Association Of Central Obesity Research Articles

Lipids as the link between central obesity and diabetes: perspectives from mediation analysis

BackgroundCentral obesity is a well-recognized risk factor for diabetes, yet the potential role of lipids in the diabetes risk associated with central obesity remains unclear. This study aimed to explore the possible mediating role of 11 lipid parameters [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), non-high-density lipoprotein cholesterol (Non-HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), remnant cholesterol (RC), and ratios of Non-HDL-C/HDL-C, RC/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C] in the association of central obesity with diabetes risk.MethodsWe utilized data from 15,453 participants in the NAGALA longitudinal cohort to assess the association of baseline central obesity indicators [waist-height ratio (WHtR), waist circumference (WC)] and the 11 lipid parameters with diabetes risk. Mediation analysis models were constructed to explore the mediating role of lipid parameters in the association of WC/WHtR with diabetes.ResultsConfirmatory associative analysis using multivariable Cox regression showed that, except for Non-HDL-C, TC and LD-C, the remaining eight lipid parameters were significantly associated with WC/WHtR and diabetes risk. Mediation analysis indicated that TG, RC, HDL-C, and lipid ratios such as Non-HDL-C/HDL-C ratio, RC/HDL-C ratio, TG/HDL-C ratio, TC/HDL-C ratio and LDL/HDL-C ratio are potential lipids affecting the diabetes risk related to central obesity. Among these, the RC/HDL-C ratio seemed to contribute the most in the WC/WHtR-related diabetes risk association, with a mediation percentage of about 37%. Additionally, lipid ratio parameters appeared to play a more mediating role in the association of central obesity-related diabetes risk than individual lipids.ConclusionsIn central obesity-related diabetes risk, most lipids, especially lipid ratio parameters, play a significant mediating role. Given these findings, we advocate for increased efforts in multifactorial risk monitoring and joint management of diabetes. The evaluation of lipids, particularly lipid ratio parameters, may be holds substantial value in the prevention and management of diabetes risk under close monitoring of central obesity.

Independent association of general and central adiposity with risk of gallstone disease: observational and genetic analyses.

General obesity is a well-established risk factor for gallstone disease (GSD), but whether central obesity contributes additional independent risk remains controversial. We aimed to comprehensively clarify the effect of body fat distribution on GSD. We first investigated the observational association of central adiposity, characterized by waist-to-hip ratio (WHR), with GSD risk using data from UK Biobank (N=472,050). We then explored the genetic relationship using summary statistics from the largest genome-wide association study of GSD (ncase=43,639, ncontrol=506,798) as well as WHR, with and without adjusting for body mass index (BMI) (WHR: n=697,734; WHRadjBMI: n=694,649). Observational analysis demonstrated an increased risk of GSD with one unit increase in WHR (HR=1.18, 95%CI=1.14-1.21). A positive WHR-GSD genetic correlation ( =0.41, P=1.42×10-52) was observed, driven by yet independent of BMI (WHRadjBMI: =0.19, P=6.89×10-16). Cross-trait meta-analysis identified four novel pleiotropic loci underlying WHR and GSD with biological mechanisms outside of BMI. Mendelian randomization confirmed a robust WHR-GSD causal relationship (OR=1.50, 95%CI=1.35-1.65) which attenuated yet remained significant after adjusting for BMI (OR=1.17, 95%CI=1.09-1.26). Furthermore, observational analysis confirmed a positive association between general obesity and GSD, corroborated by a shared genetic basis ( =0.40, P=2.16×10-43), multiple novel pleiotropic loci (N=11) and a causal relationship (OR=1.67, 95%CI=1.56-1.78). Both observational and genetic analyses consistently provide evidence on an association of central obesity with an increased risk of GSD, independent of general obesity. Our work highlights the need of considering both general and central obesity in the clinical management of GSD.

Associations of central obesity and habitual food consumption with saliva microbiota and its enzymatic profiles - a pilot study in Finnish children.

