Measures Of Obesity Research Articles

Abstract 4137518: The implications of polygenic versus phenotypic characterization of obesity for cardiovascular-kidney-metabolic health

Introduction: The overall amount and the distribution of body fat, proxied by body-mass index (BMI) and waist-to-hip ratio (WHR), are two important measures of obesity and have significant polygenic heritability. We aimed to investigate whether polygenic scores (PGS) for these traits have additional predictive utility, beyond phenotypic characterization of obesity, for cardiovascular-kidney-metabolic (CKM) health. Methods: We derived PGS for BMI (PGS BMI ) and WHR adjusted for BMI (PGS WHRadjBMI ) using PRS-CS-auto on summary statistics from ~700k individuals of European ancestry (EA) in the GIANT consortium and selecting ~1M common variants for each score. We conducted association analyses in the Atherosclerosis Risk in Communities study, a prospective cohort including 8,631 EA individuals with ascertainment of incident diabetes, hypertension, chronic kidney disease, atrial fibrillation, coronary heart disease, ischemic stroke, and heart failure. We used nested Cox models to measure the added predictive utility of PGS to BMI and WHR for incident CKM phenotypes. Results: The study cohort (age 54.4±5.7 years, 52.4% women, follow-up 24.5±7.6 years) had a baseline BMI of 26.4 kg/m 2 (median [IQR]; 21.6-29.6) and WHR of 0.94 (0.88-0.98). PGS BMI and PGS WHRadjBMI were associated with their phenotypes (partial R 2 ; BMI 0.11 and WHR 0.04, p <0.001), although with a large phenotypic variability across the distribution of PGS (IQR for 1 st and 10 th deciles of PGS; BMI 19.6-28.3 and 22.6-35.9, WHR 0.79-1.03 and 0.87-1.05). Anthropometric measures of obesity were associated with a wider gradient of risk compared to PGS for obesity–most notable for diabetes and cardiovascular phenotypes (Table 1a). Addition of PGS BMI and PGS WHRadjBMI to BMI and WHR resulted in limited improvement in risk discrimination across incident CKM phenotypes (Table 1b). Conclusions: Observed anthropometric measures of obesity are sufficient, and for certain conditions far superior, to capture the risk of incident CKM phenotypes. These findings suggest PGS for adiposity traits likely have limited clinical utility to refine risk stratification for CKM syndrome among middle aged adults.

Sex Differences in Protein Biomarkers and Measures of Fat Distribution.

Sex differences in obesity and fat distribution may in part explain differences in cardiovascular risk in men versus women. We sought to examine sex differences in the associations of obesity and adiposity measures with cardiovascular disease-related protein biomarkers. In a cross-sectional observational cohort study, we examined whether the association of obesity (body mass index [BMI] and waist circumference) and adiposity measures (visceral adipose tissue) with biomarkers demonstrates effect modification by sex using multiplicative interaction terms in multivariable linear regression models. Among 3143 participants (mean age, 50 years; 49% women), sex modified the association of BMI, waist circumference, and visceral adipose tissue with cardiovascular disease-related protein biomarkers (7 for BMI, 3 for waist circumference, and 23 for visceral adipose tissue, false discovery rate [FDR]-qint<0.05 for all). For example, higher BMI was associated with lower α1-microglobulin levels in men but not in women (ß, -0.113; SE, 0.028; P<0.001 in men versus ß, -0.007; SE, 0.024; P=0.78 in women). By contrast, higher BMI was associated with higher adipsin levels in men and women, but the association was more pronounced in women (ß, 0.287; SE, 0.023; P<0.001 in women versus ß, 0.189; SE, 0.026; P<0.001 in men). The associations of higher visceral adipose tissue with biomarkers representing adiposity, inflammation, and fibrosis were more pronounced in women versus men. We found that sex modified the associations of obesity and adipose traits with cardiovascular risk ascertained by cardiovascular disease-related biomarkers including markers of adiposity, inflammation, and fibrosis. These findings highlight potential biological pathways that may underlie some of the observed differences in obesity-related cardiovascular disease between women and men.

