Higher Waist Research Articles

Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference.

Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC). The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM). Baseline data were collected from 28 adults (mean=61.4±6.9years, 64.3% female) with obesity (BMI 38.6±5.0kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement. Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3cm). Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC. Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.

Body Composition and Clinical Outcomes in Esophageal Cancer Patients Treated with Immune Checkpoint Inhibitors.

Obesity is associated with increased mortality in various cancers, but the relationship between obesity and clinical outcomes in unresectable or recurrent esophageal cancer who receive immune checkpoint inhibitors (ICIs) remains unknown. This study investigated the association between body composition and clinical outcomes in patients with unresectable or recurrent esophageal cancer who received ICIs. Utilizing an unbiased database of 111 unresectable or recurrent esophageal cancers, we evaluated the relationships between body composition (body mass index, waist circumference, psoas major muscle volume, and subcutaneous and visceral fat areas) at the initiation of ICI treatment and clinical outcomes including the disease control rate and progression-free survival (PFS). Waist circumference was significantly associated with the disease control rate at the first assessment (P = 0.0008). A high waist circumference was significantly associated with favorable PFS in patients treated with nivolumab. In an univariable model, for 5-cm increase of waist circumference in the outcome category of PFS, univariable hazard ratio (HR) was 0.73 (95% confidence interval [CI], 0.61-0.87; P = 0.0002). A multivariable model controlling for potential confounders yielded a similar finding (multivariable HR, 0.56; 95% CI, 0.33-0.94; P = 0.027). We observed the similar finding in esophageal cancer patients treated with pembrolizumab+CDDP+5-FU (P = 0.048). In addition, waist circumference was significantly associated with the prognostic nutritional index (P = 0.0073). A high waist circumference was associated with favorable clinical outcomes in ICI-treated patients with unresectable or recurrent esophageal cancer, providing a platform for further investigations on the relationships among body composition, nutrition, and the immune status.

Obesity, Physical Performance, Balance Confidence, and Falls in Community-Dwelling Older Adults: Results from the Korean Frailty and Aging Cohort Study.

Obesity affects physical functions in numerous ways. We aimed to evaluate the association between obesity and falls, physical performance, and balance confidence in community-dwelling older adults. Using first-year baseline data from the Korean Frailty and Aging Cohort Study, 979 older adults were included. General obesity was defined based on the body mass index and body fat percentage, whereas central obesity was classified based on the waist circumference and waist-to-height ratio. Data regarding fall history and balance confidence were acquired using self-questionnaires, and a timed up-and-go test was performed to measure balance-related physical performance. Overall, 17.3% of participants experienced falls in the previous year. Central obesity, as determined by waist circumference (odds ratio, 1.461; 95% confidence interval, 1.024-2.086; p-value, 0.037) and by waist-to-height ratio (odds ratio, 1.808; 95% confidence interval, 1.015-3.221; p-value, 0.044) was significantly associated with falls. Interestingly, general obesity, measured by body fat percentage, was protective against fall-related fractures (odds ratio, 0.211; 95% confidence interval, 0.072-0.615; p-value, 0.004). Participants with central obesity had poorer physical performances in the timed up-and-go test (odds ratio, 2.162; 95% confidence interval, 1.203-3.889; p-value, 0.010) and lower balance confidence according to the Activities-specific Balance Confidence scale (odds ratio, 1.681; 95% confidence interval, 1.153-2.341; p-value 0.007). In conclusion, assessment of central obesity, particularly waist circumference, should be considered as a screening strategy for falls, and older adults with a high waist circumference should receive advice on fall prevention.

