Higher Waist Circumference Levels Research Articles

Novel anthropometric measures are positively associated with erectile dysfunction: a cross-sectional study.

Currently, a growing number of research studies have shown a positive association between obesity and erectile dysfunction, while traditional anthropometric measures, such as BMI, have limited ability to assess the risk of erectile dysfunction. Therefore, this study aimed to investigate the association between the new anthropometric index and erectile dysfunction. A study involving 3594 participants from the National Health and Nutrition Examination Survey was conducted. The study calculated various anthropometric indices such as waist circumference (WC), waist-to-height ratio (WtHR), body mass index (BMI), a body shape index (ABSI), conicity index (CI), and body roundness index (BRI). The relationship between anthropometric indices and erectile dysfunction (ED) was investigated using multivariate logistic regression and restricted cubic splines (RCS). Interaction analysis was conducted on subgroups to confirm the findings. Additionally, the efficacy of various anthropometric indicators in predicting the risk of erectile dysfunction was assessed using the receiver operating characteristic curve (ROC). After adjusting for potential confounding factors, we identified a positive and independent correlation between erectile dysfunction (ED) and all other anthropometric measures except for BMI. Additionally, the risk of ED increased by 49% and 42% for each standard deviation increment in ABSI and CI, respectively. Dose-response curve analysis demonstrated that WC, BMI, WtHR, and CI displayed a non-linear correlation with the risk of ED. The subgroup analysis revealed that individuals classified as White, who had higher levels of WC, ABSI, and CI, were more susceptible to erectile dysfunction compared to people from other races. ROC analysis showed that ABSI was superior in detecting erectile dysfunction (area under the curve: 0.750; 95% CI 0.732-0.768; optimal cutoff value: 0.083) as compared to other indices. The combination of obesity defined by BMI and other anthropometric measures showed that higher ABSI and CI levels were positively associated with the prevalence of erectile dysfunction, independent of BMI (P < .001). In this study, anthropometric indicators including ABSI, BRI, WtHR, CI, and WC were positively associated with erectile dysfunction. To improve the prevention and treatment of this condition, it is recommended that new anthropometric indicators receive greater consideration.

The association between lipid profile, oxidized LDL and the components of metabolic syndrome with serum mineral status and kidney function in individuals with obesity

BackgroundMetabolic syndrome (MetS) is presented with a cluster of cardio-metabolic risk factors with widespread prevalence. In the present case-control study, we aimed to examine the relationship between several minerals and renal function tests with the components of MetS in individuals with obesity.MethodsThis study included 127 individuals with obesity of both gender with or without MetS as the case and control, respectively. MetS was characterized based on the Adult Treatment Panel III (ATP III) criteria. Anthropometric variables and blood pressure were recorded. Mineral status including serum magnesium, copper, calcium, phosphorous, and iron were measured using standard colorimetric methods. Also, the serum lipid levels, concentrations of oxidized low-density lipoprotein (Ox-LDL), and renal function tests, including total protein, albumin, urea, creatinine, and uric acid were evaluated using commercial enzyme-linked immunosorbent assay (ELISA) kits.ResultsAccording to our results, individuals with obesity and MetS had higher levels of waist circumference (WC) and diastolic blood pressure (P < 0.05) compared to individuals with obesity and without MetS. Moreover, individuals with obesity and MetS had higher levels of serum total cholesterol (TC), triglyceride (TG), insulin, and iron (P < 0.05). In individuals with obesity and MetS, iron and albumin showed a positive relationship with LDL cholesterol and TG concentrations, respectively (P < 0.05 for all of them). Also, there was a positive association between serum magnesium and Ox- LDL in individuals with obesity with MetS. While, in individuals with obesity and without MetS, only a positive association between urea and uric acid with WC was observed (P < 0.05).ConclusionOur results suggest that disturbed serum lipids in obesity-metabolic syndrome is associated with homeostatic changes in the level of minerals or proteins that are involved in their metabolism. Although, further studies are needed to better explain and clarify the underlying mechanism of observed relationships.

