Higher Waist-hip Ratio Research Articles

Cardiometabolic risk profiles in patients with type 2 diabetes seeking services at a Regional Referral Hospital in Kenya

BackgroundPatients with type 2 diabetes are at increased risk of morbidity and mortality associated with cardiometabolic risk factors. Early identification and thus treatment of cardiometabolic risk factors may significantly reduce morbidity and mortality in such patients.ObjectiveTo determine the cardiometabolic risk profiles in patients with type 2 diabetes attending a Regional Referral Hospital in Kenya.MethodA descriptive cross-sectional study was carried out among 136 adults with diabetes. Anthropometric, clinical and biochemical measurements were taken to ascertain the cardiometabolic risks which included obesity/overweight, high waist-hip ratio, hypertension, elevated glycated hemoglobin levels, alcohol and tobacco use. Descriptive statistics were used to describe the social demographic characteristics of the participants as well as the cardiometabolic risk factors. A p-value ≤ 0.05 was considered significant.ResultsThe mean age was 56.34 (± 13.83) years with the majority (69.9%, n = 95) being female. 66.2% (n = 90) were known to be hypertensive. The mean Body Mass Index was 28.02 (95% CI 27.1, 28.9) with 66.2% (n = 90) being obese/overweight. Waist-Hip ratio revealed that 64% (n = 87) were at a high risk (> 1 for men, > 0.85 for women) of cardiometabolic complications. In addition, 63.2% (n = 86) had poor glycemic control as indicated by elevated (> 7%) levels of glycated hemoglobin (mean 8.3%, (95% CI 7.8,8.8).ConclusionCardiometabolic risks were prevalent among the participants with majority having hypertension with uncontrolled blood pressure, were obese/overweight, had a high Waist-Hip ratio and elevated glycated hemoglobin levels. This underscores the need to focus on these risks during follow-up and when designing interventions for patients with type 2 diabetes.

All-cause, cancer and cardiovascular mortality among South Asians living in the UK: Follow-up of the London Life Sciences Population (LOLIPOP) cohort

Abstract Background Although South Asians are the largest ethnic minority group in the UK, and the largest ethnic group worldwide, few studies have investigated patterns of mortality in South Asians. Methods We investigated 16,391 South Asian and 6,970 European men and women living in the UK, and participating in the London Life Sciences Prospective Population study. Participants were recruited in 2002-2008, and survival determined to 2019. We examined relationships of clinical, anthropometric, and lifestyle risk factors to mortality outcomes. Findings: Compared to Europeans, South Asians had higher prevalence of diabetes, cardiovascular disease, and hypertension, higher waist-hip ratio, fasting glucose, insulin and triglycerides, but lower smoking rates and HDL cholesterol (all P<0.001). Age and sex adjusted all-cause mortality was lower (Hazard Ratio (HR): 0.75 [0.68-0.81], P<0.001), all-cancer mortality was lower (HR 0.50 [0.43-0.58], P<0.001), and coronary heart disease (CHD) mortality was higher (HR 1.29 [1.05-1.60], P<0.01) in South Asians compared to Europeans. Mortality rates were ~50% lower for 9 of the 10 most common cancers in South Asians. After adjusting for risk factors, ethnic differences were attenuated only for CHD mortality. Interpretation: All-cause and cancer mortality are lower, but CHD mortality is higher, in South Asians compared to Europeans. Measured risk factors do not explain lower all-cause and all-cancer mortality, but do account for higher CHD mortality. Our findings provide evidence for population-specific exposures protective against cancers in South Asians, as well as the motivation to further improve cardiovascular risk reduction in this major ethnic group.

Obesity and lack of breastfeeding: a perfect storm to augment risk of breast cancer?

Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer with higher rates of recurrence and distant metastasis, as well as decreased 5-year survival rates. Racial disparities are evident in the incidence and mortality rates of triple negative breast cancer particularly increased in young African American women. Concurrently, young African American women have multiple risk factors for TNBC including higher rates of premenopausal abdominal obesity (higher waist-hip ratio) and lower rates of breastfeeding with higher parity, implicating these factors as potentially contributors to poor outcomes. By understanding the mechanisms of how premenopausal obesity and lack of breastfeeding may be associated with increased risk of triple negative breast cancer, we can determine the best strategies for intervention and awareness to improve outcomes in TNBC.