Association between overweight/obesity perception, actual body weight and cardiometabolic risk among healthy Ghanaian adults

BackgroundThe global rise in obesity, particularly among black Africans in developing nations experiencing nutritional transitions, underscores the importance of exploring Overweight/Obesity Perception (OP) as a crucial factor in maintaining an optimal body weight. Incorrect body image perception may impede efforts to achieve the desired body weight, leading to adverse outcomes related to Cardiometabolic Diseases (CMD). This cross-sectional study investigated the interplay between overweight/obesity perception, actual body weight, and CMD risk in a cohort of healthy Ghanaian adults. MethodsA total of 302 apparently healthy adults, aged 25–60 years, with Dagomba ancestry, were recruited from three communities. Participants were screened based on age, ancestry, history of communicable and Non-Communicable Diseases (NCD), and use of antidiabetic, lipid-lowering, and antihypertensive drugs. Anthropometric assessments and blood sample collections for biochemical analysis were conducted. Body image perception was measured using the Stunkard Figure Rating Scale (SFRS). Data were analyzed using descriptive statistics, chi-square tests, correlation analysis, logistic regression, and multivariate analysis. ResultsParticipants had a mean age of 38.28 ± 10.88, with 61.6% being women. While 47% accurately perceived their body weight, 53% had incorrect perceptions. Notably, 47.2% underestimated and 8.5% overestimated their weight status. Among overweight individuals, 33% underestimated and 9.4% overestimated their weight, whereas among the obese, 66.7% and 33.3% respectively had inaccurate perceptions. Gender, serum triglyceride levels, and waist circumference were significantly associated with weight perception. About 55% of overweight/obese participants and 62.1% with high waist circumference did not express a desire to lose weight. Multiple logistic regression revealed that both overweight (AOR = 6, 95% CI (1.8–20.2), p < 0.05) and obesity (AOR = 20.5, 95% CI (5–84.9), p < 0.05) significantly increased the odds of CMD. ConclusionThe findings underscore the association between overweight/obesity and an elevated risk of CMD. This emphasizes the imperative for public health interventions aimed at promoting an ideal body weight and highlighting the impact of overweight/obesity on CMD risk factors.

Metabolic syndrome: a population-based study of prevalence and risk factors

The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15–35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02–2.21, OR: 1.66, 95%CI 1.11–2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20–1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01–1.49 and OR: 1.41, 95%CI 1.01–1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Associations of Skeletal Muscle Mass, Muscle Fat Infiltration, Mitochondrial Energetics, and Cardiorespiratory Fitness With Liver Fat Among Older Adults.

Muscle mass loss may be associated with liver fat accumulation, yet scientific consensus is lacking and evidence in older adults is scant. It is unclear which muscle characteristics might contribute to this association in older adults. We associated comprehensive muscle-related phenotypes including muscle mass normalized to body weight (D3-creatine dilution), muscle fat infiltration (magnetic resonance imaging), carbohydrate-supported muscle mitochondrial maximal oxidative phosphorylation (respirometry), and cardiorespiratory fitness (VO2 peak) with liver fat among older adults. Linear regression models adjusted for age, gender, technician (respirometry only), daily minutes of moderate-to-vigorous physical activity, and prediabetes/diabetes status tested main effects and interactions of each independent variable with waist circumference (high: women-≥88cm, men-≥102cm) and gender. Among older adults aged 75 (interquartile range: 73, 79 years; 59.8% women), muscle mass and liver fat were not associated overall (N = 362) but were positively associated among participants with a high waist circumference (β: 25.2; 95% confidence intervals [95% CI]: 11.7, 40.4; p = .0002; N = 160). Muscle fat infiltration and liver fat were positively associated (β: 15.2; 95% CI: 6.8, 24.3; p = .0003; N = 378). Carbohydrate-supported maximum oxidative phosphorylation (before adjustment) and VO2 peak (after adjustment; β: -12.9; 95% CI: -20.3, -4.8; p = .003; N = 361) were inversely associated with liver fat; adjustment attenuated the estimate for maximum oxidative phosphorylation although the point estimate remained negative (β: -4.0; 95% CI: -11.6, 4.2; p = .32; N = 321). Skeletal muscle-related characteristics are metabolically relevant factors linked to liver fat in older adults. Future research should confirm our results to determine whether trials targeting mechanisms common to liver and muscle fat accumulation are warranted.

