Contribution Of Body Mass Index Research Articles

Imaging-based body fat distribution and diabetic retinopathy in general US population with diabetes: an NHANES analysis (2003–2006 and 2011–2018)

BackgroundLimited studies have investigated the correlation between fat distribution and the risk of diabetic retinopathy (DR) in the general population with diabetes. The relationship between obesity and DR remains inconclusive, possibly due to using simple anthropometric measures to define obesity. This study investigates the relationships between the android-to-gynoid fat ratio (A/G ratio, measured using dual-energy X-ray absorptiometry) and DR within the US population with diabetes.MethodsThe study used a population-based, cross-sectional approach based on the 2003–2006 and 2011–2018 data of the National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression analyses were performed on participants with diabetes to evaluate the contribution of body mass index (BMI), waist-to-height ratio (WHtR), and A/G ratio to the prevalence of DR.ResultsThe prevalence of DR was 22.2, 21.2, and 17.6% among participants with A/G ratios <1.0, 1.0–1.2, and ≥1.2, respectively. After adjusting sex, age, ethnicity, diabetes duration, hemoglobin A1c level, blood pressure level, and non-high-density lipoprotein cholesterol level, a higher A/G ratio (≥1.2) was independently associated with decreased odds of DR (odds ratio [OR], 0.565; 95% CI: 0.372–0.858) compared with the A/G ratio of 1.0–1.2. Associations between a higher A/G ratio and DR remained statistically significant after adjusting for BMI (OR, 0.567; 95% CI: 0.373–0.861) and WHtR (OR, 0.586; 95% CI: 0.379–0.907). Moreover, these associations remained statistically significant in analyses using the ethnic-specific tertiles for the A/G ratio. In sex-stratified models, these correlations remained in males. There was a significant inverse association between the A/G ratio and diabetes duration in males, which persisted after multivariable adjustments (p < 0.05).ConclusionsA novel finding indicates that a higher A/G ratio is associated with a reduced likelihood of DR in males with diabetes. The results from NHANES underscore the importance of considering imaging-based fat distribution as a critical indicator in clinical practice.

Contribution of body mass index, waist circumference, and 25-OH-D3 on the risk of pre-diabetes mellitus in the Chinese population

This study aimed to investigate the associations between body mass index (BMI), waist circumference (WC), 25-hydroxy-vitamin D3 (25-OH-D3), and the risk of pre-diabetes mellitus (PDM), as well as their predictive values in identifying PDM. A total of 1688 participants were included in this cross-sectional investigation. Spearman’s correlation analysis was used to assess the relationships between candidate indicators and PDM. The impact of indicators on PDM risk was determined by multivariate logistic regression. The receiver operating characteristic (ROC) analysis was performed to evaluate the prognostic value of indicators. Our study indicated a positive correlation between WC, BMI, and 25-OH-D3 and PDM. WC (OR = 1.05, 95% CI = 1.04–1.06, p < 0.001), BMI (OR = 1.11, 95% CI = 1.08–1.15, p < 0.001), and 25-OH-D3 (OR = 1.01, 95% CI = 1.00–1.02, p = 0.037) and an increased risk of PDM. Additionally, the ROC analysis demonstrated that WC (AUC = 0.651, Specificity = 55.00%, Sensitivity = 67.900%) had a higher diagnostic value for predicting PDM compared to the other variables (BMI, 25-OH-D3, TG, TC, LDL-C, HDL-C, and UA). A cut-off value of WC > 80.5 cm predicted PDM with both good sensitivity and specificity. Additionally, the cut-off value of waist circumference (WC) for men with prediabetes was 86.500, while for women with prediabetes, it was 76.500.

