Higher Waist-hip Ratio Research Articles

A study of waist circumference and waist-hip ratio as markers of type 2 diabetes mellitus in an urban population of district Bareilly

Background: Type 2 diabetes mellitus belongs to a group of diseases labelled as lifestyle diseases and is on the rise in Asians especially Indians. Hence finding bio-markers is important to warn people and create awareness. Aim of the present study is to estimate waist-hip ratio, waist circumference in type 2 diabetic patients with respect to gender. Methods: A cross-sectional, community based study was conducted from February 2014 to February 2015 among adults in the age group of 30 year and above residing in area covered under UHTC of Bareilly City. A simple random sampling technique was adopted to achieve the desired sample size. 640 is the sample size came out to be by applying 3.8 4𝑃𝑄/d2 formula. Subject’s waist circumference, waist-hip ratio was measured in study samples. House to house survey was done for collecting data. Data tabulated and subjected to statistical analysis. Results: Prevalence of DM and IFG was more in those who were having high waist circumference and the association was also found to be statistically significant. The association was also found statistically significant between male high waist hip ratio and Diabetes Mellitus but no association was seen between female’s high waist-hip ratio and Diabetes Mellitus.Conclusions: High waist circumference can be a screening procedure for DM individuals in both sexes, but the same scenario we haven’t seen in high waist hip ratio among females and prevalence of DM. Appropriate waist circumference and waist-to-hip ratio values are complex because they are likely influenced by gender and other factors.

Factors associated with change in self-reported physical activity in the very old: The Newcastle 85+ study.

BackgroundHigher physical activity (PA) has been linked to better health and functioning. Trajectories of PA and associated factors have been studied in older adults aged ≥65, but less is known about influences on PA change in the very old (aged ≥85).ObjectiveTo investigate factors associated with self-reported PA and PA change over time in very old adults.Methods845 participants in the Newcastle 85+ Study were followed for health and functioning at 1.5-, 3-, and 5-year follow-up (wave 2 to 4). PA scores (range 0–18) and PA levels (low (PA scores 0–1), medium (2–6) and high (7–18)) were determined using a purpose-designed PA questionnaire. We used linear mixed models (LMM) to investigate factors associated with 5-year change in PA scores.ResultsOverall, men had higher mean PA scores than women (up to 2.27 points). The highest proportion of participants (42–48%) had medium levels of PA across the waves. Although most experienced decline—stability in moderate and increases in high PA levels were also observed. The fully adjusted LMM revealed a curvilinear annual decline in PA scores of 0.52 (0.13) (β (SE), p<0.001), which decelerated by 0.07 (0.02) points (p<0.01) over time. The factors associated with low PA scores at baseline were female gender, higher waist-hip ratio, and no alcohol intake. Better self-rated and cognitive health and having fewer diseases were associated with higher PA scores. None were associated with the rate of change in PA over time.ConclusionWe observed a curvilinear trend and deceleration in PA scores decline in the very old. Men and those in better health and who drank alcohol were more physically active at baseline. None of the factors were associated with the rate of PA decline. Investigating those who maintain or increase levels of PA may inform interventions for at risk groups with PA decline.

Association of adiposity markers with Uncoupling Protein 1 3826 AG genotype

Statement of problemThe present study was conducted to determine the association of UCP1 (Uncoupling Protein 1) 3826 marker with body mass index and waist hip ratio among 193 healthy adults (89 males and 104 females) of Delhi who were voluntarily participated in the study. MethodsAnthropometric measurements were taken using standardized protocol. Blood samples were also collected from the study group for DNA analyses. ResultsA/G genotype was found to have highest waist hip ratio among females. Waist hip ratio was found to be a better predictor than body mass index among females as compared to males. ConclusionThis study highlights the contribution of UCP 1 genetic marker to adiposity markers among the heterogeneous population of North Delhi.

Metabolic Equivalent and its Associated Factors in a Rural Community of Karnataka, India.

