Higher Prevalence Of Central Obesity Research Articles

Trends in prevalence of obesity and its association with hypertension across socioeconomic gradients in rural Yunnan Province, China

BackgroundThis study aimed to uncover the changing prevalence of obesity and its association with hypertension across socioeconomic gradients in rural southwest China.MethodsData were collected from two cross-sectional health interviews and surveys from 2011 to 2021 among individuals aged ≥ 35 years in rural China. Each participant’s height, weight, waist circumference, and blood pressure were measured. The overall prevalence of obesity, central obesity, and hypertension was directly standardized by age based on the total population of the two surveys. Multivariate logistic regression was used to analyze the association between obesity and prevalence of hypertension and an individual socioeconomic position (SEP) index was constructed using principal component analysis.ResultsFrom 2011 to 2021, the prevalence of obesity, central obesity, and hypertension increased substantially, from 5.9%, 50.2%, and 26.1–12.1%, 58.0%, and 40.4% (P < 0.01), respectively. These increasing rates existed in all subcategories, including sex, age, ethnicity, education, annual household income, access to medical services, and SEP (P < 0.05). In both 2011 and 2021, lower education level and poor access to medical services correlated with higher prevalence of central obesity, while higher SEP correlated with higher prevalence of obesity and central obesity (P < 0.01). Prevalence of obesity was higher in the Han ethnicity participants and individuals with poor access to medical services than in their counterparts (P < 0.01). Whereas the prevalence of central obesity was lower in Han participants than in ethnic minority participants in 2011 (P < 0.01), this trend reversed in 2021 (P < 0.01). A positive relationship between annual household income and prevalence of obesity and central obesity was only found in 2021 (P < 0.01). Obese and centrally obese participants were more likely to be hypertensive in both survey years (P < 0.01).ConclusionsFuture interventions to prevent and manage obesity in rural China should give increased attention to high income, less educated, poor access to medical services, and high SEP individuals. The implementation of these obesity interventions would also help reduce the prevalence of hypertension.

Central obesity, obesity, and physical activity among university staffs

Waist circumference (WC) is considered as a superior indicator to predict central obesity and its related comorbidities. Limited studies were conducted to infer central obesity using WC among university staffs. A cross-sectional study through the convenience sampling method was employed using the short form international physical activity questionnaire, anthropometric measurements, and WC measurement to infer a level of physical activity, body mass index (BMI), and central obesity. Seventy staff from three private universities in Malaysia participated in this study. There is a high prevalence (78.6%) of central obesity among the participants irrespective of their age. Majority of the participants fall under the overweight (37.1%) and obese (21.4%) category of BMI 48.6% reported to be involved in low level of physical activity. No difference in prevalence of central obesity based on age, gender, and level of physical activity. There is a moderately strong correlation between BMI and WC. In this study notably a high prevalence of central obesity in participants with underweight and desirable weight category of BMI was reported, which synergizes the concept of including WC measurement in health promotion activities. Appropriate multi- component and multi-level interventions can be considered to this population to prevent/combat obesity.

Chronic spontaneous urticaria and metabolic syndrome: a relationship conundrum.

Chronic spontaneous urticaria (CSU) and metabolic syndrome (MetS) are associated with low-grade inflammation. Despite intensive research and various hypothesis, there is lack of specific pathomechanisms of urticaria. Previous studies have suggested low-grade inflammation in obesity which may be linked to urticaria. However, there is limited literature on association of MetS and CSU. So, this study was conducted to evaluate the association of MetS and its components in patients with CSU. This was a hospital-based and cross-sectional cohort study in which 481 patients of CSU and 240 age- and gender-matched controls were recruited. MetS was defined using the revised National Cholesterol Education Program Adult Treatment Panel III. BMI, waist circumference, blood pressure, fasting blood sugar, plasma insulin, and lipid profile were measured after overnight fasting. Pearson's Chi-squared test was used to calculate significance. Logistic regression analysis was done to assess MetS as a predictor of CSU. All patients were started on antihistamines according to the severity of the disease. CSU patients comprised 220 men (45.7%) and 261 women (54.3%) with 97 patients (20.12%) qualifying criteria for metabolic syndrome compared with 73 (30.42%) controls without any significant difference (p = 0.177). CSU was significantly associated with a higher prevalence of central obesity (p = 0.003) but CSU patients with central obesity did not have a higher urticaria activity score (p = 0.727) or serum IgE levels (p = 0.359). In conclusion, our study found an increased association of central obesity with CSU that was not related to the severity of urticaria. This is of significance as obesity is the most prevalent and first component of MetS to be developed. There was no increase in the overall prevalence of MetS in patients with CSU. The increased association of obesity and urticaria in our study can be partially explained by the role of antihistamines in modulation of metabolic pathway and appetite. Future research into the same can give better insights and thus can aid in better management options in CSU patients.