Variation in diversity and composition of saliva microbiota has been linked to weight status, but findings have been inconsistent. Focusing on clinically relevant conditions such as central obesity and using advanced sequencing techniques might fill in the gaps of knowledge. We investigated saliva microbiota with shallow metagenome sequencing in children with (n = 14) and without (n = 36) central obesity. Additionally, we examined the role of habitual food consumption on microbial enzymatic repertoire. Data comprised 50 children (50% male) with a mean age of 14.2 (SD 0.3) years, selected from the Finnish Health in Teens (Fin-HIT) cohort. Dietary scores for consumption frequency of sweet treats (STI), dairy products (DCI) and plants (PCI) were derived based on a self-administered food frequency questionnaire. Central obesity was defined based on waist-height ratio using the cut-off 0.5. Saliva samples were subjected to whole-metagenome shotgun sequencing, and taxonomic and functional profiling was achieved with METAnnotatorX2 bioinformatics platform. Groups had an average 20 (95% CI 14-27) cm difference in waist circumference. We identified the lack of Pseudomonas guguagenesis and Prevotella scopos, oulorum and oris as putative biomarkers associated with central obesity and observed a total of 16 enzymatic reactions differing between the groups. DCI was associated with the highest number of enzyme profiles (122), followed by STI (60) and DCI (25) (Pearson correlation p < 0.05). Intriguingly, STI showed a high positive/negative correlation ratio (5.09), while DCI and PCI showed low ratios (0.54 and 0.33, respectively). Thus, the main driver of enzymatic reactions was STI, and the related pathways involved nitrate metabolism induced by Haemophilus parainfluenzae and Veilonella dispar among others. Clinically relevant differences in central obesity were only modestly reflected in the composition of saliva microbiota. Habitual consumption of sweet treats was a strong determinant of enzymatic reactions of saliva microbiota in children with and without central obesity. The clinical relevance of these findings warrants further studies.

Association of Central Obesity and Salty Food Consumption with Small Dense LDL-C in Middle-Aged Indonesian Adults

This study aimed to investigate the association between central obesity and salty food consumption with the elevated of Small Dense Low-Density Lipoprotein-Cholesterol (sdLDL-C) among middle-aged Indonesian adults. Dietary behavior, together with the presence of obesity, leads to an increase in sdLDL-C. The study selected 8,611 subjects aged 49–64 years, from secondary data of a population-based survey conducted by the Ministry of Health of the Republic of Indonesia. The sdLDL-C concentration was determined using the Sampson equation. A significant association was observed between salty food consumption (OR=1.20; 95% CI: 1.04–1.38), general obesity (OR=2.59; 95% CI: 2.23–30), central obesity (OR=2.39; 95% CI: 2.11–2.70) and sdLDL-C. Diabetes and hypertension were positively associated with sdLDL-C, whereas Physical Activity (PA) was negatively associated with sdLDL-C. This study showed that obesity and consumption of salty food is associated with the increase of sdLDL-C, whereas PA is associated with the decrease of sdLDL-C.

The EVA (Early Vascular Aging) Study: Association of Central Obesity With Worse Arterial Health After Preeclampsia.

Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age-matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist-to-hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty-six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist-to-hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid-femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (P<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (P<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher-risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease.

Waist to height ratio as a simple tool for predicting mortality: a systematic review and meta-analysis.

The association of central obesity with higher rates of mortality is not well studied. This study evaluates the association between waist-to-height ratio (WHtR), as a measure of central obesity, with mortality. Documents were retrieved from PubMed, Web of Science, Scopus, and Google Scholar databases until May 2022. Data were extracted from cohort studies reporting effect size (hazard ratio (HR)) regarding the association between WHtR as a continuous (per 1 SD increment) or categorical (highest/lowest) measure and all-cause and cause-specific mortality. Screening of included studies was performed independently by two authors. Moreover, the quality assessment of included studies was performed based on the Newcastle-Ottawa assessment scale. Finally, random effect meta-analysis was performed to pool the data, and the outcomes' certainty level was assess based on the GRADE criteria. Of the 815 initial studies, 20 were included in the meta-analysis. Random effect meta-analysis showed that in the general population, the all-cause mortality HRs for categorical and continuous measurements of WHtR increased significantly by 23% (HR:1.23; 95% CI: 1.04-1.41) and 16% (HR:1.16; 95% CI: 1.07-1.25), respectively. Moreover, the hazard of cardiovascular (CVD) mortality increased significantly for categorical and continuous measurements of WHtR by 39% (HR:1.39; 95% CI: 1.18-1.59) and 19% (HR:1.19; 95% CI: 1.07-1.31). The quality assessment score of all included studies was high. Higher levels of WHtR, indicating central obesity, were associated with an increased hazard of CVD and all-cause mortality. This measure can be used in the clinical setting as a simple tool for predicting mortality.