Analysis of energy intakes, physical activities and metabolic syndrome according to the income level in Korean elderly people: Korean National Health and Nutrition Examination Survey 2016‒2018.

[Purpose] To determine the correlations of differences in the income level with the presence of metabolic syndrome (MetS), energy intake, and physical activity across Korean elderly populations.[Methods] We obtained data from 2,139 elderly individuals (aged >65 years) based on the Korea National Health and Nutrition Examination Survey (KNHANES) (2016‒2018). We analyzed the levels of physical activity (PA) and energy intake using the survey data. Moreover, we analyzed the differences in energy intake and PA levels according to the income level and MetS.[Results] Compared with the non-MetS group, the MetS group displayed significantly higher levels of waist circumference (p=0.000), triglycerides (p=0.000), systolic blood pressure (p=0.000), diastolic blood pressure (p=0.016), and fasting blood glucose (p=0.000) for both high and low income levels. However, the level of high-density lipoprotein cholesterol was significantly lower in the MetS group than that in the non-MetS group (p=0.000). The level of smoking in non-MetS men was significantly higher than that in MetS men across all participants (p=0.047). Except carbohydrate intake, the total energy intake (p=0.022), fat intake (p=0.009), and protein intake (p=0.005) were significantly lower in the MetS group than those in the non-MetS group for high income levels. We obtained similar results for low income levels. The two-way analysis of variance (ANOVA) did not identify an interaction between the income level and the presence of MetS; however, the total energy, i.e., the level of total energy intake, was significantly lower in participants with low income levels than in those with high income levels. For high income levels, transport PA (p=0.002), vigorous recreational PA (p=0.001), moderate recreational PA (p=0.001), and total PA (p=0.000) were significantly lower in the MetS group than those in the non-MetS group. For low income levels, moderate occupational PA (p=0.012), transport PA (p=0.018), and total PA ((p=0.000) were significantly lower in the MetS group than those in the non-MetS group. The total PA, i.e., the level of energy consumption, was significantly lower in the elderly with low income levels than in those with high income levels.[Conclusion] Regardless of the income level, the elderly with MetS exhibited low levels of energy intake and PA, compared with those without MetS. In addition, regardless of the presence of MetS, the elderly with low income levels exhibited lesser energy intake and PA. These findings implied the need for balanced nutrient intake and increased participation in PA as well as education and program development to prevent MetS in the elderly.

Risk for Cardiovascular Death Associated With Waist Circumference and Diabetes: A 9-Year Prospective Study in the Wan Shou Lu Cohort.

BackgroundIt has been reported that obesity and diabetes are both risk factors for the development of cardiovascular diseases (CVDs). However, recent articles reported that compared with body mass index, waist circumference (WC) can better reflect obesity, more closely related to visceral fat tissue which is positively associated with an increased risk of cardiovascular death. Moreover, few studies have investigated the prognostic value of both WC and diabetes during a long-term follow-up. We aimed to investigate whether the higher level of WC measurements and diabetes were able to predict cardiovascular mortality in the general population.MethodsIn this prospective cohort study, a total of 1,521 consecutive subjects free of clinical CVD were included. The endpoint was cardiovascular death. The Kaplan–Meier method and Cox regression models were used to evaluate the cumulative risk of the outcome at different WC levels with or without diabetes.ResultsDuring a median follow-up of 9.2 years, 265 patients died due to cardiovascular conditions. Kaplan–Meier survival estimates indicated that the patients with higher levels of WC (WC > 94 cm) coexisted with diabetes had a significantly increased risk of cardiovascular death (log-rank p < 0.05). After adjustment for potential confounders, multiple COX regression models showed that the incidence of cardiovascular death was significantly higher when patients with high WC coexisted with diabetes mellitus (hazard ratio: 3.78; 95% CI: 3.35–3.98; p < 0.001).ConclusionPatients with high WC and diabetes represent a high-risk population for cardiovascular death. WC and diabetes may provide incremental prognostic value beyond traditional risks factors.