Association between the weight-adjusted-waist index and Familial hypercholesterolemia: a cross-sectional study

ObjectiveThe weight-adjusted-waist index (WWI) is a novel obesity measurement indicator, and this study aims to determine the relationship between WWI and Familial hypercholesterolemia (FH).MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to March 2020, cross-sectional data from 3698 participants were analyzed. The study examined the correlation between WWI and FH using multivariate logistic regression and smooth curve fitting, and conducted subgroup analysis and interaction tests.ResultsThe study sample consisted of 3698 subjects for whom the overall probable prevalence of FH was 5.43% and increased with WWI tertile (quantile 1: 4.00%; quantile 2: 4.94%; quantile 3: 7.34%); individuals with the highest WWI tertile were significantly more likely to have FH than those with the lowest tertile (OR = 4.60,95% CI: 2.00-10.60). Subgroup analysis and interaction tests showed significant significance between WWI and personal history of early Atherosclerotic cardiovascular disease (ASCVD), family history of early ASCVD and probable prevalence of FH (p < 0.05).ConclusionThis study demonstrates a nonlinear positive correlation between WWI and FH. This may provide new ideas for the prevention and treatment of FH in the future.

Waist-to-Height Ratio Cut-Off Points for Central Obesity in Individuals with Overweight Across Different Ethnic Groups in NHANES 2011–2018

Background: The identification of surrogate measures of central obesity is of clinical importance, and the waist-to-height ratio (WtHR) has recently attracted great interest as an alternative method. Objective: For this reason, we aimed to establish specific WtHR cut-off points for adiposity (i.e., central obesity) in four different ethnicity groups across both sexes based on data from the National Health and Nutrition Examination Survey (NHANES) population. Methods: Of the total 23,037 participants who completed four cycles of the survey between the years 2011 and 2018, anthropometric measures (i.e., body weight, waist circumference, and height) and dual X-ray absorptiometry-derived visceral adipose tissue (DXA-derived VAT) results were available for 3566 individuals who were assessed in this cross-sectional study. Participants with an overweight status defined according to the World Health Organization (WHO) body mass index (BMI) cut-off points (25–29.9 kg/m2) were included. The sample was then categorized by adiposity according to the DXA-derived VAT tertiles (highest), and based on the receiver operating characteristic (ROC) curve analysis, the best sensitivity and specificity were attained for predicting central obesity using the WtHR. Results: The following WtHR cut-offs were identified as having the best discriminating ability for central obesity: 0.57 for White males and 0.58 for White females; 0.55 for Black males and 0.57 for Black females; 0.56 for Asian males and 0.59 for Asian females; and 0.57 for Hispanic males and 0.59 for Hispanic females. Conclusions: These new WtHR cut-off points should be utilized in adults with overweight to screen for central adiposity based on their sex and ethnicity, and obesity guidelines therefore need to be revised accordingly.

Prevalence of Subclinical Hypothyroidism in a Non-Diabetic Young Female Population and Its Impact on Diabetes and Cardiometabolic Risk.

We evaluated the influence of subclinical hypothyroidism (SCH) on insulin resistance (IR), cardiometabolic risk, and obesity in childbearing-age women without diabetes. This cross-sectional investigation included 282 women, aged 18 to 35 years, from rural and suburban Sri Lanka. Anthropometric and biochemical parameters, including IR and lipid/thyroid profiles, were recorded. Data were compared between SCH and euthyroidism (EU) for controls (normal weight) and cases (overweight/obese). The overall rates of SCH, EU, IR, and metabolic syndrome (MetS) were 40.42%, 59.57%, 73.40%, and 24.46%, respectively. Both controls and cases included individuals with SCH; overall, 168 participants (59.57%) had EU, while 114 (40.42%) exhibited SCH. IR was significantly associated with SCH in both weight groups (P<0.05). Among those with SCH, the odds ratios (ORs) for IR were >2 (95% confidence interval [CI], 0.45 to 3.87) in controls and >6 (95% CI, 3.52 to 8.41) in cases. Similarly, the ORs for MetS were >1 (95% CI, 0.38 to 4.16) in controls and >11 (95% CI, 8.73 to 15.01) in cases. Dyslipidemia and hypertriglyceridemia were significantly more prevalent in the SCH group (P<0.05). Women with SCH exhibited higher mean values for all obesity indices compared to their EU counterparts, surpassing normal thresholds (P<0.05). Among obesity measures, visceral adiposity index (VAI) demonstrated the highest area under the curve and sensitivity for assessing SCH and cardiovascular disease (CVD) risk. SCH must be identified and managed in young women to help prevent diabetes and cardiometabolic disorders. VAI may aid in precisely detecting SCH and CVD.