Association of central obesity with unique cardiac remodelling in young adults born small for gestational age.

Being born small for gestational age (SGA, 10% of all births) is associated with increased risk of cardiovascular mortality in adulthood together with lower exercise tolerance, but mechanistic pathways are unclear. Central obesity is known to worsen cardiovascular outcomes, but it is uncertain how it affects the heart in adults born SGA. We aimed to assess whether central obesity makes young adults born SGA more susceptible to cardiac remodelling and dysfunction. A perinatal cohort from a tertiary university hospital in Spain of young adults (30-40 years) randomly selected, 80 born SGA (birth weight below 10th centile) and 75 with normal birth weight (controls) was recruited. We studied the associations between SGA and central obesity (measured via the hip-to-waist ratio and used as a continuous variable) and cardiac regional structure and function, assessed by cardiac magnetic resonance using statistical shape analysis. Both SGA and waist-to-hip were highly associated to cardiac shape (F = 3.94, P < 0.001; F = 5.18, P < 0.001 respectively) with a statistically significant interaction (F = 2.29, P = 0.02). While controls tend to increase left ventricular end-diastolic volumes, mass and stroke volume with increasing waist-to-hip ratio, young adults born SGA showed a unique response with inability to increase cardiac dimensions or mass resulting in reduced stroke volume and exercise capacity. SGA young adults show a unique cardiac adaptation to central obesity. These results support considering SGA as a risk factor that may benefit from preventive strategies to reduce cardiometabolic risk.

Mediation Effect of Platelet Traits on Associations of Central Obesity with Aging Biomarkers in Rural Adults of Henan, China.

Background: To assess the associations of platelet traits and obesity indices with aging biomarkers (telomere length (TL) and mitochondrial DNA copy number (mtDNA-CN)). Methods: A cross-sectional study was performed among 5091 rural Chinese adults. Obesity indices (waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR)) and platelet traits (plateletcrit (PCT), platelet large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution width (PDW)) were collected by physical examination. The aging biomarkers were determined by quantitative real-time polymerase chain reaction. Generalized linear regression models and mediation analysis were applied to explore the relationships between platelet traits, obesity indices, and aging biomarkers. Results: The mean age of the participants was 56 years (range: 18–79). Each one-unit increment in WC, WHR and WHtR were related to a 0.316 (95% confidence interval (CI): −0.437, −0.196), 0.323 (95% CI: −0.513, −0.134) and 0.277 (95% CI: −0.400, −0.153) decrease in relative TL; or a 0.102 (95% CI: −0.197, −0.007), 0.109 (95% CI: −0.258, −0.041) and 0.101 (95% CI: −0.199, −0.004) decrease in relative mtDNA-CN. The proportions of obesity indices with aging biomarkers mediated by platelet indices ranged from 2.85% to 10.10%. Conclusions: Increased central obesity indices in relation to shortened relative TL or decreased mtDNA-CN were mediated by platelet traits, indicating that obesity in association with the accelerated aging process may be partially attributable to abnormal platelet activity.

Association of Central Obesity With All Cause and Cause-Specific Mortality in US Adults: A Prospective Cohort Study.