Prevalence and Association of Hypertension among the Government Civil Employees of Bangladesh Armed Forces Attending BNS Patenga (Navy Hospital), Chattogram

Hypertension is a major risk factor for several cardiovascular diseases (CVD). A descriptive, cross-sectional study was conducted to estimate the prevalence of hypertension and its risk factors among the government civil employees of Bangladesh Armed Forces reported to BNS Patenga (Navy Hospital), Chattogram, Bangladesh, between January and June 2023. The study involved participants aged 25-60 years who are government civil employees working in Bangladesh Armed Forces in Chattogram area. This study was done using multi-stage random sampling. Data on age, gender, smoking habits, sedentary lifestyle, obesity, diabetes, dyslipidemia, physical activity, diet, extra salt use, family history of hypertension, cardiovascular disease and cerebrovascular disease, anthropometric measurements and blood pressure were collected using modified WHO-STEPS protocol. Hypertension was defined according to JNC-8 guidelines. Multiple logistic regressions models were used to identify risk factors associated with hypertension. Data were collected with semi-structured questionnaire and checklist by face-to-face interview and reviewing medical records respectively. Data were analyzed by SPSS version 19.0. A total of 150 participated (128 male and 22 female). Among the study population, 17% had hyperlipidemia, 32% consume high caloric diet, 15% were overweight, 20% had smoking habit, 17% were working in stressful environment, 57% were sedentary worker, 19% having family history of hypertension. The overall age-adjusted prevalence hypertension among 150 participants was 27%, which was higher among males compared to females (25% in contrast to 2%). Bivariate analysis showed significant relationship of hypertension with age, BMI, no physical activity, tobacco use, extra salt intake, dyslipidaemia, stressful life, high calorie diet, diabetes, and family history of stroke/cardiovascular disease, hypertension, diabetes and dyslipidaemia. In the multivariate model, factors significantly associated with hypertension were older age (33%), smoking (26%), extra salt intake (35%), and high waist circumference (36%). The prevalence of hypertension was high among our study participants. Population-based intervention programs and policies for increased awareness about the risk factors, and life-style modification are essential for prevention of hypertension. CBMJ 2024 January: vol. 13 no. 01 P: 17-21

Study from the United States: increased prevalence of kidney stones in patients with high weight-adjusted waist index.

Using data from NHANES 2007-2018, to examine the association between WWI (weight-adjusted waist index) index and prevalence of kidney stones. Using multiple logistic regression analysis of the National Health and Nutrition Examination Survey (NHANES) 2007-2018, we evaluated the association between WWI index and the prevalence of kidney stones, followed by subgroup analysis of sensitive populations. Smooth curve fitting was used to determine whether there was a non-linear relationship between the WWI index and kidney stone prevalence, and threshold effect analysis was used to test this relationship. Among 29,280 participants, 2,760 self-reported renal calculi. After adjustment for all confounders, there was a positive association between WWI and kidney stone prevalence (OR = 1.20, 95% CI: 1.12, 1.28), and this positive association was stronger with increasing WWI (and P = 0.01 for trend). Our results indicate a non-linear positive correlation between WWI index and kidney stones, with the saturation threshold effect analysis and the most important threshold value at 11.02. According to subgroup analysis, WWI showed the strongest association with kidney stone prevalence in participants aged 20-39 years, males, other US ethnic groups, and participants without hypertension and diabetes. Increased WWI is positively associated with increased incidence of kidney stones, and increased WWI is a high risk for kidney stones that should be treated with caution. This association should be more pronounced in people between the ages of 20 and 39 years, in men, in other US ethnic populations, and in participants who do not have hypertension or diabetes.

Metabolic and endocrine status associate with obstructive sleep apnea risk among patients with polycystic ovary syndrome.