Sociodemographic, anthropometric, and lifestyle correlates of prediabetes and type 2 diabetes in europe: The Feel4Diabetes study

Background and aimsThe current work aimed to identify the predominant correlates of prediabetes and T2DM among a variety of socio-demographic, anthropometric and lifestyle indices, in a large sample of adults from families at high risk for T2DM. Methods and resultsIn this cross-sectional study, 2816 adults were recruited from low-socioeconomic areas in high-income countries (HICs) (Belgium-Finland), HICs under austerity measures (Greece-Spain), and low/middle-income countries (LMICs) (Bulgaria-Hungary). A positive association between the male sex (OR, 95% C.I.2.77 (1.69–4.54)) and prediabetes was revealed compared to females, while there was a negative association between younger age (<45 years) (OR, 95% C.I. 0.58 (0.37–0.92)), and low/medium levels of waist circumference (OR, 95% C.I. 0.44 (0.22–0.89)) with prediabetes compared to older age and high levels of waist circumference, respectively. Concerning T2DM, 0–0.5 cups/day of fruits and berries (OR, 95% C.I.2. 13 (1.16–3.91)) and 150–300 g fish/week (OR, 95% C.I. 2.55 (1.01–6.41)) have a positive association compared to higher consumptions, respectively. Conversely, <1 cup/week legumes (OR, 95% C.I. 0.55 (0.31–0.99) as well as 0–0.5 servings (OR, 95% C.I. 0.34 (0.12–0.95) and 0.5–1 servings (OR, 95% C.I. 0.37 (0.19–0.71) of full-fat dairy/day have a negative association compared to higher consumptions, respectively. ConclusionThese findings indicate the need for diabetes prevention measures targeting young adults and especially men, above 45 years of age, with central obesity and poor dietary habits and prioritize vulnerable groups and populations living in LMICs. National Clinical Trial numberNCT 02393872

Development and Validation of a Simple Risk Model for Predicting Metabolic Syndrome (MetS) in Midlife: A Cohort Study.

PurposeTo develop and validate a simple risk model for predicting metabolic syndrome in midlife using a prospective cohort data.DesignProspective cohort study.ParticipantsA total of 7626 members of the 1958 British birth cohort (individuals born in the first week of March 1958) participated in the biomedical survey at age 45 and have completed information on metabolic syndrome.MethodsVariables utilised were obtained prospectively at birth, 7, 16, 23 and 45 years. Multivariable logistic regression was used to develop a total of ten (10) MetS risk prediction models taking the life course approach. Measures of discrimination and calibration were used to evaluate the performance of the models. A pragmatic criteria developed was used to select one model with the most potential to be useful. The internal validity (overfitting) of the selected model was assessed using bootstrap technique of Stata.Main Outcome MeasureMetabolic syndrome was defined based on the NCEP-ATP III clinical criteria.ResultsThere is high prevalence of MetS among the cohort members (19.6%), with males having higher risk as compared to females (22.8% vs 16.4%, P < 0.001). Individuals with MetS are more likely to have higher levels of HbA1c and low HDL-cholesterol. Similarly, regarding the individual components of MetS, male cohort members are more likely to have higher levels of glycaemia (HbA1c), BP and serum triglycerides. In contrast, female cohort members have lower levels of HDL-cholesterol and higher levels of waist circumference. Furthermore, a total of ten (10) MetS risk prediction models were developed taking the life course approach. Of these, one model with the most potential to be applied in practical setting was selected. The model has good accuracy (AUROC 0.91 (0.90, 0.92)), is well calibrated (Hosmer-Lemeshow 6.47 (0.595)) and has good internal validity.ConclusionEarly life factors could be included in a risk model to predict MetS in midlife. The developed model has been shown to be accurate and has good internal validity. Therefore, interventions targeting socioeconomic inequality could help in the wider prevention of MetS. However, the validity of the developed model needs to be further established in an external population.

Prevalence and Risk Factors for Peripheral Neuropathy in Chinese Patients With Gout.

