. ANCOVA were used to assess group differences in BMI, BMIz (in children), sum of skinfolds (SS), waist to hip ratio (WHR), and central (suprailiac + subscapular) to peripheral (thigh + tricep) skinfold ratio (CvP). Models were adjusted for age and race for mothers, along with tanner stage and sex for children. Results: Women with prior GDM had greater BMI and SS compared to women in the NW group (P&amp;lt;0.0001), but did not differ from Ob. Despite similar total adiposity for GDM and Ob groups, the GDM group had greater WHR and CvP as compared to Ob (P&amp;lt;0.05). Among children, BMIz and WHR were greater in the GDM versus NW offspring (P&amp;lt;0.05), with children in the Ob group having a mean BMIz and WHR that was in between NW and GDM. Conclusion: Results support the hypothesis that women with prior GDM exhibit more central adiposity despite having similar BMI as women with Ob without prior GDM. Among children, BMIz and central adiposity increased progressively when comparing offspring of NW, Ob, and GDM mothers. The results indicate that both Ob and GDM in mothers during pregnancy may affect total and central adiposity in children. While additional research is needed, attention to maternal health before and during pregnancy is vital to mitigate against a cardiometabolic disease phenotype in children. Disclosure S. Martin: None. Funding American Heart Association (336101011); University of Alabama at Birmingham (DK079626, DK056336)

Abstract C124: Breast density and metabolic risk factors: Cross-sectional analysis of the baseline data from a phase II breast cancer prevention trial

Abstract Breast density is an established breast cancer risk factor. Metabolic disturbances and high adiposity also increase breast cancer burden, but their relationships with breast density are not clearly defined, possibly due to the limitation of mammography density measurements in obese women. We are presently conducting a phase II double-blind, randomized, placebo-controlled clinical trial to study the effect of metformin on obesity-associated breast cancer risk in overweight and obese premenopausal women with metabolic disturbances. One hundred and fifty-one participants with a large waist (≥88 cm or ≥80 cm for Asian Americans and individuals with PCOS) and one other component of metabolic syndrome (elevated triglyceride, reduced HDL-C, elevated blood pressure, or elevated fasting glucose) were accrued and randomized (1:1) to receive metformin 850 mg BID or placebo for 12 months. The primary study endpoint is change in breast density. Secondary endpoints are changes in serum insulin, insulin-like growth factor axis, adipokines, waist circumference and body weight. Thirty-six percent of the accrued participants are Hispanics. The average body mass index, waist circumference and waist-to-hip ratio of the accrued participants are 37.8 ± 6.8 kg/m2, 110.8 ± 12.4 cm and 0.90 ± 0.07, respectively. We expect to complete our clinical trial in December 2018. We performed cross-sectional analyses of the baseline data to determine the associations between metabolic disturbances and breast density parameters acquired by fat-water MRI on noncompressed breasts. This is especially relevant in our study cohort because the compressed breast thickness is greater in obese women, which results in decreased image contrast on mammogram. Potential differences by ethnicity were explored. We showed that percent density and absolute density were not related to anthropometric measurements of adiposity for the overall cohort, with similar results by ethnicity. Having elevated fasting glucose in women with a large waist was related to a lower percent density and absolute density for the overall cohort, and the association was only observed in Hispanics. Our work is the first to compare breast density assessed by fat-water MRI by ethnicity. Further research is required to confirm our findings. Due to the rising rates of obesity in the United States, we strongly believe that this trial will have an important impact in public health, especially in minority population. Citation Format: Jesse Trujillo, Edgar Tapia, Diana Villa-Guillen, Pavani Chalasani, Cynthia Thomson, Maria Altbach, Jean-Phillipe Galons, Jessica Martinez, Denise Roe, Amit Algotar, H.H. Sherry Chow. Breast density and metabolic risk factors: Cross-sectional analysis of the baseline data from a phase II breast cancer prevention trial [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C124.