КЛАСТЕРНЫЙ АНАЛИЗ КАК ИНТЕГРАТОР РАЗНЫХ МЕТОДИК ОЦЕНКИ ФИЗИЧЕСКОГО РАЗВИТИЯ ПРАКТИЧЕСКИ ЗДОРОВЫХ ЛИЦ ЮНОШЕСКОГО ВОЗРАСТА

The influence of external factors can significantly deviate the distribution of somatotypes from the indicators of the general population, which makes researchers select the most suitable scheme of so-matotyping from the already known ones or construct their own. Applicants of military universities are a particular case of such samples, formed as a result of a complex of factors, including the work of military medical commissions. The aim was to use cluster analysis to develop an integrative classifica-tion for assessing the physical development of practically healthy adolescents. Materials and meth-ods. The object of the study was 280 applicants (234 boys and 46 girls), who were examined by spe-cialists in the medical commissions of military commissariats and were considered to be practically healthy. Anthropometric data were analyzed: body length, body weight, length of the torso, limbs, girth dimensions of the torso and limbs, as well as body component composition. Hierarchical cluster analysis by the Ward method and Kendall's correlation coefficient were used in the study. Results. By means of cluster analysis of the physical development indicators of the virtually healthy individuals, we identified a significant contribution of body mass index, weight, body length in the formation of three major groups, which we characterized as: the male macrosomatic phenotype, the male mesoso-matic phenotype, and the female phenotype. Based on the proportion of muscle and fat tissue, visceral fat, distal diameter of the forearm as an indicator of bone development, body mass index and thick-ness of the skin-fat fold of the anterior abdominal wall, the following subgroups were identified: male macrosomatic phenotype, with hyperstenic features, male macrosomatic phenotype, with normosthen-ic features, male mesosomatic phenotype with digestive features, male mesosomatic phenotype with mesotonic features, male mesosomatic muscle phenotype, female megalosomic athletic and subathletic phenotype, female stenoplastic phenotype. Conclusion. The used statistical approach allows to change the classical paradigm of searching for a universal methodology of somatotyping, to the creation of algorithms of compilation of well-known schemes of physical development evaluation in the selected population groups.

Specific Associations Between Type of Childhood Abuse and Elevated C-Reactive Protein in Young Adult Psychiatric Rehabilitation Participants.

Early-life adversity such as childhood emotional, physical, and sexual trauma is associated with later-life psychiatric and chronic medical conditions, including elevated inflammatory markers. Although previous research suggests a role for chronic inflammatory dysfunctions in several disease etiologies, specific associations between childhood trauma types and later-life inflammation and health status are poorly understood. We studied patients (n = 280) admitted to a psychiatric rehabilitation center. Self-reported histories of childhood emotional, physical, and sexual trauma were collected with a standard instrument. At the time of admission, we also assessed individuals' body mass index and collected blood samples used to examine inflammatory marker C-reactive protein (CRP) levels. The prevalence of all 3 types of abuse was relatively high at 21% or more. Fifty percent of the sample had elevations in CRP, with clinically significant elevations in 26%. We found that compared with a history of emotional or physical abuse, a history of childhood sexual trauma was more specifically associated with elevated CRP. This result held up when using linear regressions to examine the contribution of body mass index. Our sample was relatively young, with an average age of 27.2 years and minimal representation of ethnic and racial minority participants. Relative to childhood emotional and physical trauma, childhood sexual trauma may lead to elevated inflammatory responses, as confirmed in our finding of an association between CRP and sexual abuse. Future studies need to assess the causal link between childhood sexual trauma and poorer health outcomes later in life.

Circulating levels of DDIT4 and mTOR, and contributions of BMI, inflammation and insulin sensitivity in hyperlipidemia.