BackgroundHealth benefits of physical activity measured in terms of metabolic equivalent minutes (MET-minutes per week) have been established. However, factors affecting physical activity, like age, gender, body mass index, waist-hip ratio, particularly in rural communities have not been documented on a large sample.MethodsBaseline physical activity data of more than 4000 subjects over 30 years of age, who were enrolled in a randomised community-based study on non-communicable diseases, were analysed. Global Physical Activity Questionnaire was used and anthropometric measurements were classified according to the MONICA study manual. Three domains of physical activity were measured as MET-minutes per week - activity at work, travel to and from places and recreational activities. Association of MET-minutes with sociodemographic variables and risk factors for cardiovascular diseases was studied.ResultsMean MET-minutes per week of females were found to be significantly lower than that of males and decreased with advancing age and higher BMI in both genders. Married persons, normal BMI, normal waist-hip ratio, lower leisure time activity had demonstrated higher MET values (P = 0.000). In our study, the prevalence of inactivity (<600 MET-minutes) was 3.2% which was similar in both males and females. As high as 96.2% of the subjects had MET-minutes of > 1200. Nearly 50% of the subjects had leisure time ranging from 121 to 240 minutes per day.ConclusionA large majority of adults over 30 years of age in a rural community in Karnataka (96.2%) had very high MET-minutes per week of >1200 per day. Abnormal BMI, higher waist-hip ratio and more leisure time were associated with lower MET-minutes which are modifiable. About 50% had more than 2 hours of leisure time per day. It is recommended that health promotion for active lifestyle should be encouraged.

Association of Random Blood Sugar with Body Mass Index in Habitants of Suburban Kathmandu District

Background: Diabetes mellitus is increasing in alarming number world­wide. The main predisposing factor being daily lifestyle which leads to obesity and other complications. Early diagnosis and life style modifica­tion among high risk group can decrease the burden of disease. This study was done to find out the random blood sugar level and assess the relationships between body mass index (BMI), waist hip ratio (WHR) and random blood sugar among the study population.&#x0D; Methods: A cross sectional study was done using retrospective data collected at the health camp conducted during month of October 2018. The study area was Nagarjun and Chandragiri municipalities of Kath­mandu district. The data was analyzed using SPSS version 21. The chi square test was used to assess relation between BMI,WHR and Random blood sugar.&#x0D; Results: The number of participants in this study was 274. Majority of the participants, (92.7%) had random blood sugar level 200mg/dl or less. Those having RBS of more than 200mg/dl were 7.3%. Among all participants, 16.06% were obese. Further the obese participants showed high waist hip ratio in 81.8% and 9.1% of them had moderate or low waist hip ratio. Further, 46 participants showed diabetic blood sugar level and were either overweight (39.13%) or obese (28.26%).&#x0D; Conclusions: This study concluded that those who had diabetic blood sugar level or high waist hip ratio had increases BMI. So such screening and preventive programme should be further expanded and even at clinical level. Additionally, patients must be counseled the reason for measuring BMI and RBS and its application for their health promotion.

Interaction between Shift Work and Established Coronary Risk Factors.

Background:Shift work is associated with increased risk of cardiovascular disease, but the causes have not yet been fully established. It has been proposed that the coronary risk factors are more hazardous for shift workers, resulting in a potential interaction effect with shift work. Objective: To analyse interaction effects of work schedule and established risk factors for coronary artery disease on the risk of myocardial infarction. Methods: This analysis was conducted in SHEEP/VHEEP, a case-control study conducted in two counties in Sweden, comprising all first-time cases of myocardial infarction among men and women 45–70 years of age with controls stratified by sex, age, and hospital catchment area, totalling to 4648 participants. Synergy index (SI) was used as the main outcome analysis method for interaction analysis. Results: There was an interaction effect between shift work and physical inactivity on the risk of myocardial infarction with SI of 2.05 (95% CI 1.07 to 3.92) for male shift workers. For female shift workers, interaction effects were found with high waist-hip ratio (SI 4.0, 95% CI 1.12 to 14.28) and elevated triglycerides (SI 5.69, 95% CI 1.67 to 19.38). Conclusion:Shift work and some established coronary risk factors have significant interactions.