Psoriasis and Its Association with Metabolic Syndrome: A Case–Control Study at a Tertiary Care Center in a Semi-Urban Region of South India

Background: Metabolic syndrome (MS) has been associated with skin diseases such as psoriasis. They share a common inflammatory pathway and therefore have an impact on each other. Objectives: To estimate the prevalence of MS and its individual components in psoriasis patients to that of the controls and to compare the characteristics in psoriasis patients with and without the MS. Materials and Methods: One hundred patients with a clinical diagnosis of chronic plaque psoriasis were evaluated for the prevalence of MS and compared with the age- and sex-matched controls. Results: The study population belongs to the semi-urban region with a low socioeconomic status. The psoriatic cases showed male preponderance, and the majority of the subjects belonged to 31–40 years of age group. The mean psoriasis area severity index score among cases was 26.19 ± 10.8, and 92% of cases were with severe disease affecting the quality of life. MS was found to be statistically significant in cases. The cases with MS had a higher prevalence of central obesity, hypertriglyceridemia, elevated fasting blood glucose levels, and hypertension. The presence of MS in psoriasis patients was statistically independent of the severity. Conclusions: Psoriasis patients should be periodically evaluated for metabolic syndrome to prevent the associated mortalities and for their effective management.

The diet assessment clarifies cardiovascular risk

Background and Aims : To determine the quality characteristics of nutrition in individuals with low cardiovascular risk (SCORE 2 < 2,5%) and to assess the relationship of nutritional characteristics with metabolic disorders and body composition.Methods: The study included 90 patients: 43.8 ± 3.2 years, 37 men (47%) and 41 womеn (53%). 62 (69%) participants with central obesity (CO), low cardiovascular risk (SCORE ≤1%, SCORE 2 < 2,5%, CMDS 0-1). All patients were provided with a nutritional questionnaire consisting of 11 questions.Results: Inappropriate nutrition was registered in all patients with CO. A number of diet factors had a correlation with TG, LDL, TC, WC, body fat mass, hepatic steatosis and epicardial fat. Among them: processed meat (r = 0.3; r = 0.4; r = 0.3; r = 0.4; r = 0.4; r = 0.4; r = 0.48, respectively; p = 0.001), the absence of nuts (r = 0.4; r = 0.4; r = 0.3; r = 0.4; r = 0.4; r = 0.4; r = 0.3, respectively; p = 0.001), insufficient quota of fruits and vegetables (r = 0.7; r = 0.7; r = 0.6; r = 0.7; r = 0.7; r = 0.5; r = 0.7 , respectively; p = 0.001). It is important that according to the nutritional scale the cardiovascular diseases risk became higher in 57% of patients.Conclusions: The low cardiovascular risk group is very heterogeneous due to the high prevalence of central obesity and unbalanced nutrition. The food scale helps to identify problem areas of the diet within 2 minutes. Background and Aims : To determine the quality characteristics of nutrition in individuals with low cardiovascular risk (SCORE 2 < 2,5%) and to assess the relationship of nutritional characteristics with metabolic disorders and body composition. Methods: The study included 90 patients: 43.8 ± 3.2 years, 37 men (47%) and 41 womеn (53%). 62 (69%) participants with central obesity (CO), low cardiovascular risk (SCORE ≤1%, SCORE 2 < 2,5%, CMDS 0-1). All patients were provided with a nutritional questionnaire consisting of 11 questions. Results: Inappropriate nutrition was registered in all patients with CO. A number of diet factors had a correlation with TG, LDL, TC, WC, body fat mass, hepatic steatosis and epicardial fat. Among them: processed meat (r = 0.3; r = 0.4; r = 0.3; r = 0.4; r = 0.4; r = 0.4; r = 0.48, respectively; p = 0.001), the absence of nuts (r = 0.4; r = 0.4; r = 0.3; r = 0.4; r = 0.4; r = 0.4; r = 0.3, respectively; p = 0.001), insufficient quota of fruits and vegetables (r = 0.7; r = 0.7; r = 0.6; r = 0.7; r = 0.7; r = 0.5; r = 0.7 , respectively; p = 0.001). It is important that according to the nutritional scale the cardiovascular diseases risk became higher in 57% of patients. Conclusions: The low cardiovascular risk group is very heterogeneous due to the high prevalence of central obesity and unbalanced nutrition. The food scale helps to identify problem areas of the diet within 2 minutes.