Evidence shows a high incidence of insulin resistance, inflammation and excess body mass index (BMI) in adults with hyperlipidemia. The present study aimed to determine the circulating levels of DNA damage inducible transcript 4 (DDIT4) and mTOR and assess the contributions of lipids, inflammatory markers, insulin sensitivity and BMI in hyperlipidemia. The study subjects were divided into a hyperlipidemia group and a normal control group (n=55 per group). Sex, age, blood pressure, waist circumference (WC), height, weight and BMI were recorded. Fasting venous blood samples were collected and an automatic biochemical analyzer was used to detect fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Quantitative ELISA kits were used to determine the levels of DDIT4, mTOR and inflammatory markers and calculate the homeostatic model assessment of insulin resistance (HOMA-IR). Compared with the normal control group, the hyperlipidemia group had significantly increased blood pressure, WC, weight, BMI, FBG, FINS, HOMA-IR, mTOR and inflammatory markers, but significantly reduced DDIT4. A concurrent correlation analysis showed that insulin resistance was positively correlated with blood pressure, BMI, lipid profiles (TG, TC, LDL-C), mTOR and inflammatory markers, but negatively correlated with HDL-C and DDIT4. Lipid profiles were positively correlated with BMI, mTOR and inflammatory markers, but negatively correlated with DDIT4. A factor analysis identified four domains in hyperlipidemia (inflammation-lipid 1 domain, 44.429%; overweight domain, 21.695%; insulin sensitivity domain, 11.782%; lipid 2 domain, 6.723%). In conclusion, people with hyperlipidemia have elevated mTOR and reduced DDIT4 and are accompanied by abnormal indicators such as insulin sensitivity, BMI and inflammatory factors. The identified domains may be applied to predict the outcomes of cardiovascular diseases and metabolic diseases in the future.

The relations between body mass index, motor skills, and physical self-concept in determining physical activities of junior karatekas

The aim of this research was to examine the contribution of body mass index (BMI), motor skills and physical self-concept in explaining the physical activity (PA) of adolescent karatekas (N=148). The average age of participants was 16,56 years (± 1,14). The following measuring instruments were used: Body Mass Index (BMI), Eurofit Physical Fitness Test Battery, Physical Self-Description Questionnaire (PSDQ), and Physical Activity Questionnaire for Adolescents (PAQ-A). The Cronbach's alpha coefficient was used to determine the internal consistency of the questionnaires. The results of the hierarchical analysis showed that the predictor variables explained 18,5% of the total variance of the criterion PA of junior karatekas. With their positive direction, the independent variables of the physical self-concept strength (β = 0.049; p &lt; 0.01), flexibility (β = 0.037; p &lt; 0.01) and self-respect (β = 0.019; p&lt; 0.05) showed the maximum statistically significant contribution to predicting the variability of the participants' PA, which means that junior karatekas who manifest the higher level of perception on those variables exhibit the higher level of PA. This study confirmed that the applied instruments are valid and suitable to predict PA among adolescent athletes in Serbia.

The Influence of Movement-Evoked Pain on Lower Extremity Physical Function in Older Adults

Older adults often exhibit impaired lower extremity physical function, which promotes a sedentary lifestyle and contributes to the development of adverse health outcomes. Studies have identified several factors that contribute to lower extremity physical function in older adults, including body mass index (BMI), self-reported pain severity, and number of painful sites. An understudied area that may improve our understanding of these impairments is movement-evoked pain (MEP). Therefore, the purpose of this study was to determine if movement-evoked pain was associated with lower extremity physical function in older adults. Older adults (n=67) completed several lower extremity physical function tasks, including a balance, gait, and chair stand assessment, and isokinetic knee flexion and extension strength testing. MEP ratings following these tasks were obtained using a visual analog scale (0-100). Pain scores from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to quantify pain severity and participants self-reported number of painful sites. Hierarchical linear regressions were run using three blocks of independent variables (Block 1 = BMI, Block 2 = WOMAC pain scores and number of painful sites, Block 3 = Movement-evoked pain) to assess contributions from each factor for each lower extremity physical function task. MEP improved the amount of variance explained in gait double support time (ΔR2 = 0.052, p = 0.023). Pain severity and number of painful sites significantly improved the amount of variance explained in stride length (ΔR2 = 0.104, p = 0.020) and repeated chair stand performance (ΔR2 = 0.205, p < 0.001). MEP accounts for a significant amount of variance in gait performance in older adults beyond the known contributions of BMI, pain severity, and number of painful sites. As such, MEP should be considered in the development of future physical function pain assessments and treatments. Grant support from NIA grants K01AG048259, R01AG059809, R01AG067757, the University of Florida Claude D. Pepper Center (P30AG028740), and the University of Florida McKnight Brain Research Foundation and Center for Cognitive Aging and Memory.