Study of stress response to novel laboratory challenges in relation to body fat distribution in normal young adults and habituation to repeated stress challenges

Background: Perceived stress negatively affects cardiovascular functions and body fat distribution. Aims: The aim is to study whether participants with greater central fat have altered autonomic activity in response to novel laboratory stress challenges and whether they adapt less effectively to repeated stress challenges over time. Materials and Methods: Two hundred and forty-four healthy adults within the age group 20–45 years were divided into eight groups consisting of 30–31 participants in each group on the basis of sex, body mass index, and waist–hip ratio (WHR). Resting pulse rate and blood pressure were measured. All participants had to go through two stress sessions. Stress sessions were arranged according to trier social stress test. Pulse, systolic blood pressure and diastolic blood pressure (DBP), heart rate variability (root mean square of successive differences), and capillary blood glucose were measured on three consecutive occasions, -at rest, immediately after stress session 1 (day 1), and immediately after stress session 2 (day 2). Results: Among lean males and lean females, there was significant difference in blood glucose level between high WHR group and low WHR group after stress session 1 and after stress session 2. Among overweight participants, no significant difference in heart rate variability was observed between high WHR group and low WHR group after stress session 1 and after stress session 2. However, in lean participants, significant difference was observed between high WHR group and low WHR group after stress session 1 and after stress session 2. Significant difference in pulse rate and DBP was observed in lean participants between high- and low-WHR groups after stress session 1 and after stress session 2. Conclusions: Central fat among lean participants may be an indicator of the allostatic load which contributes to physical damage resulting from lack of adaptation to stress. Thus, lean participants with high WHR may be at higher risk of disease.

Gallstone disease and its correlates among patients attending teaching hospital of North India.

Background:Gallstone disease (GSD) represents a significant burden for healthcare systems worldwide and is one of the most common disorders among patients presenting to emergency rooms with abdominal discomfort.Aim and Objective:This study was aimed to find correlates (demographic, dietary, and behavioral) of GSD in patients attending teaching hospital in North India.Methodology:A case–control study was conducted from January 2013 to December 2013 among subjects attending outpatient department of general surgery in a teaching hospital. Data collection for both cases and controls was done on a self-designed pretested “interview schedule” which assessed the sociodemographic profile, personal history, medical history, comorbidities, physical examination including anthropometry, and dietary intakes. To measure the strength of association, odds ratio (OR) was calculated. Binary logistic regression was used for multivariate analysis.Results:A total of 120 cases and the same number of age- and sex-matched controls were included in final analysis. In binary logistic regression, maximum association was seen with physical inactivity [OR 3.93, confidence interval (CI): 1.98–7.78] followed by current consumption of smokeless tobacco (OR 3.65, CI: 1.65–8.09), current smoking (OR 2.69, CI: 1.13–6.37), nonvegetarian diet (OR 3.10, CI: 1.65–5.83), and fat intake (OR 2.14, CI: 1.14–4.02). Current alcohol consumption (OR 0.90, CI: 0.41–1.98), high waist–hip ratio (OR 1.54, CI: 0.67–3.56), and intake of fruits and green leafy vegetables (OR 1.86, CI: 0.61–5.61) were not significantly associated with GSD.Conclusion:Physical inactivity, smokeless tobacco, nonvegetarian diet, current smoking, high fat intake, and family history were found to be risk factors for the development of GSD.

Glycaemic control for people with type 2 diabetes in Saudi Arabia \u2013 an urgent need for a review of management plan