The association between triglyceride-glucose index combined with obesity indicators and stroke risk: A longitudinal study based on CHARLS data

Background and objectiveThe triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, has been proposed as a predictor of cardiovascular events. However, the combined impact of the TyG index and obesity indicators, such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), on stroke risk was not fully understood. This study aimed to investigate the association between the TyG index combined with these obesity indicators and stroke risk in the Chinese population.Materials and methodsData on 17,708 participants aged 45 years or older for this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) from baseline (2011) to the Wave 5 follow-up (2020). Cox proportional hazards model, restricted cubic spline (RCS) and receiver operating characteristic (ROC) analysis were employed to examine the association between the TyG index and its combined obesity-related indicators with stroke. Mediation analysis was conducted to explore the mutual potential mediating role of TyG and obesity indicators in the above relationships.ResultsA total of 8,207 participants with an average age of 58.2 years were investigated, of which 11.0% were stroke individuals, 44.80% were men and 84.6% were from rural areas. TyG, TyG-BMI, TyG-WHtR, TyG-WC were significantly higher in stroke subjects than in the non-stroke subjects (P < 0.001), and were significantly and positively associated with stroke in all 3 models (P < 0.05). Restricted cubic spline models revealed nonlinear associations between TyG and TyG-BMI with stroke (P-overall < 0.001, P-nonlinear = 0.003 for TyG, and P-overall < 0.001, P-nonlinear = 0.028 for TyG-BMI), while TyG-WC and TyG-WHtR (P-overall < 0.001 and P-nonlinear > 0.05) demonstrated linear associations with stroke after adjusting for covariates. TyG-WHtR, TyG-BMI and TyG-WC had more robust predictive power than TyG for risk of stroke. TyG-WHtR or TyG-WC had the highest predictive power for stroke (AUC:0.696, 95% CI 0.677–0.715), slightly higher than the other indicators. Associations between TyG, TyG-WC, TyG-WHtR, and TyG-BMI with stroke were found to be stronger among individuals who were ≥ 55 years of age, male. The relationship between TyG and stroke was significantly mediated by BMI, WHtR and WC (15.79%, 21.72%, and 24.06% respectively), while the relationship between these obesity measures and stroke was significantly mediated by TyG (18.48%, 14.45%, and 14.70% respectively).ConclusionThe combination of TyG and obesity-related indicators was significantly associated with stroke risk, and could improve predictive power for stroke compared to the single TyG. Obesity indicators and TyG mediated each other in their respective associations with stroke risk.

Predictive superiority of abdominal obesity measures over body mass index in Indian hypertensive adults

Predictive superiority of abdominal obesity measures over body mass index in Indian hypertensive adults

Adiponectin and Risk of Psoriasis: Observational and Mendelian Randomization Studies in up to 900 000 Individuals.

Psoriasis is a chronic inflammatory skin disorder often associated with obesity. Adiponectin, an anti-inflammatory protein-hormone secreted by adipose tissue, may be a link between obesity and psoriasis. We hypothesized that low plasma adiponectin is associated with an increased risk of psoriasis in observational and causal genetic studies. In observational analyses, we used information on plasma adiponectin and psoriasis in 30 045 individuals from the Copenhagen General Population Study (CGPS). In one-sample Mendelian randomization analyses, we used genetic information on adiponectin and psoriasis in 107 308 individuals from the CGPS. In two-sample Mendelian randomization analyses, we used genetic information on adiponectin from the ADIPOGen consortium and genetic information on psoriasis in 373 338 and 462 933 individuals from the FinnGen study and UK Biobank (UKB). In observational analyses, a 1-unit log-transformed higher plasma adiponectin was associated with a hazard ratio (HR) for psoriasis of 0.67 (95% confidence interval: 0.48-0.94) in an age- and sex-adjusted model but not in a multivariable adjusted model including obesity measures with a HR of 0.95 (0.66-1.35). In genetic one-sample Mendelian randomization analysis, a 1-unit log-transformed higher plasma adiponectin was not associated with a causal risk ratio for psoriasis of 1.33 (0.77-2.32) in the CGPS. In two-sample Mendelian randomization analyses, a 1-unit log-transformed higher plasma adiponectin was not associated with causal risk ratios for psoriasis of 0.96 (0.81-1.14) in FinnGen and 1.00 (1.00-1.01) in UKB. Low plasma adiponectin is associated with increased risk of psoriasis in age- and sex-adjusted observational analyses; however, this was not the case after adjustment for obesity measures or in causal genetic analyses.