Cardiometabolic profiles in women with adenomyosis

The aim of this study was to investigate the reproductive profiles, metabolic parameters and cardiometabolic risk assessed by surrogate indexes in women with adenomyosis. Ninety-six premenopausal women who were diagnosed with adenomyosis by transvaginal ultrasound and 97 age-body mass index (BMI) matched controls with normal ultrasound during routine examination were included. Women with adenomyosis were more likely to have higher gravidity and had more abortions than women without adenomyosis. Regarding the individual metabolic syndrome components, the adenomyosis group was more likely to have higher prevalence of hypertension, low HDL-C and central obesity. No significant difference was found between the groups in terms of visceral adiposity index, lipid accumulation product and fatty liver index. Only higher blood pressure (BP) remained statistically significant after adjustment for confounding factors in multivariate analysis. Women with adenomyosis had remarkably high risk of hypertension. It may be advisable to monitor their BP closely. Impact Statement What is already known on this subject? The only anthropometric characteristic assessed in women in relation to adenomyosis is body mass index (BMI). A case-control study showed that women who are obese are more likely to have adenomyosis. The gravidity, number of spontaneous abortions and previous uterine surgeries such as dilatation and curettage (D&C) and caesarean section were found significantly associated with adenomyosis. What do the results of this study add? A remarkable finding of our study was the increased incidence of higher systolic BP in women with adenomyosis. No difference was observed in adiposity indices between women with and without adenomyosis. Higher prevalence of central obesity and lower HDL-C levels were seen in women with adenomyosis. What are the implications of these findings for clinical practice and/or further research? The study identifies that adenomyosis is associated with an increased risk of hypertension, and women with adenomyosis may be monitored closely for blood pressure changes. Our report also provides novel information about the metabolic risk profiles associated with adenomyosis.

Cardiovascular risk factors among private primary school teachers in Onitsha North Local Government Area, Anambra State

Background: Prevalence of cardiovascular risk factors has continued to increase due to changes in dietary practices and increased physical inactivity among the adult population.&#x0D; Objective: This study was designed to assess the prevalence of cardiovascular risk factors among private primary school teachers in Onitsha North Local Government Area, Anambra State, Nigeria.&#x0D; Subjects and methods: A cross-sectional survey design was employed and a multistage sampling technique was used to select 400 respondents used in the study. Questionnaire was used to obtain information on the sociodemographic characteristics, dietary habits, physical activity level, and lifestyle characteristics of the respondents. Anthropometric indices (body mass index and waist-hip ratio), blood pressure, blood glucose, and lipid profile of the respondents were obtained using standard procedures. Data obtained were coded and entered into the computer and analyzed using SPSS for windows version 21. Chi-square was used to determine the relationship existing among variables. Significance was accepted at p &lt; 0.05.&#x0D; Results: Results showed that the majority (90%) of the respondents were females while a few (9.8) were males. Most (69.5%) of the respondents skipped meals while some (30.5%) did not skip meals. A high prevalence of central obesity (57.0% WC, 47.5% WHR), hypertension (20.0%), impaired plasma glucose (30.0%), diabetes mellitus (2.5%), low HDL-cholesterol (37.5%) and hypertriglycerideamia (15%) was observed among the respondents. Female respondents were significantly (p &lt; 0.05) more centrally obese (60.0% WC, 51.55% WHR) than males (40.0% WC, 28.6% WHR). No significant (p &gt; 0.05) relationship was found between gender and blood pressure, blood glucose level, and lipid profile of the respondents.&#x0D; Conclusion: The study concluded that the prevalence of cardiovascular risk factors was high among the respondents

Impact of Lipid Genetic Risk Score and Saturated Fatty Acid Intake on Central Obesity in an Asian Indian Population.