BackgroundThe aim of this study was to assess inadequate glycaemic control and its associated factors among people with type 2 diabetes in Saudi Arabia.MethodsA cross-sectional study design was used. Adults with type 2 diabetes attending diabetes centres in Riyadh, Hofuf and Jeddah cities were interviewed and their anthropometrics were measured. Their medical records were also reviewed to collect information related to recent lab tests, medications, and documented comorbidities. Multivariable logistic regression were used for data analysis.ResultsA total of 1111 participants were recruited in the study. Mean age was 57.6 (±11.1) years, 65.2% of the participants were females, and mean HbA1c was 8.5 ± 1.9%. About three-fourths of participants had inadequate glycaemic control (≥ 7%). Multivariable analysis showed that age ≤ 60 years, longer duration of diabetes, living in a remote location, low household income, low intake of fruits and vegetable, low level of physical activity, lack of knowledge about haemoglobin A1c, high waist-hip ratio, low adherence to medication, and using injectable medications were independent risk factors for inadequate glycaemic control.ConclusionsInadequate glycaemic control is prevalent among people with type 2 diabetes in Saudi Arabia. In order to improve glycaemic control diabetes management plan should aim at controlling the modifiable risk factors which include low intake of fruits and vegetable, low level of physical activity, lack of knowledge about haemoglobin A1c, high waist-hip ratio, and low adherence to medications.

Association of Anthropometric Measures with Prostate Cancer among African American Men in the NCI-Maryland Prostate Cancer Case-Control Study.

Background: Obesity is a cancer risk factor. Although it does not increase the risk of localized prostate cancer, it raises the risk of the aggressive disease in men of European ancestry. Few studies investigated obesity as a prostate cancer risk factor in men of African ancestry. Findings from those studies were heterogeneous, but some reported an association of excess body fatness with aggressive disease.Methods: We examined the relationship of body mass index (BMI), waist circumference, and waist-hip ratio with prostate cancer in African American (AA) and European American (EA) men in the NCI-Maryland Prostate Cancer Case-Control Study consisting of 798 men with incident prostate cancer (402 AA and 496 EA) and 1,008 population-based controls (474 AA and 534 EA). BMI was self-reported. Waist circumference and waist-hip ratio were calculated from measurements at enrollment.Results: A high BMI either at enrollment or years prior to it was associated with a decreased risk of prostate cancer in AA men. In contrast, an elevated BMI tended to increase the disease risk in EA men. Waist circumference was inversely associated with prostate cancer in both AA and EA men, whereas a high waist-hip ratio did not associate with prostate cancer in AA men but tended to be associated with advanced/aggressive disease in EA men.Conclusions: Our findings reveal an obesity paradox among AA men in this study population, where a high BMI and waist circumference associated with a decreased disease risk.Impact: Our observations expand the knowledge of how obesity may affect prostate cancer risks in AAs. Cancer Epidemiol Biomarkers Prev; 27(8); 936-44. ©2018 AACR.

Waist-hip ratio as a predictor of myocardial infarction risk: A systematic review and meta-analysis.

Background and aim:Several studies have identified that obesity and being overweight can increase the risk of developing myocardial infarction (MI). However, the predictive value of the central obesity index, that is, the waist-hip ratio (WHR), regarding MI risk remains unclear. This study aimed to provide a systematic review and meta-analysis of WHR as a predictor of MI incidence.Methods:This study used relevant keywords and MeSH terms to identify studies of MI risk and WHR from PubMed, Web of Science, Embase, and Cochrane databases in November 2017.Results:We conducted a meta-analysis of 12 case-control studies in 14 eligible trials and further explored whether the predictive value of WHR on MI risk varies according to sex. The results showed that a high WHR increased MI risk (pooled odds ratio [OR] 2.62, 95% confidence interval [CI] 2.02–3.39, P < 0.00001) and that elevated WHR is more strongly predictive of MI in women than in men (pooled OR 4.63, 95% CI 3.28–6.53 in women; pooled OR 2.71, 95% CI 2.15–3.41 in men).Conclusions:MI is significantly associated with increased WHR, with a stronger association among women.

Anthropometric features as predictors of atherogenic dyslipidemia and cardiovascular risk in a large population of school-aged children.