BackgroundPrevious data on the association between central obesity and mortality are controversial. The aim of this study was to determine the associations between central obesity, as measured by the waist-to-height ratio (WtHR) and waist circumference (WC), with all cause and cause-specific mortality in U.S. adults.MethodsThe study subjects comprised a nationally representative sample of 33,569 adults >20 years of age who were recruited in the National Health and Nutrition Examination Survey between 1999 and 2014. Anthropometric data, including weight, height, and WC, were measured at each of the eight waves using consistent methodology. Death and underlying causes of death were ascertained through 31 December 2015. The association between central obesity and mortality were determined using weighted Cox proportional hazards regression models.ResultsA total of 4013 deaths occurred during a median follow-up of 7.33 years (263,029 person-years). Compared with the subjects in WtHR tertile 1, the subjects in tertiles 2 and 3 were at a higher risk of mortality from all-cause (tertile 2-hazard ratio [HR]: 1.29; 95% confidence interval [CI]: 1.13–1.47; tertile 3-HR: 1.96; 95% CI: 1.64–2.34) and cardiovascular diseases [CVDs] (tertile 2-HR: 1.40; 95% CI: 1.09–1.79; tertile 3-HR: 2.00; 95% CI: 1.47–2.73). Similarly, compared with the subjects in WC tertile 1, the subjects in tertiles 2 and 3 were at a higher risk of mortality from all-cause (tertile 2-HR: 1.15; 95% CI: 1.00–1.31; tertile 3-HR: 1.39; 95% CI: 1.15–1.67) and CVD (tertile 2-HR: 1.48; 95% CI: 1.14–1.93; tertile 3-HR: 1.74; 95% CI: 1.26–2.42). Restricted cubic spline analyses revealed an S-shaped and linear dose-relationship between WtHR and WC with all-cause mortality. Moreover, a WtHR> 0.58 or a WC > 0.98m was shown to be a risk factor for all-cause mortality.ConclusionsCentral obesity was significantly associated with increased risk of all-cause and CVD-related mortality, especially heart diseases-related mortality, even among normal weight adults. In addition to weight control, guideline designer should provide recommendations for people to decrease abdominal fat accumulation, in their effort to reduce mortality risk in later life.

Utility of Three Adiposity Indices for Identifying Left Ventricular Hypertrophy and Geometric Remodeling in Chinese Children

BackgroundPrevious studies have shown that waist-to-height ratio (WHtR) performed similarly well when compared to body mass index (BMI) and waist circumference (WC) for identifying cardiovascular risk factors. However, to our knowledge, the performance of these three adiposity indices for identifying left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling in youth has not been assessed. We aimed to determine the utility of BMI, WC and WHtR for identifying LVH and LVG in Chinese children.MethodsThis study included 1,492 Chinese children aged 6-11 years. Adiposity indices assessed were BMI, WC and WHtR. LVH and high relative wall thickness (RWT) were defined using sex- and age-specific 90th percentile values of left ventricular mass index and RWT, respectively, based on the current population. LVG remodeling included concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH), which was defined based on the combination of LVH and high RWT.ResultsThe magnitude of association of central obesity defined by WHtR with LVH [odds ratio (OR) =10.09, 95% confidence interval (CI) =6.66-15.29] was similar with general obesity defined by BMI (OR=10.49, 95% CI=6.97-15.80), and both were higher than central obesity defined by WC (OR=6.87, 95% CI=4.57-10.33). Compared with BMI, WHtR had better or similar predictive utility for identifying LVH, EH, and CH [the area under the curve (AUC): 0.84 vs. 0.79; 0.84 vs. 0.77; 0.87 vs. 0.88, respectively]; WC had worse or similar discriminatory utility with AUCs of 0.73, 0.70, 0.83, respectively.ConclusionWHtR performed similarly or better than BMI or WC for identifying LVH and LVG remodeling among Chinese children. WHtR provides a simple and convenient measure of central obesity that might improve the discrimination of children with cardiac structural damage.

Association of central obesity and high body mass index with function and cognition in older adults.

ObjectiveTo investigate the association of normal BMI with central obesity (CO), high BMI with CO, high BMI without CO, and normal BMI without CO, with function and cognition in older adults.MethodsCross-sectional study involving 754 participants ≥ 65 years. Data collected include demographics, cognition, and physical measurements.ResultsFemales had a higher prevalence of high BMI with CO and a lower prevalence of high BMI without CO than males (61.0% vs 44.6% and 4.6% vs 15.0%, respectively). Within gender, CO groups, regardless of BMI, had lower mini-mental state examination (MMSE), handgrip strength (HGS), and longer timed-up-and-go (TUG) scores. Overall, the high BMI without CO group had the highest MMSE scores, HGS, and shortest TUG. Amongst males, HGS was significantly lower in the normal BMI with CO group (B −3.28, 95% CI −6.32 to −0.23, P = 0.04). CO, regardless of normal/high BMI, had significantly longer TUG time (B 2.65, 95% CI 0.45 to 4.84, P = 0.02; B 1.07, 95% CI 0.25 to 1.88, P = 0.01, respectively) than normal BMI without CO group. CO was associated with lower MMSE scores in both genders but significant only in males with normal BMI and CO (B −1.60, 95% CI −3.15 to −0.06, P = 0.04).ConclusionCO may be a better predictor of obesity and adverse outcomes in older adults. High BMI without CO was associated with better outcomes especially in males but require further validation. Prospective longitudinal studies are needed to ascertain the impact of BMI and/or CO on function, cognition, mortality, and gender differences.