ObjectivePeripheral neuropathies (PNs) are a group of disorders that affect the peripheral nervous system. PN in gout has been scarcely described. This study is conducted to determine the prevalence and related risk factors of PN, as assessed by vibration perception threshold (VPT) in patients with gout.MethodsA total of 442 patients were included in the cross-sectional study. The VPT values were measured by using the Biothesiometer sensory quantitative tester on each patient. The VPT value of either limb higher than 15 V was considered abnormal and is considered to have PN. The univariate and multivariate logistic regression models were used to identify risk factors for PN in patients with gout.ResultsWe included 442 patients with gout, 97.5% men, 26.9% tophaceous gout, mean age 45.5 ± 15.2 years, and 7.4 ± 4.6 years of disease duration. The prevalence of PN in patients with gout was 11.1%. Patients in the abnormal VPT group were older, had a longer gout duration, and had significantly higher levels of waist circumference, waist-to-hip ratio, systolic blood pressure (SBP), and erythrocyte sedimentation rate (ESR), as compared to patients in the normal vibration group (P < 0.05). The univariate logistic regression analysis demonstrated that there was a significant association between abnormal VPT and age, duration of gout, SBP, C-reactive protein, ESR, presence of tophi, and estimated glomerular filtration rate (eGFR) in all the subjects (P < 0.05). The multivariate logistic regression analysis indicated that age (odds ratio, 1.094) and presence of tophi (odds ratio, 1.048) were independent risk factors for PN in patients with gout.ConclusionThe abnormal VPT was significantly correlated with age and presence of tophi in patients with gout and the VPT level may be useful as a screening tool for assessment of PN in gout.

Elevated serum S14 levels are associated with more severe liver steatosis by ultrasonography

S14 has been identified as a potent stimulator of de novo hepatic lipogenesis (DNL) in rodents. However, it is unclear how S14 is regulated in humans with non-alcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the relationship between serum S14 and liver steatosis in humans with NAFLD. A total of 614 participants were recruited from community. Liver steatosis were evaluated according to the Ultrasonographic Fatty Liver Indicator (US-FLI), which is a semi-quantitative liver ultrasound score. Anthropometric and biochemical indices were collected for further analysis. The risk of liver steatosis severity was estimated by a cumulative logistic regression model. NAFLD was found in 52.2% of the participants. The subjects with NAFLD showed higher levels of waist circumference, body mass index, insulin resistance, aspartate aminotransferase, dyslipidemia, visceral fat, serum S14 and risk of metabolic syndrome (MetS) than those of controls. Compared with the first tertile of serum S14, the odds ratios for the risk of more severe liver steatosis were 1.22 (95% confidence interval [CI]: 0.78–1.92) for those of the second tertile and 2.08 (95% CI: 1.28–3.39) for the third tertile (P for trend < 0.05) after adjusting for confounding factors. Higher serum S14 level was not only found in NAFLD subjects but also was positively correlated with the severity of liver steatosis. S14 may play an important role in the mechanism of DNL for NAFLD in humans.

Abstract 11145: Waist Circumference is a Predicter of All-Cause Death in General Population in Wanshou Lu

Introduction: The accumulation of abdominal fat increases risk of metabolic disorders and premature death. Whether waist circumference (WC), a surrogate marker for abdominal adiposity can predict all-cause death in general population is still inconclusive. Hypothesis: We assessed the hypothesis that higher level of WC is significantly associated with long-term all-cause death in general population. Methods: In this prospective cohort study, a total of 1521 consecutive subjects were included. The subjects. The end point was all-cause death. The association between Waist circumference and outcomes was investigated using multivariable COX regression. Results: During a median follow up of 9.1 years, there were 265 patients died. Kaplan-Meier survival estimates indicated that the patients with higher levels of waist circumference (WC&gt; 94cm) had a significantly increased risk of all-cause death (log-rank p&lt;0.001). After adjustment for potential confounders, multiple COX regression models showed that higher level of WC was an independent predictor in developing all-cause death (HR 3.02; 95% CI: 1.88-4.83; p&lt;0.001). We saw a significant increase of AUC in ROC curve after addition of WC to a clinical model, the increase of AUC is (0.586 vs 0.619) for long-term all-cause death (p&lt;0.001). Furthermore, WC significantly improved the net reclassification index (0.629; P=0.001), and integrated discrimination index (0.035; P=0.002). Conclusion: In conclusion, higher level of WC is significantly associated with long-term all-cause death. WC may provide incremental prognostic value beyond traditional risks factors. Key words: Waist circumference, obesity, all-cause death