BackgroundAutopsy studies reveal that atherosclerosis lesions can be found as early as two years of age. To slow the development of this early pathology, obesity and dyslipidemia prevention should start from childhood making it urgent to explore new ways to evaluate dyslipidemia risk in children that can be applied widely, such as the non-invasive anthropometric evaluation.ObjectiveAssess the metabolic profile of a pediatric population at a specific age to describe the association between anthropometric and biochemical cardiovascular disease risk factors; and evaluate selected anthropometric variables as potential predictors for dyslipidemic cardiovascular risk.Design and methodsAnthropometric features, bioimpedance parameters and fasting clinical profile were assessed in Lisbon and the Tagus Valley region pre-pubertal nine-year-old children (n = 1.496) from 2009–2013 in a descriptive, cross-sectional study. Anthropometric variables predictive power was evaluated through regression analysis.ResultsAt least one abnormal lipid parameter was found in 65% of “normal weight”, 73% of “overweight” and 81% of “obese” children according to the International Obesity Task Force (IOTF) standards. Dyslipidemia was present in 67.8% of children. Waist-hip ratio (WHR) explained 0.4% of total cholesterol (TC) variance. Waist circumference (WC) explained 2.8% of apolipoprotein (APO) A1 variance. Waist-circumference-to-height-ratio (WHtR) explained 2.7%, 2.8% and 1.9% of low-density lipoprotein cholesterol (LDL-c), APO B, and N_HDL-c variance, respectively. Children with abnormally high WHR levels had an increase in risk of 4.49, 3.40 and 5.30 times, respectively, for developing cardiovascular disease risk factors measured as high-risk levels of TC, LDL-c and non-HDL-c (N_HDL-c) (p<0.05). Only 29.9% of “normal weight” children had no anthropometric, bioimpedance or biochemical parameters associated with CV risk.ConclusionA large proportion of school age children have at least one lipid profile abnormality. BMI, zBMI, calf circumference (CC), hip circumference (HC), WC, and WHR are directly associated with dyslipidemia, whereas HC and calf circumference (CC) adjusted to WC, and mid-upper arm circumference (MUAC), are all inversely associated with dyslipidemia. Selected anthropometric variables are likely to help predict increased odds of having CV risk factors.

Risk factors associated with liver steatosis and fibrosis in chronic hepatitis B patient with component of metabolic syndrome.

We investigated whether metabolic syndrome exacerbated the risk of liver fibrosis among chronic hepatitis B patients and risk factors associated with liver steatosis and fibrosis in chronic hepatitis B patients with components of metabolic syndrome. This study included 1236 chronic hepatitis B patients with at least one component of metabolic syndrome. The controlled attenuation parameter and liver stiffness, patient information and relevant laboratory data were recorded. Controlled attenuation parameter was increased progressively with the number of metabolic syndrome components (p < 0.001). Multivariate analysis indicated younger age, high gamma-glutamyltransferase level, high waist-hip ratio, and high body mass index were independent risk factors associated with nonalcoholic fatty liver disease among chronic hepatitis B patients with metabolic syndrome. In the fibrosis and non-fibrosis groups, most of blood lipid was relatively lower in fibrosis group. An increased proportion of chronic hepatitis B patients with liver fibrosis was found concomitant with an increasing number of components of metabolic syndrome. Male gender, older age, smoking, aspartate aminotransferase levels, high body mass index, and low platelet level were identified as independent risk factors associated with liver fibrosis. For chronic hepatitis B patients with coexisting components of metabolic syndrome, stratification by independent risk factors for nonalcoholic fatty liver disease and fibrosis can help with management of their disease.

General and Abdominal Obesity as Risk Factors for Late-Life Mobility Limitation After Total Knee or Hip Replacement for Osteoarthritis Among Women.