Body mass index associated with monoclonal gammopathy of undetermined significance (MGUS) progression in Olmsted County, Minnesota

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant clonal disorder that progresses to multiple myeloma (MM), or other plasma-cell or lymphoid disorders at a rate of 1%/year. We evaluate the contribution of body mass index (BMI) to MGUS progression beyond established clinical factors in a population-based study. We identified 594 MGUS through a population-based screening study in Olmsted County, Minnesota, between 1995 and 2003. Follow-up time was calculated from the date of MGUS to last follow-up, death, or progression to MM/another plasma-cell/lymphoid disorder. BMI (kg/m2 < 25/≥25) was measured close to screening date. We used Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of BMI ≥ 25 versus BMI < 25 with MGUS progression and also evaluated the corresponding c-statistic and 95% CI to describe discrimination of the model for MGUS progression. Median follow-up was 10.5 years (range:0–25), while 465 patients died and 57 progressed and developed MM (N = 39), AL amyloidosis (N = 8), lymphoma (N = 5), or Waldenstrom-macroglobulinemia (N = 5). In univariate analyses, BMI ≥ 25 (HR = 2.14,CI:1.05–4.36, P = 0.04), non-IgG (HR = 2.84, CI:1.68–4.80, P = 0.0001), high monoclonal (M) protein (HR = 2.57, CI:1.50–4.42, P = 0.001), and abnormal free light chain ratio (FLCr) (HR = 3.39, CI:1.98–5.82, P < 0.0001) were associated with increased risk of MGUS progression, and were independently associated in a multivariable model (c-statistic = 0.75, CI:0.68–0.82). The BMI association was stronger among females (HR = 3.55, CI:1.06–11.9, P = 0.04) vs. males (HR = 1.39, CI:0.57–3.36, P = 0.47), although the interaction between BMI and sex was not significant (P = 0.15). In conclusion, high BMI is a prognostic factor for MGUS progression, independent of isotype, M protein, and FLCr. This association may be stronger among females.

Diabetes-Associated Susceptibility to Tuberculosis: Contribution of Hyperglycemia vs. Dyslipidemia.

Diabetes is a major risk factor for tuberculosis (TB). Diabetes increases the risk of the progression from latent tuberculosis infection (LTBI) to active pulmonary TB and TB patients with diabetes are at greater risk of more severe disease and adverse TB treatment outcomes compared to TB patients without co-morbidities. Diabetes is a complex disease, characterised not only by hyperglycemia but also by various forms of dyslipidemia. However, the relative contribution of these underlying metabolic factors to increased susceptibility to TB are poorly understood. This review summarises our current knowledge on the epidemiology and clinical manifestation of TB and diabetes comorbidity. We subsequently dissect the relative contributions of body mass index, hyperglycemia, elevated cholesterol and triglycerides on TB disease severity and treatment outcomes. Lastly, we discuss the impact of selected glucose and cholesterol-lowering treatments frequently used in the management of diabetes on TB treatment outcomes.

The Role of Body Mass Index on Perioperative Medical Complications and Outcomes Following Primary Total Knee Arthroplasty

