Greater Abdominal Obesity Research Articles

The Effects of Abdominal Obesity and Sagittal Imbalance on Sacroiliac Joint Pain After Lumbar Fusion

BACKGROUND: Postoperative sacroiliac joint pain (SIJP) is a common manifestation of failed back surgery syndrome after a posterior lumbar interbody fusion (PLIF). However, there is currently no consensus on the risk factors for SIJP after PLIF. OBJECTIVES: We explored the effects of abdominal obesity and sagittal imbalance on SIJP after PLIF. STUDY DESIGN: This is a prospective observational cohort study. SETTING: This study occurred at the Department of Spinal Surgery at a hospital affiliated with a medical university. METHODS: A total of 401 patients who underwent PLIF from June 2018 to June 2021 were enrolled in this study. 36 patients experienced postoperative SIJP. In contrast, a matched group comprised 72 non-SIJP patients. We used 1:2 propensity score matching to compare obesity features and sagittal spine parameters in the 2 groups. Inflammatory cytokines and visual analog scale (VAS) scores were measured in the SIJP group. RESULTS: A total of 36 patients (8.98%) experienced SIJP during the follow-up. Compared with the non-SIJP group, patients with postoperative SIJP had a higher body mass index (BMI), greater abdominal obesity, a higher incidence of pelvic incidence-lumbar lordosis greater than 10°, and a higher incidence of a sagittal vertical axis greater than 5 cm (P < 0.05). Receiver operating characteristic curve analysis showed that the area under the curve for waist circumference was greater than that for BMI (0.762 vs. 0.650, P = 0.049). Logistic regression analysis revealed that the risk factors for SIJP were abdominal obesity, a pelvic incidence-lumbar lordosis of greater than 10°, and a sagittal vertical axis greater than 5 cm (P < 0.05). In patients with SIJP, interleukin 6, tumor necrosis factor-alpha, and VAS scores were higher in the abdominal obesity group than in the non-abdominal obesity group (P < 0.05). LIMITATIONS: There was no uniform diagnosis of SIJP, so the incidence rate of SIJP might not be accurate. CONCLUSIONS: The significant predictors of SIJP were abdominal obesity and sagittal imbalance. Patients with abdominal obesity showed higher levels of inflammatory markers and pain intensity. More attention should be paid to body shape and the angle of correction of lumbar lordosis before lumbar surgery. KEY WORDS: Posterior lumbar interbody fusion, sacroiliac joint pain, abdominal obesity, sagittal imbalance, pelvic incidence-lumbar lordosis, sagittal vertical axis, inflammatory cytokines, visual analog scale

Association between dietary saturated fat with cardiovascular disease risk markers and body composition in healthy adults: findings from the cross-sectional BODYCON study

BackgroundDiets high in saturated fatty acids (SFAs) and greater abdominal obesity are both associated with raised low-density lipoprotein cholesterol (LDL-C) concentrations, an independent cardiovascular disease (CVD) risk marker. Although reducing SFA intake is a public health strategy for CVD prevention, the role of body fat distribution on the relationship between SFA and LDL-C is unclear. Therefore, our objective was to investigate whether the association between dietary SFAs and LDL-C concentrations is related to body composition.MethodsIn the BODYCON (impact of physiological and lifestyle factors on body composition) study, 409 adults [mean age 42 ± 16 years and median BMI of 23.5 (21.5–25.9) kg/m2] underwent a measure of body composition by dual energy x-ray absorptiometry, assessment of habitual dietary intake using a 4-day weighed food diary and physical activity level using a tri-axial accelerometer. Blood pressure was measured, and a fasting blood sample was collected to determine cardiometabolic disease risk markers. Correlations between body composition, circulating risk markers and dietary macronutrients were assessed prior to multivariate regression analysis. The effect of increasing intakes of dietary SFA on outcome measures was assessed using ANCOVA after adjusting for covariates.ResultsAbdominal visceral adipose tissue (VAT) mass was moderately positively correlated with total cholesterol (TC), LDL-C, systolic blood pressure (SBP), diastolic blood pressure and HOMA-IR (rs = 0.25–0.44, p < 0.01). In multiple regression analysis, 18.3% of the variability in LDL-C was explained by SFA intake [% total energy (TE)], abdominal VAT mass, carbohydrate%TE and fat%TE intakes. When data were stratified according to increasing SFA%TE intakes, fasting TC, LDL-C and non-high-density lipoprotein-cholesterol were higher in Q4 compared with Q2 (p ≤ 0.03). SBP was higher in Q4 versus Q3 (p = 0.01). Android lean mass was also higher in Q3 versus Q1 (p = 0.02). Other anthropometric and CVD risk markers were not different across quartile groups.ConclusionsAlthough dietary SFA was found to explain 9% of the variability in LDL-C, stratification of data according to quartiles of SFA intake did not reveal a dose-dependent relationship with LDL-C concentration. Furthermore, this association appeared to be independent of abdominal obesity in this cohort.Clinical Trail registration: Trial registration: clinicaltrials.gov as NCT02658539. Registered 20 January 2016, https://clinicaltrials.gov/ct2/show/NCT02658539.