Artificial intelligence-enhanced electrocardiography derived body mass index as a predictor of future cardiometabolic disease

Abstract Background Obesity, a key risk factor for cardiometabolic diseases, is poorly evaluated by body mass index (BMI), which doesn't account for visceral fat and fat distribution. Given that obesity-related cardiac changes can manifest in surface ECG changes, we hypothesised that an AI-ECG model could predict BMI, and the discrepancy between AI-predicted and actual BMI (delta-BMI) could indicate cardiometabolic health. We also sought to understand the biological mechanisms contributing to the AI-ECG-derived delta-BMI. Methods The AI-ECG model was developed using a data split of 60/10/30% in a USA secondary care dataset of 512,950 ECGs and externally validated in the UK Biobank (N = 42,386), employing a residual neural network architecture. Model performance was evaluated using Mean Absolute Error (MAE), Pearson correlation coefficient (r), and coefficient of determination (R2). The study aimed at identifying incident cardiometabolic diseases, using Cox regression analyses adjusted for BMI, age, and sex. To assess the underlying biological associations of delta-BMI, phenome-wide, genome-wide, metabolome-wide, and proteome-wide association studies were performed. Results In the test set, the model achieved an MAE of 3.95 (3.93–3.97), r of 0.65 (0.65-0.66), and R2 of 0.43 (0.42-0.43). In the UKB, the model achieved an MAE of 2.94 (2.91–2.96), r of 0.62 (0.62–0.63) and R2 of 0.39 (0.38-0.40). The top tertile of delta-BMI showed an increased risk of future cardiometabolic disease (test set: HR 1.15, p&amp;lt;0.001; UKB: HR 1.58, p&amp;lt;0.001) and diabetes mellitus (test set: HR 1.25, p&amp;lt;0.001; UKB: HR 2.28, p&amp;lt;0.001) after adjusting for covariates including measured BMI. Phenotypic profiling highlighted associations between delta-BMI and cardiometabolic diseases, anthropometric measures of truncal obesity, and pericardial fat mass. Metabolic and proteomic profiling associates delta-BMI positively with valine, lipids in small HDL, syntaxin-3, and carnosine dipeptidase 1, and inversely with glutamine, glycine, colipase, and adiponectin. A genome-wide association study revealed associations with regulators of cardiovascular/metabolic traits. These results highlight delta-BMI's potential as a non-invasive, ECG-based biomarker for cardiometabolic risk stratification. Conclusion Our study demonstrates the effectiveness of an AI-enhanced ECG model in accurately predicting BMI, validated across diverse populations. The introduction of delta-BMI as a predictor of cardiometabolic disease offers valuable additional prognostic insights beyond traditional BMI assessments. Our exploration of biological pathways, spanning phenotypic, genotypic, metabolomic, and proteomic associations, contributes to a comprehensive understanding of the association between delta-BMI and cardiometabolic disease. The clinical implications could extend to enhanced screening strategies, personalised risk assessment, and motivation for lifestyle interventions.

Impact of waist circumference and abdominal fat distribution on coronary artery disease severity stratified by computed tomography-derived SYNTAX score