To investigate associations of body mass index (BMI), waist circumference (WC), and waist/hip ratio (WHR) with survival to age 85 years with mobility limitation or death before age 85 years among older women with total knee replacement (TKR) or total hip replacement (THR) for osteoarthritis (OA). This was a prospective study of women (ages 65-79 years at baseline) from the Women's Health Initiative, recruited during 1993-1998 and followed through 2012. Women's Health Initiative data were linked to Medicare claims data to determine TKR (n = 1,867) and THR (n = 944) for OA. Women were followed for up to 18 years after undergoing THR or TKR to determine mobility status at age 85 years. Compared with normal-weight women, overweight, obese I, and obese II women with THR had significantly increased risk of survival to age 85 years with mobility limitation (P < 0.001 for linear trend), with the strongest risk among obese II women (odds ratio [OR] 4.37 [95% confidence interval (95% CI) 1.96-9.74]). Obese II women with THR also had increased risk of death before age 85 years. Women with THR and WC >88 cm relative to ≤88 cm had increased risk of survival to age 85 years with mobility limitation (OR 1.65 [95% CI 1.17-2.33]) but not death before age 85 years. High BMI, WC, and WHR were associated with significantly increased risk of late-life mobility limitation and death among women with TKR for OA. Among older women who underwent THR or TKR for OA, baseline general and abdominal obesity were associated with increased risk of late-life mobility limitation.

Analyses of risk factors for polycystic ovary syndrome complicated with non-alcoholic fatty liver disease.

The risk factors related to polycystic ovary syndrome (PCOS) patients complicated with non-alcoholic fatty liver disease (NAFLD) were investigated. A total of 188 PCOS patients treated in Shengli Oilfield Central Hospital (Dongying, China) from February 2014 to February 2015 were retrospectively analyzed as PCOS group, and PCOS group was further divided into NAFLD group and non-NAFLD (N-NAFLD) group according to the liver B ultrasound. In the same time-period, 65 healthy people were selected as normal control group. The differences of clinical, biochemical and metabolic indexes were compared. The levels of luteinizing hormone (LH), LH/follicle stimulating hormone (FSH), testosterone (T), free androgen index (FAI), fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) index in PCOS group were higher than those in normal control group, but the sex hormone binding globulin (SHBG) level was lower than that in normal control group (P<0.05); there were no statistically significant differences in comparisons of age, body mass index (BMI), waist-hip ratio (WHR), FSH, dehydroepiandrosterone sulfate (DHEAs) and fasting blood glucose (FBG) between the two groups (P>0.05). The prevalence rate of NAFLD in PCOS group (44.68%) was significantly higher than that in control group (24.62%) (P<0.05). The proportion of NAFLD in PCOS patients in obesity group (63.51%) was significantly higher than that in non-obesity group (15.79%) (P<0.05). In PCOS group, NAFLD patients had more obvious metabolic abnormalities [high BMI, WHR, FBG, FINS, HOMA-IR index, total cholesterol (TC) and triglyceride (TG), and low high-density lipoprotein HDL and SHBG] and androgen excess compared with those in N-NAFLD patients (P<0.05). The levels of LH, LH/FSH, FINS and HOMA-IR index in PCOS group complicated with NAFLD were higher than those in control group complicated with NAFLD (P<0.05), but the differences in age, BMI, WHR, FSH and FBG levels were not statistically significant between the two groups (P>0.05). HOMA-IR index, BMI, WHR and TG were independent risk factors for PCOS complicated with NAFLD (P<0.05).

Comparison of waist-hip ratio, prehypertension, and hypertension in young male bus drivers and non-drivers of Bengaluru city

Background: Hypertension is a public health burden globally and is one of the major risk factors for cardiovascular morbidity and mortality. Elevated blood pressure (BP) in young adulthood leads to atherosclerosis in middle age. Bengaluru is a rapidly growing city with huge traffic congestion which leads to increased stress levels in professional bus drivers. The purpose of the study was to assess whether bus drivers had higher waist-hip ratio elevated BP as compared to non-drivers. Aims and Objectives: The aim of the study was to record the anthropometric parameters, measure waist-hip ratio, record systolic (SBP), and diastolic BP (DBP) in (1) Group A - 30 Bangalore Metropolitan Transport Corporation bus drivers and (2) Group B - 30 non-drivers (clerical staff) and to assess and compare the results between both the groups. Materials and Methods: Study included 60 subjects aged between 25 and 35 years chosen based on inclusion and exclusion criteria. Questionnaire including personal history and diet history was answered by all the subjects. Physical examination was done. Waist circumference and hip girth were measured and waist-to-hip ratio (WHR) calculated in both the groups. BP was recorded in sitting position both by palpatory and auscultatory methods in both groups. The results were tabulated and statistically analyzed. Results: WHR was significantly higher in the study group as compared to subjects in the control group (P = 0.01*). There was significant elevation of SBP (P = 0.001**) and DBP (P = 0.001**) in the study group. With respect to the years of job experience, study group had more SBP (P = 0.001**) and DBP (P = 0.043*) compared to controls. Conclusion: Higher waist-hip ratio and increased BP in drivers as compared to controls suggest that drivers are at high risk of developing coronary heart disease or stroke at an early age. Drivers have to be educated about lifestyle modifications to reduce stress and maintain BP within a normal range.