Background and Hypothesis: Obesity is associated with increased medical complications and septic revision following total knee arthroplasty (TKA); however, evidence-based multidisciplinary perioperative care coordination can optimize outcomes. This study examined the relative influence of body mass index (BMI) on outcomes following TKA in an arthroplasty program with specialized perioperative medical care. &#x0D; &#x0D; Experimental Design or Project Methods: 284 consecutive primary unilateral TKAs performed by one surgeon at a designated hip and knee center between 2019 and 2020 were retrospectively reviewed. Outcomes including (1) inpatient and 90-day medical complications (cardiac, renal, respiratory, venous thromboembolism, cerebrovascular accident, joint infection, sepsis, and death), (2) 90-day emergency department (ED) visits and hospital readmissions, and (3) 90-day reoperations on the index joint were evaluated in relation to BMI. &#x0D; &#x0D; Results: 59.9% of the sample was non-obese (BMI &lt; 35 kg/m2), 20.1% severely obese (≥ 35 kg/m2), 18.3% morbidly obese (≥ 40 kg/m2), and 1.8% super-obese (≥ 50 kg/m2). There were five inpatient complications (40% non-obese, 60% morbidly obese patients, p=1.000). 64% of 11 90-day ED visits were made by non-obese patients and 36% were made by severely/morbidly obese patients (p=0.395). Nine hospital readmissions within 90-days represented 67% non-obese and 33% severely/morbidly obese patients (p=0.395). All complications were related to renal/respiratory/cardiac issues or joint infection. There were five reoperations of the index joint within 90 days (40% non-obese, 60% severely/morbidly obese, p=1.000), with infection or arthrofibrosis as the underlying cause. &#x0D; &#x0D; Conclusion and Potential Impact: We observed a similar distribution of perioperative medical complications following primary TKA regardless of BMI. Further evaluation with a larger sample and using machine learning to control for the influence of multiple potential confounders will help determine the relative contribution of various comorbidities associated with obesity on outcomes following TKA. An awareness of the relative contribution of BMI on these outcomes may improve preoperative counseling, management, and treatment of obese patients who undergo TKA.

Correlation between body mass index and blood pressure in seafarers

ABSTRACT Background High blood pressure is a serious medical condition that significantly increases the risk of cardiovascular disease. Although overweight and high blood pressure are frequent consequences for the health of life at sea, there is a paucity of information on the contribution of body mass index (BMI) to high blood pressure (HBP) in seafarers. Objective The present study was aimed to examine the relationship between BMI and blood pressure and to analyze further BMI as a risk factor for high blood pressure through a modeling approach. Materials and Methods A retrospective analysis was performed on 603 seafarers’ medical examination records. The seafarer’s blood pressure and BMI were recorded and interpreted according to the WHO criteria. Pearson product-moment correlation was examined to determine the association between BMI and blood pressure. Multinomial logistic regression models were performed to estimate the strength of association between the BMI and the HBP. Results Out of a total of 603 seafarers under study, 44.4% and 55.6% were officers and non-officers, respectively. Mean SBP, DBP, and BMI were significantly higher among non-officers than officers. BMI was positively correlated (p < .01) with both SBP (r = 0.336) and DBP (r = 0.344). About 39% and 16.6% of the study subjects were prehypertension and hypertensive, respectively. The risk of prehypertension and hypertension was higher in individuals who were overweight and obese. Conclusions Mean blood pressure levels increase parallel to the rise of BMI. Thus, emphasis should be given on a weight management program in relation to the prevention and control of high blood pressure.

The association between frequency of away-from home meals and type 2 diabetes mellitus in rural Chinese adults: the Henan Rural Cohort Study.

There is a paucity of data on the association between away-from home meals (AFHs) and type 2 diabetes mellitus (T2DM). The aim of this cross-sectional study was to explore the dose-response relationship between AFHs and T2DM in a Chinese population. A total of 29,910 participants were enrolled from the Henan Rural Cohort Study. Information on the weekly frequency of AFHs was collected by face-to-face questionnaires. Logistic regression and restricted cubic splines were used to estimate the relationship between the frequencies of AFHs and T2DM. Mediation analysis was performed to examine the contribution of body mass index (BMI) to the frequency of AFH-related T2DM. Compared with those who reported 0 AFHs per week, those who consumed ≥ 11 AFHs/week were associated with a 39% increase in the prevalence of T2DM. A nonlinear dose-response relationship between the frequency of AFHs and T2DM was found. Compared with the 0 AFHs/week group, in males, the multivariate odds ratios (OR) and 95% confidence interval (95% CI) of the groups with 11 or more AFHs/week for T2DM were 1.36 (1.01-1.84). However, no such association was found in females. BMI partly mediated the effects of the frequency of AFHs on T2DM, and the proportion explained was 23.4%. A relationship between the frequency of AFHs and T2DM was observed in the rural Chinese population. An excessive frequency of AFHs was likely to increase the prevalence of T2DM. Meanwhile, BMI partially mediates the effects of the frequency of AFHs on T2DM. The Henan Rural Cohort Study, ChiCTR-OOC-15006699, Registered 6 July 2015, https://www.chictr.org.cn/showproj.aspx?proj=11375 .