Association of a composite trait for anthropometrics, adiposity and energy expenditure with cardiometabolic diseases: An age-stratified cohort and genetic risk score analysis.

Various anthropometric measures capture distinct as well as overlapping characteristics of an individual's body composition. To characterize independent body composition measures, we aimed to reduce easily-obtainable individual measures reflecting adiposity, anthropometrics and energy expenditure into fewer independent constructs, and to assess their potential sex- and age-specific relation with cardiometabolic diseases. Analyses were performed within European ancestry participants from UK Biobank (N = 418,963, mean age 58.0 years, 56% women). Principal components (PC) analyses were used for the dimension reduction of 11 measures of adiposity, anthropometrics and energy expenditure. PCs were studied in relation to incident type 2 diabetes mellitus (T2D) and coronary artery disease (CAD). Multivariable-adjusted Cox regression analyses, adjusted for confounding factors, were performed in all and stratified by age. Genome-wide association studies were performed in half of the cohort (N = 156,295) to identify genetic variants as instrumental variables. Genetic risk score analyses were performed in the other half of the cohort stratified by age of disease onset (N = 156,295). We identified two PCs, of which PC1 reflected lower overall adiposity (negatively correlated with all adiposity aspects) and PC2 reflected more central adiposity (mainly correlated with higher waist-hip ratio, but with lower total body fat) and increased height, collectively capturing 87.8% of the total variance. Similar to that observed in the multivariable-adjusted regression analyses, we found associations between the PC1 genetic risk score and lower risks of CAD and T2D [CAD cases <50 years, odds ratio: 0.91 (95% confidence interval 0.87, 0.94) per SD; T2D cases <50 years, odds ratio: 0.76 (0.72, 0.81)], which attenuated with higher age (p-values 8.13E-4 and 2.41E-6, respectively). No associations were found for PC2. The consistently observed weaker associations of the composite traits with cardiometabolic disease suggests the need for age-specific cardiometabolic disease prevention strategies.

Predictors Of Handgrip Strength And Its Relationship To Physical Performance In Older Irish Adults

Abstract Background Handgrip strength declines with age and predicts poor physical performance and increased risk of falls and mortality. However, the strength of the relationship between handgrip strength and other physical measures is less well studied. We aimed to explore the predictors of handgrip strength in older Irish adults and its relationship to the Timed and Up and Go (TUG). Methods Study participants were from a longitudinal cohort of Irish adults aged &amp;gt;60 years; Trinity Ulster University Department of Agriculture (TUDA) study. Participants on current or long-term steroids, a history of stroke and with MMSE &amp;lt;24 were excluded. Handgrip strength was assessed with a dynamometer and defined as &amp;lt;27 kg for males and &amp;lt;16 kg for females. Abnormal performance in the TUG was defined as &amp;gt;12 seconds. Predictors of impaired handgrip were explored in multivariate logistic regression. Results There were 748 participants (68.9% female, mean age 70.2 years), of whom 33.4% had abnormal handgrip strength, which was more common in female’s vs males (39.4 vs 20.2%, p&amp;lt;0.001). Both abnormal handgrip strength and TUG was present in 13.6%. Normal handgrip strength had a negative predictive value of 76.0% for ruling out poor TUG, while abnormal handgrip had a positive predictive value of 62% for poor TUG. Predictors of impaired handgrip strength were older age (P&amp;lt;0.0001), female sex (p&amp;lt;0.0001), lower protein intake (P=0.024) and higher waist hip ratio (p=0.014). Conclusion Handgrip strength had a modest correlation with TUG A significant proportion had abnormal TUG but normal handgrip. Changes in lower limb muscle strength (affecting TUG) precede muscle loss in the upper limb. Higher protein intake predicted greater grip strength and supports the recommendation to maintain adequate intakes to prevent sarcopenia. Greater waist hip ratio is associated with reduced lean muscle mass which may explain the negative relationship we identified with handgrip strength.

Occupational Stress and Its Effect on Health Status Among Karnataka State Road Transport Corporation (KSRTC) Bus Drivers: A Cross-Sectional Study.

