High Metabolic Risk Research Articles

Waist circumference as a predictor of cardiovascular and metabolic risk factors in obese girls.

(a). to explore the relationship between waist circumference and certain cardiovascular risk factors in a group of girls; and (b). to assess the clinical relevance of waist circumference in identifying girls with higher cardiovascular risk across puberty. One-hundred and fifty-five overweight or obese girls aged 5-16 y were recruited. Overweight and obesity were defined on the basis of BMI, according to Cole. : Waist circumference was significantly correlated with plasma insulin (r=0.43; P<0.001), systolic blood pressure (r=0.22; P=0.007) and IR(HOMA) (r=0.40; P<0.001). A multivariate linear correlation analysis showed that, when adjusted for age and Tanner stage, waist circumference was significantly associated with plasma insulin (r(2)=0.23; P<0.01), IR(HOMA) (r(2)=0.17; P<0.02), systolic and diastolic blood pressure (r(2)=0.20; P=0.006 and r(2)=0.32; P<0.001, respectively). A logistic regression analysis, using IR(HOMA) as the dependent variable, showed that waist circumference was a significant independent risk factor of insulin resistance (IR(HOMA)>or=2.6) in this group of girls (OR 1.10; 95% CI 1.03-1.18; P=0.003), independently of their age and Tanner stage. Waist circumference of these girls was independently associated with certain cardiovascular risk factors, in particular insulin resistance and diastolic blood pressure, independently of age and Tanner stage. Thus suggesting that waist circumference may be reasonably included in clinical practice as a simple tool that may help to identify sub-groups of obese girls at higher metabolic risk across puberty.

Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction.

To validate transthoracic echocardiography as an easy and reliable imaging method for visceral adipose tissue (VAT) prediction. VAT is recognized as an important indicator of high cardiovascular and metabolic risk. Several methods are applied to estimate VAT, with different results. We selected 60 healthy subjects (29 women, 31 men, 49.5 +/- 16.2 years) with a wide range of body mass indexes. Each subject underwent transthoracic echocardiogram and magnetic resonance imaging (MRI) to measure epicardial fat thickness on the right ventricle. Measurements of epicardial adipose tissue thickness were obtained from the same echocardiographic and MRI views and points. MRI was also used to measure VAT cross-sectional areas at the level of L4 to L5. Anthropometric indexes were also measured. Subjects with predominant visceral fat accumulation showed higher epicardial adipose tissue thickness than subjects with predominant peripheral fat distribution: 9.97 +/- 2.88 vs. 4.34 +/- 1.98 (p = 0.005) and 7.19 +/- 2.74 vs. 3.43 +/- 1.64 (p = 0.004) in men and women, respectively. Simple linear regression analysis showed an excellent correlation between epicardial adipose tissue and waist circumference (r = 0.895, p = 0.01) and MRI abdominal VAT (r = 0.864, p = 0.01). Multiple regression analysis showed that epicardial adipose tissue thickness (r(2) = 0.442, p = 0.02) was the strongest independent variable correlated to MRI VAT. Bland test confirmed the good agreement between the two methods. Epicardial adipose tissue showed a strong correlation with anthropometric and imaging measurements of VAT. Hence, transthoracic echocardiography could be an easy and reliable imaging method for VAT prediction.

Waist circumference in the assessment of obesity and associated risk factors in coronary artery disease patients

Waist circumference ‘action levels’ have been recommended as a screening tool for overweight/obesity and associated metabolic risk factors. The use of waist circumference action levels in identifying need for weight management and higher metabolic risk was evaluated in 541 consecutive coronary artery disease patient referrals (85 female) to a long-term maintenance, community-based cardiac rehabilitation programme. Recommended waist circumference action levels identified overweight and obese patients (body mass index (BMI ≥ 25.0 kg·m –2 and ≥ 30.0 kg·m –2 , respectively) and those with lower BMI but abdominal adiposity (waist:hip ratio ≥ 0.95 males, ≥ 0.80 females) with high sensitivity and specificity values. The prevalence of several metabolic risk factors was different between male and female patients in this cohort. Male patients exceeding the lower waist circumference action level (≥ 94 cm) showed significantly increased odds ratios for hypertriglyceridemia; those at the higher action level (≥ 102 cm) additionally exhibiting low high density lipoprotein cholesterol, a raised TC:HDL-C ratio and diastolic hypertension. Male subjects with increased waist circumferences were also 2–3 times as likely to have multiple (≥ 3) metabolic risk factors. Higher odds ratios were evident only for hypertriglyceridemia in female patients above the higher action level (≥ 88 cm). Waist circumference action levels (94 cm and 102 cm in males; 80 and 88 cm in females) may be utilized in secondary prevention settings to identify subjects requiring weight management. Furthermore, waist circumferences higher than the recommended action levels may also indicate increased metabolic risk despite standard cardioprotective drug therapy.

Matching for waist to thigh circumference ratio equalizes important metabolic risk factors between randomized 30-year-old men and women

Abdominal fat distribution is associated with increased incidence of cardiovascular disease and stroke [ 1,2]. Metabolic risk factors are likely to be involved in this association since abdominal fat accumulation is related to alterations of serum lipids, blood pressure, insulin action and glucose tolerance [2]. Waist to hip and waist to thigh circumference ratios are widely used indicators of abdominal fat distribution in epidemiological and clinical studies [1,3,4]. Since men have both higher metabolic risk factors and larger abdominal fat accumulation than body fatand age-matched premenopausal women, in this study we aimed at evaluating the main metabolic risk factors in women with the same circumference ratios as men.

Incidence of perforated duodenal and gastric ulcer in Oxford.

Objective: Low sodium intake may trigger sympathetic nervous system (SNS) activation and endothelial dysfunction. Studies have not explored these associations along the glucose continuum. Accordingly, we compared endothelial function and SNS activity in individuals with low sodium intake and differing categories of metabolic risk along the glucose continuum. We hypothesized that low sodium intake is associated with (1) impairment of endothelial function and (2) higher SNS activity in individuals with higher metabolic risk. Research Design and Methods: In this prospective observational study, participants (n=54) with low sodium intake (single 24 hours urine sodium excretion &lt;150 mmol/24 hours) were categorized based on oral glucose tolerance testing as: normal glucose tolerance (NGT, n=10), impaired glucose tolerance (IGT, n=15), treatment naive type 2 diabetes (T2D−) (n=12) or treated type 2 diabetes (T2D+) (n=17). We assessed endothelial function using pulse amplitude tonometry (PAT) derived reactive hyperemic index and PAT ratio; arterial stiffness via augmentation index; muscle sympathetic nerve activity (MSNA) using microneurography; cardiac baroreflex; heart rate; blood pressure; glycosylated hemoglobin A1c (HbA1c) and lipid profile. Results: Mean (SD) sodium excretion was 110.6 (26) mmol/24 hours. Compared with NGT, IGT and T2D−, the T2D+ group had lower MSNA (p=0.005), PAT ratio (p=0.04) and baroreflex sensitivity (p=0.0002) and an augmented heart rate (p=0.02). The T2D+ group had appropriate mean (SD) glycemic (HbA1c 7.2 (1.72)%), total cholesterol (4.2 (1.0) mmol/L), low-density lipoprotein (2.2 (1.0) mmol/L) and blood pressure (systolic 136 (13), diastolic 78 (12)) (mm Hg) control. Conclusions: Individuals with T2D+ have impaired endothelial and baroreflex function, despite low sodium intake, appropriately managed cardiometabolic risk factors and lower SNS activity, compared with others along the glucose continuum. Whether low sodium intake is associated with modulation of the sympathovascular profile in T2D requires further investigation.