The association between anthropometric measures of adiposity and the progression of carotid atherosclerosis

BackgroundFew reports are available on the contribution of general and abdominal obesity to the progression of carotid atherosclerosis in late adulthood. This study investigated the impact of four simple anthropometric measures of general and abdominal obesity on the progression of carotid atherosclerosis and the extent to which the association between adiposity and the progression of plaque burden is mediated by cardiometabolic markers.MethodsFour thousand three hundred forty-five adults (median age 60) from the population-based Tromsø Study were followed over 7 years from the first carotid ultrasound screening to the next. The progression of carotid atherosclerosis was measured in three ways: incidence of plaques in previously plaque-free participants; change in the number of plaques; and total plaque area (TPA). We used generalised linear models to investigate the association between each adiposity measure – body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) – and each outcome. Models were adjusted for potential confounders (age, sex, smoking, education, physical activity). The pathways through which any associations observed might operate were investigated by further adjusting for cardiometabolic mediators (systolic blood pressure, cholesterol, and HbA1c).ResultsThere was little evidence that adiposity was related to the formation of new plaques during follow-up. However, abdominal adiposity was associated with TPA progression. WHtR showed the largest effect size (mean change in TPA per one standard deviation (SD) increase in WHtR of 0.665 mm2, 95% confidence interval 0.198, 1.133) while BMI showed the smallest. Effect sizes were substantially reduced after the adjustment for potential mediators.ConclusionsAbdominal obesity indirectly measured with WC seems more strongly associated with the progression of TPA than general obesity. These associations appear to be largely mediated by known cardiometabolic markers.

The discriminatory power of visceral adipose tissue area vs anthropometric measures as a diagnostic marker for metabolic syndrome in South African women

BackgroundA number of studies have shown central adiposity, in particular visceral adipose tissue (VAT) accumulation to be a hallmark of metabolic syndrome (MetS). In clinical practice, waist circumference (WC) is used as a proxy for VAT.AimTo compare the ability of dual energy x-ray absorptiometry (DXA)-derived VAT area and anthropometric measures of adiposity for diagnosing MetS in a sample of high risk South African women.MethodsMetS was quantified using the Joint Interim Statement (JIS) criteria. Fasting glucose, insulin and lipid profile were measured in 204 post-menopausal women. Anthropometry measures included body mass index (BMI), WC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and a body shape index (ABSI). The area under the curve (AUC) was used to assess their performance in detecting any two components of MetS (excluding WC). Optimal WC and VAT area cut-points were derived to compare their performance for diagnosing MetS and to compare to internationally recognised cut-points.ResultsThe highest AUC for the prediction of MetS was recorded for VAT, followed by WHtR and WC (AUC, 0.767, 0.747 and 0.738 respectively), but these did not differ significantly (all p ≥ 0.192). In contrast, VAT was significantly better than BMI (p = 0.028), hip (p = 0.0004) and ABSI (p < 0.0001). The optimal WC (94.4 cm) and VAT area (174 cm2 based on the Youden’s index method and 175.50 cm2 based on the CTL approach) cut-points performed similarly in detecting MetS.ConclusionDXA-derived VAT and WC had the same overall performance in discriminating the presence of any 2 MetS components in high risk South African women. These findings support the current recommendations of using WC rather than VAT for MetS risk screening, as it is cheap, accessible and easy to measure.

An exploration of the longitudinal relation between parental feeding practices and child anthropometric adiposity measures from the West Midlands Active Lifestyle and Healthy Eating in Schoolchildren (WAVES) Study

Some research suggests that parent or carer feeding practices may influence children's weight patterns, but longitudinal evidence is limited and inconsistent. The aim of this study was to investigate the relation between various parent or carer feeding practices when a child is aged 7-8 y and proxy measurements of child adiposity at age 8-9 y (weight status, waist-to-height ratio, and body fat percentage). The study was a secondary analysis of data from the West Midlands Active Lifestyle and Healthy Eating in Schoolchildren (WAVES) Study comprising a diverse sample of parents and carers and their children from 54 primary schools in the West Midlands, England [n=774 parent-child dyads (53% of the WAVES study sample)]. Information on feeding practices was collected with the use of subscales from the Comprehensive Feeding Practices Questionnaire, completed by the child's main parent or carer (self-defined). Child height, weight, bioelectrical impedance, and waist circumference were measured and converted into 3 proxy measurements of adiposity (weight status, waist-to-height ratio, and body fat percentage). Associations between these measurements and parent or carer feeding practices were examined with the use of mixed-effects logistic regression models. Of the questionnaire respondents, 80% were mothers, 16% were fathers, and 4% were other carers. Median standardized subscale scores ranged from 1.7 (emotion regulation: IQR=1.0) to 4.0 (monitoring and modeling: IQR=1.5), and significantly different subscale scores were present between child weight statuses for emotion regulation, pressure to eat, and restriction for weight control. Logistic regression modeling showed that when baseline adiposity measures were included as covariates, all associations between parental feeding practices at age 7-8 y and measures of adiposity at age 8-9 y were attenuated. Observed relations between various parental feeding practices and later adiposity are mitigated by inclusion of the baseline adiposity measure. This finding lends support to the theory of reverse causation, whereby the child's size may influence parental choice of specific feeding practices rather than the child's subsequent weight status being a consequence of these feeding practices.