Echocardiographic Changes in Type 2 Diabetes Mellitus with Reference to Body Mass Index and Waist Hip Ratio

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycaemia. India alone had 65.1 million diabetics by the year 2013. DM with high BMI & increased central obesity (WHR) have changes in the cardiac geometry evidenced in echocardiography. AIM OF STUDY: Estimation of Body Mass Index (BMI) and Waist Hip Ratio (WHR) & Establish a relationship between obesity, particularly central obesity in type 2 diabetes mellitus patients and cardiac changes with the help of echocardiography. Methods: 30 Subjects with type 2 DM attending the OPD or admitted in Katihar Medical College indoor department & 30 control patients were also be taken from the same, all of age >40 years. The cases and the controls were examined thoroughly with respect to BMI (>30) & WHR (> 0.85 for females and > 0.95 for males) and echocardiography was done. Results: The cases i.e. type 2 diabetes with high WHR and BMI had highly significant alteration in LV geometry as compared to the controls & had significantly high mean LV mass 189.10grams as compared to 134.04 grams of the controls. There was significant early diastolic dysfunction found in the cases group while no significant difference was found in systolic dysfunction between cases & controls. The incidence of changes in left ventricular geometry was higher in female type 2 diabetic subjects with high waist hip ratio and BMI as compared to males. Conclusions: Form the data of the present study it can be concluded that type 2 diabetics with obesity, particularly central type, have an increased predisposition to the development of left ventricular structural or geometrical abnormality. They have significantly higher left ventricular Mass. Obese type 2 diabetics also have higher incidence of diastolic dysfunction. All these abnormalities occur with greater frequency in females. Thus, type 2 diabetics with high BMI and Waist hip ratio have higher risk of development of cardiovascular disease, which is higher for female than males.

Nephrolithiasis Among Middle Aged and Elderly Urban Chinese: A Report from Prospective Cohort Studies in Shanghai.

Kidney stone risk factors are understudied among Asians. Our study objective was to investigate associations of obesity and other chronic diseases with incident kidney stones among the urban Chinese. Included in this study are two prospective cohorts: the Shanghai Women's Health Study (N = 69,166) and Shanghai Men's Health Study (N = 58,054). Incident kidney stones were determined by self-report in 2004 and 2008. Cox regression models were used to evaluate the associations of study variables with stone risk with adjustment of demographics, medical history, and dietary intakes. There were 2653 incident stones over 1,007,958 person-years of follow-up. Overall incidence rates (per 1000 person-years, 95% confidence interval [CI]) were 2.10 (1.99, 2.21) among women and 3.80 (3.59, 4.02) among men. Higher body mass index (BMI) was associated with risk (BMI ≥25 vs 18.5-24.9 kg/m2, women: hazard ratio [HR] = 1.14 [95% CI 1.01, 1.28]; men: HR = 1.17 [1.03, 1.32]). High waist-hip ratio (≥0.80 and ≥0.90 for women and men, respectively) was associated with risk (HR 1.13, 95% CI 1.01, 1.27 for women; HR 1.19, 95% CI 1.05, 1.35 for men). Coronary heart disease or stroke history was associated with risk in women only (HR 1.31, 95% CI 1.10, 1.56). Hypertension history was associated with risk in men only (HR 1.27, 95% CI 1.11, 1.45). No significant association with diabetes mellitus was observed. Among the Chinese, kidney stone incidence in men is almost twice that of women. Obesity is a shared risk factor. Hypertension history is associated with risk in men, whereas history of coronary heart disease or stroke is associated with risk in women.