Association of central obesity with hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy.

Obesity is typically associated with metabolic dysfunction, but its impact on hepatocellular carcinoma (HCC) remains unclear in patients with chronic hepatitis B (CHB). To study the effect of obesity on HCC development in patients with CHB receiving antiviral therapy. We included patients from a Chinese multicentre, prospective, observational, treated CHB cohort in this study. General obesity was evaluated by body-mass index (BMI). Central obesity was evaluated by waist circumference, waist-to-hip ratio and waist-to-height ratio. A total of 5754 nucleos(t)ide analogue treated patients were enrolled in the analysis. The 5-year cumulative incidence of HCC was 2.9%. Waist-to-height ratio performed better in predicting HCC development than BMI, waist circumference or waist-to-hip ratio. Patients with central obesity (defined as waist-to-height ratio >0.5) had significantly higher 5-year incidence of HCC than those without central obesity in the overall population (3.9% vs 2.1%, hazard ratio [HR]: 2.06, P=0.0001) and 745 propensity score matched pairs (4.7% vs 2.3%, HR: 2.04, P=0.026), respectively. Besides cirrhosis status and aMAP HCC risk score, central obesity was also independently associated with HCC risk (HR: 1.63, P=0.013). Waist-to-height ratio gain within 1year was associated with a significantly higher HCC risk with an adjusted HR value of 1.88 (95% confidence interval: 1.12-3.13, P=0.017). Central obesity, evaluated by the waist-to-height ratio, was associated with a twofold increase in HCC risk among CHB patients receiving antiviral treatment, highlighting the important role of abnormal metabolic function in the progression of liver disease.