Risk of obstructive sleep apnea (OSA) appears to be increased among patients with polycystic ovary syndrome (PCOS), but the underlying physiology is unclear. We sought to identify predictors of OSA risk among patients with PCOS. A cross-sectional analysis of patients evaluated for PCOS at a single tertiary center from 2017-2022 was completed. Inclusion criteria included patients 18-44 years of age who had Rotterdam criteria for PCOS and had completed a Berlin Questionnaire (BQ) for OSA risk assessment. All patients underwent standardized anthropometric, ultrasound, endocrine, and metabolic phenotyping. Of the 572 patients screened during the study period, 309 patients with PCOS met inclusion criteria, and 104 (33.7%) had a high-risk BQ. Those with a high-risk BQ, compared with those without, had significantly (P < .05) higher waist:hip ratio, low-density-lipoprotein cholesterol, triglycerides, fasting insulin, 2-hour insulin, fasting glucose, 2-hour glucose, homeostatic model assessment for insulin resistance, hemoglobin A1C, C-reactive protein, free testosterone, and free androgen index and had lower high-density-lipoprotein cholesterol and sex hormone binding globulin. In multivariable modeling controlling for all significantly differing variables in univariate analyses, hemoglobin A1C (β [standard error] 1.05 [0.45], P = .02), C-reactive protein (0.09 [0.04], P = .01), and sex hormone binding globulin (-0.02 [0.01], P = .02) associated with high-risk BQ. Dysglycemia, inflammation, and androgen status independently associate with predicted OSA risk by BQ. Future studies are needed to comprehensively assess the impact of treatment of OSA on these outcomes among patients with PCOS to better clarify the directionality and clinical implications of these associations. Christ JP, Shinkai K, Corley J, Pasch L, Cedars MI, Huddleston HG. Metabolic and endocrine status associate with obstructive sleep apnea risk among patients with polycystic ovary syndrome. J Clin Sleep Med. 2024;20(6):871-877.

Sex differential impact of comorbidities in spondyloarthritis: data from COMOSPA study

ObjectivesTo describe and compare the prevalence of comorbidities in female and male patients with spondyloarthritis (SpA) and to assess whether comorbidities had a different impact on disease outcomes in male...

Prevalence and risk factors of gastroesophageal reflux disease symptoms in Mazandaran, North of Iran: A Tabari cohort study.

Gastro-esophageal reflux disease (GERD) is a very common complaint. It is a major health concern and there is paucity of information about the epidemiology of the disease and its risk factors in Iran, especially Mazandaran province (North of Iran). This study aimed at investigating the prevalence of regurgitation and the factors associated with this condition in Tabari cohort study. This was a cross-sectional study that analyzed data from Tabari cohort study. Information including the presence and frequency of heartburn and regurgitation, demographic characteristics, socioeconomic status, occupational history, history of chronic illnesses, history of alcohol and cigarette consumption were recorded. The prevalence of GERD symptoms were 27.6% (20.4% in men, and 32.4% in women, p=0.0001). The frequency of typical symptoms was significantly higher in women than that in men. The risk of developing GERD symptoms were 1.7 times higher in women (p=0.0001). The highest prevalence of GERD symptoms was found in urban areas (41.8%, p=0.0001), in people with low educational levels (48%, p=0.0001), and in participants with history of depression symptoms (36.2%, p=0.0001). The prevalence of GERD symptoms was significantly high in individuals with higher BMI (29.5%, p=0.006), greater waist to hip ratio (29.1%, p=0.0001, p=0.0001), and high waist circumference (31.7%, p=0.0001). This study showed gender, region of residence, educational level, and depression symptoms as the main risk factors for developing GERD symptoms.