Prevalence and determinants of overweight/obesity among school-aged adolescents in the United Arab Emirates: a cross-sectional study of private and public schools

ObjectivesTo estimate the prevalence and predictors of obesity among adolescents in the United Arab Emirates.DesignCross-sectional study.SettingPrivate and public secondary schools.ParticipantsAdolescents aged 13–19 years; 434 (46.6%) from private schools and 498...

Abdominal obesity linked to a longer cone-mediated dark-adaptation recovery time in healthy eyes

Obesity has been associated with abnormal lipid metabolism and with tissue hypoxia. Human Bruch's membrane (BrM) lipid deposits have been proposed to create a diffusion barrier to metabolic exchange between the choroid and photoreceptors, delaying the regeneration of photopigments. The speed of retinal dark adaptation (DA) is dependent on the regeneration of these photopigments. While the retina is extremely sensitive to hypoxia, the inner retina, which encodes visual contrast, is more affected by hypoxia than the outer retina. This study examines the association between adiposity measures and the time course of DA measured psychophysically through contrast detection to test the functionality of both the outer and inner retina. Cone-mediated DA recovery of contrast threshold (CT) was measured following near-total photopigment bleach for 6 min in 52 healthy eyes of 52 individuals (42.6 ± 18.3 years). Stimuli were sine-wave gratings of low-spatial frequency (1 cycle-per-degree (cpd)) and low luminance (1 cd/m2) generated at the centre of a CRT monitor. CT recovery functions were fitted to an exponential decay model to determine the time constant (τ, seconds) of cone sensitivity recovery, final cone CT (CTf) and CT elevation (CT0). Weight, height and waist circumference (WC) were measured and body mass index (BMI) and waist-to-height ratio (WHtR) calculated. Relationships were examined through Spearman correlation and through multiple linear regression using age, optical and adiposity measures as independent variables. The repeatability of cone time constant measurements was estimated by the Bland-Altman method and reported as the coefficient of repeatability (CoR). Mean ± SD of time constant and CTf were 57.3 ± 27.7 s and −1.78 ± 0.20 log10 units respectively. Cone time constant showed positive Spearman correlation with WC (p = 0.008) and WHtR (p = 0.023) but not with BMI (p = 0.058). Only WHtR emerged as an independent predictor of time constant (p = 0.001). CTf was not correlated with any adiposity measures. Mean cone time constant was 41 s slower in subjects (25%, n = 13) with abdominal obesity (WHtR≥0.5). Mean CTf was not significantly different in subjects with or without abdominal obesity. CoR for cone time constant was ±16 s. In adult subjects, greater abdominal obesity (WHtR) was related to a longer contrast recovery time for cone-mediated DA (time to dark-adapt) suggesting outer retinal dysfunction. Final contrast threshold, preferentially processed by inner retinal cells, was unaffected by abdominal obesity.

Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India

Diabetes in combination with abdominal obesity and hypertension is the leading cause of cardiovascular diseases (CVD) and death. Type 2 diabetes (T2DM) increases CVD risk in two- to fourfold. The prevalence of CVD is constantly rising in India and is higher in urban areas. In addition, more than 50% of diabetic patients are still undiagnosed in the general population. The Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) is a cost-effective and very simple tool, which can be used at a primary health care center routinely. It is observed that people with increasing age, sedentary lifestyle, greater abdominal obesity, and family history of diabetes are at a high risk for diabetes and its complications. MDRF-IDRS is helpful for mass screening of diabetes and its complications in North Indian population to prevent the incidence of diabetes and with lifestyle interventions, knowledge, and awareness, it helps to reduce and revert the complications of diabetes. It is suggested that regular practice of MDRF-IDRS-based screening at primary health care center may also reduce the burden at the critical care center in North India.