High concentrations of triglycerides are associated with diabetic kidney disease in new-onset type 2 diabetes in China: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study.

AimsThe aims of this study were to evaluate the associations of metabolic abnormalities with incident diabetic kidney disease (DKD) and to explore whether dyslipidaemia, particularly high fasting triglyceride (TG), was associated with the development of DKD.MethodsIn total, 11 142 patients with new‐onset type 2 diabetes with baseline estimated glomerular filtration rates (eGFR) ≥60 mL/min/1.73 m2 were followed up during 2011‐2016. Incident DKD was defined as eGFR <60 mL/min/1.73 m2 at follow‐up. Multiple logistic regression analysis was conducted to explore the relationship of metabolic abnormalities at baseline and at follow‐up with risks of DKD. High TG was defined by TG ≥1.70 mmol/L. Low high‐density lipoprotein cholesterol (HDL‐c) was defined by HDL‐c <1.0 mmol/L for men or <1.3 mmol/L for women.ResultsParticipants who developed DKD had higher levels of waist circumference and systolic blood pressure, and lower levels of HDL‐c at both baseline and follow‐up visits. The DKD group also had higher levels of post‐load plasma glucose and TG at follow‐up. Multivariate logistic regression analysis revealed that both high TG at baseline [odds ratio (OR) = 1.37, p = .012) and high TG at follow‐up (OR = 1.71, p < .001) were significantly associated with increased risks of DKD. Patients with high TG levels at both baseline and follow‐up had higher risk of DKD compared with constantly normal TG (OR = 1.65, p < .001) after adjustment for covariates.ConclusionsIn a large population of patients with new‐onset type 2 diabetes, a high TG level was an independent risk factor for the development of DKD. Tight TG control might delay the occurrence of DKD.

Effects of Metformin on TSH Levels and Benign Nodular Goiter Volume in obese and non-obese diabetic patients

Objectives: To evaluate the impact of metformin (MTF) use on thyroid stimulating hormone (TSH) levels, thyroid volume and volume of benign thyroid nodules (TN) in diabetic patients. Methods: A total of 24 euthyroid diabetic patients with benign-looking NT on cervical ultrasound and benign TN, diagnosed by fine needle aspiration biopsy, were treated by MTF at least for 6 months. The sample was divided into 2 groups with and without obesity. There were 12 patients in each group. Serum TSH, body mass index (BMI) and waist circumference (WC) were evaluated. Ultrasound was used to evaluate TN and thyroid volumes throughout the study. Patients undergoing levothyroxine replacement, and/or using thyroid- or insulin level-influencing drugs apart from MTF were excluded. Results: Serum TSH decreased significantly after MTF (−0.26 vs 0.08 mUI/L in the group without obesity; p = 0.022). At 6 months, no significant variations were found between groups with respect to TN volumes and thyroid volumes. However, a protective effect of MTF on growing TN (OR: 0.28; CI 0.07-1.40) was detected. The reduction on TSH levels with MTF maintained was accentuated in patients with obesity and higher WC (−0.82; p = 0.032). A protective effect of MTF on growing TN was suggested (OR: 0.23; IC: 0.06–0.81) in those with higher WC. Conclusions: This study demonstrated that MTF caused a reduction in TSH levels in benign nodular goiter. This effect was more accentuated in patients with higher levels of WC and was accompanied by a suggested protective effect on TN enlargement.