Faktor risiko osteoporosis pada wanita usia 40-80 tahun: status menopause dan obesitas

Background: Osteoporosis is a disease of the musculoskeletal system which are common in women. Menopausal status which affects the production of oestrogen and obesity status that describes mass and distribution of body fat have the potential to affect bone density, which in turn may have an impact on the incidence of osteoporosis.Objective: To analyze the menopausal and obesity status as risk factors for osteoporosis in women aged 40-80 years.Method: Cross-sectional study was conducted on 224 women aged 40-80 years in Ngemplak Simongan, Semarang. Status of obesity was determined by percent of body fat, body mass index (BMI), waist circumference, and waist-hip ratio (WHR). Menopausal status was determined based on the occurrence of menstruation in the past one year, and the age was calculated from the difference between date of birth and date of measurement. Bone density was assessed frombone mineral density measurement. Chi-square test and logistic regression were used to determine the relationship and the most influential factors. The risk was expressed in ratio prevalence (RP).Results: The prevalence of low bone density and obesity in each age range, were 43.8% and 57.9% for ages 40-50 years, 67.7% and 58.6% for ages 51-60 years, 84.9% and 49.1% for ages 61-70 year, 86.7% and 66.7% for ages 71-80 years. There were significant relationships between age, menopausal status, BMI, WHR and bone density (p=0.000, p=0.032, p=0.043, p=0.017, respectively). Osteoporosis (13.3%) and osteopenia (58.7%) were most widely experienced by subjects with high WHR and menopause. Percentage of osteopenia in high WHR and non-menopause subjects (60%) was higher than normal WHR and menopause subjects (52.9%). Age 61-80 years, high WHR, and non-obese BMI were the most influenced risk factorsfor the incidence of low bone density (p=0.001, p=0.038, p=0.043). Ratio prevalence of elderly, high WHR and non-obese BMI were 1.448, 1.326, 1.208.Conclusion: High WHR explains the role of android obesity and visceral fat as risk factors for low bone density. Premenopausal women will be more at risk of having low bone density if they have high WHR.

Social determinants of common metabolic risk factors (high blood pressure, high blood sugar, high body mass index and high waist-hip ratio) of major non-communicable diseases in South Asia region: a systematic review protocol

BackgroundPrevalence of non-communicable diseases has been increasing at a greater pace in developing countries and, in particular, the South Asia region. Various behavioral, social and environmental factors present in this region perpetuate common metabolic risk factors of non-communicable diseases. This study will identify social determinants of common metabolic risk factors of major non-communicable diseases in the context of the South Asian region and map their causal pathway.MethodsA systematic review of selected articles will be carried out following Cochrane guidelines. Review will be guided by Social Determinants of Health Framework developed by the World Health Organization to extract social determinants of metabolic risk factors of non-communicable diseases from studies. A distinct search strategy will be applied using key words to screen relevant studies from online databases. Primary and grey literature published from the year 2000 to 2016 and studies with discussion on proximal and distal determinants of non-communicable risk factors among adults of the South Asia region will be selected. They will be further checked for quality, and a matrix illustrating contents of selected articles will be developed. Thematic content analysis will be done to trace social determinants and their interaction with metabolic risk factors. Findings will be illustrated in causal loop diagrams with social determinants of risk factors along with their interaction (feedback mechanism).DiscussionThe review will describe the interplay of social determinants of common NCD metabolic risk factors in the form of causal loop diagram. Findings will be structured in two parts: the first part will explain the linkage between proximal determinants with the metabolic risk factors and the second part will describe the linkage among the risk factors, proximal determinants and distal determinants. Evidences across different regions will be discussed to compare and validate and/or contrast the findings. Possible bias and limitations of this study will also be discussed.Systematic review registrationPROSPERO CRD42017067212