Associations of central obesity with earlier onset of osteoarthritis symptoms

Purpose: Obesity is a know risk factor for pain and osteoarthritis (OA), and in most studies, Body Mass Index (BMI) has been used to classify obesity (BMI>=30) in subjects at risk of OA and pain. However, BMI does not take into account the distribution of the fat mass. Waist circumference (WC) and waist to hip ratio (WHR) strongly correlates with abdominal obesity and are commonly used to measure the fat distribution and to determine central obesity. Central obesity is one of the most important components of metabolic syndrome and it has been demonstrated to be a stronger factor associated with knee pain, low back pain, and inflammation more than and, independent of BMI. In our population with knee and/or hip OA, we would like to determine whether central obesity is associated with an earlier presentation of joint pain and which joints are more affected by pain in subjects with OA and central obesity compared with subjects with OA without central obesity. Methods: In this retrospective cohort study, we examined medical records and interviewed 770 patients with a confirmed diagnosis of OA, who attended the orthopedics outpatient clinic-referred from other services with advanced hip and/or knee joint wear and persistent joint pain. We asked the patients the age of onset of OA-pain in years and which joint was the first affected and which joints were currently affected by pain using the Numerical Rating Scale (NRS). Waist and hip circumferences were measured and central obesity was defined as unhealthy when the Waist to Hip Ratio (WHR) was equal or higher than 0.90 in men or equal or higher than 0.85 in women, according to the World Health Organization (WHO). Potential confounders in the relation central obesity and pain, like depression, anxiety, physical activity, education, alcohol intake, and smoking were analyzed. Analysis of variance (ANOVA), linear and logistic Regression Analyses was performed. Betas (β) and Odds Ratio (OR) with 95% confidence interval (CI) are presented. All analyses were adjusted for age, gender, and body mass index. Results: In our population 25% of subjects were affected by hip-OA, 49% with knee-OA, and 26% with both joints affected. Knee was the first joint that reported pain in 56% of the subjects followed by hip (38%), low back (4%), and other joints (2%). From all 770 subjects included in the analysis, 46% were obese (BMI≥30). Most of our population (65%) had central obesity. BMI was slightly associated with earlier onset of OA-pain (B=-0.11, P= 0.07) and central obesity was significantly associated with earlier onset of OA-pain in years (B =-2.77, P = 0.002) and B = -2.53 P = 0.006, after adjustment for age, gender and BMI. Subjects with central obesity started with OA-symptoms 2.5 years earlier than subjects without central obesity (Fig. 1, P=0.006). The odds of starting with OA-pain before the age of 50 years in individuals with central obesity was 1.7 times higher compared with individuals without central obesity (OR: 1.72, CI: 1.07-2.78, P=0.025). In addition, our population with hip or knee OA reported low back pain (35.5%), hand (10%), shoulder (9.2%), foot or ankle pain (9.1%), or elbow pain (3.2%). Central obesity was associated with a higher number of joints affected by pain (Fig. 2). subjects with unhealthy central obesity had approximately 10.4% more joints affected by pain (Fig. 2, P= 0.04). Subjects with central obesity in addition to hip or knee OA-pain had higher odds of foot or ankle pain (OR=2.11, CI: 1.0-4.46) and low back pain (1.51, CI: 1.0-2.28). Conclusions: BMI is a well-established risk factor for pain and OA and regarding joint pain central obesity is perhaps the most important obesity related-trait. Central obesity not only exerts influence on the number of joints with pain but might determine the age of onset of OA-symptoms. Subjects with central obesity and OA, are at higher odds of reporting low back and/or foot or ankle pain. Several potential mechanisms of the relationship between obesity and pain have been proposed. However, today we recognize that mechanical-structural explanations for the association of obesity with OA and pain are not the only ones. Metabolic-inflammatory factors associated with an excess of adipose tissue should be recognized as a more important factor for pain and pain initiation than BMI. According to our Results, central obesity might exert an important role in the development of OA-pain and might influence pain at other joints in subjects already affected with OA. Considering that waist circumference increases in the elderly and that in the last 20 years major increases in WC and WHR have been observed in adults from developed countries, the reduction of abdominal fat should be targeted in programs of joint pain management. Further analysis will try to determine the exact contribution of abdominal fat tissue to joint pain.

Associations of general obesity and central obesity with the risk of hepatocellular carcinoma in a Korean population: A national population-based cohort study.

Numerous previous studies have shown an association between general obesity and hepatocellular carcinoma (HCC). However, relatively few reports on the association of central obesity and HCC are available in Asian populations. Therefore, we investigated the association between WC representing central obesity and the risk of HCC in addition to BMI representing general obesity and the risk of HCC in Korea. A total of 10 505 818 participants who received the National Health Insurance Service (NHIS) health checkups in 2009 were screened for study eligibility, and 26 979 cases of HCC occurred during the 7.3 years of mean follow-up. General obesity increased the risk of HCC with hazard ratios (HRs) of 1.14 (95% CI, 1.11-1.18) for BMI 25.0-<30.0 kg/m2 and 1.52 (95% CI, 1.43-1.61) for BMI ≥30 kg/m2 compared to those whose BMI is within the normal range. Central obesity was also associated with a higher risk of HCC. For the participants with a WC ≥105 cm in men and WC ≥100 cm in women, the risk of HCC was higher than that of the reference group (HR = 1.69, 95% CI, 1.54-1.85). The HRs were 1.13 (95% CI, 1.07-1.19) for nonobese participants with central obesity, and 1.34 (95% CI, 1.30-1.38) for obese participants with central obesity compared to those without both conditions. Our findings suggest that the risk of HCC increases even more when general obesity is combined with central obesity. Moreover, central obesity is associated with the risk of HCC, regardless of general obesity.

Obesity prevalence in Brazilian firefighters and the association of central obesity with personal, occupational and cardiovascular risk factors: a cross-sectional study

ObjectivesThis study aimed to investigate the obesity prevalence in a population of Brazilian firefighters and the association of central obesity (CO) with sociodemographic, occupational, life habits, fitness and health status...