Abstract Background Waist circumference (WC) is the most convenient anthropometric measure of obesity. Recently, abdominal fat distribution (AFD) has been identified as a more important risk factor for coronary artery disease (CAD) than the absolute amount of adipose tissue. However, studies examining the impact of body composition indicators (BCIs) on CAD severity are lacking. The computed tomography (CT)-derived SYNTAX score (CT-SXscore) is a feasible method for grading CAD severity based on coronary CT angiography (CTA) findings. Purpose This study was aimed to evaluate the association between BCI and CAD severity using the CT-SXscore. Methods We enrolled consecutive patients with suspected CAD who underwent CTA using a 320-row multidetector CT scanner between October 2014 and March 2020. Plain abdominal CT was also performed at the umbilical level to measure the visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas. The total adipose tissue (TAT) area was calculated as the sum of VAT and SAT. To assess the AFD, the VAT/SAT (V/S) ratios were also calculated as the VAT area divided by the SAT area in each case. WC was measured by tracing the body contour at the umbilical level in CT images. The severity of coronary artery stenosis was assessed using CTA. Significant stenosis was defined as a stenosis diameter of ≥50%. The CT-SXscore was calculated in patients with more than one significant stenoses. Each stenotic lesion was evaluated to calculate the CT-SXscore in the same manner as the invasive coronary angiography assessment. We assessed the effects of BCI [i.e., WC, body mass index (BMI), each adipose tissue area, and V/S ratios] on the CT-SXscores. Results 308 eligible patients (mean age, 70.9 ± 10.6 years; 69.5% males) were evaluated. The median values of WC, BMI, TAT, SAT, VAT, and V/S ratio were 84.8 cm, 23.6 kg/m2, 198.2 cm2, 111.8 cm2, 81.0 cm2, and 0.67, respectively. Although WC showed a significant correlation with BMI, TAT, SAT, and VAT area, no correlation was observed between WC and V/S ratio (Figure1). The CT-SXscore showed no association with WC, BMI, and TAT area; however, it exhibited a weak negative correlation with the SAT area and a weak positive correlation with the VAT area. Additionally, a strong correlation was observed between the CT-SXscore and V/S ratio. In the multivariate regression analysis, WC, BMI, TAT, SAT, and VAT were no longer associated with the CT-SXscore after adjusting for traditional coronary risk factors, whereas the V/S ratio remained as the only independent predictor of CAD severity based on the CT-SXscore (Figure2). Conclusions WC was strongly correlated with other BCIs, except for the V/S ratio; however, it could not be identified as a predictive factor of CAD severity. Among the BCIs, only the V/S ratio was an independent predictor of CAD severity, indicating that the AFD revealed by the V/S ratio may be a more important risk factor for progression of CAD than other BCIs.Figure1Figure2

Association of Central and General Obesity Measures With Pelvic Organ Prolapse.

To examine the association between the combination of central and general obesity measures and the risk of pelvic organ prolapse (POP). Waist/height ratio and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) for 251,143 participants (aged 39-71 years) without pre-existing POP from the UK Biobank were collected at enrollment between 2006 and 2010. Participants were followed through December 19, 2022. Incident POP was identified using International Classification of Diseases, Tenth Revision codes and operating procedure codes in the medical records. Cox proportional hazards model was used to estimate the association between obesity measures and incident POP. Population-attributable fractions were calculated to indicate the proportion of cases that were attributable to obesity measures. During a median follow-up of 13.8 years, 9,781 POP cases were recorded. Central obesity (waist/height ratio 0.5 or greater) was associated with a 48% increased risk of POP regardless of BMI (hazard ratio [HR] 1.48; 95% CI, 1.41-1.56). Approximately 21.7% (95% CI, 19.1-24.4%) of all POP cases were attributable to central obesity. In addition, overweight without central obesity (BMI 25-29.9 and waist/height ratio less than 0.5) was associated with a 23% higher risk of POP (HR 1.23; 95% CI, 1.14-1.34), and this accounted for 2.0% (95% CI, 1.1-2.9%) of all POP cases. The magnitude of increased POP risk associated with central obesity varied by age (younger than 60 years vs 60 years or older: 57% vs 39%) and by history of hysterectomy (no vs yes: 54% vs 27%). Central obesity and overweight without central obesity are risk factors for POP.

Obesity and Multiple Sclerosis Severity: A Mendelian Randomization Study.

Obesity is implicated in the development of multiple sclerosis (MS), but its effect on disability is less well-established. This study examined the effects of various obesity measures on MS severity in 12,584 MS cases, using Mendelian randomization to mitigate confounding. Results showed a significant association between higher genetically-determined body mass index (N = 806,834) and increased MS severity (P = 0.02). This finding was supported by additional measures of general obesity but not adiposity distribution. The convergence of this genetic evidence with prior observational studies strengthens the association between obesity and adverse long-term disability in MS, suggesting weight management as a potential therapeutic strategy. ANN NEUROL 2024.