Meta-Analysis of the Relationship between Abdominal Obesity and Diabetic Kidney Disease in Type 2 Diabetic Patients

Background and Objectives: The meta-analysis aimed to investigate the association of visceral fat area (VFA), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) with diabetic kidney disease (DKD) in type 2 diabetic patients. Methods: Included studies were searched from Pubmed, Embase, and the Cochrane Library before July 2020. We synthesized the pooled results of the above relationships by meta-analysis. Results: Fourteen cross-sectional studies were enrolled. The pooled results indicated there was a significant difference in continuous VFA, WC and WHR/WHtR between patients with DKD and those without DKD (standard mean difference, SMD, 0.24, 95% confidence interval, CI, 0.13–0.36, p = 0.000). For VFA, patients with DKD had higher VFA levels than those without DKD (SMD 0.27, 95% CI 0.03–0.50). In the WC subgroup, patients with DKD had higher WC levels than those without DKD (SMD 0.17, 95% CI 0.10–0.24); similarly, abdominal obesity (dichotomized WC) was significantly associated with an increase in the odds of DKD (expected shortfall, ES, 1.57, 95% CI 1.32–1.86). However, the association of continuous WHR/WHtR with DKD was not statistically significant (SMD 0.43, 95% CI –0.12 to 0.97), while we found this relationship was statistically significant when analyzed categorically (ES 1.58, 95% CI 1.22–2.06). Conclusion: In this meta-analysis, we found abdominal obesity parameters (continuous VFA, WC) were associated with increased odds of DKD, and type 2 diabetic patients with DKD were more likely to have abdominal obesity (categorized using WC or WHR/WHtR).

Association of Adiponectin−11377 C/G (rs266729) Gene Polymorphism with Nonalcoholic Fatty Liver Disease and Metabolic Features in Egyptian Women

The present cross-sectional study included 150 unrelated non-alcoholic fatty liver disease (NAFLD) patients and 150 healthy subjects. ADIPOQ (-11377C / G) variant was genotyped with polymerase chain reaction-restriction fragment polymorphism (PCR-RFLP) method for both patients and controls. Anthropometric and biochemistry parameters were measured. The Homeostasis Model Insulin Resistance Assessment (HOMA-IR) was used to assess the insulin resistance. The rs266729 polymorphism was associated with NAFLD with significant increase in CG genotype compared to those with the wild genotype CC (OR = 9.24, 95% CI = 4.96 - 17.21, p<0.001) in co dominant tested inheritance model as well in dominant tested inheritance model with CG/GG genotype (OR = 9.58, 95% CI = 5.32 – 17.28, p< 0.001). The G allele increased the risk of NAFLD (OR = 6.06, 95% CI = 3.65 - 10.05, p< 0.001) in comparison with C allele. Subgroup comparison in NAFLD revealed significant higher levels of waist circumference (WHR), HOMA-IR, systolic blood pressure (SBP), fasting glucose and LDL-C in GG and GC carriers compared to CC genotype and significant lower levels of serum adiponectin. Conclusions: The study suggests that ADIPOQ gene polymorphism can be used as a helpful biomarker for NAFLD and abnormal metabolic parameters. Our study sheds light on its role that might be played in the pathogenesis of NAFLD. Proper evaluation of NAFLD is likely to improve therapy effectiveness and safety management.