Linking socioeconomic inequalities and type 2 diabetes through obesity and lifestyle factors among Mexican adults: a structural equations modeling approach.

To assess the association between type 2 diabetes (DM2) and socioeconomic inequalities, mediated by the contribution of body mass index (BMI), physical activity (PA), and diet (diet-DII). We conducted a cross-sectional analysis using data of adults participating in the Diabetes Mellitus Survey of Mexico City. Socioeconomic and demographic characteristics as well as height and weight, dietary intake, leisure time activity and the presence of DM2 were measured. We fitted a structural equation model (SEM) with DM2 as the main outcome, and BMI, diet-DII and PA served as mediator variables between socioeconomic inequalities index (SII) and DM2. The prevalence of DM2 was 13.6%. From the fitted SEM, each standard deviation increases in the SII was associated with increased scores of DM2 (β=0.174, P<0.001). The results in the present study show how high scores in the index of SII may influence the presence of DM2.

Micronuclei frequency in peripheral blood lymphocytes of healthy subjects living in Turin (North-Italy): contribution of body mass index, age and sex

Background: Increased micronuclei (MNi) frequencies in human lymphocytes are an indicator of chromosome instability and could be influenced by different exogenous and endogenous factors. The increased exposure to environmental pollutants has led to the awareness of the necessity for constant monitoring of urban human populations.Aim: We evaluated the MNi frequency in a sample belonging to the non-occupationally exposed population of Turin (North-Western Italy). A possible effect of body mass index, age and sex on the genomic damage levels was also investigated.Subjects and Methods: The study included 150 subjects. MNi, nucleoplasmic bridges (NPBs) and nuclear buds (NBUDs) were scored in 1,000 lymphocytes per subject.Results: The MNi, NPBs and NBUDs average frequencies (‰ ± S.D.) were 7.19 ± 2.51, 1.65 ± 1.54 and 2.07 ± 1.76, respectively. Turin shows one of the highest MNi frequencies with respect to other Italian cities and European regions. A significant correlation was found between MNi, NPBs, NBUDs frequencies, age and body mass index.Conclusion: Baseline MNi frequency was established in a sample of a city, like Turin, exposed to high levels of environmental pollutants. We hope that the results of this study can be used as a stimulus for future biomonitoring programmes in other Italian and globally distributed cities.

The Association Between Salivary Ghrelin Levels with Anthropometric Measures in Underweight, Normal, Overweight and Obese Healthy Adult Males.

The study aimed to measure salivary ghrelin levels in healthy adult males and investigate their association with age, weight, height, total as well as regional body fat and muscle mass. The study also aimed to investigate the relative contribution of body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in predicting salivary ghrelin levels in the studied groups. A sample of young adult males was divided into underweight, normal weight, overweight, and obese groups, according to their BMI. Standardised methods were used to measure height, WC and HC. Total body fat, visceral fat, subcutaneous fat, total and regional muscle mass were assessed by bioelectrical impedance technique utilising Karada scan. Salivary ghrelin concentrations were assessed using enzyme-linked immunosorbent assay. A total of 90 adult males were included in the analysis (underweight n=9, normal weight n=41, overweight n=22, and obese n=18). One-way ANOVA test revealed significant differences among the groups in all of the variables except height and salivary ghrelin levels. Multiple linear regression revealed a significant association between salivary ghrelin levels with total fat, subcutaneous fat, visceral fat and muscle mass in the obese group. The analysis also revealed that BMI, WC, HC, WHR and WHtR were reliable predictors for salivary ghrelin levels in the obese group but not in other groups. Anthropometric measures can be used as predictors for salivary ghrelin levels in healthy obese adults. However, they are poor predictors for salivary ghrelin levels in healthy lean, normal and overweight adults.