Association of Body Mass Index (BMI) with Diet, Physical Activity, and Lifestyle among Undergraduate Dental Students in a Private Dental College in Bangladesh

Background: Obesity can lead to severe health problems and elevate the risk of diseases such as hypertension, dyslipidemia and diabetes due to metabolic changes. Undergraduate dental students often struggle to maintain a healthy lifestyle and eating habits due to academic pressures. BMI, a standard obesity measure, is simple to calculate and assess nutritional status, helping to identify and prevent obesity-related diseases in at-risk individuals. Method: A cross-sectional study was performed among 253 students of Sapporo Dental College, a private dental college in Uttara, Dhaka, Bangladesh, to reveal the prevalence of overweight and obesity according to BMI and its association with dietary habits, physical activities, and lifestyles among them. Data was collected using a self-written, anonymous, semi-structured questionnaire using the convenient sampling technique between July 2023 and September 2023. Result: Among the 253 participants, females (n = 190, 75.10%) are more than males (n = 63, 25%). The prevalence of normal weight, underweight, overweight, and obesity among the participants was 132 (37.93%), 31 (8.91%), 56 (16.09%), and 129 (37.07%), respectively, based on BMI. 84% of obese students were taken 1 meal from outside per day (p values &lt; 0.05). 52% obese students did not engage in any form of physical activity on a weekly basis (p value 0.03). 55.5% obese students slept for &lt; 6 hours every night (p-value 0.04). Conclusion: Early modifications of lifestyle improve health. Annual screenings help to prevent obesity. Fitness and diet programs can reduce dental students' chronic disease risk. Study participants are future physicians. Thus, dental students should be physically active and aware of their eating and sleep habits to reduce obesity, which might influence patients' outlooks. Update Dent. Coll. j: 2024; 14(2):15-20

Association between different patterns of obesity and the short-term outcomes of gastric cancer surgery.

Previous studies have shown that general and central obesity are each linked to adverse outcomes in gastrointestinal cancers. However, their combined effect on gastrointestinal cancers surgery outcomes were less understood. This study aims to integrate both general and central obesity to examine the outcomes of gastric cancer surgery in different obesity patterns. We retrospectively analyzed 248 patients who underwent gastric cancer surgery between 2021 and 2023 in a single institute. The Inbody720 body composition analyzer measured body composition. We evaluated the relationship between obesity patterns - combining BMI with central obesity measures (waist circumference, waist-to-hip ratio, visceral fat area) - and postoperative complications and 30-day readmission. Central-only obesity were more likely to induce fistula (P = 0.025), while non-obesity was more likely to develop postoperative abdominal effusion (P = 0.049) and bleeding (P = 0.042). Central-only obesity was significantly associated with severe postoperative complications after adjustment for hypertension, diabetes, abdominal surgery history, preoperative albumin levels, age, sex, and surgical types. This remains significant even after adjusting for muscle mass. However, we did not find the same results for significant complications. Regarding 30-day readmission, there are no differences between different patterns of obesity. Central-only obesity is an independent risk factor for severe postoperative complications in gastric cancer, while a high BMI appears to be associated with a lower risk compared to non-obese patients, but not significant postoperative complications. The likelihood of readmission within 30 days post-surgery may not be related to the patient's pattern of obesity.

Role of Planetary Health Diet in the association between genetic susceptibility to obesity and anthropometric measures in adults.

The roles of overall diet quality in linking genetic background with anthropometric measures are unclear, particularly regarding the recently developed Planetary Health Diet (PHD). This study aims to determine if the PHD mediates or moderates the relationship between genetic susceptibility to obesity and anthropometric measures. The study involved 2942 individuals from a Finnish population-based cohort (54% women, mean age 53 (SD ± 13) years). Habitual diet was assessed using a validated 130-item food frequency questionnaire, and the PHD Score (total score range 0-13 points) was adapted for Finnish food culture to evaluate diet quality. Genetic susceptibility to obesity was evaluated with a polygenic risk score (PRS) based on one million single nucleotide polymorphisms associated with body mass index (BMI). Baseline anthropometrics included weight, height, waist circumference (WC), and body fat percentage, with changes in these measures tracked over 7 years. A five-step multiple linear regression model and multivariable logistic regression with interaction terms were used to assess the mediating and moderating effects of the PHD. These analyses were also replicated in another Finnish cohort study (2 834 participants). PRS for BMI was positively associated with baseline BMI and changes in anthropometric measures, except waist circumference (p = 0.12). Significant associations were observed for baseline BMI and WC (p < 0.001), changes in BMI and WC (p = 0.01), and body fat percentage change (p = 0.05). However, the PHD (average score 3.8 points) did not mediate or moderate these relationships. These findings were consistent in the replication cohort. Diet quality assessed with the PHD did not mediate or moderate the associations between genetic susceptibility to obesity and anthropometric measures. This lack of effect may be partly due to low adherence to the PHD and the older age of participants ( > 50 years) at baseline.