PREVALÊNCIA DE SÍNDROME METABÓLICA E PERFIL NUTRICIONAL DE PACIENTES OBESOS CARDIOPATAS HOSPITALIZADOS

A Síndrome metabólica é considerada uma doença crônica não transmissível complexa, associada a um conjunto de riscos cardiometabólicos, dentre eles: dislipidemias, intolerância à glicose, resistência à insulina, hipertensão e obesidade. Objetivos: Avaliar a prevalência de Síndrome Metabólica e o perfil nutricional de pacientes obesos cardiopatas de um Hospital Universitário. Estudo transversal com 33 pacientes obesos cardiopatas de um hospital universitário de Campo Grande – MS. Avaliou-se: peso, altura, circunferência da cintura, inquérito de frequência alimentar, pressão arterial, glicose em jejum, níveis séricos de HDL-c e de triglicerídeos. Para prevalência da SM utilizou-se critérios do National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III, 2002). Foi utilizado o software SPSS, considerando nível de significância de 5%. Resultados: O tipo de cardiopatia e co-morbidade mais frequentes foram Infarto Agudo do Miocárdio (30,3%) e a hipertensão (36,6%), respectivamente. Quanto ao perfil nutricional, clínico e bioquímico, todos os participantes apresentaram elevados níveis de circunferência da cintura, de glicose de jejum e de triglicerídeos, bem como, reduzido nível de HDL-c, porém sem diferença significativa entre os grupos adultos e idosos. Não foram identificadas diferenças significativas no consumo alimentar entre os grupos avaliados. Verificou-se alta prevalência de Síndrome Metabólica nos obesos cardiopatas avaliados (84,85%), sendo 85,71% entre os adultos e 100% entre os idosos. Conclusões: A associação de alterações no perfil nutricional, clínico e bioquímico, que caracterizaram a alta prevalência de síndrome metabólica nos pacientes avaliados, juntamente com os fatores hereditários, reforçam a necessidade de implantação de medidas preventivas para atenuar essa condição.

2105-P: Waist Circumference and All-Cause Mortality Independent of Body Mass Index in Korean Population from the National Health Insurance Health Checkup, 2009-2015

Background: Waist circumference (WC) is an index of abdominal obesity and associated with co-morbidities and mortality. Higher WC is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality. Methods: A total of 23,263,878 subjects (men = 11,813,850 and women = 11,450,028) who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85-90 cm in men and 80-85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC. Results: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65-85 years than subjects aged 40-65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1.156, 1.412, and 1.614 in normal BMI and 1.145, 1.401, and 1.909 in overweight, respectively). Conclusion: There was a linear association between WC and all-cause mortality across all BMI categories even in the subjects with normal or overweight BMI. Physicians should check WC routinely even in the subjects with normal weight or overweight. Disclosure Y. Kim: None. S. Yoo: None. S. Lee: None.

Waist Circumference and All-Cause Mortality Independent of Body Mass Index in Korean Population from the National Health Insurance Health Checkup 2009⁻2015.

Background: Waist circumference (WC) is an index of abdominal obesity and associated with co-morbidities and mortality. Higher WC is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality. Methods: A total of 23,263,878 subjects (men = 11,813,850 and women = 11,450,028) who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85–90 cm in men and 80–85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC. Results: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65–85 years than subjects aged 40–65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1.156, 1.412, and 1.614 in normal BMI and 1.145, 1.401, and 1.909 in overweight, respectively). Conclusion: There was a linear association between WC and all-cause mortality across all BMI categories even in the subjects with normal or overweight BMI. Physicians should check WC routinely even in the subjects with normal weight or overweight.

Waist Circumference and Mortality in Korea: Evidence from the National Health Insurance Health Checkup 2009-2015

Background: Higher waist circumference (WC) is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality. Methods: A total of 23,263,878 subjects who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85-90 cm in men and 80-85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC. Findings: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65–85 years than subjects aged 40–65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1·156, 1·412, and 1·614 in normal BMI and 1·145, 1·401, and 1·909 in overweight, respectively). Interpretation: This study provides evidence of the need to lose WC in the subjects with normal or overweight BMI categories. The importance of assessing WC routinely should be raised and the guidelines to keep proper WC are stressed. Funding Statement: We would like to thank the Korean National Health Insurance Corporation and all the participants of the study and health check-up. This study was supported by grant HC16C2285 from the Korean Health Technology and Research and Development project, Ministry of Health and Welfare, Republic of Korea. This research was also supported by a grant of the Development of an Interactive Medical History Taking Software (2017-0-00588), funded by the Ministry of Science and ICT, Republic of Korea Declaration of Interests: The authors have nothing to disclose. Ethics Approval Statement: The study protocol was approved by the Institutional Review Board of the Korea University Anam Hospital (ED17115) and permission for the use of health checkup data was granted by the NHIS (NHIS-2018-1-035).