Occupational stress is a critical health concern across various professions, often linked to adverse health outcomes and increased risk-taking behaviors. Bus drivers are especially vulnerable due to prolonged shifts, exposure to environmental pollutants, and higher rates of sickness absenteeism. This study aimed to assess the prevalence of occupational stress among Karnataka State Road Transport Corporation (KSRTC) bus drivers and the factors contributed. In addition, it explores the relationship between job-related stress and overall health status, providing insights into the occupational challenges faced by this workforce. A cross-sectional study was conducted over two years from June 1, 2022, to June 30, 2024, at the KSRTC depot in Kolar, serving urban and rural areas. A representative sample of 235 bus drivers was selected from a total of 654 using simple random sampling. Socio-demographic details, including age, gender, education, religion, family type, and per capita income, were collected using a pre-tested semi-structured self-administered questionnaire. Stress levels were assessed using the American Institute of Stress (AIS) questionnaire, a widely used tool for evaluating various stress dimensions. Data were collected through interviews, entered into Excel, and subsequently analyzed using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). The study revealed that 65% of KSRTC bus drivers experienced moderate to severe stress. Significant factors associated with occupational stress included urban residency, divorce, chronic alcohol consumption, current tobacco chewing, hypertension, higher BMI, long working hours, and high waist-hip ratio. Binary logistic regression showed urban residents had higher stress odds than rural residents (OR=1.27, p=0.03). Divorced individuals and chronic alcoholics also had higher odds of stress (OR=1.24, p=0.05 and OR=1.33, p=0.04, respectively). Stress was significantly associated with hypertension (OR=1.40, p=0.01), obesity (OR=1.30, p=0.03), morbid obesity (OR=1.47, p=0.01), high-risk waist-hip ratios (OR=1.42, p=0.01), and longer working hours (>12 hours, OR=1.30, p=0.03). Health assessments revealed a high prevalence of hypertension (39%) and obesity (65%). The study highlights a high prevalence of occupational stress among KSRTC bus drivers in Kolar, with 65% experiencing moderate to severe stress. Factors such as urban residency, lifestyle habits, and physiological parameters significantly contribute to stress. These findings underscore the need for targeted health promotion programs and policy changes to enhance the health of essential workers and improve road safety.

SARS-COV-2 breakthrough infection and its covariates among healthcare providers of a hospital in Bangladesh during the omicron wave

IntroductionBreakthrough infection by SARS-COV-2 virus among vaccinated individuals has been reported from all over the world and it has created a substantial challenge in designing strategies to live with the virus in the post-pandemic era. Factors affecting the extent and nature of breakthrough infection are still not fully understood and those are known to vary depending on host and agent factors. Health Care Workers (HCWs), especially in hospital settings, are front-liners in combating the epidemic and, consequently, they are more vulnerable to breakthrough infection by SARS-COV-2. Like most of the countries of the world, Bangladesh went through several waves of COVID-19 and the last (3rd wave) was the widespread Omicron wave during the winter of 2022. HCWs in Bangladesh have been disproportionately affected by the virus. Under this context, the aim of the present study was to explore breakthrough infection (BTI) and its host-related covariates among HCWs of a COVID-dedicated city-based hospital during the Omicron wave in Bangladesh. Materials and methodsAn observational cross-sectional study was conducted on 267 HCWs of the Narayanganj Tertiary (300-bed) hospital during February–March 2022 which coincided with the terminal part of the 3rd wave. Data were collected by trained Field Assistants using Interviewer-administered Data Collection Forms with Questionnaires as instruments. Previous COVID-19 status (any time after the onset of the pandemic and within last 3 months) was explored by the history of specific symptoms as well as by the confirmatory rtPCR test reports from DGHS approved laboratories Anti-nucleocapsid antibody (Anti-N-Ab) in venous blood samples, assayed by a chemiluminescent ELISA technique, was used as a seroprevalence-based marker of breakthrough infection during the preceding few months. Data were analyzed by bivariate as well as multivariate statistics using the IBM-SPSS software. ResultsThe median age (range) of the HCWs was 38 (21–65) years; Body Mass Index (BMI, kg/m2) 25 (15–49); and Waist-Hip Ratio (WHR) was 0.92 (0.46–1.21). The male subjects had significantly higher median age (p = 0.01) and higher WHR (p = 0.001) as compared to the female subjects. As per the BMI category, subjects with overweight and obesity constituted 83.3 % of the male subjects as compared to 61.6 % of the female subjects (p = 0.001). The time lapse between receiving of 3rd dose and blood sampling was significantly higher among females compared to males (median days 60 vs 49, p < 0.02) indicating earlier vaccination with 1st booster dose among females. A proportion of 51.85 % male and 49.68 % female subjects showed Anti-N-Ab positivity; there was no significant difference between the gender groups. Also, there was no significant difference among male and female subjects regarding the Ab levels. On Spearman correlation analysis, a tendency of association of WHR with Ab level was observed among the male subjects; however, the association did not show statistical significance (p = 0.09). On binary logistic regression Ab positivity was found to be independently associated with WHR (p = 0.03), and prior SARS-COV-2 infection within the last 3 months (p = 0.02) among males. When all the subjects were considered together, COVID symptom positivity during the last 3 months (p = 0.067) and receiving the 1st booster dose (p = 0.07) showed a tendency of association with Ab positivity. On multiple regression analysis, Ab levels showed a negative association with WHR (p = 0.035) among males. ConclusionsMore than 50 % of the vaccinated hospital-based HCWs in Bangladesh suffered from BTI during the winter of 2022 when the Omicron wave (the 3rd wave) of COVID-19 was at its peak. The data also indicate that overweight and obesity are major host-related risk factors underlying BTI. Inadequate coverage by a booster dose seems to be another determinant of BTI and the level of immune response in this population.