Abnormalities in lipid metabolism have been linked to the development of obesity. We used a nutrigenetic approach to establish a link between lipids and obesity in Asian Indians, who are known to have a high prevalence of central obesity and dyslipidaemia. A sample of 497 Asian Indian individuals (260 with type 2 diabetes and 237 with normal glucose tolerance) (mean age: 44 ± 10 years) were randomly chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a previously validated questionnaire. A genetic risk score (GRS) was constructed based on cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genetic variants. There was a significant interaction between GRS and saturated fatty acid (SFA) intake on waist circumference (WC) (Pinteraction = 0.006). Individuals with a low SFA intake (≤23.2 g/day), despite carrying ≥2 risk alleles, had a smaller WC compared to individuals carrying <2 risk alleles (Beta = −0.01 cm; p = 0.03). For those individuals carrying ≥2 risk alleles, a high SFA intake (>23.2 g/day) was significantly associated with a larger WC than a low SFA intake (≤23.2 g/day) (Beta = 0.02 cm, p = 0.02). There were no significant interactions between GRS and other dietary factors on any of the measured outcomes. We conclude that a diet low in SFA might help reduce the genetic risk of central obesity confirmed by CETP and LPL genetic variants. Conversely, a high SFA diet increases the genetic risk of central obesity in Asian Indians.

MAFLD Predicts the Risk of Cardiovascular Disease Better than NAFLD in Asymptomatic Subjects with Health Check-Ups.

Metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to compensate for the conventional concept of nonalcoholic fatty liver disease (NAFLD). We investigated the superiority of MAFLD versus NAFLD in predicting the risk of atherosclerotic cardiovascular disease (ASCVD). A total of 2,144 subjects without a history of ASCVD, who underwent a comprehensive medical health check-up, were selected for the study. The associations between fatty liver status and coronary risk surrogates, such as coronary artery calcium score (CACS), coronary artery disease, quantitative stenosis grade, and 10-year ASCVD risk, were analyzed. MAFLD and NAFLD were identified in 995 (46.4%) and 891 (41.6%) subjects, respectively. Subjects with MAFLD or NAFLD were more likely to be male and had a significantly higher prevalence of central obesity, obesity, hypertension, diabetes, and dyslipidemia (all, p < 0.05) than their counterparts. In terms of coronary risk surrogates, the MAFLD or NAFLD population had a significantly higher proportion of subjects with CACS > 100, coronary artery disease, higher grade of coronary artery stenosis, and higher 10-year ASCVD risk (all, p < 0.05) than their counterparts. Multivariable logistic regression models showed an independent association between MAFLD/NAFLD and coronary risk surrogates (all, p < 0.05). However, NAFLD only, defined as 'NAFLD, but not MAFLD,' was not associated with an increased coronary risk, compared to MAFLD. Although both MAFLD and NAFLD discriminated different ASCVD risks, MAFLD predicted the risk of ASCVD better than NAFLD in asymptomatic subjects who underwent medical health check-ups.

Central Obesity in Axial Spondyloarthritis: The Missing Link to Understanding Worse Outcomes in Women?

To determine (1) the prevalence of central obesity in axial spondyloarthritis (axSpA) and its effect on disease-related outcomes and (2) how this differs between sexes. Data were extracted from the Ankylosing Spondylitis Registry of Ireland. Patients with physical measurements for the calculation of anthropometric measures were included. BMI and waist-to-hip ratio (WHR) were used to compare classifications of obesity. Comparison analyses based on sex and central obesity were carried out. Multivariate analysis examined the effects of these factors on the following patient-reported outcomes: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, and the Health Assessment Questionnaire (HAQ). In total, 753 patients were included in the analysis. Of these patients, 29.6% (n = 223) were classified as obese based on their BMI, and 41.3% (n = 311) were classified as centrally obese according to the WHR. The prevalence of central obesity was significantly higher among women with axSpA compared to men (71.6% vs 29.9%, P < 0.01). Central obesity had a clear effect on patient outcomes, regardless of sex. Presence of central obesity was associated with significantly worse BASFI scores (P < 0.01), HAQ scores (P < 0.01), and ASQoL questionnaire scores (P = 0.01), with a nonsignificant trend toward worse BASDAI scores (P = 0.07). There was a high prevalence of central obesity as assessed by the WHR in axSpA, most notably among women with axSpA. This modifiable comorbidity was significantly associated with worse quality of life, greater impairment of functional ability, and a trend toward worse disease activity. Regular use of the WHR to screen for central obesity as part of an axSpA assessment would provide an opportunity for prompt identification and intervention for at-risk patients.

Cross-sectional Study Shows an Association between Paediatric Lichen Planus and Dyslipidemia.