Obesity from Clinical Evaluation to Management Local Perspective

For over two millennia, physicians have been aware of the morbidity and mortality linked to overweight and obesity. Various definitions of obesity, as outlined by the World Health Organization (WHO) and the Centers for Disease Control &amp; Prevention (CDC), utilize the Body Mass Index (BMI) to characterize these conditions. Screening for high-risk patients is crucial for guiding lifestyle changes, treatment decisions, and risk reduction strategies.1,2 The assessment involves clinical and laboratory studies to categorize the type and severity of obesity, forming the foundation for effective management. Globally, the prevalence of obesity in 2015 exhibited a rising trend in females compared to males. Between 1980 and 2015, the prevalence surged from 11.1% to 38.3% for males aged 25 to 29 in low to middle-income countries.3 Pakistan ranks tenth among 188 countries, with half of its population classified as overweight or obese. Alarming projections from the World Obese Federation estimate that 5.4 million Pakistani school-aged children will grapple with obesity by 2030, emphasizing the dual challenges of overnutrition and poor nutrition.4,5 World Health Organization data indicates that 58.1% of Pakistanis are overweight, with 43.9% classified as obese. Asian cutoffs, though not globally recognized, suggest that 72.3% of Pakistanis are overweight, with obesity affecting 58.1% of the population. Research by Danielle H. Bodicoat et al. suggests an obesity threshold of 25 kg/m2 for South Asian individuals, coupled with a very high Waist Circumference (WC).6 A WC ≥ 31 inches (80cm) in Asian females and ≥ 35 inches (90cm) in Asian males is considered abnormal. The primary rationale for managing obesity is to mitigate morbidity, including conditions like diabetes, hypertension, dyslipidemia, heart disease, stroke, sleep apnea, and cancer, ultimately reducing mortality. The initial step in managing obesity involves screening to determine the degree of overweight using BMI and waist circumference measurements. However, studies reveal that only 6% of individuals receive ongoing care for weight management, such as prescriptions for obesity medication or referrals to dieticians.7,8 BMI classifications, primarily based on cardiovascular disease (CVD) risk, may underestimate risks for conditions like diabetes in the Asian population. Beyond BMI, measuring waist circumference is essential for identifying adults at increased risk for morbidity and mortality, especially in the BMI range of 25 to 35 kg/m2.9 In addition to physical examinations, measurements of fasting glucose (or glycated hemoglobin [A1C]), thyroid-stimulating hormone (TSH), liver enzymes, and fasting lipids should be conducted.10 Investigating the causes of obesity involves ruling out a sedentary lifestyle, increased caloric intake, and secondary factors. Medical history should include inquiries about medications that cause weight gain and smoking cessation. Weight loss interventions are recommended for those with a BMI exceeding 25 kg/m2, aiming to prevent, treat, or reverse complications associated with obesity. In conclusion, managing obesity in the Pakistani population requires a comprehensive approach involving clinical and laboratory assessments by physicians. This includes evaluating height, weight, BMI, waist circumference, blood pressure, serum triglycerides, serum HDL, cholesterol, fasting blood sugar/HbA1C, history of sleep apnea, medication history, physical activity, and etiological factors. Moreover, physicians should possess knowledge of dietary goals and medications promoting weight loss and consider bariatric surgery if non-responsive to other interventions.

Tình trạng dinh dưỡng ở người bệnh đái tháo đường type 2 tại bệnh viện Nội tiết Trung Ương, năm 2022

Objective: To describe the nutritional status of patients with type 2 diabetes at the National Hospital of Endocrinology in 2022. Methods: Cross-sectional study, interviews by direct questionnaire on 203 patients with type 2 diabetes at the National Hospital of Endocrinology from 10 to 12/2022. 203 patients were female, accounting for 54.2%, the mean age was 62.1(±12.4). The percentage of high waist circumference according to BMI group (CED, normal, overweight, obese) was 0%, 45.3%, 65.9% and 92.9%, respectively. The ratio of waist circumference/height according to BMI group (CED, normal, overweight, obese) was 38.5%, 85.3%, 90.2% and 94.7%, respectively. The ratio of waist circumference/height according to BMI group (CED, normal, overweight, obese) this difference is statistically significant with p&lt;0.05. Therefore, it is necessary to adjust the diet, to have a reasonable weight loss plan for hunger, physical activity, physical education and counseling to maintain the indicators in the normal range. Overweight/obesity is common among study subjects, overweight/obesity rate is higher in women than in men.

Obesity and Albuminuria in Patients with Chronic Renal Disease and Hypertension as a Comorbidity: The Optimum Body Mass Index

Background: Obesity was associated with a greater risk for development of Chronic Kidney Disease (CKD) among subjects with and without hypertension, diabetes or cardiovascular disease. We aimed to consider the association between obesity and albuminuria in patients with CKD according to Estimated Glomerular Filtration Rate (e-GFR) and demonstrated hypertension. We also aimed to observe the optimum Body Mass Index (BMI) in this population. Methods: One hundred-thirty-three overweight and/or obese subjects with manifested hypertension were participated and they were matched to forty-three hypertensive control subjects with a normal body weight. Our participants were classified in both eGFR and albuminuria categories according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria. The obesity was defined as a high BMI (≥25 Kg/m2 as overweight and/or ≥30 Kg/m2 as obese) and the central obesity as a high waist circumference (WC) (≥94 cm in males and ≥80 cm in females). Results: The most of subjects with a lean/normal BMI did not have albuminuria (x2=24.2, p=0.001) and the most of those with a high BMI, but with a normal WC did not have albuminuria (x2=39.7, p=0.001). The high WC was found to be a main risk factor for albuminuria adjusting to confounders. Conclusions: The central obesity was shown to be the most important factor for albuminuria in patients with classified CKD rather than a high BMI independently on hypertension. The optimum BMI seems to be in the normal range for these patients similarly to the general population.