Obesity and brain volumes: mediation by cardiometabolic and inflammatory measures

BackgroundThis study aimed to investigate the relationship between overall obesity, central obesity and brain volumes, as well as to determine the extent to which cardiometabolic and inflammatory measures act as...

Obesity and its association with self-efficacy and metabolic risk factors by region of birth among 40-year-olds participating in the Swedish targeted health dialogues

ObjectiveTargeted Health Dialogues (THD) is a public health intervention program that aims at preventing cardiovascular disease. THDs were implemented in the Swedish region Scania, in 2020, with the novelty of being conducted in a metropolitan area with a multiethnic population.This study investigated the prevalence of obesity among 40-year-old THD participants in Scania by region of birth, and its associations with self-efficacy and additional metabolic risk factors. MethodsCross-sectional data were retrieved from measurements in the THDs. Study participants included 1831 40-year-olds. Differences in characteristics by region of birth were assessed using chi-squared and ANOVA tests. The associations between overweight, obesity, and high waist-hip ratio (WHR) and self-efficacy and metabolic risk factors (blood pressure, LDL cholesterol, plasma glucose) were assessed using binominal and ordinal logistic regression, adjusted for sex and education and tested for interactions by region of birth. Results35.1 % of the participants were overweight (BMI 25–29.9), and 18.7 % were obese (BMI ≥30) with the highest levels among participants born outside Sweden (p = 0.005). Abdominal obesity was also more prevalent among participants born outside Sweden (p = 0.002). Obesity was associated with increased odds of having low self-efficacy (OR per BMI-level: 1.48 (CI 1.24–1.76) and additional metabolic risk factors. No interactions with region of birth were detected. ConclusionsThe prevalence of obesity differed between region of birth and obesity was associated with having low self-efficacy. These findings underline the need to customise lifestyle interventions in a multiethnic population to increase health equity.

Health determinants among participants in targeted health dialogues offered to all 40-year-old individuals in a metropolitan region of 1.4 million people