U-shaped Association Between Weight-Adjusted-Waist Index and Arterial Stiffness Among Adult Hypertensive Patients: A Population-Based Study in the United States.

The weight-adjusted-waist index (WWI) is an innovative measure of obesity that appears to surpass body mass index (BMI) in assessing lean body mass and fat mass. This study aimed to evaluate the relationship between WWI and AS in hypertensive adults in the United States. The study included 9753 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey (NHANES), which spanned the years 2007-2016. WWI was calculated by dividing waist circumference (in cm) by the square root of body weight (in kg), and arterial stiffness (represented by estimated pulse wave velocity [ePWV]) was analyzed as the outcome. Weighted multiple linear regression and smooth curve fitting were used to test for linear and nonlinear associations. Threshold effects were determined using a two-part linear regression model. Additionally, subgroup analyses and interaction tests were conducted to gain a more in-depth understanding of the observed associations. The mean WWI of the participants was 11.32 ± 0.76. After multivariable adjustment, WWI showed a significant nonlinear association with ePWV, with a U-shaped association observed between the two. Specifically, WWI below the threshold of 10.23 was negatively associated with arterial stiffness (β = -0.39, 95% CI: -0.54 to -0.25), while WWI above the threshold of 10.23 was positively associated with arterial stiffness (β = 0.04, 95% CI: 0.01-0.07). To conclude, the present findings imply that maintaining WWI within an optimal range could reduce AS in hypertensive individuals and potentially decrease cardiovascular risk. However, this observation needs to be confirmed in large clinical trials.

DNA polymorphisms in inflammatory and endocrine signals linked to frailty are also associated with obesity: data from the FRASNET cohort.

Obesity and frailty are prevalent geriatric conditions that share some pathophysiological mechanisms and are associated with adverse clinical outcomes. The relationship between frailty, obesity, and polymorphism remains inadequately explored. Single nucleotide polymorphisms (SNPs) offer insights into genetic predispositions that may influence the development of both frailty and obesity. We aimed at investigating whether SNPs associated with frailty also play a role in obesity. Data were collected from the FRASNET cross-sectional study, which included community-dwelling older individuals residing in Milan and nearby areas. Participants were recruited through random sampling. They underwent multidimensional geriatric assessments, which included the collection of blood samples for SNP analysis. Frailty was assessed using the frailty index, and body composition was evaluated using bioelectrical impedance analysis and anthropometric measures. SNPs related to frailty and linked to the renin-angiotensin system (CYP11B2 rs1799998, AGT rs5051, and AGTR1 rs2131127), apoptosis pathways (CASP8 rs6747918), growth hormone signaling (GHR rs6180), inflammation (TLR4 rs5030717, CD33 rs3865444, and FN1 rs7567647), adducin (ADD3 rs3731566), and the 9p21-23 region (rs518054) were found to be associated with various measures of obesity in community-dwelling older adults. Frailty-related SNPs contribute to obesity in community-dwelling older adults. We identified a novel association between adducin SNPs and visceral fat, which has not been previously reported. Detecting genetic predispositions to obesity and frailty early could aid in identifying individuals at risk, facilitating the adoption of preventive interventions. This represents an initial step toward promoting early intervention strategies.

Exploring Adiposity and Chronic Kidney Disease: Clinical Implications, Management Strategies, Prognostic Considerations.