Anthropometrics and Plasma Atherogenic Index in Saudi Women Madinah KSA.

to determine the lipid profile levels and association with anthropometric measurements and atherogenic index of plasma values in females from Taibah University. A cross-sectional study was conducted from January 2019 to January 2020 at the female section of Taibah University, located in Madinah, Saudi Arabia. The study sample consisted of 240 females ranging from 19 to 50 years. Measurements related to anthropometry such as height, weight, waist, and hip circumference, were calculated. Body Mass Index, Lipid profiles, and Atherogenic Index of Plasma were also measured. Almost 73.4% of the participants were obese and overweight, with a mean BMI of 28.79±5.7 kg/m2. Overweight and obese women were observed to have high total cholesterol and triglyceride levels (P≤0.05). Out of 244 participants, 120 (49.2%) and 44 (18%) were at intermediate and high risk of cardiovascular disease (CVD), respectively, as determined by the atherogenic index of plasma AIP. Intermediate and high-risk CVD groups had higher lipid profile levels and high waist-to-hip ratio compared to those in females at low risk (P≤0.05). AIP was positively and significantly associated with total cholesterol and triglyceride but negatively correlated with HDL concentration. Furthermore, the BMI had significantly positive correlation with triglyceride and waist to hip ratio (P≤0.05). The majority of the participants were overweight and obese, with high levels of triglycerides and total cholesterol and high waist to hip ratio, placing them at intermediate or high risk of CVD based on AIP values. Additional CVD risk screenings, targeted specifically at overweight and obese women, are needed.

SARC-F and modified versions using arm and calf circumference: Diagnostic performance for sarcopenia screening and the impact of obesity.

SARC-F is limited by low sensitivity for sarcopenia identification. As surrogates of muscle mass, mid-arm circumference (MAC) and/or calf circumference have been proposed as additions to SARC-F to enhance sarcopenia identification. The aim of this study was to evaluate the diagnostic performance of SARC-F, SARC-CalF, SARC-F + MAC, and SARC-CalF + MAC in sarcopenia detection, and to assess the impact of obesity on their diagnostic performance. We studied 230 healthy non-frail community-dwelling older adults age >50 years. We performed receiver operating characteristic curve analysis for SARC-F, SARC-CalF, SARC-F + MAC and SARC-CalF + MAC against sarcopenia diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 as the reference standard. Obesity was defined by high waist circumference (men ≥90 cm, women ≥80 cm). We performed subgroup analysis to compare between obese and non-obese groups. The prevalence of sarcopenia was 27.0% by AWGS 2019. SARC-CalF + MAC had the best diagnostic performance (area under the curve [AUC] 0.74, 95% confidence interval [CI] 0.67-0.81; sensitivity 66.1%; specificity 69.1%), followed by SARC-CalF (AUC 0.70, 95% CI 0.62-0.78; sensitivity 21.0%; specificity 95.8%). SARC-F (AUC 0.57, 95% CI 0.49-0.66; sensitivity 0%; specificity 100%) performed significantly worsethan its modified versions (P < 0.05). There was higher accuracy of sarcopenia identification in obese compared with non-obese groups for SARC-F + MAC (AUC 0.75, 95% CI 0.65-0.85 vs. 0.58, 95% CI 0.46-0.70) and SARC-CalF + MAC (AUC 0.75, 95% CI 0.66-0.85 vs. 0.70, 95% CI 0.59-0.81). The addition of arm circumference to SARC-CalF confers better diagnostic accuracy for sarcopenia identification, especially in the obese group. Thus, MAC may complement SARC-CalF for community screening of sarcopenia amongst healthy community-dwelling older adults by increasing sensitivity for the detection of sarcopenic obesity. Geriatr Gerontol Int 2024; 24: 182-188.