Objective To examine cardiovascular risk factors in 40-year-old participants in the health screening program targeted health dialogues (THDs). Design Cross-sectional study. Setting 99 Swedish healthcare centers. Intervention Metabolic risk factors and health behaviors were assessed. THDs were provided. Subjects 1831 (62.3%) THD participants that consented to take part in the research project. Main outcome measures (1) Prevalence of metabolic risk factors (blood pressure, LDL cholesterol, fasting plasma glucose, BMI, waist-hip ratio) and unhealthy behaviors (tobacco, alcohol, diet, physical activity) by sex, education, and place of birth. (2) Associations between different health behaviors and between the number of unhealthy behaviors and prevalence of metabolic risk factors. (3) THD participation by sociodemographics compared to age-matched controls. Results Men had a higher prevalence of all metabolic risk factors, excessive alcohol use and tobacco use than women. Lower educated individuals had a higher prevalence of metabolic risk factors (except for LDL cholesterol) and tobacco use than highly educated. Participants born outside Sweden had a higher prevalence of obesity, high waist-hip ratio, and tobacco use. Participants with 3–4 unhealthy behaviors had significantly higher prevalence of each of the metabolic risk factors except BMI. Women, highly educated and Swedish-born participants were slightly over-represented in the THDs. Conclusion Considering the associations between unhealthy behaviors and metabolic risk factors, the THD method, covering lifestyle as well as objective health measures, may be an appropriate method for early identification of individuals at risk for future non-communicable diseases in the whole population with a specific focus on certain groups. ClinicalTrials.gov NCT04912739

Hypertension care cascade and their determinants among older adolescents in India: evidence from a nationally representative cross-sectional survey.

Adolescent hypertension in India is an emergent public health concern with lack of programmatic focus on regular screening amongst both individuals and healthcare providers. This study was conducted to assess the hypertension care cascade (prevalence, awareness, treatment and control status of hypertension) from nationally representative data. We used data from the demographic and health surveillance (DHS) comprising India's National Family Health Survey Fifth Round (2019-2021). The prevalence of hypertension among 204,054 older adolescents (15-19 years) was 5.08% (95% CI: 4.94-5.23%) wherein 42.26% (95% CI: 40.69-43.64%) were aware of their condition, 43.70% (95% CI: 41.73-45.70%) of those aware were receiving treatment, and 85.88% (95% CI: 83.83-87.71%) of those on treatment achieved blood pressure control. Overall, there were nearly 60% newly diagnosed hypertension cases detected on screening. Females had significantly lower odds, while those with diabetes and higher waist-hip ratio had significantly higher odds of having hypertension. The awareness of their hypertensive status was higher among females and rural residents, while it was lower among adolescents that were obese and tobacco smokers. Improved blood pressure control was associated with a lower waist-to-hip ratio. In conclusion, nearly five in every hundred older adolescents in India are clinically hypertensive with significantly higher odds linked with obesity and male gender. Awareness and utilization of antihypertensive treatment was lower than the classical rule of halves signifying deficiencies in hypertension screening and management strategies for older adolescents within the existing public health policy framework.

High Obesity Indices Are Associated with Gastroesophageal Reflux Disease, but Low Obesity Indices Are Associated with Peptic Ulcer Disease in a Large Taiwanese Population Study

Introduction: Gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB). Methods: A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD. Results: The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p = 0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001), and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001) and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the values of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not. Conclusion: This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.

Analyzing the Moderating Effect of Physical Fitness on the Relationship between Abdominal Obesity and Metabolic Syndrome in Older Women

PURPOSE This study aimed to analyze the moderating effect of physical fitness on the relationship between abdominal obesity and metabolic syndrome (MetS) in older women.METHODS A total of 190 participants were categorized based on waisthip ratio (WHR) into high (50%) and low (50%) groups, as well as based on Z-score of fitness into high (25%; high fit), moderate (50%; moderate fit), and low (25%; low fit) groups. Logistic regression was used to assess the relative risk of MetS based on abdominal obesity and fitness levels, and moderation analysis using the Process macro was conducted to explore the moderating effect of fitness on the relationship between abdominal obesity and MetS risk factors.RESULTS After adjusting forcovariates, logistic regression showed that high WHR (odds ratio (OR)=2.721, &lt;i&gt;p&lt;/i&gt;=0.004) led to a significantly higher risk of MetS compared with low WHR; the high fit group (OR=0.360, &lt;i&gt;p&lt;/i&gt;=0.044) had a significantly lower risk of MetS compared wih the low fit group. Moderation analysis revealed that the impact of abdominal obesity on MetS risk factors varied depending on the level of fitness (&lt;i&gt;β&lt;/i&gt;=-0.495, &lt;i&gt;p&lt;/i&gt;=0.037), and the results remained significant after covariate adjustment (&lt;i&gt;β&lt;/i&gt;=-0.458, &lt;i&gt;p&lt;/i&gt;=0.049).CONCLUSIONS This study suggests that the risk of MetS from abdominal obesity can be mitigated by higher levels of physical fitness. These findings highlight the need for participation in regular physical activity to maintain a high level of fitness, along with proper nutritional intake, to prevent MetS in older women.