Obesity poses a significant and growing risk factor for chronic kidney disease (CKD), requiring comprehensive evaluation and management strategies. This review explores the intricate relationship between obesity and CKD, emphasizing the diverse phenotypes of obesity, including sarcopenic obesity and metabolically healthy versus unhealthy obesity, and their differential impact on kidney function. We discuss the epidemiological evidence linking elevated body mass index (BMI) with CKD risk while also addressing the paradoxical survival benefits observed in obese CKD patients. Various measures of obesity, such as BMI, waist circumference, and visceral fat assessment, are evaluated in the context of CKD progression and outcomes. Mechanistic insights into how obesity promotes renal dysfunction through lipid metabolism, inflammation, and altered renal hemodynamics are elucidated, underscoring the role of adipokines and the renin-angiotensin-aldosterone system. Furthermore, the review examines current strategies for assessing kidney function in obese individuals, including the strengths and limitations of filtration markers and predictive equations. The management of obesity and associated comorbidities like arterial hypertension, type 2 diabetes mellitus, and non-alcoholic fatty liver disease in CKD patients is discussed. Finally, gaps in the current literature and future research directions aimed at optimizing the management of obesity-related CKD are highlighted, emphasizing the need for personalized therapeutic approaches to mitigate the growing burden of this intertwined epidemic.

The relationship between weight-adjusted-waist index, body mass index and diabetic retinopathy among American adults: a population-based analysis

Diabetic retinopathy (DR) is a common complication of diabetes, with its prevalence increasing globally. While previous research has linked obesity indices such as body mass index (BMI) to DR, the association with weight-adjusted-waist index (WWI) remains unclear. Additionally, the relationship between WWI and DR has not been fully elucidated. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (2005–2008) to investigate these associations in Americans aged 40 and above. The study included 5436 participants (2705 men and 2731 women). Weighted logistic regression analysis revealed a significant increase in DR prevalence with higher WWI and BMI values. Smooth curve analysis demonstrated a linear correlation between WWI and DR. The findings suggest that both WWI and BMI are independently associated with DR risk among older US adults, highlighting the importance of considering central obesity measures in assessing diabetic complications.

8585 Using Stimulants to Treat Childhood Obesity

Abstract Disclosure: C. Elatrash: None. S.R. Sisley: None. Background: Hyperphagia, characterized by excessive hunger, can significantly contribute to weight gain in early-onset childhood obesity and lacks an FDA-approved therapy. Stimulants commonly used in the treatment of attention deficit and hyperactivity disorder (ADHD) have a significant side effect of suppressing appetite. However, there is no data on the effectiveness of stimulants to reduce measures of obesity in children with severe obesity and hyperphagia. Methods: We retrospectively analyzed electronic medical records of children &amp;lt; 17 years old with severe, early-onset obesity (defined as a Body Mass Index (BMI) ≥ 120% of the 95th percentile (BMI%95th) prior to age 5 years) who were seen in the Genetic Disorders of Obesity Program (GDOP) at Texas Children’s Hospital (TCH). We included children who had a history of abnormal food behavior consistent with a clinical diagnosis of hyperphagia by having 2 of 9 symptoms of hyperphagia (consuming large portions, consistently feeling hungry, not feeling full with one serving, temper tantrums over food, asking for food frequently, sneaking food, getting up at night to eat, hiding food, constant asking for snacks) and were prescribed lisdexamfetamine treatment for hyperphagia for 6 months. We extracted BMI %95th for up to 12 months prior to treatment and 6 months after treatment. Paired t-tests were utilized to compare data from pre- vs. post-treatment. Results: Our cohort included 22 patients and was 68.2% female, 50% non-Hispanic White, 36.4% Hispanic white, and 13.6% black, with a mean age of 7.73 years±3.82 (range 3-17 years). There was a significant decrease in BMI%95th after treatment with lisdexamfetamine (167.3±38.8 vs. 158.0±40.2; p&amp;lt;0.001). We also observed a significant change in the rate of weight gain after lisdexamfetamine treatment; prior to treatment, patients gained 0.6 BMI%95th points/month compared to a loss of 1.9 points/month after treatment (p=0.002). 16 (72.72%) patients reported tolerable side effects, the rate of side effects was (33)33.33%. 19(57.57%) lasted from 1 week to 1 month and 6(18.18%) lasted more than 1 month. Side effects included adverse behavioral (9)27.27%, sleep disturbance (5)15.15%, and headache (4)12.12%. Conclusion: Children with severe obesity and clinical hyperphagia showed reductions in BMI%95th after six months of lisdexamfetamine treatment. Future research is needed to confirm the clinical efficacy of lisdexamfetamine in this high-risk population. Keywords: Childhood obesity, Stimulants, Hyperphagia, Pharmacologic Treatment Presentation: 6/3/2024