Few studies have shown an association between adult lichen planus and dyslipidemia, but none has shown an association with the pediatric population. We planned to study the association between pediatric lichen planus and metabolic syndrome (MS). This is a single-centre, cross-sectional, case-control study from July 2018 to December 2019 at a tertiary care institute. Twenty children in the age group of 6-16 years, diagnosed as cases of childhood/adolescent lichen planus, and 40 age- and sex-matched controls were included in this study and evaluated for metabolic syndrome.Patients' anthropometry including weight, height, waist circumference, and body mass index (BMI) was recorded. Blood samples were sent for the measurement of fasting plasma glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, and triglyceride levels. The mean HDL was found to be significantly lower in children with lichen planus compared to children without lichen planus (p = 0.012), although there was no statistically significant difference in the frequency of patients having deranged HDL levels between the groups (p = 0.326). Children with lichen planus had a higher prevalence of central obesity, but the difference was not statistically significant (p = 0.101). There was no significant difference between mean BMI, hypertension, triglyceride, LDL, and fasting blood sugar values between the groups. Using the logistic regression analysis model, it was found that the strongest independent variable that impacts the occurrence of lichen planus was an HDL value less than 40 mg/dl (p = 0.017; OR 1.02 to 1.29). This study shows an association between paediatric lichen planus and dyslipidemia.

Abdominal Obesity in Overweight Schoolchildren from Portoviejo (Ecuador). Conicity Index Cut-Points for Sustainable Health

(1) Background: Abdominal obesity describes the accumulation of visceral fat. Monitoring of abdominal obesity in children aids prognosis of atherogenic risk and prediction of the emergence of different comorbidities, many of which persist into and throughout adulthood. For this reason, it is of great diagnostic value to the sustainability of health in populations. The aim of this study was to evaluate abdominal obesity in overweight schoolchildren from Portoviejo (Ecuador) and propose conicity index cut-points for sustainable health. (2) Methods: The sample was formed by 356 schoolchildren whose BMI z-score deemed them to be overweight. Height, weight, waist circumference (wstC), various skinfolds, percent body fat, conicity index (CI) and overweight classification according to wstC were determined. (3) Results: The mean age was 6.83 ± 1.2 years, 17.4% were obese, 34.8% were overweight and 47.8% were at risk of being overweight according to their BMI z-score. The mean height was 1.29 ± 0.12 m, whilst the mean weight was 35.21 ± 11.57 kg. When classifying according to wstC, 37.9% were identified as obese, 28.1% had high-risk abdominal adiposity and 34% were normal. The average CI was 1.16 ± 0.06, whilst that of body fat was 19.34 ± 6.03, with 56.2% of individuals having body fat values lower than 20%. (4) Conclusions: The sample showed a high prevalence of central obesity. Significant agreement was not found between classifications of nutritional status according to BMI z-score and wstC.

Setting \u2013 based prevalence and correlates of central obesity: findings from a cross-sectional study among formal sector employees in Dodoma City, Central Tanzania

BackgroundObesity at the workplace has been associated with symptoms of lower self-esteem, increased individual and employer healthcare costs, increased absenteeism and presenteeism and reduced productivity. Therefore, this study was designed to study the prevalence and correlates of central obesity among formal sector employees in Dodoma City.MethodsStudy design was a cross-sectional survey conducted from March to June, 2019. Participants were employees from formal sector employment defined as those paid regular monthly wage and with either a secured permanent or temporary contract. Simple random sampling was used to select four out of fifteen large buildings hosting various establishments. Respondents were obtained conveniently and interviewed face to face. Central obesity was defined as a waist circumference greater than 102 cm for males and greater than 88 cm for females. Chi-square test was conducted to assess the differences among the groups. Simple and multiple logistic regression models were fitted to identify the correlates of central obesity.ResultsA total of 392 respondents (98% response rate) agreed and participated in the study. The overall prevalence of central obesity was found to be 41.8% (164/392). The prevalence of central obesity was significantly higher among females (67.4% p < 0.001), respondents aged ≥51 years (60%, p = < 0.001), administrators (55.1% p = < 0.05), respondents with salary of > 1,000,000 Tanzanian Shilling (TSh.) per month (54.4%, p = < 0.05), respondents who eat homemade meals at the workplace (64.2%, p = < 0.05) and respondents with hypertension (62.5%, p = < 0.05). Correlates of central obesity were found to be female sex (AOR = 9.53; 95% CI: 5.49, 16.78), increased age, eating homemade meals at the workplace (AOR = 2.32; 95% CI: 1.04, 4.19) and hypertension (AOR = 3.15; 95% CI: 1.41, 6.91).ConclusionsThe present study revealed high prevalence of central obesity among formal sector employees in Dodoma City. Scholars and stakeholders are urged to generate more evidences and design appropriate interventions to curb the situation.