Region, Location, and Age-Specific Comparison of Nutritional Status of In-School Adolescent Girls (10-19 years) in Nigeria

Objective: This study was conducted to assess the nutritional status of adolescent girls using anthropometric indices. Methods: Descriptive cross-sectional study of 2261 in-school adolescent girls aged 10 -19 was conducted. A multistage stratified random sampling procedure was used to select participants from three geopolitical zones in Nigeria. Two states selected from each zone; North Central (Kogi and Niger States), South East (Abia and Imo States) and South West (Osun and Ondo States). Body Mass Index-for-age, Waist-Hip-Ratio (WHR), and Waist-Height-Ratio were calculated by anthropometry of weight, height, hip, waist and Mid-Upper Arm Circumferences. Data were analysed on SPSS Version 24. Frequency, percentages, mean and standard deviations were used for descriptive while logistic regression and chi-square analyses were used for inferential statistics. Significance was taken at p&lt;0.05. Results: Mean age was 14.86 years (± 1.78 years) and actual body weight was 47.81 kg (± 9.02 kg), which is lower than the ideal weight of 54.52 kg (± 9.05 kg). The negative variance of -6.71 kg shows that the girls weighed 6.71 (±9.73) kg less than their ideal weight. Overweight/Obesity/Risk of Abdominal Obesity was highest in South East region (p = .005) while underweight/undernourishment was highest in South West (p = .005). However, no significant difference was recorded between the urban and peri-urban populations (p = .005). Older girls; 14 -16yrs (OR = 2.311, 95%CI = 1.263 – 4.229) and 17 -19yrs (OR = 2.182, 95%CI = 1.253 – 3.799) were twice more likely to be Overweight/Obesity compared to 10 -13yrs. Those who were within the 14 -16yrs age range were thrice more likely to have higher WHR (OR = 3.043 95%CI = 2.334 -3.978) than those younger. Conclusion: There was a significant difference in the nutritional status of adolescent girls across regions and age ranges hence a need for regional nutrition-sensitive intervention programmes among adolescent girls. Keywords: High School Girls; Health Status; Body Stature; Body Measurement; Nigeria Region

Association between lifestyle, metabolic syndrome and risk of Diabetes Mellitus in workers

Background: The multivariate assessment of lifestyle can contribute to the identification of factors that are associated with diabetes mellitus (DM) and metabolic syndrome (MS). Objective: To evaluate the multivariate association of lifestyle, body composition, physiological measurements and sociodemographic information with DM and MS. Methodology: We conducted a descriptive study with a cross-sectional design, assessing 155 workers, with a mean age of 35.23 ± 10.22 years. We analyzed sex, body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio, body fat percentage (BF%), blood pressure, level of physical activity, risk of DM, readiness for physical activity (PAR-Q) and presence of SM. Result: The Multiple Correspondence Analysis showed that very high BF%, obesity (BMI), sedentary lifestyle, hypertension, and moderate risk of DM were correlated. However, regression analysis showed that workers with high WHR and obesity were, respectively, 9.22 (95% CI: 2.72-31.21) and 61.71 (95% CI: 6.68-569.9.21) more likely to have MS. According to PAR-Q, those who answered 'Yes' in the questionnaire were 12.52 (95% CI: 1.516-103.44) more likely to have a high risk of DM. Conclusion: There was a correspondence between the level of physical activity and risk factors for MS in the exploratory multivariate analysis.

Traumatic Brain Injury and Posttraumatic Stress Disorder Are Associated with Physical Health Burden among Post-9/11 Women Veterans.