Weight Gain Trajectory and Pain Interference in Young Adulthood: Evidence from a Longitudinal Birth Cohort Study.

Obesity is associated with chronic pain, but the contribution of body mass index (BMI) trajectories over the life course to the onset of pain problems remains unclear. We retrospectively analyzed how BMI trajectories during the transition to adulthood were associated with a measure of pain interference obtained at age 29 in a longitudinal birth cohort study. Data from the National Longitudinal Survey of Youth, 1997 Cohort (follow-up from 1997 to 2015), were used to determine BMI trajectories from age 14 to 29 via group trajectory modeling. At age 29, respondents described whether pain interfered with their work inside and outside the home over the past four weeks (not at all, a little, or a lot). Multivariable ordinal logistic regression was used to evaluate pain interference according to BMI trajectory and study covariates. Among 7,875 respondents, 11% reported "a little" and 4% reported "a lot" of pain interference at age 29. Four BMI trajectory groups were identified, varying in starting BMI and rate of weight gain. The "obese" group (8% of respondents) had a starting BMI of 30 kg/m2 and gained an average of 0.7 kg/m2/y. On multivariable analysis, this group was the most likely to have greater pain interference, compared with "high normal weight" (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.14-1.88), "low normal weight" (OR = 1.45, 95% CI = 1.13-1.87), and "overweight" trajectories (OR = 1.33, 95% CI = 1.02-1.73). Obesity and rapid weight gain during the transition to adulthood were associated with higher risk of pain interference among young adults.

Nonalcoholic Fatty Liver Disease in The Rotterdam Study: About Muscle Mass, Sarcopenia, Fat Mass, and Fat Distribution.

ABSTRACTNonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide. Obesity is a major risk factor for NAFLD and recently, low skeletal muscle mass emerged as additional risk factor for NAFLD. However, the different contributions of body mass index (BMI) to the risk of NAFLD are not yet well‐known. We therefore studied body composition and muscle function with NAFLD in an elderly population‐based study. Participants of European descent underwent dual‐energy X‐ray absorptiometry (DXA) and hepatic ultrasonography. NAFLD was defined as liver steatosis in absence of secondary causes for steatosis. Skeletal muscle index (SMI) was defined as appendicular lean mass/height2 and (pre)sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP) consensus guidelines. All analyses were stratified by sex and BMI (cut point: 25 kg/m2) and adjusted for age, weight, height, homeostasis model assessment of insulin resistance (HOMA‐IR), triglycerides, and android‐fat‐to‐gynoid‐fat ratio (AGR). We included 4609 participants, of whom 1623 had NAFLD (n = 161 normal‐weight and n = 1462 overweight). Presarcopenia and sarcopenia prevalence was low (5.9% and 4.5%, respectively) and both were not associated with NAFLD. SMI was associated with less NAFLD in normal‐weight women (OR, 0.48; 95% CI, 0.29 to 0.80). A similar association for SMI and NAFLD was seen in normal‐weight men, but significance dissipated after adjustment for AGR (OR, 0.63; 95% CI, 0.39 to 1.02). Generally, fat mass was a better predictor for NAFLD than lean mass. In particular, android fat mass was associated with all NAFLD subgroups (OR from 1.77 in overweight men to 8.34 in normal‐weight women, p max = 0.001), whereas substitution of gynoid fat mass for other body components had a significant protective association with NAFLD in every subgroup, but normal‐weight men. Likewise, AGR was the best performing predictor for NAFLD prevalence (OR from 1.97 in normal‐weight men to 4.81 in normal‐weight women, p max < 0.001). In conclusion, both high fat mass and low SMI were associated with normal‐weight NAFLD. However, fat distribution (as assessed by AGR) could best predict NAFLD prevalence. © 2019 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.