Abstract P219: Central Obesity and All-cause and Cause Specific Mortality: a Systematic Review and Dose-response Meta-analysis of Prospective Studies

Background: The association of central obesity and mortality risk has not been systematically investigated. The strength and shape of dose-response relationship between central obesity and all-cause and cause specific mortality still remains unclear. Therefore, we conducted a systematic review and meta-analysis to clarify the associations. Methods: Categorical and dose-response meta-analysis was conducted involving of prospective studies. PubMed and Embase were searched up to April 1st, 2017 for eligible studies of waist circumference, waist-to-hip ratio and all-cause and cause specific mortality. Random-effects models were used to derive the summary relative risks (RRs) and corresponding 95% CI for specific categories of central obesity and a continuous association using generalized least-squares trend estimation. Results: A total of 1 760 947 participants in 50 studies were included in the meta-analysis. The pooled RRs for a 10 cm increase in waist circumference were 1.06 (95% CI, 1.04-1.08; I 2 =92.9%), 1.06 (95% CI, 1.03-1.08; I 2 =90.9%), 1.21 (95% CI, 1.06-1.35; I 2 =88.1%) and 1.05 (95% CI, 1.02-1.08; I 2 =86.5%) for all-cause, cardiovascular disease (CVD), coronary heart disease (CHD), and cancer mortality, respectively. We found a nonlinear relationship between waist circumference and all-cause mortality among both women (p&lt;0.001) and men (p=0.011). The summary RRs for a 0.1 unit in waist-to-hip ratio were 1.17 (95% CI, 1.12-1.21; I 2 =88.2%), 1.26 (95% CI, 1.17-1.34; I 2 =66.3%), 1.25 (95% CI, 1.10-1.40; I 2 =67.8%) and 1.13 (95% CI, 1.09-1.16; I 2 =0.0%) for all-cause, CVD, CHD, and cancer mortality, respectively. There was evidence of a nonlinear relationship between waist-to-hip ratio and all-cause mortality among women (p=0.016) rather than men (p=0.424). The dose-response relationship between central obesity and cause specific mortality were linear, except the association of waist circumference and CVD mortality (p=0.037), and waist-to-hip ratio and cancer mortality (p=0.039). Conclusions: Higher waist circumference and waist-to-hip ratio measured continuously and categorically, increase the risk of all-cause mortality among men and women and are associated with increased risk of CVD, CHD and cancer mortality.

Sex differences in neurocognitive screening among adults living with HIV in China

HIV-infected (HIV+) women may be more vulnerable to neurocognitive impairment (NCI) due to psychological and physiological factors but previous studies show mixed findings. We investigated the neurocognitive performances in HIV+ versus HIV- women and men. This cross-sectional analysis included 669 HIV+ patients (223 women) and 1338 HIV-uninfected (HIV-) controls (446 women) which were frequency matched on sex, education, and 5-year age categories. NCI was screened using the Mini-mental State Examination. Psychomotor speed was assessed using timed alternating hand sequence test. Prevalence of NCI was higher among women versus men in the HIV+ group (16.1% vs 10.5%) but not the HIV- group (4.3% vs 3.5%). HIV+ women performed worse compared to men on psychomotor speed, orientation, attention, and calculation, whereas HIV- women performed worse compared to men on attention and calculation. Adjusted interaction effects of HIV status × sex (women vs men) were significant on orientation, attention, and calculation, and marginally significant on psychomotor speed (p = 0.053). In multivariable models, among both HIV+ women and men, less years of education and depressive symptoms were associated with NCI. Waist-to-hip ratio above the cut-off was strongly associated with NCI among HIV+ women. HIV+ women perform worse on cognitive measures compared to HIV+ men. The association of central obesity with NCI in HIV+ women should be noted.

Association of Central Obesity with Sex Hormonebinding Globulin: A Cross-sectional Study of 1166 Chinese Men.