Background: Little research focuses on physical health outcomes of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) among post-9/11 women veterans (WVs). This study examined lifetime TBI, current PTSD, and their associations with biomarkers of cardiometabolic health, sleep, pain, and functional disability among post-9/11 WVs. Methods: WVs (n = 90) from the Translational Research Center for TBI and Stress Disorders longitudinal cohort study were included in this study. Gold standard clinician administered interviews assessed lifetime TBI (Boston Assessment of TBI-Lifetime) and current PTSD symptoms (Clinician-Administered PTSD Scale-IV). Objective measures of health included waist-hip ratio (WHR) and fasted blood biomarker (high density lipoprotein [HDL], low density lipoprotein [LDL], blood glucose, triglycerides) levels. Self-reported surveys assessed sleep, pain, and functional disability. Results: Just under two-thirds (58.9%) of WVs experienced a lifetime TBI, and just over half (53.3%) of this sample had a current PTSD diagnosis at the time of testing. Lifetime TBI was significantly associated with higher WHR, triglycerides levels, and worse pain and sleep (ps = <0.01 to 0.02; ds = 0.01 to 1.12). Current PTSD was significantly associated with higher WHR, lower HDL, and worse pain and sleep (ps = <0.01 to 0.02; ds = 0.009 to 1.19). PTSD was significantly associated with lower total functioning and each of its subdomains (βs = -0.58 to 0.63; ps = <0.001 to 0.02). Lifetime TBI was significantly associated with total functioning, mobility, and life/work (βs = -0.20 to 0.30; ps = <0.01 to 0.02). Conclusions: These findings highlight the importance of screening for lifetime TBI and cardiovascular disease for WVs and support transdiagnostic treatment approaches targeting physical health outcomes.

High Body Fat as a Predictor of Osteoporosis Risk in Postmenopausal Women: Insights From a Community-Based Cross-Sectional Study in Rural South India.

Osteoporosis poses a significant health burden, particularly among postmenopausal women. While obesity in the form of BMI has been implicated in various health conditions, the relationship between waist-hip ratio (WHR) and osteoporosis remains debated. This study aims to estimate the prevalence of osteoporosis risk and explore the association between WHR and osteoporosis risk among postmenopausal women in rural South India. A community-based cross-sectional study was conducted in the Chengalpattu district of Tamil Nadu. The study enrolled 435 postmenopausal women aged 45 years and above and the data were collected on socio-demographic characteristics, anthropometric measurements, and osteoporosis risk assessment using the Osteoporosis Self-assessment Tool for Asian Women (OSTA) scale. Logistic regression analysis was performed to identify factors associated with osteoporosis risk with 95%CI. The mean (SD) age of participants was 54.5 (8.6) years, 87% were married, 33% were illiterate with mean (SD) WHR of 0.88 (0.1). Around 80.5% of the participants were categorized as low risk, 16.1% as intermediate risk, and 3.5% as high risk based on OSTA scores. Older age, lower educational attainment, and higher waist-hip ratio were significantly associated with increased osteoporosis risk. This community-based study found a 20% osteoporosis risk among postmenopausal women using the OSTA scale, with age, lower education, and waist-hip ratio as key determinants. Early identification and interventions, particularly targeting older and obese individuals, are crucial to alleviate the burden and complications of osteoporosis.

Abstract P427: Vitamin D Deficiency and Cardiovascular Disease (CVD) Risk Factors in American Indian Adolescents: The Strong Heart Family Study

Introduction: Vitamin D deficiency (VDD) may be associated with CVD risk factors, such as obesity, diabetes, and dyslipidemia and is amenable to successful interventions through changes in diet and vitamin supplementation. Aims: To describe the prevalence of VDD among American Indian adolescents from SHFS and determine its association with obesity, diabetes, and dyslipidemia incidence in follow-up exams. Methods: We included adolescents (&lt;20 years) from the SHFS, who had serum vitamin D measured on stored samples collected at the baseline examination, 2001-2003 (n=307). We defined VDD as ≤20ng/mL and obesity as baseline Body Mass Index (BMI) ≥95%, follow-up BMI ≥30kg/m 2 , waist-hip-ratio (WHR) ≥0.9 for males, or WHR ≥0.85 for females. Diabetes was defined as measured fasting plasma glucose level ≥126 mg/dL or taking hypoglycemic medication. We defined dyslipidemia as abnormal total cholesterol, LDL-C, HDL-C, non-HDL-C, triglycerides, or taking medication. We used log binomial generalized estimating equations to determine if the prevalence or incidence of obesity, diabetes, or dyslipidemia differed according to VDD, while controlling for age, gender, and center (Arizona, Oklahoma, or Dakotas). Results: VDD prevalence was 50.8% in AI adolescents, and it was associated with the prevalence of BMI≥95%, high WHR, and dyslipidemia. By the first follow-up, 28.8% developed a BMI≥30kg/m 2 , 58.8% developed high WHR, 6.2% developed diabetes, and 62.6% developed dyslipidemia. By the second follow-up, 11.4% developed diabetes. The risk of high WHR (RR=1.28, CI=1.04-1.58, follow-up=5.8 years), and the risk of diabetes (RR=2.32, CI=1.05-5.12, follow-up=13.3 years) was higher in those with baseline VDD while controlling for covariates (Table 1). Conclusions: These data suggest that VDD in adolescence may contribute to the development of high WHR and diabetes later in life, which are strongly associated with CVD. Thus, the results of this analysis may provide a critical step toward reducing or controlling CVD at an early age.