Evidence on the contribution of body mass index to mortality: What does this mean for India?

Evidence on the contribution of body mass index to mortality: What does this mean for India?

Causal Associations in Type 2 Diabetes Development.

Obesity, glucose, insulin resistance [homeostatic model assessment, version 2, for insulin resistance (HOMA2-IR)], and insulin secretion (HOMA2-β) have been associated with type 2 diabetes (T2D) observationally. However, the causal, genetic contribution of each parameter to this risk is largely unknown and important to study because observational data are prone to confounding but genetic, causal data are free of confounding and reverse causation. We examined the causal, genetic contribution of body mass index (BMI), glucose level, C-peptide level, HOMA2-IR, and HOMA2-β to the risk of T2D in 95,540 individuals from the Copenhagen General Population Study and estimated the absolute 10-year risks. Cox regression analysis, instrumental variable analysis, and Poisson regression analysis were performed to estimate the observational hazard ratios, causal, genetic ORs, and absolute 10-year risks of T2D. For 1-SD greater level, BMI was associated with an observational 66% (95% CI, 62% to 72%) and causal, genetic 121% (95% CI, 25% to 291%) greater risk of T2D; glucose with an observational 44% (95% CI, 41% to 46%) and causal, genetic 183% (95% CI, 56% to 416%) greater risk of T2D; and HOMA2-IR with an observational 30% (95% CI, 18% to 44%) and causal, genetic 12% (95% CI, 2% to 22%) greater risk of T2D. In contrast, for 1-SD greater level, HOMA2-β was associated with an observational 14% (95% CI, 11% to 16%) and causal, genetic 21% (95% CI, 8% to 32%) lower risk of T2D. The upper tertiles of HOMA2-IR were associated with absolute 10-year diabetes risks of 31% and 37% in obese women and men, age >60 years, and a glucose level of 6.1 to 11.0 mmol/L. BMI, glucose level, HOMA2-IR, and HOMA2-β are causally associated with T2D.

The effect of body mass index, lower extremity performance, and use of a private car on incident life-space restriction: a two-year follow-up study

BackgroundThe purpose of the study was to explore the single and combined contributions of body mass index (BMI) and lower extremity performance as modifiable physical factors, and the influence of use of a private car as an environmental factor on prevalent and incident life-space restriction in community-dwelling older people.MethodsCommunity-dwelling people aged 75–90 years (n = 823) participated in the Life-Space Mobility in Old Age (LISPE) two-year follow-up study. Participants who reported that the largest life-space area they had attained, without aid from any device or another person, was the neighborhood or less were considered to have life-space restriction. Incident life-space restriction was the endpoint of Cox’s proportional hazard model. BMI, lower extremity performance (Short Physical Performance Battery, SPPB), and use of a private car were predictors.ResultsAt baseline, people who had both obesity (BMI ≥30.0) and impaired lower extremity performance (SPPB 0–9) had a higher prevalence of life-space restriction (prevalence ratio 3.6, 95% confidence interval, CI, 2.0–6.3) compared to those with normal weight (BMI 23.0–24.9) and intact physical performance (SPPB 10–12). The 581 people without life-space restriction at the baseline contributed 1033 person-years during the two-year follow-up. Incident life-space restrictions were reported by 28.3% participants. A higher hazard ratio (HR) for incident life-space restriction was observed in subjects having both obesity and impaired lower extremity performance (HR 3.6, 95% CI, 1.7–7.4), impaired lower extremity performance only (HR 1.9, 95% CI 0.9–4.1), and obesity only (HR 1.8, 95% CI, 0.9–3.5) compared to those with normal weight and intact performance. Private car passengers (HR 2.0, 95% CI, 1.3–3.0) compared to car drivers had a higher risk of life-space restriction. All models were adjusted for age, sex, chronic diseases, and education.ConclusionsOlder people with impaired lower extremity performance have an increased risk of incident life-space restriction especially if combined with obesity. Also, not driving a car renders older people vulnerable to life-space restriction.