Prevalence of Obesity and Predictive Value of Central Obesity among Medical Doctors to Diagnose Hypertension

Introduction: Central obesity has been shown to have worse health outcomes than general obesity and plays a greater role in the causation of cardiovascular diseases. Prevalence of central obesity is high in Nigeria and is associated with increased cardiovascular risk. Aim: To assess the prevalence of central obesity in medical doctors in Bayelsa state using four obesity indices and to determine the association between these indices and compare the ability of these indices to predict cardiovascular risk. Materials and Methods: This was a descriptive cross-sectional study conducted between August 2018 and January 2019. Using a structured self-administered questionnaire, data was collected from 244 randomly selected medical doctors. Data included socio-demographic information, work duration and professional cadre, Blood Pressure (BP) was taken. Anthropometric measures which included weight (in Kg), height (in metres), Waist Circumference (WC) and Hip Circumference (HC) in centimeters was taken. From the different measures: Waist-Hip Ratio (WHpR), Waist-Height Ratio (WHtR), Body Mass Index (BMI) was calculated. Based on WHO recommended thresholds, WC, WHpR, WHtR and BMI were used in categorising participants as obese and non-obese. Correlation analysis was done and Receiver Operating Characteristic (ROC) curve was constructed. Statistical significance was set at p-value &lt;0.05. Results: Most doctors in the study were less than 30-year-old (40.2%), married (54.9%) and female doctors made up a third of the respondents (29.9%). The mean age of study participants was 37.4 years (SD-11.3 years) and mean duration of medical practice was 9 years (SD-11.1 years). The prevalence of elevated BP was 26.6% using a BP threshold of ≥140/90 mmHg. The prevalence of obesity was 18.4% using BMI ≥30 kg/m2. Based on WC, WHtR, and WHpR categorisations, the prevalence of obesity was 44.3%, 58.2%, and 63.1%, respectively. The weakest relationship existed between BMI and BP (r=0.15; p=0.019); while the correlation coefficient (r) between WC and WHtR showed a very strong positive relationship (r=0.88; p=0.001). ROC curve analysis revealed all anthropometric indices obtained modest performances in predicting Cardiovascular Diseases (CVD) risk as indicated by AUC values that were equal to or higher than 0.60. WC performed best in predicting hypertension in study participants (0.69) while BMI was the worst performer (0.60). Conclusion: A high prevalence of central obesity in medical doctors is worrisome given the associated cardiovascular risks. This study shows all four anthropometric indices (WC, WHtR, WHpR and BMI) are useful in predicting cardiovascular risk, with the best and worst predictors being WC and BMI, respectively.

Isolated systolic hypertension and central blood pressure: Implications from the national nutrition and health survey in Taiwan.

We aimed to investigate the association between isolated systolic hypertension (ISH) and central blood pressure (BP) in a nationally representative population, with a focus on the young and middle‐aged adults (<50 years old). A total of 2029 adults without taking antihypertensive medications, aged ≥ 19 years old, participated in the 2013–2016 National Nutrition and Health Survey in Taiwan. Central and brachial BP were simultaneously measured using a cuff‐based stand‐alone central blood pressure monitor purporting to measure invasive central BP (type II device). Central hypertension was defined by central systolic (SBP)/diastolic BP (DBP) ≥130 or 90 mm Hg, and ISH was defined by brachial SBP ≥ 140 and DBP < 90 mm Hg. Overall, the prevalence rates of ISH, isolated diastolic hypertension (IDH, brachial SBP < 140 and DBP ≥ 90 mmHg), and systolic/diastolic hypertension (SDH, brachial SBP ≥ 140 and DBP ≥ 90 mmHg) were 6.51%, 1.92%, and 4.34%, respectively. ISH subjects had significantly higher central pulse pressure (PP) (62.8 ± 9.7 mm Hg for age < 50 years and 72.4 ± 13.5 mmHg for age ≥ 50 years) than those subjects with either IDH (44.7 ± 10.7 and 44.9 ± 10.6 mmHg) or SDH (55.2 ± 14.0 and 62.6 ± 17.1 mmHg). All ISH adults had central hypertension, and a higher prevalence of central obesity than the normotensives (80.95% vs. 26.15%, for age < 50 years; and 63.96% vs. 43.37% for age ≥ 50 years). All untreated subjects with ISH, whether younger or older, had central hypertension and had significantly higher central PP than those with IDH or SDH. Central obesity was one of the major characteristics of ISH, especially in the young‐ and middle‐aged adults.