Background Both sex hormone-binding globulin and central obesity have been found to be associated with metabolic and cardiovascular diseases. However, the direct relation between sex hormone-binding globulin and central obesity has not been demonstrated.Methodology We performed a cross-sectional study of 1166 male participants from Zunyi, Guizhou, western China, in 2013. Each participant completed a questionnaire and had a brief clinical exam with a fasting blood sample taken. All blood samples underwent standard laboratory testing for sex hormone-binding globulin. Level of serum sex hormone-binding globulin was compared by demographic characteristics, and multiple linear regression was used to evaluate the independent association of variables and sex hormone-binding globulin level.Results The mean serum level of sex hormone-binding globulin was increased in old-aged men (older than 40 years; mean 44.68±20.58 nmol/L), low diastolic blood pressure (<90mmHg; 43.76±20.50 nmol/L), waist-to-height ratio <0.5 (48.73±20.59 nmol/L), no education (52.36±22.91 nmol/L), farm occupation (43.58±20.60nmol/L), non-alcohol or former user (44.78±20.94 nmol/L) and long-term medication history (44.79±21.50 nmol/L). Factors independently associated with sex hormone binding globulin level on multiple regression were waist-to-height ratio (β=- 11.84 [95% confidence interval -13.96,-9.72]), age(β=12.40 [9.63,15.17]) and diastolic blood pressure (β=-5.07 [-7.44,-2.71]).Conclusions Central obesity has an independent inverse relation with serum level of sex hormone binding globulin among western Chinese men

Association of Central Obesity and Waist/Hip Circumference With Dislipidemia

Dislipidemia is a lipid metabolic disorder which marked by raised of total cholestrol ratio, LDL, and Trigliserida also reduction HDL ratio. Dislipidemia is risk factor of coronary heart disease, arterio sklerosis, acute miokard infark, Diabetes Melitis, Hipertension, and Chronic Kidney Disease. The aim of this study is knowing the association of central obesity and RLPP with dislipidemia in interna policlinic patient at RSUD Meuraxa. The design of the study is analytic observational with cross sectional approach. Sampling was conduct with purposive sampling with 64 samples. Rate the central obesity and RLPP with measurement while dislipidemia gained from patients registration book formed in laboratorium result. The result was based on age the biggest portion was more than 45 years old (78,1 %) , women more dominant (70,35 %) with central obesity (76,6%) and high RLPP (85,5%). High cholestrol 56,3 %, high LDL 78,1%, high Trigliserida 59,4 and low HDL 62,5%. The result of spearman correlation there was association between of central obesity with dislipidemia P = 0,046 and and RLPP with dislipidemia P = 0.029. We can conclude that there was association between central obesity and RLPP with Dislipidemia.Key words : Dislipidemia, Central Obesity, Waist/Hip Circumference, RLPP

Central Obesity Plays an Important Role for the Development of Type 2 Diabetes in Bangladeshi Women

Background: Diabetes mellitus coexists at a greater frequency with hypertension, obesity, central obesity, and dyslipidemia. Obesity has been identified as the most important modifiable risk factor in the aetiology of type-2 diabetes mellitus. Central obesity has been shown to be the most pathogenically important in the causation of metabolic disorders including type-2 diabetes. Aims: To determine the association of central obesity with type 2 diabetes in Bangladeshi women. Subjects and Methods: A total of 60 type 2 diabetic female subjects along with 60 healthy female subjects were recruited in this study. Anthropometric indices were measured using standard techniques. Serum glucose was measured using glucose-oxidase method, insulin was measured using ELISA and thyroid hormones were measured using chemiluminescence based automated Immulite Auto analyzer (DPC, USA). Insulin secretory capacity and insulin sensitivity were estimated using fasting glucose and fasting insulin by HOMA-CIGMA software. Results: Waist circumference of the control (89±8) subjects was significantly (p=0.046) lower than the diabetic (94±11) subjects. Waist-hip ratio of the control subjects was significantly lower compared to diabetic subjects. Fasting plasma insulin level in control subjects (7.6±2.2) was significantly (p=0.009) lower compared to diabetic subjects (11.8±9.8). Plasma lipid profile and thyroid hormone status in control and diabetic subjects were not found significantly different. Insulin secretory capacity (HOMA %B) and insulin sensitivity (HOMA%S) in control subjects (93±21, 95±39 respectively) were found to be significantly higher com-pared to diabetic subjects (45±32, 67±42 respectively). In age-adjusted binary logistic regression analysis, waist circumference was found to be significantly associated with diabetes. In multiple linear regression analysis TSH was found to be significantly associated with waist circumference. Conclusion: Waist circumference may be an independent indicator for the development type 2 diabetes in Bangladeshi women which may have influenced by thyroid stimulating hormone (TSH). DOI: http://dx.doi.org/10.3329/bjms.v13i3.19149 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.278-284