Erratum to: Risk of breast, endometrial, colorectal, and renal cancers in postmenopausal women in association with a body shape index and other anthropometric measures.

A body shape index (ABSI) has been proposed as a possible improvement over waist circumference (WC) as a marker of abdominal adiposity because it removes the correlation of WC with body mass index (BMI) and with height. We assessed the association of ABSI with four obesity-related cancers compared to that of other anthropometric measures of adiposity. We used data from the Women’s Health Initiative, a large cohort of postmenopausal women, recruited between 1993 and 1998 and followed until September 2013, to assess the associations of ABSI and other anthropometric measures with risk of cancers of the breast, endometrium, colorectum, and kidney. The four comparison anthropometric measures were BMI, WC, waist circumference-to-height ratio (WHtR), and waist-hip ratio (WHR). Over a median of 12.7 years of follow-up, among 143,901 women, we identified 7,039 invasive breast cancers, 1,157 endometrial cancers, 1,908 colorectal cancers, and 376 kidney cancers. We used Cox proportional hazards models to estimate the association of quintiles of the five measures with risk of the four cancers. Unlike the other anthropometric indices, ABSI was not associated with increased risk of breast or endometrial cancer. BMI and WC were comparable as predictors of breast and endometrial cancer, and these associations were unchanged after mutual adjustment. For colorectal and kidney cancers, ABSI was a significant predictor comparable to BMI; however, WC showed the strongest association with colorectal cancer, and WC, WHtR, and WHR all showed stronger associations with kidney cancer. In contrast to other anthropometric measures, ABSI showed no association with risk of breast or endometrial cancer and was more weakly associated with risk of colorectal and kidney cancers compared to more established measures of central adiposity.

Body composition of obese adolescents: association between adiposity indicators and cardiometabolic risk factors.

The association between obesity during adolescence and the increased risk of cardiometabolic diseases indicates the need to identify reproducible and cost effective methods for identifying individuals who are at increased risk of developing diseases. The present cross-sectional study investigated the occurrence of metabolic consequences of obesity in adolescents and the use of adiposity indicators as predictors of cardiometabolic risk. A fasting blood sample was taken in 93 pubertal obese adolescents aged 13-18 years old (39 males, 54 females) for the assessment of cardiometabolic risk markers (glucose, lipid profiles, insulin resistence, and inflammatory and endothelial dysfunction markers). Together with anthropometry, total fat mass and lean mass were determined by dual-energy X-ray absorptiometry (DXA). The prevalence of dyslipidaemia and disorders in glucose metabolism are noticeably higher in the present study. There was no correlation between the percentage of body fat according to DXA and most indicators of adiposity. For boys, the arm circumference values predicted the increase in fasting insulin (r² = 0.200), homeostasis model assessment of insulin resistance (r² = 0.267) and cardiometabolic risk score (r² = 0.338). The percentage of body fat according to DXA predicted the inflammation score (r² = 0.172). For girls, body mass index was the parameter that best described the variability of fasting insulin (r² = 0.079) and inflammation score (r² = 0.263). The waist-to-stature ratio was able to predict the triglyceride values (r² = 0.090). Anthropometric measures of adiposity, such a body mass index, waist-to-stature ratio, arm circumference and waist circumference,should be considered in the clinical evaluation of obese adolescents.

Correlation of adiposity indices with cardiovascular disease risk factors in healthy adults of Singapore: a cross-sectional study.

BackgroundObesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD). Nonetheless, the best adiposity indices to evaluate the CVD risk factors remain contentious and few studies have been performed in Asian populations. In the present study, we compared the association strength of percent body fat (PBF) to indirect anthropometric measures of general adiposity (body mass index (BMI) and body adiposity index (BAI)) and central adiposity (waist circumference (WC), and waist-to-hip ratio (WHR)) for the prediction of CVD risk factors in healthy men and women living in Singapore.MethodsA total of 125 individuals (63 men and 62 women) took part in this study. PBF was measured by using three different techniques, including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Anthropometric measurements (WC, hip circumference (HC), height, and weight), fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were determined according to standard protocols. Correlations of anthropometric measurements and PBF with CVD risk factors were compared.ResultsIrrespective of the measuring techniques, PBF showed strong positive correlations with FSI, HOMA-IR, TC/HDL, TG/HDL, and LDL/HDL in both genders. While PBF was highly correlated with FBG, SBP, and DBP in females, no significant relationships were observed in males. Amongst the five anthropometric measures of adiposity, BAI was the best predictor for CVD risk factors in female participants (r = 0.593 for HOMA-IR, r = 0.542 for TG/HDL, r = 0.474 for SBP, and r = 0.448 for DBP). For males, the combination of WC (r = 0.629 for HOMA-IR, and r = 0.446 for TG/HDL) and WHR (r = 0.352 for SBP, and r = 0.366 for DBP) had the best correlation with CVD risk factors.ConclusionMeasurement of PBF does not outperform the simple anthropometric measurements of obesity, i.e. BAI, WC, and WHR, in the prediction of CVD risk factors in healthy Asian adults. While measures of central adiposity (WC and WHR) tend to show stronger associations with CVD risk factors in males, measures of general adiposity (BAI) seems to be the best predictor in females. The gender differences in the association between adiposity indices and CVD risk factors may relate to different body fat distribution in males and females living in Singapore. These results may find further clinical utility to identify patients with CVD risk factors in a more efficient way.Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-016-0114-4) contains supplementary material, which is available to authorized users.

EVALUATION OF THE BODY ADIPOSITY INDEX IN PREDICTING PERCENTAGE BODY FAT AMONG COLOMBIAN ADULTS

the body adiposity index (BAI) is a new simplistic method for predicting body fat percentage (BF%) via a simple equation of hip circumference to height. Up to now, few studies have evaluated the performance of BAI in determining excess fat in Colombians. The aim of this study was to evaluate the usefulness of BAI as a predictor of body fat in among Colombian adults. cross-sectional study carried out in a sample of 204 male belonging to the education sector from Bogotá, Colombia. BAI was calculated based on the equation reported in the Bergman et al. %BF determined by tetrapolar bioimpedance analysis (BIA) was used as the reference measure of adiposity. Bland-Altman analysis was used to assess the agreement between the two methods: BAI and BIA. Associations between anthropometric measures of adiposity were investigated by Pearson correlation analysis. in general pupulation, the BAI overestimates %BF (mean difference: 12.5 % [95%CI = -4.04 % to -21.02 %]), mainly at lower levels of adiposity (mean difference: 10.2 ± 3.3). Significant correlations were found between BAI and all measurements, being the strongest-moderate correlation with %BF (r = 0.777, p < 0.001), waist to height ratio (r = 0.557, p < 0.001) and BMI (r = 0.480, p < 0.001). the results of this investigation indicate that BAI results in large individual errors when predicting BF% among Colombian adults and has a tendency to provide overestimated values as BF% decreases. Therefore, this method can be a useful tool to predict %BF in Colombian adults, although it has some limitations.

Risk of breast, endometrial, colorectal, and renal cancers in postmenopausal women in association with a body shape index and other anthropometric measures.

A body shape index (ABSI) has been proposed as a possible improvement over waist circumference (WC) as a marker of abdominal adiposity because it removes the correlation of WC with body mass index (BMI) and with height. We assessed the association of ABSI with four obesity-related cancers compared to that of other anthropometric measures of adiposity. We used data from the Women's Health Initiative, a large cohort of postmenopausal women, recruited between 1993 and 1998 and followed until September 2013, to assess the associations of ABSI and other anthropometric measures with risk of cancers of the breast, endometrium, colorectum, and kidney. The four comparison anthropometric measures were BMI, WC, waist circumference-to-height ratio (WHtR), and waist-hip ratio (WHR). Over a median of 12.7years of follow-up, among 143,901 women, we identified 7,039 invasive breast cancers, 1,157 endometrial cancers, 1,908 colorectal cancers, and 376 kidney cancers. We used Cox proportional hazards models to estimate the association of quintiles of the five measures with risk of the four cancers. Unlike the other anthropometric indices, ABSI was not associated with increased risk of breast or endometrial cancer. BMI and WC were comparable as predictors of breast and endometrial cancer, and these associations were unchanged after mutual adjustment. For colorectal and kidney cancers, ABSI was a significant predictor comparable to BMI; however, WC showed the strongest association with colorectal cancer, and WC, WHtR, and WHR all showed stronger associations with kidney cancer. In contrast to other anthropometric measures, ABSI showed no association with risk of breast or endometrial cancer and was more weakly associated with risk of colorectal and kidney cancers compared to more established measures of central adiposity.