Association between serum levels of vascular endothelial growth factor, macrophage inhibitory cytokine and markers of oxidative stress, with the metabolic syndrome and its components in obese individuals

Abstract Aim Metabolic syndrome (MetS) is a clinical disorder with widespread prevalence. In the current study, we aimed to investigate the serum values of macrophage inhibitory cytokine (MIC)-1, vascular endothelial growth factor (VEGF) and markers of oxidative stress among patients with metabolic syndrome. Material and methods Twenty obese patients with MetS and 20 obese apparently healthy controls were participated in the current case-control study. The participants’ body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP) were measured. Serum levels of total cholesterol (TC), triglyceride (TG), low and high density lipoprotein cholesterol (LDL-c and HDL-c), vascular endothelial growth factor (VEGF), MIC-1 (macrophage inhibitory cytokine 1), superoxide dismutase (SOD) and glutathione peroxidase (GPX) were also determined by commercial ELIZA kits. Results Participants in MetS group had higher levels of WC, DBP and higher serum concentrations of TG and TC compared with control group (P Conclusion The higher serum values of MIC-1 and VEGF in patients with MetS and the negative association of VEGF with serum LDL concentrations opened a new window about the possible pathologic role of these factors in the etiology or pathophysiology of MetS. Further studies are warranted for solidification of achieved results.

Anthropometric measures of obesity and renal artery calcification: Results from the Multi-Ethnic Study of Atherosclerosis

Background and aimsRenal artery calcium (RAC) has been linked to several cardiovascular disease (CVD) risk factors, including age, male gender, and hypertension. The purpose of this study was to determine whether anthropometric measures of obesity are associated with presence of RAC. MethodsWe studied 1287 community-dwelling adults enrolled in the Multi-Ethnic Study of Atherosclerosis. Logistic regression models adjusted for CVD risk factors were used to examine body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) as primary predictors of RAC. ResultsStudy participants had a mean age of 67.7 years, 55.7% were female, and 36.8% were non-Hispanic White. Prevalence of RAC was 33.3%. WC and WHR as continuous variables were not significant with adjustment. Subjects with high WC, as defined by World Health Organization cut-offs, had significantly higher odds for RAC in the fully adjusted model. BMI and HC were not significantly associated with RAC in any models. ConclusionsIn this community-based sample of older adults, higher levels of WC are significantly associated with RAC independently of CVD risk factors. Adults who meet World Health Organization criteria for high WC may be at higher risk for complications of calcified atherosclerosis in the renal arteries.

Relationship between dietary consumption of vitamins and minerals, body mass index, and waist circumference: a population-based study of adults in southern Brazil

The study's objective was to investigate the association between inadequate dietary consumption of micronutrients and indicators of general and abdominal obesity. Cross-sectional analysis of the second wave of the EpiFloripa Adults longitudinal study, including 1,222 individuals, aged 22-63 years and residing in Florianópolis, Santa Catarina State, Southern Brazil. Food consumption data was obtained from two 24-hour food recalls, and habitual consumption and prevalence rates of inadequate consumption of calcium, iron, zinc, and vitamins A, C, D, and E were estimated according to the Institute of Medicine and National Research Council guidelines. General obesity was defined based on the body mass index (BMI) values and abdominal obesity was based on waist circumference (WC) values. For most of the micronutrients investigated (calcium and vitamins A, C, D, and E), consumption levels were below the recommendations, with high prevalence of inadequate consumption in the sample as a whole. Only inadequate vitamin C intake was higher among obese individuals (general or abdominal). In addition, there was an inverse association between lower consumption of calcium and iron and higher BMI and WC, and between lower consumption of vitamins A and D and higher WC levels (β = -0.92cm; 95%CI: -1.76; -0.08 and β = -0.69 cm; 95%CI: -1.32; -0.06, respectively), especially in young adults. The study showed an inverse association between inadequate dietary consumption of micronutrients and general and abdominal obesity in a sample of adults in Southern Brazil.