The prevalence and clustering of metabolic syndrome risk components in Chinese population: a cross-sectional study.

The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components. The present study evaluated the epidemiological characteristics of the MetS components and their clustering condition among Chinese adults. 68383 participants aged 18-80 years from TIDE were scored on a six-point (0-5) MetS severity score (MSSS), which quantified their cumulative amount of MetS risk components. We evaluated the epidemiological characteristics of these components and their clustering conditions. Additionally, we examined the relation of age with the prevalence of different MSSSs or specific MetS components using restricted cubic splines. Among 68383 participants, 26113 men and 24582 women had abnormal MetS components. There were significant differences in most epidemiological characteristics between the 6 MSSS groups. The top three prevalence of abnormal metabolic components were high systolic blood pressure (SBP) (9.41%, n=6568), high waist circumference (WC) (8.13%, n=6120), and the cooccurrence of high SBP and high WC (6.33%, n=4622). Participants were more likely to have all five MetS components when HDL-C was low. Restricted cubic splines showed that when the MSSS ≥3, the MetS prevalence of male peaked and that of the female population increased most rapidly at 40-60 age group. The 40-60 age group can be regarded as the high-risk period of MetS, and elderly women have a higher risk of multiple metabolic disorders than men. The top three clustering of abnormal metabolic components were high SBP, high WC, and their combination. Multiple components aggregation was more likely to occur when HDL-C decreased.

Birth outcomes and early growth patterns associated with age at adiposity rebound: the Ma’anshan birth cohort (MABC) study

ObjectiveEarly onset of adiposity rebound (AR) is considered an early indicator of obesity risk. Our objective was to investigate the association of birth outcomes and early physical growth patterns with early AR in children.MethodsStudy subjects (n = 2705) were enrolled from the Ma’anshan birth cohort (MABC). The body mass index (BMI), head circumference, waist circumference, and body fat were collected. Rapid weight gain (RWG) was defined by the change in weight standard-deviation score in the first two years of life. Group-based trajectory modeling (GBTM) was used to determine children’s physical growth trajectories. The age of AR was fitted using fractional polynomial function models.ResultsChildren with very high BMI trajectories (RR = 2.83; 95% CI 2.33 to 1.40), rising BMI trajectories (RR = 3.15; 95% CI 2.66 to 3.72), high waist circumference trajectories (RR = 4.17; 95% CI 3.43 to 5.06), and high body fat trajectories (RR = 3.01; 95% CI 2.62 to 3.46) before 72 months of age were at a greater risk of experiencing early AR. Low birth weight (LBW) (RR = 1.86; 95% CI 1.28 to 2.51), preterm birth (PTB) (RR = 1.50; 95% CI 1.17 to 1.93), and small for gestational age (SGA) (RR = 1.37; 95% CI 1.14 to 1.64) associated with increased risk of early AR. Moreover, infants experiencing RWG (RR = 1.59; 95% CI 1.40 to 1.83), low BMI trajectories (RR = 1.27; 95% CI 1.06 to 1.53) and rising BMI trajectories (RR = 1.50; 95% CI 1.22 to 1.84) in the first two years were at higher risk of developing early AR subsequently. Compared to the group with non-early AR, the BMI of children with early AR tended to be lower first (from birth to 6 months of age) and then higher (from 18 to 72 months of age).ConclusionsChildren with overall high BMI, high waist circumference, and high body fat before 72 months of age are more likely to experience early AR, but infants with low BMI trajectories, rising BMI trajectories and infants experiencing RWG in the first two years of life similarly increase the risk of early AR. These results can help to understand the early factors and processes that lead to metabolic risks.