Association of Body Composition, Lipid Parameters and Lifestyle Factors with Bone Health Status in Males and Females of North India: A Case-Control Study

A number of epidemiological and animal studies have indicated the fine balance among bone and fat metabolism as the connecting link between osteoporosis and obesity. Excess abdominal fat is associated with an abnormal lipid profile causing greater predisposition towards metabolic diseases like osteoporosis. Quantitative ultrasonometry (QUS) T-score being the surrogate marker of osteoporosis was studied in this case-control study (254 cases, 250 controls) comprising of both males and females to investigate its potential association with anthropometric predictors of adiposity and lipid parameters. According to the WHO criteria, patients with a T-score ? -1.0 SD were marked as cases and ? -1.0 SD as controls. Information on demographic and lifestyle factors, anthropometric measurements and lipid profile was recorded for all the participants. Results depicted that QUS T-score was inversely correlated with the predictors of obesity including BMI, WHtR and BAI in the pooled group, BMI, WHtR and TC in females, and directly correlated with TGL in males. After attenuating for the confounding factors, while obesity indices remained significant in pooled and females, the influence of lipid parameters among males was nullified. However, principal component analysis in all groups pointed obesity to be the major determinant, followed by lipid parameters, accounting for 90% of the variance. Additionally, calcium and fruit intake, post-menopausal and socio-economic status, and smoking had a significant role to play. To conclude, the present data indicates that individuals with greater abdominal obesity might pose a higher risk of developing bone metabolic diseases like osteopenia and osteoporosis, necessitating the need for evaluating the bone status in obese individuals, whilst, the role of lipid parameters still remains conflicting. This might open new avenues in understanding the mechanism underlying bone metabolism.

Diabetes in India: what is different?

The purpose of this study was to review the epidemiology and pathogenesis of diabetes in Asian Indians with a particular focus on 'Asian Indian type 2 diabetes phenotype'. The prevalence of diabetes is rapidly increasing among Asian Indians, particularly in the past two decades. The diabetes rates in urban India now exceed that seen in Indians migrated to developed nations. Urbanization, changes from traditional healthier diets to high-refined carbohydrate intake, and sedentary lifestyle have contributed to this steep increase in the prevalence of diabetes in India. Type 2 diabetes among Asian Indians is characterized by onset at a younger age, greater abdominal obesity despite relatively lower BMI, greater insulin resistance, and early decline in beta cell function. Asian Indians are also at a higher risk for premature coronary artery disease. The clinical profile of type 2 diabetes in Asian Indians differs from Caucasians with higher central obesity, increased inflammatory markers such as high sensitive C-reactive protein, greater insulin resistance, early loss of beta cell function, and a higher risk of coronary artery disease. Mechanistic studies are needed to characterize the pathophysiology of the Asian Indian phenotype.

PS8 - 39. Bcll glucocorticoid receptor polymorphism is associated with greater body fatness and higher insulin resistance: The Hoorn and CODAM Studies

Glucocorticoid receptor (GR) polymorphisms play an important role in the downstream effects of glucocorticoids (GCs). The BclI polymorphism has been shown to be associated with an enhanced GC sensitivity, which may result in greater abdominal obesity and its metabolic consequences.

High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia.

BackgroundVitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency (< 50 nmol/L) and the association of 25-hydroxyvitamin D with metabolic risk factors among an existing Malay cohort in Kuala Lumpur.MethodsThis is an analytical cross sectional study. A total of 380 subjects were sampled and their vitamins D status (25-hydroxyvitamin D), fasting blood glucose, full lipid profile were assessed using venous blood. Systolic and diastolic blood pressure, weight, height and waist circumference were measured following standard protocols. Socio-demographic data such as sex, age, smoking status etc were also collected. Data was analysed using t-test, chi-square test, General Linear Model and multiple logistic regression.ResultsFemales made up 58% of the sample. The mean age of respondents was 48.5 (SD 5.2) years. Females had significantly lower mean Vitamin D levels (36.2; 95% CI: 34.5, 38.0 nmol/L) compared to males (56.2; 95% CI: 53.2, 59.2 nmol/L). Approximately 41% and 87% of males and females respectively had insufficient (< 50 nmol/L) levels of 25-hydroxyvitamin D (p < 0.001). The prevalence of Metabolic Syndrome for the whole sample was 38.4 (95% CI: 33.5, 43.3)%. In the multivariate model (adjusted for age, sex, abdominal obesity, HDL-cholesterol, diastolic blood pressure), insufficient Vitamin D status was significantly associated with 1-year age increments (OR: 0.93; 95% CI: 0.88, 0.98), being female (OR: 8.68; 95% CI: 5.08, 14.83) and abdominal obesity (OR: 2.57; 95% CI: 1.51, 4.39). Respondents with insufficient vitamin D were found to have higher odds of having Metabolic Syndrome (OR: 1.73; 95% CI: 1.02, 2.92) after adjusting for age and sex.ConclusionsOur results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.

Mismatch between perceived and actual overweight in diabetic and non-diabetic populations: a comparative study of South Asian and European women

Diabetes is more common in South Asian (defined here as Indian, Pakistani and Bangladeshi origin) populations compared with Europeans. This may be related to their greater abdominal obesity.1Weight loss and...