Screening of central obesity among normal-weight children and adolescents in Shandong, China.

The prevalence of central obesity in the total population has been reported in numerous studies. However, information on the prevalence of central obesity within normal-category BMI is scant. In the present study, we examined the profiles of central obesity among normal-weight children and adolescents. A total of 29516 (14226 boys and 15290 girls) normal-weight children and adolescents (excluding underweight, overweight and obesity) aged 7-18 years were included in the final analysis. Central obesity was defined by the international age- and sex-specific cut-offs of waist circumference (WC) and threshold of waist:height ratio (WHtR ≥ 0·5). All subjects were classified into four groups (Q1-Q4) according to the age- and sex-specific quartiles of BMI, those in the upper fourth (Q4) were defined as 'high-normal BMI' and those in the lower fourth (Q1) were defined as 'low-normal BMI'. The prevalence of central obesity as measured by WC was 9·90 (95 % CI 9·41, 10·39) % for boys and 8·11 (95 % CI 7·68, 8·54) % for girls; by WHtR was 2·97 (95 % CI 2·69, 3·25) % for boys and 2·44 (95 % CI 2·20, 2·68) % for girls. Subjects in the Q4 group had a much higher prevalence of central obesity than their counterparts in the Q1 group (P < 0·01). Our findings suggest that the health risks of children with normal-weight central obesity may be missed when BMI is used alone as a measure; it is meaningful to include WC in clinical practice and to include the simple message 'Keep your waist to less than half your height'.

The association between obesity and poor outcome after COVID-19 indicates a potential therapeutic role for montelukast

It is widely believed that infection with the SARS-CoV-2 virus triggers a disproportionate immune response which causes a devastating systemic injury, particularly in individuals with obesity, itself a chronic, multi-organ inflammatory disease. Immune cells accumulate in visceral adipose tissue and together with paracrine adipocytes release a wide range of biologically active cytokines (including IL-1β, IL5, IL6 and IL8) that can result in both local, pulmonary and systemic inflammation. A more intense ‘cytokine storm’ is postulated as the mechanism behind the extreme immune response seen in severe COVID-19.It is striking how dangerous the combination of obesity and COVID-19 is, resulting in a greater risk of ICU admission and a higher mortality. Furthermore, patients from a BAME background appear to have increased mortality after SARS-CoV-2 infection; they also have a higher prevalence of central obesity and its metabolic complications.In the absence of an effective vaccine, the therapeutic potential of immune-modulating drugs is a priority, but the development of new drugs is expensive and time-consuming. A more pragmatic solution would be to seek to repurpose existing drugs, particularly those that might suppress the heightened cytokine activity seen in obesity, the major risk factor for a poor prognosis in COVID-19.Montelukast is a cysteinyl leukotriene receptor antagonist licensed to treat asthma and allergic rhinitis. It has been shown to diminish pulmonary response to antigen, tissue eosinophilia and IL-5 expression in inflammatory cells. It has also been shown to decrease elevated levels of IL-1β and IL8 in humans with viral upper respiratory tract infections compared with placebo-treated patients. In addition, in silico studies have demonstrated a high binding affinity of the montelukast molecule to the terminal site of the virus’s main protease enzyme which is needed for virus RNA synthesis and replication.Montelukast, which is cheap, safe and widely available would appear to have the potential to be an ideal candidate drug for clinical trials, particularly in early stage disease before irreparable tissue damage has already occurred. HypothesisThrough a direct anti-viral effect, or by suppression of heightened cytokine release in response to SARS-CoV-2, montelukast will reduce the severity of immune-mediated multiorgan damage resulting from COVID-19, particularly in patients with central obesity and metabolic syndrome.

Fetal Exposure to Chinese Famine Increases Obesity Risk in Adulthood.