Association between dietary insulin index and load with cardiometabolic risk factors and risk of metabolic syndrome among the patients with type 2 diabetes: a cross-sectional study

BackgroundThis study aims to investigate the association between dietary insulin index (DII) and load (DIL) with cardiometabolic risk factors and the risk of developing metabolic syndrome (MetS) among patients with type 2 diabetes (T2DM).MethodsA cross-sectional study was conducted among 500 T2DM patients. Dietary intake was assessed using a validated food frequency questionnaire, and DII and DIL were calculated based on insulin response and energy content. Logistic regression analyses were performed to determine the odds ratios (ORs) for MetS.ResultsParticipants in the highest quartile of DIL had significantly higher odds of MetS (OR: 2.16; 95% CI: 1.02–4.25, P = 0.039) and hyperglycemia (OR: 1.69; 95% CI: 1.08–4.96, P = 0.032). We also discovered that patients in the highest quartile of DII had higher odds of MetS (OR: 1.69; 95% CI: 1.08–4.96, P = 0.034) and hyperglycemia (OR: 1.39; 95% CI: 1.04–4.12, P = 0.019). Furthermore, participants in the highest quartile of DIL (OR: 1.64; 95% CI: 1.00-2.59, P = 0.03) and DII (OR: 1.42; 95% CI: 1.05–1.95, P = 0.026) had higher odds of high waist circumference. When it came to hypertriglyceridemia, we found a significant association between DII and DIL only in the crude model, not the fully adjusted model. However, we didn’t observe any significant association between DII and DIL with hypercholesteremia, Low HDL, and high blood pressure (P > 0.05).ConclusionOur study provides evidence suggesting that a higher DII and DIL may be associated with an increased risk of cardiometabolic risk factors and MetS in patients with T2DM.

Abstract B098: Adiposity measures and obesity-related cancer: A report from the Oklahoma Strong Heart Study and Strong Heart Family Study

Abstract Background: Obesity, defined as a body mass index (BMI) ≥30 kg/m2, disproportionately affects American Indian (AI) people and is increasingly implicated in the incidence of certain cancers. Indeed, while obesity-related cancers account for 43% of incident cancers among all Americans, they account for 51% of incident cancers among AI people. Emerging evidence indicates that body fat distribution (e.g., central vs. peripheral) is associated with cancer independent of BMI. AI adults have a higher prevalence of central adiposity than other populations, yet prospective measures of adiposity associated with increased risk of obesity-related cancer over time in AI people remain limited. Methods: We partnered with the Strong Heart Study/Strong Heart Family Study (SHS/SHFS) and the Oklahoma Central Cancer Registry to link study cohort records with cancer surveillance records from 1997-2019 to systematically classify cancer incidence among cohort participants. We evaluated baseline measures of adiposity, including waist circumference (females cutpoint at 88 cm, males cutpoint at 102 cm) waist-to-hip ratio (females cutpoint at 0.85, males cutpoint at 0.90), and percent body fat (females cutpoint at 35%, males cutpoint at 25%), by the presence of incident obesity-related cancer. We classified survival time as time from the baseline exam date to cancer diagnosis, death, or the end of the study period, whichever occurred first. Participants without a cancer event were censored. To compare survival time by each adiposity measure, we used the log-rank test and generated Kaplan-Meier curves. Results: We identified 140 participants with an obesity-related cancer that linked with a cancer registry record (n=1956 without cancer). The average age at the baseline SHS/SHFS exam was 54 years for those with cancer and 48 years for those without cancer. The average age at cancer diagnosis was 69 years. The most common forms of obesity-related cancer were colorectal (n=40, 29%) and post-menopausal female breast cancer (n=35, 25%). We observed a higher incidence of obesity-related cancer among those with high waist circumference (7.8% v. 4.3%), high waist-to-hip ratio (7.5% vs. 4.2%), and high percent body fat (7.4% v. 4.6%) compared with lower levels of these adiposity measures. We observed differences in time to cancer by waist circumference (p=0.004), waist-to-hip ratio (p=0.03), and percent body fat (p=0.03). Discussion: We observed significant differences in time to cancer diagnosis by multiple adiposity measures within the SHS/SHFS in Oklahoma. As a next step, we plan to link with the other SHS/SHFS sites in the Dakotas and Arizona. This study will provide a solid foundation upon which to base interventions to ameliorate risk factors for obesity-related factors in this underserved population. Citation Format: Amanda E. Janitz, Jessica A. Reese, Jean A. Leidner, Janis E. Campbell, Amanda M. Fretts, Dorothy A. Rhoades. Adiposity measures and obesity-related cancer: A report from the Oklahoma Strong Heart Study and Strong Heart Family Study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B098.