Clinical and Serological Associations of Subclinical Atherosclerosis in Spondyloarthropathy

Background: Patients with spondyloarthropathy (SpA) have a higher risk of subclinical atherosclerosis (SCA). We assessed clinical and serological determinants of SCA in Indian SpA patients. Methods: Patients with SpA (fulfilling ASAS 2010 criteria; n = 104) attending our hospital were recruited; mean carotid intima-media thickness (CIMT) was performed by carotid ultrasonography, along with clinical assessment and traditional risk factor evaluation. Microparticles were extracted from plasma and total, as well as endothelial microparticles (EMP), platelet microparticles, T lymphocyte microparticles and B lymphocyte microparticles, were analysed by flow cytometry. Serum samples were analysed for inflammatory cytokines previously implicated in atherosclerosis, namely interleukin 1β (IL-1β), IL-6, IL-17, IL-27, IL-33 and tumour necrosis factor-alpha. Thirty-eight healthy controls were used for comparison. Subgroup analyses compared parameters between SpA with SCA (i.e., with carotid plaque or more than 75th percentile of CIMT for that age and sex in the Indian population) versus those without SCA. Ethical approval and written, informed consent were obtained. Results: Despite significantly younger age, lower body mass index and higher total cholesterol in controls compared to SpA, those with SpA had higher CIMT. Traditional cardiovascular risk factors (older age, higher waist-hip ratio) and novel markers of inflammation (serum IL-1β, IL-6) were associated with SCA. While total microparticles, EMP, T lymphocyte and B lymphocyte microparticles were increased in SpA than in healthy controls, they were not associated with SCA. Conclusions: Traditional risk factors and serum inflammatory cytokines IL-1β and IL-6 are associated with higher SCA in Indian SpA patients.

Construction and validation of a nomogram to predict left ventricular hypertrophy in low-risk patients with hypertension.

Electrocardiography (ECG) is an accessible diagnostic tool for screening patients with hypertensive left ventricular hypertrophy (LVH). However, its diagnostic sensitivity is low, with a high probability of false-negatives. Thus, this study aimed to establish a clinically useful nomogram to supplement the assessment of LVH in patients with hypertension and without ECG-LVH based on Cornell product criteria (low-risk hypertensive population). A cross-sectional dataset was used for model construction and divided into development (n=2906) and verification (n=1447) datasets. A multivariable logistic regression risk model and nomogram were developed after screening for risk factors. Of the 4353 low-risk hypertensive patients, 673 (15.4%) had LVH diagnosed by echocardiography (Echo-LVH). Eleven risk factors were identified: hypertension awareness, duration of hypertension, age, sex, high waist-hip ratio, education level, tea consumption, hypochloremia, and other ECG-LVH diagnostic criteria (including Sokolow-Lyon, Sokolow-Lyon products, and Peguero-Lo Presti). For the development and validation datasets, the areas under the curve were 0.724 (sensitivity=0.606) and 0.700 (sensitivity=0.663), respectively. After including blood pressure, the areas under the curve were 0.735 (sensitivity=0.734) and 0.716 (sensitivity=0.718), respectively. This novel nomogram had a good predictive ability and may be used to assess the Echo-LVH risk in patients with hypertension and without ECG-LVH based on Cornell product criteria.