Fetal exposure to famine may have long-term consequences in adulthood. The purpose of the present study was to explore the association between famine exposure in fetal life (Chinese famine in 1959–1961) and obesity risk in adulthood. A total of 8054 subjects (3422 male, 4632 female) were recruited from the cross-sectional 2010–2012 China National Nutrition and Health Survey (CNNHS). The subjects born in 1960 and 1961 were selected as the exposed group, while the subjects born in 1963 were selected as the unexposed group. Multiple linear or logistic regression was performed to examine the association between fetal exposure to famine and risk of obesity (body mass index (BMI), waist circumference (WC), obesity, central obesity) adjusting for gender, education level, economic status, physical exercise, sedentary time, smoking, drinking, the intake of livestock and poultry and the intake of cereal and beans. Compared with the unexposed group, WC increased by 0.52 cm after adjusting the covariates (p = 0.021) and females in the exposed group had a significantly higher prevalence of central obesity with an odds ratio (OR) of 1.15 (1.01,1.31) after adjusting the confounders (p = 0.030). WC increased by 0.71 cm, 1.21 cm after adjusting the covariates compared with the unexposed group among the total subjects and the female subjects in urban areas (p = 0.021, p = 0.001). The female subjects had a significantly higher prevalence of obesity and central obesity, with ORs of 1.34 (1.04,1.71) (p = 0.022), 1.28 (1.07,1.53) (p = 0.008) respectively. Our results suggest that fetal exposure to the Chinese famine increased obesity risk in adulthood, and the association was stronger in female and urban subjects.

Prevalence of Obesity and Correlated Hypertension and Hyperglycaemia Status among Participants of a Health Screening Programme in Inanam Sub-District, Kota Kinabalu, Sabah, Malaysia

Obesity is a known risk factor for non-communicable diseases, including hypertension and diabetes mellitus, with Malaysia having the highest prevalence of obesity among Southeast Asian countries. Additionally, the delivery of medical services to the rural communities remains challenging despite efforts to increase accessibilities to the healthcare facilities. Therefore, regular health screening programmes specifically aiming at these communities are necessary for early diagnosis and intervention to prevent complications while improving the patients’ quality of life. A health screening programme was conducted in a sub-district of Kota Kinabalu, Sabah, Malaysia, where 50 participants were examined for general obesity based on body mass index (BMI) together with central obesity according to waist circumference (WC) and waist-to-hip ratio (WHR). Bioelectrical impedance analysis was performed to estimate body fat percentage (fat%) and body fat mass, along with the measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), and capillary blood glucose. The median age of the participants was 39.50 years. The prevalence of general obesity, central obesity based on WC and WHR, hypertension, and hyperglycaemia was 28%, 78%, 74%, 24%, and 20%, respectively. Both fat% and fat mass had positive correlations to the BMI (fat%: r = 0.656, p = 0.001; fat mass: r = 0.868, p = 0.001) and WC (fat%: r = 0.505, p = 0.001; fat mass: r = 0.761, p = 0.001). DBP had positive correlations with the BMI (r = 0.390, p = 0.005), WC (r = 0.467, p = 0.001), and WHR (r = 0.331, p = 0.019), while SBP had a positive correlation only with WC (r = 0.341, p = 0.015). Conversely, capillary blood glucose had no significant correlation with either BMI, WC, or WHR. The higher prevalence of central obesity among participants of the health screening program compared to the national level should raise concern among the healthcare providers regarding the future risk for hypertension and hyperglycaemia in this community.

Central obesity and hypertension among rural adults of Paschim Medinipur, West Bengal, India

Obesity is generally classified into generalized obesity (BMI ≥30 kg/m2) and abdominal or central obesity (WC ≥90 cm for men and WC ≥80 cm for women) based on World Health Organization recommendation for Asians. Hypertension is one of the most common obesity-related complications, and about 30% of hypertensive individuals can be classified as being obese. The present study aimed to investigate the effect of different age groups (years) on the anthropometric and derived variables. It determined the correlation between anthropometric and derived variables and also estimated the frequency of central obesity and hypertension. Finally, it investigated the relationship between central obesity and blood pressure among rural Bengalee adults of Dirghagram village of Ghatal Block, Paschim Medinipur, West Bengal, India. The present cross-sectional study was undertaken among 310 rural adults (154 males; 156 females) aged over 18 years. Our study was carried out during March, 2017. Height (cm), weight (kg), waist circumference (cm), hip circumference (cm) and blood pressure (systolic and diastolic) were measured using standard procedures. One way ANOVA analysis on most of the anthropometric and derived variables showed a statistically significant increase from younger to older age group in both sexes (p&lt;0.001;p&lt;0.01; p&lt;0.05). In addition to that, more females had central obesity using waist circumference (55.8% vs. 19.5%), waist hip ratio (87.2% vs. 35.7%), waist height ratio (73.7% vs. 44.2%), and conicity index (87.2% vs. 57.8%) criteria, and hypertension (52.5% vs. 27.3%). The prevalence of central obesity was much higher in case of hypertensive individuals. Therefore, the present study showed a high prevalence of central obesity among the rural adults of Dirghagram village. Furthermore, central obesity contributed in increasing hypertension among the villagers.